House Of Commons
Tuesday, 5th August, 1913.
The House met at a Quarter before Three of the clock, Mr. SPEAKER in the Chair.
Private Business
Private Bills [ Lords] (No Standing Orders applicable),—Mr. Speaker laid upon the Table Report from one of the Examiners of Petitions for Private Bills, That, in the case of the following Bill, brought from the Lords, and referred on the First Reading thereof, no Standing Orders are applicable, namely:—
Aldbar Trust Estates Bill [ Lords].
Ordered, That the Bill he read a second time.
McBride's Divorce Bill [ Lords],
Read the third time, and passed, with an Amendment.
- Derby Corporation Bill (by Order),
- Dover Harbour Bill (by Order),
- Heathfield and District Water Bill (by Order),
- Southport Corporation Bill (by Order),
Consideration of Lords Amendments deferred till this evening, at a quarter-past Eight of the clock.
- North British Railway Bill [Lords] (by Order),
- Rochford Rural District Council Bill [Lords] (by Order),
- Ebbw Vale Water Bill [Lords] (by Order),
- London and South-Western Railway Bill [Lords] (by Order),
Third Reading deferred till this evening, at a quarter-past Eight of the clock.
- Leith Harbour and Docks Bill [Lords] (by Order),
- Ipswich Dock Bill [Lords] (by Order).
- Leicester Corporation Bill [Lords] (by Order),
- Reading Corporation Bill [Lords], (by Order),
- Ascot Authority Bill [Lords] (by Order),
- London Electric Railway Bill [Lords] (by Order),
- Southend-on-Sea Corporation Bill [Lords] (by Order),
- Watney, Combe, Reid, and Company Bill [Lords] (by Order),
Consideration, as amended, deferred till this evening, at a quarter-past Eight of the clock.
Alexandra Park and Palace Bill [ Lords] (by Order),
Limerick Harbour Commissioners Bill [ Lords] (by Order),
Second Reading deferred till this evening, at a quarter-past Eight of the clock.
Gas and Water Orders Confirmation (No. 1) Bill [ Lords] (by Order),
Third Reading deferred till this evening, at a quarter-past Eight of the clock.
Local Government Provisional Orders (No. 21) Bill (by Order),
Third Reading deferred till Friday.
Pier and Harbour Provisional Orders (No. 3) Bill [ Lords] (by Order).
Third Reading deferred till this evening, at a quarter-past Eight of the clock.
Lanarkshire (Middle Ward District) Water Order Confirmation Bill (by Order),
Wemyss Tramways Order Confirmation Bill [ Lords] (by Order),
Considered; to be read the third time To-morrow.
Electric Lighting Provisional Order (No. 6) Bill [ Lords] (by Order),
Electric Lighting Provisional Order (No. 7) Bill [ Lords] (by Order),
Consideration, as amended, deferred till this evening, at a quarter-past Eight of the clock.
Cardiff Railway Bill [ Lords],
Reported, with Amendments; Report to lie upon the Table, and to be printed.
Workmen's Compensation Act, 1906
Copy presented of Order, dated 30th July, 1913, made by the Secretary of State for the Home Department, extending the provisions of the Workmen's Compensation Act, 1906, to Writer's Cramp and consolidating the Orders of 22nd May, 1907, and 2nd December, 190S, with an Amendment [by Command]; to lie upon the Table.
Shops Act, 1912
Copies presented of Orders made by the Councils of the under-mentioned Local Authorities, and confirmed by the Secretary of State for the Home Department, under the Act: county of Chester (South Ward of the Hazel Grove and Bramhall urban district), boroughs of Bury, Carlisle, Blackburn, Brighouse, Barnsley, Wallasey, Jarrow, and Leicester, and urban districts of Worksop (two) and Weston-super-Mare [by Act]; to lie upon the Table.
Sanatoria
Return presented relative thereto [ordered 21st July; Mr. Grant]; to lie upon the Table, and to be printed.
Local Taxation Returns (England And Wales)
Copy presented of the Annual Local Taxation Returns for 1911–12. Parts II., III., V., and VI. [by Act]; to lie upon the Table, and to be printed.
Clergy (West Indies)
Copy presented of Return of the Amount payable on 5th January, 1913, out of the Consolidated Fund for Ecclesiastical Purposes in the West Indies [by Act]; to lie upon the Table.
General Lighthouse Fund
Copy presented of Account of the General Lighthouse Fund, showing the Income and Expenditure for the year ending 31st March, 1913 [by Act]; to lie upon the Table, and to be printed.
Army (Territorial Force)
Copy presented of Scheme made by the Army Council for the Establishment and Constitution of an Association for the county of the City of London under the Territorial and Reserve Forces Act, 1907 [by Act]; to lie upon the Table.
Public Works Loans Bill
Copy ordered, "of Statement of Particulars of Loans of which the balances outstanding are proposed to be remitted or
written off (in whole or in part) from The assets of the Local Loans Fund."—[ Mr. Masterman.]
Education Board Provisional Order Confirmation (London, No 1) Bill Lords
Reported, without Amendment [Provisional Order confirmed]; Report to lie upon the Table, and to be printed.
Bill to be read the third time To-morrow.
Public Rights Of Way Bill Lords
Read the first time; to be read a second time To-morrow, and to be printed. [Bill 308.]
Oral Answers To Questions
Employment Of Children Act
1.
asked the Secretary of State for the Home Department whether he can give particulars of the number of cases in 1912 in which proceedings were instituted under the Employment of Children Act in respect of the carrying of excessive weights by children and of the result of such cases; and whether he is proposing to take any further steps with a view to putting a stop to this practice?
I have no separate information as to the number or result of cases taken in respect of this particular offence by the local authorities who, as my hon. Friend will be aware, are charged with the general administration of the Act. As regards the last part of his question, I would refer him to the answer which I gave to a question on this subject on the 10th of July by the Noble Lord the Member for South Nottingham.
Factory Employment (Women And Girls)
2.
asked the Secretary of State for the Home Department, if he will say what is the total number of women and girls at present employed in factories and workshops; what is the total number of women inspectors; whether there has been recently any increase in the number of such inspectors; whether the increase that has been made during the years 1910, 1911, and 1912 in the female inspectorate has been commensurate with the increase in the male inspectorate; and whether he is proposing to make any further increase in the number of women inspectors?
The latest figures at present available are those for 1907, as the tabulation of the returns for 1912 is not yet completed. In 1907 the total number of women and girls employed in factories and workshops was a little over 1,850,000. The authorised number of women inspectors is now twenty, two having been added during the present year. No additions were made in the years 1909 to 1911, but five were added in 1908 and three in 1906, so that in the last seven years the staff has been exactly doubled. During the same period the ordinary male inspecting staff (as distinct from inspectors for special purposes) has been increased from 135 to 182, an addition of forty-seven.
Suffragist Prisoners
3.
asked what are the terms of the licences under which suffragist prisoners are now being released?
The terms are the same as those which I read to the House during the Committee stage of the Prisoners (Temporary Discharge for Ill-health) Bill on the 8th April last, and they are printed in the OFFICIAL REPORT for that date.
4.
asked how many persons have been arrested for offences committed in connection with the suffragist movement since 25th April; how many were arrested between 25th January and 25th April of this year; how many were arrested between 25th April and 30th July of last year; and the number and nature of the offences which have been committed by prisoners released on licence since 25th April?
I am not in possession of the information the Noble Lord desires as to the number of persons arrested for offences in connection with the suffragist movement. Arrests are not in ordinary course reported to the Home Office. The number of persons committed to prison might be ascertained with time and trouble, but these figures would not necessarily be complete, as the connection with the suffragist movement is not always known, and in any case I think that nothing would be gained by comparing the number of offences committed during certain short periods. Offences in connection with the suffragist movement have been committed in large numbers on special occasions. I may mention, for example, that over 200 suffragist prisoners were received in Holloway prison in March, 1912, and only one in April of that year. As regards the number and nature of offences committed by persons released on licence, if the Noble Lord will put down an unstarred question, I will be glad to give him the information.
Has the right hon. Gentleman any information showing whether these offences are diminishing or increasing?
I will see if I can give any information which would indicate with some certainty a conclusion on the point.
Will it include those arrests which take place in connection with the rearrest of these prisoners?
I am dealing now not with arrests but with convictions.
When convictions take place for obstruction of the police in connection with rearrests?
I shall include those, of course.
Miners' Dispute (Vancouver)
5.
asked the Secretary of State for the Home Department whether he is aware that agents in this country have been inducing Durham miners to leave their employment in this country for work in the mines at Vancouver, British Columbia, on the strength of a statement that there was no dispute there and that conditions were normal; that when the men arrived at Vancouver they found that a dispute was in progress, and being unwilling to act as strikebreakers they found themselves stranded; whether he has any power to prevent such misrepresentation; and, if not, whether be proposes to secure such power?
My right hon. Friend has asked me to answer this question. I have no information as to the cases to which my hon. Friend refers, but if he will be good enough to furnish me with particulars, I will cause inquiries to be made. Inducing a person to emigrate by means of false representations is an offence which is punishable under the Merchant Shipping Acts.
Queenie Gerald (Prosecution)
6.
asked whether, in the prosecution of Miss Queenie Gerald at the London Sessions, on the 10th instant, the Crown accepted the plea of guilty on the charge of keeping a disorderly house, and did not proceed with a more serious charge?
8.
had given notice of the following question: To ask the Secretary of State for the Home Department if he will state under what Acts, and in respect of what offences, Queenie Gerald was charged at the London Sessions on the 10th July; what is the maximum penalty which can be imposed in respect of each of such offences; upon which charge was she found guilty; what was her punishment; whether any and which charges were withdrawn; and, if so, for what reason?
The indictment included three counts under Section 7 (4) of the Criminal Law Amendment Act, 1912, for exercising control for the purpose of gain over the movements of three prostitutes, and three counts under Section 1 of the Vagrancy Act, 1898, and Section 7 (4) of the Criminal Law Amendment Act, 1912, for living in part on the immoral earnings of the same three prostitutes. The maximum penalty for each of these offences is two years' imprisonment. There was also a count for keeping a disorderly house—an offence under the common law punishable with fine and imprisonment. The Crown proceeded with all the charges, none were withdrawn, and the prisoner pleaded guilty to all counts of the indictment. The Deputy-Chairman informs me that in the absence of any evidence of procuration in the ordinary sense, the girls who were the principal witnesses having admittedly been prostitutes before they came under the prisoner's influence, he felt that he would not be justified in passing a more severe sentence than three months' imprisonment in the second division, coupled with an order to pay the costs of the prosecution. In view of the statements made in the Press, I think it necessary to add that no communication was made to the Deputy-Chairman by or on behalf of the Home Office or the police bearing upon this case. The case was opened and pressed as a bad one, and there was no suppression or withdrawal of evidence by the police throughout the proceedings.
Why were the names of people suppressed?
I can only say that there was no suppression of names. It is quite true that there were certain names in a diary which was found on the premises, but the mention of those names would not and could not have been relevant to the charge. I would like perhaps to add, so far as I am concerned, as a charge has been made against me personally, that I was not aware of any of the names until after the trial was over.
Factories And Workshops (Fatal Accidents)
7.
asked the Home Secretary whether his attention has been called to the fact that in the course of the last twenty years the annual number of fatal accidents in factories and workshops has increased from 422 to 945, an increase of nearly 125 per cent., although the total number of factories and workshops has only increased, during the same period, by 70 per cent., that the total number of fatal accidents during 1912 was greater than it has ever been before; whether there are any special circumstances to account for this increase; and whether he is taking any special steps to deal with the matter?
I am aware of these figures, which I furnished myself to my hon. Friend in reply to a question by him last week. The question of the increase in the number of accidents in factories was thoroughly investigated by the Accidents Committee and is discussed at length in their Report, which was issued in 1911. It is impossible to deal with the subject in reply to a question, and I would accordingly refer my hon. Friend to that Report and the Annual Report of the Chief Inspector. My Department is busily engaged in carrying out the various measures which were recommended by the Committee, so far as it is possible to do so without legislation.
Is my right hon. Friend aware that the increase in recent years has been quite exceptional, and can he give me any particular reasons, or any particular circumstances, to account for that exceptional increase?
The subject was dealt with in Debate a fortnight ago. I will endeavour to supplement what was said in Debate if my hon. Friend will put a question to me.
War In Balkans
10.
asked the Secretary of State for Foreign Affairs whether his attention has been called to the statements in the Consular Report to three of the Embassies of Great Powers at Constantinople and the Report of the assistant bishop to tie Metropolitan of Rodosto, that the destruction of the town of Malgara and the massacre of the Greek population of that place was due to the Turkish Army and especially to the 27th Regiment of the Aleppo Division, and that the signal for pillaging and massacre in each village was given by the commanding officers; and what Report has been received from His Majesty's Consular staff upon this incident?
The Report in question has not yet reached me.
11.
asked the Secretary for Foreign Affairs whether his attention has been called to the statement of Sir Edwin Pears, the leader of the Consular bar at Constantinople, that when the decision was taken, to reoccupy Thrace, Moslem refugees were hastily transferred from Asia Minor and let loose upon the country, that the worst atrocities occurred, that part of the plan was to compel the villagers to sign a report ascribing the atrocities to the Bulgarians and expressing thanks to the Turks for their paternal protection, and that at Haskeni, near Kanopolis, all the women of the village were gathered in a large threshing floor, where the soldiers were let loose upon them; and whether any representations on the subject of recent outrages in Thrace have been made by His Majesty's Ambassador to the Sublime Porte?
I have not seen the statement referred to, but I have heard that excesses have been committed by returning refugees, and that attempts have been made by the authorities to obtain false evidence from the Christians, His Majesty's Chargé d'Affaires has spoken to the Grand Vizier on the subject. I must, as usual, point out that charges of similar excesses have been made against other nationalities, and that we have spoken in. the same way to their Governments.
Was the Report re-received from His Majesty's Consul at Rodosto himself?
Perhaps the hon. Member will give me notice.
San Francisco Exhibition
12.
asked the Secretary for Foreign Affairs whether the British Government have decided not to give official support to the San Francisco Exhibition in celebration of the opening of the Panama Canal; whether their decision has any connection with the attitude of the United States. Government regarding the Panama toll question; and whether His Majesty's Government will assist British exhibitors desiring to take part in the exhibition?
His Majesty's Government have come to the conclusion that they would not in present circumstances be justified in asking the country to incur the heavy expenditure required to participate in this exhibition. This decision was based partly on the estimate of the cost of a representative commercial exhibit at the San Francisco Exhibition. This is estimated at a quarter of a million. at least, and such a sum would be quite out of proportion to any commercial advantages which are likely to result Moreover, inquiries which have been made among commercial centres in the United Kingdom have not shown any active desire to participate in the exhibition. The conditions of foreign participation laid down by the authorities prescribe that the exhibits are to be distributed among a series of international pavilions, thereby rendering it impossible to obtain an effective national display as in previous exhibitions. The question was considered and dealt with on these grounds without any reference to the Panama tolls question. Indeed, I may add that His Majesty's Government have done nothing to discourage the participation of the self-governing Dominions in the exhibition. As regards the last part of the question, I will communicate with my right hon. Friend the President of the Board of Trade.
Can the right hon. Gentleman inform the House whether Germany and other countries are taking part officially in this exhibition?
I have not heard that Germany is taking part in this exhibition. Perhaps my hon. Friend will give me notice, and I will ascertain what information we have.
I desire to know how the estimate of £250,000 has been arrived at as the probable cost of our exhibiting at San Francisco. Is the right hon. Gentleman aware that the expense of the British section at the Chicago Exhibition in 1893 was only £60,000; that the expense of the Japanese was £120,00, of Germany only £120,000, and of the French £120,000? How is it possible that the cost of the Commission to carry out the British section at San Francisco could be £250,000?
The hon. Member will see, when he reads my answer, that in one paragraph of it I say that the conditions in regard to this exhibition are not the same altogether as in regard to previous exhibitions. The estimates were arrived at, I understand, by inquiries on the spot.
Will the right hon. Gentleman consider the advisability of placing the whole matter in the hands of some existing council or committee, such as the council of the Society of Arts?
I do not see that in a great commercial matter of this kind the council of the Society of Arts could be referred to. The matter has been very carefully investigated by the Board of Trade.
May I ask my right hon. Friend, as the Government do not seem inclined to take part in this exhibition, will there be any objection to the British section being carried out by private individuals, as was done in the case of the French Exhibition in 1889? There was a refusal then on the part of the Government, and it was undertaken by the City of London, and it very much pleased the French people.
I have already said that we have done nothing to discourage the official participation of the self-governing Dominions, and we should not think of doing so in the case of participation by private individuals.
Pekin Syndicate
13.
asked the Secretary for Foreign Affairs whether he is aware that Mr. H. P. King, formerly in the employment of the Pekin Syndicate, was offered a sum of money conditionally upon his maintaining silence respecting the affairs and the trade of the syndicate in China; that Mr. H. P. King declined these terms and resigned his appointment; and that, on his having sent to a London paper information of vital importance to the investing public, an injunction was granted by the Consular Court at Tientsin and Mr. H. P. King was committed to prison for seven days; and whether he will call for a Report upon the whole matter from the Consul-General?
I have no information with regard to the statements in the first part of the question. In answer to the latter part, as I informed the hon. Member in my reply to his question of the 1st instant, a Report shall be obtained from His Majesty's Consul-General.
With regard to the former answer on this question, does the right hon. Gentleman realise that I want the inquiry somewhat enlarged, in order that it may extend not only over the suffering of this gentleman, but over the commercial conditions which it reveals?
I cannot undertake to inquire into the relations between the person employed and those who employed him. I can only undertake to inquire into the action of, the Consul-General.
An inquiry into the commercial conditions in China is what I wanted.
I cannot investigate the affairs of every British company which operates outside the British Empire.
Egyption Assembly (Elections)
14.
asked the Secretary for Foreign Affairs whether his attention has been called to the statement that Harvey Pasha, the head of the police in Cairo, called together the mamurs of the districts and gave them directions as to how the elections to the new Egyptian Assembly were to be carried out; and why the head of the police was selected for this duty?
The answer is in the negative, but if the statement is correct I do not see why directions should not be given by Harvey Pasha. Somebody has to give them in all countries where elections take place.
Is it customary in the Constitution of this country for a direction of this character to be conveyed by the head of the police?
I imagine that the official under whom an election is to be carried out in this country happens to be the High Sheriff. It may be that the head of the police is the proper person there. I cannot say without inquiry.
Mexico
15.
GUINNESS asked the Secretary for Foreign Affairs whether, in view of the danger to lives of British subjects arising from the continuance of disorder in Mexico, he will take steps to prevent the shipping of war supplies to the rebels from British Possessions, and will try to induce other countries concerned also to prevent such exportations?
I have had no information of war supplies being shipped from the British Possessions to the Mexican rebels. The question of the exportation of such supplies from other countries is not one in which His Majesty's Government can influence other Governments?
Will the right hon. Gentleman also prevent the supply of arms to the Government?
I have no information as to supplies being shipped from British Possessions at all.
Religious Endowments (India)
16.
asked the Under-Secretary of State for India whether endowments of non-Christian religions recognised by pre-British governments in India have in like manner been recognised and confirmed by the British-Indian Government; and, if so, what is the proportion of such endowments to the amounts paid by the British-Indian Government in the last financial year for buildings, services, and ministers in India in respect of different branches of the Christian religion?
In reply to the first part of the question, I would refer the hon. Member to the reply given to him on the 15th July. I am unable to give the information asked for in the second part of the question, as figures as to the total amount of Indian religious endowments are not available.
17.
asked the Under-Secretary of State for India whether the charges of ecclesiastical establishments in India, as given in Parliamentary Paper No. 81, of 1908, still continue to be paid to a similar amount as in the year 1906–1907, to which that Return relates; whether the total sum paid out of the revenues of India for clergy and establishments of the Churches of England, Scotland, and Rome approximates still to 3,500,000 rupees annually; and whether it is the policy of the Government of India to increase, diminish, or maintain the charges under this head?
The answer to the first part of the question is in the affirmative. As regards the second, my hon. Friend has arrived at his figure of three and a half millions of rupees by adding together the totals of two returns of the same expenditure. The total sum expended in 1906–7 was 2,300,000 rupees. The corresponding sum in 1911–12 was 2,280,000 rupees, showing a small decrease.
18.
asked how many Wesleyan places of worship have been erected in India since 1905, and how many previously, towards which the Government of India have made contributions; and whether, before making contributions to Wesleyan places of worship, application for contributions was made to the Wesleyan Centenary Fund?
From the Return communicated to my hon. Friend it appears that three Wesleyan places of worship have been erected in India since 1905 towards which Government contributions have been made. As to the remaining questions the Government of India have promised to furnish information.
19.
asked the Under-Secretary of State for India whether he has information showing the number of Presbyterian places of worship in India towards which the Government have since 1905 made or promised contributions; whether, before granting such contributions, the Government of India was satisfied that no funds were available for these places of worship from the Presbyterians of Scotland and elsewhere; and whether it is part of the settled policy of the Government of India to spread and support Presbyterianism with funds raised by taxes levied on Hindus and Mahomedans?
From the statement furnished to my hon. Friend it appears that there are eight Presbyterian places of worship erected in India since 1905 towards which Government contributions have been made. The Government of India have promised to furnish information in respect of the second question. With regard to the policy of the Government in the matter, I would refer toy hon. Friend to the answer I have just given to the hon. Member for East Nottingham.
20.
asked the Under-Secretary of State for India whether he is aware that since 1905 no Christian places of worship have been erected in Madras with Government contributions, and that, in the same period, seventeen Christian places of worship have been erected in the Punjaub by the aid of Government contributions; whether a different policy is pursued in this respect in Madras to that pursued in other parts of India; and, if so, what reason can be alleged for the different policies?
The facts which my hon. Friend gleans from the Return recently communicated to him are due to difference, not of policy, but of circumstances. No additional churches are built until or unless they are required.
21.
asked the Under-Secretary of State for India how many Christian places of worship have been erected since 1905 in India towards which the Government have contributed; what is the total seating accommodation of these places of worship; whether any census has been taken of the attendances at these places of worship; and, if not, what inquiries were made to show that the places of worship were required or, after erection, were properly attended.
From the statement furnished to my hon. Friend, it appears that there are fifty-two Christian places of worship erected in India since 1905 towards which Government contributions have been made. The Government of India have promised to furnish the information asked for in the last three parts of the question.
22.
asked the Under-Secretary of State for India whether an opinion was sought in 1899 by the Secretary of State for India, either from the Law Officers of the Crown or from other learned counsel, on the point whether buildings maintained wholly or in part by the Government of India, or to which the Government of India had made contributions for building, could be used for the religious services of His Majesty's troops of all denominations; whether the bishops and clergy of the Anglican Church had sole control and use of such churches; whether the opinion obtained was based upon the law of India or of England; whether the bishops and clergy of the Anglican Church have on any occasion since 1899 been requested to allow the use of churches and buildings under their control for the religious worship of Presbyterians, Wesleyans, or other Christians; and, if so, what answer had been received?
The point put to learned counsel, and subsequently to the Law Officers in 1899, was solely as to the effect of the consecration of churches in India by Anglican bishops with the consent of the Government. The opinion given was that churches so consecrated could not be used for religious services other than Anglican without the sanction of the Anglican bishop. The opinion was based upon an express or implied agreement subsisting between the consecrating bishop and the Government, and no question of Indian law was involved, except as to how far the English ecclesiastical law governing consecration applied to India. I shall be happy to send my hon. Friend a copy of the White Paper of 1908. With the sanction of the bishop consecrated churches have frequently been used for Presbyterian and Wesleyan services.
Criminal Law (India)
23.
asked the Under-Secretary of State for India whether, in case the dispatch relating to a proposed alteration of the criminal law with a view to preventing torture by the police does not arrive in time to be laid upon the Table before the Debate on the Indian Budget, he will take steps to communicate to the House the effect of the telegraphic summary he has already received?
Yes, Sir. I hope to make a statement in the Budget Debate.
This will not diminish our chance of having the full Papers laid on the Table whenever they arrive.
No, as soon as they come they will be prepared for publication.
Provincial Civil Service, India (Mr A W Buchanan)
24.
asked the Under-Secretary of State for India if he can ascertain the date upon which Mr. Buchanan gave orders to an inspector of police to remove the little girl Ainah from the house of Captain McCormick and restore her to her mother; the date of the warrant issued by Mr. Buchanan for the arrest of Captain McCormick on a charge of rape; the date upon which Mr. Buchanan was transferred from Victoria Point to another district; the date upon which he was passed over for promotion by an officer junior to himself; and whether the Secretary of State has satisfied himself that the conduct of Mr. Buchanan in bringing to light the McCormick case has had no bearing whatever upon his transfer and failure to get promotion?
In June, 1911, the Commissioner of the division recommended that Mr. Buchanan should be replaced at Victoria Point by an officer of higher status. On the 3rd July Mr. Buchanan first reported the existence of the kidnapping allegations against Captain McCormick. On the 12th July he handed the case to the police, who brought the child away on the 14th. On the 19th July Mr. Buchanan issued a warrant for the arrest of Captain McCormick. Mr. Buchanan was transferred from Victoria Point on the 16th October, 1911, and it was on the 29th May, 1913, that his junior was promoted in the circumstances that I have already explained. The Secretary of State has satisfied himself that the transfer and the passing over were decided quite independently of Mr. Buchanan's action in bringing the McCormick case to light.
25.
asked how long Mr. A. W. Buchanan has been a member of the provincial Civil Service; and whether there has been any occasion before this year upon which he has been superseded for promotion by an officer junior to himself?
Mr. Buchanan has been a member of the Burma Provincial Service for twenty years. I am not aware whether he had ever been passed over for promotion before this year.
Cotton Growing (India)
26.
asked the Under-Secretary of State for India how many European experts in cotton growing are now employed by the Government of India; how many bales of cotton India produced last year; and how many acres of land are now under cotton in that land?
For the number of the European staff employed I must refer the hon. Member to the answer given to him on the 9th December last. The cotton crop of 1912–13 is estimated to have yielded 4,397,000 bales, from an area of nearly 22,000,000 acres.
British Army
Officers' Pay
27.
asked whether the money required for the increase of pay of officers of the Regular Army serving in India is included in the Indian Budget; and, if so, whether these officers will obtain the increase from 1st January, 1914?
28.
asked the Secretary of State for War if the increase of officers' pay, as notified in his statement recently, is to apply to all branches of the Army or are there to be any exceptions?
I ant not at present in a position to add anything to the information which I gave to the House in reply to a question put by the hon. Gentleman the Member for East Nottingham on 25th June.
Recruiting
29.
asked the Secretary of State for War whether, in view of the diminished numbers of recruits offering themselves for enlistment and of the competition of emigration agencies, he will take steps to improve the recruiting machinery of the Army throughout the country?
The organisation and efficiency of the recruiting machinery of the Army has been and is now receiving the closest attention.
Red Cross Correspondence
30 and 64.
asked the Secretary of State for War (1) if he is aware that orders sent through the post by the secretary of a Red Cross detachment to the members is treated by the Post Office as being in the nature of a letter and is not given the benefit of the ½d. rate; if he will use his influence with the Postmaster-General to get this ruling altered in favour of those doing a public work recognised by the War Office; (2) why the official orders sent to the members of a Red Cross detachment are not given the benefit of the ½d. rate; and if he can see his way to alter the ruling recently given in the case of the Honiton detachment, and permit official orders to be sent out under the same conditions as circulars?
My right hon. Friend has asked me to reply to these questions. A communication of the kind in question is not admissible at the halfpenny rate unless it is wholly printed, or printed on a form with entries of the restricted character described upon page 12 of the Post Office Guide. The term "printing" includes any mechanical process ordinarily used to reproduce a number of identical copies of a written original, but there are certain restrictions which are stated at the top of page 13 of the Post Office Guide. Such limitations are necessary if the halfpenny post is not to encroach upon the province of the penny post. I am not in a position to exempt any persons or any body of persons from the operation of these regulations, but the Red Cross detachment can secure the advantage of the halfpenny post by using forms of the character I have described for its circular notices instead of sending wholly written communications.
Will the right hon. Gentleman reconsider his decision in view of the fact that the detachments have to work on very small funds and are not able to have a printing press or to have the letters typewritten?
It is not a question of Red Cross detachments against any other organisation. No organisations are exempted from these regulations. These detachments can get the benefit of halfpenny post by adopting the very simple method which I have suggested of having their notices partly printed or partly reproduced by mechanical process and the mere dates and names filled in the blank spaces.
Can the right hon. Gentleman tell me where they can get that done for nothing?
The cost is infinitesimal.
Territorial Force
31.
asked the Secretary of State for War when he proposes to make public the new measures to be taken for making the Territorial Army more popular and more efficient?
I am not at present able to add anything to the statement which I made during the Debate on Army Estimates on 30th July.
79.
asked the Secretary to the Treasury whether land valuers employed under the Finance (1909–10) Act, 1910, are only permitted to attend Territorial training for one week on full pay; that the second week's training entails the loss of a week's pay or of a week's holiday; and whether, in view of the importance of a good example being set by the Government to other employers, he will take steps to provide for these officials being treated with greater generosity?
Land valuers employed under the Finance (1909–10) Act, 1910, are subject to the same regulations, in regard to special leave for Territorial training, as other Civil servants. I am not prepared to alter these regulations.
National Reserve
32.
asked the Secretary of State for War what steps are being taken to ascertain the number of men in the National Reserve who are likely to be effective for war; and whether it is proposed to include them in the scheme for Home defence?
The work of classification is now proceeding, and until it is completed I shall not be in a position to make any statement on the subject.
Can the right hon. Gentleman say when he expects to get that report completed, and will he bear in mind that there is grave danger of the men interested in this movement losing their interest if something is not done soon?
I hope not. The work is proceeding and in some cases is nearly completed, but in some it is not. I do not think it would be well to make a partial statement, but I will let the hon. and gallant Gentleman know as soon as I can deal with it.
Trooping Season (Drafts)
33.
asked the Secretary of State for War whether there will be a sufficient number of men to provide drafts required by all arms during the ensuing trooping season, or whether inducements will have to be offered to men serving in India to extend their service?
It is anticipated that all the drafts required will be provided during the ensuing trooping season; the answer to the last part of the question is in the negative.
Old Park, Canterbury
34.
asked the Secretary of State for War whether his attention has been called to the fact that the military authorities at Canterbury are still encroaching upon the ancient rights of the public by closing, and endeavouring to close, certain public footpaths across the Old Park and adjacent lands; and if he will cause these matters to be put right at the earliest opportunity?
The question presumably refers to a footpath which was the subject of a communication from the town clerk of Canterbury in June last. I understand that the General Officer Commanding is in communication with the town clerk on the matter.
National Rifle Association
35.
asked the Secretary of State for War whether any alteration is suggested or contemplated in the arrangements that have existed for upwards of fifty years between the War Office and the National Rifle Association in the carrying out of the annual meeting and competitions; if so, to what extent and for what reason?
A Committee is now considering this matter.
May I ask whether I can have the right hon. Gentleman's assurance that he will not allow the War Office to do anything to damage the prosperity of the National Rifle Association?
We are most anxious that the National Rifle Association should continue the excellent work which it has done for many years past. It would be a great mistake for me to make any statement when a Committee is actually at this moment considering the whole question.
When are we likely to have the Report of the Committee?
I could not say exactly, but their deliberations will be concluded I think in the course of a few weeks.
Finance Act, 1909–10 (Licence Duty)
37.
asked the Chancellor of the Exchequer whether thousands of claims are outstanding in respect of Licence Duty in excess of the actual rent paid to the lessor; whether, in some of such cases, the claim is for more than double such rent; whether many such cases have been brought specially under his notice; when he proposes to take such action as will relieve innocent sufferers in this behalf under the licensing provisions of the Budget of 1909–10; and why no provision is made in the Revenue Bill of this Session?
I would refer the hon. Member to the statement I made in connection with the matter, on Tuesday last, when the Revenue Bill was under consideration.
National Insurance Act
Expenditure
39.
asked the Chancellor of the Exchequer if he will state how the expenditure actually incurred under the National Insurance Act, arid, so far as can be estimated, to be incurred under the National Insurance Act (1911) Amendment Bill, compares with the estimate he made when introducing the National Insurance Act, 1911?
It would be impossible to answer the question of the hon. Member without requiring special returns of their expenditure from the societies and branches administering the Act, the number of which is over 20,000. Full returns of income and expenditure will be called for in due course, but it would be unreasonable to require the societies, at this juncture, to interrupt the ordinary routine of their work in order to make up their accounts for the sole purpose of such a comparison as the question suggests.
Amendment Bill
45.
asked the Prime Minister whether His Majesty's Government proposes to introduce next Session a Bill for the amendment of the radical defects in the National Insurance Act with which the National Insurance Act (1911) Amendment Bill does not deal?
I do not know to what the hon. Member refers, nor am I prepared to make any announcement on this subject as regards next Session.
Medical Practitioners (Banffshire)
80.
asked the Secretary to the Treasury whether applications have been made by medical practitioners in the highland of Banffshire for an increase of mileage rate on account of bad roads and the difficulty of access to many districts, especially in the winter season; and whether, in view of the fact that the English Insurance Commissioners have already granted increased mileage in respect of certain mountainous districts in England, he will take steps to see that the Scottish Commissioners do not delay coming to a decision in respect of similar districts in Scotland?
I am informed that the Scottish Commissioners have received one representation of the kind referred to, and that they hope to complete shortly a scheme for the distribution of the sum available from the Special Mileage Fund.
Medical Panel (Cornwall)
81.
asked the Secretary to the Treasury if his attention has been called to a case in which a person who was a contributor under the National Insurance Act and was employed as a governess in Cornwall fell ill, was medically treated by a panel doctor there, and on getting worse returned home, where the panel doctor refused to treat her on the ground that the doctor in Cornwall would draw the allowance, thus depriving her of her sick pay, although she was a fully paid-up contributor; and, if so, will he say whether the insured person has any claim against the insurance committee or against the doctor for expenses necessarily incurred by her?
No, Sir. My attention has not been called to any case of the kind referred to in the question, but if the hon. Member will supply me with particulars I shall be glad to make inquiries.
Will the right hon. Gentleman consider whether it would be possible to have some general exchange for patients, so that insured persons may not be called upon to pay two contributions?
I shall be glad to receive any suggestions to prevent persons paying two contributions, though I am not aware of any case in which they are so doing.
Supply (Ministers' Statements)
46.
asked the Prime Minister if he will consider the advisability of recommending that Ministers should circulate their statements before their Department is discussed in Supply, and confine their observations to a reply, and thus give opportunity to the private Member for criticism?
I see no reason to depart from the normal practice of the House, but no doubt the Committee on Procedure will take the hon. Member's suggestion into consideration.
Is not the primary object of Debates in Supply to enable Members to bring up grievances against Departments? Has the right hon. Gentleman noticed how largely the limited time is monopolised by Ministers making optimistic statements about the virtues of their own Departments? Will he therefore be good enough to present this view to the Procedure Committee?
I am quite sure that the Procedure Committee will consider what my hon. Friend says, but I do not think it is my business to bring it before them.
Venereal Disease
48.
asked the Prime Minister if any answer has yet been given to the medical profession concerning their request for a Royal Commission on venereal disease; and whether, in view of the fact that the Government are opposed to any suggestion for the re-enactment of the Contagious Diseases Acts, can any assurance be given that the subject shall not be reopened by any Commission that may be appointed?
The matter is still under consideration.
Tuberculous Cows (Derby)
53.
asked the President of the Board of Agriculture if he is aware that under the Tuberculosis Order of 1913 two cases have recently occurred in Derby in which cows brought in for sale to the borough market have there been seized on the certificate of the borough veterinary inspector as suffering from tuberculosis of the udder; that in both cases they were ultimately certified by the county medical officer of health to be free from tuberculosis; that their owners have consequently been put to needless expense for the compulsory keep of the cows and for loss of milk during the period of their detention, while the county authorities have already had to find the cost of veterinary inspectors, biological tests, and county police in connection with the cases; and if he will state whether it is proposed that compensation for the loss sustained should be paid?
I am informed that in May last two cows with defective udders were brought to Derby market for sale, and that in accordance with notices served by the veterinary inspector of the local authority under. Article 11 of the Tuberculosis Order, they were sent back to the premises from which they came. Subsequent veterinary examination showed that the defect of the udder was in neither case due to tuberculosis. If the owner had complied with the requirements of Article 2 or Article 10 of the Order, by reporting these two cases of apparent disease of the udder and isolating the affected animals until they had been examined by a veterinary inspector, most of the loss and inconvenience which have been caused would have been avoided. The Board have no power to make compensation in these cases.
Regent Street Quadrant
54.
asked the President of the Board of Agriculture if his attention has been called to the fact that there has been no opportunity of discussing the question of the rebuilding of the Quadrant; and if the final decision will be deferred until next Session, after plans have been exhibited and the matter further discussed?
I would refer the hon. Member to the replies I gave to him and to the hon. Member for North Somerset on the 14th July.
55.
asked the President of the Board of Agriculture if the Report of the Committee on the rebuilding of the Quadrant is proposed to be carried out, or the opinion expressed by five out of the six architects called to give evidence before the Committee that the skyline of the Piccadilly Hotel will be followed in the case of the shops to be built on either side, so as to keep as much light in the streets as possible?
It is proposed to adhere to the recommendations of the Committee in essential particulars.
56.
asked the President of the Board of Agriculture if the opinions of the shopkeepers of Regent Street are to be given due weight to before the Report of the Committee, which ignores their wishes completely, is adopted?
If the hon. Member refers to the Report of the Committee on the Regent's Quadrant, I am unable to admit that it ignores the wishes of the shopkeepers of Regent Street, and in settling a design for the completion of the Quadrant it is proposed to adhere to the recommendations of the Committee in essential particulars.
What is the necessity for hurrying this matter?
There will not be any undue hurry over it.
Then we shall see the plans?
Labourers' Cottages (England And Wales)
57.
asked the President of the Board of Agriculture whether, in order to secure accurate information with reference to the building of cottages for rural labourers in different parts of the country, where the cost of labour, materials, and transport vary considerably, and to avoid returns being provided to the Board by those only whose cottage building owing to local conditions is either exceptionally costly or exceptionally cheap, he will send forms to selected landowners and local authorities in every county in England and Wales inviting them to give the necessary particulars applicable to their own localities?
As was explained in a notice which was circulated to the Press last week by my authority, the Board will be glad to receive from landowners and local authorities in all parts of England and Wales accurate information on the points mentioned by the hon. Gentleman. Forms on which the information may be given will be supplied on application to the Board.
Does not the right hon. Gentleman realise that the object of my question is that it should not be left to landowners to apply to the Department, but that certain landowners should be chosen to whom forms should be sent with a request that they would fill them in?
I have no power to insist on landowners giving any information; they must supply it willingly. If they are prepared to give it, we shall be glad to receive it.
Meat Supply
58.
asked the Secretary of State for the Colonies whether he will ask the Federal Government for information regarding the alleged intention of American firms to make a monopoly of the meat supply from Australasia to the United Kingdom?
Yes, Sir.
Southern Nigeria
59.
asked the Secretary of State for the Colonies if he can say upon what terms the land secured on lease by the Government of Southern Nigeria from the Sapele chiefs at a rent of £100 a year is sub-let for occupation; and what is the total revenue now derived from it?
As I informed the hon. Member last week, the Governor has been asked for a report and will be requested to include in it the information now asked for.
Can the right hon. Gentleman say when the report is likely to arrive?
As soon as it can be provided.
Johannesburg Riot (Trial Of British Citizens)
60.
asked the Secretary of State for the Colonies whether he can state if Mrs. Fitzgerald and Mr. A. Crawford, the treasurer and chairman of the Johannesburg Socialist party, who were arrested for alleged participation in the recent rioting in Johan- nesburg, are being tried privately in the fort, which is the common gaol of Johannesburg, and not in the Law Courts; and whether, if so, he can make any representations to the South African Government through Lord Gladstone on the subject of the rights of British citizens to an open trial?
No, Sir, I have no official information on the subject.
Leith Dock Strike
40.
asked the Secretary for Scotland whether he has any official information showing that boys from the Leith Industrial School or Reformatory have been engaged doing work of the dockers on strike at Leith; if not, whether he will make inquiries into the matter; and, if this has been done, will he say what action he proposes to take in the matter?
It is not the case that boys of the Leith Industrial School were engaged in doing the work of the dockers who were on strike. They were engaged in loading the school's firewood on to lorries. This work has always been done by the boys, and never by the dockers.
Small Holdings
41.
asked the Secretary for Scotland whether his attention has been drawn to the fact that in various districts where fifteen months ago arable ground was available for small holdings, a policy of planting trees has been pursued by certain landlords in order to defeat the hopes of applicants making application for such land; and whether, in these circumstances, he will take special steps to meet such cases?
I have no information, and no reason to believe, that any such policy is being adopted.
Does not the right hon. Gentleman think it would be very foolish if a landlord were to part with arable land for such a purpose?
I think it is inherently improbable that any landlord would be so lost to his own interests.
Will the right hon. Gentleman believe that this question is based on actual facts?
If the hon. Member will give me the facts, certainly.
51.
asked the Secretary for Scotland if there is a Commission prospecting in Stirling for land for small holdings; and if a Government valuer there is the factor for the Duke of Montrose, who owns most of the land being dealt with?
There is no such Commission in connection with the Board of Agriculture for Scotland or any other Department for which I am responsible, nor has the Board of Agriculture for Scotland employed the gentleman referred to as a valuer.
Education Grants (Scotland)
42.
asked the Secretary for Scotland whether the proportion of Grants to Scottish education as compared with England is vitiated by the fact that other Scottish objects suffer because money intended for them is used for educational purposes; and whether an equivalent Grant to Scotland is due on the total amount consequent on the provisions of the Education (No. 2) Bill?
It is impossible to institute comparisons which involve complicated financial calculations in answer to a question or to make short replies on such subjects which are not open to misapprehension. The matter was discussed yesterday in the Debate on the Estimates.
St Kilda
43.
asked the Secretary for Scotland whether, now that a wireless installation has been set up in St. Kilda, he will take the opportunity of securing periodic reports as to the condition of affairs on the island?
As means of telegraphic communication now exist, I think it may be assumed that the Government will be duly apprised of any exceptional state of matters arising in the island.
Will the right hon. Gentleman himself take periodic action, instead of waiting for the island to telegraph in exceptional circumstances?
I really do not see that it is necessary unless there is distress in the island.
Sunday Opening (Scotland)
44.
asked the Secretary for Scotland whether his attention has been called to the fact that the sheriffs of Dundee and Greenock allow Sunday opening under the Burgh Police Act, 1911, while the sheriffs of Leith and Aberdeen disallow it; whether he is aware that the sheriff for Helensburgh refuses entire Sunday closing and the sheriff for Gourock grants it; whether he is aware that there is no appeal against such decisions to the Court of Session, and that many of the decisions are contrary to the expressed wishes of the local councils; and whether he is prepared to bring in amending legislation to alter such anomalies?
The statements in my hon. Friend's question are not quite accurate. By-laws enacting complete Sunday closing in Dundee, Greenock, and Gourock, were confirmed, while confirmation was refused in the case of the Helensburgh by-laws. As regards Leith and Aberdeen by-laws, I have no information as to proceedings before the sheriffs and no by-laws from these towns have been submitted to me for confirmation. I am aware that there is no appeal to the Court of Session against the decision of a sheriff confirming or refusing to confirm by-laws. As regards the latter part of the question, I would refer my hon. Friend to my reply to his question on this subject on 16th July.
What does the Secretary for Scotland propose to do to meet the wishes of the local authorities, who so frequently have their wishes vetoed by the sheriffs?
I can do nothing without legislation, and certainly no legislation can be proposed at the present moment. The Act lays down the principle that the sheriffs should consider the circumstances and review the proposed by-laws.
Will the right hon. Gentleman deal with the matter next year?
I cannot give any promise; I will consider the matter.
Art Lectures (Edinburgh)
49.
asked the Secretary for Scotland whether he will state the time when the popular art lectures will be begun in connection with the National Galleries, Edinburgh, and, if possible, the name or names of the lecturer?
The lectures will probably be given in December and January by Mr. Caw, the director of the National Gallery.
Land Court (Scotland)
50.
asked the Secretary for Scotland whether he will consider the possibility of postponing for a period the work of the Land Court in considering the rents of those already on the land until more headway has been made with placing new applicants on the land or, alternatively, arrange the work of the Court in such a way that whenever it sits for the former purpose it will at the same time deal with the second in the same place?
The Land Court has arranged its work so far as possible in such a way that it has dealt with applications by the Board of Agriculture for Scotland for new holdings and enlargements at the same time as it arranged sittings in the district for the purpose of dealing with existing rents, and has given a preference to districts concerned in applications by the Board. This course was followed, for example, in Islay, Tiree, and Lismore this summer. Every application presented by the Board of Agriculture up to 1st July last has been heard by the Court with the exception of some applications from Orkney and one case of enlargement of pasture in Ross-shire, but in these cases steps have been taken to have minutes lodged by the respondents in order to prepare them for hearing in the autumn Session.
Royal Parks (Lakes)
61.
asked the hon. Member for St. George's-in-the-East, as representing the First Commissioner of Works, whether the edging of the Serpentine and St. James' water with concrete is done with a view to economy or to esthetic effect; and what is the purpose of the rail along the edge of these lakes?
Although certainly not æsthetic, the concrete is placed with a view to economy to prevent the margin being worn away by the action of the water. The rail in St. James' Park, along the edge of the water, is to prevent children falling into the water.
As private owners when they make an ornamental lake can afford a puddled bank which holds the water and is much prettier than a concrete edge, could not a public Department afford some money to add to the effect?
