House Of Commons
Tuesday, 23rd July, 1946
The House met at Half past Two o' Clock
Prayers
[Mr. SPEAKER in the Chair]
Confectionery Allocation, Sheldon (Petition)
I beg leave of the House to present a humble Petition from 1,400 inhabitants of the parish of Sheldon in the City of Birmingham in the Parliamentary constituency of Solihull. The Petition showeth:
" That the sweets and confectionery allocation allotted to Mr. C. H. Andrews of 8, Arden Oak Road, Sheldon, is insufficient to provide the said people of Sheldon with comfort and nourishment in the form of sweets and confectionery as is reasonable and desirable, and your Petitioners pray that they may be granted relief from such hardship by the Honourable Commons of Great Britain and Northern Ireland in Parliament assembled with an increased allocation of sweets and confectionery, and your Petitioners, as in duty bound, will ever pray.''
Petition to lie upon the Table.
Private Business
Portsmouth Corporation Bill
Lords Amendments considered, and agreed to.
Caledonian Insurance Company Bill Lords
As amended, considered; to be read the Third time.
Royal London Ophthalmic Hospital, Royal Westminster Ophthalmic Hospital And Central London Ophthalmic Hospital (Amalgamation, Etc) Bill Lords
As amended, considered; to be read the Third time.
Tyne Tunnel Bill Lords
As amended, considered; to be read the Third time.
West Sussex County Council Bill Lords
As amended, considered; to be read the Third time.
Campbeltown Water, Etc, Order Confirmation Bill
"to confirm a Provisional Order under the Private Legislation Procedure (Scotland) Act, 1936, relating to Campbeltown Water, etc.," presented by Mr. Secretary Westwood; and ordered (under Section 7 of the Act), to be considered Tomorrow, and to be printed. [Bill 148.]
Oral Answers To Questions
Ministry Of Works
Temporary Houses (Erection Time)
2.
asked the Minister of Works what has been the average time taken for the erection of temporary houses, including the time required for the preparation of the site.
From the beginning of site preparation to the occupation of the house, the average time taken has been about nine months. The period is being reduced as the rate of supply of certain items improves.
Can the right hon. Gentleman say how this time compares with the estimate originally given?
No, I cannot.
Can the right hon. Gentleman say what period is involved when the sites are prepared and no work is going on, before building commences?
In that period of nine months that I have given, about three months.
Commons Chamber (Ceiling Repair)
3.
asked the Minister of Works whether it is intended to repair the ceiling of the present Chamber of the House of Commons where the German bomb penetrated.
The repair of the ceiling of this Chamber will be put in hand during the coming Recess.
Is not this bomb damage part of the history of this ancient House, and would it not, therefore, be much better to leave it as it is at present?
Temporary Principal (Appointment)
5.
asked the Minister of Works what were the qualifications upon which he decided to appoint Mrs. Violet Dean to her post in his Department; what is the post she occupies; what is her salary; and why the post was not offered to an ex-Serviceman.
Mrs. Dean entered the service of my Department as a temporary administrative assistant in May, 1943, having been recruited in the normal way through the Central Interviewing Board of the Ministry of Labour Appointments Department. She was promoted to her present post of temporary principal on the salary range £572–£784 in December, 1945, as she was considered to be the best candidate for the post having regard to her administrative capacity and experience since the date of her appointment.
Since her promotion, has she been employed on snooping duties, and if so how many convictions has she obtained?
If a Question of this kind is to be asked, is it not more in accordance with good taste and with the customs of this House that the name of the civil servant referred to should be communicated to the Minister concerned privately?
I think so; I must confess that I thought it unfortunate to say that the lady was employed on snooping duties.
Withdraw.
But she was.
National Portrait Gallery, Scotland
6.
asked the Minister of Works if he is aware that the National Portrait Gallery of Scotland has been closed since 1939; why this arrangement as regards picture galleries applies to Edinburgh and not to London; and if the gallery is still occupied by the National Registration Identity Cards department of the Government.
The answer to the first and last parts of the Question is in the affirmative. As regards the second part, this Gallery, in common with most of the London galleries and museums, was closed during the war, when the exhibits were evacuated for safety. Every effort is being made to secure alternative accommodation for the National Register Office staff, but in view of the particularly acute shortage of office premises in Edinburgh, I am unable at present to hold out any prospect of an early release.
Is the right hon. Gentleman aware that the citizens of Edinburgh, and of Scotland generally, have been denied for some six years seeing this important exhibition of famous Scotsmen and Scotswomen, and that they think it more important to see this exhibition than to retain their National Registration cards?
As soon as alternative arrangements can be made, an opportunity to see the exhibition will be given.
Brick Supplies, Cumberland
8.
asked the Minister of Works in view of the shortage of bricks for all purposes in the West Cumberland development area, whether he will consider the establishment of a brick works, controlled by his Department, seeing that there are ample clay deposits in the area.
I am always prepared to consider establishing further brickworks where additional capacity for brickmaking is required. I think, however, that the most expeditious way of meeting the requirements of West Cumberland is to assist the existing works to resume full production as rapidly as possible.
9.
asked the Minister of Works the position, so far as the supplies of bricks are concerned for housing, covering the Millom Rural District Council, the Ennerdale Rural District Council and the Whitehaven Borough; whether his attention has been called to the fact that men are being paid off owing to the shortage of bricks; and what he is prepared to do to overcome this shortage.
There is a shortage of bricks in this area. I am prepared, with the agreement of my right hon. Friend the Minister of Health, to arrange to supply Belgian bricks and to send bricks from an adjoining area.
Fuel And Power
Anglo-Iranian Oil Company (Output)
14.
asked the Minister of Fuel and Power what the output of the Anglo-Iranian Oil Company was in 1945; what proportion of this production was imported into the United Kingdom; and where the remainder was sent.
As regards the first two parts of the Question, the output of crude oil by the Anglo-Iranian Oil Company in Persia in 1945 was 16,840,000 tons. During that year only about 1 per cent. of this production was brought to the United Kingdom. In regard to the last section of the Question, the major part of the company's output during 1945 went into the Eastern area for war purposes, both British and American.
Can the right hon. Gentleman say by what percentage the imports to this country are likely to go up this year?
I could not say offhand.
Miners' Coal Allowance
15.
asked the Minister of Fuel and Power the average amount of coal allowed per week to miners and the prices paid by them.
On the average, 3½ cwt. of coal per miner per week are supplied to those miners entitled to receive either free or concessionary coal. Of the total quantity supplied, about 58 per cent. was at reduced prices, the average price in 1945 being 8s. per ton.
Fuel Accumulation, Bromley
18.
asked the Minister of Fuel and Power if he is aware that 15 trucks of coal have accumulated at Bromley South Station as a result of the withdrawal of the permit from Mr. C. Mortimer, of 57, High Street, Orpington; and if he will, in consultation with the Minister of Transport, take the necessary steps to enable Mr. Mortimer to continue his coal delivery work.
The accumulation of 15 wagons at Bromley South Station was brought about by the cancellation of hired transport owing to lack of coal supplies up to 8th July, followed by the unexpected arrival on the 9th July of eight wagons of coke in addition to normal coal supplies. By working over the week-end the wagon accumulation was cleared by the firm of coal merchants concerned. As regards the last part of the Question, I would refer to the reply given yesterday by my right hon. Friend, the Minister of Transport, in answer to a similar Question.
Is the right hon. Gentleman aware that Mr. Mortimer had his lorry taken off the road by a telephone message in a very peremptory manner from a bureaucrat in Bromley? Will he take steps to see that, as this is the only lorry which has weights, scales and sacks, this kind of interference with a private business of a private citizen is not continued?
I understand that the permit authorising the use of the vehicle expired on 31st May, and that Mr. Mortimer did not make application for its renewal immediately thereafter. He has since done so, and, of course, authorisation will be made.
Can the right hon. Gentleman explain how it comes about that, under a planned economy, the arrival of eight wagons was unexpected?
When one is dealing with matters of coke and coal anything can happen.
Peat
19.
asked the Minister of Fuel and Power what tonnage of peat is expected to be available this winter for domestic fuel in Scotland.
I regret that this information is not available.
Slurry (Coal Charge)
20.
asked the Minister of Fuel and Power why he refused to permit a Warwickshire colliery to give away for use in brick making 30,000 tons of washery slurry, now occupying agricultural land, unless 15s. per ton was paid to the Coal Charges Fund; and whether, in order to encourage useful disposal, he will exempt slurry from the levy.
All disposals of fuel for purposes of combustion have to bear coal charge. If an undertaking is unable to dispose of any of its products as fuel, and wishes to do so for some purpose other than combustion, the Ministry is prepared to consider the question of exemption from coal charge, provided the facts are laid before them prior to the sale. The Warwickshire Coal Company recently asked the Ministry to exempt its slurry from coal charge on the grounds that its selling value could not support the charge. The Ministry replied setting out the position as above, and invited presentation of the facts if any of the products could not be sold as fuel, but only as rubbish at a price which would not cover coal charge. So far, no request for exemption from coal charge under the conditions prescribed has been received.
Does not this case illustrate the urgent necessity for amending the Coal Charges Order, so as to get rid of the flat rate levy?
No, Sir, I should not think so. Obviously, one could not apply the flat rate principle to coal charges.
Would the right hon. Gentleman say what washery slurry is?
Slurry, when coal was plentiful, was waste. Now it is used——
For coal.
Departmental Staffing
21.
asked the Minister of Fuel and Power why his Department retains publicans and other people who have other occupations and declares ex-Servicemen redundant, in the same Departments, doing the same work.
I do not regard an outside occupation as debarring an officer from employment, so long as he efficiently discharges the duties of his office and complies with the regulations attaching to his particular employment. The discharge of redundant staff is in accordance with the terms of the agreement reached with the Staff Side of the Departmental Whitley Council; ex-Servicemen are given every consideration and are only dispensed with in accordance with this agreement. I do not know what particular case my hon. Friend has in mind, but if he will give me particulars I am quite willing to look into it.
Does the right hon. Gentleman fully realise that when any such question of redundancy occurs, it tends to create suspicion in the minds of the staff concerned? I will certainly let the right hon. Gentleman have the case I have in mind.
Gas Works (Coal Supplies)
22.
asked the Minister of Fuel and Power whether a better quality of coal will be supplied to gas undertakings in the North-East of Scotland.
The supplies available for gas works are being distributed as fairly as possible in collaboration with the regional spokesmen of the industry in respect of quality and quantity. Until outputs are substantially higher than they have been, we could only improve supplies in particular cases at the expense of other gas works.
Is the right hon. Gentleman aware that the coal we are getting in the North-East at present is providing only 75 per cent, of the gas per ton produced from similar coal before the war?
If that allegation can be substantiated, no doubt, the gas undertaking will inform me.
Petrol Rationing
23.
asked the Minister of Fuel and Power if he will allow the basic petrol ration for the months of August and September to be taken up in either of the two months.
Basic ration coupons for July will be valid for use during August at the increased rate which becomes operative on 1st August, and the August coupons will be similarly valid for use in September. I am not prepared, however, to ante-date the September coupons.
Lighting (Old Premises)
24.
asked the Minister of Fuel and Power whether he will give an assurance that, where no alternative method of light or power is available, old premises, in respect of which application for the supply of electricity has been outstanding for several years, will not be treated any less favourably than new buildings.
Yes, Sir; but only in very exceptional cases will it be found that no alternative method of light or power is available.
Paraffin Supplies
25.
asked the Minister of Fuel and Power whether he will now make an increase of 50 per cent. in the paraffin ration.
I have been endeavouring to improve the position in regard to supplies of paraffin for the country but it is one of the petroleum products which is in short supply, and I am not yet able to announce any relaxation. I would also refer the hon. Member to the reply I gave on 30th April to the hon. Member for Evesham (Mr. De la Bère).
Can the Minister give us any reassurance that he considers it will be possible for him to increase the supplies before the winter?
I wish I could, but at the moment I cannot.
Official's Coal Supply (Inquiry)
27.
asked the Minister of Fuel and Power why the Bristol Regional Office of his Department made certain preferential issues of fuel, of which he has been informed; and if he will make a statement.