I do not think that concrete is necessarily non-æsthetic if the grass is properly dealt with. If my hon. Friend will point out any places where the grass is defective, I will have them remedied.
62.
asked the hon. Member for St. George's-in-the-East, as representing the First Commissioner of Works, whether the First Commissioner of Works will make it possible for boys of school age to bathe in the Serpentine during the school holidays at any hour of the day, and after the holidays at any hour after 4.30 p.m.?
The First Commissioner is prepared to extend the hours so that until the end of September boys may bathe from 5 p.m. instead of 6 p.m. as at present permitted.
Indian Mail Service
63.
asked the Postmaster-General whether he has under consideration the question of providing India with two mails a week?
This question will come under consideration when the present contract for the Indian mail service comes to an end, but I am not at present in a position to say what view will be taken.
Imperial Wireless Chain
66.
asked the Postmaster-General what would be the total monetary loss sustained by the Marconi Company in respect of any one station in the event of there being twelve months' delay on the part of the company in completing such stations?
The loss would be made up of (1) £1,800 by way of monetary penalty; (2) the forfeiture of 2 per cent. interest payable under the contract; (3) whatever additional sum the company might be losing as the interest on capital employed in the undertaking; and (4) the postponement of royalty payments for a year. It is clearly impossible to give an exact estimate of the total.
67.
asked the Postmaster-General whether, in view of the criticism passed upon the Marconi continuous high-frequency machine passed in paragraph 26 of the expert Advisory Committee's Report, he will insist on retaining paragraph 3 of clause 3?
No doubt the hon. Member has in mind Clause 2 and not Clause 3, which does not touch this matter. Before the provision referred to becomes effective, the Postmaster-General must be satisfied that the Marconi system of continuous waves is as efficient and economical as any competing system. I may add that the Advisory Committee reported in paragraph 26 that the only continuous high-frequency generator they had seen tried with success over long distances was the Marconi machine, and the criticism mentioned by the hon. Member was that the power used for the experiments was not sufficient for commercial purposes, but that there seemed to be no reason why higher power should not be obtained.
72.
asked the Secretary to the Board of Trade whether the solicitor to the Board of Trade will make an immediate inquiry into the transactions involved in the issue of American Marconi shares in April, 1912, by Mr. Godfrey Isaacs and Mr. Percy Heybourn, in view of the fact that the Dublin Stock Exchange entered a protest in connection with the matter to the London Stock Exchange, and that the committee of the London Stock Exchange has deferred the consideration of the question for many months?
If, as I presume, the question of the hon. Member relates to the method of the issue of the shares in the America Marconi Company, the Board of Trade have no jurisdiction to hold an inquiry into such a matter.
Aircraft
Aerodrome At Hoo
77.
asked the First Lord of the Admiralty whether he is aware that a new aerodrome, to be erected at Hoo by Messrs. Vickers and Company, has been wholly imported from the Continent, including glass, nails, and putty, the whole having been brought over in two vessels; can he say whether this aerodrome forms part of a Government contract given to the firm named; and, if so, whether any clause has been inserted in such contract giving preference to British labour or stipulating that the wages paid and hours of labour shall conform to the trade union regulations observed by British competing firms?
The source of materials for the airship shed in question is a matter for the contractors, subject to Admiralty tests as to fitness. So far as I am aware, Messrs. Vickers are employing none but British labour in the erection of the shed. The Fair-Wages Clause has been embodied in the contract with the firm, who will be required to observe its conditions so far as any work executed in this country is concerned.
What is the use of having a Fair-Wages Clause in this country if the Government buy goods made abroad under unfair wages conditions?
The Fair-Wages Clause runs in this country. In this case it is not a question so much of money as of time and experience.
Is it not also a question of wages? If wages abroad are less than here, would not that have an effect on our own workpeople?
I do not know whether I quite understand the hon. Gentleman; does he say that in protected countries wages are lower?
Yes; but if the wages are lower abroad, what is the good of having the Fair-Wages Clause here? What is the good of it if the Government buy from lower-waged people abroad—that is the question?
Weston-Super-Mare Pier
68.
asked the President of the Board of Trade if he has received communications relative to the danger to the public caused by mismanagement at the Weston-super-Mare Pier on 12th July, 1913; whether he is aware that what was experienced by the travelling public upon that occasion is typical of what often occurs at Weston-super-Mare when large bodies of people have to travel to South Wales from this holiday resort; and if he will hold an official inquiry into the whole question involved, with a view to having regulations established which will prevent a repetition of this danger and inconvenience to those who have to use the boats sailing from the Weston-super-Mare Pier?
I have received complaints on this subject, and am in communication with the Weston-super-Mare Company thereon. I will consider what action, if any, it is desirable and possible for the Board of Trade to take with a view to diminishing the risk of incidents such as my hon. Friend refers to, and will send him a further communication in due course.
Sight Tests
69.
asked the President of the Board of Trade whether he can state out of 151 failures in the new Board of Trade eyesight tests as between the 1st April and 8th July, how many of the candidates who failed held certificates and had passed the sight tests previously; and how many of the candidates without certificates who were failed had put in the qualifying time at sea necessary for second mate's certificates?
Of the 151 candidates who failed in colour vision during the period mentioned, eighteen held certificates of competency, and must therefore have passed the sight tests on some previous occasion. Thirty-nine who were candidates for certificates of competency in either the mercantile marine or the fishing service must have performed the qualifying service necessary for those certificates. I have no means of ascertaining how many of the remainder who were candidates for sight tests only may have had the qualifying time at sea necessary for a second mate's certificate.
Labour Exchanges
70.
asked the President of the Board of Trade if he is aware of the amount of overtime that the clerks employed at some Labour Exchanges have, since January of the present year, worked; that in some instances they have worked 400 hours and have only been paid for 100 hours; and whether he will take such steps as are necessary to secure the payment within a reasonable time to these men for all the overtime they work?
I am afraid I can only refer my hon. Friend to the answer which I gave in reply to the hon. Member for Hammersmith on 17th July, of which I am sending him a copy.
73.
asked the Secretary to the Board of Trade whether Labour Exchange managers have power, without the sanction of the Board of Trade, to insert an unlimited number of advertisements in the newspapers; if not, whether he is aware that on 26th July upwards of 100 advertisements appeared in a newspaper published at Hereford, including advertisements for insurance agents, policemen, teachers, and domestic servants, etc., application to be made to the Hereford Labour Exchange; and whether the Board of Trade sanctioned these advertisements?
By the courtesy of certain newspapers, details of unfilled vacancies notified to the Labour Exchanges are from time to time published in their columns. The advertisements referred to by my hon. Friend were inserted in pursuance of an arrangement of this nature. No expense to the public is involved.
Merchandise Marks Act, 1891
71.
asked the President of the Board of Trade whether, in view of the fact that new regulations have been issued under the Merchandise Marks Act, 1891, to check fraudulent misdescription of goods, the Board of Trade will defray the cost of a prosecution where the offence committed is injurious to the general interests of the country; if so, whether this applies to prosecutions undertaken in Great Britain by the Irish Industrial Development Association or other bodies charged with the safeguarding of genuine Irish products from fraudulent misdescription; and whether the regulations are also intended to deal with the export to foreign countries of Syrian lace described as Irish lace in cases where an Irish or British firm operates through an agent in Syria?
I am afraid that the Board of Trade cannot undertake to defray the cost of prosecutions undertaken by the Irish Industrial Development Association or other similar body. Where, however, on the representation of such a body the Board of Trade themselves undertake a prosecution, it is their practice to bear the cost of such prosecution, including all costs within reason that are incurred after they have satisfied themselves that the case is one in which they should prosecute. As regards the third part of the question, the Board can, of course, only prosecute where an offence under the Act is committed in the United Kingdom, and the question whether the case referred to by my hon. Friend would involve such an offence is one on which without further information I cannot offer an opinion.
Royal Navy
Construction Of Oil Tanks
74.
asked the First Lord of the Admiralty whether he will consider the advisability of constructing all future oil tanks below ground and placing them as far as possible from the sea?
The hon. and gallant Member may rest assured that no aspect of this important question will be overlooked by the Admiralty. The problem presented is that of striking a balance between advantages and disadvantages.
Goodood Races
75.
asked the First Lord of the Admiralty whether, in view of the fact that the Goodwood race meeting is the one meeting in the year easily accessible to and keenly appreciated by a number of naval officers, and in view of the lack of amenities appertaining to modern naval service, he will arrange that, if possible, the Home fleet may be in harbour during the last week in July?
Sir. I fear that the exigencies of the Service render this impossible; but a full period of leave will be given to all ranks now that the manæuvres are concluded.
Will the right hon. Gentleman arrange the movements of the Fleet in the Firth of Forth in order that the men may be able to attend some whippet races?
British And German Battleships (Cost)
76.
asked the First Lord of the Admiralty whether he has seen a statement issued by the German Admiralty showing that the cost of the recent German battleships "Kaiser" and "Friedrich der Grosse" compares unfavourably with similar British ships both in cost per ton and cost per pound of broadside fire; and whether our advantage in the cost of shipbuilding is being allowed for in comparisons of international naval power?
The cost of construction does not affect the relative strength of navies, but only the facility or otherwise by which they arrive at that strength.
Admiralty Contract (Fair-Wages Clause)
78.
asked the Secretary to the Admiralty if he is aware that painters employed by Messrs. Vickers, Sons, and Maxim, Sheffield, on armourplate work are only receiving 6½d. and 6¾d. per hour for a 53-hour week, whereas the rate of the district is now 8d., to be followed in January next by a further advance of ½d. per hour; and whether he will cause inquiry to be made?
No complaint as regards this matter has been received by the Admiralty, but in view of my hon. Friend's statements inquiry will be made.
Land Purchase (Ireland)
87.
asked the Chief Secretary for Ireland whether he has now made inquiries into the question of turbary on the Rowland-Blennerhassett estate, near Beaufort; what is the nature of the power possessed by the Estates Commissioners over the turbary; and whether steps will be taken to secure to the tenants who purchased under the Ashbourne Act a fair share of this turbary, in accordance with the promise made at the time of the sale by the vendor's representative?
A s I have already informed the hon. Member, the Estates Commissioners have no knowledge of any promises such as those referred to and have no power to interfere in the matter. Their powers are limited to estates sold under the Land Acts of 1903 and 1909, and the holdings in question were sold over twenty years ago under the Act of 1885. As regards the holdings, which are the subject of the present proceedings before the Commissioners under the Acts of 1903 and 1909, the Commissioners will see that the tenants are provided with turbary.
88.
asked the Chief Secretary for Ireland if he will state the cause of the delay in granting to Timothy Sullivan of Granardkille, a purchasing tenant on the Hamilton estate, a sum of money promised him by inspectors of the Estates Commissioners for the purpose of building a proper dwelling-house and out-offices on his farm; and whether, in view of the fact that the sale is now four or five years completed, will the loan promised be advanced to enable him to make the farm economic?
I would refer the hon. Member to my reply to his similar question on the 29th July, to which I have nothing to add.
89.
asked the Chief Secretary for Ireland whether he can state the reason for delaying the vesting of the M'Cormick estate, at Cooldoney, in the tenants who signed their agreements five years ago; whether he is aware that the landlord is willing to take stock in order to complete the sale; and will he represent to the Estates Commissioners the desirability of closing with the offer and vesting the property forthwith in the tenants?
This estate has not yet been reached in order of priority on the principal register of direct sales (all cash), and, having regard to the claims of other estates, the Estates Commissioners are not at present in a position to say when it will be reached. The vendor did not make application within the prescribed time for payment in Land Stock.
Constitutional Law
9.
asked the Secretary of State for the Home Department whether, under the existing constitutional law and practice, the remission or modification of sentences passed upon persons convicted of crimes or offences rests with the Crown acting upon the advice of Ministers; and, if so, whether this practice is strictly observed in all cases.
The answer to both questions is in the affirmative.
Chippenham (Dismissal Of Inspector Of Nuisances)
85.
asked the President of the Local Government Board whether he can now state the result of his inquiries into the dismissal by the rural district council of Chippenham of their inspector of nuisances; whether he is satisfied with the reasons given by the council; and whether he will withhold the Board's consent to the new appointment unless he is fully satisfied that the new inspector will have complete freedom to discharge his duties in a thorough manner?
I cannot say I am entirely satisfied with the council's reasons for dismissing the inspector of nuisances, and I propose to have some further investigation made into the administration of the rural district council. In the meantime no sanction to the new appointment will be given.
Doncaster Rural Council
86.
asked the President of the Local Government Board whether his attention has been called to the action of the Doncaster Rural Council in rejecting the recommendation of their sanitary committee to issue a Closing Order in respect of five cottages at Barmborough, which the medical officer of health had reported were in a state so dangerous and injurious to health as to be unfit for human habitation; and whether he proposes to take any steps in the matter?
I am in communication with the district council on the subject.
Civil Service Appointments (Age Limit)
38.
asked the Chancellor of the Exchequer whether candidates for Civil Service appointments as a rule are required to be within certain age limits; and if apart from any disciplinary punishment which may be inflicted upon candidates making wrong statements as to their age, they render themselves liable to legal penalties?
The answer to the first part of the question is in the affirmative, and, with regard to the second part, the answer depends upon the circumstances of each case.
If there is any discrepancy in the ages at all is any notice taken by the Government?
I could not answer that off-hand.
National Teachers, Ireland (New Pension Scheme)
91.
asked the Chief Secretary for Ireland when he expects to be able to announce his proposals regarding the new pension scheme for national teachers in Ireland; and whether in that scheme he proposes to include teachers who are at present receiving pensions under the existing scheme?
I am afraid I am not yet in a position to make any statement.
Orsers Of The Day
Business Of The House
May I ask the right hon. Gentleman, the Prime Minister, whether he has any statement to make about business?
To-night after the discussion on the National Insurance Bill we hope to take—
Foreign Jurisdiction Bill: Committee. Industrial and Provident Societies (Amendment) Bill: Committee. Public Works Loans Bill: Second Reading. Merchant Shipping (Certificates) Bill: Second Reading. Public Health (Prevention and Treatment of Disease) Bill: Committee. Telegraph (Money) Bill: Second Reading. Isle of Man (Customs) Bill: Third Reading. Expiring Laws Continuance Bill: Committee; and if time permits and agreement can be reached, the Highlands and Islands (Medical Service) Bill.I am afraid there cannot be much hope of subsequent time, because that list sounds like the beginning of a new Session.
May I ask the right hon. Gentleman in view of the fact that we have the Insurance Bill, to which there are a very large number of Amendments down to-day, whether he would not reconsider his decision to take so many private Bills after the Insurance Bill? It is not that I object to these private Bills, they are all, I believe, with one exception, agreed, but I object to their being taken at three o'clock or four o'clock in the morning.
shook his head.
Shakes of the head are not recorded in the OFFICIAL REPORT. Will the right hon. Gentleman say something.
I have only blocked these Bills in order to secure a discussion on my Irish Bill, and if I am assured that I can get an hour or an hour and a half to expose the nefarious action of the Government I am quite willing to let the other Bills go through without discussion.
I am not sure I can say anything about that. With re- gard to what the hon. Baronet said, I find shakes of the head, although not reported, are commented on. I will give the hon. Baronet an articulate answer. We do not propose to take these Bills at an unreasonable hour, but I hope we may be allowed to get them through.
It is not that I object to the Bills, but even if the Bills are not objected to, someone may desire to say something on them.
May I ask the Chancellor of the Exchequer if he hopes to take the Revenue Bill on Tuesday; and if so, when the Government Amendments in connection with the Reversion Duty is to appear upon the Paper?
It will be taken on Monday.
Will the right hon. Gentleman answer that part of the question as to when the Amendment on the Reversion Duty will appear on the Paper?
I hope tomorrow or Thursday.
Is the Prime Minister able to intimate his intentions with regard to Lumber 7 Order—the Importation of Plumage Bill?
I am afraid we shall not be able to take that.
Bills Presented
Factory And Workshop (Cotton Cloth Factories) Bill
"To abolish the infusion of steam and other forms of artificial humidity in Cotton Cloth Factories." Presented by Mr. ALBERT SMITH; supported by Mr. Gill, Mr. Snowden, Mr. Wardle, Mr. Tyson Wilson, Mr. Hodge, and Mr. Clynes; to be read a second time upon Thursday, and to be printed. [Bill 304.]
Quarries And Slate Mines Bill
"To provide for the establishment of a minimum wage and regulation of the hours of labour in the case of workmen in Slate Quarries and Slate Mines." Presented by Mr. ELETS DAVIES; supported by Mr. William Jones, Mr. Haydn Jones, and Mr. John Hinds; to be read a second time upon Tuesday next, and to be printed. [Bill 305.]
Lands Valuation (Scotland) Bill
"To amend the Law relating to the Valuation of Lands in Scotland, so as to facilitate the unrating of improvements and the rating of land values." Presented by Mr. DUNDAS WHITE; supported by Mr. Sutherland and Mr. Charles Price; to be read a second time upon Tuesday next, and to be printed. [Bill 306.]
Municipal Representation
I beg to move, "That leave be given to introduce a Bill to authorise the introduction of proportional representation in municipal elections; and for other purposes connected therewith."
The object of the Bill is to confer on municipal boroughs the right, under certain conditions, to adopt, in place of the present system of election, a system of proportional representation. It is not proposed to make the change compulsory. Unless it commends itself to three-fifths of the members present and voting at a council meeting after due notice, no change can take place. It must, therefore, command a wide general assent before this Bill can conic into operation in any borough. To ensure that all members of the council are informed beforehand that the question is coming up for discussion and decision, special notice of any resolution must be given not less than one month beforehand. This will afford plenty of time for full discussion in the Press and in public meeting and otherwise, which will enable councillors before voting to ascertain public feeling in regard to the matter, and if opposition exists, to enable this to be fully expressed and organised. The change, therefore, is unlikely to be effected, unless it is desired by a large majority not only of councillors but also of their constituents. If, after this opportunity of becoming seized of the merits and of local circumstances and opinion, the resolution is passed by a majority of three to two, the practice of electing annually one-third of the members will be discontinued, and triennial general elections will take their place. I think this all to the good. Too frequent elections kill public interest, especially when only partial in character. The proportional system will almost certainly bring back after each election a large number of former councillors who desire to continue their services to the community. If so, it will secure the continuity of personal service and of experienced administration aimed at by the system of retiring only one-third annually. It will also allow sufficient time between elections for fresh questions to arise that will secure more widespread interest in the elections themselves. But should results prove unsatisfactory the Bill provides for a reversion to the old system after three years by resolution of the council passed by the same majority as that by 'which the change had been effected. It is, therefore, purely experimental, and if the community it affects desire, can be abandoned by a simple process involving no cost or trouble. The rest of the Bill simply details the method and machinery for elections under a proportional system, and the Schedules give rules for counting votes, and a form of the ballot paper. Shortly stated, the proposal is this: The ballot paper will, as DOW, contain the names of all candidates who have been duly nominated. Every elector will be entitled to one vote only. This ho will indicate by writing the number I against the name of the candidate of his choice. But he may also place the numbers 2, 3, etc.. against the names of others, according to his preference for them, These second, third, and fourth preferences will only be counted if on the first count enough candidates to fill all the seats do not secure the quota of votes necessary to elect them. This quota is arrived at by dividing the total number of ballot papers by one more than the number of seats to be filled. Thus in a ward represented by five members, any candidate who secured one-sixth of the votes given, plus one, would be elected. If he obtained more than the quota, then the second preferences on his surplus papers would be divided amongst candidates who had not secured a quota, and, if necessary, the lower preferences would be divided until the full number of members had been elected. In this way several important results would follow. No party ticket could secure the monopoly of representation in any ward to the complete exclusion of other parties. Minorities would secure representation in proportion to their strength. Every ward, therefore, would almost certainly be contested. Every voter would be represented, if not by the candidate of his first choice, then by one to whom he had given his preference. No votes would be wasted, and the sense of injustice felt by the elector who is practically disfranchised under the present system would disappear. Effective opposition and criticism would be ensured on public bodies. Members would be less dependent than now on the party caucus, and more free to exercise an independent and unbiassed judgment on the administrative questions which came before them, checked only by the knowledge that their action was subject to the approval of their constituents at the next election. You would thus combine real representation with real freedom of discussion, and prevent machine-made majorities on councils from riding roughshod over the convictions and desires of large minorities in the constituencies. If these results are desirable, no one with a knowledge of the facts will deny that the present system fails utterly to secure them. To show this I need only refer to the borough council elections in London last November. In four metropolitan boroughs the minorities were completely unrepresented — Chelsea, Westminster, Lewisham, and Fulham. In Fulham, 30,339 Moderates secured every seat, whilst 20,154 Progressives and 2,420 Labour and Socialists did not secure one. In Lambeth, 92,870 Moderates secured fifty-six seats and 48,325 Progressives two. In Battersea, however, owing to the erratic way in which the system works, 47,759 Moderates secured only twenty-four seats, whilst 37,035 Progressives secured thirty seats—i.e., a minority of 12,000 votes obtained a majority of six seats. I wonder if that is the secret of the opposition to this improvement of my right hon. Friend the President of the Local Government Board who represents that borough in this House? In many metropolitan borough councils besides the four named practically no opposition exists, though in the constituencies there are large masses of voters whose opposition finds no voice. Now effective criticism is the breath of life to representative government. In its absence triumphant and unexposed majorities have every inducement to domineer over their opponents, and to do in the dark what they would not attempt in the glare of publicity. This involves danger of corruption and of all the evils for which publicity is the one corrective. Publicity can only be secured by effective opposition. Without it the electors cannot be informed, and in the absence of information they can neither be interested nor vote intelligently. The result is that many wards go uncontested, and apathy, the greatest foe to pure and effective government, prevails. This is inevitable where minorities know that contests are hopeless because a disciplined and organised majority can deprive them of all representation. It would be impossible under a proportional system, which, by giving minorities an effective voice in government, would almost certainly revive public interest, make local government more popular, attract to the councils men of a higher type, less fettered to party, and more devoted to the public good, and thus make our municipal institutions more useful and more wisely directed to beneficent ends than ever before. The need of a proportional system of some kind is growingly felt outside Parliament. It has been approved in conferences of the trade unions and I.L.P., by the Young Liberals, and the London Reform Union. Some metropolitan boroughs—namely, Wands-worth and Camberwell, and provincial boroughs, namely, Carnarvon, have passed resolutions in its favour. The Insurance Commissioners for England and Ireland, the National Union of Railwaymen, National Union of Clerks and B. M. Association have adopted it. It is in operation in Belgium, Switzerland, Sweden, and Denmark for municipal, and in Belgium, Sweden, Finland, Switzerland, Wurtemberg, and Tasmania for parliamentary elections—The hon. Member has already exceeded his allotted time.
Question put, and agreed to.
Bill ordered to be brought in by Mr. Chancellor, Sir William Anson, Sir William Bull, Mr. Burt, Mr. George Greenwood, Mr. Mackinder, Mr. Newman, Mr. George Roberts, Mr. Snowden, and Mr. Wiles. Presented accordingly, and read the first time; to be read a second time To-morrow, and to be printed. [Bill 307.]
National Insurance Act (1911) Amendment Bill
As amended (in the Standing Committee), considered.
Two new Clauses ( Medical Benefit only to exclude Services of Specialists) and ( Provision of Medical Benefit for Persons away from Home) appeared first on the Amendment Paper in the name of the hon. Member for Wilton (Mr. Charles Bathurst).
The first two Clauses standing in the name of the hon. Member for Wilton properly come in as Amendments to Clause 10.
As regards these two Amendments, I endeavoured to move them in Committee, and I was told by the Chairman that they were not relevant to any of the Clauses, and that I ought to put them down as new Clauses. That is the reason why I have put them down on the Report stage.
I am very sorry, but that is my ruling.
As regards these particular Clauses, they are really an Amendment of Section I of the original Act dealing with voluntary contributors.
Clause 10 in this Bill deals with medical benefit, and it seems to me to be the proper place to introduce anything connected with medical benefit.
May I point out that Clause 10 relates to a very small class of persons now under the Act, but the new Clause which is suggested would cover the whole of the insured?
4.0 P.M.
The title of the new Clause is "Medical Benefit," and the best arrangement would seem to be that all suggested Amendments dealing with medical benefit should come under that Clause, so that all Amendments which may from time to time be made with regard to medical benefit may be found under one heading. The same observation also applies to the next two Clauses (Free Choice of Doctor) and (Limit of Numbers on a Doctor's Panel), standing in the name of the hon. Member for Salisbury (Mr. G. Locker-Lampson). The new Clause of the same hon. Member, dealing with Medical Referees, should be an Amendment to Clause 11. The Clause (Representation of Medical Profession on Committee for Seamen's National Insurance Society), standing in the name of the hon. Member for the University of London (Sir P. Magnus), is an Amendment to Clause 22. The next Clause (Pooling Arrangements for Centralised Societies having Members in more than one part of the United Kingdom), standing in the name of the hon. Members for East Edinburgh (Mr. J. Hogge) and Glasgow (Mr. MacCallum Scott), is an Amendment to Clause 15, and so also is the following Clause (Pooling Arrangementsin case of Societies with Members in snore than one part of the United Kingdom), standing in the name of the hon. Member for Lanarkshire (Mr. Pringle).
Must I give notice of this Amendment under Clause 15?
The hon. Member must keep an eye on Clause 15 when it comes along, but in case it should not be reached to-day it would, of course, be advisable to put it on the Paper. The first of the two next Clauses (Seamen employed on ships temporarily outside the United Kingdom), standing in the name of the hon. Member for Dulwich (Mr. Frederick Hall), ought to be an Amendment to Clause 22, and the second (Employed Contributors) involves a charge, and we cannot deal with it on Report. A third Clause (Exception of Hospital Employés) in the name of the same hon. Member should be an Amendment to Clause 6. Two Clauses (Attendance of Second Doctor) and (Diseases Caused by Misconduct of Insured) standing in the name of the hon. Member for the University of London, are Amendments to Clause 10, and the next Clause (Vesting the Powers of the Several Bodies of Insurance Commissioners in the Joint Committee) standing in the name of the hon. Member for Colchester (Mr. Worthington-Evans) is an Amendment to Clause 27 or to Clause 15.
On the point of Order. May I ask you to reconsider that decision for a moment? This new Clause which I have put down has for its object the abolition of the four Commissions, and the Clause to which you call my attention is merely one, as I understand it, to permit regulations to be made by the Treasury under Section 83 of the principal Act, which is not the Section which creates the four Commissions. Clause 27 is really an administrative Clause, giving special powers to the Joint Committee, and the new Clause, on the other hand, is one to abolish the four Commissions and vest all the powers of the four Commissions in one Committee, which in future would be the sole Commission. I submit that it really deals with a very much wider subject, and a subject quite separate from that dealt with in Clause 27.
The hon. Member might put it as the first Sub-section of Clause 27. It is still relevant to the Joint Committee of the Insurance Commissioners.
It really does away altogether with the Joint Committee as at present known. It is quite true that the words "Joint Committee" are to be found, in my new Clause, but they are not used in the same sense as they are used in Clause 27 of the Bill. I submit, therefore, that it is really not at all relevant to that Clause.
On a point of Order. The hon. Gentleman succeeded in convincing the Chairman of the Committee upstairs that it was relevant to that Clause.
I would ask the right hon. Gentleman to refresh his memory. It was not on that Clause that it was taken, it was on the Clause which is now Clause 15.
No. Clause 15 was introduced as a new Clause by myself.
I beg the right hon. Gentleman's pardon.
This time I am glad to find myself in agreement with the Chairman of the Committee. The hon. Member's next Clause (Provisions relating to Administration Expenses) imposes a charge.
May I submit to you that the only effect of this is to take 4d. per person per annum from the reserve values fund and put it into the administrative account of the approved society. The reserve values fund is not a fund which is supplied out of moneys provided by Parliament except in the first instance as a paper credit and not as a cash transaction at all. It is repaid out of the contributions paid by the insured persons and not out of moneys provided by Parliament. I therefore submit that it is not putting a charge upon Parliament.
Supposing the contributions fall short, who has to pay it then?
The contributions cannot fall short in this sense. There is a fixed proportion of the contribution, namely, 1½d per week for women, and 1 5–9d. for men, and the total contribution by the employer and the employed is 7d. I agree that some things diminish under the Act, but I do not think that 7d. can fall below 1½d. and 1 5–9d.
It is quite true, as I understand it, that there may be an in- crease of reserve funds, but every expenditure carries with it two-ninths State contribution, and, therefore, next year when we begin to contribute two-ninths out of the State fund it must form a charge.
New Clause—(Alternative Arrangements For The Panel System)
"If the Insurance Commissioners are satisfied that the insured persons or any considerable proportion of them within an area, or part of an area, are not receiving satisfactory medical treatment under the panel system the Commissioners may authorise the insurance committee to make, or may themselves make, such other arrangements as will secure to insured persons within the area, or part, such better medical service as is practicable having regard to the funds available for the purpose, or arrangements whereunder insured persons within the area, or part of the area, may be required to make their own arrangements for receiving medical attendance and treatment, including medicines and appliances, and whereunder the insurance committee or the Insurance Commissioners undertake to pay the cost of such medical attendance and treatment upon such scale as they may determine with the approval of the Commissioners so calculated that the medical attendance and treatment so secured shall be of a quality not inferior to that provided under the panel system."
Clause brought up, and read the first time.
I beg to move, "That the Clause be read a second time."
This is an attempt to amend the arrangements which can be made under the panel system. It is really unnecessary to say very much in support of the new Clause, because the very wording of it is its justification. The idea is that where the Commissioners or the insurance committee are of opinion that insured persons are not receiving satisfactory medical treatment under the panel system the Commissioners may authorise the insurance committee to make special arrangements which will ensure a better medical service being given to insured persons. First of all, the service must be better than that which is enjoyed for the time being under the panel system, and the limit put upon it is that it must be practicable, having regard to the funds available for the purpose. That is the first part of the Clause. It is unnecessary at the present moment to go into the question of the panel system. Everybody who has had experience of the administration of the principal Act has, I think, come to the conclusion that some fresh power should be given to enable insurance committees to deal with the deficiencies in the working of the panel system. We have not, as a House of Commons, had enough experience to say precisely what form the new arrangements should take, and my proposal is that the insurance committee should suggest arrangements and that the Commissioners should approve of them. This is not an attempt to supersede the panel system. My intention is simply to arm the authorities with powers to give that medical attendance which is promised to insured persons under the principal Act and to enable them to overcome unnecessary and unreasonable difficulties that the working of the panel system presents to-day. The second part of the new Clause enables the committee to cause other arrangements to be made so that insured persons may receive certain monetary payment if medical attendance cannot be provided owing to any breaking down of the arrangements that are made. Again, I want to safeguard the rights of insured persons, and the final words of the new Clause read:—Everybody who has had experience of the working of the Act knows that it has broken down or threatens to break down, not all round, but only in certain special districts, and the purpose of my Clause is to arm the authorities with powers to meet the difficulty."The medical attendance and treatment so secured shall be of a quality not inferior to that provided under the panel system."
I beg to Second the Motion.
This Clause was discussed to a considerable extent in the Committee upstairs, and I know that it found sympathy, because sympathy was expressed with it by all parties in the Committee. It was rather late in the proceedings of the Committee, and the hon. Gentleman the Member for Sevenoaks (Mr. Forster), who is leading the party opposite, asked that it might be deferred to the Report stage for reconsideration. My hon. Friend therefore withdrew the Clause, and we did not come to a division upon it. I hope that now those hon. Gentleman who saw good in the Clause will be able to see their way to support it, and that we may place it in the Act. The Clause, as my hon. Friend has said, does not touch the ordinary panel system at all. We have got 18,000 doctors working on the panel system, and so long as it works satisfactorily we do not, at this stage, at all events, propose to make any alteration in the system. We are appointing a Committee to gather information, and we shall be more prepared to deal with any change, if any change is needed, after that information has been obtained by that committee. This Clause is to enable arrangements to be made where there is no satisfactory panel system. We are obliged to give medical benefit to the persons concerned, and I think that it is necessary in the interests of the insured persons that we should be in a position to give that medical benefit if there is no satisfactory panel. Two examples occur to my mind. One was raised by the hon. Gentleman the Member for Mile End (Mr. Harry Lawson), and was strongly supported by him. There are certain districts in East and South London where at present, owing to the persistent under-doctoring of the people for many years, although all the doctors are on the panel, or nearly all, yet we cannot give medical attendance sufficient for the people. We hope in time, as the hon. Gentleman said in Committee, that doctors will drift into those areas and, come on the ordinary panel system. It may be necessary to attract some doctors to those areas by some sort of support, and I think I can say that in many of those areas the doctors who are being overworked would welcome some such alteration as this. Another question which is very uppermost in the minds of people at present is that of seaside resorts where there is a sudden influx of people who demand treatment as insured persons. There, I think, it is quite likely that some arrangement will have to be made to supplement the panel system to meet this sudden influx of insured persons. There may also be a necessity for dealing with those cases where the insured persons are few in number, and where it cannot be arranged under the ordinary panel system. I want it to be clearly understood that, in accepting this Clause. I do not wish to accept anything which interferes with the panel system so long as it is satisfactory. This is an alternative and supplementary method of procedure to be adopted in cases where, for one reason or another, insured persons are not able at present to get satisfactory treatment.
It is true that in the Standing Committee I expressed the opinion that it would be wiser that the consideration of this Clause should be postponed until we reached the Report stage, because, working as we were in Committee, it was quite impossible to give adequate consideration to it, owing to the limited time at our disposal. The right hon. Gentleman has said that the Commissioners have no intention of interfering with the ordinary panel system except in cases where it has broken down, or where it has not been satisfactorily established. But it does not want this new Clause to empower the Commissioners to take any such step as they may think desirable, in any case where the panel system is not working satisfactorily, because the provisions of Section 15 cover the case completely. As the right hon. Gentleman knows the Section very well, it is hardly necessary for me to remind him what it proposes, but I may tell the House that Section 15 already provides that, where the Insurance Commissioners are not. satisfied with the panel system in any area, they may dispense with the adoption of such system, they may authorise the insurance committee to make any such arrangement as the Commissioners may approve, or the Commissioners may themselves make such arrangements as they think fit, or they may suspend the right to the medical benefit altogether. As far as that difficulty is concerned, therefore, there is ample power in the Commissioners at the present moment, and to that extent this new Clause is not needed.
There is one provision in the new Clause I do not like at all, and that is the provision that where such other arrangements—arrangements other than the panel system—may be made so as to secure better medical service, such better medical service is to have regard to the funds available for the purpose. I do not quite know what that means. Under the provisions of Section 15, where the ordinary panel system is not in working order, but where the Commissioners authorise insurance committees to allow people to make their own arrangements, then the individual insured person gets full value of his contribution which would be applicable to the provision of medical benefit. There is nothing in Section 15 of the Act limiting the amount that may be given to each contributor to such funds as may be available for the purpose, and it seems to me, if we pass this Clause in its present form, we shall be giving, either to the Commis- sioners or to some other people, the power of setting a limit to the amount which may be restored to the individual contributor as being his proportion of the amount available for the provision of medical benefit. I do not like that. I learn with regret that the Government have consented to incorporate this Clause in the Bill, and, in view of what I have said with reference to the ample powers which at present reside in the Commissioners, I do not think the Clause is necessary, and I shall vote against it.I agree with the hon. Member that this is a clumsy and unworkmanlike method of altering the Clause in the original Act. But I cannot agree with my hon. Friend in thinking that it makes no change. The panel system, especially in parts of London, to a large extent has broken down, owing to the paucity of doctors and the under-doctoring of the people, and if the great hospitals had not kept their doors open to all the sick poor who went there, there would have been far greater hardship. There has been a considerable amount of hardship and suffering in the administration of the Act so far. The point which I should like my hon. Friend to consider is this, that in the original Act you can only deal with the area of administration. Now the area of administration for the purpose of the Insurance Act is the county area. The point I wish to make is that in the original Act they could only deal with the area of administration, which is the county area. London is an administrative county. At the same time there are whole districts of an area in which the conditions are peculiar and unlike those of any other part of that area. There is an enormous variety of conditions of life, and later on it may be not only possible but necessary to regulate the medical panel in special quarters of London, and to give it that which is not necessary in other parts of London. For that reason I think the proper mode of dealing with this would have been to amend the proviso of the principal Act. To introduce a new Clause merely for that purpose adds confusion to confusion. I am bound to say I think the right hon. Gentleman, probably through want of time in the interval between the Committee stage upstairs and the Report stage here, has not been able to suggest such Amendments in drafting as to make an Act an Act which may be understood of the people. He did promise consideration to the question of printing at length the Clauses repealed, but one disadvantage we are under here is that the new Clause introduced is merely an amendment of the original Act, and the object aimed at by the Clause could have been better secured by an amendment of that Act. As I think it is necessary the Commissioners should be free to deal with parts of an administrative area, I shall not feel at liberty to vote against this Clause. But I do feel deeply the unnecessary suffering which is being inflicted on working people in the East End, and in the South of London, and even though it be a clumsy way of effecting the object aimed at, I cannot withhold my support.
I hope the Secretary to the Treasury will give some assistance to the Committee in this matter. It is desirable there should be an amendment of Section 15 of the original Act, so as to add to the word "area" the words "part of an area." That especially applies to large places like London, because a part of London may require to be dealt with in a different way to the rest of London. If the amendment were confined to that, I should be perfectly prepared to support it, but, as it is not, and as it goes a great deal further, I feel, like my hon. Friend the Member for Sevenoaks (Mr. Forster), it is extremely difficult to support the Clause as it appears on the Paper. Let me tell the House why. Under the original Act the Insurance Commissioners, or the insurance committee, can allow anyone for whom they cannot supply medical attendance on the panel system to provide their own medical attendance. If they do that, they must give them a sum equal to the cost of the benefit—that is, a Sum of 8s. 6d. or 9s., including the grant. Under this Amendment they have the same power, but no greater power, and they get it not by giving a man 8s. 6d. or 9s., but by giving him some sum prescribed upon a scale which the Insurance Commissioners may determine. But that sum is obviously smaller than the 8s. 6d. or 9s., or it would not be necessary to bring this Amendment in. If it is the sum provided by the original Act, why is this new Clause brought in to amend the original Act? If it is only because it is desired to extend the power from an area to part of an area, then a simple Amendment of the original Act, by inserting the words "part of an area," would carry out the object of the Clause, and would also meet the views of the hon. Member for Mile End. But that is not the intention. There is something more at the back which neither the Mover nor the Secretary to the Treasury have explained. There seems to be some desire to set up some other system. Suppose, for example, a whole-time system was set up in part of an area, and the salaries which were paid to the whole-time officers took up a large part of the fund available for medical benefit in that area. Suppose then insured people who objected to being doctored by whole-time men and wanted a free choice of doctors, desired to make their own arrangements. The answers of the insurance committee would be, "We have set up whole-time men, the only money available for medical benefit has been absorbed in payment of the salaries of the whole-time men, and, if you do not choose to get your medical benefit from those men, you can only have a proportion of what is left." That would work out at 2s. 6d. or 3s. per head, a sum quite inadequate to give medical benefit to those who do not choose to come in under the whole-time scheme. I believe that is at the back of this Amendment. If so, it should be stated to the House. If it is not at the back of the Amendment, then the point can be met in the way suggested by my hon. Friend the Member for Mile End by adding the words "or part of an area" to the word "area" in the Section of the principal Act.
Question, "That the Clause be read a second time," put, and agreed to.
Clause added to the Bill.
The next Clause standing in the name of the hon. Member for Perth (Mr. Whyte) dealing with pooling arrangements for centralised societies should come as an Amendment to Clause 15, and that in the name of the hon. Member for the Wilton Division (Mr. C. Bathurst) (Exemption from Employer's Contribution) to Clause 5. The new Clause (Punishment of Husband Depriving Wife of any Benefit) is an Amendment to Clause 32, while the proposed new Clause of the hon. Member for the Eifion Division (Pooling Arrangements for Centralised Societies) comes as an Amendment to Clause 16. The Clause of the hon. Member for the Wilton Division (Increase of Women Members on Insurance Committees) comes as an Amendment to Clause 28, and the Clause (Limitations of Patients on Doctor's Panel) is an Amendment to Clause 10). The Clause of the hon. Member for Stoke-on-Trent (Appointment of Commission for the United Kingdom) is an Amendment to Clause 27, and the Clause (Definition of "Incapable of Work") is an Amendment to Clause 12. The next new Clause on the paper (Definition of "Confinement" and "Confined") is an Amendment to Clause 13, and the new Clause (Provision to Avoid Transfers Within an International Society) is an Amendment to Clause 15. The proposed new Clause of the hon. Member for Mile End with regard to benefits to aliens is out of order, as it imposes a charge, while that regarding outdoor relief for Scotland should come as an Amendment to Clause 39.
New Clause—(Amendment Of Section 51 Of Principal Act)
"In Sub-section (1) of Section 51 of the principal Act, for the words:—
Where the managers of any institution carried on for charitable or reformatory purposes prove that the persons who are inmates of and supported by the institution—
there shall be substituted the following words, namely:—
Where the managers of any institution carried on for charitable or reformatory purposes prove that the persons who for such purposes are inmates of the institution."
Clause brought up, and read the first time.
I beg to move, "That the Clause be read a second time."
This is a proposal to amend Section 51 of the principal Act, and the object is to clear away a doubt in regard to the definition of Inmates of Charitable Institutions. The words I have placed on the Paper, in substitution of the words in the principal Act, make it perfectly clear that the expression "inmate" does not include persons employed in the institution. My sole object is to remove all doubt as to the meaning of the word "inmate," which, in another place, has been interpreted as a person employed in such institution. In these circumstances I think it is well that the doubt should be cleared up, and the doubt is removed effectually by the words I propose.I beg to second the Motion.
The new Clause merely represents, so far as I have been able to ascertain, the practice which now obtains. We accept the Clause.
Question put, and agreed to.
Clause added to the Bill.
New Clause—(Meaning Of "Working Day")
"For the purposes of Part I. of the principal Act and of this Act any day on which an employed person in fact works for payment shall be deemed to be a working day."
Clause brought up, and read the first time.
I beg to move, "That the Clause be read a second time."
This Clause is, to some extent, in the same category as that which has just been accepted. The expression "working day" occurs in the Second Schedule, and, I think, also in Section 98. It is submitted that for the purposes of the Act it is the best definition of the term "working day."I beg to second the Motion.
I do not know that I quite follow my hon. Friend. If he wants the words "in fact works" inserted in connection with the waiting period of three days, so that when a man works on Sunday he shall be qualified, that matter can be raised in connection with another Clause. If he wants the words inserted in connection with Schedule 2 they are in the Schedule, therefore the Clause is unnecessary. I hope my hon. Friend will withdraw the Clause.
Clause, by leave, withdrawn.
The next new Clause (Definition of "confinement" and "confined") should come as an Amendment to Clause 13. The next (Offences and legal proceedings) should come as an Amendment to Clause 32. As to the Amendments to Clause 1, in the names of the hon. Member for East Edinburgh (Mr. J. Hogge) and the hon. Member for North-West Lanarkshire (Mr. Pringle), the first one deals with insurance committees in Scotland, and should come in Clause 39, while the next two, I think, impose a charge.
Clause 3—(Abolition Of Reduction Of Benefits In Certain, Cases)
(1) The rate of sickness benefit shall not be reduced in the case of an insured person who became an employed contri- butor within one year after the commencement of the principal Act by reason that at the date of so becoming an employed contributor he was of the age of fifty years or upwards, and accordingly Sub-section (3) of Section nine and C in Part I. of the Fourth Schedule of the principal Act shall be repealed.
(2) Part I. of the principal Act shall apply to persons who at the commencement of the principal Act were of the age of sixty-five or upwards, and under the age of seventy, and to persons who have since the commencement of the principal Act attained or may hereafter attain the age of sixty-five in like manner as it applies to other persons, and accordingly Sub-section (4) of Section one, paragraph ( a) of Sub-section (4) of Section four, and Section forty-nine of the principal Act shall be repealed:
Provided that a person who is of the age of sixty-five or upwards at the time of entering into insurance shall not be entitled to medical benefit after he attains the age of seventy unless the number of weekly contributions paid by or in respect of him exceeds twenty-six.
(3) The Insurance Commissioners may make such regulations as they may consider necessary for providing, in the case of any such classes as aforesaid, for the transition from the provisions of the principal Act affecting them to the provisions of that Act as amended by this Section.
I beg to move, in Sub-section (1), to leave out the words "one year" ["within one year after the commencement of the principal Act"], and to insert instead thereof the words "sixty-five weeks."
I am not quite sure that I ought not to tell you, Sir, that the Amendment may be out of order, on the ground that it imposes a charge. Under Clause 2 of the Bill, sixty-five weeks have been substituted for one year, so that employed contributors and voluntary contributors can gain the advantages of the Act within a period of sixty-five weeks, instead of the original period of one year. At the time that Clause 3 was moved in Committee upstairs, that alteration had not been made. Had it been made, I have no doubt that the form of the alteration would have been sixty-five weeks instead of one year. It seems absurd that for all people except those over fifty years of age sixty-five weeks should be the qualifying period, but for those over fifty years of age one year should be the qualifying period. It seems unwise to differentiate between the two classes in a mere matter of thirteen weeks. If the Amendment does impose a charge, of course I shall not be able to move it. I do not know whether the Secretary to the Treasury is going to claim that it does impose a charge.That is not for me to decide, but I should have thought it did increase the charge. If it does not, we will consider it, and see whether we can insert it in another place.
I suppose the hon. Member for Colchester will be satisfied with that?
I am afraid it does impose a charge.
Amendment, by leave, withdrawn.
Clause 4—(Insured Person)
"Paragraph ( b) of Sub-section (3) of Section one of the principal Act shall have effect as if there were added thereto "or, being of the age of sixty or upwards, show to the satisfaction of the Insurance Commissioners that they have ceased to be insurable as employed contributors."
I beg to move, after the word "that" ["show to the satisfaction of the Insurance Commissioners that"], to insert the words "on or since attaining the age of sixty."
The Clause will then read:—I have a consequential Amendment to leave out the word "have"—"Paragraph (b) of Sub-section (3) of Section one of the principal Act shall have effect as if there were added thereto 'or, being of the age of sixty or upwards, show to the satisfaction of the Insurance Commissioners that'"—
In the original Act this Sub-section (3) deals with voluntary contributors. I suggest that unless we have some such words as these there will, in effect, be a lacuna as between the original Act and this Amending Bill, and it will be quite possible that persons who may have been insured for over five years, and have an income of possibly £1,000 or upwards, and yet will be able to enjoy the benefits of Section 1, Sub-section (3). As the Clause reads at present voluntary contributors under the original Act are confined to those who are either—"on or since attaining the age of sixty they have ceased to be insurable as employed contributors."
"engaged in some regular occupation and are wholly or mainly dependent for their livelihood on the earnings derived by them from that occupation; or
(b) have been insured persons for a period of five years or upwards;
If, as a matter of fact, there has been a lapse in his insurance before he has attained the age of sixty years, under this provision in the Amending Bill it is quite possible that he may be possessed of an income of £1,000 a year, and may, because he has reached sixty, be entitled to become insured as a voluntary contributor. What I want is to secure that he is continually insured up to the age of sixty. If he is continually insured up to the age of sixty, the case I have in mind cannot arise. It is perfectly clear that if his income exceeds £160 a year, he cannot continue to be insured up to the age of sixty. Therefore, it is quite impossible for a man of large means to become at the age of sixty an insured person under this provision; whereas, if the five years have elapsed between the time he ceased to be an insured person, it might be taken under this Clause that he again becomes an insured person because he has reached the age of sixty. It is quite conceivable that although he might have become in the meantime a man of considerable means, he can find himself, unlike the rest of the community, in a position to become a voluntary contributor. I think I have shown to the right hon. Gentleman that it is a little lacuna which has not been noticed by the draftsman which requires to be put right in this way, otherwise it will be possible for a fairly rich man to become, what clearly he is not entitled to become, a voluntary contributor under the original Act. The point is a little difficult, but I hope I have made my meaning clear to the right hon. Gentleman.and the persons possessing such qualifications who become or continue to be insured persons are in this Act referred to as voluntary contributors: Provided always that no person whose total income from all sources exceeds one hundred and sixty pounds a year shall be entitled to be a voluntary contributor unless he has been insured under this part of this Act for a period of five years or upwards."
expressed dissent.
Apparently I have not made my meaning clear. Will the right hon. Gentleman kindly consider what is going to happen under this Clause supposing that a person has had £160 a year up to five years ago, then ceased to be an employed contributor, and then reaches the age of sixty years. What is to prevent that man, because in the meantime he has become a man of wealth, becoming a voluntary contributor and being included under the advantages of Sub-section (3) of Section I? If that contingency is possible, I suggest that the only possible way to overcome it is to provide that no person shall have the benefit provided under Clause 4, unless it is given to him on or since attaining the age of sixty years. That is a contingency which I suggest might possibly arise.
I beg to second the Amendment.
This is largely a matter of drafting. My advisers tell me that the Clause as it stands fully carries out the intention of the Clause as passed in Committee. The intention was to prevent people being pushed out of the insurance altogether at the age of sixty by being compelled to retire on a pension, which is a very common thing under certain superannuation schemes. The idea was that it was very unfair that that person should not be allowed to continue as a voluntary contributor by the mere fact that he ceased to do work as an employed contributor. The "five years" applies to the five years before he becomes pushed out of insurance. I know the hon. Gentleman (Mr. C. Bathurst) is keen on drafting points, and that he is a very expert draftsman. I will look into the subject. The Amendment only appeared on the Paper to-day. If necessary, it shall be put right. Our intention is the same.
I do not wish to press the Amendment, but I am afraid that the right hon. Gentleman and his advisers have not realised the importance of the point.
Amendment, by leave, withdrawn.
I beg to move, at the end of the Clause, to insert the words "and where any persons who by virtue of this Section are entitled to become voluntary contributors become such contributors, the rate of contribution payable by them shall continue to be the employed rate."
This is consequential upon what the Committee did upstairs, and provides that persons after the age of sixty who keep in employment shall only pay the contribution at the employed rate, their reserve values having already been credited when they became insured persons. It is only fair that they should continue to pay at the employed rate.Question, "That those words be there inserted," put, and agreed to.
Clause 5—(Exemptions)
After paragraph ( b) of Sub-section (1) of Section 2 of the principal Act which relates to exemptions, the following paragraph shall be added:—
(c) Ordinarily and mainly dependent for his livelihood on the earnings derived by him from an occupation which is not employment within the meaning of this Act.
I beg to move, in paragraph (c), after the word "meaning" ["within the meaning of this Act"], to insert the words "of Part I."
Part I. of the principal Act sets out the various occupations which are deemed to be employment within the meaning of the Act, and thereby constitute a person engaged in them an employed contributor. Unless the words "of Part I." are added, it might conceivably apply to occupations which are found in Part II., which are excepted employments which do not constitute an employed contributor within the meaning of the Act. In order to make the meaning of this Clause quite definite, it is necessary to add these words to show that it is intended to include those occupations which constitute employment within the meaning of the principal Act, and not those occupations which are not employment within the meaning of the principal Act.I beg to second the Amendment.
I think we might consider this. I am not quite sure that the words are necessary, but I am inclined to think they are.
Amendment, by leave, withdrawn.
I beg to move, at the end of the Clause, to insert "(2) In all cases where the employer is under a legal obligation to pay wages during sickness to any person employed by him in accordance with any established custom or Common law, then and in every such case the employer shall be exempt from liability to pay contributions under the National Insurance Act and the Insurance Commissioners shall make an order that the employer's contribution shall be paid by the person so employed."
This is intended to meet the case which was raised by the hon. Gentleman (Sir Luke White), in consequence of an assurance which was given to the National Farmers' Union by the Chancellor of the Exchequer in reference to those men who are in the habit of living-in in farms in the North of England, receiving board and lodging and, in addition, a money way of 10s. to 12s. a week. In those cases, when a man feels ill, he gets, of course, the whole benefit of the attendance upon him while he is sick and his board and lodging and, in addition, sickness benefit under the Act. The Chancellor of the Exchequer, when this was pointed out on the Second Reading, said he thought it was a matter which required consideration, and I suggest that it does, because it is a direct incentive to malingering, as well as operating an injustice to the farmer. I think this custom is prevalent in Lancashire, parts of Yorkshire, Durham, and Northumberland, and it is a case which is not covered by Section 47 of the principal Act, which permits a deduction in the amount payable, both by employer and employed, in those cases, which are also common in the North of England and Scotland, where the farmer pays a man his full wages for six weeks and no longer. This is a case where the farmer makes provision for the accommodation of his employé throughout the whole of his illness and pays him full wages during that time, and it was brought to the attention of the Chancellor of the Exchequer by a deputation from the National Farmers' Union, representing many thousands of farmers all over the country—a very strong trade union—to whom he gave an undertaking some two years ago that he would give attention to the matter, and see whether he could not provide that such employers should be exempt from the payment of the employer's contribution under the Act. Representations have come, I believe, from members on all sides of the House, from the National Farmers Union and from similar bodies, urging them to give attention to the matter and remove what appears to be an admitted grievance.
In the original Act, we tried to deal with cases of this kind by Section 47, in which if six weeks' sickness is guaranteed by the employer there is a reduction in the contribution of a penny, both by the employer and the employed, which is not a bad way of dividing it, and I think some 80,000 persons are now insured under the operations of Section 47. I do not know that any case has been made for an extension of Section 47, because I do not know how many persons really undertake as a legal obligation to pay sick pay to their employés for a year; but I am quite sure that if anything is to be done to meet that case it must be done by extension of Section 47, and not in the way the hon. Member suggests. He suggests that where a legal obligation only extends to sick pay, the employed shall pay full insurance, not only for the year's sickness, but for sanatorium and maternity benefit, for permanent disablement and for medical and all the other benefits under the Act. I am not at all sure how the actuarial calculations would work out of a year's obligation during sickness as distinct from six weeks, but I am quite sure, owing to the very much more numerous cases where men are ill for something like six weeks, it would be a very diminishing amount. It might only be an actuarial calculation of a halfpenny or a farthing. Under these circumstances, it seems to me impossible to say that the employed person, just because of the obligation of providing for sickness being upon the employer for a short period of time, should have to pay the whole of the employer's contribution which goes through all the various parts of the insurance, including the administration part of the approved society, and the medical benefit which is a very expensive insurance, and the others. There would be no guarantee under this Clause, if we passed it, that at the end of the time there might not be permanent disability of the insured person, and under those circumstances it seems to me quite unfair that the employed person alone in those cases should be bearing the whole burden of his insurance, whereas in other cases the employer is contributing his share. I do not think we ought to abolish Section 47, which this would do, to meet a comparatively few possible hard cases. Therefore, I should very strongly ask the House not to accept the Clause.
I really regret very much that the right hon. Gentleman has not even reiterated the promise of the Chancellor of the Exchequer that the case which was brought before the notice of the House on the Second Reading by the hon. Member (Sir Luke White) should receive the attention of the Government.
It has.
If it has received the attention of the Government they appear to be quite content to leave things as they are. The result of leaving things as they are is that the labouring population who are brought under the provisions of Section 47 may be far better off when they are sick than when they are well. The Chancellor of the Exchequer admitted that that was undesirable. The Secretary to the Treasury apparently does not think it is. I hope, at any rate, that the Secretary to the Treasury will take counsel with the Chancellor of the Exchequer with a view to putting things on a more satisfactory footing. The hon. Gentleman (Sir Luke White) referred to a legal decision which had just been given that the labourer was entitled to the whole of his wages, and that the employer was not allowed to deduct anything on account of his contribution. In other words the employer was compelled to pay his full contribution though he was at the same time paying full wages. The right hon. Gentleman has not taken counsel, apparently, with the Chancellor of the Exchequer. I only hope he will do so, because undoubtedly a real grievance exists.
Amendment negatived.
I beg to move, at the end of the Clause, to insert "(d) A person employed by a hospital or other similar institution in any capacity, and who receives free medical treatment at such institution and the institution by whom they are employed."
It is a well-known fact that in all our hospitals the employés have been in the habit of receiving from their own medical officers free medical attendance, and it is generally admitted that all who are employed, and who sleep on the premises, if they are ill, are provided for during the whole time. They are in exactly the same position as if they were perfectly well. It seems hard, when one takes into consideration the enormous difficulties the hospitals have at present in obtaining the necessary funds to carry on their work—
Not in the North.
5.0 P.M.
I am afraid that many of the large London hospitals are perhaps not in the same comfortable position as those in the North, and I cannot help thinking, from my knowledge of the various Sections, and the way many of these Clauses were met in the Committee, that sympathy will be extended to hospitals in the South, which are not in such comfortable circumstances as those in the North. My only desire is that these people should not be handicapped any longer. They cannot possibly get anything out of the fund, and, of course, if it is said that there may he a way by which, eventually, it would be desirable that these hospitals should be nationalised, that is a question of a totally different description altogether. The only thing we have to look to is the condition of the hospitals at the present time, and the sources from which they obtain their funds. Under these circumstances, is it desirable that we should place upon them heavier charges now than they had to bear eighteen months ago? I hope the Financial Secretary will, at all events, be able to accept the Amendment. Even if he cannot accept it as to the hospitals, I hope he will accept it as to the persons employed, so as to mitigate the evil in some way or other.
I beg to second the Amendment.
I hope the hon. Gentleman will not press this Amendment. He is really proposing to except hospital employés under this Schedule on account of the free medical treatment which they receive from the institution; that is to say, the medical treatment which they receive for a specified period without any guarantee of wages. It would be regarded as an adequate substitution for the benefits under the Act, and I am quite sure the hon. Gentleman will see that this free medical attendance in the institution cannot be made a substitution for the benefits under the Act. The proposal is to relieve the hospitals of all liability in respect of the provision by them of benefits received in the institutions which are far less than the benefits under the Act as a whole. Supposing one of these persons leaves the hospital, he would be excepted by the operation of the Act. What will happen then? It will affect him seriously in the future. The medical officer of the hos- pital who provides the medical treatment can, with the concurrence of the other panel doctors, go on the panel for the purpose of treating the employé of the hospital. That gives the hon. Gentleman what he desires, and, therefore, the Government cannot accept the Amendment.
The objection raised by the right hon. Gentleman is, I think, good in part. I quite agree with him that it would not be a proper thing for us to penalise the employés in hospitals in respect of sickness and disablement benefits, and to take from them what they have every right to expect. At the same time, as things now are, they are penalised in the other direction. If they were, and are now, receiving medical benefit, they are receiving treatment at the hospital, and therefore, in so far as they pay for that which they received before, they are in a worse position than they occupied before the Insurance Act was passed into law. Surely this goes for substituted benefit, and for a variation under Section 13 of the original Act! I do not gather that anything has been done in their favour. Why should not Section 13 be applied to their case? It is eminently one which ought to come under it, because I cannot see that there is any common advantage in a particular class of employé being damnified by the operation of the Insurance Act. That is what has happened. The Amendment of my hon. Friend may be far too wide, and I do not think the Government should be asked to accept it. It is a case that ought to be considered, for it has escaped their attention, and, so far as I know, the attention also of the Insurance Commissioners. I am glad that my hon. Friend has called attention to the case of hospital employés. I hope the right hon. Gentleman will give some assurance that the Commissioners will take action in the matter, as they are empowered to do under Section 13 of the original Act.
I am afraid the wording of Section 13 of the original Act is not very perfect in this respect, because the benefit which he wishes to have commuted is medical benefit, and I think the only two benefits which can be commuted under that Section are sickness and disablement benefits. There seems to be a reason why the Government, not perhaps in this Bill this Session, but in the Amending Bill next Session, which is already promised, should extend Section 13 so as to enable them to apply it to medical benefit as well as to sickness and disablement benefits, in order that what my hon. Friend proposes may be carried out.
Amendment negatived.
Clause 7—(Arrears Of Contributions)
(1) Where an employed contributor who is a member of an approved society pays to the society such part of any arrears which have accrued due by or in respect of him during any period of unemployment as would have been payable otherwise than by the employer had he continued in employment, the part which would have been so payable by the employer shall be excused, and the amount of the member's arrears shall be reduced accordingly. For the purpose of calculating the parts which would have been payable by the employer and otherwise than by an employer had an employed contributor continued in employment, the rate of his remuneration shall be deemed to exceed two shillings and sixpence a working day, unless he proves to the satisfaction of the society that his normal rate of remuneration was two and sixpence a working day or less, in which case his rate of remuneration shall be deemed to be such normal rate.
(2) Where in any year a society, or in the case of a society with branches a branch of a society, proves to the satisfaction of the Insurance Commissioners that the total number of weekly contributions which accrued due as arrears during the preceding year in respect of all its members who were employed contributors exceeded the standard number (that is to say three weekly contributions for every such member) then, for the purpose of recouping to the society the loss it will suffer, there shall be paid to the society, or to the society on behalf of the branch, as the case may be, out of the sums retained by the Insurance Commissioners for discharging their liabilities in respect of reserve values, the prescribed amount for every week by which the standard was so exceeded, but not exceeding the total amount so excused as aforesaid:
Provided that if the aggregate amount so payable in any year exceeds one hundred thousand pounds the excess shall be paid out of moneys provided by Parliament.
(3) The Insurance Commissioners may make regulations for carrying this Section into effect.
I beg to move, in Sub-section (1), to leave out the word "normal" ["his normal rate of remuneration"], and to insert instead thereof the word "usual."
This is the Clause which provides that in the case of arrears of contributions henceforward an employed contributor, who is in arrears, shall only pay his own contribution and shall not pay his employer's contribution. Then arises the difficult question as to what is the employer's contribution, because in the case of persons receiving less than 2s. 6d. per working day the employer's contribution may not be 4d. but may be run up to 5d. or 6d. Then comes the question, How are you going to ascertain in every case what is the employer's contribution from which the employed contributor shall be exempted? Of course, there are a large number of persons who are in occasional agricultural employment, and that is the class to which I wish particularly to refer the House in discussing this matter. This Clause provides that, in any case the onus shall be upon this man—and I think it is a serious onus—to prove to the satisfaction of the society that his normal rate of remuneration was either 2s. 6d. or less per working day. I think it is very difficult for that man, whether in good or bad employment, to prove to the executive of his society what his normal rate of remuneration was. What was clearly intended here by the expression "normal" was his usual rate of remuneration. I object to the word "normal," because it suggests the rate of remuneration when in continuous good employment. That is what the word "normal" conveys to my mind, and that is exactly what we do not want this unfortunate man to have to prove, because occasional employment may bring down his wages from 3s. to is. 6d. per day, and he ought to get the full benefit of the lower wage, or, in other words, the full benefit of the higher contribution which his employer would have made, and which the man, now that he is in arrears, is to be excused from paying. The word "normal" does not convey what the Clause is intended to meet. It does not convey what rate of pay the man has received, taking his wages over an average of days. It suggests rather the rate of remuneration he would get if in continuous, and for him, good employment. I suggest that the word "normal" does not meet the case in this class of labour, and that the word "usual" would be more likely to be inter- preted in his favour, as it is clearly intended we should interpret it.I beg to second the Amendment.
We had a long Debate on this matter in Committee. The word originally proposed by the hon. Member was "average" and we objected to that. I think he saw the force of the objection. We also object to the word "normal" on the same ground as the hon. Gentleman. I think "usual" is perfectly harmless, and we will accept the Amendment.
Amendment agreed to.
Further Amendments made: In Subsection (1), after the word "two" ["remuneration was two and sixpence a working day or less"], insert the word "shillings."—[ Mr. Bathurst.]
Leave out the word "normal" ["deemed to be such normal rate"], and insert instead thereof the word "usual."—[ Mr. Bathurst.]
:I beg to move, in Sub-section (2), to leave out the words "the standard number (that is to say three," and to insert instead thereof the word "two."
The effect of the Amendment, if carried, would be to relieve the funds of the approved society from an inroad which is about to be made upon them in respect of the remission of an insured person's arrears, and to place the liability which will arise upon the reserve value fund to a larger extent than is contemplated by the Bill.The Amendment, as I understand it, would mean that an increased amount would be required. The hon. Gentleman proposes to meet it by saying that the amount of the increased liability shall be paid out of the sinking fund, but if you increase the liability you are also bound to increase the contingent liability. He must, therefore, inevitably lay the charge on that fund.
The right hon. Gentleman was right on the former occasion, but he is not right now. There are three funds which would go to pay the amount remitted to the insured person in respect of arrears of contributions. The first, is the society's own funds, the second, is the sum not exceeding £100,000 from the reserve value fund, and then, if there is anything left, the money is provided by Parliament. What I am proposing is that part of the liability should be shifted from the approved societies fund on to the reserve value fund, and not on to the moneys provided by Parliament at all, and in order to protect the moneys provided by Parliament my consequential Amendment is that the £100,000 shall be changed into £150,000, so that Parliament shall not be called on to pay any money until £150,000 has been paid out of the reserve value fund. The right hon. Gentleman cannot say that this Amendment, with its difference between two weeks and three weeks, is going to make £50,000 difference or anything like it.
The question is whether the responsibility of the charge should be laid on the subject, and in this case there is not the slightest doubt that the subject will have to bear the contingent liability.
I will meet the right hon. Gentleman's point when I come to my Amendment lower down. I will not put in any limit or will put in such a large limit as will satisfy him that no charge shall be put on moneys payable by Parliament, and that question will not arise until we come lower down. I, therefore, submit that my Amendment is in order, and that I should be allowed to move it. We had a discussion in Committee upstairs on this. I feel it is necessary to ask hon. Gentlemen to follow what is being done by this Amendment, and how the funds of the society are being benefited. Therefore, I must ask forbearance for a moment while I try to explain what is happening under the original Act and what is going to happen under this Bill. Under the original Act a man contributes so long as he is in employment. He may, therefore, contribute fifty-two contributions in the year, but those fifty-two contributions are valued for the purpose of paying the benefits as if they were forty-eight only and not fifty-two, and there is a margin of at least three weeks, that are referred to in this Amendment. That three weeks are preserved in hand as a margin for the societies that do not receive fifty-two contributions. If, on the average, they receive forty-nine contributions in the course of the year, the number of the contributions they receive and their liabilities for benefits balance, and they will be in a state of exact solvency. If, on the other hand, they receive more than forty-nine contribu- tions, it is something that gives an additional margin out of which they can pay additional benefits, if in the course of time it accumulates to such a sum as will enable them to so employ it. This Bill says that in future employed contributors, in order to avoid the penalty of arrears, need not pay the employer's share of the contribution so long as they are unemployed. That will cost the society something. The Government says in this Bill, "We will refund the societies anything that they may lose in excess of the three weeks' average per annum," That is to say, the three weeks additional contribution which that society would receive from all the members who were employed for fifty-two weeks of the year, the three weeks in addition to the forty-nine, the standard, would be taken away from them to pay arrears owing to individual members not having to pay up employers' contributions when they are unemployed. The effect of my Amendment is that there shall be refunded to the approved societies any loss in excess of two weeks, instead of three weeks.
I hope that the Secretary to the Treasury will accept this Amendment. He did refuse in Committee an Amendment, which I think was moved by my hon. Friend the Member for Salisbury (Mr. G. Locker-Lampson), asking that the societies should be refunded any loss whatever that they suffered. The present Amendment is a more modest one, asking that they shall be refunded all loss which they suffer over two weeks. This will make a considerable difference to the societies. It may make a difference of £30,000 or £40,000 a year to the societies in the aggregate. But it is not only for the societies in the aggregate; it is for the particular societies that I am more concerned, because on some societies the effect of unemployment will be very much worse than on others. In some specialised societies—for example, the British Steel Smokers, or the Iron Tinplate Workers' approved societies, or such trade societies as I have in my mind—unemployment might very easily affect them to a much larger extent than it would affect a general society with members of all employments, where the risk of unemployment at any time would be spread over a large area, and not concentrated on a special trade. The British Steel Smokers have made a very elaborate calculation of the effect upon them of the Amending Act, and, as I understand the calculations, they con- sider that an extra liability is thrown upon their funds of £9,000, being about 22s. per member, and as against that there is an expectation for a slight increase of annual contributions of £312. The additional annual contribution is nothing like enough to pay the additional liability which is thrown upon them under this Bill. I hope the House will understand that I am in favour of the remission of the employed contributor's contribution while he is out of employment, but I want that loss made up to the society out of the reserve value fund, and not out of the margin which they will require for the purpose of sickness and invalidity claims. I say that they have no margin to spare, and if this Amendment is made it ought not to be made at the cost of the funds. It ought to be made at the cost of the reserve value funds. I am not asking that more money should be paid out of moneys provided by Parliament, but I am asking that the reserve value fund should be raided to the extent of £150,000 a year, if necessary, instead of to the limit of £100,000, which the right hon. Gentleman takes at the present moment.I beg to second the Amendment.
We had a very long discussion in the Committee on the whole of this question, and there may have been something—there was something—said as to whether greater obligations should not be undertaken by the State in connection with this matter if the State had funds for the purpose, but I must confess that there is no kind of argument at all, if I may say so with respect, for the particular proposition of the hon. Gentleman. What does it mean? The reserve funds are contributed by all societies, bad as well as good—I mean bad in unemployment as well as good in unemployment—and the more you take from the reserve fund and the greater charge you lay on it in favour of societies which have a small amount of unemployment, the more you definitely take away from the societies which have a large amount of unemployment. To him who hath you give, and from him who hath not, you take away even that which he seemeth to have. That is the worst possible way of dealing with this subject. The whole idea underlying the paying of arrears of contributions in part out of this reserve fund was that there should be a kind of capitalisation of risk of unemployment. Consequently, the main benefit goes to these societies which have a large amount of unemployment. The hon. Gentleman by this proposition would make the benefit go to those societies who are so lucky as to have a small amount of unemployment. We must first see how this Clause works, as there are so many factors of which we must have experience. For instance, no one knows how many societies will pay the employer's contribution which they are authorised to do. No one knows how much the fact that a man has now to pay up only fourpence to get rid of arrears instead of sevenpence will increase the number of fourpences paid up, or how many more fourpences will be paid up than there would have been sevenpences, and how those fourpences will bring up the particular profits of those societies. That profit is not at all allowed for in the actuarial calculations, and any money so paid is a pure gain to the society. I confess that I cannot accept figures such as those which the hon. Gentleman advances because they leave out all these calculations, which at present I agree is inevitable, and he says that they only gain £312. We cannot tell how much arrears will be paid off nor how many more people will be willing to pay arrears now that the sevenpence is taken away from it. All these are facts which must be taken into consideration, and I submit that it is better to let the Clause work as it stands. It is a very great boon. Two sources, the State and the sinking fund, certainly contribute. Possibly the society contributes also, though to a limited extent, though I must confess that all my advisers, my actuaries, including one of the most brilliant
Division No. 257.]
| AYES.
| [5.29 p.m.
|
| Abraham, William (Dublin, Harbour) | Boyle, Daniel (Mayo, North) | Crumley, Patrick |
| Acland, Francis | Brace, William | Cullinan, John |
| Addison, Dr. Christopher | Brady, Patrick Joseph | Davies, David (Montgomery Co.) |
| Adkins, Sir W. Ryland D. | Brocklehurst, W. B. | Davies, Ellis William (Eifion) |
| Alden, Percy | Brunner, John F. L. | Dawes, J. A. |
| Allen, Arthur A. (Dumbartonshire) | Bryce, J. Annan | De Forest, Baron |
| Allen, Rt. Hon. Charles P. (Stroud) | Burke, E. Haviland- | Delany, William |
| Arnold Sydney | Burt, Rt. Hon. Thomas | Denman, Hon, R. D. |
| Atherley-Jones, Llewellyn A. | Buxton, Noel (Norfolk, North) | Devlin, Joseph |
| Baker, H. T. (Accrington) | Buxton, Rt. Hon. Sydney C. (Poplar) | Dickinson, W. H. |
| Baker, Joseph Allen (Finsbury, E.) | Byles, Sir William Pollard | Dillon, John |
| Balfour, Sir Robert (Lanark) | Carr-Gomm, H. W. | Donelan, Captain A. |
| Banbury, Sir Frederick George | Cawley, Sir Frederick (Prestwich) | Doris, William |
| Barlow, Sir John Emmott (Somerset) | Cawley, Harold T. (Lancs., Heywood) | Duffy, William J. |
| Barnes, G. N. | Chancellor, Henry George | Duncan, C. (Barrow-in-Furness) |
| Beale, Sir William Phipson | Chapple, Dr. William Allen | Edwards, Clement (Glamorgan, E.) |
| Beck, Arthur Cecil | Clancy, John Joseph | Edwards, John Hugh (Glamorgan, Mid) |
| Benn, W. W. (T. Hamlets, St. George) | Clough, William | Elverston, Sir Harold |
| Bentham, G. J. | Collins, G. P. (Greenock) | Esmonde, Dr. John (Tipperary, N.) |
| Bethell, Sir J. H. | Condon, Thomas Joseph | Esmonde, Sir Thomas (Wexford, N.) |
| Birrell, Rt. Hon. Augustine | Cornwall, Sir Edwin A. | Essex, Sir Richard Walter |
| Boland, John Pius | Cotton, William Francis | Falconer, James |
| Booth, Frederick Handel | Cowan, W. H. | Fenwick, Rt Hon. Charles |
| Bowerman, C. W. | Craig, Herbert J. (Tynemouth) | Ferens, Rt. Hon. Thomas Robinson |
actuaries in England, Mr. Watson, and the very skilled actuarial Committee to which this question was referred at my request, both of them say, that taking the subject as a whole, and speaking generally, there should be no loss to the societies through the operation of this Clause.
A most remarkable change has come over the attitude of the Government on this question on Report as compared with their attitude in Committee. In the Committee stage, when it was possible to move an Amendment which would have thrown this on the National fund, the right hon. Gentleman adopted that Clause of the Bill which takes £100,000 away from the reserve value. To-day, when it is impossible to move that any part of it should fall upon the State, the right hon. Gentleman says, "how wicked it would be to take from the reserve valuation. It is taking from him who hath not, and giving to him who hath." If that be a sound argument at all, why should he have done so under the Bill to the extent of £100,000 a year?
On that point the whole question is this: The hon. Gentleman proposes to add extra money to the reserve value for the purpose of directly giving money to the societies which have very little unemployment. That is a perfectly new proposition. We say that the money should be given to the societies which have a very large percentage of unemployment.
Question put, "That the words proposed to be left out stand part of the Bill."
The House divided: Ayes, 259; Noes, 81.
| Ffrench, Peter | Macdonald, J. Ramsay (Leicester) | Rea, Rt. Hon. Russell (South Shields) |
| Field, William | Macdonald, J. M. (Falkirk Burghs) | Rea, Walter Russell (Scarborough) |
| Fitzgibbon, John | McGhee, Richard | Reddy, Michael |
| Flavin, Michael Joseph | Maclean, Donald | Redmond, John E. (Waterford) |
| France, Gerald Ashburner | Macnamara, Rt. Hon. Dr. T. J. | Redmond, William (Clare, E.) |
| George, Rt. Hon. D. Lloyd | MacNeill, J. G. Swift (Donegal, South) | Redmond, William Archer (Tyrone, E.) |
| Gill, A. H. | Macpherson, James Ian | Richardson, Thomas (Whitehaven) |
| Ginnell, Laurence | MacVeagh, Jeremiah | Roberts, Charles H. (Lincoln) |
| Gladstone, W. G. C. | M'Callum, Sir John M. | Roberts, G. H. (Norwich) |
| Glanville, H. J. | M'Laren, Hon. H. D. (Leics.) | Roberts, Sir J. H. (Denbighs) |
| Goldstone, Frank | M'Laren, Hon. F.W.S. (Lincs.,Spalding) | Robertson, J. M. (Tyneside) |
| Greig, Colonel J. W. | Manfield, Harry | Roche, Augustine (Louth) |
| Griffith, Ellis J. | Marks, Sir George Croydon | Roe, Sir Thomas |
| Guest, Major Hon. C. H. C. (Pembroke) | Marshall, Arthur Harold | Rowlands, James |
| Guest, Hon. Frederick E. (Dorset, E.) | Masterman, Rt. Hon. C. F. G. | Rowntree, Arnold |
| Gwynn, Stephen Lucius (Galway) | Meagher, Michael | Runciman, Rt. Hon. Walter |
| Hackett, John | Meehan, Francis E. (Leitrim, N.) | Samuel, Rt. Hon. H. L. (Cleveland) |
| Hall, Frederick (Yorks, Normanton) | Meehan, Patrick J. (Queen's Co., Leix) | Samuel, J. (Stockton-on-Tees) |
| Harcourt, Rt. Hon. Lewis (Rossendale) | Middlebrook, William | Scanlan, Thomas |
| Harcourt, Robert V. (Montrose) | Millar, James Duncan | Scott, A. MacCallum (Glas., Bridgeton) |
| Harmsworth, Cecil (Luton, Beds.) | Molloy, Michael | Seely, Rt. Hon. Colonel J. E. B. |
| Harmsworth, R. L. (Caithness-shire) | Molteno, Percy Alport | Sheehy, David |
| Harvey, A. G. C. (Rochdale) | Money. L. G. Chiozza | Shortt, Edward |
| Harvey, T. E. (Leeds, West) | Morgan, George Hay | Simon, Rt. Hon. Sir John Allsebrook |
| Hayden, John Patrick | Morrell, Philip | Smith, Albert (Lancs., Clitheroe) |
| Hayward, Evan | Morison, Hector | Smyth, Thomas F. (Leitrim, S.) |
| Hazleton, Richard | Morton, Alpheus Cleophas | Snowden, Philip |
| Hemmerde, Edward George | Muldoon, John | Stanley, Albert (Staffs, N.W.) |
| Henderson, J. M. (Aberdeen, W.) | Munro, R. | Strauss, Edward A. (Southwark, West) |
| Henry, Sir Charles | Munro-Ferguson, Rt. Hon. R. C. | Sutton, John E. |
| Hewart, Gordon | Murray, Captain Hon. Arthur C. | Taylor, John W. (Durham) |
| Higham, John Sharp | Neilson, Francis | Taylor, Theodore C. (Radcliffe) |
| Hinds, John | Nolan, Joseph | Taylor, Thomas (Bolton) |
| Hobhouse, Rt. Hon. Charles E. H. | Norton, Captain Cecil W. | Tennant, Harold John |
| Hodge, John | Nugent, Sir Walter Richard | Thomas, J. H. |
| Hogge, James Myles | Nuttall, Harry | Thorne, G. R. (Wolverhampton) |
| Holmes, Daniel Turner | O'Brien, Patrick (Kilkenny) | Thorne, William (West Ham) |
| Holt, Richard Durning | O'Connor, John (Kildare, N.) | Toulmin, Sir George |
| Howard, Hon. Geoffrey | O'Connor, T. P. (Liverpool) | Trevelyan, Charles Philips |
| Hughes, S. L. | O'Doherty, Philip | Ure, Rt. Hon. Alexander |
| Isaacs, Rt. Hon. Sir Rufus | O'Donnell, Thomas | Wadsworth, John |
| John, Edward Thomas | O'Dowd, John | Walsh, Stephen (Lancs., Ince) |
| Jones, Rt.Hon.Sir D.Brynmor (Sw'nsea) | O'Grady, James | Ward, John (Stoke-upon-Trent) |
| Jones, Henry Haydn (Merioneth) | O'Kelly, Edward P. (Wicklow, W.) | Wardle, George J. |
| Jones, J. Towyn (Carmarthen, East) | O'Malley, William | Waring, Walter |
| Jones, William (Carnarvonshire) | O'Neill, Dr. Charles (Armagh, S.) | Webb, H. |
| Jones, W. S. Glyn- (Stepney) | O'Shaughnessy, P, J. | White, J. Dundas (Glasgow, Tradeston) |
| Jowett, F. W. | O'Shee, James John | White, Patrick (Meath, North) |
| Joyce, Michael | O'Sullivan, Timothy | Whittaker, Rt. Hon. Sir Thomas P. |
| Keating, Matthew | Outhwaite, R. L. | Whyte, A. F. (Perth) |
| Kellaway, Frederick George | Palmer, Godfrey Mark | Williams, J. (Glamorgan) |
| Kelly, Edward | Parker, James (Halifax) | Williams, Llewelyn (Carmarthen) |
| Kennedy, Vincent Paul | Pearce, Robert (Staffs, Leek) | Wilson, Hon. G. G. (Hull, W.) |
| King, J. | Pease, Rt. Hon. Joseph A. (Rotherham) | Wilson, John (Durham, Mid) |
| Lambert, Richard (Wilts, Cricklade) | Phillips, John (Longford, South) | Wilson, Rt. Hon. J. W. (Worcs., N.) |
| Lardner, James C. R. | Pointer, Joseph | Wilson, W. T. (Westhoughton) |
| Law, Hugh A. (Donegal, W.) | Ponsonby, Arthur A. W. H. | Wing, Thomas Edward |
| Lawson, Sir W. (Cumb'rld, Cockerm'th) | Price, C. E. (Edinburgh, Central) | Wood, Rt. Hon. T. McKinnon (Glasgow) |
| Leach, Charles | Priestley, Sir W. E. B. (Bradford, E.) | Young, William (Perthshire, E.) |
| Levy, Sir Maurice | Primrose, Hon. Neil James | Yoxall, Sir James Henry |
| Lewis, Rt. Hon. John Herbert | Pringle, William M. R. | |
| Lundon, Thomas | Radford, G. H. | TELLERS FOR THE AYES.—Mr. Illingworth and Mr. Gulland. |
| Lyell, Charles Henry | Raphael, Sir Herbert H. | |
| Lynch, A. A. |
NOES.
| ||
| Agg-Gardner, James Tynte | Craig, Ernest (Cheshire, Crewe) | Gretton, John |
| Baird, John Lawrence | Craik, Sir Henry | Hamilton, C. G. C. (Ches., Altrincham) |
| Baldwin, Stanley | Dalrymple, Viscount | Harris, Henry Percy |
| Baring, Maj. Hon. Guy V. (Winchester) | Dalziel, Davison (Brixton) | Henderson, Major H. (Berkshire) |
| Barnston, Harry | Denniss, E. R. B. | Henderson, Sir A. (St. Geo., Han. Sq.) |
| Bathurst, Charles (Wilts, Wilton) | Duncannon, Viscount | Hoare, S. J. G. |
| Bentinck, Lord Henry Cavendish- | Eyres-Mansell, Bolton M. | Hope, James Fitzalan (Sheffield) |
| Bird, Alfred | Fell, Arthur | Hope, Major J. A. (Midlothian) |
| Blair, Reginald | Finlay, Rt. Hon. Sir Robert | Horner, Andrew Long |
| Boyle, William (Norfolk, Mid) | Fisher, Rt. Hon. W. Hayes | Hunt, Rowland |
| Bridgeman, W. Clive | Fitzroy, Hon. Edward A. | Ingleby, Holcombe |
| Burn, Colonel C. R. | Forster, Henry William | Kinloch-Cooke, Sir Clement |
| Cassel, Felix | Glazebrook, Captain Philip K. | Lawson, Hon. H. (T. H'mts., Mile End) |
| Cator, John | Goldsmith, Frank | Lloyd, George Butler (Shrewsbury) |
| Cecil, Evelyn (Aston Manor) | Gordon, Hon. John Edward (Brighton) | Locker-Lampson, G. (Salisbury) |
| Cecil, Lord R. (Herts, Hitchin) | Goulding. Edward Alfred | Lowe, Sir F. W. (Birm., Edgbaston) |
| Clay, Captain H. H. Spender | Grant, J. A. | MacCaw, William J. McGeagh |
| Clive, Captain Percy Archer | Greene, Walter Raymond | Magnus, Sir Philip |
| Mount, William Arthur | Sanders, Robert Arthur | Tullibardine, Marquess of |
| Newdegate, F. A. | Spear, Sir John Ward | White, Major G. D. (Lancs., Southport) |
| Newman, John R. P. | Stanley, Hon. G. F. (Preston) | Wills, Sir Gilbert |
| Orde-Powlett, Hon. W, G. A. | Steel-Maitland, A. D. | Wolmer, Viscount |
| Pease, Herbert Pike (Darlington) | Stewart, Gershom | Wood, John (Stalybridge) |
| Pollock, Ernest Murray | Swift, Rigby | Yate, Colonel C. E. |
| Pryce-Jones, Col. E. (M'tgomy B'ghs) | Talbot, Lord E. | Younger, Sir George |
| Handles, Sir John S. | Thompson, Robert (Belfast, North) | |
| Roberts, S. (Sheffield, Ecclesall) | Thomson, W. Mitchell- (Down, N.) | TELLERS FOR THE NOES.—Mr. Worthington-Evans and Mr. F. Hall |
| Salter, Arthur Clavell | Tryon, Captain George Clement |
Clause 8—(Calculation Of Arrears)
Subject to the provisions of Sub-section (4) of Section ten of the principal Act insured persons who are in arrear shall be liable to such suspension or reduction of benefits as may be prescribed so, however, that any such reduction or suspension of benefit shall be approximately equivalent to the value of the loss occasioned by the failure to pay the contributions in arrear, and the provisions of the principal Act regulating the suspension and reduction of benefits on account of arrears shall cease to have effect, and the regulations may prescribe the time within which, and the conditions under which, arrears may be paid up.
I beg to move, after the word "regulations" ["the regulations may prescribe"], to insert the words "of the Insurance Commissioners." This Clause deals with the calculation of arrears—
:I agree.
Amendment agreed to.
I beg to move, at the end of the Clause, to add the words,
It appears to me that though this is a somewhat complicated matter, at the same time there are insured persons who are sent abroad to work, and are absent for perhaps two years, and it might well be that, while they are absent, they might become suspended. I want to ask the right hon. Gentleman how a suspended person can get back into insurance if there is no reserve value credited to his society. I do not know whether the same question applies to an expelled person, but it looks to me that some persons who return from abroad would find that they could not get the society to take them back as there was not a reserve value to its credit."And shall prescribe that if at any time after suspension from benefits an insured person becomes employed, and within three months thereafter becomes a member of an approved society, there shall be credited to such approved society a reserve value applicable to his age as if he had then joined insurance for the first time, and at a date within one year from the passing of the principal Act."
I do not want to take any unfair point; but surely, if some of these people are to be brought back into insurance it must necessarily mean an increased charge so far as the two-ninths of the benefit are concerned.
I understand that this reserve value will not be an increased charge. It will come out of the reserve value fund; and if a man, once suspended, could not get back into insurance, surely you would be punishing him for life in respect of a small offence; he never could get back into any approved society.
I agree, but this question was not raised by the hon. Gentleman in Committee, otherwise we might have had an interesting discussion. But surely, if you bring persons back into insurance it must be an increased charge on the taxpayer in respect of two-ninths of the benefit which would not otherwise have to be paid.
If the right hon. Gentleman takes that view, surely he should address himself, not to my hon. Friend, but to the Chair!
I confess I am not sufficiently skilled in this matter to be able to detect these things until I hear the arguments, but I think it is clear—
Before you rule, Sir, on the matter, may I point out that my hon. Friend is asking that a man who is suspended from benefit and goes out of insurance shall have the reserve value which was his before he went away when he comes back? He had a reserve value before he went away, and, when he comes back, he does not increase the charge, because he has that reserve value which was his before he went out. What my hon. Friend wants is that if the man comes back he should have that reserve value.
If he comes back, and comes into insurance, there must necessarily be an increased cost to the State with respect to the two-ninths of the benefit.
The real question is that the person has the reserve value before he goes out, and the same reserve value will do for him when he comes back.
That is not the proposition before the Committee. The proposition is for a new reserve value and a new insurance, and the old reserve value remains; and of the new reserve value for a new insured person, the State pays two-ninths.
I submit that the Amendment makes no greater charge than the original proposal made in Committee, and the right hon. Gentleman's argument that it would be a greater charge should have been made in Committee.
I do not profess to understand all these matters, but having heard the arguments, I think that the Amendment does increase the charge. A man comes back and finds that his former status as an insured person has disappeared, and he has to start de novo. In consequence the charge is increased.
This is not exactly a point of Order, but I wish to point out that we will consider the hon. Gentleman's suggestion. I do not want to rule out any suggestion which is made in good faith, but which I am quite sure is not in order.
May I withdraw the Amendment? I do hope the Government will consider the platter, as it seems to me there will be very great hardship.
Would I be in order in moving to omit the Clause for the purpose of discussing its provisions? If so, I will move to that effect.
That cannot now be done, as an Amendment was moved.
Clause 9—(Benefits Of Exempted Persons)
(1) Regulations made by the Insurance Commissioners under Sub-section (4) of Section four of the principal Act shall provide for applying the contributions paid in respect of persons who hold certificates of exemption in providing medical benefit and sanatorium benefit for such persons and the cost of the administration of such benefits, and such persons shall, if they fulfil such conditions as may be imposed by those regulations, become entitled to medical benefit and sanatorium benefit as if they were members of approved societies, and the provisions of the principal Act and this Act with respect to the payment and administration of those benefits (including those relating to the application of moneys provided by Parliament towards the cost of those benefits and the expenses of the administration thereof) shall, subject to any modifications, adaptations, and exceptions contained in the regulations, apply accordingly.
Provided that—
(2) This Section shall apply to persons in Ireland with this modification, that the benefits to be provided shall be such as may be specified in a scheme framed by the Irish Insurance Commissioners, but the sum to be contributed out of moneys provided by Parliament towards the cost of those benefits and the administration thereof shall be the same as if the benefits were benefits to insured persons.
I beg to move, to leave out the Clause.