I assume the hon. Member is referring to the report in the Press of the statement by the Salisbury Local Fuel Overseer regarding the supply of large anthracite to Lady Fergusson, the wife of the Permanent Secretary of my Department. To remove misconceptions which that statement might cause, I should point out that large anthracite is not in the list of restricted fuels; it is not a suitable substitute for house coal for use in ordinary domestic grates, and it has been the policy of my Department that it should be used in large domestic boilers as far as it can be made available in preference to the restricted fuels. Licences for supplies of it are not required, and indeed the Local Fuel Overseer advised Lady Fergusson, who had applied to him, that it was not necessary for a permit to be issued to obtain it, and that she was quite in order in asking her registered merchants to let her have a supply of it. It is not the practice of my Department to prescribe to coal merchants the amounts of this fuel to be delivered to individual customers.
In view, however, of the fact that public allegations have been made of improper or undue influence for securing preferential treatment for the Permanent Secretary of my Department, I have, at Sir Donald Fergusson's request, arranged for an independent investigation into the matter, and this is being undertaken by Sir John Forster, K.C.Coal Industry
Polish Mineworkers
17.
asked the Minister of Fuel and Power whether he now has any further information to give as to the prospect of the Government's proposal for the employment of Polish ex-soldiers in British coalmines being carried out.
I would refer the hon. Member to the answer I gave him to a similar Question on 18th June.
Could the right hon. Gentleman say what the present state of the negotiations is? It is a very long time since the Foreign Secretary held out hope of this employment.
We are still in discussion on this matter, but the number of Poles available who are suitable for work of this description is not high. I propose to deal with the matter tomorrow in the course of the Debate,
Will the Minister see that, pending the return of these men to Poland, consideration is given, in connection with their employment in the mines, to their being taken away entirely from military control, British or Polish, so that they may be free men working in the mines?
If there should be any Poles who can be employed in the mines —I have already indicated that there are not many available—they would have to be employed under civilian supervision.
Does the right hon. Gentleman appreciate that this is a matter of very considerable urgency How long does he think these negotiations are going on?
There can be no question of urgency about it, if the number available is small.
Injured Miners (Employment)
26.
asked the Minister of Fuel and Power if he has yet given instructions that the so-called black list of injured miners, operated through the Indemnity Society, should be abandoned.
It has been made clear to colliery managements that they should not refuse to employ a man merely because he is in receipt of compensation. Special action is taken in an endeavour to provide suitable employment for compensation men who are capable of performing a reasonable day's work, and in appropriate cases consideration would be given to the issue of directions.
Is the Minister aware that this is not carried out in pits in South Wales, and if I give him instances of the practice not being carried out, will he take action in the matter?
I certainly will if the information is conveyed to me, but I would suggest also that such cases should be reported to the trade union concerned.
Employment
Women's Auxiliary Services (Recruitment)
28.
asked the Minister of Labour whether, in view of the shortage of female labour of all kinds, he will hold up recruitment of women into the Auxiliary Services until the position has eased.
No. Sir. Voluntary recruitment of women to the Women's Auxiliary Services is designed to lessen the needs of the Services for men, and to adopt the hon. Member's suggestion would delay the release of men now serving.
is it not reasonable that women who have been demobilised and find civilian life distasteful should be able to return to the Services? Is the Parliamentary Secretary aware that in my constituency a woman has been prevented from returning to the Services, although she is very capable?
That hardly arises on this Question.
Nurses (Recruitment)
29.
asked the. Minister of Labour how many girls have enrolled as student nurses between the beginning of the special recruiting campaign and the latest convenient date; and how many female nurses left the profession for any reason during the same period.
The number of female student nurses entering training from and including September, 1945, when the special recruiting campaign began, and 10th June, 1946, the latest date up to which information is available, was approximately 20,000. I am unable to say how many female nurses left the profession during the same period
Transferred Welsh Workers
31.
asked the Minister of Labour whether he will have a special register kept of any suitable vacancies in South Wales, and inform those who have migrated from Wales during recent years of such vacancies so that they may have an early opportunity of returning to their native country.
I regret that it would be impracticable to introduce the full scheme suggested by my hon. Friend, but suitable vacancies in their home area are brought to the notice of workers who have recently transferred from home under the temporary transfer scheme, and their return is facilitated.
Is the Parliamentary Secretary aware that a quarter of a million people left Wales during the depression and after the 1918 war, and that many of them would like to go back if there are vacancies for them? Could some scheme be provided whereby they could be informed of any possible vacancies?
That is why we introduced the temporary transfer scheme, under which all workers transferred are notified of vacancies in their own areas.
Is the Parliamentary Secretary aware that at the present moment there are tens of thousands of people unemployed in South Wales? Will something be done about that before bringing more people into the area?
That is why we have the temporary transfer scheme.
National Institute Of Houseworkers (Board)
32.
asked the Minister of Labour if he is now in a position to state the names of the persons appointed to serve on the Board of the Institute of Domestic Workers.
Yes, Sir. As my right hon. Friend has already informed the House, he invited Miss Dorothy Elliott to be chairman of the board of directors of the National Institute of Houseworkers, and he has now appointed her and nine other members of the Board, a list of whose names I will circulate in the OFFICIAL REPORT. One further appointment of a person with experience of domestic training remains to he made. I may add that an advisory council, representative of the various interests concerned, is being set up to assist the Institute in its work. My right hon. Friend is happy to say that Miss Violet Markham has consented to become chairman of the council.
Will the Parliamentary Secretary say whether in this instance the Government will follow the excellent practice which was incorporated in the Services of promotion from the ranks?
Will Miss Markham be personally informed of her appointment, or, as in the case of her compulsory retirement, will she hear about it in the Press?
I thought I said that Miss Markham had consented to accept this appointment.
Have any of the people whose names are to be circulated in the OFFICIAL REPORT any practical experience of domestic work?
I think that it is an admirable list, and that when hon. Members see it they will be very pleased.
Following is the list:
Board of Directors of the National Institute of Houseworkers, Ltd.
Miss Dorothy Elliott, B.A., O.B.E., J.P., formerly national woman officer of the National Union of Municipal and General Workers (Chairman).
Miss N. K. Ayris, member et the National Union of Domestic Workers.
Miss G. Drysdale, J.P., deputy secretary of the Scottish Council of Social Service.
W. G. Fuller, Esq., of the Ministry of Labour and National Service (Financial Director).
Mrs. K. W. Jones-Roberts, B.A., J.P., member of the Merionethshire County Council.
R. T. Laughton, Esq., C.B.E., managing director of the Royal Hotel, Scarborough, formerly managing director of the National Service Hostels Corporation, Ltd.
Mrs. E. Neville-Smith, B.A., member of the executive of the National Federation of Women's Institutes.
Miss M. E. Sutherland, M.A., J.P., woman officer of the Standing Joint Committee of Working Women's Organisations.
J. J. Taylor, Esq., O.B.E., executive officer of the Workers' Travel Association.
Mrs. Kenneth Wood, A.R.San.I., M.C.A., M.R.S.T. (Miss Etty Potter), principal of the Low Moor Domestic Science College, Birmingham.
Scotland
Public Health, Aberdeen
34.
asked the Secretary of State for Scotland if he will state in round figures, comparing the years 1938 and 1945–46, the effect of the war and food rationing on the health of the people of Aberdeen, with particular reference to the incidence of disease and to infantile and maternal mortality.
As the reply is long and involves a number of figures, I am sending a statement to my hon. and learned Friend.
is the right hon. Gentleman in a position to say whether the figures show an upward or downward trend?
I can say that the figures prove that the position is fairly satisfactory.
Senior Leaving Certificate Examination
35.
asked the Secretary of State for Scotland if, in view of the general dissatisfaction with the examination for Senior Leaving Certificate, he will reconsider the whole question of the use of this examination before next year.
I am not aware of any general dissatisfaction with the examination for the Senior Leaving Certificate, though my attention has been drawn to criticism arising from certain conjectures and mis-statements which have recently received publicity. The future of this examination will be considered in the light of the report on secondary education which I shall soon be receiving from the Advisory Council on Education in Scotland.
Will the Minister bear in mind, when reconsidering this question, that there is a good deal of dissatisfaction with the method of awarding this certificate, and that this examination should not be merely a selective test but a test of attainment at the end of the period of secondary training?
I extended the life of the Advisory Committee by three months to enable them to complete their investigations and report to me on this problem. I have nothing further to add until I have received their report.
Two-Apartment Houses
36.
asked the Secretary of State for Scotland how many two-apartment houses are provided for in the schemes promoted by local authorities up to the end of May.
Out of 29,000 houses covered by tenders approved between 1st January, 1945, and 31st May, 1946, only eight are of two-apartments. These houses comprise four for occupation by elderly couples, and four included in a prewar scheme
Fish Meal
37.
asked the Secretary of State for Scotland why, in view of the serious cuts which poultry keepers will have to make in their livestock owing to lack of feeding-stuffs, he is not taking steps to use all fish which is not available for human consumption for the production of fish meal for poultry instead of allowing surplus fish to be dumped in the sea.
Full use is made by the fishing industry of by-product factories for the conversion of fish into fish meal. The quantity of fish dumped in the sea during the first six months of this year has been very small, and amounted to only one-twentieth of r per cent. of the quantity of fish landed. It was not an economic proposition to transport this relatively small quantity to a factory.
Dundee Mental Hospital (Nurses)
40.
asked the Secretary of State for Scotland whether he is aware of the shortage of female nurses at the Dundee Mental Hospital branch of Liff, as at present there are only 20 female nurses looking after 300 patients; and what steps he is taking to remedy this.
I am informed that, while there are only 20 female nurses on the permanent staff, there are also three full-time and 15 part-time temporary nurses at the hospital referred to. With regard to the last part of the Question, I would refer the hon. Member to my reply to his Question on 2nd July.
While appreciating that answer, may I ask the Minister if he would look into the case of the female nurses serving in this mental hospital, because I believe that there is considerable hardship experienced by them, owing to the lack of staff?
In view of the supplementary question, I will take particular note of this matter and have inquiries made.
Agricultural Executive Committees
41.
asked the Secretary of State for Scotland whether he will reconsider his decision to change over from the old W.A.E.Cs. to the new district committees in November; and whether he will consider causing the change to take place in the spring of 1947.
I propose to proceed with the appointment of the new area executive committees in November. In order, however, to avoid any possibility of prejudicing the plans now being made for next year's vital harvest, I have decided, instead of setting up the local sub-committees mentioned in my reply of 14th May to the hon. Member for East Fife (Mr. Henderson Stewart), to invite the existing agricultural executive committees to remain in office for a further period for the performance of specific food production duties.
Can the Minister say whether these committees will have the same powers as they have at present, or will they come under the area committees in any way?
They will have practically the same powers as at present. I want them to continue until such time as we are through the crisis we are in at the moment so far as food production is concerned.
Housing Procedure
42.
asked the Secretary of State for Scotland if he will explain the changes made in housing procedure resulting from the recent representations made to him by the Fife County Council; and if this improved procedure will apply, in future, to all housing activities in Scotland.
The arrangements broadly provide for the approval of sites in suitable cases by means of local contacts between my Department and the county council. I shall consider extending these arrangements wherever this is useful and practical. Questions of distance and local practice might rule out their general adoption. I am anxious to simplify housing procedure to the utmost extent and will continue to seek the guidance of the liaison committee of local authority representatives who advise me in this respect.
Does not the Minister agree with the estimate made by the county council that, as a result of their representations, the time spent on formalities has been reduced from well over 100 days to less than 30 days?
Far be it from me to deprecate any local authorities in their claims. If they choose to be happy that way, I do not want to take away their happiness.
If that extraordinary reduction in "red tape" can be brought about, why did the hon. Member delay so long in denying the charge which I made?
The facts are that the reduction is nothing like that amount. Let people be happy. I am much more happy that they should get on with building houses than have needless controversy about them.
I want to be happy.
Bread Rationing (Farm Workers)
43.
asked the Secretary of State for Scotland if he has any further statement to make on the effect upon farm workers' perquisites of the new bread-rationing Order.
I am still in consultation with my right hon. Friend the Minister of Food and hope that an announcement will be made very shortly.
In view of the Order now on the Table with regard to oatmeal, does not the right hon Gentleman think it absolutely necessary that the House should be informed of this matter before the Order is passed?
The Minister of Food is carrying through negotiations at the present time, and is engaged on the prepartions of the special provisions to deal with the perquisites of farm workers.
If there is an Order on the Table, how is it that the Minister has not come to a decision with regard to this matter?
I have already pointed out that the Minister of Food is working on the provisions at the moment, and we hope, as I have already stated, that we shall he able very shortly to make an announcement.
Are we to assume that the Order putting oatmeal on points was issued without giving preliminary considerations to these complications which have arisen?
The right hon. Gentleman must not assume that.
Is the Minister aware that a great deal of the trouble in the country is because the public are not taken sufficiently into the confidence of the Government?
Brickworks, Inverkeithing
44.
asked the Secretary of State for Scotland if he has yet completed his inquiries into the position of the brickworks at Inverkeithing, Fife; whether he is aware that foreign-made bricks are being brought to a housing site within a mile of this brickworks; and if he will expedite the completion of the works so that production may be commenced at an early date.
I am glad to say that as a result of the satisfactory conclusion of negotiations between the owners of this brickworks and the promoters of the Forth Road Bridge (Draft) Provisional Order, the way is now clear to bring the brickworks into production, and the Ministry of Works are in close touch with the owners to expedite the installation of the necessary machinery and equipment.
Broadcasting Advisory Committee
46.
asked the Lord President of the Council if the members of the Advisory Committee on Scottish Broadcasting will be appointed by the Governors of the B.B.C. or by the Secretary of State for Scotland.
Theseappointments will be made by the Governors of the B.B.C. who, in exercising their responsibility, will naturally take such consultations as are appropriate. I think that the hon. Member can rest assured that full account will be taken of any views expressed to the Governors by the Secretary of State.
Is the Minister aware that, if we cannot get control of our own radio in Scotland, the least we can expect is that the Scottish Department will select the advisers to the B.B.C. Governors on Scottish programmes, and not leave it to the B.B.C. to appoint their own Scottish advisers?
Up to now, it has been the custom when bodies set up advisory committees for them to appoint them, whether they are the Government or anyone else. That practice is being followed. I have made arrangements whereby the Secretary of State for Scotland will be consulted, and he concurs in that arrangement.
Would it not be more in accordance with Scottish sentiment if the Secretary of State for Scotland at least made some of these appointments?
I do not think that I can add to the answer that I have given. I think that this is quite a reasonable arrangement in all the circumstances.
Is the right hon. Gentleman aware that not one Scotsman or Scotswoman is on the Board of Governors of the B.B.C.?
I am not sure about that.
It is perfectly true.
The Advisory Committee will be drawn from Scotland, but if Members of the Opposition, who last week were arguing against the Government having an undue hand in the B.B.C., are now going to argue that the Government, and not the B.B.C., should appoint the Advisory Committee, I wish they would reconcile their views.
Will the Lord President of the Council ask the Secretary of State for Scotland to make a real fight in the Government for his rights in this matter?
The Secretary of State for Scotland makes a much better fight for the rights of Scotland than the hon. Member and his political friends do for the rights of Great Britain.
School Leaving Certificate
67.
asked the Secretary of State for Scotland the number of pupils who left school at the end of session 1945– 1946; the number who had gained a two-years' certificate; the number who had gained a day-school certificate, higher; and the number who had gained the higher leaving certificate.
I regret that the number of pupils who left school at the end of session 1945– 46 is not available. As regards day school certificates, responsibility for the award of two-years' certificates since 1933, and of three-years' certificates since 1939, has rested wholly with education authorities: no returns of the numbers awarded annually are received. The number of senior leaving certificates awarded in 1946 was 4,469: a number of appeals, however, are under consideration, and the final figure will be somewhat higher.
Harvest Labour
68.
asked the Secretary of State for Scotland if he is aware that offers to undertake harvesting work are being rejected by the Department of Agriculture for Scotland because of the availability of prisoners of war; and whether it is still necessary to employ juvenile labour.
It has been found possible to dispense with a proportion of the civilian labour, other than persons from Employment Exchanges, hitherto required for the grain harvest in consequence of the increases in the number of prisoners of war and other forms of supplementary labour. I regret, however, that the labour thus set free is not available to enable us to do without the services of school children for the potato harvest.
Will my right hon. Friend reconsider that reply, because it certainly will not give any encouragement to civilians to volunteer for future harvest work when prisoner of war labour is not available?
Iron And Steel Federation Houses
69.
asked the Secretary of State for Scotland which local authorities have refused to accept the British Iron and Steel Federation house.
The town councils of Falkirk, Hamilton, Milngavie and Rutherglen and the county councils of Ayr and Dunbarton were unable to accept the provisional allocation of British Iron and Steel Federation houses made to them. The 450 houses involved have since been allocated to other local authorities.
Can my hon. Friend say what the reasons were for rejecting these house, in view of the great shortage in this district, and whether steps have been taken by these local authorities to compensate people for the loss which has been suffered?
The reasons vary. Some did not like the house because their architects objected. In one or two cases they have taken steps to get other permanent prefabricated houses. Personally, I would have thought that when the housing shortage in Scotland was so acute no local authority would have refused an offer of a Government house.
Subordinate Legislation (Treasury Circular)
45.
asked the Prime Minister whether his attention has been called to paragraph 10 of Treasury Circular No. 21/46, stating that subordinate legislation, purporting to be made with retrospective effect, is ultra vires unless the parent statute clearly confers power to give such effect; and whether legislation will be introduced to give validity to the Air Navigation (Amendment) (Ministry of Civil Aviation) Order, 1945 (S.R. & O., 1945, No. 163.7), and the Further Education Grant Regulations, 1946 (S.R. & O., 1946, No. 352), which, according to the circular, are ultra vires
I have been asked to reply. My right hon. Friend the Prime Minister has seen the Treasury circular referred to. It is for the guidance of the heads of Departments to whom it is addressed, and it states a general proposition. Regard has to be had to the precise statutory powers in each case, and my right hon. Friend does not accept the contention that legislation, as suggested by the hon. Member, is necessary.
Will the Chancellor of the Exchequer say how he reconciles the validity of these Orders with the opinion of the Law Officers?
They are not in conflict.
Will the right hon. Gentleman make this Circular available to the House?
There is a later Question about that on the Order Paper.
56.
asked the Chancellor of the Exchequer if he will arrange for copies of Treasury Circular No. 21/46, concerning subordinate legislation, to be available in the Vote Office.
Yes, Sir.
Germany
Insulin Priorities
47.
asked the Chancellor of the Duchy of Lancaster what are the respective priorities for the supply of insulin to civilian internees in Germany and to the general German population; and why the latter are lower in the scale than the former.
In the British zone insulin is supplied to both civilian internees and the general public through the German authorities. The Control Commission have laid down no priorities for its supply, nor am I aware of any adopted by the Germans. My in- formation is that supplies are adequate to meet hospitals demands in full for both the general public and the internees; limited quantities are also available for sale to the public in chemists' shops.
Hamburg (Incidents)
48.
asked the Chancellor of the Duchy of Lancaster whether he has any information to give the House respecting recent disorders in Hamburg.
So far as I am aware there have been only two incidents. On 27th June, 50 German women had arranged to meet outside the town hall so that six of their number could present a petition to the German burgomaster against the requisitioning of premises for British personnel without the provision of similar alternative accommodation. This incident was seized upon by rowdy elements and a crowd of two to three thousand persons collected outside the town hall. The crowd was quickly and peacefully dispersed by the German police assisted by British military police; some 20 persons were arrested. The Commander-in-Chief issued a warning and the incident seems closed. On 17th July, there was a much smaller demonstration by some 300 workers against alleged bad food. This was quickly dispersed and the ringleader arrested.
Is the Minister fully satisfied that the conditions existing in Hamburg generally at the moment, to which the question refers, are such that it is prudent and expeditious to send the families of men there at the present time?
I think that, taking all the factors into consideration, there is no alternative to allowing our staff over there to have their families with them, and that the conditions are such as to enable that to be possible. The incident to which reference is made in the Question, was something which arose through a misunderstanding as to the operation of that scheme. It was comparatively peaceful and was dispersed without even the police having to draw their truncheons. The observations and the pronouncements made upon it by the German Press and the leaders of the German political parties have endorsed that fact.
Some of us have seen these conditions in Hamburg, and would the Government not consider that a proper angle of approach to this question of maintaining contact between the officers in Germany and their families at home is rather to be found in giving adequate leave at reasonable times rather than sending the wives and families to Germany?
I can assure the hon. Member that these considerations have been very closely examined by the Government. The fact is that we do require to retain a considerable number of people in Germany of the right quality as far as they can be obtainable, and it is quite impossible to keep them separated from their families for long periods.
National Finance
Food Subsidies
49.
asked the Chancellor of the Exchequer to what extent the increased prices to be paid to the farmers and other factors will increase the amount of the food stabilisation subsidy; and what is now the estimated total for this financial year.
I would refer the hon. Member to my reply to the hon. Member for Newbury (Mr. Hurd) last Thursday.
In view of the food situation, would it not be of more help to the country if prices were allowed to find their own level, when the law of supply and demand would settle these things?
That is not the view of the Government.
Closed Tax Offices
50.
asked the Chancellor of the Exchequer how many tax offices have been closed since 1939 and in what respective places; how many have been reopened since the cessation of hostilities and where; and what additional staff would be necessary to reopen all offices at present closed.
As the answer is detailed, I will, with permission, circulate it in the OFFICIAL REPORT.
Without referring to hordes of unnecessary officials, can the Chancellor say when the tax office in Darwen will be reopened?
No, Sir. The answer is still the same as when the hon. Gentleman asked exactly the same question a short time ago—we must be on our guard against the employment of unnecessary hordes of officials.
Can the right hon. Gentleman say how many other tax offices have been reopened and how many officials employed?
None that have been closed have been reopened in my time.
If we must be on our guard against hordes of unnecessary officials, why on earth do the Government go ahead with the rationing scheme for bread?
Following is the statement:
Since the outbreak of the war 10 tax offices have been closed down in the following towns:
- Swansea—4 offices reduced to 2.
- Wigan—3 offices reduced to 1.
- Bradford—11 offices reduced to 10.
- Middlesbrough—4 offices reduced to 3.
- St. Helens—2 offices reduced to 1.
- South Shields—2 offices reduced to 1.
- Dundee—3 offices reduced to 2.
- Paisley—3 offices reduced to 2.
None of these offices has been reopened. The additional staff required to reopen these offices would not be large, but I could not justify the expense involved.
War Damage Payments
51.
asked the Chancellor of the Exchequer if he will now authorise payments to be made to persons over 65 years of age in respect of their war-damage claims for private chattels.
No, Sir, not as an automatic rule, but my right hon. Friend the President of the Board of Trade is always prepared to give special consideration to hardship claims from elderly persons.
Does the right hon. Gentleman realise that all the arguments he used when agreeing to pay postwar credits to elderly people apply with equal force to elderly people as far as war damage chattels are concerned, and will he not, with the President of the Board of Trade, take some action to see that people get some benefit from their claims while they are still alive?
I gave the reasons in reply to an earlier question why the two cases are different and I will not repeat them now, but the cases are not on all fours. We are anxious to make these payments as soon as the general situation permits, but we must keep a watch against making too many payments in a short time.
Will the Chancellor of the Exchequer bear it mind that a forensic triumph is no solution to the people without tables and chairs?
58.
asked the Chancellor of the Exchequer if he has now completed his consideration of the day to be appointed for the payment of claims under the War Damage Acts; and if he will now indicate when value payments will be made to those who insured against war damage and who have claims against the War Damage Fund.
No, Sir, not yet.
Dollar Expenditure (Petrol)
52.
asked the Chancellor of the Exchequer the estimated increase in annual dollar expenditure as a result of the petrol relaxations recently announced.
Fifteen million dollars at present prices.
Why should there be any extra dollar expenditure in view of the fact that the Abadan oilfields could hopelessly undersell American production if they really tried?
The question I was asked was how many more dollars are going to be spent.
It is not necessary.
American Loan (Drawings)
53.
asked the Chancellor of the Exchequer whether funds made available under the U.S. Loan may be drawn by this country in gold as well as in dollars.
No, Sir.
United States Funds (Transfer To Uk)
54.
asked the Chancellor of the Exchequer if he is aware that, following the recent rise in prices in the U.S.A. and the revaluation of Canadian and Swedish currencies, there has been an influx of funds to this country from the U.S.A., in anticipation of a similar revaluation of sterling; and if he will inform the House as to the measures His Majesty's Government intends to take against this movement assuming considerable proportions.
The influx of funds to this country is due to an increase in the strength of sterling, as the result of the approval of the American Loan by Congress. I do not consider that any measures of the kind suggested in the second part of the Question are required.