I do so for the purpose of raising a very important point, namely, as to what ought to be done with that part of the contribution which is provided by the employer in the case of exempted persons. The House will remember that under Section 2 of the original Act there were two classes of people who could be exempted, a person in receipt of any pension or income of the annual value of £26 or upwards and not dependent upon his personal exertions, or partly or mainly dependent for livelihood on some other person. It is proposed in this particular Clause that the money paid by the employer shall be used for certain purposes. I want the House to consider whether those are the best uses that can be made of that particular money. Because I think there is no particular hurry why we should decide in this Bill the ultimate destination of that money; there is then no particular grievance in omitting this Clause from the Bill. These people pay nothing. They are absolutely non-contributory, and, therefore, not entitled, as a matter of fact, to anything. They either have money of their own or they have people looking after them. The reason the employer is asked to pay is to prevent preferential employment of those people, and to prevent other people being handicapped. Under the original Act it will be recalled that the Insurance Commissioners have no specific regulations with regard to those people, except the direction in the case of the provision of reserve values for those people who may subsequently become employed contributors, and presumably, applicable mainly to apprentices. I notice in the Annual Report on the National Insurance Act, Part I., that there is a remarkable set of figures dealing with these two particular cases of exemption. On page 169 of that Report we get the total number of certificates of exemption granted up to the 31st March, 1913, as 91,751. More than 50 per cent. of that number are people who are in receipt of a pension or income. There are 27,235 who are granted exemption on the ground that they have a pension mainly in connection with the Navy, the Army, and the police, and there are 28,976 who have exemption on account of them having the income necessary to keep them outside the provisions of the Act, or altogether 56,211. When you come to the other Section, those who are dependent upon the exertions of some other individual, you find that the married women who are dependent upon their husbands, total no fewer that 19,292. Those people are not contributing anything, and are therefore not entitled to anything, but by this Clause are going to receive benefits which I suggest might be used for other purposes, and purposes which would help other classes of the community more deserving of help than they are. For instance, if you compare those 19,292 married women who are dependent on their husbands with the widow or the spinster who is casually employed, those married women may be receiving under this new Clause benefits which are denied to those other women. I think everybody in the House will agree that that class of woman is much more entitled to whatever benefit can be re- ceived than the married woman who is dependent upon her husband. Similarly, with the apprentices, who are the next class on this particular list. It is a very valuable thing to them to have this particular reserve value when they become employed contributors. As a matter of fact, in some cases those benefits will be a very large addition to the subsidy which is already provided for doctors under this Act, because if the House will turn it over in its mind it will realise that a large number of apprentices are sons of wealthy parents, apprentices, for instance, in the legal profession, in chartered accountancy, or in architects' offices, none of whom in any case would ever make any attempt to draw this particular benefit. I may be asked what alternatives can be suggested, and I have thought of one or two which may lead the House to a useful discussion on this matter if they do not care to omit the Clause. There is the great problem of what is to be done ultimately with the deposit contributors under the original Act. It has been suggested before that they will ultimately have to be put into an approved society which may be handled by the Commissioners themselves. We all know that these deposit contributions are in a special class by themselves, and that it may be necessary to find money to put them in a position which would warrant us in setting up a special society under the control of the Commissioners. There is one object to which this money could be devoted, the subsidising of a society of deposit contributors. There is another suggestion which appeals to me even more than that, and that is the casual worker. The House knows that the casual worker may never be in benefit because of his inability to pay up arrears, and the conditions of his work are such that he is not able with the same facility as other workmen to achieve that purpose. Why not, then, have a scheme by subsidies to keep the casual worker in benefit by assisting him to pay up his arrears? There is a valuable object for which this money could be used. Thirdly, there are cases which I do not think ought to have arisen under the Act and to which I would have addressed myself had not the Amendment I put down been ruled out of order. Why not use some of this money to complete the medical service in cases of consultation and operations, and such matters as that? My principal point is that I do not understand the urgency now of this money, which is not contributed by these people, being used for these purposes when those are the figures of the first year's working with regard to exemptions. I think there are other uses to which this money could be devoted which would bring about very much more substantial results than those suggested in the Clause; therefore I beg to move.I beg to second the Amendment.
There was some debate upon this Clause in Committee, and I think that the result of that debate was that there was a general agreement that the scheme proposed for dealing with the contributions that come under this Section was the scheme which was most likely to benefit the persons affected. To begin with, I think I should take exception to my hon. Friend's suggestion that the money should be used outside the class of persons who are dealt with. He has suggested alternatives to which this money should go, but in so far as I have had experience of the working of this matter a good deal of the complaints have come not from the employed, but from the employers, who say, "Why should I pay for persons who are getting no benefit?" There is the reason, of course, that we do not want to encourage those persons at the expense of ordinary employed persons, and, therefore, we have to make this condition. But most of the employers are quite willing to agree if this money which they pay does go to the benefit of their own employés in respect of whom it is paid, and in that event a good deal, if not the whole, of their objection to it would cease. Therefore, I submit that any scheme that we prepare ought to have that condition laid down, that it should be a scheme for the benefit of the persons in whose respect this money is paid. Then there came the question before us of how much money we had got to pay, and that we could not find out until we had some months' experience of the Act. Even now we cannot say that we have any certain knowledge of the number of those exempt persons. On the one hand, exempt persons are always joining approved societies and coming into full insurance, as they realise the full advantages of full insurance, and, on the other hand, more persons come into the catalogue of exempt persons from time to time.
6.0 P.M. But on the figures which are given our actuaries tell us that we should be safe in the scheme which we are propounding in this Bill—that is, the scheme to give to all these persons at least medical and sanatorium benefit. When I say "at least," I mean to signify that if there is any more money than that which would be used in providing medical and sanatorium benefits, it can be used later on for their advantage. In providing these benefits we are not taking away from them the possibility of obtaining maternity benefit or sickness benefit or any other, if it is proved, in time, that the money is available to meet those particular demands. The reason why it was necessary for us to bring in medical benefit under the Bill, instead of merely prescribing that the money should go to that benefit, was because the giving of medical benefit means a payment by the Exchequer which any other benefit would not mean. If it is desirable, as everyone seems to think it is, except myself, that money should be transferred from the State to the insured person, then, in so far as we are giving medical benefit, we are giving these people far greater advantages than they would have by giving them any other. They are getting medical attendance for the amount which is paid in respect of them, and that will cost the Government something like £20,000. Why did we choose medical benefit? A large number of these persons are pensioners of a certain age, and recommendations were made in respect, to them that what they wanted above all else was free medical attendance. Another considerable number are persons in very poor circumstances indeed, and who are not able to afford insurance. There are persons, for instance, living in the poorer districts of London, who have obtained exemption certificates because they are mainly dependent on other persons; they are working, and they would like insurance if they could afford it. Strong representations were made in their interests by women's trade unions and other working women's societies; it was stated that what was wanted by these persons, who are scarcely every really well, was medical attendance and treatment, and that if that, could be given it would be a very great boon. The employers, too, who are paying subscriptions, ought to have some voice in the matter. All those whom I have consulted on the matter say, "It would be in our interests as well as in the interests of the insured persons if you could give medical attendance, because the more they are kept well the better it is for us as well as for them." With such a concentration of interests upon this benefit, I think I had no alternative but to propose it to the House. It is a benefit only to be given by mutual insurance. Everyone has to come in in order that they may get medical benefit. Therefore we are turning this fund into a mutual insurance fund, and by the help of the contribution from the State it will be able to give all these people who need it medical attendance.My quarrel is not at all with the nature of the benefit. My point is that here, in a Bill which has gone very hurriedly through the House and has not been considered in all its aspects, you are ear-marking for a particular purpose a sum of money which many of us think might be devoted more advantageously to other purposes. The right hon. Gentleman has said that the employers pay a contribution. But, after all, the employers get back that contribution from the community. There is no employer to-day who has not to a large extent passed on his share of contribution under the Insurance Act to the consumer, that is the general public. It is the general public in the long run who have to make this contribution, and the more effective purpose to which the money could be put would be in dealing with the poorer sections of the community, who are paying under considerable difficulty owing to the increased cost of living, rather than those people the list of whom I have read out. The right hon. Gentleman drew a pathetic picture of persons in the East End of London dependent on other people. But in this list there are only 3,724 out of 91,751. Nearly 75 per cent. of these people do not require this benefit nearly so much as the poor widows and spinsters engaged in casual employment. All I am asking is that the right hon. Gentleman should not ear-mark this fund in this particular way in a Bill which, after all, is only one contribution towards the Amendment of the original Act, but should leave it open so that these sums of money could be dealt with in other ways. I hope he will agree to that.
Amendment negatived.
I beg to move, after the word "benefit" ["providing medical benefit and sanatorium benefit"], to insert the words "or, in accordance with the scheme to be approved by the Insurance Commissioners, one or more of the other benefits or additional benefits set out in the principal Act if preferred."
Although the right hon. Gentleman has possibly made out a good case against eliminating the whole Clause, I do not think that what he has said militates against this particular Amendment. If this Amendment is accepted, it will be necessary to make a consequential alteration by inserting later in the Clause the words, "or such other benefits as aforesaid." I cannot understand why the right hon. Gentleman should limit the benefits he is going to give to these persons to medical and sanatorium benefits. I do not see that there is any reason at all for so doing, because, after all, medical benefit will not be wanted by various classes of people who are to get the benefit of the employer's contribution. Take a man working under a medical practitioner. Such a man, if he happens to be an exempted person, obviously will not want medical benefit under this Clause. There are various other classes who might be named. It seems rather hard that if they do not want medical benefit, and do not happen to be suffering from tuberculosis, they should not be able to get some alternative benefit. If the right hon. Gentleman accepts the Amendment it will not add in the least to the cost of the scheme. In Committee the right hon. Gentleman said it would be very difficult indeed to give alternative benefits, because actuarialy it might be almost impossible to arrange the benefits individually. I have, therefore, after consultation with an actuarial friend of mine, altered the Amendment by putting in the words "in accordance with a scheme to be approved by the Insurance Commissioners." My friend assures me that it would be perfectly possible, by some pooling arrangement under regulations issued by the Insurance Commissioners, to give alternative benefits if they happened to be required by any of these persons. I hope the right hon. Gentleman will consider this Amendment favourably.I beg to second the Amendment.
I would point out that in the case of Ireland it is provided that. a scheme of benefits may be framed by the Commissioners. If it is possible to do it in the case of Ireland, it is a little difficult to see why it should be impossible on this side of St. George's Channel, unless there are some political reasons. All that my hon. Friend proposes is that the Commissioners should be empowered to frame a scheme for alternative benefits, and it would be only reasonable that that power should be given to the Commissioners on both sides of St. George's Channel.I can disabuse the hon. Member's mind at once of any idea that any preferential treatment has been given to Ireland for any other reasons than the necessities of the case. The hon. Member for Salisbury suggests that we should give other ordinary or additional benefits. But you have only the employer's contribution, and my right hon. Friend has shown that it is very doubtful indeed whether you could provide sickness and disablement benefits if they were chosen. This is mutual insurance, and if you granted a choice to certain individuals you would not be able to carry out your scheme. For sickness or disablement benefit you want reserve values. You have not any reserve values here, and you have no machinery for creating them. Therefore, I think, we have done all we can with this particular fund. The acceptance of the Amendment would make it quite impossible to carry out the scheme.
The right hon. Gentleman's arguments, if applied to the original Act, would have prevented the insertion of Section 13 as applicable to insured persons. What my hon. Friend is now suggesting is that these exempted persons who ought to get some insurance in respect of the employer's contribution should have, if they wish it, and the Insurance Commissioners formulate a scheme for the purpose, the same power of choice as is given to insured persons. Insured persons, if schemes are brought in by approved societies, can have alternative benefits under Section 13, and the same reasons which made the House at the last moment allow that Section to be put into the original Act ought to make the House accept my hon. Friend's Amendment on this occasion. The right hon. Gentleman argued that they cannot have sickness or invalidity benefit because both these benefits require a reserve value. They do not require a reserve value. Why should they? It is better to have a reserve value because you can give a bigger benefit. But in the original Act those who are over sixty-five were entitled to sickness benefit, but there was no reserve value provided for them. If the right hon. Gentleman could provide a reserve value for exempted persons, they would be able to get a better benefit; but if he cannot provide a reserve value for them, at least he can give them the same sort of sickness benefit as was given to people over sixty-five years of age under the original Act. Neither of the arguments adduced by the Government really meet the case put forward by my hon. Friend. I hope the House will see that an alternative benefit is provided to the extent of the contribution. As it is, all that is intended to be given to these exempted persons is a benefit which absorbs about half the sum that is paid in contributions for them by their employers. The Report of the Insurance Commissioners has shown that about 11s. 4d.—I think it is 11s. 4d.—is the average that is paid in respect of each of these exempted persons. Seven-ninths of the medical and sanatorium benefits come, I think, to 5s. 7d. There is, therefore, a balance to their credit of 5s. or 5s. 9d.; and unless the whole of that is going to be absorbed in administrative expenses, there is certainly nothing against giving a reasonable alternative benefit. I hope my hon. Friend will press his Amendment to a Division.
This is just one of those arguments which, when put before the House, ought to make the Government adhere to the Clause and resist the Amendment. The arguments are that these exempted persons do not themselves contribute towards this benefit, and there was a proposal, therefore, that the benefits might be used for other people. That was resisted. Now an Amendment is before the House to the effect that not only should benefit be given to exempted persons, but that the exempted persons, who pay nothing, should have a choice of which benefit they should receive. The money to provide these benefits comes from the employers, and from the State, and it does seem to me that in deciding what benefits are to be given in relation to those contributions, we ought to consider the interests of the State and of those employers. Let me take a case of a pensioner. Most employers, I think, to-day would feel a sort of moral obligation if that person became ill to provide him or her with medical or sanatorium treatment. I think it is only right if we force the employer to pay a contribution in relation to that person, we should, at any rate, relieve the employer of that obligation to provide medical benefit for that person if he becomes ill. I do not say there is a legal, but a moral obligation. The same thing applies to sanatorium benefit. You refer to the State contribution, surely no better return can be given to the State for its contribution than that this exempted population should receive adequate medical or sanatorium treatment.
May I inquire what is going to be done with the other half of the amount referred to if medical and sanatorium benefit only takes one-half of the contributions? Will you not leave it to the Insurance Commissioners to frame some scheme which may give something in addition to the medical or sanatorium benefits, or some substituted benefit, which will cover the whole ground and not only use up part of the money? That is the real point!
I can answer that in a moment. There is another charge laid on this fund; that is a charge that money shall be provided out of this fund for reserve values if any of these people subsequently enter into insurance. It is a very important charge, though of rather an indefinite amount. We must keep a reserve in order to meet that charge, since we have no indication of what kind of average amount may be required to meet it. It will be perfectly possible that then whatever money is left may be used for such benefit. But let the hon. Member be quite clear: this is a separate fund. No money will be used except for the benefit of persons in that fund.
I think what the right hon. Gentleman has just said really adds strength to the case that my hon. Friend behind me has made out. The right hon. Gentleman says he does not know how much will be required out of the balance; how much will remain after medical and sanatorium benefit has been provided. It may not absorb the whole balance remaining to the credit of the insured individual. If the House accepts the Amendment, of my hon. Friend, the Insurance Commissioners, as soon as they are in a position to decide how much is needed for each one of those contributions, will be able to set themselves to work and frame a scale of benefit which will absorb the balance. If a scale of benefit were framed, each individual would be able to choose for himself what he would have. I really cannot see why the House should not adopt this suggestion. It will give a little elasticity. It will give a little time to the insured persons to choose. It will not inflict any damage upon anybody. I therefore hope the House will accept the Amendment.
May I, in a single word, point out to the hon. Gentleman opposite that we had this matter put forward in the Debates in connection with the principal Act? If the hon. Member will turn to Section 13 of the principal Act, he will see that where we gained elasticity we particularly exempted those two benefits, the medical and the sanatorium benefit, and we did not allow any of the insured persons to choose other benefits than those. The argument is precisely the same now. It was just because of the nature of these benefits that we decided to use them in this particular case.
The speech of the hon. Gentleman who has just spoken is the kind of speech that I never let pass if I have an opportunity of protesting against them. It is the vice of the whole of this scheme of insurance, which is really making it so difficult of acceptance in the country; it is this insane idea that the people who sit here know so much more about the matter than everybody else, and than the people themselves concerned. For my part, I shall certainly vote for this Amendment, if pressed, for it seems to me perfectly clear that if you can give greater elasticity to this Act it is better to do so. That is a proposition which seems to me to be absolutetly incapable of refutation. I have heard no arguments against the position from either of the two Ministers who have spoken. It is quite plain that you can do this, because you are going to do it in Ireland. The right hon. Gentleman the Secretary to the Admiralty misunderstood the argument of my hon. and learned Friend beside me. He did not suggest that there was any unfair favouritism to Ireland. What he suggested was that if you can give elasticity in Ireland, you can also do it in England. That seems to be a perfectly clear proposition. I cannot conceive any reason why it should not be carried out. The hon. Member who spoke a moment ago seemed to think that the question was one of what was fair to the State and what was fair to the employer. I protest altogether against that way of looking at it. The thing is, if you are to have this scheme at all, in what way can you give or do the most benefit to the people you pretend to benefit. That is the whole question. It appears to me, therefore, to be a question, not of whether the State or the employer would or would not like best this method of dealing with it. That is irrelevant. I do not myself agree with the hon. Member. I believe myself that the employer would take the same view as I do, that the great object was to benefit those who are entitled to benefit. The employer would not take any interest in it as to whether they were benefited in one way or another. In any case I certainly hope that this Amendment will be accepted, because it will give a measure of elasticity to this particular proposal.
I am somewhat surprised, in view of the concluding remarks of the Noble Lord, that he did not support the Motion of my hon. Friend the Member for East Edinburgh.
I certainly should have supported it if the hon. Member had gone to a Division.
We had no vocal evidence of the Noble Lord's support. It was certainly a much more rational Amendment upon which the Noble Lord might have intervened in our discussion. The Noble Lord dealt with this case as if people dealt with in this Clause were people who are being dealt with in order to be benefited. They are only brought under the Act, not for their benefit, but simply to prevent them having preferential treatment over other people. There is no suggestion that they have been brought under the Act at all in order to be benefited. Money is to be paid in respect of them. How is that money to be applied? The Amendment which is before the House at the present time insists that the whole of that money should be applied for the benefit of these people—mark you, people who are paying nothing themselves!
Not this Amendment.
Certainly.
It merely provides, if you are to apply it to their benefit, that a certain measure of elasticity as to how it is to be applied shall be given.
A large part of the arguments which have been adduced in favour of the Amendment is that after you pay for medical and sanatorium benefit there is a considerable balance, and that this balance should also be applied by the Commissioners for the benefit of these people. I think it was the Noble Lord who made use of that suggestion.
No, no.
That is the main suggestion at the root of the Amendment. If that be so, it prevents the Commissioners applying any part of the money for the benefit of the people to whom it should be and to whom it could be much more beneficially employed. As my hon. Friend beside me pointed out, these people are really paying nothing towards insurance at all. The contribution is a charge upon the employer alone. In the great majority of cases the employer does not himself really pay this contribution. He shifts it by enhancing the price of his commodity to the general community. By that enhancement this Act has laid a charge upon the general community. I think that if we do anything to provide that the money derived from this charge should be used exclusively for the benefit of the employed person in respect of whom it is paid, we are doing an injustice to a large number of the people in this country, we are being called upon, through this system of indirect taxation, to pay that which they can very ill afford.
I would like the Secretary to the Treasury to explain one remark which he made in resisting this Amendment, which I should be prepared to support. I refer to the question of the necessity of retaining this money for the purpose of providing reserve values for certain people who afterwards will become employed contributors. That can only apply so far as I can ascertain, to apprentices. These apprentices number something over 12,000 out of a total of 91,000. Of those apprentices a large number are bound to be, and as a matter of fact are, the sons of people who have never come under this Insurance Act. They are young fellows, for instance, who are engaged in engineering works, and pupils to the legal and other professions. They will never come under this Act. Surely, then, the argument of the Secretary to the Treasury which applies merely to a residuum of men who are apprentices now, and afterwards become employed contributors—that it will absorb so much money that he cannot afford this elasticity is wrong. I appeal to him to be elastic himself in this matter and to yield.
It does not only apply to apprentices, but we must have the reserves values to enable those concerned to enter into insurance. As to the other question advanced, hon. Members will see that if any other benefit is substituted for medical benefit, it will, as a matter of fact, do an injury to these
Division No. 258.]
| AYES.
| [6.29 p.m.
|
| Agg-Gardner, James Tynte | Glazebrook, Captain P. K. | Pryce-Jones, Colonel E. |
| Archer-Shee, Major Martin | Goldsmith, Frank | Randles, Sir John S. |
| Baird, J. L. | Gordon, Hon. John Edward (Brighton) | Rawson, Colonel R. H. |
| Baker, Sir R. L. (Dorset, N.) | Goulding, Edward Alfred | Roberts, S. (Sheffield, Ecclesall) |
| Baldwin, Stanley | Grant, J. A. | Salter, Arthur Clavell |
| Banbury, Sir Frederick George | Greene, Walter Raymond | Samuel, Samuel (Wandsworth) |
| Barnston, Harry | Gretton, John | Sanders, Robert A. |
| Bathurst, Charles (Wilts, Wilton) | Guinness, Hon. Rupert (Essex, S.E.) | Scott, Leslie (Liverpool, Exchange) |
| Benn, Ion Hamilton (Greenwich) | Hall, Frederick (Dulwich) | Snowden, Philip |
| Bentinck, Lord H. Cavendish- | Hamilton, C. G. C. (Ches., Altrincham) | Spear, Sir John Ward |
| Bird, A. | Harris, Henry Percy | Stanier, Beville |
| Blair, Reginald | Henderson, Major H. (Berks, Abingdon) | Stanley, Hon. G, F. (Preston) |
| Boyle, William (Norfolk, Mid) | Henderson, Sir A. (St. Geo., Han. Sq.) | Steel-Maitland, A. D. |
| Bull, Sir William James | Hibbert, Sir Henry F. | Stewart, Gershom |
| Burn, Colonel C. R. | Hoare, S. J. G. | Swift, Rigby |
| Cater, John | Hope, James Fitzalan (Sheffield) | Talbot, Lord Edmund |
| Cecil, Evelyn (Aston Manor) | Hope, Major J. A. (Midlothian) | Terrell, Henry (Gloucester) |
| Cecil, Lord R. (Herts, Hitchin) | Horner, Andrew Long | Thompson, Robert (Belfast, North) |
| Clay, Captain H. H. Spender | Hunt, Rowland | Thomson, W. Mitchell- (Down, N.) |
| Clive, Captain Percy Archer | Ingleby, Holcombe | Thynne, Lord Alexander |
| Craig, Ernest (Cheshire, Crewe) | Kinloch-Cooke, Sir Clement | Tryon, Captain George Clement |
| Craik, Sir Henry | Lloyd, George Butler (Shrewsbury) | Walker, Colonel William Hall |
| Dalrymple, Viscount | Lowe, Sir F. W. (Birm., Edgbaston) | White, Major G. D. (Lancs., Southport) |
| Dalziel, Davison (Brixton) | MacCaw, Wm. J. MacGeagh | Wills, Sir Gilbert |
| Dennis, E. R. B. | Magnus, Sir Philip | Wolmer, Viscount |
| Dickson, Rt. Hon. C. Scott | Morrison-Bell, Major A. C. (Honiton) | Wood, Hon. E. F. L. (Yorks, Ripon) |
| Duncannon, Viscount | Mount, William Arthur | Wood, John (Stalybridge) |
| Eyres-Monsell, Bolton M. | Newdegate, F, A. | Worthington-Evans, L. |
| Fell, Arthur | Newman, John R. P. | Yate, Colonel C. E. |
| Finlay, Rt. Hon. Sir Robert | Nield, Herbert | |
| Fisher, Rt. Hon. W. Hayes | Pease, Herbert Pike (Darlington) | TELLERS FOR THE AYES.—Mr. G. Locker-Lampson and Mr. Cassel |
| Fitzroy, Hon. E. A. | Pollock, Ernest Murray | |
| Forster, Henry William |
NOES.
| ||
| Abraham, William (Dublin, Harbour) | Burt, Rt. Hon. Thomas | Duffy, William J. |
| Acland, Francis Dyke | Buxton, Noel (Norfolk, North) | Duncan, C. (Barrow-in-Furness) |
| Addison, Dr. C. | Buxton, Rt. Hon. Sydney C. (Poplar) | Edwards, Clement (Glamorgan, E.) |
| Adkins, Sir W. Ryland D. | Byles, Sir William Pollard | Edwards, John Hugh (Glamorgan, Mid) |
| Alden, Percy | Carr-Gomm, H. W. | Elverston, Sir Harold |
| Allen, Arthur A. (Dumbartonshire) | Cawley, Sir Frederick (Prestwich) | Esmonde, Dr. John (Tipperary, N.) |
| Allen, Rt. Hon. Charles P. (Stroud) | Chancellor, H. G. | Esmonde, Sir Thomas (Wexford, N.) |
| Arnold, Sydney | Chapple, Dr. William Allen | Essex, Sir Richard Walter |
| Atherley-Jones, Llewellyn A. | Clancy, John Joseph | Falconer, James |
| Baker, H. T. (Accrington) | Clough, William | Fenwick, Rt. Hon. Charles |
| Baker, Joseph Allen (Finsbury, E.) | Clynes, J. R. | Ferens, Rt. Hon. Thomas Robinson |
| Balfour, Sir Robert (Lanark) | Collins, G. P. (Greenock) | Ffrench, Peter |
| Barlow, Sir John Emmett (Somerset) | Condon, Thomas Joseph | Field, William |
| Barnes, George N. | Cornwall, Sir Edwin A. | Fiennes, Hon. Eustace Edward |
| Beale, Sir William Phipson | Cotton, William Francis | Fitzgibbon, John |
| Beck, Arthur Cecil | Cowan, W. H. | Flavin, Michael Joseph |
| Benn, W. W. (T. Hamlets, St. George) | Craig, Herbert J. (Tynemouth) | France, G. A. |
| Bentham, G. J. | Crumley, Patrick | George, Rt. Hon. D. Lloyd |
| Bethell, Sir John Henry | Cullinan, John | Gill, A. H. |
| Birrell, Rt. Hon. Augustine | Davies, David (Montgomery Co.) | Ginnell, Laurence |
| Boland, John Pius | Davies, Ellis William (Elfion) | Gladstone, W. G. C. |
| Booth, Frederick Handel | Davies, Timothy (Lincs., Louth) | Glanville, H. J. |
| Bowerman, C. W. | Dawes, J. A. | Goldstone, Frank |
| Boyle, Daniel (Mayo, North) | De Forest, Baron | Greig, Colonel James William |
| Brace, William | Delany, William | Griffith, Ellis J. |
| Brady, Patrick Joseph | Denman, Hon. Richard Douglas | Guest, Hon. Major C. H. C. (Pembroke) |
| Brocklehurst, W. B. | Devlin, Joseph | Gwynn, Stephen Lucius (Galway) |
| Brunner, John F. L. | Dickinson, W. H. | Hackett, J. |
| Bryce, J. Annan | Dillon, John | Hall, Frederick (Yorks, Normanton) |
| Burke, E. Haviland- | Donelan, Captain A. | Harcourt, Rt. Hon. Lewis (Rossendale) |
| Burns, Rt. Hon. John | Doris, William | Harcourt, Robert V. (Montrose) |
particular persons. As to the third point, of course, it is quite impossible—and I think the hon. Member realises it—to give medical benefit which will extend after the age of seventy on a scheme of mutual insurance to include that.
Question put, "That those words be there inserted in the Bill."
The House divided: Ayes, 94; Noes, 259.
| Harmsworth, Cecil (Luton, Beds.) | Marks, Sir George Croydon | Richardson, Thomas (Whitehaven) |
| Harmsworth, R. L. (Caithness-shire) | Marshall, Arthur Harold | Roberts, Charles H. (Lincoln) |
| Harvey, A. G. C. (Rochdale) | Masterman, Rt. Hon. C. F. G. | Roberts, G. H. (Norwich) |
| Harvey, T. E. (Leeds, West) | Meagher, Michael | Roberts, Sir J. H. (Denbighs) |
| Hayden, John Patrick | Meehan, Francis E. (Leitrim, N.) | Robertson, John M. (Tyneside) |
| Hayward, Evan | Meehan, Patrick J. (Queen's Co., Leix) | Roche, Augustine (Louth) |
| Hazleton, Richard | Middlebrook, William | Roe, Sir Thomas |
| Hemmerde, Edward George | Millar, James Duncan | Rowlands, James |
| Henderson, J. M. (Aberdeen, W.) | Molloy, M. | Rowntree, Arnold |
| Henry, Sir Charles | Molteno, Percy Alport | Runciman, Rt. Hon. Walter |
| Hewart, Gordon | Money, L. G. Chiozza | Samuel, Rt. Hon. H. L. (Cleveland) |
| Higham, John Sharp | Mooney, John J. | Samuel, J. (Stockton-on-Tees) |
| Hinds, John | Morgan, George Hay | Scanlan, Thomas |
| Hobhouse, Rt. Hon. Charles E. H. | Morrell, Philip | Seely, Rt. Hon. Colonel J. E. B. |
| Hodge, John | Morison, Hector | Sheehy, David |
| Hogge, James Myles | Morton, Alpheus Cleophas | Shortt, Edward |
| Holmes, Daniel Turner | Muldoon, John | Simon, Rt. Hon. Sir John Allsebrook |
| Holt, Richard Durning | Munro, R. | Smith, Albert (Lancs., Clitheroe) |
| Howard, Hon. Geoffrey | Munro-Ferguson, Rt. Hon. R. C. | Smyth, Thomas F. |
| Hughes, Spencer Leigh | Murray, Captain Hon. A. C. | Stanley, Albert (Staffs, N.W.) |
| Isaacs, Rt. Hon. Sir Rufus | Neilson, Francis | Strauss, Edward A. (Southwark, West) |
| John, Edward Thomas | Nolan, Joseph | Sutton, John E. |
| Jones, Rt. Hon. Sir D. Brynmor (Swansea) | Norton, Captain Cecil W. | Taylor, John W. (Durham) |
| Jones, H. Haydn (Merioneth) | Nugent, Sir Walter Richard | Taylor, Theodore C. (Radcliffe) |
| Jones, J. Towyn (Carmarthen, East) | Nattall, Harry | Taylor, Thomas (Bolton) |
| Jones, William Carnarvonshire) | O'Brien, Patrick (Kilkenny) | Tennant, Harold John |
| Jones, W. S. Glyn- (Stepney) | O'Connor, T. P. (Liverpool) | Thomas, James Henry |
| Joyce, Michael | O'Doherty, Philip | Thorne, G. R. (Wolverhampton) |
| Keating Matthew | O'Donnell, Thomas | Thorne, William (West Ham) |
| Keilaway, Frederick George | O'Dowd, John | Toulmin, Sir George |
| Kennedy, Vincent Paul | O'Grady, James | Trevelyan, Charles Philips |
| Kilbride, Denis | O'Kelly, Edward P. (Wicklow, W.) | Ure, Rt. Hon. Alexander |
| King, Joseph | O'Malley, William | Wadsworth, John |
| Lambert, Rt. Hon. G. (Devon, S.Molton) | O'Neill, Dr. Charles (Armagh, S.) | Walsh, Stephen (Lancs., Ince) |
| Lambert, Richard (Wilts, Cricklade) | O'Shaughnessy, P. J. | Ward, John (Stoke-upon-Trent |
| Lardner, James C. R. | O'Shee, James John | Wardle, George J. |
| Law, Hugh A. (Donegal, West) | O'Sullivan, Timothy | Waring, Walter |
| Lawson, Sir W. (Cumb'rld, Cockerm'th) | Outhwaite, R. L. | Webb, H. |
| Leach, Charles | Palmer, Godfrey | White, J. Dundas (Glasgow, Tradeston) |
| Levy, Sir Maurice | Parker, James (Halifax) | White, Patrick (Meath, North) |
| Lewis, Rt. Hon. John Herbert | Pearce, Robert (Staffs, Leek) | Whittaker, Rt. Hon. Sir Thomas P. |
| Lundon, Thomas | Pease, Rt. Hon. Joseph A. (Rotherham) | Whyte, A. F. (Perth) |
| Lyell, Charles Henry | Phillips, John (Longford, S.) | Williams, John (Glamorgan) |
| Lynch, A. A. | Pointer, Joseph | Williams, Liewelyn (Carmarthen) |
| Macdonald, J. Ramsay (Leicester) | Ponsonby, Arthur A. W. H. | Williamson, Sir Archibald |
| Macdonald, J. M. (Falkirk Burghs) | Price, C. E. (Edinburgh, Central) | Wilson, Hon. G. G. (Hull, W.) |
| McGhee, Richard | Priestley, Sir W. E. B. (Bradford) | Wilson, John (Durham, Mid) |
| Maclean, Donald | Pringle, William M. R. | Wilson, Rt. Hon. J. W. (Worcs., N.) |
| Macnamara, Rt. Hon. Dr. T. J. | Radford, George Heynes | Wilson, W. T. (Westhoughton) |
| MacNeill, J. G. Swift (Donegal, South) | Raphael, Sir Herbert Henry | Wing, Thomas Edward |
| Macpherson, James Ian | Rea, Rt. Hon. Russell (South Shields) | Wood, Rt. Hon. T. McKinnon (Glasgow) |
| MacVeagh, Jeremiah | Rea, Walter Russell (Scarborough) | Young, William (Perth, East) |
| M'Callum, Sir John M. | Reddy, M. | Yoxall, Sir James Henry |
| M'Laren, Hon. H. D. (Leics.) | Redmond, John E. (Waterford) | |
| Manfield, Harry | Redmond, William (Clare, E.) | TELLERS FOR THE NOES.—Mr. Illingworth and Mr. Gulland. |
| Markham, Sir Arthur Basil | Redmond, William Archer (Tyrone, E.) |
I beg to move, in paragraph (a), to leave out the word "if," and if that be agreed to I shall move various consequential Amendments which are upon the Paper.
As this proviso reads in the Bill, I venture to think it either makes nonsense, or will not achieve what the right hon. Gentleman intends. What is done here is to say that these exempted persons fulfilling certain conditions which are the conditions in the Commissioners' regulations shall become entitled to medical and sanatorium benefit as if they were members of approved societies, and it goes on to say:—What is the effect of that? The conditions contained in the regulations, and already imposed upon the persons affected by them, and we will suppose that the conditions provide for payment of no more than twenty-six weekly contributions. We look to the proviso to see what happens, and we read that in spite of that, that "if the number shall have exceeded twenty-six." It means that if the number exceeds twenty-six, it shall be read down to twenty-six. I propose to recast the Clause so that it should read, "Provided that the conditions so imposed shall not require payment of upwards of twenty-six weekly contributions before the person becomes entitled to such benefits." I think that is what the right hon. Gentleman means, and if it is, I should like to see these words adopted in place of what is at best a very vague expression."Provided that if the condition so imposed require payment of a number of weekly contributions before the person becomes entitled to such benefits, that number shall not exceed twenty-six."
I beg to second the Amendment.
The hon. Member says that if we pass these Amendments they will make the Clause more intelligible. That being so, we shall be glad to accept them.
Question, "That the word proposed to be left out stand part of the Clause," put, and negatived.
Further Amendments made: Leave out the word "condition" ["if the conditions so imposed"], and insert instead thereof the word "conditions."
Leave out the word "imposed," and insert instead thereof the words "shall not."
Leave out the words "a number of" ["payment of a number of weekly contributions"], and insert instead thereof the words "upwards of twenty-six."
Leave out the words "the number shall not exceed twenty-six."
I beg to move, in Sub-section (2), after the word "Ireland" ["This Section shall apply to persons in Ireland"], to insert the word "Scotland."
If this Amendment be accepted, I shall propose a further Amendment to insert after the word "Irish" ["framed by the Irish Insurance Commissioners"], to insert the word "Scottish." That would then read that the Section shall apply to persons in Ireland and Scotland, and that schemes can be prepared by both Commissioners. There is another Clause later on on which the general question of national treatment can be raised, but I am now raising this question in order to have an explanation as to why this is confined to Ireland. I understand one of the reasons that it is confined to Ireland is because of the question of doctors. I do not know if the right hon. Gentleman in charge of the Bill has noticed the Order Paper with the notice of Motion in connection with the Highlands and Islands Medical Service Bill, for Scotland, because if he has he will be acquainted already with the fact that there are a very large number of places in Scotland where a similar condition exists. It is true obviously that if you are going to allow Ireland and the Irish Commissioners for a particular local reason elasticity in framing certain conditions, that elasticity ought surely to be extended to Scotland also! The Highlands and Islands Medical Service is designed to meet certain conditions in Scotland which do not arise elsewhere. That in itself proved that the conditions in different countries require elasticity, and I am moving this Amendment in order that we may hear some explanation as to why that elasticity should not apply to Scotland.I beg to second the Amendment.
On the previous Amendment I pointed out that Ireland was given elasticity which was not given to the rest of the United Kingdom. If we cannot secure that elasticity for England and Wales, let us at all events secure it for Scotland, and make it quite clear that what is impossible for England and Wales is possible for Scotland.This point is as clear as the noonday sun. [An HON. MEMBER: "Speak up."] The hon. Member said he could not understand why an exception was made in the case of Ireland. May I point out that there was no question of Ireland at all as the Bill was originally brought in, but it was immediately pointed out that there was no medical benefit in Ireland unless it was provided for all in Ireland? I have no doubt that when medical benefit is provided in Ireland in years or months to come, then this particular class of persons will have medical benefit just the same as in England or in Scotland. That is the only reason why the distinction is made in the case of Ireland. I cannot see why distinction should be made between England and Scotland, because the conditions are similar. I do not know that I need occupy the time of the House in repeating the arguments on that point. All the employers I have consulted, and all those who have a right to speak for those interested on this point, are in favour of the course we have taken.
Amendment negatived.
Clause 10—(Medical Benefit)
(1) No voluntary contributor whose total income from all sources exceeds one hundred and sixty pounds a year shall be entitled to receive medical benefit, but in that case the weekly contribution which would otherwise be payable by him shall be reduced by one penny.
(2) Paragraph ( e) of Sub-section (2) of Section fifteen of the principal Act shall extend to members of societies other than such friendly societies as are mentioned in that paragraph who were at the date of the passing of the principal Act entitled as such members to medical attendance and treatment in like manner and subject to the like conditions as it applies to members of such friendly societies.
I desire to move to leave out the Clause, because in my opinion, and in the opinion of my hon. Friends, this is a breach of contract bearing in mind the provisions in Section 1 of the principal Act. That Section provided that certain persons should be entitled to enjoy the benefits of health insurance as voluntary contributors, and it provided, amongst other things, that if they were insured persons in the ordinary sense for the first five years of their insurance, although they might enjoy an income of upwards of £160 per annum they should still benefit like other insured persons as voluntary contributors. A considerable number of secondary school teachers and clerks have paid insurance upon a misunderstanding, and they have not received any value for their money. Surely, it is grossly unfair that those persons should now be deprived of any medical benefit hereafter, although under the principal Act they have paid on the footing that they would receive that benefit if they happened to fall ill. The only circumstances under which I should not press this Amendment would be if the right hon. Gentleman was able to assure me that he was prepared to accept the Amendment standing in the name of the hon. Member for Worcester (Mr. Goulding) which would confine this Clause to all persons becoming insured after the passing of this Amending Bill.
I beg to second the Amendment.
This Clause was inserted to fulfil a pledge made by the Chancellor of the Exchequer to the medical profession under which some 18,000 doctors offered to go on to the panel, and in this matter the Government ask the House of Commons to support them. After all, what does it mean? Contributors at the present time can only enjoy this benefit if their income is less than £160 a year. There is a certain number of persons covered by Clause 1 of the Act who having been insured persons for five years and having got to a salary of over £160 a year would naturally pass out of the Act. The majority of them are persons of the middle or upper classes who have been learning trades and have passed up to positions of considerable emolument. All the alteration proposed by this Clause is that after five years if they pass upwards into those positions of emolument, they shall not get medical benefit but shall be excused the contribution which is equivalent, or otherwise it means that they can contract out as far as medical benefit is concerned. They can still remain members of their society and pay contributions and get the other benefits, but in that case they will have to provide their own medical benefit out of the money they save owing to being excused their contribution. It is not true to say that in regard to the class which the hon. Member opposite mentioned of secondary teachers they will not receive any advantage. They will, during the five years in which they pay medical benefit receive insurance against illness, and if during those five years they are ill, they will receive medical benefit. Under those circumstances I do not think it is too much to ask the House to support a compromise which was made with the medical profession, the violation of which would be a breach of faith so far as the Government is concerned.
Amendment negatived.
I beg to move, in Sub-section (1), after the word "contributor," to insert the words "becoming insured after the passing of this Act."
The right hon. Gentleman has just informed us that this Clause is intended to give effect to a pledge given by the Government to the doctors, but he did not deny either on the Committee or in this House that the giving of that pledge inflicts an injustice upon a certain body of persons belonging to the clerk class and secondary school teachers. The right hon. Gentleman has used the extraordinary argument that these people are to be excluded because when their salaries rise to £160 they are then considered amongst the wealthy classes. I never remember hearing any such argument in regard to the large number of mechanics and other well paid artisans who are earning £4 a week. On the contrary, full benefits were given to those classes, and the voluntary contributor was really devised so as to meet the case of clerks and people of that sort. I do not know whether the arrangement come to by the Government with the medical profession is a just one or not, but I hope this House will include under the Act those who have entered into a contract with the Government and the approved societies and secure to them the benefits which it is now suggested should be taken from them. If during five years they have entered into the insurance and their wages or salaries have been raised to £160 a year, then they have the right to become voluntary contributors. Their contributions have been received by the approved societies and the Government have entered into that arrangement by solemn contract with these people, and now, for the first time, they are proposing, because these people are not a large body possessing a great organisation, to make this Clause effective, and that is the reason why this grave act of injustice is going to be done to them. I challenge the right hon. Gentleman or any Member of the Government to name a single insurance corporation or commercial undertaking who would be able to come before this House and ask for a breach of this kind to be met, without giving them any compensation whatever. I take a very ordinary case, that of a clerk whose salary is fixed and who has a bonus. That salary may in any year come up to the standard of £160 a year, and a year or two afterwards it may drop below that sum, and when that clerk comes back into insurance be comes under a reduced benefit. That is a case which may arise frequently because it is a class of employment which we knows exists. With regard to the class who have already entered into this insurance and, believing in the bona fides and honesty of Parliament have paid their contributions and entered into participation of what they considered the benefits secured to them for like, what is going to happen to the contributions which those people have already paid if this Amendment is made retrospective? They are all frittered away and put aside, and these people are deliberately deprived of the benefits they have insured for. The right hon. Gentleman says they are giving them ample compensation by a reduction of payment as regards their liabilities in case this Clause affects them. Their own actuary has estimated that the cost of medical benefit is 1½d. a week and not 1d. The Government in dealing with Ireland on this question took the valuation as 1½d., and why are you going to give to those in Ireland terms which you are not giving to those clerks in those in Ireland terms which you are not giving to those clerks in England? The right hon. Gentleman also said that this was a small class, but may I remind him that there are some 25,000 of them. I do not say all of them are likely to suffer under this Clause, but every one of them has entered into a contract which should be respected, but this is only to be done as from the passing of this Act. The right hon. Gentleman said their numbers were so small that they were not worthy of consideration.I never said that.
May I point out to the right hon. Gentleman that those representing friendly societies and approved societies have passed a resolution declaring that:
Friendly societies passed that resolution unanimously, and if there is any difficulty about the medical profession, surely the Government are not going to make hanky-panky over it, and if there are pounds, shillings, and pence lost to the medical profession by giving this full benefit, surely the Chancellor of the Exchequer might grant that amount and act honestly towards these people."We strongly disapprove of the proposal that members with an income of over £160 should be deprived of medical benefit to which they had hitherto been entitled and for which they had paid contributions."
I beg to second the Amendment.
7.0 P.M This is a pettifogging Clause. It does not so very much matter on what scale the injustice is perpetrated if it is perpetrated, and this is a case of distinct injustice, whether there be a form of contract or not. The tradition of our legislation here is not in favour of taking advantage of any small technicalities of law-making, and I submit that to rule this class of voluntary contributors, however small it may be, out of their medical benefit is quite unworthy of the House of Commons. Besides that, it is doing exactly that which we ought to be very wary of doing. It is still further complicating the financial arrangements of the approved societies. It has already been difficult enough for the great friendly societies, principally the affiliated orders, to adapt themselves to the new conditions, but here you are introducing a new exception which will make things still more difficult, however small may be the scale on which it will operate. I ask, Is it worth doing? I suppose that this is looked upon as a sop to the medical profession, but I hardly think that it is worth their while accepting this as an instalment or as making up to them to some extent what they think to be the disadvantages under which they have been placed owing to the operations of the Insurance Act. We all have our own ideas as to the extent of those disadvantages, but whatever view we take of the doctors' grievance, this goes a very little way to meet it. If that be so, is it worth while interfering with the provisions of the Act? The policy of the great insurance companies has been exactly in an opposite direction. They have always refused to take—those of them who prosper most—advantage of legal technicalities. They have tried to conduct their business in a broad spirit, and they have found that in so doing they have won public confidence and that liberality has been the best policy from every point of view. The Government is going to act in exactly the opposite direction. They are going to stand on the legal technicality that there is no contract with voluntary contributors, and they are going to deprive them of the benefit to which they are entitled under the principal Act. The right hon. Gentleman may feel that he has done his best to redeem the pledge, if it was given, but, if it is opposed to the policy of Parliament—and I think the provision which follows will show him that it is—then he is relieved of any further responsibility. I do not fancy that he can have his heart in this Clause. It is offered as a sop, but I do not think that it is worthy of acceptance by the medical profession, and I am perfectly certain that it is opposed to the sound policy of working with the friendly societies as far as we can and of not interfering any more than we are obliged with the old lines on which they have carried on their great organisations of thrift.I am sorry that I cannot support the Amendment, but I rather dissent from the view that this is a sop to the medical profession. I do not look upon it from that point of view in any way whatever. Let us look at it from a commonsense point of view. Is it the case, as an ordinary matter of common sense, that men in receipt of incomes above £160 measure their medical benefit by 8s. 6d. or 9s 6d. per week, or wish to measure it in that way? To suppose that a man enjoying an income of over £160 a year is likely to make use of a mere panel doctor and to be content with that without the choice he would ordinarily have is not in accordance with the real social facts of the position. Such a man resents mere contract practice. He would naturally be prepared to get his own doctor and to pay for him even if he had the right, under the strict terms of his contract with the friendly society under the Insurance Act, to get medical attendance without any charge whatever. It is not the case that these people will be content with such medical attendance as is secured for them under the Insurance Act. Who are these people? It has been pointed out that there are a number of clerks belonging to friendly societies who earn over £160 a year and who yet wished to have this medical treatment. I do not think that is the case. It is a very rare case.