Does the Chancellor of the Exchequer consider the movement of funds to constitute a genuine long-term investment, or is it merely a speculative one, which may rob his good-natured efforts to improve the value of sterling of much of their effect?
We are watching the position, and so far I am not dissatisfied with the course of events.
Palestine (Expenditure)
55.
asked the Chancellor of the Exchequer the total of his Department's expenditure in Palestine during the most recent period of six months for which figures are available.
£ 17¾ million for the six months to 31st March, 1946.
Income Tax (Pensions)
57.
asked the Chancellor of the Exchequer if he will state, for the year 1937– 38, how many of the persons whose incomes exceeded £ 200, out of the 290,000 not gainfully employed, returned their incomes under the Income Tax Acts for money received from pensions or superannuation allowances; and what proportion of the £200,000,000 this represents.
The figures I gave in my reply to my hon. Friend on 16th July related to the number of people with no earned income. Pensions are treated as earned income for Income Tax purposes.
Can the Chancellor state what action the Government are taking or intend to take to see that those people who are getting vast incomes without working and using rationed clothes and food should be put to useful work?
We have made one or two tax adjustments that may help.
British Credit Facilities, France
60.
asked the Chancellor of the Exchequer what credit facilities are at present in operation to enable prospective buyers in France of British manufactured products to purchase goods which will be ready for delivery within the next 12 months.
Normal commercial and banking facilities, including guarantees by the Export Credits Guarantee Department.
Is the right hon. Gentleman aware that, owing to the excellent British exhibits which have been shown in France, a large number of prospective French buyers have booked orders which cannot be fulfilled, because of the French shortage of sterling? Will he give the matter his further attention, with a view to enabling the French to overcome that shortage?
Yes, Sir, I am very anxious to encourage trade between this country and France, but it must not be all one-way trade.
Dutch Fruit (Imports)
61.
asked the Chancellor of the Exchequer why he still permits the use of our exchange for importing luxury peaches and melons from Holland by air; and if he will take steps to stop this.
It is the policy of His Majesty's Government to make it possible for all sections of the population to eat more fruit. The Dutch, moreover, are good customers, as well as good friends, of ours, and we should be glad by restoring mutually advantageous trade, to help them to recover from the effects of the occupation of their country by the Germans.
Would it not be much cheaper if people picked blackberries?
I would like to tell my hon. Friend that a Treasury official bought a very good Dutch peach for 4d.
May Day (National Holiday)
59.
asked the Chancellor of the Exchequer whether he will consider proclaiming 1st May each year a national holiday as a tribute to the efforts of the workers during the war period.
While they warmly sympathise with the motive behind my hon. Friend's suggestion, the Government do not think it desirable to add at present to the number of fixed holidays.
Will the Chancellor bear that suggestion in mind in the future?
Yes, Sir. Let us get output up and then we will think again.
I should like to ask whether it is suggested that conscientious objectors of the last war, now serving in His Majesty's Government, should make speeches on this occasion?
I do not understand the relevance of the question nor do I admire the tone behind it. It seems to me to be malicious and irrelevant, and I observe that it comes from a friend of an enemy of this country.
On a point of Order. Did I hear the right hon. Gentleman say that the supplementary question asked by the hon. Member for Mid-Bedford (Mr. Lennox-Boyd) was malicious as well as irrelevant and that it came from a friend of an enemy of this country? I ask you, Mr. Speaker, under the Rules of Procedure, to have those words taken down so that the House can take note of them.
It is, I believe, in the Standing Orders that words can be taken down, but I have never known that done. In fact, that Rule has fallen into disuse for some time.
Further to that point of Order. Do we now understand that no protection is to be offered to Members of this side or of the other side of the House when it is said that what they are doing is malicious or friendly to enemies of this country? I ask for your protection.
The hon. Gentleman did not ask me for my protection; he asked me to take the words down. I gave my answer to that. If the hon. Gentleman wants to know if the word "malicious" is out of Order, I do not think it is. I do not think there is anything in the word "malicious" which means an unworthy motive, but I must confess I was a little surprised when I heard the right hon. Gentleman use the phrase "a friend of an enemy of this country." [HON. MEMBERS:"Withdraw."] Hon. Members will please remember that if I want a thing withdrawn I will ask for it to be withdrawn. Hon. Members must not take my duties from me. I was going to suggest that I thought perhaps the right hon. Gentleman was over the borderline when he used the words "a friend of an enemy of this country." That is not what should be said by a Member of this House.
Those who give must expect to get, but if it is judged that my riposte to the hon. Gentleman, whose support of General Franco's Government is notorious, was slightly over the borderline, I withdraw it.
Further to that point of Order. As General Franco has never been declared a public enemy, think the original supplementary was not quite fair, but I am perfectly content to leave confidence in my loyalty in the hands of the House.
On a point of Order. When my hon. Friend the Member for Oxford (Mr. Hogg) was putting his point of Order to you, Sir, the Chancellor of the Exchequer was nodding agreement. As, therefore, he agrees with what my hon. Friend says, can those words be taken down?
It is no good trying to stir up the troubled waters any more. I think a satisfactory conclusion has been reached; let us leave it at that.
Statutory Orders (Authority To Sign)
62.
asked the Financial Secretary to the Treasury whether he is aware that 282 officials are entitled to sign S.R. & Os, on behalf of eight Ministers, namely, the President of the Board of Trade, the Ministers of Health, Fuel and Power, Transport, Agriculture, Supply, Labour and the Secretary of State for Scotland; and whether he will limit this authority to not more than three senior officers in any one Ministry.
Consideration is being given to the possibility of reducing the lists of officials empowered to authenticate Statutory Rules and Orders made by the Ministers referred to. It will, however, not be feasible to apply so severe a /imitation as the hon. Member suggests. The fact that a particular official signs an Order does not, of course, mean that he makes it. The Order is made by the responsible Minister, and the signature is merely to authenticate.
While appreciating that answer, may I ask the hon. Gentleman if he does not agree that the only remedy the public have against abuse of this power is by negative Prayer, and that as the Orders have the force of law the number of our non-Parliamentary rulers should be drastically reduced?
The officials empowered to authenticate these documents are frequently laid down in Statutory Rules and Orders, and although the number may seem large at the moment by no means all the officials sign the Orders.
Would not the hon. Gentleman agree that his reply is a veiled tribute to the "active back benchers"?
Could the hon. Gentleman give a guarantee that the Ministers concerned actually see the Orders which are signed by the officials?
Yes, Sir, and, of course, they are responsible for them.
But do they understand all of them?
Did anyone see the Oatmeal Order?
63.
asked the Financial Secretary to the Treasury the average length of service of the civil servants who are entitled to sign S.R. & Os, for the following Ministers, respectively: President of the Board of Trade, Minister of Health, Minister of Labour, Minister of Fuel and Power, Minister of Transport, Minister of Agriculture, Minister of Supply and the Secretary of State for Scotland.
As the answer is long, I will, with permission, circulate it in the OFFICIAL REPORT.
Following is the answer:
The following table gives the average length of service of the officials empowered to authenticate Statutory Rules and Orders made by the Ministers quoted:
| Years. | |
| President of the Board of Trade | 19 |
| Minister of Health | 27 |
| Minister of Labour | 30 |
| Minister of Fuel and Power | 25 |
| Minister of Transport | 26 |
| Minister of Agriculture and Fisheries | 25 |
| Minister of Supply | 29 |
| Secretary of State for Scotland | 26 |
Citizens' Guide (Regulations)
64.
asked the Financial Secretary to the Treasury if he will consider the compilation of a citizens' guide, annotated and indexed, including Statutory Rules and Orders, rationing and other necessary information, issued through His Majesty's Stationery Office at a nominal price.
No, Sir. I should have thought that there was enough official literature.
Is the hon. Gentleman aware that citizens are anxious to know and keep the law, and that there is no handy method whereby they can learn the law if he denies this request?
The Statutory Rules and Orders which are issued from time to time are catalogued and indexed. The hon. Member will find that that is so if he goes to the Library.
Members Of Parliament (Welsh Typist)
65.
asked the Financial Secretary to the Treasury whether he will make arrangements to enable Members to obtain the services of a typist who may be able to type letters, etc., in Welsh, as and when required.
Typists for the use of Members are not provided at the public expense or from Government resources. The obtaining of a Welsh speaking and writing typist is, therefore, a matter for the Members concerned.
Government Departments (Correspondence)
66.
asked the Financial Secretary to the Treasury whether he is aware that in many Government Departments it has become the normal practice not to reply to letters; and whether he will instruct Ministers to engage additional temporary clerical assistance, if necessary, in order that correspondents can be assured a prompt and courteous acknowledgment or interim reply.
No, Sir. I am sure, however, that the Minister concerned will be happy to make inquiry if the hon. Member would furnish him with particulars of cases where replies to correspondents' letters are delayed.
Surely, the hon. Gentleman knows that in the case of many Departments there is no attempt to answer letters from taxpayers for weeks?
I realise that there are delays, but the reason is well known to the House. There is a staff shortage, and Members write many letters. We are trying to answer them as soon as possible.
Does not the hon. Gentleman realise that this Question does not apply to correspondence from Members, but from the public? Surely, it would be better to send a printed interim reply, rather than let people suffer the disappointment and frustration which they are undergoing at the present time.
Would the hon. Gentleman see that letters from Ministers to the public at least carry a date, an address, and a signature, which is very often not the case?
Terrorist Outrage, Jerusalem
(by Private Notice) asked the Prime Minister whether he has any statement to make on the bomb outrage at the British Headquarters in Jerusalem.
Hon. Members will have learned with horror of the brutal and murderous crime committed yesterday in Jerusalem. Of all the outrages which have occurred in Palestine, and they have been many and horrible in the last few months, this is the worst. By this insane act of terrorism 93 innocent people have been killed or are missing in the ruins. The latest figures of casualties are 41 dead, 52 missing and 53 injured. I have no further information at present beyond what is contained in the following official report received from Jerusalem:
Every effort is being made to identify and arrest the perpetrators of this outrage. The work of rescue in the debris, which was immediately organised, still continues. The next-of-kin of casualties are being notified by telegram as soon as accurate information is available. The House will wish to express their profound sympathy with the relatives of the killed and with those injured in this dastardly outrage. The High Commissioner, Sir Alan Cunningham, has returned to Palestine by air. As the House knows, His Majesty's Government are at this moment in consultation with the Government of the United States with a view to arriving at proposals for a just settlement of the Palestine problem which will be placed before representatives of both Arabs and Jews. His Majesty's Government have stated, and state again, that they will not be diverted by acts of violence from their search for a just and final solution of this problem.'' It appears that, after exploding a small bomb in the street, presumably as a diversionary measure—this did virtually no damage—a lorry drove up to the tradesmen's entrance of the King David Hotel and the occupants, after holding up the staff at pistol point, entered the kitchen premises carrying a number of milk cans. At some stage of the proceedings, they shot and seriously wounded a British soldier who attempted to interfere with them. All available information so far is to the effect that they were Jews. Somewhere in the basement of the hotel they planted bombs which went off shortly afterwards. They appear to have made good their escape."
While associating myself and my hon. Friends on this side of the House with the Prime Minister's expressions of horror at this dastardly and inexcusable outrage, and also with the words of sympathy he has expressed towards the relatives of those who lost their lives, I would like to put one question to him. I quite understand that the right hon. Gentleman may not be able to give details, but we would like to be assured that the Government intend to take every step in their power here, and to provide the local authorities with any sanction they may need to take any steps in their power, to prevent, if possible, a recurrence of any such incident as this.
Certainly. The right hon. Gentleman will realise that I am awaiting a full report from the High Commissioner and the, military authorities as to the steps that are required by them.
While associating myself with everything that the Prime Minister said, will he consider whether there is anything which the Jews in Great Britain, who are shocked by this murderous and senseless outrage, which brings dishonour and shame to the name of Jew, can do to help to put an end to such outrages, and in particular, will he call upon the religious and lay leaders of the Jews in this country, including the leaders of the Zionist organisation, publicly and unreservedly to condemn these dastardly outrages, and to pledge their full and loyal support to the Government in any action they may take to suppress them?
Certainly, I will consider the suggestion of my hon Friend.
May I, first, associate myself with every word that my right hon. Friend the Prime Minister has said about the criminal insanity of this outrage? May I, next, ask him whether there is any credible evidence or any direct evidence so far that the perpetrators of it were Jews? Thirdly, may I ask him whether he appreciates that the continued detention in Palestine without trial of almost every moderate and responsible leader inevitably leaves the field free to the terrorists?
With regard to the first question, I have already stated that I have no information beyond what is given by the official report. It would be quite improper for me to try to make any conjecture beyond what I have got from the official report. As to the second part of the hon. Gentleman s question, it is quite incorrect to suggest that every responsible leader has been held in prison or anywhere else. I would say that the hon. Member does an injustice to the members of the Executive of the Jewish Agency by suggesting that arrests made of a certain number of persons included the whole of the responsible leadership of Jewry. It is quite untrue.
Will the Prime Minister take note that there are in this country hundreds of ex-officers and men trained with the resistance movements during the war, and, in order to further the admirable object which he has enunciated, will he consider using these people, who are well trained, to put down organisations of this kind, whether Arab or Jewish?
I shall have to depend, in regard to that, on the advice of our military advisers who will, I am sure, ask for any forces they require.
In view of the fact that the members of that most gallant force, the Palestine Police Force, are in some doubt about their terms of service, will the right hon. Gentleman make it clear that the relatives of those killed and also those seriously wounded will receive exactly the same pensions as they would receive if they were killed in action, in view of the fact that they are fighting against as vile and treacherous a foe as the Nazis?
I understand that is the position, but I would like to give a considered answer. Perhaps the noble Lord will put down a question to my right hon. Friend the Secretary of State for the Colonies.
In considering the suggestion made by the hon. and gallant Member for Central Glasgow (Colonel Hutchison), will the Prime Minister be careful not to set up anything like the "Black and Tans"?
While joining in the strong expression of sympathy for the dependants of those who suffered as a consequence of this terrible outrage, may I ask the Government seriously to consider, in dealing with this problem of Palestine, the necessity of bringing about an independent Palestinian State where Arabs and Jews will have to co-operate together?
As the hon. Member knows, we are now considering with representatives of the United States of America what should be the permanent solution, and we are making great progress in those talks.
Is the Prime Minister aware that a report has already been circulated in this country from General Barker showing that he has for some time desired to take over the whole of the King David Hotel, and has been unable to do so, and in view of that will the Prime Minister initiate early inquiries; and will he also publicly disclaim any association of the Government with the statement, which was reported in the "Jewish Standard" of 12th July to have been made by the hon. Member for East Coventry (Mr. Crossman), advising Jews to go underground and oppose the airborne division by all means other than violence?
With regard to the first point, I have not seen the statement by General Barker, but I am having an inquiry made into the position with regard to the King David Hotel. As for any statement of Government policy, that is made by responsible Ministers, and not by other individuals.
Whilst expressing my deepest sympathy with those who have suffered and my horror at and condemnation of the dastardly actions which have been taken by these desperadoes, may I ask the right hon. Gentleman if he is aware that these feelings are those of the Jewish communities of the world; that the Jewish Agency Executive and the National Council of Palestine Jewry have expressed similar sentiments and are desirous of suppressing those responsible as rapidly as possible?
I have noted that statement and welcomed it.
Business Of The House
May I ask the Leader of the House if he has any statement to make about Business this week?
I am much obliged to the right hon. Gentleman. The Canadian Government have asked, as a matter of urgency, for a Bill to amend the British North America Acts to be submitted to Parliament here. The object of the Bill is to provide for a readjustment of representation in the House of Commons of Canada. Under the Statute of Westminster, legislation amending the British North America Acts is reserved to the United Kingdom Parliament. The Bill passed through all its stages in another place yesterday, and I trust that the House will be agreeable to passing it through all its stages in this House on Friday, before we proceed to the Third Reading of the National Health Service Bill.
It may be convenient for me to inform the House of the days upon which we propose to take other items of Business during the week. Tonight, after the conclusion of the Report stage of fie National Health Service Bill, we shall ask the House to take the Second Reading of the Isle of Man (Customs) Bill. Tomorrow, after the Business of Supply, we propose to take the Committee and remaining stages of the Isle of Man (Customs) Bill; the Motion to approve the Biscuit (Charges) (Amendment) (No. 2) Order; and the final stage of the three Government of Burma Orders. On Thursday, after Business of Supply, we shall ask the House to consider Lords Amendments, which are expected to De received today, to the National Insurance (Industrial Injuries) Bill. We shall then proceed with the Report and Third Reading of the Diplomatic Privileges (Extension) Bill [Lords], which has already been announced.May I ask the Leader of the House whether, in view of present anxiety, he is yet able to state when the Debate on Palestine will take place?
Yes, Sir, it is intended that the Debate shall take place next week.
On which day?
I do not want to be committed because sometimes there are final readjustments, but probably on Wednesday end Thursday.
Can the right hon. Gentleman say when the House will adjourn for the Summer Recess?
If all goes well, and sweetness and light remain in the functioning of the usual channels, I hope to be able to say on Thursday.
Can the right hon. Gentleman give the House some idea of how long the additional Business on Friday is likely to take because we are taking on that day the Third Reading of the National Health Service Bill upon which a great many Members desire to speak?
I am not trying to commit the House to this precedent, but my right hon. Friend the Chief Whip did tell me that in 1943 the whole thing took seven minutes. I think the House will agree that the Parliament of Canada having so resolved, this House must meet their wishes
Business Of The House
Motion made, and Question put,
" That the Proceedings on Government Business be exempted, at this day's Sitting,
Division No. 266.]
| AYES.
| [3.46 p.m.
|
| Adams, W. T. (Hammersmith, South) | Ede, Rt. Hon. J. C. | McEntee, V. La T. |
| Alexander, Rt. Hon. A. V. | Edwards, Rt. Hon. Sir C. (Bedwellty) | McGhee, H. G. |
| Allen, Scholefield (Crewe) | Edwards, John (Blackburn) | Mack, J. D. |
| Alpass, J. H. | Edwards, W. J. (Whitechapel) | McKay, J. (Wallsend) |
| Anderson, A. (Motherwell) | Evans, John (Ogmore) | Mackay, R. W. G. (Hull, N.W.) |
| Anderson, F. (Whitehaven) | Evans, S. N. (Wednesbury) | Maclean, N, (Govan) |
| Attewell, H. C. | Ewart, R. | McLeavy, F. |
| Attlee, Rt. Hon. C. R. | Fairhurst F. | MacMillan, M. K. (Western Isles) |
| Austin, H. L. | Farthing, W. J. | Macpherson T. (Romford) |
| Awbery, S S | Fletcher, E. G. M. (Islington, E.) | Mainwaring W H. |
| Ayles, W. H. | Foot, M. M. | Mallalieu, J. P W. |
| Ayrton Gould, Mrs. B. | Forman, J. C. | Mann, Mrs. J. |
| Bacon, Miss A. | Foster, W. (Wigan) | Manning, C. (Camberwell, N.) |
| Baird, Capt. J. | Freeman, Maj. J. (Watford) | Manning, Mrs. L. (Epping) |
| Balfour, A. | Gallacher, W. | Mathers, G. |
| Barstow, P. G. | Ganley, Mrs. C S | Mayhew, C. P. |
| Barton, C. | Gibbins, J. | Medland, H. M. |
| Battley, J. R. | Gibson, C. W. | Millington, Wing-Comdr. E. R |
| Bechervaise, A. E. | Gilzean, A. | Mitchison, Maj. G. R. |
| Belcher, J. W. | Glanville, J. E. (Consett) | Monslow, W. |
| Bellenger, F. J. | Gooch, E. G. | Montague, F. |
| Benson, G. | Greenwood, Rt. Hon. A. (Wakefield) | Moody, A. S. |
| Berry, H. | Greenwood, A. W. J (Heywood) | Morgan, Dr. H. B. |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Grenfell, D. R. | Morley, R |
| Bing, G. H. C. | Grey, C. F. | Morris, P. (Swansea, W.) |
| Binns, J. | Grierson, E. | Morrison, Rt. Hon. H. (Lewisham E) |
| Blackburn, A. R | Griffiths, D. (Rother Valley) | Mort, D. L. |
| Blyton, W. R. | Griffiths, W. D. (Moss Side) | Moyle, A |
| Bottomley, A. G. | Gruffydd, Prof. W. J. | Murray, J. D |
| Bowles, F. G. (Nuneaton) | Guest, Dr. L. Haden | Nally, W. |
| Braddock, Mrs. E. M. (L'p'l, Exch'ge) | Gunter, Capt. R. J. | Naylor, T. E. |
| Braddock, T. (Mitcham) | Guy, W. H. | Nichol, Mrs. M. E. (Bradford, N.) |
| Brook, D. (Halifax) | Haire, Flt.-Lieut. J. (Wycombe) | Nicholls, H. R. (Stratford) |
| Brooks, T. J. (Rothwell) | Hale, Leslie | Noel-Baker, Capt. F. E (Brentford) |
| Brown, George (Belper) | Hall, Rt. Hon. G. H. (Aberdare) | Noel-Buxton, Lady |
| Brown, T. J. (Ince) | Hannan, W. (Maryhill) | Oldfield, W. H. |
| Brown, W. J. (Rugby) | Hardy, E. A. | Orbach, M. |
| Bruce, Maj. D. W. T. | Harris, H. Wilson | Paling, Rt. Hon. Wilfred (Wentworth) |
| Buchanan, G. | Harrison, J. | Paling, Will T. (Dewsbury) |
| Burden, T. W. | Hastings, Dr Somerville | Palmer, A. M. F. |
| Burke, W. A. | Haworth, J. | Parker, J. |
| Butler, H. W. (Hackney, S) | Henderson, A. (Kingswinford) | Parkin, B. T. |
| Byers, Frank F. | Henderson, Joseph (Ardwick) | Paton, Mrs. F. (Rushcliffe) |
| Gallaghan, James | Herbison, Miss M. | Paton, J. (Norwich) |
| Champion. A. J. | Hobson, C. R. | Pearson, A. |
| Chater, D. | Holmes, H. E. (Hemsworth) | Peart, Capt. T. F. |
| Chetwynd, Capt. G. R. | Horabin, T. L | Perrins, W. |
| Cluse, W. S. | House, G. | Piratin, P. |
| Cobb, F. A. | Hoy, J | Poole, Major Cecil (Lichfield) |
| Cocks, F. S. | Hudson, J. H. (Ealing, W.) | Porter, E. (Warrington) |
| Collick, P. | Hughes, Hector (Aberdeen, N.) | Porter, G. (Leeds) |
| Collindridge, F. | Hughes, H. D. (W'lverh'pton, W.) | Pritt, D. N. |
| Collins, V. J. | Hynd, H. (Hackney, C.) | Pryde, D. J. |
| Colman, Miss G. M | Hynd, J. B. (Attercliffe) | Pursey, Cmdr, H. |
| Comyns, Dr L. | Irving, W. J. | Randall, H. E. |
| Cook, T. F. | Janner, B. | Ranger, J. |
| Corlett, Dr. J | Jeger, G. (Winchester) | Rankin, J |
| Cove, W. G. | Jeger, Dr. S. W. (St. Pancras, S.E.) | Rees-Williams, D R |
| Crossman, R. H. S | John, W. | Reeves, J. |
| Daggar, G. | Jones, D. T. (Hartlepools) | Raid, T. (Swindon) |
| Daines, P. | Jones, P. Asterley (Hitchin) | Rhodes, H. |
| Davies, Ernest (Enfield) | Keenan, W. | Richards, R. |
| Davies, Harold (Leek) | Key, C. W. | Ridealgh, Mrs. M. |
| Davies, Haydn (St. Pancras, S.W) | Kinghorn, Sqn.-Ldr E | Roberts, Goronwy (Caernarvonshire) |
| Davies, R. J. (Westhoughton) | Kinley, J. | Roberts, W. (Cumberland, N.) |
| Davies, S. O. (Merthyr) | Kirby, B. V. | Robertson, J. J. (Berwick) |
| de Freitas, Geoffrey | Kirkwood, D | Rogers, G. H. R. |
| Delargy, Captain H. J. | Lang, G. | Scott-Elliot, W. |
| Diamond, J. | Lee, F. (Hulme) | Shacklelon, Wing-Cdr. E. A. A |
| Dobbie, W. | Levy, B. W. | Sharp, Lt.-Col G. M. |
| Dodds, N. N. | Lewis, A. W. J. (Upton) | Shurmer, P. |
| Driberg, T. E. N. | Lewis, J. (Bolton) | Silverman, S, S. (Nelson) |
| Dugdale, J. (W. Bromwich) | Lewis, T. (Southampton) | Skeffington, A. M. |
| Dumpleton, C. W. | Lipson, D. L. | Skeffington-Lodge, T. C. |
| Durbin, E. F M. | Logan, D. G. | Skinnard, F, W. |
| Dye, S. | McAdam, W. | Smith, C. (Colchester) |
from the provisions of the Standing Order (Sittings of the House)."—[ The Prime Minister.]