The case of secondary school teachers has been quoted. Is there a single secondary school teacher earning more than £160 a year who is himself attended or whose family is attended by a doctor provided for him under the Insurance Act? [HON MEMBERS: "Certainly."] I know a large number of schools where they pay their secondary teachers something between £160 and £250 a year, and every one of them strongly resents being relegated to the Insurance Act, and they have never so far as I know made use of it. They would be very sorry to do so. They have their own medical attendants who have attended them and their families for years, and they are not prepared to use, and they are not in the habit of using, merely the medical attendance provided for them under the Act. I, therefore, object to saying that this is merely what is called a sop to the medical profession. It matters very little to the medical profession. It is in accordance with their wish to preserve those close, those confidential, and those friendly relations with their patients which had prevailed in the past and which they think are now being upset by the introduction, in a class which does not wish it and for which it is not suited, of a mechanical sort of relation between medical adviser and his patient. I am positively certain after conferring with these teachers that many of them will welcome this change. The payment is something which they considerably grudge, knowing that the last thing in the world they would think of doing would be to use this medical attendance provided for them under the Act. I am perfectly sure, if the right hon. Gentle- man sticks to the Bill as it is, that he will find he is conferring a boon not so much upon the medical profession as upon many of those very people who are brought within the range of this Clause in the Bill. They will welcome the relief of part of their contribution, and they will not feel any hardship in being deprived of a benefit which I feel perfectly certain that in nine cases out of ten they never for a moment think of accepting. I hope that the right hon. Gentleman will hold to the Bill as it now stands, and I am sorry that I cannot support my hon. Friend.I welcome the support of the hon. Member opposite, but I cannot say that I endorse all of his arguments. I must confess that his statement about the service of a mere panel doctor was perhaps a little derogatory to 18,000 of the medical profession. My belief is that on the average you will get just as good medical attendance from doctors on the panel as from doctors off the panel. The hon. Member is dealing with some 25,000 voluntary contributors. If their income is at present over £160 per year, they cannot come into insurance, and the only question is how far, supposing some of them find their income going above that amount, medical arrangements should be made. I altogether repudiate the suggestion of the hon. Gentleman (Mr. Goulding)—I am sure that he made it in good faith—that I said because they were few we could neglect them.
It is in the OFFICIAL REPORT of the Committee.
I said that when great confusion is caused in the friendly societies by some enormous change the possibility, after five years, of 5 per cent. of 25,000 persons having to make their own arrangements for medical attendance in return for the equivalent they pay to the societies for medical attendance can really be left altogether out of calculation. The hon. Gentleman says that we are breaking faith with these people. We are no more breaking faith with them than any insurance committee would be breaking faith with them if they laid down a limit of £160 and said that everyone with £160 a year would have to make their own arrangements for medical attendance. It is exactly similar to that, and you cannot say that is breaking faith with anybody. It is a possibility which might come to them ordinarily under the Act, and to persons who cannot at present prophesy whether they will come under it at all.
Is it not the fact with regard to these people that while their wages are under £160 per year you compel them to join and that it is only when they go up above £160 they become voluntary contributors?
We certainly compel some to come under the Act, and as long as they are under the Act and paying for medical attendance they will receive full medical attendance. They will receive full medical attendance for all the five years during which they are paying for it. After that their condition will merely be the same as if a limit of £160 were imposed by an insurance committee, and any committee can impose such a limit at this moment. It is therefore idle to talk about some solemn pledge having been broken in the matter. We are giving them back exactly the equivalent of what it would cost the approved society. If we gave back more than the penny, we should be imposing a charge upon the approved societies in connection with these persons, and there is no reason why that charge should be imposed. I do not think that it was an unfair pledge for the Government to have given, and I do not think that it does injury to any person. It may be that in some cases the suggestion of the hon. Member for the University of London will be carried out, and that one of these gentlemen joining at the age of sixteen, and subsequently gaining an income of several thousand pounds a year, may prefer not to have the doctor but to have the money, one penny per week, to spend as he likes. Apart from that, I think the hon. Gentleman will realise that this is a not unfair thing to give the doctors, of whom 18,000 have come on the panel.
I rise to support the Amendment, and I regret to find myself in disagreement with the hon. Member for Glasgow and Aberdeen Universities, more especially as he told us he addressed himself to the question from a common-sense point of view. I wonder what effect some of the remarks he has made in the course of this Debate will have upon the large class of his constituents—mere panel doctors—who constitute 70 per cent. of the medical graduates of the Universities of Glasgow and Aberdeen. There are some people who will not forget that observa- tion. The hon. Gentleman takes an extraordinary view of the attitude of mind of those who have over £160 a year. He says that these men will have an utter contempt for the services of the "mere panel doctor." I do not think he can say that of Scotsmen, for even they with over £160 a year will consider that medical attendance represented at 8s. 6d. a year is worth consideration. Later on the hon. Member suggested that it amounted to one penny per week; but I must say that, bearing in mind the inconsistencies of his proposition, one has some difficulty in discovering the common sense of his point of view.
But I did not rise in the main to deal with the inconsistencies of the hon. Gentleman. I wish to draw attention to the main facts of the case as they stand. This is a proposal to vary a contract contained in an Act of Parliament. It may be a small variation. It may be one that affects few people; but it is a variation which is to be carried through without consulting them, and contrary to the Act, and no matter how small it is, no matter how few the number of people affected, I maintain that Parliament has no right to do it. There are other variations in relation to committees of insurance which are proposed in this Bill as it at present stands, and with which we shall have to deal later on, and I trust we may hope for the support and assistance of hon. Gentlemen opposite in our action upon them, provided we make good our case. On the general ground of principle I think there has been no answer to the speeches of the hon. Members for Worcester and Mile End. It may be that the Secretary to the Treasury has rashly and recklessly made promises to the doctors. Of course, if he has done so, we regret the fact; but the matter is one of very slight practical consideration to the medical profession as a whole, and I am sure that that profession would infinitely prefer that a promise rashly made should be broken rather than that Parliament should vary the conditions of a contract contained in an Act of Parliament. My right hon. Friend said that the insurance committees were entitled to deny medical treatment to the voluntary contributor under the conditions mentioned. But the situation in relation to the insurance committee is quite different from the action we are now asked to take. After all, in regard to insurance committees, insured persons have a voice in respect of any arrangement which may be made with medical men; but we hold that the action of the insurance committees has no analogy with the action which the Government are now calling upon us to take. I hope the House will accept the Amendment proposed by the hon. Member opposite, and that it will do so mainly on the ground that it will prevent a variation of the contract made with the doctors, and, secondly, because the arguments put forward by the Secretary to the Treasury in support of this variation have really no weight, and do not meet the situation mentioned by the hon. Gentleman opposite.The position, as I understand it, is a very simple one. An arrangement has been entered into between the House of Commons and certain people, and it is now proposed that that arrangement should be broken. My hon. Friend comes forward and says, "You are perfectly entitled to break that arrangement as far as new subscribers are concerned, but you are not entitled to do so as regards old subscribers." The hon. Member for Glasgow University, in order to controvert that proposition, says he knows a large number of people with an income of £160 a year or more who would not like to have a panel doctor. May I suggest that that has nothing to do with the question at issue? The question is, Are we going to alter an Act of Parliament to the detriment of the people who have come under that Act of Parliament on the understanding that certain things are going to be done? I would never be a party to an arrangement of that sort. I never particularly approved the Insurance Act, but when you have entered into a legal bargain, as long as it was understood by both parties, you have no business to break it on any consideration of any sort whatever. The argument brought forward by my hon. Friend appeared to me to be an argument which supports the contention I am taking up, because my hon. Friend says that this is not going to have any effect at all, that people with £160 a year do not want to have a panel doctor, and that, therefore, really nothing will happen if the Amendment of my hon. Friend is carried. But we shall be keeping our word, which, I venture to say, is the first thing Members of the House of Commons ought to do.
My hon. Friend spoke of contributors being "compelled" to come under the Insurance Act. Has he read the first line of the Section, which provides that "No voluntary contributor"?
The hon. Gentleman forgets that people under a given income were compelled to come under this Clause, and it was then understood that certain circumstances would arise if their income went above that figure. Now it is said we should not do what two years ago we promised we would do. The argument of the right hon. Gentleman, unless he can prove I am wrong, is that only about 25,0000 people are going to be affected by the proposal. That is one of the worst arguments I have ever heard advanced. What would it matter if even only one person is affected? The only question is, Did you do a certain thing? If you did, you are bound to accept the Amendment of my hon. Friend. If you did not, it is another matter altogether. I dare say it is quite true that the effect of carrying this Amendment will be very small, but there is a much greater effect which might occur, and that is that the trust of the people in the House of Commons, which is already, I think, a diminishing quantity, will certainly be further diminished if Amendments of this sort are resisted.
I have some difficulty in dealing with this matter, because the Amendment now in the Bill ought to have formed part of the original Act. But when the hon. Member for the City of London speaks of a contract having been entered into between two parties I should like him to inform me who were the parties to this particular contract. I take it that they were the medical profession on the one hand, and the approved societies or insured persons on the other. It will be recollected that the medical profession entered into their part of the contract on the understanding that this particular Clause, which ought not to have been inserted in the original Bill, should be amended on the very first occasion, and it was under this condition that they entered into their part of the contract. Therefore, if we do not give the medical profession the advantages which they expected to receive, we shall certainly be breaking our contract with them, and I think the hon. Gentleman will realise it is quite as important not to break a contract with one party, as it is not to break it with another party. Just look at the common sense of this particular Clause, if I may use that phrase! When the Insurance Act was passing through the House of Commons it was pointed out that there was great absurdity in the arrangement then proposed. It was pointed out by myself and other Members that there were a large number of persons who were in receipt of incomes of less than £160 a year, but who, in a few years, might come into incomes ranging from £500 to £2,000 per annum, and it was never intended that persons of that class should be compulsorily insured, or, indeed, allowed to become voluntarily insured. It was said distinctly that some alteration must be made on the very first occasion.
The hon. Gentleman has referred to the teachers, and the hon. Member for Aberdeen University was quite correct when he said that secondary teachers in our schools wish to be exempted entirely from the operation of this Bill. I recognise, as everybody does, that thousands of the doctors on the panel are men of very great eminence, and what the secondary teachers desire is not so much to avoid having to be treated by panel doctors as not to be compelled to have medical attendance under the conditions imposed by the Act. That is a somewhat different proposition to the one attributed to my hon. Friend, and I am sure it is what he really intended to say. We must also remember that the medical benefits have only been in operation for about eight months; therefore, the amount contributed by insured persons who became voluntary insurers is extremely small. I quite recognise that as a matter of justice compensation ought to be given them for the fact that they may have paid eight months' insurance without being able subsequently to receive any benefit. But unless the payment proposed is sufficient to give them that amount of compensation, it is very much better they should be allowed to reduce their subscriptions for the few years they are to be allowed to claim medical benefit. Undoubtedly the Government is in a difficulty in this respect, and the sooner they get out of it by rendering it impossible that persons with large incomes, compelled actually against their will to become insured persons under this Act, shall be allowed to obtain medical benefit at the small sum now proposed the better it will be for all concerned.I do not intend to deal with any of the arguments that have been advanced in favour of the Amendment, which I heartily support; but I desire to put before the House two practical points which occur to me as the secretary of an approved society. The first is, that under this Clause are approved societies to be put into the position of inquisitors? Are they to be continually asking who has got an increase in salary that brings him over the £160 limit? Secondly, the amount of clerical work connected witih this Act is great enough as it is, without imposing upon them another new task. Whenever it comes to the knowledge of an approved society that a member has secured a higher wage or salary than £160, they will have to apply to the Commissioners for a form, fill it up, and send it to them intimating that there is such a case. There will be a great number of cross entries to be made in the books as a consequence. I believe that is increasing the work of approved societies quite unnecessarily. For these two reasons I shall support the Amendment.
The hon. Member who has just sat down has not seized the point at issue. These being voluntary contributors, they will not be employed contributors who, in respect of wages earned, are compulsorily contributors. They are not referred to in the Clause at all. The point here is that under Section 1, Sub-section (3) of the principal Act, voluntary contributors who have been insured persons for a period of five years or upwards are allowed to continue in insurance. It is quite evident that no voluntary contributors can be deprived of anything referred to in Section 1 of the principal Act until July, 1917. As a matter of fact, the persons with whom we are dealing are not now entitled to take advantage of the provisions of Section 1. All that we are now doing is to say that in July, 1917, this particular provision shall not apply as originally proposed. The contributions for medical benefit are not carried forward. The hon. Member for Worcester (Mr. Goulding) seemed to think that we were depriving voluntary contributors of something, because something was carried forward. Nothing is carried forward. The amount is paid out every year towards the doctors on whose lists these persons are.
I did not mention anything about carried forward. I said that the penny was the compensation instead of the penny halfpenny.
In no case does it apply to persons who are compulsorily insured. The whole of this controversy illustrates the difficulty of attempting to impose an income limit. It will be within the recollection of the House that a good many of us on this side, myself included, from the very first strongly opposed a compulsory income limit. I remember that it was moved from the other side, but I do not recollect that the hon. Baronet the Member for the City of London (Sir F. Banbury) objected at the time it was proposed that there should be a compulsory income limit of £2 in respect of medical benefit.
I thought the Insurance Bill was a bad thing, and I never took much part in it.
That is no excuse for the ground of principle which the hon. Baronet raised. A proposal was made, after we had passed Section 1 of the Insurance Act, and had entered into this obligation, as the hon. Baronet thinks it is, that medical benefit should not apply to those with an income above £2. That broke down in argument. I never did think that these matters were worth all the argument used about them. I agree with the hon. Member for Mile End (Mr. Harry Lawson) that there is not so much in this as has been made of it, and that it amounts to substantially but very little. A good many cases were brought forward of persons in industrial districts who at one time had been apprentices and had joined a club, and were receiving medical attendance for something like 6s. a week. We had a case put before us of persons coming for medical attendance in a carriage and pair, and who were members of a club. The Government promised that in order to obviate advantage being taken of Section 1, Sub-section (3) of the principal Act, to do that kind of thing in future, they would allow a general income limit as applied to voluntary contributors, and to that class of persons in respect of medical benefit. It is in fulfilment of that promise that this Clause is introduced. Although I quite agree with the hon. Member for Mile End that there is not very much in it of any value to the medical profession, yet it is said it was a pledge. It seems to me there is no breach of faith in it, because nothing can happen under this Clause until July, 1917.
The hon. Member who has just sat down was quite right in saying that this matter emphasises the difficulty of establishing any income limit in relation to questions of this kind. I say that on the whole it was a mistaken direction to take to impose anything of the kind. The question of the violation of a contract has been raised. Whenever that question is raised we are told that Parliament is a sovereign body and can make one law one year establishing a certain contract and can, the next year, make another tearing up that contract. No doubt it is true that Parliament is a sovereign body. If we were not, the lawmaking power would be altogether a nullity. But that argument does not invalidate the argument, advanced from the other side as well as from this side, that in the case with which we are dealing, that of persons whom I can only describe as small folk in little companies all over the country, we are not entitled to rest our claim to change their condition with regard to insurance simply upon the sovereign power of Parliament. Even when the right hon. Gentleman advances the argument that this is the fulfilment of the pledge to the doctors, I must say that the form of the Amendment proposed by the hon. Member for Worcester (Mr. Goulding) seems to be a device which enables the House not only to carry out its pledge to the doctors, but also to a certain extent to safeguard the interests of the voluntary contributors. I cannot understand the position of the hon. Member for Glasgow and Aberdeen Universities (Sir H. Craik). He argues one way one moment and another way the next moment. When he refers to the major part of his constituents as "mere panel doctors," I agree with my hon. Friend (Mr. Pringle) in wondering what those constituents will have to say the next time he consults them. The hon. Member for the University of London (Sir P. Magnus) took much safer ground when he described them as "distinguished persons." I am altogether at a loss to know why so much difficulty should he made about the acceptance of an Amendment of this kind, which does not sweep the whole class away. I doubt very much if I could have voted for the proposal of the hon. Member for the Wilton Division (Mr. C. Bathurst), but I shall certainly support the proposal of the hon. Member for Worcester in the Lobby.
I rise because I think it is necessary to protest against the breach of contract argument which has been introduced. Let the matter be treated upon its merits. We can certainly never hear anything from the Opposition again about repealing the Insurance Act, for if to make a difference with regard to one benefit for one class is a breach of contract, then surely the repeal of the Insurance Act would be a wholesale breach of contract! That is not the view I take. I would call the attention of the House to the fact that when it passed this Act, Parliament was not so foolish as to deliver itself into the hands of the medical profession. What is the position? One has heard from the Opposition more than once that we have made a certain promise to the people, that we have agreed to provide medical benefit, and they say, "Now provide them." Then they goad us by saying, "Make your terms with the doctors." Parliament took care, when it passed the Insurance Act, to have a safeguard, which was that the Insurance Commissioners—not the insurance committees—should have power to suspend medical benefit. That is in the Act now. If they do that, they can return to the insured person this part of his contributions, which is a yearly contribution.
If Parliament has taken that power in regard to the whole of the insured persons, surely there is no breach of contract in the Commissioners year by year, if a particular class reaches an income limit of over £160—it may be £500 or £1,000—saying to the individual, "We are no longer in a position to provide medical benefit for you under the terms of the Act. The profession will not do it." The hon. Member for Worcester realised that difficulty. He said that if the medical profession is not prepared to treat these people who are comparatively well off on the terms of the Act, then you must get an extra Government Grant. If he had put that in his Amendment, it would have been out of order. What does he really mean? That we are to go to the medical profession and say that five years from now, whatever is the income of a person who remains a voluntary contributor, "You must treat him on the terms provided by the Act, namely, on the same terms that you are treating everybody else." If he wants us to do that, there is no difficulty in providing it, but he has not said that. The Opposition tell us that we have made a bargain with the insured person, that we must pay the medical profession what they ask, and come to Parliament for a fresh Grant. The Debate this afternoon has been particularly interesting from this point of view. When the Act was going through the House, hon. Members opposite goaded us as being the people who wanted to sweat the doctors. Hon. Members opposite were the people who wanted an income limit in order to protect the doctors. Now they turn round and say, "You have no right to place an income limit, even of £160, on persons who become voluntary contributors." I hope the medical profession will note the change of front which has been adopted by hon. Members opposite. Is it done to place the administrators of the Act in a new difficulty. If we were to pass this Amendment we should pledge ourselves to provide medical benefit for anyone, whatever his income might be, provided that at one time he has been a compulsorily insured person. What we are now asked to say is that whatever that person's income may be in future, we are to be under a contract with him to see that he shall get his medical benefit, and, if we cannot provide it for 8s. 6d., we must pay the medical profession what they ask for treating men with these means. It savours of putting the administrators of the Insurance Act into a difficulty in regard to the medical profession.I feel bound to say something about this Clause, because it is the result of very protracted negotiations which I have had with the medical profession. This is one of the points which they criticised constantly at all the conferences which I had with them, and the one which I felt the least capable of equitably persisting in. They said, "Here you have a provision for medical attendance for a class of persons who earn weekly wages and are not in a position to pay heavy doctor's bills. That is the justification for a contract practice and that is the justification for the equivalent of it which you have in this Act. A doctor's bill sometimes means ruin for life to a man who is only earning a small weekly wage; but, they said, that does not apply to that person if he ceases to be a weekly wage earner and becomes a man who is very well off, and it is rather hard on us that we should have to attend to a man who may be earning £500, £600, £700, or it may be £1,000 a year at the rate of 7s. a year, that being the class we look to in order to make up the deficiencies in our income which arise very often from the scale of charges which we impose upon the working classes. Even in districts where there is no contract practice, it is very well known that the scale of charges for the working classes is different from the scale charged to the person who is well off. I felt that there was a good deal to be said from their point of view, and I undertook that in the first Amending Bill which we introduced I would see that the Government put in a Clause to this effect and would press it upon the attention of the House and I feel in honour bound to stand by that pledge. The proposition has been put forward that the conditions of an Act of Parliament are equivalent to a contract between the subject and the State as a reason why we could not depart from this. You cannot possibly do that in an Act of Parliament. To say that you cannot alter the provisions of an Act of Parliament without involving a breach of contract with the subject is an impossible proposition, and you could not defend it under any conceivable conditions. In this case, at any rate, you have four years' notice, and at the end of the four years any person of this sort will really get outside the contract terms, and will have to make his own conditions with the doctors. I thought many of the demands put forward by the doctors were very unreasonable, but I really could not resist this. I thought it was a very reasonable demand to make, and I felt, therefore, that we were in honour bound to see to it; but if there is anything in the contract question at all my hon. Friends must remember that since this pledge was given £1,600,000, outside the Act altogether, was found in order to assist the payment of the doctors, so that, at any rate the very Act of Parliament which makes this alteration in the conditions makes another very substantial contract in favour of these persons and finds £1,600,000 for that purpose.
It cuts them out of the £1,600,000.
At the end of the four years. I am only pointing out that you cannot alter an Act of Parliament as if it were a contract because here we had to find £1,600,000 which is not in the contract at all for the purpose of the vast majority of those who are insured persons. I do not think these are the persons who have a fair right to demand the bounty of the State, and for that reason I felt I was right in giving the pledge to introduce this Clause, and the Government must stand by it.
I am rather surprised at the right hon. Gentleman's statement. He told us that Parliament had allocated £1,600,000 for the payment of the doctors, but he did not tell us that he was compelled to pay it in order that he might get the services of the doctors at all. It seems to me from some of the statements we have heard to-night that there is a desire to cast on one side all questions as to whether the House of Commons has made a contract or has not. The Chancellor of the Exchequer says an Act of Parliament cannot be a contract, but the fundamental principle in all business is that if you have made a contract you cannot depreciate the terms of it without both parties consulting, and if the Chancellor of the Exchequer considers that point he will see that the Amendment is the only position which can be upheld. We have heard a good many questions in regard to the price paid for the doctors. I am pleased to see that an Amendment is coming on, because I cannot see how they are going to get the equivalent by reducing the price by one penny per week. When the
Division No. 259]
| AYES.
| [7.56 p.m.
|
| Agg-Gardner, James Tynte | Guinness, Hon. Rupert (Essex, S.E.) | Roberts, G. H. (Norwich) |
| Baird, J. L. | Guinness, Hon.W. E. (Bury S. Edmunds) | Roberts, S. (Sheffield, Ecclesall) |
| Baker, Sir R. L. (Dorset, N.) | Gwynne, R. S. (Sussex, Eastbourne) | Rowlands, James |
| Baldwin, Stanley | Hall, Frederick (Dulwich) | Salter, Arthur Clavell |
| Banbury, Sir Frederick George | Harris, Henry Percy | Samuel, Samuel (Wandsworth) |
| Barnes, George N. | Henderson, Major H. (Berks.) | Sanders, Robert A. |
| Barnston, Harry | Henderson, Sir A. (St. Geo., Han. Sq.) | Scott, Leslie (Liverpool, Exchange) |
| Bathurst, Charles (Wilts, Wilton) | Hewins, William Albert Samuel | Smith, Albert (Lancs., Clitheroe) |
| Beck, Arthur Cecil | Hibbert, Sir Henry F. | Snowden, Philip |
| Benn, Ion Hamilton (Greenwich) | Hills, John Waller | Spear, Sir John Ward |
| Bentinck, Lord Henry Cavendish- | Hodge, John | Stonier, Beville |
| Bird, A. | Hope, Major J. A. (Midlothian) | Stanley, Hon. G. F. (Preston) |
| Blair, Reginald | Horner, Andrew Long | Sutton, John E. |
| Boyle, William (Norfolk, Mid) | Houston, Robert Paterson | Swift, Rigby |
| Boyton, J. | Hunt, Rowland | Talbot, Lord Edmund |
| Bryce, J. Annan | Ingleby, Holcombe | Terrell, George (Wilts, N.W.) |
| Bull, Sir William James | Jowett, Frederick William | Terrell, Henry (Gloucester) |
| Burn, Colonel C. R. | Locker-Lampson, G. (Salisbury) | Thomas, James Henry |
| Cecil, Lord R. (Herts, Hitchin) | Lowe, Sir F. W. (Birm., Edgbaston) | Thompson, Robert (Belfast, North) |
| Clive, Captain Percy Archer | Macdonald, J. Ramsay (Leicester) | Thomson, W. Mitchell- (Down, North) |
| Clynes, J. R. | Mount, William Arthur | Thorne, William (West Ham) |
| Dalrymple, Viscount | Munro-Ferguson, Rt. Hon. R. C. | Ward, John (Stoke-upon-Trent) |
| Dalziel, Davison (Brixton) | Newdegate, F. A. | Wardle, George J. |
| Denison-Pender, J. C. | Newman, John R. P. | Whyte, A. F. (Perth) |
| Dickson, Rt. Hon. C. Scott | Nield, Herbert | Williams, J. (Glamorgan) |
| Duke, Henry Edward | O'Grady, James | Wills, Sir Gilbert |
| Eyres-Monsell, Belton M. | Parker, James (Halifax) | Wilson, W. T. (Westhoughton) |
| Fitzroy, Hon. E. A. | Pease, Herbert Pike (Darlington) | Wolmer, Viscount |
| Fletcher, John Samuel | Perkins, Walter F. | Yate, Colonel C. E. |
| Gill, A. H. | Pointer, Joseph | Younger, Sir George |
| Glazebrook, Captain Philip K. | Pollock, Ernest Murray | |
| Goldstone, Frank | Price, C. E. (Edinburgh, Central) | |
| Gordon, Hon. John Edward (Brighton) | Pringle, William M. R. | TELLERS FOR THE AYES.—Mr. Goulding and Mr. Harry Lawson. |
| Greene, W. R. | Randles, Sir John S. | |
| Gretton, John | Richardson, Thomas (Whitehaven) |
NOES.
| ||
| Abraham, William (Dublin, Harbour) | Allen, Rt. Hon. Charles P. (Stroud) | Beach, Hon. Michael Hugh Hicks |
| Acland, Francis Dyke | Arnold, Sydney | Beale, Sir William Phipson |
| Addison, Dr. C. | Baker, H. T. (Accrington) | Benn W. W. (T. H'mts., St. George) |
| Alden, Percy | Baker, Joseph A. (Finsbury, E.) | Bentham, G. J. |
| Allen, Arthur A. (Dumbarton) | Balfour, Sir Robert (Lanark) | Birrell, Rt. Hon. Augustine |
Bill came before the House I was entirely opposed to any persons earning more than £160 a year being allowed to be insured. The whole question has been decided as to the payment to the doctors and the amount of contribution by the people whom you compelled twelve months ago to be insured, and now, because it is compulsory, you are going to say, "We are going to take away any advantages which may accrue." I cannot believe that the House of Commons is going to tear up the agreement. It is not a question of the number that you have to deal with, but a question of principle, and I hope my hon. Friend will press this to a Division, and I shall look very carefully through the Division list to see if those who have spoken to-day, and hon. Members below the Gangway, are prepared to support what, according to the assent they gave, they believe should be done.
Question put, "That those words be there inserted in the Bill."
The House divided: Ayes, 100; Noes, 228.
| Boland, John Pius | Hayward, Evan | O'Connor, John (Kildare, N.) |
| Booth, Frederick Handel | Hazleton, Richard | O'Connor, T. P. (Liverpool) |
| Boyle, Daniel (Mayo, North) | Henderson, J. M. (Aberdeen, West) | O'Doherty, Philip |
| Brady, Patrick Joseph | Henry, Sir Charles | O'Donnell, Thomas |
| Brocklehurst, William B. | Hewart, Gordon | O'Dowd, John |
| Brunner, John F. L. | Higham, John Sharp | O'Kelly, Edward P. (Wicklow, W.) |
| Burt, Rt. Hon. Thomas | Hinds, John | O'Malley, William |
| Byles, Sir William Pollard | Hobhouse, Rt., Hon. Charles E. H. | O'Neill, Dr. Charles (Armagh, S.) |
| Cater, John | Holmes, Daniel Turner | O'Shaughnessy, P. J. |
| Cawley, Sir Frederick (Prestwich) | Holt, Richard Durning | O'Shee, James John |
| Cawley, Harold T (Heywood). | Horne, Edgar (Surrey, Guildford) | O'Sullivan, Timothy |
| Chancellor, Henry George | Howard, Hon. Geoffrey | Outhwaite, R. L. |
| Chapple, Dr. William Allen | Hughes, S. L. | Palmer, Godfrey Mark |
| Clancy, John Joseph | Illingworth, Percy H. | Pearce, Robert (Staffs, Leek) |
| Clough, William | Isaacs, Rt. Hon. Sir Rufus | Pease, Rt. Hon. Joseph A. (Rotherham) |
| Collins, Godfrey P. (Greenock) | John, Edward Thomas | Phillips, John (Longford, S.) |
| Condon, Thomas Joseph | Jones, Rt.Hon.Sir D.Brynmor (Sw'nsea) | Ponsonby, Arthur A. W. H. |
| Cornwall, Sir Edwin A. | Jones, Haydn (Merioneth) | Priestley, Sir W. E. B. (Bradford, E.) |
| Cotton, William Francis | Jones, W. S. Glyn- (T. H'mts, Stepney) | Primrose, Hon. Nell James |
| Cowan, W. H. | Joyce, Michael | Pryce-Jones, Colonel E. |
| Craig, Herbert J. (Tynemouth) | Keating, Matthew | Radford, G. H. |
| Craik, Sir Henry | Kellaway, Frederick George | Raphael, Sir Herbert Henry |
| Crumley, Patrick | Kennedy, Vincent Paul | Rawson, Colonel R. H. |
| Cullinan, John | Kilbride, Denis | Rea, Rt. Hon. Russell (South Shields) |
| Davies, David (Montgomery Co.) | King, J. | Rea, Walter Russell (Scarborough) |
| Davies, E. William (Eifion) | Lambert, Rt. Han. G. (Devon,S.Molton) | Reddy, M. |
| Davies, Timothy (Lincs., Louth) | Lambert, Richard (Wilts, Cricklade) | Redmond, John E. (Waterford) |
| Davies, Sir W. Howell (Bristol, S.) | Lardner, James C. R. | Redmond, William (Clare, E.) |
| Dawes, J. A. | Lawson, Sir W. (Cumb'rld, Cockerm'th) | Redmond, William Archer (Tyrone, E.) |
| Delany, William | Leach, Charles | Richardson, Albion (Peckham) |
| Denman, Hon. Richard Douglas | Levy, Sir Maurice | Roberts, Charles H. (Lincoln) |
| Denniss, E. R. B. | Lundon, Thomas | Roberts, Sir J. H. (Denbighs) |
| Devlin, Joseph | Lyell, Charles Henry | Robertson, John M. (Tyneside) |
| Dickinson, W. H. | Lynch, A. A. | Roche, Augustine (Louth) |
| Dillon, John | Macdonald, J. M. (Falkirk Burghs) | Roe, Sir Thomas |
| Donelan, Captain A. | McGhee, Richard | Rowntree, Arnold |
| Doris, William | Maclean, Donald | Samuel, J. (Stockton-on-Tees) |
| Duffy, William J. | Macnamara, Rt. Hon. Dr. T. J. | Scanlan, Thomas |
| Duncan, C. (Barrow-in-Furness) | MacNeill, J. G. Swift (Donegal, South) | Scott, A. MacCallum (Glas., Bridgeton) |
| Edwards, Clement (Glamorgan, E.) | Macpherson, James Ian | Seely, Col. Rt. Hon. J. E. B. |
| Edwards, John Hugh (Glamorgan, Mid) | MacVeagh, Jeremiah | Sheehy, David |
| Elverston, Sir Harold | M'Callum, Sir John M. | Shortt, Edward |
| Esmonde, Dr. John (Tipperary, N.) | Magnus, Sir Philip | Simon, Rt. Hon. Sir John Allsebrook |
| Esmonde, Sir Thomas (Wexford, N.) | Manfield, Harry | Smyth, Thomas F. |
| Essex, Sir Richard Walter | Markham, Sir Arthur Basil | Stewart, Gershom |
| Falconer, J. | Marks, Sir George Croydon | Strauss, Edward A. (Southwark, West) |
| Fell, Arthur | Marshall, Arthur Harold | Taylor, John W. (Durham) |
| Fenwick, Rt. Hon. Charles | Masterman, Rt. Hon. C. F. G. | Taylor, T. C. (Radcliffe) |
| Ferens, Rt. Hon. Thomas Robinson | Meagher, Michael | Taylor, Thomas (Balton) |
| Ffrench, Peter | Meehan, Francis E. (Leitrim) | Tennant, Harold John |
| Field, William | Meehan, Patrick J. (Queen's Co., Leix) | Thorne, G. R. (Wolverhampton) |
| Fitzgibbon, John | Middlebrook, William | Toulmin, Sir George |
| Flavin, Michael Joseph | Millar, James Duncan | Trevelyan, Charles Philips |
| France, G. A. | Molloy, M. | Ure, Rt. Hon. Alexander |
| George, Rt. Hon. D. Lloyd | Molteno, Percy Alport | Wadsworth, John |
| Ginnell, Laurence | Money, L. G. Chiozza | Walsh, Stephen (Lancs.. Ince) |
| Gladstone, W. G. C. | Mooney, J. J. | White, J. Dundas (Glasgow, Tradeston) |
| Glanville, H. J. | Morgan, George Hay | White, Patrick (Meath, North) |
| Greig, Colonel James William | Morrell, Philip | Whittaker, Rt. Hon. Sir Thomas P. |
| Griffith, Ellis J. | Morrison-Bell, Major A. C. (Honiton) | Williams, Llewelyn (Carmarthen) |
| Guest, Hon. Frederick E. (Dorset, E.) | Morison, Hector | Wilson, Hon. G. G. (Hull, W.) |
| Gulland, John William | Morton, Alpheus Cleophas | Wilson, John (Durham, Mid) |
| Gwynn, Stephen Lucius (Galway) | Muldoon, John | Wilson, Rt. Hon. J. W. (Worcs., N.) |
| Hackett, John | Munro, Robert | Wing, Thomas Edward |
| Hall, Frederick (Normanton) | Murray, Captain Hon. A. C. | Wood, Hon. E. F. L. (Yorks, Ripon) |
| Harcourt, Rt. Hon. Lewis (Rossendale) | Needham, Christopher T. | Wood, John (Stalybridge) |
| Harcourt, Robert V. (Montrose) | Neilson, Francis | Wood, Rt. Hon. T. McKinnon (Glas.) |
| Harmsworth, Cecil (Luton, Beds) | Nolan, Joseph | Young, William (Perth, East) |
| Harmsworth, R. L. (Caithness-shire) | Norton, Capt. Cecil W. | Yoxall, Sir James Henry |
| Harvey, A. G. C. (Rochdale) | Nugent, Sir Walter Richard | |
| Harvey, T. E. (Leeds, West) | Nuttall, Harry | TELLERS FOR THE NOES.—Mr. William Jones and Mr. Webb. |
| Hayden, John Patrick | O'Brien, Patrick |
I beg to move, in Sub-section (1), after the word "penny," to insert the word "halfpenny."
I am not sure of the exact actuarial equivalent of medical benefit, but undoubtedly it is 1.51d. The right hon. Gentleman has, I believe, already explained in Committee that, in fact, this actuarial equivalent is considerably reduced by administration and other expenses, but he nevertheless admits that it is worth more than ld. I think it comes out, in any case, at something like l¼d., or a shade under. I move this Amendment because I desire to see some compensation given to the voluntary contributor who is deprived of medical benefit which he was to have enjoyed under the principal Act. I am taking into account the compensation which he deserves, and which could not be less than 1½d.—1¼d. as representing the actuarial equivalent with administration expenses deducted, and the other 1¼d. as representing the compensation due to him.I beg to second the Amendment. I hope it will be accepted by the Government. I said on the previous Amendment that I hoped compensation would be given to those persons who, under the conditions of the principal Act, were compelled to come into insurance, and, having since paid their insurance fees, have to lose medical benefit because their income is now over £160 a year.
We propose that those persons who came into insurance, and who have now over £160 a year, may continue in insurance for all save medical benefit. We are giving as nearly as possible the exact equivalent of what the society would have to pay. The exact amount is 56d. a year which the society would be paying for medical benefit. The nearest figure we can get is 52d. a year—that is, 1d. per week—and I do not think a person who is fortunate enough in five years to pass out of medical insurance, because he has got very much better off, should demand, or will demand, that the members who are left should have a levy laid on their funds in respect of what he saves to the society by passing out.
Would the right of compensation be the same as is given when an insurance company fixes the income limit?
That cannot be proposed here. That is a totally different proposition. I am not sure whether it was proposed and negatived upstairs, but it cannot be proposed here.
If there is the same difficulty, is it not desirable to follow the precedent set in the principal Act?
Amendment, by leave, withdrawn.
I beg to move, at the end of Sub-section (2), to add,
It is quite impossible to make a new speech on the question of the free choice of doctors. If the Chancellor of the Exchequer were here, I do not believe he would deny that over and over again, while the principal Bill was passing through this House, he promised in the country that insured persons should be able to have the doctors of their choice. Practically every speech which contained that promise has been quoted in this House, and I do not propose to quote the old speeches again. But I happen to have got a copy of the "British Medical Association Journal," which contains a statement by the right hon. Gentleman which, I think, has never been quoted in this House. When the Bill was going through the House originally the hon. Member for Hoxton (Dr. Addison) appeared to be very anxious indeed as to whether persons were really going to get their choice of doctors, and he contended that there should be provision for enabling patients to choose their own doctor. The Chancellor of the Exchequer in reply to the hon. Member, used these words:—"(3) An insured person, on satisfying the local insurance committee that he desires the services of a medical practitioner who has not entered into arrangements with such committee under Sub-section (1) of Section fifteen of the principal Act, and that he understands the consequences of making arrangements under Sub-section (3) of that Section, shall be at liberty to take such services under that Sub-section."
Subsequently at a special representative meeting on 1st June, the Chancellor of the Exchequer said:—"There is nothing in the Bill to prevent the free choice of doctors."
That is the free choice of doctors—"Personally, I am strongly in favour of it"—
I agree that there is no guarantee in the principal Act that insured persons shall have the doctors of their choice. The principal Act simply says that the insurance committees, if they think fit, shall be allowed to make their own arrangements outside the panel. Although there is no guarantee in the Act, I submit that, the Chancellor of the Exchequer over and over again, while the Bill was passing through the House, gave his personal undertaking that insured persons should have the doctor of their choice. I submit that the refusal of the free choice of doctors all over the country over and over again is having results which have probably never occurred to, or impressed themselves upon, the mind of the Chancellor of the Exchequer. In London, and I believe in Edinburgh especially, there are a great many doctors who are not on the panel. There are a great many people who have been attended by those doctors since their birth, and who were actually being attended by them for some illness or other at the time the Act came into operation, and I do not see why they should not have the right, in view of the undertaking given by the Chancellor of the Exchequer, of being treated by those doctors who are outside the panel. I quite agree that one ought not to try to break down the panel system. I do not believe any responsible person to-day in the least wishes to break down the panel system; but I do maintain that if the circumstances of a patient are exceptional—that is to say, supposing he has had a special doctor for a long series of years, or supposing that he considers a particular doctor can especially well look after his complaint—he ought to be able to go outside the panel, and have the doctor of his choice. I move this Amendment in order to give the right hon. Gentleman an opportunity of repairing what I consider a very great injustice at the moment. I have refrained from making long quotations, and if I have not quoted all that was said in the country, I hope the Financial Secretary to the Treasury will not think that I have not made out a case in favour of the Amendment. I should like to mention that the Joint Committee of Approved Societies are very strongly in favour of this Amendment, and for the benefit of hon. Members who were not in the Committee upstairs and who may not have seen the communication which was sent round by the Joint Committee, I may mention that that Committee includes representatives of the National Federation of Friendly Societies, the General Federation of Trade Unions, the National Union of Deposit Societies, the National Union of Borrowing Societies, the National Federation of Dividing Associations, and the National Federation of Approved Societies. All these societies want the Government to adopt this Amendment. They have said so quite plainly in their circular. It being a quarter-past Eight of the clock, and there being Private Business set down by direction of the Chairman of Ways and Means, under Standing Order No. 8, further proceeding was postponed without Question put."I think one of the essentials of cure is that the patient should have faith in his doctor, and you cannot have faith in your doctor if you have a doctor thrust upon you whom you have not chosen."
Private Business
Derby Corporation Bill (by Order),
Dover Harbour Bill (by Order),
Lords Amendments considered, and agreed to.
Heathfield and District Water Bill,
Motion made, and Question proposed, "That the Lords Amendments be now considered."
Unless the Chairman of Ways and Means can give me some information as to whether the Bill contains provision for the proper protection of the men engaged on the construction of these works, I must object. I objected to this Bill the other day, and was told by someone that I should be informed as to whether adequate protection had been provided, but I have heard nothing whatever about it. In those circumstances I must object.
The hon. Member cannot object when it is put down by Order.
Perhaps I had better inform the hon. Member that this is only a question of the Amendments of the other House. The point to which he refers is one which it would not be possible to raise on that question. I cannot inform him, on the spur of the moment, whether the Clause to which he refers is in the Bill or not. The Committees are obliged by our Standing Orders to look into the question, and I have no doubt that it was done in this case.
One or two Bills have come down from the House of Lords which have been before Committees of this House, important Bills involving great constructional works, in which no provision has been made for housing accommodation of the men until I blocked the Bill, and this in spite of the Standing Orders. Even yesterday a Clause was inserted by promoters on my suggestion where the Committee did not think it necessary to do so, in the case of works involving nearly a million of money.
I do not wish to take up time to-night on a matter of which I have no notice. I cannot give the hon. Member any reply now, and, therefore, I move "That the Debate be now adjourned."
Question put, and agreed to.
Debate to be resumed To-morrow.
Southport Corporation Bill (by Order),
Lords Amendments considered, and agreed to.
North British Railway Bill [ Lords] (by Order),
King's Consent, on behalf of the Crown, signified; read the third time, and passed, with Amendments.
Rochford Rural District Council Bill [ Lords] (by Order),
Verbal Amendment proposed by the Promoters, and agreed to; Bill read the third time, and passed, with Amendments.
Ebbw Vale Water Bill [ Lords] (by Order),
Bill read the third time, and passed, with Amendments.
London and South-Western Railway Bill [ Lords] (by Order),
King's Consent, on behalf of the Crown, signified; Bill read the third time, and passed, with Amendments.
Leith Harbour and Docks Bill [ Lords) (by Order),
Ipswich Dock Bill [ Lords] (by Order),
Leicester Corporation Bill [ Lords] (by Order),
Reading Corporation Bill [ Lords] (by Order),
Ascot Authority Bill [ Lords] (by Order),
London Electric Railway Bill [ Lords] (by Order),
Watney, Combe, Reid, and Company Bill [ Lords],
Bills Ordered for Third Reading; Standing Orders 223 and 243 suspended; Bills read the third time, and passed, with Amendments.
Southend-on-Sea Corporation Bill [ Lords],
New Clause added, and Amendments proposed by the Promoters agreed to; Standing Orders 223 and 243 suspended; Bill read the third time, and passed, with Amendments.
Alexandra Park and Palace Bill [ Lords] (by Order),
Limerick Harbours Commissioners Bill [ Lords] (by Order),
Bills read a second time.
Ordered, That Standing Orders 211 and 236 be suspended, and the Committee on unopposed Bills have leave to sit and proceed to-morrow.
Gas and Water Orders Confirmation (No. 1) Bill [ Lords] (by Order),
Pier and Harbour Provisional Orders (No. 3) Bill [ Lords] (by Order),
Read the third time, and passed, with Amendments.
Electric Lighting Provisional Order (No. 6) Bill [ Lords] (by Order).
I beg to move, "That the Bill be now considered.
I make this Motion in order to say a word or two in regard to the position in which the Bill stands. This Bill, as it came down from the other House, contained two Provisional Orders, one of which was opposed and the other unopposed. The time of the Session was very late, and it seemed to me, that the Bill could only get through its further stages provided that the Opposition was removed. Therefore, I invited all those whom I knew to be interested in the Bill to meet me in my room for a conference in order to see whether the Opposition could be removed. I found that I was unsuccessful in that effort, and that the Bill would be opposed on the Second Reading in the House, and there was already a petition against one of the Orders which necessitated its going before an Opposed Bill Committee upstairs. The earliest evening that was possible to take the opposed Second Reading was this evening, and the Opposed Bill Committee could not sit before Wednesday of next week. The right hon. Gentleman, the Chairman of the Committee of Selection informed me that it was out of the question to think of setting up an Opposed Bill Committee at that period of the Session. It seemed to me a choice between the loss of the Bill with the two Orders, and saving one of those Orders, and when the facts were put before the Board of Trade who attended the conference, they came to the conclusion that it was better to save one Order than to lose both. That is the simple explanation. It is a merely a matter of the calendar and days of the week, which accounts for the proceedings hitherto. Since that time I have been doing the best I can to bring the parties to terms, and what I propose to do now, with the co-operation of the Board of Trade, whose assent I have received to the proposal, is to suggest that the consideration to-night should be adjourned, and I will put down on the Paper the necessary Motion empowering the Unopposed Bill Committee to divide this Bill into two, separating the two Orders, and then, later, I will ask the House to sanction the carrying over of the opposed Order in order that the expenditure already incurred upon it by its promoters will not be lost. In any case, if opposed, the Bill could not have had any possible chance of getting through in the present Session. Therefore, in order to arrive at the position which I suggest, I would advise the hon. and learned Member to move the Adjournment of the Debate, and I will, at the earliest possible moment, put down my Motion.I beg to move, "That the Debate be adjourned."