The House divided: Ayes, 283; Noes, 136.
| Smith, Ellis (Stoke) | Thorneycroft, Harry (Clayton) | Whiteley, Rt. Hon. W. |
| Smith, S. H. (Hull, S.W.) | Thurtle, E. | Wilkes, L. |
| Snow, Capt. J. W. | Timmons, J. | Wilkins, W. A. |
| Solley, L. J. | Titterington, M. F. | Willey, F. T. (Sunderland) |
| Sorensen, R. W. | Tolley, L. | Willey, O. G. (Cleveland) |
| Soskice, Maj. Sir F. | Tomlinson, Rt. Hon. G. | Williams, D. J. (Neath) |
| Sparks, J. A. | Vernon, Maj. W. F. | Williams, J. L. (Kelvingrove) |
| Stamford, W | Viant, S. P. | Williamson, T. |
| Stewart, Capt. Michael (Fulham, E.) | Wadsworth, G. | Willis, E. |
| Stokes, R. R. | Walkden, E. | Wills, Mrs. E. A. |
| Stress, Dr. B. | Walker, G. H. | Wilson, J. H. |
| Stubbs, A. E. | Wallace, G. D. (Chislehurst) | Woodburn, A. |
| Swingler, S. | Wallace, H. W. (Walthamstow, E.) | Woods, G. S. |
| Taylor, H. B. (Mansfield) | Warbey, W. N. | Wyatt, Maj. W. |
| Taylor, R. J. (Morpeth) | Watkins, T. E. | Yates, V. F. |
| Taylor, Dr. S. (Barnet) | Watson, W. M. | Zilliacus, K. |
| Thomas, Ivor (Keighley) | Wells, P. L. (Faversham) | |
| Thomas, John R. (Dover) | Wells, W. T. (Walsall) | TELLERS FOR THE AYES
|
| Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) | Westwood, Rt. Hon. J. | Mr. Simmons and |
| Mr. Popplewell |
NOES.
| ||
| Amory, D. Heathcoat | Hope, Lord J. | Prior-Palmer, Brig. O. |
| Astor, Hon. M. | Howard, Hon. A. | Raikes, H. V. |
| Baldwin, A. E. | Hudson, Rt. Hon. R. S. (Southport) | Ramsay, Maj. S. |
| Baxter, A. B. | Hurd, A. | Reed, Sir S. (Aylesbury) |
| Beamish, Maj. T. V. H. | Hutchison, Lt.-Cm. Clark (E'b'rgh W.) | Reid, Rt. Hon. J. S. C. (Hillhead) |
| Birch, Nigel | Hutchison, Col. J. R. (Glasgow, G.) | Renton, D. |
| Boles, Lt.-Col. D. C. (Wells) | Jarvis, Sir J. | Roberts, Maj. P. G. (Ecclesall) |
| Boothby, R. | Jeffreys, General Sir G. | Robertson, Sir D. (Streatham) |
| Bower, N. | Jennings, R. | Robinson, Wing-Comdr. Roland |
| Boyd-Carpenter, J. A. | Joynson Hicks, Lt-Cdr. Hon. L. W. | Sanderson, Sir F |
| Braithwaite, Lt. Comdr. J. G. | Keeling, E. H. | Savory, Prof. D. L. |
| Buchan-Hepburn, P. G. T. | Kerr, Sir J. Graham | Scott, Lord W. |
| Bullock, Capt. M. | Lambert, Hon. G. | Shepherd, W. S, (Bucklow) |
| Challen, C. | Lancaster, Col. C. G. | Smiles, Lt.-Col. Sir W. |
| Channon, H. | Langford-Holt, J. | Smith, E. P. (Ashford) |
| Clifton-Brown, Lt.-Col. G. | Legge-Bourke, Maj. E. A. H. | Smithers, Sir W |
| Corbett, Lieut,-Col. U. (Ludlow) | Lennox-Boyd, A. T. | Snadden, W. M. |
| Crookshank, Capt. Rt. Hon. H F. C. | Lindsay, M. (Solihull) | Spearman, A. C M |
| Crosthwaite-Eyre, Col. 0. E. | Linstead, H. N. | Spence, H. R. |
| Crowder, Capt. John E. | Lloyd, Maj. Guy (Renfrew, E.) | Stanley, Rt. Hon. O. |
| Cuthbert, W. N. | Lloyd, Selwyn (Wirral) | Stewart, J. Henderson (Fife, E.) |
| Darling, Sir W. Y. | Low, Brig. A. R. W. | Stuart, Rt. Hon. J. (Moray) |
| Davidson, Viscountess | Lucas-Tooth, Sir H. | Studholme, H. G. |
| De la Bère, R. | MacAndrew, Col. Sir C. | Sutcliffe, H. |
| Dodds-Parker, A. D. | MacDonald Sir M. (Inverness) | Taylor, Vice-Adm. E. A. (P'ddt'n, S.) |
| Dower, Lt.-Col. A. V. G. (Pennth) | MacDonald, Cant. Sir P. (1. of Wight) | Teeling, William |
| Drayson, Capt. G. B. | Mackeson, Brig. H. R. | Thorneycroft, G. E. P. (Monmouth) |
| Duthie, W. S. | McKie, J. H. (Galloway) | Thornton-Kemsley, C. N. |
| Eccles, D. M. | MacLeod, Capt. J. | Thorp, Lt.-Col. R. A. F. |
| Eden, Rt. Hon. A. | Macpherson, Maj. N. (Dumfries) | Touche, G. C. |
| Fleming, Sqn.-Ldr. E. L | Maitland. Comdr J. W | Turton, R. H. |
| Fletcher W. (Bury) | Manmngham-Suiler, R. E. | Vane, W. M. F. |
| Fox, Sqn.-Ldr. Sir G. | Marples, A. E. | Walker-Smith, D. |
| Fraser, Maj. H. C. P, (Stone) | Marsden, Capt. A. | Ward, Hon. G R. |
| Fraser, Sir I. (Lonsdale) | Marshall, O. (Bodmin) | Watt, Sir G. S. Harvie |
| Gage, C. | Marshall, S. H. (Sutton) | Wheatley, Colonel M. J. |
| Galbraith, Cmdr. T. D. | Medlicott, F. | Williams, C. (Torquay) |
| Gammans, L. D. | Merer, Sir J | Williams, Gerald (Tonbridge) |
| Glossop, C. W. H. | Moore, Lt.-Col. Sir T. | Willoughby de Eresby, Lord |
| Glyn, Sir R. | Morris-Jones, Sir H. | Winterton, Rt. Hon. Earl |
| Gomme-Duncan, Col. A. G. | Orr-Ewing, I. L. | York, C. |
| Grimston, R. V. | Osborne, C. | Young, Sir A. S. L. (Patrick) |
| Hare, Hn. J. H (Woodb'ge) | Peake, Rt. Hon. O. | |
| Haughton, S. G. | Pickthorn, K. | TELLERS FOR THE NOES
|
| Head, Brig. A. H. | Ponsonby, Col C. E. | Commander Agnew and |
| Headlam, Lieut.-Col. Rt. Hon. Sir C | Prescott, Stanley | Major Conant |
| Hinchingbrooke, Viscount | Price-White, Lt.-Col. D. | |
Orders Of The Day
National Health Service Bill
As amended (in the Standing Committee and on recommittal), further considered.
Clause 33—(Arrangements For General Medical Services)
3.50 p.m.
I beg to move, in page 24, line 29, after "practitioners," to insert "or others."
There are two issues lying behind this Amendment. The first is that nature-cure practitioners who reach a required standard of training and qualification should be recognised under the Bill. Such practitioners comprise naturopaths, osteopaths, and others. The second is that patients should have the free and unfettered right to attend the practitioner of their own choice. The first request does not rest solely on the merits of nature-cure practitioners, but, conversely, on the point that medical practice, in so far as it is based upon the application of medicine, drugs and vaccines, is undesirable. The question of quackery usually arises on the nature-cure practitioner issue, but I suggest that no class is less deserving of the taunt of quackery than are nature cure practitioners. In fact, the charge of quackery might lie with more accuracy upon medical practice to the extent that it relies upon chemistry, medicines, drugs and vaccine. During the Debate on the Second Reading, the hon. Member for Ripon (Mr. York) referred to rheumatism, and expressed anxiety as to whether the Bill would be able to deal effectively with that serious disease. He mentioned, in relation to its seriousness, that about one-seventh of the industrial incapacity of this country arises from rheumatism. I have been prone to rheumatism, and have had considerable experience of medical practice. I have also had experience of nature cure practice, From my own experience—and I am definitely not exaggerating-1 say I have had more benefit from three days' nature cure for rheumatism, than from 13 years' treatment by medical practice. I say that without exaggeration. I speak as I find. If a practitioner of any school sticks a pin into my body, I am the person who can say whether it hurts. I am the judge also of the effects of medical treatment on the one hand and of nature cure treatment of rheumatism on the other. Recently I was in close contact with a famous hospital in this country which specialises in the treatment of rheumatism. I do not think that they claim to compete with the efficacy of nature cure practice in the treatment of rheumatism. I saw one young fellow there. He is about 30 years of age. He had been in and out of that hospital under treatment for rheumatism for some 15 years. I am satisfied that he can derive no substantial benefit from the treatment he was receiving, and that if he attends until he is as old as Methuselah he will not recover from the disease of rheumatism. Nature cure practice is the effective answer to rheumatism. Take the question of cancer. On a previous occasion and in connexion with another Bill, I referred to the case of a lady medical practitioner in the North of England. This lady doctor contracted cancer of the breast. She had been in medical practice for many years. She was in a position to get the very best medical advice this land can provide and she obtained it. She went to eight of the leading cancer specialists of Great Britain. The sum total of their advice was that she should undergo a major operation and also radium treatment and deep X-ray therapy. She decided to accept none of that advice. Instead, she went to a qualified nature cure practitioner. One year fallowing that advice by the medical specialist, she was examined by the head of the cancer research department of Scotland and he certified that there was absolutely no trace of malignancy, or, in other words, that she was completely cured. I hope the Minister will appreciate what that means——4.0 p.m.
Can the hon. Gentleman tell us what the principle of nature cure is? How are these persons qualified?
I hope that I shall be permitted to develop my speech. I appreciate the importance of the aspect of qualification, and I hope to deal with it. I said that I am a layman. I have no knowledge of the science of nature cure, but I speak as a layman who has experienced treatment from it. I have experienced both medical treatment and nature cure treatment over many years. As I said, the person who has a pin stuck in him is the person who can decide whether it hurts.
One of the principles underlying this Amendment is full freedom of choice for the patient to attend whichever practitioner he desires. Take the case of that lady practitioner to whom I have referred. As against that of a working-class person she was comparatively well-to-do and could afford to go to the practitioner of her choice. It may have cost her 20 to 50 guineas, but whatever it was, it was worth while to her, because it probably meant the difference between life end death. Suppose it had been a poor person. It might have been one of the colliery friends of the Minister, destitute because of disease suffered over a period of years. Facing this issue of life and death, he would have to find 20, 30 or 40 guineas. Would he have freedom of choice? Obviously he would not have. Speaking from memory, I think I have seen a statement in writing by my right hon. Friend, to the effect that this Bill will not interfere with the freedom of nature cure practice. My right hon. Friend contends, quite honestly I know, that he has the patients, and particularly the poor patients, in mind, but when he stated that there would be freedom in the practice of nature cure, he must have had in mind either the practitioners themselves, who are comparatively well-to-do, or such patients who have sufficient wealth to pay for the services of a nature cure practitioner. This question of freedom of choice is vitally serious for the working class type of individual. The Bill calls upon that person to pay into the National Health scheme 4s. 11d. per week. That is a comparatively heavy contribution for a working class man, and notwithstanding that payment, if the individual is up against the issue of life or death, he may have to go without nature cure treatment if he has not the wherewithal to pay for it. Unfettered freedom of choice for the poor person can only mean that the services of a nature cure practitioner must be paid for from the National Health Service Fund. I now want to deal with the matter of tuberculosis. Immediately before the war I associated with a worker in a heavy manual trade—constructional engineering —in Glasgow. He had a very fine physique. I lost touch with him during the war until I heard from him about nine months ago. I was astonished to learn that he had been a victim of tuberculosis for some four or five years. A couple of months ago I met him in Glasgow, and I was astonished to find him a wreck, compared with what he was before the war. He told me that he had gone through the whole gamut of medical practice in regard to tuberculosis. He had gone to his panel doctor, to a specialist, then to hospital and sanatorium, back to work, had a relapse, and had then gone to the tuberculosis clinic, and he was still going downhill. I know a great deal as a layman about this issue of medical practice and nature cure practice. I felt quite confident that the man had no hope under medical practice, but my conclusion was that he had plenty of scope and hope under nature cure practice. I arranged for him to be treated by a qualified naturopath. That was in April last. After about three weeks, he wrote me in the most glowing terms about the progress he was making, and on 10th June he told me that he was getting along very well indeed. I read the letter this morning and noted particularly one of his statements. He said:I have here a letter dated 19th June from the qualified naturopath about this man who has been treated by the naturopath since April and who, as I say, had previously had five years of medical practice treatment. It says:" My cough has stopped although during my nature cure treatment I have stopped taking the cough cure and emulsion."
The Minister and medical practitioners might reply that that case is an exception, but I can assure the House that I am not exaggerating when I say that a hundred thousand cures by naturopaths in cases which were given up by medical practitioners can be quoted. I agree that there are cases of failures by naturopaths which have been cured by doctors, but the number of cures by naturopaths in cases given up by the medical practitioners would exceed comparable cures by medical practitioners I am sure by one hundred to one. It is amazing what support this principle of freedom of choice has throughout Great Britain. It is a very serious matter. The case I have mentioned was that of a poor working-class man who had been living for the last year or so on a destitution basis. He was faced with the issue of life or death. He is paying 4s. 11d. into the National Health Insurance Fund, and the Minister, as the Bill stands, will deny that man the nature cure treatment which would bring him health and vitality. I submit that the whole principle needs very serious consideration." The only symptom at present is a slight cough. Respiration, sleep, energy and appetite are all good. However, I think that the disease condition, although greatly slowed up, is still slightly active. I intend to continue the treatment for another month at least."
May I interrupt the hon. Member for a moment? Would he tell the House whether these nature cure practitioners would be prepared to offer service to the community on the same capitation basis as that which the medical profession will be offered under the State medical service? I understand that their terms are rather expensive.
I am obliged for the question. The answer is in the affirmative. These people will be only too pleased to help. When my hon. Friend says that he understands their services are expensive, I would point out that they are only expensive in this way: when they can offer life as against death, cheque books are open, but fees in general are quite reasonable. If to-morrow I have influenza, I can cure myself without spending a penny. When I say "cure myself" it reminds me of my right hon. Friend. The reason I went in for nature cure was because I used to lose a great deal of time from my work, which I loved, owing to influenza and minor ailments. If there was an epidemic of influenza, probably the doctor himself would not come along because he himself had influenza, I would ask what sort of a person was he, to treat me? The right hon. Gentleman also loves his work, but he lost a week or more in Committee on this Bill. I know how he loves his job because he was a trade union official. He loves it even more as Minister, particularly at this time of his life, yet in that Committee he lost a week or more. Furthermore, he lost a week at the National Conference of the Labour Party.
Does my hon. Friend suggest that a naturopath is never ill at all?
I am saying this, based on 20 years' experience as a layman, that I have been in the same position time and time again, but I have not lost time from work. I have left home many a time with influenza symptoms but by the time I have got home at night I have forgotten all about them. That is the test to the layman. Under medical treatment, if I left my home with influenza, I knew from experience that I had better get home as quickly as possible, and get into bed. My right hon. Friend has the wrong notion about nature cure. He thinks it is a question of orange juice and the necessity for cleaning out the bowels.
What is it then?
4.15 p.m.
I am not an expert on that, but had my right hon. Friend understood nature cure, he would not have lost that time. I have seen him since with his little tins and pills and pellets. [Laughter.] It is very serious, Mr. Speaker, though I know it causes laughter. It is very serious because his lack of knowledge of the nature cure means the death of many in this country, and needless suffering for millions. I think that my right hon. Friend ought to get some understanding of this question, because a terrible price is being paid in this country for lack of knowledge.
As to qualifications, there is difficulty among the nature cure practitioners with regard to this matter. There are certain schools which are organised and they recognise a high standard of qualification. They lay down for their members a minimum four years' training, and unless the standard of qualification laid down is reached, no student is admitted into the organisation. Generally, all over he country there is an endeavour on the part of these nature cure practitioners to get their standard of qualification on an acceptable basis. I agree readily that we cannot expect the Minister to dip into the national funds for practitioners whose qualifications cannot be proved. Tae practitioners know quite well that they must reach a reasonable standard of qualification, and they are giving that every consideration. I think that my right hon. Friend should be prepared to give them some help. He cannot afford to stand aside and say, "These people are not qualified and unless and until they can show a standard of qualification, I shall leave them alone," because, while he is adopting that attitude, there are many who are suffering illness needlessly. Two last points. First, I saw a letter from an hon. Member opposite to one of his clients, wherein he stated that these nature cure practitioners should be recognised only provided they took a medical degree.May I interrupt the hon. Gentleman? He said he had seen a letter from an hon. Member on this side of the House to one of his clients. Is he accusing an hon. Member on this side of being a nature cure practitioner?
I only referred to the letter to make a point, I will make my point clear in a moment. I hope the Minister will not adopt the attitude that these naturopaths can only be recognised provided they first take a medical degree because, in my opinion, that would be a cowardly running away from responsibility. The hon. Member who said that, meant this To start with, he did not know whether nature cure was good or bad. He did not go into that at all. What he said in effect to his constituent was, "Give me, a representative of the public, the refuge of a medical degree and, after achieving that degree, the nature cure practitioner can do what he likes." I say that is a cowardly and an evasive way of dealing with the issue. Is it right that nature cure practitioners, who are most definitely opposed to medicine and chemicals, drugs, pills and so forth, should be asked to take a medical degree? Certainly it is not fair and ought not to be expected of them. They are prepared to take a degree on their basis, the basis of nature cure practice. I submit that this is a very serious issue. I submit also that my right hon. Friend cannot discharge his responsibility and stand still, at least he ought to arrange for an inquiry into this subject.
When I ask for an inquiry, I do not mean a committee made up of medical practitioners, because that would be like asking a board of devoted fishermen to decide on the ethics of fishing; their decision would be hard lines on the poor fish. An inquiry can only be fair, provided it is carried through by a lay body. I think the Minister ought at least to agree to that Incidentally, there was an inquiry into osteopathy by this House some 11 years ago, but the inquiry board was composed to a large extent of medical representatives, so the board was unfair to start with. Furthermore, the osteopaths were not ready. They conducted their case, as far as many of their witnesses were concerned, foolishly, and it would not be right for the Minister to condemn an inquiry today because of something that happened in 1935.The hon. Member seems to be unaware that there was a second osteopath inquiry in the House of Lords by a Select Committee. They had a very large number of sessions. The fact was that in the middle of that inquiry the osteopaths threw in their hand and said they were not going any further.
I think the hon. Member for London University (Sir E. Graham-Little) is referring to the inquiry I have in mind, that in 1935. Even if it were more recent that that, I would remind the Minister that only yesterday he was defending his Parliamentary Secretary on a statement the Parliamentary Secretary made a year ago. If the Parliamentary Secretary can make one statement a year ago and be defended by the Minister for making an opposite statement today, I think an inquiry on this subject should also be allowed. The position is so serious, that I hope the Minister will, at least, see that the door is kept open. At present it is slammed against the nature cure practitioner, and against free and unfettered freedom of choice. That is a very undesirable position and should have the careful consideration of the Minister.
I beg to second the Amendment.
I think I have very sound reasons to advance in its favour. The question of whether patients, after the Bill has become law, shall be subject only to medical treatment, or not, is a matter of serious concern to hundreds of thousands of people. There are fields of specialised treatment worthy of consideration, such as the field of physiotherapy and massage——Does the hon. Member suggest that physiotherapy is excluded from the Health Service?
I am going to suggest that there is no recognition of any school of physiotherapists acceptable to the Minister ——
The hon. Member is wholly misinformed. The registered Society of Physiotherapists and Gymnastics is part of the auxiliary services normally attached to any hospital.
It is very comforting to know that, apart from ordinary treatment, there is this treatment, which can be of great assistance to men and women, now brought into the, ambit of the Health Service. I welcome the Minister's intention to bring within the hospital services medical auxiliaries and physiotherapists. But he should give some serious regard to the extension of training of physiotherapists for the benefit of the whole community. There is a serious shortage of them. Workers, particularly in Cleveland, contribute to special funds to provide for such treatment. These people will be denied, after paying their contributions in those areas, the type of treatment they need.
indicated dissent.
They will be denied the physiotherapists in the areas, and will not get the benefit of physiotherapists in the health service. I am informed that they have to go on paying outside the Bill and outside their normal contributions, unless the Minister can extend the service. He should do something very quickly to extend the training, so as to allow the vast number of people coming out of the Forces, the Royal Army Medical Corps and so on, who have had some kind of experience and training, to fit into a scheme of this kind. I am very glad to know that the Minister will agree to that.
There is, however, a field of healing outside the purely medical auxiliaries. It is that described by the mover of the Amendment, naturopathy, osteopathy, and the various kindred therapies associated with nature cure which do not come within the ambit of the Health Service. The patient is denied the opportunity of choosing the type of health treatment he or she desires. It is not a free Health Service to people who have to contribute through the National Exchequer, if in times of sickness they are denied benefit if they refuse to subscribe to orthodox medical treatment to which they have a conscientious objection. We have to have some regard to conscientious objection in this matter. On the question of qualification, I do not think the medical profession would claim that they have the monopoly of medical brains and scientific practice. The Minister does not claim that, for in 1941 he said:" Entirely opposed to our experience." He says that there are varying grades in the British Medical Board but the health services will vary and will be monopolised by the orthodox medical practitioners. People who object to submitting themselves to treatment will be denied their right of benefit under the Bill, and denied the right of benefit given them by the National Health Insurance Act, 1936. In that Act provision is made whereby people of the type I have tried to describe are provided for as follows:" I am bound to say that it does not seem to me that quacks cease to be quacks by reason of their being given a charter. The suggestion that because doctors have to pass examinations, quackery is eliminated from the medical profession, is a suggestion that is entirely opposed to our experience."
In short, it means that insurance committees up and clown the country, if perfectly satisfied that people outside the realm of orthodox medicine treat individuals, their benefit is shared and such payments as it would cost the service shall be refunded to the practitioner or the healer who treats the patient. In the new Bill he is denied that right. Knowing the Minister's broad outlook on such questions, I hope he will look very closely at this matter and give the right of freedom of choice if possible in tae new Health Bill to enable people to have the type of treatment they desire. I am not going to argue that all people outside the medical profession are fully qualified people or, for one moment, that there are no quacks. But I do say there are a number of highly trained men and women, educated people, practising the art of healing who are having magnificent results and poor people are being denied the right to the type of treatment they can give, and the benefit which accrue from such treatment, because of the restrictions placed upon them by the law. 4.30 p.m. The Minister himself said, again in 1941:" Regulations made for the purpose of medical benefit shall authorise the Insurance Committee by which medical benefit is administered to require any person whose income exceeds a limit to be fixed by the Committee, and to allow any persons, in lieu of receiving medical benefit under such arrangements as are hereinbefore mentioned to make their own arrangements for receiving medical treatment and attendance and in such cases the Committee shall, subject to the Regulations, out of the funds out of which the cost of medical benefit is payable, contribute towards the cost of medical treatment and attendance for those persons sums not exceeding in the aggregate the amounts which the Committee would otherwise have expended in providing medical benefit for them."