I wish to express my indebtedness, both to you, Sir, and to the right hon. Gentleman the Chairman of Ways and Means, for the course taken in this matter. I must say that at one time I was filled, perhaps, with undue suspicion as to the course taken, and if I have done any injustice to the Chairman of Committees, whether mentally or otherwise, I wish to express my regret for it. I think it is to the honour of this House that under its procedure as a High Court of Justice, as it is when we are dealing with private Bills, it should not be possible to suppose it to be in any way tainted or affected by private considerations. The reason why I felt so strongly about this matter is this: This Bill has been promoted by a very well-known gentleman in Ireland (Mr. William Murphy), at the instance of the Kingstown Commissioners. He undertook to lay out upon it the sum of £40,000 out of his own pocket, and he did so after the Kingstown Commissioners had exhausted every effort, including, unfortunately, having to allow their own Order to lapse for the last ten years, to provide that township of 18,000 inhabitants with a supply of electricity. I think any man in a country like ours who comes forward to spend a large sum of money in that way deserves some encouragement. In addition to that, in opposing the gas company in the House of Lords, he spent a sum of £2,000; and it did seem to me a very strong order that this Bill, when it reached this House, after passing the Lords unanimously, should suddenly be throttled by a procedure which at the time I was unacquainted with. The position of the Lords was extremely interesting from one point of view, because by an accident there was struck upon the panel in their Lordships' House, the owner of the largest portion of the property in Kingstown, Lord Longford, who was absolutely indifferent as between the gas company and the electric lighting proposal, and he with Lord Chairman and others—I am afraid if the hon. and learned Member enters into the merits of the question it may add to my difficulties. I have done my best to meet the hon. Member.
I will say no more, for perhaps the least said the soonest mended. As I took this unusual course, which I very much regret, of blocking a large number of private Bills, perhaps some twenty in number, a thing I have never done before in all my thirty-two years' experience here, and have put the promoters to very great trouble and expense, which I do very greatly regret, I did think that some explanation from me was necessary; but if the right hon. Gentleman, the Chairman, is now willing that the matter should be allowed to pass without further explanation or vindication of any kind, I entirely accept his proposal. At the same time, I do trust that next Session, when this matter comes before the Committee, it will be considered on its merits, and not with reference to any other proposal which the advantage this delay gives to its opponent may effect. I say no more than that, and I move the Adjournment of the Debate.
Question put, and agreed to; Bill deferred till to-morrow.
Electric Lighting Provisional Order (No. 7) Bill [ Lords] (by Order).
As amended, considered.
Ordered, that Clause 26 a be left out, and that the following new Clause be inserted:
( Restriction on Linking Up with London Stations and Areas).
The powers contained in the London Electric Supply Act, 1908, as regards
making any connection between the area of supply specified in or any generating station authorised to be erected under this Order, and any area of supply of or any generating station of any authorised undertakers or specified companies referred to in the said Act of 1908 shall only be exercised subject to the approval of the Board of Trade, and the undertakers when submitting any proposals for any such connection shall furnish particulars of such proposals to the London County Council, who shall be entitled to make representations to and be heard by the said Board thereon.—[ The Deputy-Chairman.]
Bill to be read the third time.
National Insurance Act (1911) Amendment Bill
Postponed proceeding resumed on Question proposed on Clause 10.
Which Question was to add at the end of Sub-section (2) the following Sub-section:—
"(3) An insured person, on satisfying the local insurance committee that he desires the services of a medical practitioner who has not entered into arrangements with such committee under Sub-section (1) of Section 15 of the principal Act, and that he understands the consequences of making arrangements under Sub-section (3) of that Section, shall be at liberty to take such services under that Sub-section."
Question again proposed, "That those words be there inserted in the Bill." Debate resumed.
I was pointing out to the House that this Amendment was supported by a joint committee, and a very important body indeed. I may now read a statement in the "British Medical Journal" showing that the British Medical Association are also in favour of this Amendment. In its issue of the 12th of this month, the "British Medical Journal" says in a leading article:—
They go on to say:—"Both on public and professional grounds, it appears to be essential that no obstacle should be put in the way of placing at the disposal of the insured the services of medical men whose practices lie among the working classes."
As I have already pointed out, the provision under the Sub-section is merely to obtain the permission of the insurance committee to allow private arrangements to be made. That is to say, unless the insurance committee agrees, the member of a society is not able to make private arrangements outside the panel. I do submit that it is enormously important, and, as the Chancellor of the Exchequer has told us, faith is nine points of all healing, that the insured person should really have confidence in his doctor. I believe it is one of the most important parts of pathological treatment that you should really have confidence in the doctor attending you, and confidence cannot possibly exist if you are forced to accept the services of a doctor whom you do not want and whom you do not believe in. I really think I have said enough on the point, and I trust that the Government will do their best to accept the Amendment. I cannot see any reason why they should not do so. I make it quite clear in the Amendment that if a person wants to make private arrangements outside the panel he is to be made to understand exactly what the consequences will be. If he makes a private arrangement outside the panel he, of course, stands the risk of receiving the sum of money which he gets under the Act, and of the doctor who is outside the panel asking him for more for the treatment of his particular disease. I mean by that that the doctor outside the panel may say, "I will take the fee which you have got under the principal Act, but you must pay so much extra in addition." I made that quite plain in the Amendment, and, therefore, I really do not, see that there is anything in the way of the Government accepting this Amendment. The approved societies want it and the British Medical Association have no objection to it, and I believe if hon. Members in this House really voted, as I hope they will to-night, according to their consciences, there would not be the slightest doubt whatever of this Amendment being passed into law."Full opportunity should be taken on Clause 15, Sub-section (3)."
I consider this a very important Amendment, and I hope after what has been said by my hon. Friend that the Government will give it their most favourable consideration. A great deal has been said about the advantage to the patient of choosing the medical man in whom he happens to have confidence. In addition to what has been recalled to the memory of the House by the hon. Member who moved, I desire to draw attention to Sub-section (3) of Section 15 of the principal Act, where it is provided that the regulations made by the Insurance Commissioners shall authorise the insurance committee by which medical benefit is administered to require certain persons and to allow any other person in lieu of receiving medical benefit under such arrangements as aforesaid to make their own arrangements for receiving attendance and treatment, including medicine and appliances, and in such cases the Committee shall contribute from the funds a proportionate sum in respect of medical attendance which the insured person under such circumstances would get for himself. Why is it that that is to so great an extent a dead letter? The Insurance Commissioners have, I believe, authorised the insurance committees to make such arrangements, and why is it that arrangements of that kind have been made in so few cases? I think that some explanation is desirable upon that point, and, inasmuch as freedom of choice has not been given to insured persons to anything like the extent the country was led to expect, I hope that the House will see its way to adopt the Amendment of my hon. Friend, which ensures that the intention which Parliament expressed in that Sub-section will be carried into effect. I consider this a most important Amendment, and I earnestly hope that we shall hear from the Treasury Bench that effect will be given to it.
I thank the hon. Gentleman for the way in which he has moved this Amendment. He did so on strictly business lines. He realised that all the old complaints as to what was said and what was not said were appropriate in their right position, but are not appropriate to the Report stage of this Bill. I wish the hon. Gentleman had seen his way to doing what we agreed to do on the Committee stage of the Bill—that is, that all Amendments as to the relations between the insurance committees and approved societies on the one hand, and the medical profession on the other, should be withdrawn, and that those who sought to obtain further Amendments desired by the doctors should withdraw at this time their suggestions, on the condition that all those who sought Amendments which might put the doctors in a worse position, or which the doctors might think would put them in a worse position, should also withdraw their proposals. Curiously enough, the hon. Gentleman occupies the position of proposing both those kinds of Amendments, and one of them he has put on the. Paper again on this Report stage and the other he has not. So, while on the one hand he is now advancing an Amendment, which I have no doubt will be supported by a considerable bulk of the medical profession, he is not advancing an Amendment which drove the medical profession into a special arrangement at their last conference to, alter their business in order to pass resolutions repudiating that Amendment altogether. The carrying of the one, as I think, would carry as an inevitable consequence the carrying of the other. If the one was carried, I think the other ought to be carried also.
Which Amendment is it?
The hon. Gentle-man who moved this Amendment proposed an Amendment allowing the friendly societies to make their own arrangements with the insured persons who were their own members with certain doctors, such doctors as they could get to become whole time servants under the societies. The doctors, as I think everyone knows, at once entered into a very considerable agitation in order to prevent that Amendment being carried.
As the hon. Gentleman has mentioned that Amendment, may I say it contained a contracting out Clause which would have probably the same effect as the Amendment I now propose.
In that case I cannot quite understand why the whole British Medical Association opposed the Amendment. There is not the slightest doubt, and I do not want to misrepresent the doctors, of what they think of that particular Amendment of the hon. Gentleman. Apart from such questions as that, what does this Amendment mean? It means by the use of an autocratic power from above, to break through the discretion given to the insurance committees. The hon. Gentleman said his Amendment had the support of the approved societies. I doubt if it has of the actual rank and file. The insurance committee is the most democratic body existing in this country more than guardians or borough councils or any other body, and we are keeping them democratic by a Clause later on in this Bill which allows opportunity for poor men to serve on those committees. Three-fifths of each of those committees, that is a clear majority, are appointed by approved societies, and their sole object in being on the insurance committees must be to look after the interests of the approved societies, including all the members of the approved societies. These insurance committees have absolutely unfettered discretion to give free choice of doctor outside the panel system to any member who chooses to ask for it. You are going to fake away that discretion. You will smash the insurance committees, you will lose the panel doctors, who have come in to the number of 18,000 to work the panel system, and you will violate the principle which the insurance committees were set up to carry out—that of local autonomy suited to the needs of the particular districts which they represent. Hon. Members seem still to wonder why the insurance committees have a difficulty in giving this free choice. I cannot tell anyone at present to what extent they exercise that discretion. Many of them have exercised it on a comparatively large scale; some on a comparatively small scale. They have to consider what we here and the Insurance Commissioners have not to consider, and that is how they can provide an efficient medical service for all the people in their locality. As I have repeated again and again, and have never been answered, if the conditions are such that persons who want to contract out with their own doctors are persons of healthier lives than those persons who do not want to contract out, the insurance committees have no moral right to see all those healthy lives going out from the panel system, at the same time leaving all the bad lives to be treated at the same cost by the panel doctors.
That is really the vital position. It is because the insurance committees must of necessity have that discretion that I ask the House not to smash it up by such an Amendment as this. I think that this question will settle itself if hon. Members are not too impatient. A committee is to be appointed to consider certain aspects of the Question, and I believe that if time is given—we have had only six months since the great fight with the doctors—hon. Gentlemen will find that the great majority of the doctors in any possible area will come in either fully under the panel system or for a limited number of patients so long as there is an average number, or that in the few exceptional cases which remain the insurance committees, without any fear as to what will happen to the general bulk of their insured persons will be able to allow insured persons to make their own arrangements. I am quite sure that if this Amendment is carried the whole controversy, which we hope is dying down, will flare up again, and we shall be in. the midst of a controversy, not between the Insurance Commission and the doctors or the insured persons, but between the insured persons themselves and the committee which represent them on the one hand and the medical profession on the other—a controversy above all things to be avoided. Those who speak for the medical profession cannot have it both ways. If we are to make it compulsory, without any discretion in the insurance committees, that anyone is to be allowed to have medical attendance outside the panel system, they must be allowed to choose any medical treatment they like outside the panel system. Hon. Members below the Gangway had an Amendment on the Paper suggesting that we should compel insurance committees to allow insured persons to choose institutes, medical clubs, or any of the various kinds of arrangements which treat not only insured persons, but women and children as well—the arrangements which we sanctioned under Section 15 (3), but not under Section 15 (4). In large parts of the country the controversy now developing is not whether persons will be allowed to have free choice of doctor, which means the institute, but the medical profession them-selves are asking us not to allow this free choice. If you have free choice of doctor outside the panel system you must have free choice of institute as well, and there inevitably follows free choice of friendly society doctors. That is why I urge the hon. Member and his Friends not to carry this question further. If the Amendment were carried it would mean the destruction of the panel system. It would mean the friendly societies trying to reassert the old friendly society system, which may be quite right, but out of which the House, by a large majority, helped the doctors under the implied agreement that the doctors in their turn would come in and help us under the panel system. I would appeal to the House to leave the discretion as at present to the insurance committees, and to consider the situation as it develops between the doctors and the insured persons during the coming time. We shall then have the report of the committee which is to be appointed to consider whether insured persons are receiving a satisfactory medical service; whether there are any suggestions by which they can receive a more satisfactory medical service, and what relation the present medical service has to any excessive sickness which exists. When that Committee has reported and that time has elapsed, if the panel system with possibly contracting out permitted by the insurance committees is not working satisfactorily, then, and not now, will be the time to make such proposals as are made by the hon. Gentleman.I desire to support the Secretary to the Treasury. If this Amendment is carried the whole Insurance Act will be placed in jeopardy. It will be familiar to all that when the Insurance Act passed there was great doubt whether it could be made workable. The great majority of the doctors believed that the whole status of their profession had been lowered by the passing of that Act, but with a magnanimity which I think was not fully recognised, they decided to give the Act a fair trial. The panel system was not very palatable to them at the beginning, but they are now giving it a fair trial. If they are to have all the existing disadvantages of the panel system, it is unfair to them to introduce in this Amending Bill still further disadvantages, which would make their position almost intolerable. After the Act has been in operation for some considerable time it may be necessary to revise the position of the medical profession with respect to the panel system and the whole working of the Act, but I seriously ask the House not to entertain this Amendment which would again place the whole Act in jeopardy.
The hon. Gentleman who has just sat down has told us that if this Amendment is carried the whole Insurance Act will be placed in jeopardy. That is a remark which has also fallen from the Secretary to the Treasury. Of course, all—
I do not want to be misreported as having said that.
What the hon. and right hon. Gentlemen pointed out only goes to show how unworkable the Insurance Act is in its present state, and what radical and drastic Amendments are required in order to make it a measure adapted to the needs of the people. The whole of the hon. Member's speech went to show that the Act, even with the Amendments which are introduced in this Bill, still falls far short of what we have reason to expect from the speeches that were made in this House and throughout the country in regard to the advantages which the working classes and the people generally would derive from the Act. I think it was the right hon. Gentleman the Secretary to the Treasury whose whole speech I have not had the pleasure of hearing—who said that we on this side of the House were speaking for the medical profession. I want to say in regard to this Amendment that we are not speaking for the medical profession, but distinctly for the insured persons. It is not the medical profession who cry out for a choice of doctors; it is the insured persons. They desire to choose their doctor for the very substantial reasons which were given by the Chancellor of the Exchequer in the passages quoted by the hon. Member who has moved this Amendment. What is the position which the Government at present take up in regard to this important question of the choice of doctors? We know quite well that over and over again—I am not going to repeat any of the quotations referred to by my hon. Friend—that the Chancellor of the Exchequer pointed out that the Act would allow choice of doctors. He further stated that medical benefit could not be advantageously given unless the insured person had the opportunity of the choice of doctor. What now is the position of the Government? It is that choice of doctors is absolutely impossible. "If," they say, "you have choice of doctors the Act will be in jeopardy," and therefore you cannot expect choice of doctors. I think I must leave it in that position. If this Act is to be enforced under the conditions imposed there can be no choice of doctors, and everything the Chancellor of the Exchequer has said, and the Chancellor's promises, cannot be carried into effect. I am afraid that is not a happy position in which the Members of the Treasury Bench now find themselves; but I think they will realise, as we have realised from the beginning, that this Act requires drastic amendment from its very foundation in order that it may be a workable measure and calculated to improve the health of the country.
I am going to support the Amendment which has been moved by my hon. Friend for the reason that it gives the insured person a greater freedom—a freedom which is necessary, I believe, if he is to have the benefits which are supposed to be secured to him under the Act. The right hon. Gentleman the Secretary to the Treasury seemed to blame my hon. Friend the Member for Salisbury for having brought forward this Amendment. He seemed to think that because in Committee my hon. Friend had moved two Amendments, both of which he believed to be in the interests of the insured person, one of which apparently was liked by the doctors whilst the other was disliked by them—that that balance having been maintained in Committee it also ought to be maintained on Report—that he ought not to move any Amendment on the question of free choice. I cannot myself see what Amendments in Committee have to do with the immediate position that is before the House. The immediate question before the House is this: Has the insured person to have free choice of doctor, or has he not to have free choice of doctor? The Secretary to the Treasury has answered that by saying: "Oh, no, we cannot give free choice of doctor: if we chi it will break down the Act: if we do, we drive a bureaucratic power through the democratic insurance committees and we prevent them exercising their discretion." The case of the right hon. Gentleman is that it is impossible to do what, when the original Bill was going through, the Chancellor of the Exchequer so constantly told Members of this House, and told the insured public at White fields, the Opera House, and many other places Although the right hon. Gentleman opposite does not like it, I am going to remind the House what his right hon. colleague did say when this question was being discussed three years ago, and when the Bill was in Committee. The Chancellor of the Exchequer said:—
He wanted it two years ago, when the Chancellor of the Exchequer promised it. He wants it to-day and the Secretary to the Treasury replies, "Oh", it is impossible: if so, you are going to alter the factor of discretion of the insurance com- mittees." Just for a moment see what is the case of the Insurance Committees in practice! In theory they have the right to say to each individual who applies, "Oh, yes, you have made out a case which entitles you to choose your own doctor from amongst the doctors who are not on the panel, and, therefore, we will let you have what you ask for, and give you 8s. 6d. or 9s. towards the cost of your medical benefit." That is their theoretical discretion. How is it possible, either in London, Middlesex, Lancashire, or in many other places where there are a large number of insured persons, for any insurance committee to really exercise the discretion of treating each case on its merits? I know they are not doing it. They are refusing the people in batches, for the simple reason that it is quite impossible for them to take the case on its merit and inquire into it and see whether or not there is some special reason which requires that a certain individual shall be entitled to choose his own doctor. Surely our business is not to set, up an official body which shall inquire into the circumstances of every insured person's case: Surely it is for us to trust the insured person to exercise his discretion to-his own best advantage, either by taking a panel doctor or by using a medical institute. I quite agree, if a free choice of doctor is allowed, it must be allowed in favour of medical institutes, provided that the medical institute is-carrying on a practice which does give sufficient and proper medical benefit. With that proviso I quite agree, if you do allow a free choice, you must allow the insured person an unfettered judgment in who is to treat him when he is ill. I believe myself that the discretion that is placed in the insurance committees is very pretty in theory, but that in practice it actually breaks down. Take the Cumberland Insurance Committee. In February last—I have not the information up-to-date —they refused, without any inquiry at all, all applicants leave for power to make their own arrangement. They did not exercise any discretion at all. They simply refused all applications for the right to-select a doctor who was not on the panel. In Wisbech and in Chatteris in February last, the insured person had no choice and was obliged to take the doctor who was sent down, originally by the Insurance Commissioners, who was adopted by the local insurance committee, paid a salary, and turned into a full-time man. The locally insured person had to take that doctor's service whether he wished it or not. Application for power to make a free choice or to contract out was absolutely declined without considering the merits of the case—and there are cases which have merits! I have had dozens of letters from people who have really thought that they had a right to choose their own doctors. There is a case that I have in mind, that of a man who had some hurt in his limbs which prevented him from walking. He had been attended for eight years by a doctor who did not go on the panel. He applied for permission to continue to be treated by that doctor. He was refused and was referred to the panel doctor. His doctor had treated him for eight years and presumably knew more about him. Why on earth in a case like that, if the doctor is willing to continue the treatment, should that man be sent to a panel doctor whom he had never seen. I quite admit that the panel doctor might be the better doctor, but why should the man be forced to change his medical attendant because the insurance committee were too busy to consider the details of his claim, and that is not the only case. There are hundreds of similar cases. The right hon. Gentleman the Secretary to the Treasury said that if this Amendment were accepted we should run the risk of losing the services of the panel doctors. Surely that cannot be a serious statement. What risk is there of losing the services of the panel doctors because men are entitled to choose either panel doctors or doctors off the panels? Surely the free choice would increase the number of doctors who would be willing to look after insured patients. You would get a larger area of choice and a larger number of men coming to the service of the insured people. It. seems to me that, far from running any risk of hurting the medical service, you would be improving it, not only by increasing the number of men who would serve the insured people, but also by preventing a division of the profession into two classes, panel doctors and non-panel doctors, and you would raise the tone of the medical service and put the insured persons much more upon the level of those who do not have to rely on contract practices for their medical attendance."Though free choice of doctors will, to some extent increase the charge, I personally have always been in favour of it. After all confidence in your doctor is essential. No Mall who can afford to do otherwise would have a doctor prescribe for him by any club or society. He wants his own doctor to doctor him the doctor in whom he has full confidence."
I do not desire to give a silent vote upon this matter, because it is one that really affects the constituency I have the honour to represent, perhaps almost more than any other in the country, because we have a very large number of insured persons who are anxious to take advantage of Subsection (3) of Section 15, and who are refused by the insurance committee of the county, acting, I believe, under instructions from the Insurance Commissioners. The Government must deal with this question one way or another; there is no doubt about that, because in the North of England we have a large number of well-paid workmen and others who are anxious to have their own medical men. They do not and will not go to the panel doctors, and you really cannot compel them. I am told that something like over 2,000 men have signed their cards and applied for exemption and leave to contract out under Section 15, but in every case they have been refused. We heard it stated distinctly, and it was always understood, and we always argued and explained this Act in that light, that there was a free choice of doctors, and when these men and women —a very large number of them teachers—have applied to contract out, and were ready to make their own arrangements with their own doctors, in every case, without exception, they were refused. I have scores and scores of cases brought to my own knowledge, appealing to me as Member for the borough to try and have this matter put right, but in every case the county committee has refused to give them the right to contract out.
I think we ought to have some reason why it is that this right is denied these persons. If the Government is not prepared to state the reason why, then I think it must be this: There is no doubt, and there is no use denying it, that there was a fight between the Commissioners and the doctors as to whether the doctors would go on the panel or not. That fight is over, I believe, to a great extent. We have a very large number of doctors in my own town on the panel, but there are a very large number of doctors who are not on the panel, men who have not done what is called contract practice in the past. These men have attended hundreds and thousands of these insured persons who are desirous of keeping their own doctors. I have gone so far as to bring the doctors to the Insurance Commissioners, but up to the present time there has been no settlement and I think we are entitled when there is such a large demand in many towns in the North of England to have this matter put right. The demand is general. I know that in the county of Durham there has been a very large number of applications for free choice of doctors, quite apart from the town in which I live. Therefore, I contend if the Government are not prepared to insist that regulations of the Insurance Commissioners shall be made so that these persons may claim the right under Sub-section (3) of Section 15, some other steps ought to be taken to meet their case.That has already been dealt with.
I do not very often speak, and I think I have a right to place a case like this before the House, and to press it upon the Government as I did in Committee upstairs.
I merely observed that the hon. Member would have heard that point answered had he been here a moment ago.
I am sorry I was not here., but I know it was not answered upstairs, and when I am requested by hundreds of my own Constituents to press this point upon the Government, I think I have a right to do so. I have gone so far as to try to bring the parties together, and I think I now have a right to place the case before the House of Commons, even if it delays business for a short time. I press upon the Government that they should instruct the Insurance Commissioners that where people who are insured persons claim the right to contract out, and where they are prepared under Sub-section (3) of Section 15 to take the money in lieu of medical benefit and to make their own arrangements with their own doctors, to meet these people once and for all and tell them they are prepared to deal with this matter either through regulations or by an Amendment such as is before the House at the present moment. I do not say that that Amendment is a satisfactory one. I prefer the Sub-section in the Act as it stands. If that Sub-section were carried out, and the regulations of the Commissioners were not as onerous as they are, we should not have this conflict of interest in our boroughs and towns with regard to medical benefits.
I desire to support this Amendment. If a doctor before he goes on the panel has the right to choose whether he will attend insured persons or not, surely an insured person ought to be equally at liberty to secure the services of a medical man who is not on the panel! When the Bill was passing through the House it was declared over and over again that the insured person would have the choice of his own doctor. Unless this Amendment is carried that promise cannot be fulfilled. We all feel that it is important that a person who is ill should be able to choose the doctor in whom he has the most confidence, and that cannot be secured unless this Amendment is adopted.
I cannot quite follow the arguments of the Financial Secretary to the Treasury or those used by the hon. Member below the Gangway when they say that the adoption of this Clause would wreck the Bill. After all, it is open to an insured person to contract out and choose his own doctor, but under the Bill only a small number will be able to exercise that right. To say that this is a question which will affect 18,000 doctors is pressing that objection much too far. It is well known that in doctoring faith in the doctor has a great deal to do with the matter, and I can quite conceive that the curing of a sick person might be put back owing to the fact that he felt a grievance because he could not choose his own doctor. If a sick man is told that he must have a doctor on the panel, and not one of his own free choice, it might retard his recovery altogether. If it is really true that this Clause is going to wreck the whole Bill, then we might have to consider whether it is worth carrying this measure at all. If it is only intended to deal with a small percentage of exceptions and give this right which may mean so much to the sick person, I cannot see why the Government is opposing this proposal so strongly. If the hon. Member carries his proposal to a Division I hope we shall receive a strong support from the other side of the House in trying to defeat the Financial Secretary to the Treasury on this point.
I happen to know one or two cases in point where an injustice has been done under this Act. They were persons who were anxious to continue the attendance of the doctors who had attended them before the Insurance Act, and they were not able to have this privilege, and they had to call in fresh doctors. Of course I do not say a word against those doctors. I know some of them are hopelessly over- worked, and have not time to give full attention to all the cases sent to them. The Under-Secretary made an attack upon my hon. Friend, and stated that he moved some objectionable Clause in the Committee upstairs. I wish to place before the Committee the absolutely simple point that these poeple who have been attended by certain doctors before the Act was passed should be allowed under this Bill to have the right to say, "I do not wish to have a panel doctor, but I will take a small sum of money and go to the doctor I have had before." I think that is reasonable. The right hon. Gentleman says that we must not pass this Amendment because it would smash up the medical benefit under this Bill, and the hon. Member below the Gangway said that, we should wreck the Bill by this Amendment.
I am sure the hon. Member does not wish to misrepresent me. I said that this Amendment would place the whole Act in jeopardy on account of the agitation it would be sure to arouse amongst the medical profession.
That means that there are so many people under this Act dissatisfied with the attendance of panel doctors that they would make use of this Amendment to such an extent that it would make it impossible for the panel doctors to continue. That is something like the case of a railway company who took off a refreshment car because there were so many people wanted to use it. Here we have a statement from the Government, that if this Amendment were carried such is the feeling of dissatisfaction with the panel doctors, among insured persons, that it would jeopardise the whole Act and smash up medical benefit. I was perfectly amazed that the right hon. Gentleman had nothing stronger than that to say against this Amendment. Surely this is a simple Amendment which the Government ought to accept. It is simply a proposal that the people who have paid their insurance money, and who are offered the services of a panel doctor, who may be overworked or who may be distasteful to them, should be allowed to have the doctor who has previously attended them, and pay him out of their own pockets. The right hon. Gentleman says that this would be monstrously unfair, because all the good lives would go to doctors who were not on the panel and only the bad lives would go to the panel doctors. I do not think it would have that effect, because, as a rule, it is the bad lives who are anxious to stick to their own doctors. A patient does get attached to a certain doctor, although he may not have been thoroughly successful in curing him. For these reasons I shall support the Amendment, and I hope the Government will meet this point and do what I am perfectly certain is a thing wished for by a very large number of people in this country at the present time.
I think that a good deal of that which we heard earlier in the day about the breaking of contracts applies to this Amendment. It appears to me that the House of Commons has arranged and directed that these people who are compulsorily insured shall have the choice of doctor. That was made perfectly clear in the Act, and it was made still clearer by the speeches of the Chancellor of the Exchequer in the country. We have undertaken to give the insured person free choice of doctor, and we ought to stick to that point. I do not think that the medical profession are opposed to this Amendment; indeed, from what I know of them, they are keenly in favour of it. I do not think that you would have any strike of doctors, I think that they would support the House of Commons if we gave this free choice of doctor. This is really a democratic matter. It is the working classes of this country who want the right which has been promised by the Chancellor of the Exchequer. I notice that none of the hon. Members below the Gangway have taken any part in this Debate, and I should like to hear what the leader of that party has to say. I am convinced that the working classes of this country look to the representatives of labour they have returned to this House to specially watch their interests, and my vote in this matter will be very largely guided by what the Leader of the Labour party has to say on the subject. At the present, moment I am convinced that the working men of the country want this Amendment, and, unless the Leader of the Labour party can convince me the other way, I shall vote for it.
I fail entirely to understand the object of this Amendment, because it seems to me that it does not carry the matter in the least bit further than Section 15, Sub-section (3) of the Act. That gives insurance committees full discretion to do what they think fit, subject, of course, to certain circumstances warranting persons being allowed to make their own arrangements. The last speaker said that this was really a democratic Amendment. Let us see who really are the people who have the discretion. Who are the insurance committees to whom this discretion is permitted? They are not Government officials. They are not persons selected by the doctors, or by the Government, or by anybody else. Three-fifths of them are people democratically elected, people representing insured persons who have in the last two or three months been actually elected by a democratic vote, and I believe by proportional representation of which hon. Gentlemen opposite are so very fond. Those are the people who have the discretion. My hon. Friend the Member for Stockton (Mr. J. Samuel) said that he believed instructions were sent out by the Insurance Commissioners to do this or that. No such instructions at all have been given in the county of London, and I cannot understand that the insurance Commissioners would interfere in a matter with which they have absolutely no concern, and as to which the insurance committees could tell them to mind their own business.
The Sub-section itself says that it is subject to regulations made by the Insurance Commissioners, and we have been given to understand that those regulations have been sent out.
The hon. Member is entirely mistaken. No regulations have been issued fettering the discretion of the insurance committee. We have had no trouble in London except at the beginning when we had a circular sent out by a few members of the British Medical Association, and it has since been admitted to me that it was done intentionally with the idea of breaking down the medical system. That was absolutely admitted to me by one of the gentlemen who sent out the circular. The last statistics of the hon. Member for Colchester (Mr. Worthington-Evans) were apparently in February, which, of course, was when this agitation was at its highest. Since then every application has been considered on its merits. I, myself, had certain lines laid down by my committee, and I this morning went through forty or fifty applications, and there were only two which had to be refused. When you get a case, such as that quoted by the hon. Member for Colchester, where a person has been treated for eight years, it is granted as a matter of course, and I believe that it would be granted by any insurance committee. I believe that even the Stockton Committee or the committee for the county of Durham would grant it. Such cases are the very cases which come under Section 15. I do not believe that the trouble exists at all or that the Amendment is of the least use, and, if it were carried, it would stir up the whole of the agitation again.
I think that it would be a very good thing if the Amendment were put in the Bill so that definite directions might be given to the insurance committees as to the way in which the House, and I think the insured community, would wish them to exercise the discretion which they have now. The hon. Gentleman who has just sat down, and who is chairman of the London Insurance Committee, tells us that the Insurance Commissioners have not sought in any way to affect the discretion of the insurance committees. Of course, the Insurance Commissioners have not sought to influence the discretion of the committees. That was done by the Chancellor of the Exchequer. Just when the negotiations with the medical profession were hanging in the balance the Chancellor of the Exchequer made a speech in which he made it clear that the Government would not allow insurance committees to use their discretion in this matter, and it is because the insurance committees have acted as the very faithful servants of the Chancellor of the Exchequer that so much of this difficulty has arisen. The Insurance Commissioners just about that time, recognising the right of the insured community to the free choice of doctor, as well as the right of the insurance committees to allow that free choice, issued to insured persons the pink ticket, at the bottom of which was printed a notice as follows:—
That shows perfectly clearly that the Insurance Commissioners recognise the right of insured people to exercise that choice which the Chancellor of the Exchequer promised them. I have been tempted to look back upon the history of this question by what has fallen from the hon. Member, but I do not wish to be unduly controversial. I want to give my view with reference to the necessity for passing the Amendments proposed by my hon. Friend. He has said that he does not wish to break down the panel system, but that he wishes to supplement it. We are told by the Government that the panel system is securely established. We are told that they have got upwards of 18,000 doctors on the panel at the present time. We were told by the Chancellor of the Exchequer some time ago that if he could only get the services of 10,000 doctors he could work the Act under the panel system. He has therefore now got nearly double the number of doctors he declared to be essential. If you have really got the panel system firmly established as you say that you have, then you will not be running any risk in giving the insured person the right of choosing his doctor. I know that the hon. Member for Stockton (Mr. J. Samuel) speaks with great authority in this matter and has a great knowledge of the real wishes of the people who live in his constituency. I know from my own experience the real wishes of a great many of the working classes in my own Constituency. I know, we all know, that it used to be even under the old friendly society practice quite a common occurrence for friendly society members to pay out of their own pockets the fees of their own doctors, although they were entitled by the subscriptions they paid to their society to the contract service of the society doctor. You have not in the least removed the objection which is sincerely felt by a great body of the working-class population in this country to contract medical service. You have not removed that simply by passing the Act. The objection to contract service still remains. I believe it is largely at the bottom of what appears to be the neglect of a great many people to select their doctor on the panel at the moment. Evidently they do not intend to have a panel doctor. You compel them to subscribe for one, but you cannot make them go to one. They are driven, when ill, to call in a medical man of their own free choice, because the insurance committees exercise their discretion in the way pointed out by hon. Gentlemen opposite, and, consequently, these people are denied the right which I say the Act gives them, and which they ought to have."To doctors and insured persons.— If you are arranging with the insurance committee to obtain your treatment from a doctor not on the list, and wish to claim a contribution towards the cost of treatment, you must send this ticket to the insurance committee."
What is the meaning of the various Amendments on this point which have been put forward? The first proposal was that you should inaugurate a system in which you have no choice at all. This Amendment proposes there should be indiscriminate choice, and the next Amendment suggests it shall be limited to 2,500. They are absolutely incompatible, and I want to find out what system the Opposition really want. That is the whole question before us. It was the question in February. What was the reason why the insurance committees declined the wholesale applications from people who wanted to make their own arrangements? The object of the applications was to break down the system, and it would have been broken down. There is no question about that. The powers which it is proposed to confer under this Amendment are already in the Act, in Section 15, Sub-section (3), and, as the chairman of the London committee has explained, they are now being carried out in all cases where they are really needed. Insurance committees did not carry them out in February because of the campaign to defeat the whole system and take away the foundation stone. Now this discretion on the part of insurance committees is being largely exercised.
But I have no doubt that, if we introduce this Amendment into the Bill it will only have the effect of stirring up strife again, and that I am inclined to think is the main purpose of the Opposition. It is of no use the hon. Member for the Wilton Division to shake his head. It is the inevitable effect of an Amendment of this kind. The powers are already in the Bill, and there can be no other result of introducing an Amendment of this kind than to lead to another wholesale agitation against the panel system. Hon. Members opposite are incurring a responsibility which some day they will regret. They tell us not to draw this distinction between panel doctors and non-panel doctors. But who has drawn the distinction? It has arisen because a most malicious campaign was engineered in January and February to depreciate the qualities of the men who went on the panel. We have had the hon. Member for Glasgow University talking to-day about "mere panel doctors," but I know for a fact that in a large number of counties every man in general practice is on the panel. This is a vast campaign to detract from the very large number of men on the panel. That campaign has been dying down. I want it to die down. This Amendment will only resuscitate the whole thing, and I hope the House will not make itself a party to putting into the Bill words which will simply reopen these miserable controversies. We have already in the Bill what is proposed in this Amendment, and I believe that the insurance committees will exercise the power with wisdom and discretion.I should not have risen to speak on the Amendment had the hon. Member opposite not suggested that it was put down deliberately in order to stir up strife. I should like to say that a very large number of the organisations of approved societies have requested this House to support this Amendment, and, in addition to that, the Medical Association, through its journal, has also invited support of an Amendment of this nature. I am a member of an insurance committee and I resent the suggestion which has been made on the other side of the House that insurance committees would object to greater latitude being given to them in the emphatic way such an Amendment suggests.
This Amendment does not give any greater latitude whatever.
I do not care how you put it, but I suggest that this would emphasise what we desire to see—it would emphasise the latitude which already exists and which enables insurance committees, if they so choose, to allow a person to obtain a privilege which is specifically given him under the principal Act. Three-fifths of the insurance committees are representative of approved societies. Speaking for my own insurance committee, I am quite satisfied that two-thirds will be emphatically unanimously in favour of this Amendment. Why is it that insurance committees have taken this line all over the country? It is because they do not want to appear to be contumacious towards the Government. They do not want to appear to be inspired by party spirit in their administration. That is the sole reason why they have not oiled the wheels and have not given a greater number of persons desiring to have separate medical attendance the opportunity of obtaining what the Act has provided for them. I am certain a large number of the provincial insurance committees, so far from considering that it would upset their administration, would welcome such a Clause as this. In fact, they would be enabled thereby, especially if the Government gave their assent to this Amendment, to carry out what they desire; they only want the assurance that the Government and the Insurance Commissioners are not opposed to the line they would like to adopt.
If this Amendment were carried, it would pull down the whole superstructure of the Act about our heads. It is essential that each doctor should be loyal to the approved society as well as to his patients, and it is necessary, too, that he should be under a certain amount of control. It is claimed that this is a democratic Amendment. The principle of democracy is that those who pay should control. Now approved societies pay the fees and they should, therefore, exercise control. It is necessary that doctors should come under a certain amount of discipline. If a doctor does not consider the interests of the society and his duty towards it as well as his duty to his patients, it will be quite possible for him to make rules and regulations of his own. He might prescribe expensive medicines without regard to the funds of the society. He could also discriminate between panel patients and ordinary private patients, and he could make rules and regulations by which the private patients should attend at certain hours and the panel patients be relegated to less convenient hours. If he has a vested interest in the society you will find he will consider the interests of the society as well as of his patients.
He is not paid by the societies.
If you allow him to take patients outside all disciplinary control he may indulge his pet patients. There are doctors to-day who are taking extra fees; they are getting the ordinary panel fees, and the patients are arranging to provide an additional fee every year, thus supplementing the ordinary fee. How are you going to keep control over the doctors, seeing that human nature is what it is, if they have no sense of loyalty to the approved societies themselves? Every doctor can be on the panel if he likes. The campaign against panel doctors has tended to divide the doctors into two great classes—those who are panel doctors and those who are not, and to show that those who are not panel doctors are more skilful and able than those who are. That is a false discrimination. You will find that doctors will come on to the panel more and more if they think they cannot get patients unless they do. An actuary I know went through the books of a doctor who was on the panel and he found that the doctor was getting 16s. per visit for all the panel patients he visited. From the number he had on the panel and the amount he got at the end of each quarter it worked out at 16s. per visit. When doctors find that out, you will find them coming on the panel. If you allow them to make private arrangements with patients you will destroy that kind of disciplinary control which is necessary for the successful working of the Act.
I suppose the two speeches to which we have just listened from the hon. Member for Hoxton (Dr. Addison) and the hon. Member for Stirlingshire (Dr. Chapple) are intended as the model of the spirit which will drop all hostility and spread peace generally among the various interests. I wonder what the attitude of the medical profession can be expected to be in face of such denunciations as those of the hon. Member for Hoxton. "A base conspiracy" were the words he used.
Dr. ADDISON rose—
I ant not going to give way. The hon. Member is fond of getting up to make a violent attack on the Members of his own profession, and then of interrupting those who follow him. The hon. Member has thought it not unworthy of his position here to make accusations against members of his own profession which I do not hesitate to say are libellous. As my hon. Friend pointed out, it is not merely in the interests of the doctors and professional interests that a free choice of doctors is insisted upon, but it is in the interests of the ordinary insured persons and of the friendly societies themselves. If the hon. Member will allow me to say so, of the two royalties—loyalty to his Government or loyalty to his profession—he has chosen the first rather than the second. We now see the spirit with which the supporters of the Government treat the profession. We are now told plainly and straightforwardly that they are to be under the discipline of the friendly societies that they are not to use expensive drugs which they may think necessary for their patients, because the friendly societies might object to it. This is one instance in which the interests of the profession are the interests of the country at large and of the insured persons. The profession is standing up for what they consider to be an essential point, the choice by the patient of a doctor, which is the only foundation of that confidence between a patient and doctor, which is the first condition of success. I do not attach significance to the various sarcasms which the hon. Member for Perth (Mr. Whyte) and the hon. Member for North-West Lanarkshire (Mr. Pringle) have addressed to myself. I do not withdraw a single word of the speech I made, and I am perfectly ready to answer to any of my own Constituents quite as much as the hon. Member for North-West. Lanarkshire or the hon. Member for Perth.
You never meet them.
I meet them a good deal oftener than some Members think, and I am in contact with them in a way perhaps hon. Members do not know. I know their wishes, and that they are not likely to misunderstand the words I used when I said that a large number of the respectable middle-classes of this country, however well they may think of the panel doctor, are not prepared to take hint because he is on the panel. They wish to choose their own doctor, however respectable the panel doctor may be, because they select him for themselves, and there is sympathy between them. In supporting, as I do most heartily, the Amendment of the hon. Member for Salisbury (Mr. G. Locker-Lampson) I am convinced that I am acting not only in the interests of one profession, but in the interests of the health of the community generally, and in the interests of the insured person to whom it is a privilege which they highly prize and which can only be secured by an Amendment of this kind. The hon. Member for Hoxton told us that the discretion of the local insurance committees is being used. Then what harm is there in the Amendment? If it is being used, why not put in a permissive provision of this kind. Hon. Members opposite know perfectly well that it is not being used as largely as it ought to be, because the insurance committees are acting under the dominating influence of the Commissioners, who are against this plan, and who are inclined to be animated by the feeling to which the hon. Member for Hoxton gave expression, that if you once allow this to be done generally it would break down the foundations of the Bill. Let the Bill take care of itself. We are looking after the interests of the insured persons, the health of the country, and the establishment on a sound basis of the relations between the medical profession and the patients.
I desire to give a reason or two why I cannot support the Amendment proposed by hon. Gentlemen opposite. I do not want to question their sincerity in moving the Amendment, and am quite prepared to admit that in a case of this kind it is impossible to make a Bill to the liking of every individual. But if this Amendment is carried, I am convinced that not only will it not improve the Act, but that it will make the administration of the Act worse. Secondly, there is the question of the insurance committees. The Amendment says that the insurance committees are to be satisfied whether applicants should have the right to choose a doctor outside the panel. What is to be the standard of satisfaction; and will every insurance committee have the same standard? I fear that by this Amendment you will set up internal disruption that will do more harm to the individuals concerned than the Act does at the present time. You are going to have a certain number of persons who can satisfy the committee, and other persons who will make applications which will be refused, and who will go back to their societies and want to know the reason why. The whole thing in a very short time would be in a turmoil. The same thing applies to the doctors. You have a certain class of doctors who may be given the privilege of having increased fees for their services, while some of the doctors on the panel may not, and they will want to know the reason why. I do not wish to impute for a moment that the Mover of the Amendment wishes to smash up the panel system, but I am perfectly sure that if there is anything which is calculated to do that, it is the setting up of jealousies between the doctors as to the amount of the fees they are getting. Whether I am right in my opinion or not, I am perfectly convinced that if this Amendment is carried it will do more to smash up the panel system than anything that has been proposed. Could anybody conceive that 14,000,000 of insured persons could be satisfactorily dealt with by any system in the short time that the Act has been in operation? We have to face the fact as it is. The short time the Act has been in operation could not give anybody the best idea as to how medical benefit can be worked on a satisfactory basis, and if we could only get it in efficient working order so as to ascertain where the real difficulties are, and thus find a real remedy for the real defects, that is the only way in which we can do any good in this direction. I know something about the working of the Act from the approved society point of view, and I also know how things are going on with regard to insurance committees, and I am more than afraid that if the Amendment is carried, not only will there be dissension and disruption in the insurance committees, but it will be carried from there to the approved societies, and the same thing will apply amongst doctors, and it will do more harm than it could possibly do good. I hope the House will reject the Amendment.
This has been very elaborately discussed for some considerable time. If controversial matter has been introduced on either side, I regret it. Considering how much we were able to keep aside from controversial matter in Committee and how Gentlemen of all parties helped us in Committee, I suggest that Gentlemen of all parties might abstain from taunts, and controversies on the Report stage of the Bill. I am very grateful to the House for having allowed us to make the progress we have made, but we seem to have come to a sort of hitch on this Amendment. I think the arguments have been fairly presented, and everyone has made up his mind how he is going to vote, and we might now go to a Division. The only point I would make in respect to the hon. Member (Sir H. Craik) is this: I do not think he heard my speech, but those who were unfortunate enough to hear it will recognise that my appeal was for conciliation and for the healing influences of time. We have only had six months' experience, and we could not arrange a system under the present Act which would be satisfactory to all parties.
10.0 P.M
I do not think the right hon. Gentleman can have heard the speech of the hon. Member (Dr. Addison), for any thing more provocative we could not well have had. He told us that the Amendment was a base campaign, and all sorts of things which were very undesirable. Therefore, I think the right hon. Gentle- Man's appeal should be directed, in the first instance to his own colleagues. I was interested to hear the remarks of the hon. Member (Mr. Albert Smith). He told us it would be quite impossible to form any scheme which would give satisfaction to 14,000,000 insured persons in regard to medical benefit. I quite agree it will be very difficult to frame any rules which will meet with everybody's satisfaction; but why close the door to alternative schemes? Why not make the scheme as elastic and as wide as we possibly can? It is a most extraordinary argument to come from those who represent the Labour party that everyone is to be brought into one compartment whether he likes it or not, and forced to have a doctor to attend him whether he is the doctor of his choice or not, when he knows perfectly well that even in the old days, when friendly societies could manage their own affairs, many people refused to have the friendly society doctor because they wished to have the doctor of their own choice. We have been referred to former promises of the Chancellor of the Exchequer, and my hon. Friend (Mr. Worthington-Evans) quoted some of his sayings, but I do not think he quoted this one, which is the gist of this Amendment. The Chancellor of the Exchequer, during his Tabernacle
Division No. 260.]
| AYES.
| [10.5 p.m.
|
| Agg-Gardner, James Tynte | Eyres-Monsell, Bolton M. | Lloyd, George Ambrose (Stafford, W.) |
| Baird, John Lawrence | Fell, Arthur | Lloyd, George Butler (Shrewsbury) |
| Baker, Sir Rondolf L. (Dorset, N.) | Finlay, Rt. Hon. Sir Robert | Lowe, Sir F. W. (Birm., Edgbaston) |
| Baldwin, Stanley | Fisher, Rt. Hon. W. Hayes | M'Neill, Ronald (Kent, St. Augustine's) |
| Banbury, Sir Frederick George | Fitzroy, Hon. Edward A. | Magnus, Sir Philip |
| Baring, Major Hon. Guy V. (Winchester) | Fletcher, John Samuel | Markham, Sir Arthur Basil |
| Barlow, Montague (Salford, South) | Forster, Henry William | Morrison-Bell, Major A. C. (Honiton) |
| Barnston, Harry | Gibbs, George Abraham | Mount, William Arthur |
| Bathurst, Charles (Wilts, Wilton) | Glazebrook, Captain Philip K. | Newdegate, F. A. |
| Beach, Hon. Michael Hugh Hicks | Goldsmith, Frank | Newman, John R. P. |
| Benn, Ion Hamilton (Greenwich) | Gordon, Hon. John Edward (Brighton) | NieId, Herbert |
| Bentinck, Lord H. Cavendish- | Goulding, Edward Alfred | Pease, Herbert Pike (Darlington) |
| Bigland, Alfred | Grant, James Augustus | Perkins, Walter Frank |
| Bird, Alfred | Greene, Walter Raymond | Pollock, Ernest Murray |
| Blair, Reginald | Gretton, John | Pryce-Jones, Colonel E. |
| Boyle, William (Norfolk, Mid) | Guinness, Hon. Rupert (Essex, S.E.) | Randles, Sir John S. |
| Boyton, James | Guinness, Hon.W. E. (Bury S. Edmunds) | Rawlinson, John Frederick Peel |
| Bridgeman, William Clive | Gwynne, R. S. (Sussex, Eastbourne) | Rawson, Colonel Richard H. |
| Bull, Sir William James | Hall, Frederick (Dulwich) | Roberts, S. (Sheffield, Ecclesall) |
| Burn, Colonel C. R. | Hamilton, C. G. C. (Ches., Altrincham) | Salter, Arthur Clavell |
| Campbell, Captain Duncan F. (Ayr, N.) | Harris, Henry Percy | Samuel, J. (Stockton-on-Tees) |
| Cassel, Felix | Henderson, Major H. (Berks, Abingdon) | Samuel, Samuel (Wandsworth) |
| Cater, John | Henderson, Sir A. (St. Geo., Han. Sq.) | Sanders, Robert Arthur |
| Cecil, Evelyn (Aston Manor) | Hibbert, Sir Henry F. | Scott, Leslie (Liverpool, Exchange) |
| Cecil, Lord R. (Herts, Hitchin) | Hills, John Waller | Spear, Sir John Ward |
| Clay, Captain H. H. Spender | Hoare, Samuel John Gurney | Stanier, Beville |
| Clive, Captain Percy Archer | Hope, James Fitzalan (Sheffield) | Stanley, Hon. G. F. (Preston) |
| Craik, Sir Henry | Hope, Major J. A. (Midlothian) | Steel-Maitland, A. D. |
| Dalrymple, Viscount | Horne, Edgar (Surrey, Guildford) | Stewart, Gershom |
| Dalziel, Davison (Brixton) | Horner, Andrew Long | Swift, Rigby |
| Denison-Pender, J. C. | Houston, Robert Paterson | Talbot, Lord Edmund |
| Denniss, E. R. B. | Hunt, Rowland | Terrell, George (Wilts, N.W.) |
| Dickson, Rt. Hon. C. S. | Ingleby, Holcombe | Terrell, Henry (Gloucester) |
| Duke, Henry Edward | Jessel, Captain H. M. | Thomson, W. Mitchell- (Down, North) |
| Duncannon, Viscount | Kerry, Earl of | Thynne, Lord Alexander |
speech, definitely put forward the proposals which are contained in this Amendment. He said:—
"The first thing to happen is that he will have free medical attendance. He can have the doctor of his own choice.…"
Does the hon. Gentleman opposite think the panel doctor is necessarily the doctor of his own choice? He knows it is not.
"He is not obliged to go to Doctor A because there happens to be a majority in the Club which prefers Doctor A. Doctor B has pulled him through before. He says, 'That is the man I put my trust in,' and faith is nine points of belief, spiritual, mental, or physical. What a tine thing it is to get the doctor you want, and to get someone else to pay for it! That is the Government Insurance Bill."
I ask the hon. Member opposite if he claims that in opposing this Amendment he is doing the best he can to give the working men free choice of the medical attendance he wants It is perfectly absurd. You may say a man ought to be forced to go to a doctor he does not want, but you cannot say that you are carrying-out the Chancellor of the Exchequer's promise or the wishes of the working classes in this country if you force them to go to a doctor they do not believe in.
Question put, "That those words be there inserted in the Bill."
The House divided: Ayes, 114; Noes,. 245.
| Tryon, Captain George Clement | Wood, Hon. E. F. L. (Yorks, Ripon) | Younger, Sir George |
| White, Major G. D. (Lancs, Southport) | Wood, John (Stalybridge) | TELLERS FOR THE AYES.—Mr. G. Locker-Lampoon and Mr. Harry Lawson. |
| Wills, Sir Gilbert | Worthington-Evans, L. | |
| Wolmer, Viscount | Yate, Colonel Charles Edward |
NOES.
| ||
| Abraham, William (Dublin, Harbour) | Goldstone, Frank | Muldoon, John |
| Acland, Francis Dyke | Greig, Colonel James William | Munro, Robert |
| Addison, Dr. Christopher | Griffith, Ellis Jones | Munro-Ferguson, Rt. Hon. R. C. |
| Adkins, Sir W. Ryland D. | Guest, Hon. Frederick E. (Dorset, E.) | Murray, Captain Hon. Arthur C. |
| Alden, Percy | Gulland, John William | Needham, Christopher T. |
| Allen, Arthur A. (Dumbartonshire) | Gwynn, Stephen Lucius (Galway). | Neilson, Francis |
| Allen, Rt. Hon. Charles P. (Stroud) | Hackett, John | Nolan, Joseph |
| Arnold, Sydney | Hall, F. (Yorks, Normanton) | Norton, Captain Cecil W. |
| Baker, Harold T. (Accrington) | Harcourt, Rt. Hon. R. L. (Rossendale) | O'Brien, Patrick (Kilkenny) |
| Baker, Joseph Allen (Finsbury, E.) | Harcourt, Robert V. (Montrose) | O'Connor, John (Kildare, N.). |
| Balfour, Sir Robert (Lanark) | Harmsworth, Cecil (Luton, Beds) | O'Connor, T. P. (Liverpool) |
| Barlow, Sir John Emmott (Somerset) | Harmsworth, R. L. (Caithness-shire) | O'Doherty, Philip |
| Barnes, George N. | Harvey, A. G. C. (Rochdale) | O'Donnell, Thomas |
| Beale, Sir William Phipson | Harvey, T. E. (Leeds, West) | O'Dowd, John |
| Beck, Arthur Cecil | Hayden, John Patrick | O'Grady, James |
| Benn, W. W. (T. Hamlets, St, George) | Hazleton, Richard | O'Kelly, Edward P. (Wicklow, W.) |
| Bentham, George Jackson | Henderson, John M. (Aberdeen, W.) | O'Malley, William |
| Bethell, Sir John Henry | Henry, Sir Charles | O'Neill, Dr. Charles (Armagh, S.) |
| Boland, John Pius | Hewart, Gordon | O'Shaughnessy, P. J. |
| Booth, Frederick Handel | Higham, John Sharp | O'Shee, James John |
| Bowerman, Charles W. | Hinds, John | O'Sullivan, Timothy |
| Boyle, Daniel (Mayo, North) | Hodge, John | Outhwaite, R. L. |
| Brace, William | Hogge, James Myles | Palmer, Godfrey Mark |
| Brady, Patrick Joseph | Holmes, Daniel Turner | Parker, James (Halifax) |
| Brocklehurst, W. B. | Holt, Richard Durning | Pearce, Robert (Staffs, Leek) |
| Brunner, John F. L. | Howard, Hon. Geoffrey | Pease, Rt. Hon. Joseph A. (Rotherham) |
| Bryce, J. Annan | Hughes, Spencer Leigh | Phillips, John (Longford, S.) |
| Burke, E. Haviland- | Illingworth, Percy H. | Pointer, Joseph |
| Burt, Rt. Hon. Thomas | Isaacs, Rt. Hon. Sir Rufus | Ponsonby, Arthur A. W. H. |
| Buxton, Noel (Norfolk, North) | John, Edward Thomas | Price, C. E. (Edinburgh, Central) |
| Byles, Sir William Pollard | Jones, Rt. Hon. Sir D. Brynmor (Swansea) | Priestley, Sir W. E. B. (Bradford, E.) |
| Carr-Gomm, H. W. | Jones, Henry Haydn (Merioneth) | Primrose, Hon. Neil James |
| Cawley, Sir Frederick (Prestwich) | Jones, J. Towyn (Carmarthen, East) | Pringle, William M. R. |
| Cawley, Harold T. (Lancs., Heywood) | Jones, William S. Glyn. (Stepney) | Radford, George Heynes |
| Chancellor, Henry George | Jowett, Frederick William | Rea, Rt. Hon. Russell (South Shields) |
| Chapple, Dr. William Allen | Joyce, Michael | Rea, Walter Russell (Scarborough) |
| Clancy, John Joseph | Keating, Matthew | Reddy, Michael |
| Clough, William | Kellaway, Frederick George | Redmond, John E. (Waterford) |
| Clynes, John R. | Kennedy, Vincent Paul | Redmond, William (Clare, E.) |
| Collins, Godfrey P. (Greenock) | Kilbride, Denis | Redmond, William Archer (Tyrone, E.) |
| Condon, Thomas Joseph | King, Joseph | Richardson, Albion (Peckham) |
| Cornwall, Sir Edwin A. | Lambert, Rt. Hon. G. (Devon, S. Molten) | Richardson, Thomas (Whitehaven) |
| Cotton, William Francis | Lambert, Richard (Wilts, Cricklade) | Roberts, Charles H. (Lincoln) |
| Cowan, W. H. | Lardner, James C. R. | Roberts, George H. (Norwich) |
| Crumley, Patrick | Law, Hugh A. (Donegal, West) | Roberts, Sir J. N. (Denbighs) |
| Cullinan, John | Lawson, Sir W. (Cumb'rld, Cockerm'th) | Robertson, John M (Tyneside) |
| Davies, David (Montgomery Co.) | Leach, Charles | Roche, Augustine (Louth) |
| Davies, Ellis William (Eifion) | Levy, Sir Maurice | Roe, Sir Thomas |
| Davies, Timothy (Lincs., Louth) | Lewis, Rt. Hon. John Herbert | Rowlands, James |
| Davies, Sir W. Howell (Bristol, S.) | Low, Sir Frederick (Norwich) | Rowntree, Arnold |
| Dawes, James Arthur | Lundon, Thomas | Runciman, Rt. Hon. Walter |
| Delany, William | Lyell, Charles Henry | Samuel, Rt. Hon. H. L. (Cleveland) |
| Denman, Hon. Richard Douglas | Lynch, Arthur Alfred | Scanlan, Thomas |
| Devlin, Joseph | Macdonald, J. Ramsay (Leicester) | Scott, A. MacCallum (Glas., Bridgeton) |
| Dickinson, W. H. | Macdonald, J. M. (Falkirk Burghs) | Sheehy, David |
| Dillon, John | McGhee, Richard | Shortt, Edward |
| Donelan, Captain A. | Maclean, Donald | Simon, Rt. Hon. Sir John Allsebrook |
| Doris, William | Macnamara, Rt. Hon. Dr. T. J. | Smith, Albert (Lancs., Clitheroe) |
| Duffy, William J. | MacNeill, J. G. Swift (Donegal, South) | Smyth, Thomas F. (Leitrim, S.) |
| Duncan, C. (Barrow-in-Furness) | Macpherson, James Ian | Snowden, Philip |
| Edwards, Clement (Glamorgan, E.) | MacVeagh, Jeremiah | Stanley, Albert (Staffs, N.W.) |
| Edwards, John Hugh (Glamorgan, Mid) | M'Callum, Sir John M. | Strauss, Edward A. (Southwark, West) |
| Elverston, Sir Harold | Manfield, Harry | Sutton, John E. |
| Esmonde, Dr. John (Tipperary, N.) | Marks, Sir George Croydon | Taylor, John W. (Durham) |
| Esmonde, Sir Thomas (Wexford, N.) | Marshall, Arthur Harold | Taylor, Theodore C. (Radcliffe) |
| Falconer, James | Masterman, Rt. Hon. C. F. G. | Taylor, Thomas (Bolton) |
| Fenwick, Rt. Hon. Charles | Meagher, Michael | Tennant, Harold John |
| Ferens, Rt. Hon. Thomas Robinson | Meehan, Francis E. (Leitrim, N.) | Thomas, J. H. |
| Ffrench, Peter | Meehan, Patrick J. (Queen's Co., Leix) | Thorne, G. R. (Wolverhampton) |
| Field, William | Middlebrook, William | Thorne, William (West Ham) |
| Fitzgibbon, John | Millar, James Duncan | Toulmin, Sir George |
| Flavin, Michael Joseph | Molloy, Michael | Trevelyan, Charles Philips |
| France, Gerald Ashburner | Molteno, Percy Alport | Ure, Rt. Hon. Alexander |
| Gill, Alfred Henry | Morgan, George Hay | Wadsworth, John |
| Gladstone, W. G. C. | Morrell, Philip | Walsh, Stephen (Lancs., Ince) |
| Glanville, Harold James | Morison, Hector | Ward, John (Stoke-upon-Trent) |
| Wardle, George J. | Williams, Llewelyn (Carmarthen) | Wood, Rt. Hon. T. McKinnon (Glasgow) |
| Waring, Walter | Williamson, Sir Archibald | Young, William (Perthshire, East) |
| Warner, Sir Thomas Courtenay | Wilson, Hon. G. G. (Hull, W.) | Yoxall, Sir James Henry |
| White, J. Dundas (Glasgow, Tradeston) | Wilson, John (Durham, Mid) | |
| White, Patrick (Meath, North) | Wilson, Rt. Hon. J. W. (Worcs, N.) | TELLERS FOR THE NOES.—Mr. William Jones and Mr. Webb. |
| Whyte, Alexander F. | Wilson, W. T. (Westhoughton) | |
| Williams, John (Glamorgan) | Wing, Thomas Edward |
I beg to move, at the end of Sub-section (2), to add,
"(3) The regulations of the Insurance Commissioners shall provide for arrangements being made by every insurance committee for the provision of adequate medical attendance and treatment, as required by the principal Act for insured persons entitled to medical benefit whose condition does not require the services of a specialist or consultant." This Amendment, which I move as a Sub-section of Clause 10, was ruled out of order as a new Clause when I endeavoured to move it as such. By Section 8 of the principal Act it was provided that every insured person shall receive medical treatment and attendance, including the provision of proper medicines and such medical and surgical appliances as may be prescribed by regulations of the Insurance Commissioners. When we come to Section 15, to which I particularly draw the attention of the House, it will be found that the Insurance Commissioners regulations are to provide for arrangements being made to secure that the insured persons shall receive adequate medical attendance and treatment from the medical practitioners with whom arrangements are so made. The object of this Amendment is to ensure that every employed contributor shall receive adequate medical attendance and treatment as provided by the principal Act. In a great many cases of trifling ailments, particularly those connected with the eyes, nose, throat and ears, all ailments, which under the old voluntary system insurance doctors used to treat as a matter of course, are being regarded as diseases which require the services of a specialist, with the result that doctors are declining to treat them altogether under their contract, or else they: are in some cases handing them on to their own partners, not being doctors on the panel, as being specialists in this particular type of disease, and this treatment which they give has to be paid for out of the pockets of the insured persons. This sort of thing is happening, I am sorry to say, in a great many cases to my knowledge in my own district, and also in South Wales. I am sure that the House will agree that this is certainly not what is intended by the Act in Section 15 when the expression "adequate medical attendance and treatment" is used as being the doctor's services to which the employed person is entitled. The object of this Amendment is to ensure that every employed contributor shall have as a matter of right, and as the result of his own contributions all such ordinary medical attendance and treatment as does not necessarily require the attendance of an expert specialist or consultant. This Amendment is framed in very moderate language, much more moderate than that in which I intended to move it in Committee. I have already got the support of at least one doctor in the House to this particular form of my Amendment, and I hope that it may receive the approval of the other medical men in the House. It is intended to throw upon the doctor, in every case in which he refuses to attend to these trifling ailments of various organs, the onus of showing that such ailment requires specialist treatment or else that it should be brought under the contract.I desire to second this Amendment, to secure for these insured people what was guaranteed to them under the principal Act—that they should have adequate medical attendance. I understand that the Insurance Commissioners have issued a regulation which leaves ground for a great deal of the action of the doctors in claiming that certain ailments come under the heading of special treatment. I understand that they have indicated in their regulations, at any rate, that medical attendance and treatment are such services as may be given by a practitioner of as may be given by a practitioner of ordinary professional competence and skill. The interpretation which the Commissioners have put on medical attendance and treatment is not such as would guarantee it to the people, who are compelled to come under this Insurance Act and under the principal Act. My hon. Friend has stated that the treatment of cases of affection of the eye and nose is frequently regarded as an exceptional service, and not a service which the ordinary practitioner should deal With. One is perfectly aware, certainly in country districts, that in days gone by, before we knew of the Insurance Act, treatment of the eye and nose was given by the ordinary medical practitioner. I have a case within my own knowledge of a servant girl whose eyes were inflamed, and unfortunately in their treatment difficulties arose. The services in that case were not considered ordinary services which ordinary practitioners render. She at any rate did not get adequate medical treatment, and she had to incur the expense of being treated by a specialist. That is not really giving a fair and generous interpretation of the very simple and complete words of the principal Act, namely, "adequate medical attendance and treatment."
This Amendment would worsen the conditions instead of making them better. I hope the hon. Gentleman, who is always fair in these matters, will withdraw it. Every insured person has a claim to all kinds of treatment and medical benefit, except that which alone a specialist can give is already included in the Act and regulations, and if the regulations are not being worked, it is not a question of amending the Act, but of amending the administration. On the other hand, as to specialist treatment, I know of no definition which is generally accepted, and if the Amendment were passed, it might be possible for the doctors to refuse treatment which he now gives under the Act, which would be very bad for the insured person, because the doctor on the panel might happen to be a specialist in brain or heart disease. But at present he is giving the full influence of his intelligence to the advantage of the insured person, although he happens to be a specialist in heart disease. If, however, you rule out all specialist treatment that practitioner will be enabled to charge, because he is experienced in this particular disease, extra fees beyond what he is now charging. I think that would be disastrous in regard to the insured persons. What is it now that the Act and regulations give to the insured person? They give to the insured person who chooses his doctor on the panel the right to the treatment which that doctor can give, except treatment which may be interpreted as specialist treatment. Instead of interpreting that in an Act of Parliament, which would involve a Schedule of five or six pages saying what specialist treatment is—and then we could not do it, as my right hon. Friend says—in the case of any dispute as to whether it is specialist treatment or not, we provide ample apparatus for arriving at a decision. If the doctors are doing as the hon. Member for Worcester (Mr. Goulding) suggests, and are refusing to treat simple cases that do not require specialist treatment on the ground that they are not under obligation to treat those cases, the proper course is not to amend the Act, because the Act fully provides that they shall treat those cases, and the regulations also provide a course as to the usual ordinary apparatus and channel of complaint which is open to insured persons and the friends of insured persons to see that those doctors really do carry out what they have agreed to do in the contract. I agree, and here I repeat what I said on a former Amendment, that difficulties have arisen in cases, but I submit those difficulties have arisen in six months of working of the Act, which completely changes the conditions of medical treatment. I believe in many cases those difficulties are bonâ fide on the part of the doctors, and in a little time a few decisions will make those difficulties no longer exist. I had cases brought to my notice in which I am sorry to say the doctor seems to have been violating the actual regulations laid down under the Act. I would ask Gentlemen who represent the doctors here to realise that I am not in the least putting any general charge against the doctors. It may be through ignorance, just as much as through deliberate intention, and I think, without doubt, in a very short time and with the co-operation of the best leaders of the medical profession, we shall be able to eliminate those cases. If we are able to eliminate those cases it is far better than making any alteration in the Act. As it stands under the regulations, I think we shall be able to ensure that every insured person in the country shall receive medical benefit, apart from what everyone will agree is specialist treatment, in conformity with the Act as laid down, and if that is so, and we are appointing a Committee to investigate the subject, then I would very much rather not produce an Amendment which, in a sense is, though the hon. Member for Wilton (Mr. C. Bathurst) may say he has captured one doctor in the House, an Amendment which is a challenge and in part a censure on the doctors.
made some remarks which were inaudible.
I am working for conciliation.
So am I.
There is another point which I think is vital in connection with the Amendment. If the Amendment were carried it would throw the obligation of all institutional treatment on the approved societies without any contribution from the State, and it would bring up the whole question of the hospitals, which everyone interested in the hospitals would agree had better be deferred. It would compel the societies to arrange for hospital treatment without any kind of help from the Government. That would be the worst possible way in which to settle this question. For those reasons, and as I believe that those cases, which have been amongst doctors, enormously in the minority of the doctors, can be very largely met if hon. Gentlemen on both sides will let us go on putting what pressure we can to nut the Act into force. I would ask the hon. Gentleman to see his way to withdraw his Amendment.
The right hon. Gentleman, in answering the case put forward on behalf of this Amendment, told us it was superfluous, and that the Act as it stood provided for adequate medical treatment and attendance, and as far as that part of his argument was concerned I think he was right, and I think the Act does clearly provide for that. But I think the reason the hon. Gentleman the Member for Wilton (Mr. C. Bathurst) has for moving his Amendment is that the purposes of the Act have not been given effect to, and cases were put forward both in Committee upstairs and just now, both by the Proposer and Seconder of the Amendment., to show that the interpretation which should be put on the Act as to what adequate medical attendance and treatment should be given has in fact not been given. That is why this Amendment has been placed on the Paper. The right hon. Gentleman, after saying that the Amendment was superfluous, went on to say that if it were pressed it would directly challenge the doctors. Upon which argument does he rely? If it only emphasises the wording of the Act, how can it challenge the doctors, seeing that they have agreed to work the Act? The right hon. Gentleman is not entitled to use the argument both ways. Another argument was that it would stop specialists who were on the panel from giving their peculiar or particular knowledge to cases which needed it. How many brain, eye, or ear specialists are there on any panel throughout the United Kingdom?
Quite a large number.
If I put down a question will the right hon. Gentleman tell me how many there are? I think he will find that there are not many specialists on the panels at all. The right hon. Gentleman says that theme has been only six months' working of this Act, and that there have been some difficulties, but that if time is given those difficulties will diminish. I think we are entitled to argue that if there has been a certain amount of difficulty in six months there will be much more in the year, because when people realise what they are paying for, when they get more acquainted with this complicated Act, and learn what they are entitled to, we shall hear of many more difficulties. The right hon. Gentleman says that we must have a few decisions upon these points, so that people may know what their exact position is. My experience of decisions so far is that they only make confusion worse confounded. Some of the decisions under certain Sections of the Act contradict each other, and you do not know where you are at all. The right hon. Gentleman has not in any way answered the case made by my hon. Friend. We must have either an Amendment of this sort or a definite undertaking from the right hon. Gentleman that people will not be promised benefits which cannot be given. If the right hon. Gentleman cannot provide proper attendance and treatment let him say so and amend the Act in that respect, but do not let him go on having promises made all over the country which promises cannot be carried out.
I had on the Paper an Amendment to Clause 1 dealing with practically the same point as that raised by the hon. Member opposite. I wanted to raise the question whether or not an insured person was getting the adequate medical treatment which he is definitely promised under Section 15 (2) of the original Act. I wanted to draw attention to it on this occasion, because in this Bill, which is primarily a Bill to make legal certain previous payments to doctors, to which are attached a lot of other things, you are spending about £2,000,000 of the nation's money. This is equal, obviously, to a capital sum of well between £60,000,000 and £70,000,000. Therefore this seems to me an opportune occasion on which we should determine what really "adequate" treatment means. I do not think that the Amendment of my hon. Friend opposite goes far enough. I do not think he is entitled to leave out those other things, if the word "adequate" has any meaning at all in the English language. I would like to draw the attention of the House to another, what I consider, very objectionable proceeding in these regulations which are submitted to us from time to time, I presume by the Commissioners. I do not know whether we are ever to have the opportunity of discussing them. It would have defied the leisure of any Member of this House to read the various publications that came from the Commission during the last Session. You find one of these which has more Clauses really than the present Bill. The Regulation which I am reading from now has sixty-one Clauses, in addition to Schedules. In the first Schedule of this particular Regulation the Commissioners presumably proceed to write off something from what was promised in the original Act. They say definitely here:℄
Did the House of Commons mean that, when it passed this Act? Did it mean that "adequate" medical treatment meant more than the bottle of medicine treatment which is so popularly associated with the kind of thing that obtained before this Act came into operation? Did it mean that the Insurance Act was only to deal with the kind of diseases through which we make our way in childhood? Or did it mean that we were to deal with diseases which arise from our contact with industrial pursuit? Because if it did not mean that, then it meant preventing the insured person receiving what I conceive Parliament meant him to receive—full and sufficient medical treatment. I very respectfully submit that when, in this Bill, we are increasing the charge so considerably, a charge which is going again to go to the medical profession, that we have a duty to perform to the person who is affected by this Act, and that we should attempt to secure to him all that "adequate" really means. Because I believe that I am prepared to support this Amendment, although personally I think it falls short of what we are entitled to claim for the people who are insured."The practitioner shall give to persons who are for the time being entitled to obtain treatment from him, such treatment as is of the kind which can consistently, nod in the best interests of the patient, he properly undertaken by the general practitioner of ordinary professional competence and skill."
I only rise to ask my hon. Friend to withdraw his Amendment. I cannot see that the Amendment will avail in the least or do more than the provisions and the Act already effect. There is nothing in this Amendment, as far as I can see, that is not contained in the original Act. I agree that the wording of the Act does provide that every insured person should receive from the medical practitioner adequate medical treatment, and that if he does not receive adequate medical treatment, there ought to be some means of bringing his case before those who should take care that such adequate medical treatment is provided. But when it is suggested that the ordinary medical practitioner shall give treatment which is only given by a specialist, I cannot help thinking that we are doing an injury to the insured persons rather than helping them. Who is to be the judge whether a specialist is required in any case? Surely it is the medical practitioner. What happens in our own cases? If we consult our medical adviser, and he says, "This is a difficult case, and I should like to have the advice of Mr. So-and-so," we feel we should consult the specialist suggested. Why not let the insured person have the same voice as we would, have in similar circumstances? If you would define the case in which a specialist is required, you would have to put in a whole schedule of cases which would be most difficult for anyone here to determine. I cannot help thinking that in this matter, as in other matters, you must really trust the doctor. If you have not confidence in one doctor you must have some other doctor. Under the panel system you can change from one doctor to another. I do not see that insured persons would gain anything if you required the ordinary medical practitioner to treat a patient in cases in which he thinks some other person would be better able to treat him. I cannot see that any advantage would be gained from this Amendment, and I cannot help thinking great disadvantage would result if this Amendment were carried. I hope my hon. Friend will, in the interest of the insured persons, withdraw this Amendment.
I rise to say a few words because although my name was not mentioned I could not help seeing that I was twice alluded to. I wish, therefore, to offer an explanation. The hon. Member in his original Amendment used the words "beyond the competence of the ordinary practitioner." I rather took objection to that phrase, because in the medical profession it would be held that no case was beyond the competence of the duly qualified practitioner. I consulted the hon. Member, and, with that agreeable commerce of a man of the world and invariable courtesy which distinguishes him, he listened to my argument and substituted the words in the present Amendment, so that the words referring to specialists and consultants are really mite. But that does not imply I endorse the whole Amendment, and still less does it imply that the hon. Member captured me. On the contrary, it is the Financial Secretary to the Treasury that has captured me, because I have followed him through the entire Bill. I have followed him, at least with the eye of faith—the evidence of things unseen. Now if I have any influence left with the hon. Member for Wilton I would join my appeal to that of the hon. Member who has just sat down in asking him to withdraw this Amendment, not because I do not think it contains the germs of much that is good, but because I think when the Insurance Act is in operation for a few months longer this question can be again reverted to and the whole matter can be threshed out from the point of view he has in mind; and, perhaps, later his proposal can be brought up in a more substantial and considered form, and a form which would be acceptable not only to him but also to the Financial Secretary to the Treasury.
I regret that the hon. Member has hoisted the white flag on this point. It seems to me that the Amendment proposed by the hon. Member for Worcester is calculated to serve a very useful purpose, because it has drawn attention to the regulations issued by the Commissioners in reference to medical benefit which seem to whittle down the amount of medical attendance promised in the original Act. It is for the purpose of reinforcing the provisions of the principal Act and to secure the adequate medical attendance therein mentioned, that this Amendment has been proposed. If the Financial Secretary to the Treasury were to state that in administering medical benefit and interpreting these regulations, something more was to be expected than is secured under the attenuated wording of the Clause as it exists, then those who feel dissatisfied might not press this Amendment. In view of the regulations which have been issued, I think we are entitled to something further than has been stated by the right hon. Gentleman. In reference to this Amendment we have had a completely different defence of the existing system from the hon. Member for the London University, and the Financial Secretary to the Treasury. According to the hon. Member, no general practitioner would ever think of performing any operation or any treatment requiring the service of a specialist. On the other hand, the right hon. Gentleman told us that among the "mere panel doctors" there are persons who are experts upon all conceivable illnesses. In these circumstances I think it is well that the Commissioners should indicate to these experts that the full amount of their skill should be at the service of insured persons. If the phrase which stands in the regulations is to determine the treatment of insured persons, then the attention of the Financial Secretary is right. If the regulations are limited in the sense of the proposal now before the House it will be obvious to these distinguished panel doctors that not only the ordinary competence of a duly qualified medical practitioner is required, but also any expert knowledge and special skill they may have attained. In those circumstances I think we should at least have an assurance that the wording of the regulations should be amended so as to be brought into conformity with the wording of the original Act.
I ask leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
I beg to move, at the end of the Clause, to add the following Sub-section:—
I move this Amendment in consequence of the failure of what is called the green card system. I dare say that the House is aware that an insured person who leaves the area of his own insurance committee is expected to obtain a green card from that committee, ensuring for him or her medical attendance and treatment in the district to which the person passes. Perhaps I may instance the case of the domestic servant, who is the greatest sufferer under the present system. The servant does not as a rule know, a long time beforehand, when she is going away from home. It is a matter entirely in the discretion of her mistress or master, as the case may be, and very often she either does not know how long she will be away or she is wholly ignorant of the green ticket system. The employed person finds herself, we will say, at a seaside place, not having made any provision for medical attendance outside her own area. What actually happens? This domestic servant, finding herself in a fresh environment, falls ill and sends for a doctor. The doctor informs her that he is not her panel doctor and cannot attend her, and she asks, "What am I to do?" He there-upon says, "Write to your society." She writes to her society, and the society write to her, and says, "You ought not to write to us; you ought to apply to your insurance committee." She then writes to her insurance committee, and, if it happens to be the last fortnight in August, the insurance committee probably does not meet, it being holiday time, and the unfortunate servant does not get any relief at all. A month passes during these communications, and there is no one whose services she is entitled to claim, with the result that she either has to pay for a doctor out of her own pocket or, possibly, she dies because she does not receive any proper medical treatment. This Amendment is simply to ensure that every person shall, as the result of his or her contribution, have a right to receive medical treatment within the area within which he or she may be for the time being. It would require very little adjustment as between the various insurance committees if they were instructed, according to the latter part of this Amendment, to make provision for the time being for those who happen to be resident within their area. I desire to move this Amendment in justice to a very large class of insured persons who have very little control over their movements."(3.) A person entitled to medical benefit shall be entitled to be provided with adequate medical attendance and treatment in whatever part of Great Britain he may happen to be at the time of his illness, whether notice of his leaving home has or has not been previously given; and the Insurance Commissioners shall as soon as may be practicable make arrangements under which the several insurance committees shall provide such medical attention and treatment as may be required by such persons for the time being within the areas of such committees, and the expenditure involved thereby shall be shared among all such committees in proportion to the total number of insured persons residing in their areas respectively."
I beg to second the Amendment.
In addition to domestic servants, there is a very large class of ordinary working men affected by this Clause. Probably 30 per cent. of the railway men of this country spend three days out of every week in a foreign station. They do not know from day to day the particular station to which they are going to run. The result is that those men may require medical treatment in that particular town, and, although they pay in the same way as other insured persons, they are deprived of medical treatment because they happen to be in a town away from their own home. Therefore, I quite conceive that the application of this particular Amendment will be equally effective to them. That is a point which ought to be met, and I consequently support the Amendment.The first part of the Amendment is unnecessary; it is clearly stated in the Act that the insured person has this right. The second part is unfair, and I hope it will be withdrawn. The Government refuse to accept it. There is not the slightest doubt that an insured person is entitled to medical benefit, even if he moves from one part of the country to another. It is laid down in the Act that insured persons shall have medical treatment wherever they happen to be. The hon. Gentleman criticised the methods adopted by the Commissioners to carry that out. But I have no indication in any of the complaints I have received, that the methods adopted by the Commissioners do not carry it out. The censure rests, not on the methods, but on the administration of the Insurance Commissioners. The last part of the Amendment is unjust. The hon. Member suggests that the expenditure involved shall be charged upon the committees in proportion to the total number of insured persons residing in their areas, respectively. We are not adopting that method. We are adopting the method that the Commissioners shall spend the money required for those who travel in proportion to the number who travel outside their area. I will give an illustration. The number of insured persons in Dorset is about the same as the number in Oldham. The hon. Gentleman says the payment should be on the basis that the number of those who move out of Dorset is the same as the total who leave Oldham. We say that that is unfair to the Dorset doctors, because they would be deprived of a certain amount of their medical money, whereas very few of their patients actually move. The doctors in Oldham, on the other hand, would not have to give up any medical money, although a large number of their patients actually pass from their responsibility during the holidays and go to places like Blackpool and Southport.
11.0 P.M. The principle adopted by the Commissioners is that the doctors in each district from which insured persons move, having taken twelve months' responsibility for those insured persons, shall contribute towards the expense incurred in connection with those who do move out of the district, whereas the hon. Member would mulct all doctors alike, whether or not their patients move out of the district. I repeat that that is unfair. I believe our method is working; if it is not we will endeavour to see that it does, and its working will be great facilitated by the Amendment moved by the hon. Member for Leicester. If there is not a sufficiency of panel doctors in places where people go in great numbers in certain months, the Amendment suggested by the hon. Member for Leicester will enable us to meet that case, and I can guarantee in the name of the Insurance Commissioners that the cases of the people who go in great numbers to watering-places will be met by our green certificate under our ordinary panel system, and we shall take care that doctors are provided to meet the great rush, so that every one who demands medical attendance even for the whole twelve months of the year shall have it wherever he may be. I cannot accept the suggestion that the levy should be upon those doctors who, perhaps, are responsible for their patients for the whole twelve months in the year, and yet who have to contribute in relief of doctors, who, perhaps, are responsible for only five, six, seven, eight, or eleven months in the year.I think my hon. Friend has rendered good service in bringing this matter before the attention of the House. I am bound to say that, until I heard the concluding portion of the right hon. Gentleman's speech, I certainly intended to vote with my hon. Friend if he went to a Division. But the right hon. Gentleman has now given a guarantee—it is rather a bold guarantee to give—that, under the arrangements that have now been made by the Insurance Commissioners, the people who move will get adequate medical treatment, to which they are entitled.
I do not wish there to be any misunderstanding. I said it would be done, given the addition made, without a Division of the House, at the instance of the hon. Member for Leicester (Mr. Ramsay Macdonald).
Under the arrangements which have been made, or are in course of being made, he guaranteed that adequate medical benefit will be available for those persons who travel. That is what we want. It was to secure adequate medical treatment for them that my hon. Friend moved the Amendment, and it was upon that account that I should have supported him if he went to a Division. I do not know whether he will be satisfied with the guarantee the right hon. Gentleman has given. If he is not satisfied, and still intends to press the matter to a Division, I shall support him.
This matter happened to come before me yesterday when I was visiting my Constituency. A gentleman there, who is an employer of labour, a contractor, told me only yesterday that he employed a considerable number of men on works in different counties. The men naturally go from one works to another. As he opens new works he has to send men to carry them out. He certainly informed me that, in point of fact, they did not get any medical attendance as a result of the practical working of the Act. It is very difficult for us to criticise the right hon. Gentleman, who has a great amount of official information at his back. He tells us that the whole thing is arranged on the green card system. As a matter of fact, it is not working. This Amendment is designed to call the attention of the House to the fact that it is not working. I confess I do not feel satisfied with the mere assurance of the right hon. Gentleman that it shall work. No one doubts that the right hon. Gentleman desires, and has always desired that the Act should work. We never thought of charging him with a male- volent desire to secure the non-attendance of insured persons by medical practitioners. Of course he wishes it to work, and has done his best, and so have the Commissioners, to bring it into operation. The practical effect, with all their efforts, is that it is not working at all at the present moment in a very large number of cases. Three separate classes have been brought before the right hon. Gentleman—the domestic servants, of whom my hon. Friend has spoken; the railway servants, of whom the hon. Gentleman opposite (Mr. Thomas) has spoken; and the contractor's men, of whom I have personal information. It is a very serious matter indeed, and I trust my hon. Friend will go to a Division. If he does, I shall certainly support him.
The Secretary to the Treasury said that this system is included in the Act. What is much more important than the Act is the fact. The fact is that the green ticket system has broken down, and very great hardship is being inflicted on the classes already mentioned. The Domestic Servants' Society, containing 75,000 members, says that, as a matter of practice, its members are not getting any advantage under the Act. You may say it is due to their own ignorance or their own neglect, but they are not getting the advantages. That being so, as the system is not working, I cannot see that the guarantee of the Secretary to the Treasury carries us much further. He says we are going to have some changes under the Clause of the hon. Member (Mr. Ramsay Macdonald), adopted this afternoon. I never thought it touched this particular grievance. It was introduced for other purposes, and I do not see how it can be twisted into making any change which will be in the least satisfactory. What is the good of having paper benefits? What we want is that they shall have the real benefits under the Act, and if, as a matter of fact and practice, all these people who are working under the green-ticket system are failing to obtain medical benefit it is only right that these words, particularly the latter part of the Amendment, should be adopted, and I hope my hon. Friend will press the matter to a Division, and that we shall make it incumbent upon the Government to give those people who are transferred from district to district by reason of their calling the benefits to which they are entitled.
I think I have special knowledge relating to this class of people and the only part of the Amendment which is of the slightest importance to them is these words, "whether notice of his leaving home has or has not been previously given." We have discovered in working the Act that there is a great difficulty in a man having to give the notice. First of all he has to find out the Insurance Commissioner's address in the locality he proceeds to and then to give notice to the secretary of the fact that he has removed within his jurisdiction, so that a medical man shall be appointed for the purpose of giving him proper attendance. If we could get over that or if we could understand that in principle these words will be adopted there would not be the slightest difficulty.
The right hon. Gentleman has said that he will give us a guarantee that the difficulties which have presented themselves up to now shall be done away with. Has he come to any arrangement by which the delay will be obviated, because my experience of the green-ticket system is really the delay which an insured person has to suffer if he moves his place of residence in getting medical attendance at once. The green ticket has to be submitted to the insurance committee, and he has to get a doctor, and so forth. If the device which is guaranteed as meeting this particular difficulty gets over the delay and the ticket can be presented at once, and some doctor will be seen, we need not press the Amendment, because what the hon. Member (Mr. J. Ward) said is to a very large extent right, that the giving notice is one obstacle and that the delay in getting the officer to accept him is another. The ticket ought not to have to be approved by the insurance committee.
I do not know that I should have risen but for the suggestions of a breakdown. If there had been any general complaint I think I should have heard something about it myself, and many of those who, like myself, are connected with very large societies would have known something of it. It is all very well for hon. Members to talk as if there was any great breakdown. I have made inquiries to find out what has been the experience of the societies, and they say they have seen no complaints. I quite admit that there may be something in what was said as to railway servants. I see that there is a possibility—and it has occurred—of railwaymen away from home not getting medical benefit. I wish hon. Members to see this matter in its real perspective. As a rule, railwaymen are not sent away from home for a long time. It is a very rare thing for the men to be sent away more than two or three days to work, and when it is so, I agree it should be made quite clear what they are entitled to. I do not wish the House to be led away with these exaggerated statements. The cases are few and far between.
We all know from a great deal of experience that the hon. Member for Pontefract (Mr. Booth) holds the view on this subject that, what he does not know is not knowledge at all. That is quite an amiable delusion which does not do us any harm. I should like the right hon. Gentleman to inform me what happens in the case of insured people who take their holidays in Ireland where there is no medical benefit under the Act. Does the guarantee which the right hon. Gentleman has given extend to people who go to Ireland for holidays? Suppose that people who are taking holidays fall ill in Ireland, how are they to derive the medical benefit for which they have paid in this country? I shall be personally grateful to the right hon. Gentleman if he will explain how that is to be done.
People who go to Ireland must comply with the conditions which prevail in Ireland. They cease to pay for medical benefit, and consequently they are not insured persons in respect of that benefit. [An HON. MEMBER: "They pay partially."] They are paying week by week during the year for insurance against illness which requires medical attendance, and while in Ireland they will pay less, and they will not be entitled to medical benefit. I can assure hon. Members on all sides that the Commissioners are with them in this matter. Their only desire is, as soon as it can be effectively done, to provide medical attendance and treatment wherever a man goes. In the normal case at present, the green ticket can be presented to any panel doctor in the neighbourhood, and it must be received by any panel doctor, and while the insured person is in the neighbourhood the panel doctor is responsible for medical attendance.
There is one other class of person who has not been mentioned. I know of a case of a servant who was sent home sick, and for three weeks could not get the attendance of a panel doctor in the district to which she went. Such a case as that must be dealt with under this particular Amendment.
There are many people insured in Ireland who come over here for a certain portion of the year, servants and others. I understand that while here they pay according to English rates, and I would like to know if they are entitled to the services of a panel doctor?
Persons who are unfortunate enough to emigrate from Ireland to England temporarily pay the extra rate while in England, and are entitled to medical attendance while here.
I understood the Secretary to the Treasury to say that he opposed this Amendment because the first part of it was unnecessary, and the second part was unjust. I do not think that he appreciates the point made by my hon. Friend, because the object in moving the first part of the Amendment is to get rid of the notice which is now necessary before a person can get a green ticket. I called the right hon. Gentleman's attention the other day to the case of a man, who, having left Leicester and moved into Northampton, applied for a green ticket, and it took him six weeks to get it. Meanwhile he would have been without medical attendance, but that the doctor trusting that he would get it in time did, in fact, give him medical benefit without a green ticket. My hon. Friend moved the Amendment to force the right hon. Gentleman to so arrange the system that this notice should not be necessary. The second part of the Amendment is said to be unjust because it sets up a method of remuneration that would be unfair to one set of doctors or the other. I think that the right hon. Gentleman did injustice to my hon. Friend because my hon. Friend does not suggest any particular form of remuneration, except that it shall be shared among the Committees in proportion to the number of insured persons residing in the areas generally. The Insurance Commissioners and the right hon. Gentleman have issued a pamphlet which is called the "Medical Benefit Temporary Residents Memorandum, 171, I.C." It consists of thirty-nine Clauses and ten pages, and is an extremely complicated document. It talks about case value machinery. If the right hon. Gentleman has discovered case value machinery embodied by my hon. Friend in his Amendment it would be quite easy to have met that point by adopting the case value machinery of the district. In making regulations to carry out the provisions of the Act the Commissioners would not have the slightest difficulty in putting right any little inequality that might arise from the exact words of this Amendment. In substance we get this, that my hon. Friend's Amendment is intended to force this one
Division No. 261.]
| AYES.
| [11.20 p.m.
|
| Agg-Gardner, James Tynte | Gibbs, George Abraham | Pease, Herbert Pike (Darlington) |
| Archer-Shee, Major M. | Gill, Alfred Henry | Perkins, Walter Frank |
| Baird, John Lawrence | Glazebrook, Captain Philip K. | Pointer, Joseph |
| Baker, Sir Randall L. (Dorset, N.) | Goldsmith, Frank | Pollock, Ernest Murray |
| Baldwin, Stanley | Goldstone, Frank | Price, C. E. (Edinburgh, Central) |
| Banbury, Sir Frederick George | Gordon, Hon. John Edward (Brighton) | Pryce-Jones, Colonel E. |
| Baring, Major Hon. Guy V. (Winchester) | Goulding, Edward Alfred | Randles, Sir John S. |
| Barlow, Montague (Salford, South) | Grant, J. A. | Rawlinson, John Frederick Feel |
| Barnes, George N. | Greene, W. R. | Richardson, Thomas (Whitehaven) |
| Barnston, Harry | Gretton, John | Roberts, George H. (Norwich) |
| Beach, Hon. Michael Hugh Hicks | Guinness, Hon. Rupert (Essex, S.E.) | Roberts, S. (Sheffield, Ecclesall) |
| Benn, Arthur Shirley (Plymouth) | Guinness, Hon. W. E. (Bury S. Edmunds) | Samuel, Samuel (Wandsworth) |
| Benn, Ion Hamilton (Greenwich) | Gwynne, R. S. (Sussex, Eastbourne) | Sanders, Robert Arthur |
| Bentinck, Lord H. Cavendish- | Hall, Frederick (Dulwich) | Smith, Albert (Lancs., Clitheroe) |
| Bigland, Alfred | Hamilton, C. G. C. (Ches., Altrincham) | Snowden, Philip |
| Bird, Alfred | Harris, Henry Percy | Spear, Sir John Ward |
| Boyle, William (Norfolk, Mid) | Henderson, Major H. (Berks, Abingdon) | Stanley, Albert (Staffs., N.W.) |
| Boyton, James | Henderson, Sir A. (St. Geo., Han. Sq.) | Stanley, Hon. G. F. (Preston) |
| Bridgeman, William Clive | Hills, John Waller | Steel-Maitland, A. D. |
| Bull, Sir William James | Hodge, John | Stewart, Gershom |
| Burn, Colonel C. R. | Hope, James Fitzalan (Sheffield) | Sutton, John E. |
| Cassel, Felix | Hope, Major J. A. (Midlothian) | Talbot, Lord Edmund |
| Cator, John | Horne, Edgar (Surrey, Guildford) | Taylor, John W. (Durham) |
| Cecil, Evelyn (Aston Manor) | Horner, Andrew Long | Terrell, George (Wilts, N.W.) |
| Cecil, Lord R. (Herts, Hitchin) | Hunt, Rowland | Terrell, Henry (Gloucester) |
| Clay, Captain H. H. Spender | Ingleby, Holcombe | Thynne, Lord Alexander |
| Clive, Captain Percy Archer | Jessel, Captain Herbert M. | Tryon, Captain George Clement |
| Clynes, J. R. | Jewett, Frederick William | Tullibardine, Marquess of |
| Craik, Sir Henry | Kerry, Earl of | Walsh, Stephen (Lancs., Ince) |
| Dalrymple, Viscount | Lawson, Hon. H. (T. H'mts., Mile End) | Wardle, George J. |
| Dalziel, Davison (Brixton) | Lloyd, George Ambrose (Stafford, W.) | Wedgwood, Josiah C. |
| Denison-Pender, J. C. | Lloyd, George Butler (Shrewsbury) | White, Major G. D. (Lancs., Southport) |
| Denniss, E. R. B. | Locker-Lampson, G. (Salisbury) | Whyte, Alexander F. |
| Dickson, Rt. Hon. C. Scott | Macdonald, J. Ramsay (Leicester) | Williams, John (Glamorgan) |
| Duke, Henry Edward | Mackinder, Halford J. | Wills, Sir Gilbert |
| Duncan, C. (Barrow-in-Furness) | M'Neill, Ronald (Kent, St. Augustine's) | Wilson, W. T. (Westhoughton) |
| Duncannon, Viscount | Magnus, Sir Philip | Wood, Hon. E. F. L. (Yorks, Ripon) |
| Eyres-Monsell, Bolton M. | Morrison-Bell, Major A. C. (Honiton) | Wood, John (Stalybridge) |
| Fell, Arthur | Mount, William Arthur | Worthington-Evans, L. |
| Fiennes, Hon. Eustace Edward | Newdegate, F. A. | Yate, Colonel C. E. |
| Fisher, Rt. Hon. W. Hayes | Newman, John R. P. | |
| Fitzroy, Hon. Edward A. | Nield, Herbert | TELLERS FOR THE AYES.—Mr. C. Bathurst and Mr. J. H. Thomas. |
| Fletcher, John Samuel | O'Grady, James | |
| Forster, Henry William | Parker, James (Halifax) |
NOES.
| ||
| Abraham, William (Dublin, Harbour) | Bentham, George Jackson | Buxton, Rt. Hon. Sydney C.(Poplar) |
| Acland, Francis Dyke | Birrell, Rt. Hon. Augustine | Byles, Sir William Pollard |
| Addison, Dr. Christopher | Boland, John Pius | Carr-Gomm, H. W. |
| Adkins, Sir W. Ryland D. | Booth, Frederick Handel | Cawley, Sir Frederick (Prestwich) |
| Allen, Arthur A. (Dumbartonshire) | Boyle, Daniel (Mayo, North) | Cawley, Harold T. (Lancs., Heywood). |
| Allen, Rt. Hon. Charles P. (Stroud) | Brace, William | Chancellor, Henry George |
| Arnold, Sydney | Brady, Patrick Joseph | Chapple, Dr. William Allen |
| Baker, Harold T. (Accrington) | Brocklehurst, William B. | Clancy, John Joseph |
| Baker, Joseph Allen (Finsbury, E.) | Brunner, John F. L. | Clough, William |
| Balfour, Sir Robert (Lanark) | Bryce, John Annan | Collins, Godfrey P. (Greenock) |
| Barlow, Sir John Emmott (Somerset) | Burke, E. Haviland- | Condon, Thomas Joseph |
| Beale, Sir William Phipson | Burns, Rt. Hon. John | Cornwall, Sir Edwin A. |
| Beck, Arthur Cecil | Burt, Rt. Hon. Thomas | Crumley, Patrick |
| Benn, W. W. (T. Hamlets, St. George) | Buxton, Noel (Norfolk, North) | Cullinan, John |
thing—the right of the insured person to medical benefit wherever he is without the long clumsy form of notice and also to provide that the doctors who look after those temporary residents shall be paid a proper proportionate fee. I believe that the Amendment means that, and I shall support my hon. Friend if he goes to a Division.
Question put, "That those words be there inserted in the Bill."
The House divided: Ayes, 128;. Noes, 215.
| Davies, David (Montgomery Co.) | Jones, J Towyn (Carmarthen, East) | O'Shaughnessy, P. J. |
| Davies, Ellis William (Elfion) | Jones, William S. Glyn- (Stepney) | O'Shee, James John |
| Davies, Timothy (Lincs., Louth) | Joyce, Michael | O'Sullivan, Timothy |
| Davies, Sir W. Howell (Bristol, S.) | Keating, Matthew | Palmer, Godfrey Mark |
| Dawes, James Arthur | Kellaway, Frederick George | Pearce, Robert (Staffs, Leek) |
| Delany, William | Kennedy, Vincent Paul | Pease, Rt. Hon. Joseph A (Rotherham) |
| Denman, Hon. Richard Douglas | Kilbride, Denis | Phillips, John (Longford, S.) |
| Devlin, Joseph | King, Joseph | Ponsonby, Arthur A. W. H. |
| Dickinson, W. H. | Lambert, Rt. Hon. G. (Devon,S.Molton) | Priestley, Sir W. E. B. (Bradford, E.) |
| Dillon, John | Lambert, Richard (Wilts, Cricklade) | Primrose, Hon. Neil James |
| Donelan, Captain A. | Lardner, James C. R. | Pringle, William M. R. |
| Doris, William | Lawson, Sir W. (Cumb'rid, Cockerm'th) | Radford, George Heynes |
| Duffy, William J. | Levy, Sir Maurice | Reddy, Michael |
| Edwards, Clement (Glamorgan, E.) | Lewis, Rt. Hon. John Herbert | Redmond, John E. (Waterford) |
| Edwards, John (Glamorgan, Mid) | Low, Sir Frederick (Norwich) | Redmond, William (Clare, E.) |
| Elverston, Sir Harold | Lundon, Thomas | Redmond, William Archer (Tyrone, E.) |
| Esmonde, Dr. John (Tipperary, N.) | Lyell, Charles Henry | Richardson, Albion (Peckham) |
| Esmonde, Sir Thomas (Wexford, N.) | Lynch, A. A. | Roberts, Charles H. (Lincoln) |
| Essex, Sir Richard Walter | Macdonald, J. M. (Falkirk Burghs) | Roberts, Sir J. H. (Denbighs) |
| Falconer, James | McGhee, Richard | Robertson, John M. (Tyneside) |
| Fenwick, Rt. Hon. Charles | Maclean, Donald | Roche, Augustine (Louth) |
| Ferens, Rt. Hon. Thomas Robinson | Macnamara, Rt. Hon. Dr. T. J. | Roe, Sir Thomas |
| Ffrench, Peter | MacNeill, J. G. Swift (Donegal, South) | Rowlands, James |
| Field, William | Macpherson, James Ian | Rowntree, Arnold |
| Fitzgibbon, John | MacVeagh, Jeremiah | Samuel, Rt. Hon. H. L. (Cleveland) |
| Flavin, Michael Joseph | M'Callum, Sir John M. | Samuel, J. (Stockton-an-Tees) |
| France, Gerald Ashburner | Manfield, Harry | Scanlan, Thomas |
| George, Rt. Hon. D. Lloyd | Markham, Sir Arthur Basil | Scott, A. MacCallum (Glas., Bridgeton) |
| Gladstone, W. G. C. | Marks, Sir George Croydon | Seely, Rt. Hon. Colonel J. E. B. |
| Glanville, H. J. | Marshall, Arthur Harold | Sheehy, David |
| Greig, Colonel James William | Masterman, Rt. Hon. C. F. G. | Shortt, Edward |
| Guest, Major Hon. C. H. C. (Pembroke) | Meagher, Michael | Simon, Rt. Hon. Sir John Allsebrook |
| Guest, Hon. Frederick E. (Dorset, E.) | Meehan, Francis E. (Leitrim, N.) | Smyth, Thomas F. (Leitrim, S.) |
| Gulland, John William | Meehan, Patrick J. (Queen's Co., Leix) | Taylor, Theodore C. (Radcliffe) |
| Gwynn, Stephen Lucius (Galway) | Middlebrook, William | Taylor, Thomas (Bolton) |
| Hackett, John | Millar, James Duncan | Tennant, Harold John |
| Hall, Frederick (Yorks, Normanton) | Molloy, Michael | Thorne, G. R. (Wolverhampton) |
| Harcourt, Rt. Hon. L. (Rossendale) | Money, L. G. Chiozza | Toulmin, Sir George |
| Harcourt, Robert V. (Montrose) | Morgan, George Hay | Trevelyan, Charles Philips |
| Harmsworth, Cecil (Luton, Beds) | Morrell, Philip | Ure, Rt. Hon. Alexander |
| Harmsworth, R. L. (Caithness-shire) | Muldoon, John | Wadsworth, J. |
| Harvey, T. E. (Leeds, West) | Munro, Robert | Ward, John (Stoke-upon-Trent) |
| Hayden, John Patrick | Munro-Ferguson, Rt. Hon. R. C. | Waring, Walter |
| Hazleton, Richard | Murphy, Martin J. | Warner, Sir Thomas Courtenay |
| Henderson, J. M. (Aberdeen, W.) | Murray, Captain Hon. Arthur C. | White, J. Dundas (Glasgow, Tradeston) |
| Henry, Sir Charles | Needham, Christopher T. | White, Patrick (Meath, North) |
| Higham, John Sharp | Neilson, Francis | Williams, Llewelyn (Carmarthen) |
| Hinds, John | Nolan, Joseph | Williamson, Sir Archibald |
| Hobhouse, Rt. Hon. Charles E. H. | Norton, Captain Cecil W. | Wilson, Hon. G. G. (Hull, W.) |
| Hogge, James Myles | Nuttall, Harry | Wilson, John (Durham, Mid) |
| Holmes, Daniel Turner | O'Brien, Patrick (Kilkenny) | Wilson, Rt. Hon. J. W. (Worcs., N.) |
| Holt, Richard Durning | O'Connor, John (Kildare, N.) | Wing, Thomas Edward |
| Howard, Hon. Geoffrey | O'Connor, T. P. (Liverpool) | Wood, Rt. Hon. T. McKinnon (Glasgow) |
| Hughes, Spencer Leigh | O'Doherty, Philip | Young, William (Perth, East) |
| Illingworth, Percy H. | O'Donnell, Thomas | Yoxall, Sir James Henry |
| Isaacs, Rt. Hon. Sir Rufus | O'Dowd, John | |
| John, Edward Thomas | O'Kelly, Edward P. (Wicklow, W.) | TELLERS FOR THE NOES.—Mr. William Jones and Mr. H. Webb. |
| Jones, Rt.Hon.Sir D.Brynmor (Swansea) | O'Malley, William | |
| Jones, H. Haydn (Merioneth) | O'Neill, Dr. Charles (Armagh, S.) |
I beg to move that the following Sub-section be added to the Bill. "No insured person shall be entitled to require attendance by any practitioner other than the practitioner selected by, or allotted to, the insured person."
This Amendment is intended to supply an omission in the principal Act and I have no doubt therefore it will be accepted by the Financial Secretary. It does not refer to the cases which have been discussed already as to consulting specialists, but it refers or is intended to refer, to those cases in which the practitioner feels it necessary to perform some surgical operation, and we know quite well when surgical operations have to be performed an anæsthetist has to attend, as the general practitioner is not able to supply the anæsthetic at the same time as he performs the surgical operation. It appears that no arrangement has been made in the Act for the calling in of an anæsthetist, or for providing for his payment. It cannot be expected that the ordinary practitioner should himself pay the fee for the second doctor. Unless there is some arrangement by which the fee of the second doctor is paid, all that can happen is that a particular case may be referred to a hospital, and an operation which ought to take place immediately may be postponed to the injury of the patient. I feel certain that this point had not occurred to the framers of the Act, therefore I will simply move the Amendment in the hope that the Secretary to the Treasury will at once see the necessity of it.I beg formally to second the Amendment, and in so doing, to ask the right hon. Gentleman how far the Government wish to get to night? We do not desire to shirk our duties or to obstruct in any way, but we would like to know how far the Government wish to get.
I do not quite understand the object of the hon. Member (Sir P. Magnus). If he suggests that when a second doctor is called in extra money should be provided by the State in order to pay him, the Amendment is out of order and there is nothing more to be said about it. If, on the other hand, he suggests that the doctors might make such arrangements under the present system as, without any further State contribution, would put aside a certain sum for this purpose, that can be done under the Act and there is no need for the Amendment at all. So much is that the case that the Manchester Insurance Committee, by the wish of the doctors, have adopted the system of paying such special fees from the ordinary fees which the doctors receive, and thus the position is met. It is a very small matter. According to the latest figures, there were 240,000 medical attendances in Manchester and less than forty cases where this arrangement was required. So far as the doctors agree to divide the 9s. which they may receive for medical treatment, etc., so that a certain proportion shall be left for this purpose, they are perfectly free to do it under the Act.
As to the question of the hon. Member for Sevenoaks, I am very much in the hands of the hon. Member and his friends, who I gladly agree have treated the Bill on its merits, without any kind of attempt to bring in extraneous conditions. I think it is the general wish of the House that the Bill should be finished to-morrow, and the only question is the allocation of the time as between to-day and to-morrow. As I read them, there are only two Clauses still remaining which will need substantial discussion—one dealing with maternity benefit and the other with the four Commissioners. I should have liked to get Clause 13 to-night, and so begin on Clause 15 to-morrow. But if the hon. Member for Sevenoaks says that his friends rather desire to devote the time at their disposal so that we may go straight on to the maternity benefit Clause to-morrow, I accept that suggestion. We can get what are non-controversial Clauses, the remainder of Clauses 10, 11, and 12, and we can begin to-morrow afternoon immediately on maternity benefit.I think that arrangement will be acceptable to my hon. Friends, and we will do what we can to carry it through, provided that there is no shirking of adequate discussion.
Under those circumstances I shall be prepared to move the Adjournment of the Debate at the end of Clause 12.
The right hon. Gentleman said that there was a general desire in the House to finish the Bill to-morrow. He must not say that except subject to the condition that the Government has no further time to give to the Bill, because there is no doubt we are being rushed very badly. We are having to curtail our criticism of the Bill owing to the absence of time; in fact, my hon. Friend the Member for Salisbury is not, as he told me just now, going to move a really important Amendment, because there will not be sufficient time to do it justice, either in the discussion to-night or in the scramble to-morrow. As the right hon. Gentleman said in Committee, if we had insisted on our new Clauses the Bill would have been very seriously jeopardised, if not differed altogether. Many of my Friends and myself desire to discuss this Bill at much greater length than we are able to do, and agreement is only possible in view of the circumstances of the case.
In view of what the hon. Gentleman has said as to our conditions of working now, I think it is the desire of all parties to conclude the Session, if possible, next week. Under these circumstances it is not possible to give more than one day more.
If the Government are not willing to accept my Amendment I shall not press it, but I would point out that the responsibility rests with the Government.
Amendment, by leave, withdrawn.
I beg to move to add the following Sub-section to the Bill, "No insured person shall be entitled to require attendance or treatment for any disease or disablement caused by his own misconduct other than venereal diseases.
Sub-section (4) of Section 14 of the principal Act is hereby repealed." Section 14, Sub-section (4) of the principal Act reads:— "Where under any such rule as aforesaid payment of sickness or disablement is suspended on the ground that the disease or disablement has been caused by the misconduct of the person claiming the benefit, such person shall not thereby become disentitled to medical benefit." Where the insured person has been guilty of some act of misconduct by which he has brought on disablement or disease upon himself, surely the doctor ought not to be required under the ordinary terms to give attendance he would give in other circumstances.The hon. Gentleman must see this is a deliberate attempt to take away from the insured persons what they have a right to under the Bill, and not only what they have a right to under the Bill but what 18,000 doctors, the vast majority of whom are engaged in working-class practice, have agreed to give in return for the money they are being given. They have accepted to treat those diseases under the Bill. I think the hon. Member will realise it is very important that those diseases arising from misconduct of persons should be treated. In the circumstances that the doctors have agreed to treat them I cannot arrange, except by law, a condition that insured persons shall be deprived of treatment they are given under the Act, and what the overwhelming majority of the doctors are ready to give and for which they have signed contracts.
Question, "That those words be added to the Bill," put, and negatived.
I beg to move that the following new Sub-section be added to the Bill, "That where under the provisions of Section 15 of the principal Act the Commissioners suspend the right of medical benefit in respect of any insured person the amount which they are to pay out to each such insured person shall, notwithstanding anything contained in that Section, be the amount payable to the Insurance Committee in respect of the medical benefit to such persons."
Sub-section (15) of the principal Act provides that the Insurance Committee may in certain circumstances suspend the right to medical benefit, and in that case pay to each such person a sum equal to the estimated cost of his medical benefit during that period. The Insurance Committees are having considerable difficulty in estimating what they are really to pay to persons whose medical benefit has been suspended. The phrase in the principal Act is that they are to pay to him a sum equal to the estimated cost of his medical benefit. What that means I am sure I do not know. The Insurance Committees receive from the Commissioners a given amount towards the cost of providing medical benefit for every insured person in the district. If we suspend medical benefit, obviously that is the amount we ought to be called upon to provide.I beg to second the Amendment.
I hope that the hon. Member will see his way to withdraw this Amendment. I do not think it is quite fair to hand in a manuscript Amendment like this at the last moment.
Amendment, by leave, withdrawn.
Clause 11—(Sickness Benefit)
(1) So much of Sub-section (5) of Section 8 as requires the payment of fifty contributions between two periods of disease or disablement in order to prevent the one being treated as a continuation of the other shall cease to have effect.
(2) At the end of the same Sub-section the following provision shall be added—
"Where by virtue of Sub-section (1) of Section 11 of this Act a part only of sickness benefit has been paid to an insured person, he shall for the purposes of this Sub-section be treated as having been in receipt of sickness benefit for a period bearing the same proportion to the whole period in respect of which such part benefit was paid to him as that part bears to the whole benefit, and the period so resulting shall be deemed to have been continuous and to have expired on the last day of the incapacity in respect of which the partial benefit was paid."
I beg to move to add at the end of the Clause, as a new Sub-section—
Under the principal Act disablement has to be absolutely complete. There are many instances of partial disablement. For instance, a man may be able to lead a healthy life in the absence of work. There are many people who suffer from chronic diseases apart from having a dislike for work, and who are susceptible to hemorrhage and epilepsy which makes them partially unfit for work, and they would not come under the provisions of the principal Act. There ought to be some provisions for disablement due to chronic disease or susceptibility to disease induced by an ordinary occupation. My Amendment would make the Clause clear and enable certificates to be given to those whose health would be injured if they followed their ordinary employment.(3) For the purposes of the provisions of the principal Act and this Act, relating to sickness benefit and disablement benefit, a person shall be deemed to be incapable of work if either—(a) he is unable to work; or (b) he is, although able to work, yet so unfit for work that he ought not to work in the interests of his health, whether bodily or mental; and any reference in these provisions to incapacity for work shall be construed in a corresponding manner."
Amendment not seconded.
Clause 12—(Amendment Of Paragraph (C) Of S 8 (1) Of Principal Act)
Paragraph ( c) of Sub-section (1) of Section 8 of the principal Act shall have effect as if for the words "commencing from the fourth day after being so rendered incapable of work" there were substituted the words "commencing on the fourth day of such incapacity," and for the purposes of that paragraph as so amended a day on which the incapacitated person was prevented by the incapacity from doing any effective work shall be treated as a day of incapacity, but a Sunday shall not be so treated unless the incapacitated person would, but for the incapacity, have worked on that day.
I beg to move to leave out the words "and for the purposes of that paragraph as so amended a day on which the incapacitated person was prevented by the incapacity from doing any effective work shall be treated as a day of incapacity, but a Sunday shall not be so treated unless the incapacitated person would but for the incapacity have worked on that day."
There seems to have been a good deal of discussion as to how Sunday should be treated. We had a very long discussion in Committee with reference to this matter, and it transpired that many societies had, irrespective of the regulations, taken Sunday as a fourth day. As the law stands at present if anybody happens to be taken ill on a Thursday, Thursday is the first day, Friday the second day, and Saturday the third day, but Sunday does not count. It will be admitted that there are heaps of different classes of employment which necessitate Sunday labour. It is impossible to do without it. It is very largely the case with regard to railway men, workmen employed on main drainage, tramway employés, and various other classes. Under this Clause as it is proposed in the Amending Bill Sunday is to be taken as one of the days, provided the man had any work to do on that day, but, as hon. Members know full well, many a man is called upon almost at the last moment to work on a Sunday when perhaps it is not his actual working day according to rota. A man is off duty on a given Sunday, but owing to certain circumstances an alteration is made which necessitates his going to work on that day. He has to prove conclusively to the Insurance Committee that notwithstanding that it was to be a day's rest yet according to the alteration he was called upon to work. I can see all sorts of trouble that is likely to arise if it is left in the present condition, and I cannot help thinking that it would be a great deal plainer and better if these words were left out so that there could be no possibility of doubt. That would do away with all the difficulty. Many Trade Unions have ignored the recognised conditions of the present Bill, and I think therefore that if these words were left out it would facilitate matters. It would give all these men who are at any time called upon to work on a Sunday a day to be counted as a fourth day, and it would do away with any disability.I beg to second the Amendment.
It seems to me that if the Clause is allowed to stand as it is it will prevent Sunday in any case being counted as a waiting day. At present some societies count Sunday as a waiting day and some do not, according to the rules of the society. Many societies who would not pay sickness benefit on a Sunday count Sunday as a waiting day. I think that we should leave the law as it stands at present and allow societies to count Sunday as a waiting day or not as they please. I am confident that in Scotland at all events the majority of the societies do count Sunday as a waiting day. If anybody turns up the handbook on sickness issued by the Scottish Commissioners, he will see that in the opinion of the Scottish Commissioners Sunday should be counted as a waiting day. It also affects farm servants considerably who are ill for short periods, and, if Sunday is cut out from counting as a waiting day, when a farm servant is taken ill on a Friday or Saturday he will certainly have to wait four whole days and may have to wait nearly five days before he gets any benefit. As the law stands at present, this is the only result if a man is taken ill, on Wednesday.We had considerable debate in Committee on this waiting day Clause, and two points emerged. The first was whether sickness benefit commenced on or from the fourth day, and it was unanimously agreed that it commenced on that day. This Amendment however does not touch that point. Then it was suggested that Sundays should be counted under all circumstances, even if it was a day on which a man would otherwise habitually be working and he would actually lose wages. The opinion seemed to be that the arrangement embodied in the Clause is a fair one. But the hon. Member is trying to secure that Sunday shall count at all times. That I think would inflict considerable hardship. No doubt if Sunday is a day upon which a man is ordinarily working it should be counted, and that is the purport of the Clause. I hope the House will leave it at that, as that is the form on which the Committee agreed.
12.0 M.
There was, it is true, considerable debate in Committee on this question, and I pointed out that in my view under the Act as it stood unamended Sunday would have counted in every case. No doubt it is the practice of friendly societies notwithstanding the words of the original Act not to count Sundays in the waiting days. But in my opinion the words of the Clause are peculiarly inapt for carrying out the decision come to by the Committee. They are too involved and if any Court were asked to adjudicate upon them I have not the slightest idea what interpretation it would place upon them. If the right hon. Gentleman will look at the words inserted somewhat hurriedly in the discussion in Committee, he will see what difficulties there are. They run "a day on which the incapacitated person was prevented by incapacity from doing any effective work." First one would have to consider whether the person was actually prevented by incapacity not merely for doing work, but from doing effective work. What "effective" means I do not know. Secondly one would have to consider whether it really was a day on which even apart from the incapacity the person would have had immunity from any work at all. Suppose the illness occurred during a period of unemployment. Could the man have done effective work even if not rendered incapable by illness? It would seem as if this Clause was so ambiguously worded, that if ever it came before a Court to be interpreted, it is impossible to say in what way it would be construed. Whether it would be construed as meaning that you must consider whether the person, even if well, could have got employment on that particular day or not, I do not know. It is extremely difficult to say what the meaning of "effective" is. You have to consider not merely whether a person is capable of work, but whether he is capable of effective work. It is introducing a new word, which may have a serious bearing on the rights of insured persons, and limit those rights. I think it is extremely desirable to adopt the Amendment.
On a point of Order. Does not the hon. and learned Gentleman's speech show that this Amendment would increase a charge? If the waiting day is removed, it must increase the amount of medical benefit and the charge upon the State.
I think the Amendment is more a definition of the words as to the waiting day, and that the House may very fairly look at it from that point of view.
May I appeal to the House upon this matter? No ques- tion of all the questions discussed in Committee was more thoroughly threshed out, and there was no question upon which there was a greater general desire to come to an agreement. Finally, after hours of discussion, the Clause which is now in the Bill was offered to the Committee by my right hon. Friend as being the best general solution. When it was offered Members on both sides agreed that with such a difficult problem it was the best solution; so much so, that the hon. and learned Member for West St. Pancras (Mr. Cassel), although he made his protest, as he has done to-night, agreed not to divide against it. In these circumstances I suggest that the House might accept the Clause as the solution of a difficult problem and as having the united support of all sides of the Committee.
The right hon. Gentleman will bear in mind the circumstances in which the Committee accepted the Clause. Those who were on the Committee will remember what a scramble it was. We were doing our level best to finish, and although we had a long discussion and did not divide against the Clause, can hon. Members feel that the words were wholly satisfactory? I, for one, never felt satisfied with the actual form of words relating to Sunday, and I think it will be better to leave out the word "Sunday" altogether. Whatever form of words we hit upon will be open to objection. The main point with which we were endeavouring to deal in Committee is undoubtedly dealt in the Clause, and I do not know whether we can carry it further.
May I ask whether Sunday work is different from week-day work? Incapacity on a week day is to be incapacity from doing effective work, and the word "effective" is not used in regard to Sunday. I should have thought that as a matter of drafting, if the intention was that they should both be treated the same, that the words should be the same. There is a distinction drawn between the two. I do not know whether it is a draftsman's error. Personally, I have, the greatest difficulty in understanding either the Clause or the distinction.
I will look into that.
Amendment, by leave, withdrawn.
I beg to move to leave out the words "doing any effective work," and to insert instead thereof the words "effectively working at his usual employment."
It is almost necessary to put in some such words as these, in order to be quite certain that the person who is enjoying a waiting day could not be employed upon any work other than his ordinary work. It has been pointed out by a large society of several thousand members in the North of England that if a man can prove that he would have been working in his garden on what would otherwise be regarded as a waiting day, that would be sufficient for the purpose of the Clause. What is clearly intended is that no day should be regarded as a waiting day except such a day on which he would have been capable of working at his own employment.The effect of the Amendment would be that the man might go away and be fully employed at some other occupation, and that might count as a working day. I do not think we can accept that. The hon. Member would be well advised to leave the Clause as it stands.
Amendment negatived.
Clause 13—(Maternity Benefit)
(1) Maternity benefit shall in every case be the mother's benefit, and paragraph ( e) of Sub-section (1) of Section 8 of the principal Act shall be altered accordingly by the insertion of the words "to the mother of the child" after the first word "payment" in that paragraph; and in Sub-section (1) of Section 18 of the principal Act for the words "treated as a benefit for her husband, and shall be administered in cash or otherwise by the approved society of which he is a member" there shall be substituted the words "administered in the interests of the mother and child in cash or otherwise by the approved society of which the husband is a member."
(2) At the end of Sub-section (1) of Section 18 of the principal Act the following words shall be inserted:—
Where a woman who is an employed contributor is the wife of an insured person, then—
(a) if her husband is a member of an approved society, and by reason of an insufficient number of contributions having been paid by or in respect of him, or on account of arrears, no maternity benefit is payable in respect of his insurance, she shall on her confinement be entitled to receive in respect of her own insurance such sum as she would have been entitled to receive if he had not been an insured person; and (b) If her husband is a deposit contributor, and by reason of an insufficient number of contributions having been paid by or in respect of him or of the insufficiency of the sum standing to his credit in the Deposit Contributors Fund, no maternity benefit or a sum less than the full maternity benefit is payable in respect of his insurance, she shall on her confinement be entitled to receive, in respect of her own insurance, such sum as, with the sum (if any) payable in respect of her husband's insurance, is equal to the sum she would have been entitled to receive if he had not been an insured person.
(3) Where a woman confined of a child is herself an insured person and is a married woman or, if the child is a posthumous child, a widow, she shall, in lieu of any sickness or disablement benefit to which she may be entitled under Sub-section (6) of Section 8 of the principal Act, be entitled to receive a maternity benefit from the society of which she is a member or the insurance committee, as the case may be, in addition to any maternity benefit to which she may be otherwise entitled in respect of her husband's or her own insurance, and every approved society and insurance committee shall make rules to the satisfaction of the Insurance Commissioners requiring any woman in respect of whom any such sum is payable in respect of her own insurance to abstain from remunerative work during a period of four weeks after her confinement.
(4) So much of Sub-section (1) of Section 18 of the principal Act as provides that if a duly-qualified medical practitioner is summoned in pursuance of the rules made under the Midwives Act, 1902, the prescribed fee shall, subject to regulations made by the Insurance Commissioners, be recoverable as part of the maternity benefit shall cease to have effect."
I beg to move, in Sub-section (1), to leave out the words "shall in every case be the mother's benefit," and paragraph (e) of Sub-section (1) of Section 8 of the principal Act shall be altered accordingly by the insertion of the words "to the mother of the child" after the first word "payment" in that paragraph, and to insert instead thereof the words "but where the benefit is payable in respect of the husband's insurance, the wife's receipt or his receipt on her behalf shall be a sufficient discharge to the society or committee, and, where the benefit is paid to the husband, he shall pay it to the wife or apply it for the maintenance and care of the wife and child."
Resolved, "That the Debate be now adjourned."—[ Mr. Masterman.]
Debate to be resumed to-morrow (Wednesday).
Foreign Jurisdiction Bill
Considered in Committee, and reported without Amendment; Bill read the third time, and passed.
Industrial And Provident Societies (Amendment) Bill
Considered in Committee.
[Mr. MACLEAN in the Chair.]
Clause 1—(Limit Of Holdings)
In paragraph ( a) of Section 4 and in paragraph 5 of the Second Schedule of the Industrial and Provident Societies Act, 1893 (hereinafter referred to as the principal Act), "three hundred pounds" shall be substituted for "two hundred pounds" as the maximum amount of the interest which any person may have or claim in the shares of a society.
I desire to move, formally, to leave out the Clause.
I beg to second the Amendment.
Clause disagreed to.
Clause 5—(Triennial Returns Of Share- Holders)
A registered society shall once at least in every three years make out and send to the registrar, together with the annual return for the year, a special return signed by the auditor or auditors showing the holding of each person in the society (whether in shares or loans) at the date to which the said annual return is made out: Provided that where such persons are in the list of members kept by the society distinguished by numbers it shall be sufficient if they are distinguished in the special return by such numbers, and in that case it shall not be necessary to specify their names.
I beg to move to leave the words "three years" and to insert instead thereof the word "year."
The Clause as it now stands requires that the return should be made every three years. I understand that the object of the Clause is really to provide that where people invest in co-operative societies nothing but the simple amount should be known. Under the principal Act no person may invest more than £200 in any one society, but there is nothing to prevent a person investing in every society that chooses to take his money. In that way he might have a large sum invested and escape payment of anything in the shape of Income Tax. It seems to me that the Clause as it stands casts an enormous amount of work and trouble upon industrial societies without being in any way effective.Which Amendment is the hon. Member moving?
I am moving the Amendment to leave out the words "three years" and to insert the word "year," but that Amendment must be read with another of which I have given notice, to leave out the words "of each person in the society (whether in shares or loans) at the date to which the said annual return is made out: Provided that where such persons are in the list of members kept by the society distinguished by numbers it shall be sufficient if they are distinguished in the special return by such numbers, and in that case it shall not be necessary to specify their names," and to insert instead thereof the words, "and the name and address of every person who by way of shares or loans has a holding exceeding ten pounds."
I have no desire to interfere with the time at which this return should be made. What I am asking the Committee to say is that it is reasonable to ask every year for a return of those who have any considerable holding in the societies. I admit frankly that the great mass of these cases the holders are bonâ fide workmen whose total income is below the Income Tax limit, but there is this possibility that a person may have the full £200 in as many societies as choose to accept the investment. My Amendment would relieve the society of making useless returns in regard to the whole of its members. As the Clause stands I think that the whole thing is absolutely worthless and throws needless work and trouble upon the co-operative societies.I desire to support the Amendment. I am in full sympathy with the co-operative movement, but these societies should conform to the usual law which is applied to companies. I cannot see why they should not make a return once a year exactly the same as ordinary companies do. I am also in favour of the second Amendment that these returns should state the names, addresses, and occupations rather than the numbers. There is a substantial risk that persons who are capitalists should invest in different societies, and it is impossible for the Revenue to find out without a great deal of difficulty whether they are liable for Income Tax. A third Amendment is that every return made under Section 14 of the principal Act shall be kept in a register which may be inspected by any person on payment of a 1s. fee. I would have no objection to the fee being reduced to 6d. or even 3d., but the principle should be adhered to.
I propose to answer the three Amendments put before the Committee at the same time, though in form they are directly contradictory to each other. The fact is that the whole of this Clause is to get a statement of the position of each of the members of the various societies in relation to his own society. This is entirely a domestic matter for the convenience of members of the society.
I explained the whole of the circumstances on the Second Reading, and I do not propose to trouble the House any further, save to say that I am unable to accept any of the Amendments.I think the mover of the Amendment and the hon. Gentleman opposite have entirely misconceived the object of this Clause. Its object is not to show up co-operators to the ordinary public; it is to enable a member of any co-operative society to safeguard his own interest in requiring the society to make a return once in three years, along with the balance sheet.
I ask leave to withdraw my Amendment.
Amendment, by leave, withdrawn.
Clause 6—(Amendment Of Principal Act As To Nominations)
(1) The principal Act shall as respects nominations made after the commencement of this Act have effect as if the following provisions were substituted for Section 25 of the principal Act:—
"(1) A member of a registered society not being under the age of sixteen years may by writing under his hand delivered at or sent to the registered office of the society during the lifetime of such member or made in any book kept thereat, nominate any person or persons to or among whom there shall be transferred at his decease such property in the society as may be his at the time of his decease (whether in shares, loans, or deposits, or otherwise), or so much thereof as is specified in such nomination, if the nomination does not comprise the whole. If on the death of the nominator the amount of his property in the society comprised in. the nomination exceeds one hundred pounds the nomination shall be valid to the extent of the sum of one hundred pounds, but not further or otherwise:
Provided that a person so nominated shall not be an officer or servant of the society unless such officer or servant is the husband, wife, father, mother, child, brother, sister, nephew, or niece of the nominator.
(2) A nomination so made may be revoked or varied by a subsequent nomination signed and delivered or sent or made as aforesaid or by any similar document in the nature of a revocation or variation under the hand of the nominator so delivered sent or made as aforesaid, but shall not be revocable or variable by the will of the nominator or by any codicil thereto.
(3) The society shall keep a book wherein the names of all persons so nominated and all revocations or variations (if any) of such nominations shall be recorded, and the property comprised in any such nomination to an amount not exceeding one hundred pounds shall be payable or transferable to the nominee although the rules of the society declare the shares not to be transferable.
(4) The marriage of a member of a society shall operate as a revocation of any nomination made by him before such marriage, provided, that in the event of an officer of a society having transferred any property of a member to a nominee, in ignorance of a marriage contracted subsequent to the date of the nomination, the receipt of the nominee shall be a valid discharge to the society, and the society shall be under no liability to any other person claiming such property.
(2) The principal Act shall as respects nominators dying after the commencement of this Act have effect as if the following provisions Are substituted for Sub-section (1) of Section 213 of the principal Act:—
"(1) On receiving satisfactory proof of the death of a nominator, the committee of the society shall, subject to the limitation on amount herein-before provided, either transfer the property comprised in the nomination in manner directed by the nomination, or pay to every person entitled thereunder the full value of the property given to him, unless the shares comprised in the nomination, if transferred as directed by the nominator, would raise the share capital of any nominee to a sum exceeding three hundred pounds, in which case they shall pay him the value of such excess. (2) Where a nominee who is nominated under the provisions of this Act is under sixteen years of age, the society may pay the sum nominated to either parent, or to a guardian of the nominee, or to any other person of full age who will undertake to hold the same on trust for the nominee or to apply the same for his benefit and whom the society may think a fit and proper person for the purpose, and the receipt of such parent, guardian, or other person shall be a sufficient discharge to the society for all moneys so paid.
Amendment made: In Sub-section (2) leave out the word "three" ["three hundred pounds"] and insert instead thereof the word "two."—[ Mr. Hobhouse.]
Question, "That the Clause stand part of the Bill," put, and agreed to.
Question, "That Clause 9 ( Exemption from Stamp Duty) stand part of the Bill," put, and negatived.
Remaining Clauses and Schedules agreed to.
Bill reported; as amended, to be considered to-morrow (Wednesday).
Public Works Loans Bill
Read a second time, and committed to a Committee of the Whole House for tomorrow (Wednesday).
Merchant Shipping (Certificates) Bill Lords
Order for Second Reading read.
Motion made and Question proposed, "That the Bill be now read a second time."—[ Mr. Gulland.]
I believe it is understood that, after the Second Reading, the Bill is not to be proceeded with to-day.
Question put, and agreed to.
Bill committed to a Committee of the Whole House for Monday next.—[ Mr. Gulland.]
Public Health (Prevention And Treatment Of Disease) Bill
Considered in Committee.
[Mr. MACLEAN in the Chair.]
Clause 2—(Enforcement Of Epidemic Diseases Regulations By County Councils)
The Local Government Board shall have power to declare that one of the authorities to execute and enforce regulation made by the Board under Section 130 of the Public Health Act, 1875, with a view to the treatment of persons affected with cholera or any other epidemic, endemic, or infectious disease, and preventing the spread of cholera and such other diseases, shall be the council of a county, and that Section shall have effect accordingly as if a county council were an authority within the meaning of that Section.
Amendment made: At the end of the Clause, add the words "Provided that,
except in case of emergency, the Local Government Board shall not require the council of a county to execute and enforce any such regulations without the consent of such council."—[ Mr. Goldsmith.]
Question, "That the Clause, as amended, stand part of the Bill," put, and agreed to.
Clause 3—(Treatment Of Disease And Pro- Vision Of Laboratory Facilities)
(1) It shall be lawful for the council of any county or county borough to make any such arrangements as may be sanctioned by the Local Government Board for the treatment of disease and for the provision of laboratory facilities for use in connection with the treatment or prevention of disease.
(2) Any expenses incurred in providing such treatment or facilities shall, in the case of a council of a county borough, be defrayed as part of the expenses incurred by them in the execution of the Public Health Acts, and in The case of a county council as expenses for general county purposes, or if the Local Government Board by order so direct, as expenses for special county purposes charged on such part of the county as may be provided by the order.
Amendment made: In Sub-section (1): Leave out the words "county borough" and insert instead thereof the words "or any sanitary authority."
I beg to move in Sub-section (1) to leave out the word "disease" ["prevention of disease"], and to insert instead thereof the word "tuberculosis."
This very much limits the Bill, but I think it ought to be done. This Bill, as it was introduced and read a second time, gives enormous powers to the county councils. Such ought not to be given at a very late period in the Session and without any general direction by the House, either on Second Reading or in Committee. After all, these powers are very large. It will give the power to county councils to make any repayment hereafter for the treatment of any disease whatever; that is to say, it will be lawful hereafter for any county council either to construct, equip, or maintain any hospital or convalescent home; and it would be perfectly possible to overthrow the whole of our policy of voluntary hospitals in London, and to put those hospitals on the rates. That may or may not be a wise policy; some day we may discuss it in this House. But it is a policy which ought not to be adopted at a very early hour of the morning, under a Bill which cannot possibly reveal the real possibilities of the measure to those who are discussing it. It ought not to be adopted without very full and very thorough consideration. I think the right hon. Gentleman will agree with me that he will obtain all that he can at present desire, if he secures that it should be lawful for county councils in the future to make any arrangements, which should be sanctioned by the Local Government Board, for the treatment of tuberculosis That is a matter which has been discussed in this House, and we are all agreed that the county councils should co-operate with the national exchequer, and with other bodies for the building of sanatoria. This Bill will give the county councils further power, not only to build sanatoria, and to treat tuberculosis for those insured under the National Insurance Act, but also for those who are not insured. It will not compel county councils to take any such action, but it will make it perfectly legal for them to take that action if they choose so to take it. It. will be a power, very valuable, no doubt to those interested in carrying out the National Insurance Act, and very valuable to those interested in combating this disease, and I think the right hon. Gentleman will agree that this Bill, so limited, will be a very valuable Bill, and one that will promote the object which all of us have at heart, whether we sit on one side of the House or on the other.I accept the Amendment.
Amendment agreed to.
Further Amendment made: In paragraph (1) Sub-section (3) leave out the words, "and for the provision of laboratory facilities for use in connection with the treatment or prevention of disease," and insert instead thereof the words, "provided that the powers conferred by this Section shall be in addition to and not in lieu of any other powers."—[ Mr. Burns.]
I beg to move, in Sub-section (3), paragraph (2) to leave out the words "in providing such treatment or facilities," and to insert instead thereof the words "under this Act." I understand that this Amendment is accepted by the Local Government Board.
Amendment agreed to.
Further Amendment made: In Subsection (3) leave out the words, "council of a county borough," and insert instead thereof the words, "sanitary authority."—[ Captain Jessel.]
Question, "That the Clause, as amended, stand part of the Bill," put, and agreed to.
Clause 4—(Reception, Of Patients Into Hospitals Provided By The Metropolitan Asylums Board)
(1) It shall be lawful for the managers of the Metropolitan Asylums District with the sanction of the Local Government Board to enter into agreements for the reception into hospitals provided by the managers of patients suffering from any disease, and for this purpose the managers shall be deemed to be a sanitary-authority.
(2) Any such agreements may provide that the cost of the treatment of the patients so received, or some part thereof, shall be borne otherwise than as provided by Section 80 of the Public Health (London) Act, 1891.
I beg to move to leave out the Clause.
The substance of this Clause, in an, amended form, has been inserted in the National Insurance Act (1911) Amendment Bill, upstairs. Clause 37 of that Bill, it is 'considered, meets substantially all that we sought to achieve under Clause 4 of the present Bill. In accordance, therefore, with an agreement come to and a promise given, I beg to move that this Clause be omitted.Question, "That the Clause stand part of the Bill," put, and negatived.
Clause 5—(Short Title)
This Act may be cited as the Public Health (Treatment and Prevention of Disease) Act, 1913.
Question proposed, "That the Clause stand part of the Bill."
In the title the Bill called "Prevention and Treatment of Disease," and in this Clause it is "Treatment and Prevention of Disease." Which title is the right hon. Gentleman going to have?
"Prevention and Treatment of Disease."
Then it ought to be altered in Clause 5; otherwise you will have it mixed up.
Amendment made: Leave out the words "Treatment and Prevention" and insert instead thereof the words "Prevention and Treatment."—[ Mr. Burns.]
Question, "That the Clause, as amended, stand part of the Bill," put, and agreed to.
Bill reported; as amended, to be considered to-morrow (Wednesday).
Telegraph (Money) Bill
Read a second time, and committed to a Committee of the whole House for tomorrow (Wednesday).
Isle Of Man (Customs) Bill
Order for Third Reading read.
Motion made and Question proposed, "That the Bill be now read the third time."
I hope that when this Bill comes before the House next time, some Law Officer of the Crown will be able to explain in a more definite way the relations of this House to the Legislature of the Isle of Man. I shall ask that Question on the Bill next Session.
Question put, and agreed to.
Bill read the third time, and passed.
Expiring Laws Continuance Bill
Considered in Committee, and reported, without Amendment; Bill read the third time, and passed.
The remaining Government Orders were read and postponed.
Whereupon Mr. SPEAKER, pursuant to the Order of the House of 22nd July, proposed the Question, "That this House do now adjourn."
Question put, and agreed to.
Adjourned accordingly at Twenty minutes before One a.m., Wednesday, 6th August, 1913.