It is perfectly true that under the new Bill the legal status or the non-legal status of people outside the profession will be maintained, but the status of people within the medical profession will be that laid down by the B.M.A. in the exercise of their monopolistic attitude in this matter. Their position will be considerably stronger. The choice that exists will mean the choice of a doctor, or of being given a doctor if one makes no choice. It means undergoing medical treatment, and it is for such treatment that cash benefits will be paid from the fund. I wish to make this simple appeal: I wish to ask the Minister to consider this matter at a very high level. The qualifications of the people for whom we are pleading are worthy of examination and consideration. I know full well that we cannot argue today that they should be included in the Bill. The fact is that they must be recognised by charter, before they can be included. I know that to argue the case today would be to argue against a closed door. But if the Minister will stick to the argument he put in 1941, if he has the same outlook and the same point of view, I am convinced that he will shed himself of all prejudice, and have an inquiry made into the qualifications, claims and demands of this vast school of healing, which is supported by hundreds of thousands of people in this country. The Minister, to quote again from his words in 1941, referring to the healers who practise their art unrestricted until they meet the opposition of the medical school, probably in the law courts, when on hopeless cases they go down, then dealt specifically with herbalists, who will be penalised by the Bill. He said:" No reputable doctor will claim any high percentage of science for medicine; medicine is about 25 per cent. science and 75 per cent. art; and as long as there is a body of protected citizens who cannot claim any high degree of scientific accuracy for their practice, it is very dangerous to prevent anybody else from practising the same arts."
It is argued that this type of what might be called empirical or experimental healing is costly. It might be in some cases. Medical treatment can be costly. There are the same difficulties in orthodox treatment. There are the high charge and the low charge. There is also, free of charge, a service by osteopaths. I have here a little book about Salvation Army work ha Glasgow entitled "Underworld of a Great City" in which it is stated of their clinic:"…as long as a body of people is working on a vast deal of empirical research conducted by citizens who have no legal licence, and do not need one, it would be a very bad thing for the medical profession to prevent them going on with the investigations and explorations because a very great deal of what is today described as quackery becomes the accepted practice in medicine tomorrow, as is known by anyone who is familiar with the history of medicine."—[OFFICIAL REPORT, 8th July, 1941; Vol. 373, c. 92–94.]
Because this service is not given in the general medical service in this country, people who want the service, men, women and children, have to submit to free treatment, to treatment given free by public spirited people, and the benefits will warrant the continuance of this free clinic, which is now in its tenth year. I put to the medical profession this point: that the people to whom I am referring are the people who get the rejects of the medical profession after all other types of treatment and all other schools of medicine have been tried. The cures are in proportion to the type of patient they have to treat. I am not suggesting that they arc phenomenal or wonderful, but having regard to the type of case that comes to them as a last resort, the number of cures is a substantial contribution to the furtherance of this great work. I, therefore, suggest that the Minister might keep in mind, the statements he made in 1941, when he was pleading the case I am pleading today from the same benches as those from which I am now speaking. I hope that he will consider favourably the argument I have advanced."To this hall comes a visiting osteopath, who carries on what has been described as the only osteopath clinic in Scotland …he has dealt with some 500 cases in the course of a year, and a number of wonderful cures have been reported."
I do not rise with any intention of discourtesy to other Members who have also risen, but in order to continue the practice which I have followed throughout the Report stage, namely, of replying immediately when an Amendment is before the House, in order to put Members in possession of the Government's point of view on the matter. I have been rather hardly treated by both my hon. Friends who have moved and seconded this Amendment. The mover of the Amendment threw all reticence to the winds and discussed my private affairs with a candour which I found rather embarrassing. Perhaps he could discover, in nature cure, some specific for public reticence. The seconder of the Amendment has quoted against me, queerly enough, a number of observations made in 1941, which I should have thought still stood. In 1941, I was defending the right of persons to conduct experimental investigation into all forms of therapy, without any interference from anybody. I still take up that position; I still think that the heterodoxy of yesterday becomes the orthodoxy of today, and that the medical profession today normally practises many forms of therapy which it yesterday rejected. There is nothing wrong with that. It is not being interfered with and we are not discussing it at the moment. We are discussing an entirely different matter. I can assure hon. Members in all parts of the House that I do not intend to commit the indiscretion of forming a judgment as to the relative merits of one form of therapy as against another. It is not my function, nor is it the function of the House at the present time. We are discussing an Amendment which would place on the executive council of each area, the obligation of providing whatever kind of medical attention any citizen might want. That is an impossible suggestion.
My right hon. Friend knows perfectly well that that is not behind the Amendment. I agree that the words of the Amendment are wide, but I explained in my speech the narrow limit of them. Obviously, my right hon. Friend should take the narrow limit, and it is for him to provide the proper wording.
The House is legislating. An Amendment is before the House and if the language of that Amendment were included in the Bill, the consequences would be that anybody, any Tom, Dick or Harry, would be able to prey upon the credulity of any citizen, and could call upon the State to provide the money for that service.
On a point of Order. I do not object to the Minister using that argument, but the intention behind the Amendment is that there should be trained people chosen by the Minister.
If the hon. Member will permit me, I will come to that statement in a moment or two. At the moment, I am dealing with what is actually before the House. I am pointing out what would be the result if this language were adopted. The position would be chaotic. Now, I come to the point of substance raised by hon. Members. It is that one should select, from a number of forms of therapy lying outside the medical Acts, some forms of treatment which we would be prepared to give. I challenge any hon. Member to say at once where the frontier should be fixed. It is necessary if we are to provide a free health service that we should be able to identify objectively the kind of service we will give. We must stop somewhere. I have met representatives of these various bodies. Many of them are persons of dedicated zeal who I am quite certain have done a great deal of good to very many people with whom they have come into contact, although the evil they have done is not on record. That is the whole difficulty. Unfortunately, the evil done by doctors is not on record either——
Under this Bill, which involves compulsory contributions, will patients be compelled to obtain only tae attention of the qualified medical practitioner?
Perhaps the hon. and gallant Member will permit me to finish my argument. I will deal with the point in the course of my remarks, but at fie moment I am dealing with an entirely different matter. It is necessary that tie House, if they are going to place upon the Minister the responsibility of providing a service, should accept the obligation of defining that service. So far Parliament have decided that the kind of service which the executive councils will organise shall be the medical services within the medical Acts. Once a doctor has a qualification which entitles him to to go on the medical register, no one interferes with the kind of treatment which he gives. In point of fact, some of the best and most experienced general practitioners conceive it to be their duty merely to remove obstructions for nature to do its own remedial work. They would be described by many people as nature-paths, but they are people who have passed the examinations and acquired the right to give whatever form of treatment they conceive to be necessary. If these persons, belonging to these various creeds or bodies, believe that they have got something which is beneficial to man kind, all they need do is to acquire the necessary qualifications. No one insists upon what they should do after they have acquired the qualifications. But I am bound to say, it seems to me to be an appalling situation that the State should be called upon to provide any form of treatment, which the hon. Member himself is unable to define because one of the characteristics of what we are being asked to define is that almost all the evidence is subjective, and based upon testimony. If it was capable of systematisation, codification or verification it would become an accepted form of medical therapy. That is the whole difficulty.
rose——
No, I cannot give way. I have almost finished. I did not interrupt the hon. Member. Without expressing any comment upon the methods of these different forms of therapy, I say that the House ought not to place upon the Minister the impossible task of deciding between the relative merits of the different forms of treatment I come now to the question put to me by the hon. and gallant Member for South Paddington (Vice-Admiral Taylor). Individual citizens will be perfectly free. They are not compelled to accept any form of treatment. If they wish to avail themselves of a form of treatment not provided in the National Health Service, they will have to pay for it.
I thank the Minister very much for that answer. It has already been pointed out that poor people cannot afford to pay both compulsory contributions to the National Health Service, and also to someone else for treatment.
4.45 p.m.
Mention been made of the contributions. As a matter of fact, the vast proportion of the contribution is not for medical services at all. It is for pensions, invalidity allowances, and all kinds of things. Only a very small proportion of the contribution is for the public health services. Most of the service is free. The proportion is less than 8d. and I am convinced that as time goes on far less than 8d. of the 4s. 1d. will be taken. Therefore, that point falls. The issue before us is perfectly clear. It is that we must limit the obligation placed upon the Government to what is scientifically ascertainable. I am not suggesting for a moment that that means that medicine is 100 per cent. sound. We know it is not, but it is scientifically ascertainable. A person has passed a certain examination and is on the register. Therefore, those are the persons we must organise and put at the disposal of the community.
There is one further point with reference to what was said by my hon. Friend the Member for Sunderland (Mr. Ewart). It is perfectly true that under the National Health Insurance Acts there is some provision, very rarely exercised, for the subvention of a person who wishes to have some other form of medical treatment. That, as I say, is rarely exercised and difficult to administer. Indeed, if it were extended, it would be impossible to administer. I was rather astonished by the suggestion that physiotherapy and occupational therapy, and other forms of treatment of that sort, were unorthodox and frowned upon. On the contrary, one of the most——I did not suggest they were unorthodox. I said they should be extended.
The answer is that they are being extended. Furthermore, these forms of treatment have been fostered by distinguished doctors. One of the most distinguished physicians of our day, Lord Horder, has been President of the Chartered Society of Physiotherapists. Another distinguished doctor, Sir Reginald Watson-Jones, carried out very important experiments in remedial exercises and physiotherapy in the Royal Air Force during the war. Those have been developed. The hon. Member is perfectly correct when he says we have not enough physiotherapists. I quite agree with him. We have not enough dentists or doctors either. It does not lie against the proposal that we are short of the personnel to carry out the treatment. I have taken powers in the Bill to provide for this matter, and I look forward to the training of additional physiotherapists. I trust it will not be necessary, because it seems to me the principles are perfectly clear, to carry this discussion very far. If we are extravagant with our time so early in the day, we shall have to be parsimonious with it later in the evening.
I have great sympathy with this Amendment. This Health Service is a compulsory contributory service, which has been described as providing free medical attendance, and that means free medical attendance so far as the services of a fully qualified medical practitioner arc concerned. I have had a number of letters from people who have raised this matter with me, asking whether it would not be possible, under this Bill, to do something for those people who either do not believe in, or, at any rate, do not consult the ordinary medical practitioners, but who have received great benefits from treatment by other methods of healing. They are asking whether it would not he possible for them to be allowed the fees which they pay to those who treat them, so that they will not have to pay those fees, and, in addition, pay their contributions to the National Health Service.
There is no doubt that there are a great many people in this country who have gained an immense benefit from those who are not duly qualified medical practitioners. In saying that, I am not saying anything against the medical profession. The medical practitioner has one method of curing the ills from which we may be suffering. Other methods are employed by other people, who are not duly qualified in the same way as the qualified medical practitioner, in the sense that they have not gone through a seven years course, and are not recognised by the Government. The people who go to these healers, outside this Bill, will have to pay their fees in addition to their Health Service contributions. I think it is high time something was done so that other methods of curing the ills of the body should be recognised in this country. I know that there are great difficulties with regard to qualification. It is quite right that people should possess proper qualifications when they set themselves up to cure the ills of the body. In other countries, there are certain qualifications, and some of these people go through a very extended course, while, in other cases, they do not. But these qualifications are not recognised in this country, and I very much regret the fact that osteopaths, bone setters and people like them are not recognised in this country. I know, from personal experience, and from the fact that members of my family and my friends have received the utmost benefit from what is described as unorthodox treatment, that they do a great deal of good. They have no position in this country, however, and are riot recognised by the State and do not come under this National Health Service. I know it is not possible to do it today, but I think it is time that the usefulness of these people was recognised by the medical profession and that it is not only the qualified medical practitioner, after a seven years' course, who can cure the ills of the body, but also many of these unorthodox people who have treated their patients with a great deal of benefit to them. It is not a question of not going to a qualified medical practitioner because there is a conscientious objection to doing so, but because, in many cases, people have gone to these unorthodox healers after the medical practitioners have completely failed. Then the patient, having gone to the unorthodox healer, has been cured. Naturally people who derive benefit from such methods want to continue to be treated by these people, but, under this Bill, that appears to be impossible. The Minister has said that any method of healing will he recognised by the Government, provided that the person employing it possesses the necessary medical qualifications. That means that everybody would have to go through this course of, I think, seven years to become a medical practitioner before they are recognised as being qualified to treat not in accordance with the medical practitioner's method, but in accordance with the one which they utilise. Most of this seven years' training would be a complete waste of time, and I think that the insistence on having to go through that long medical course is a mistake. I hope the Minister will consider this matter again to see whether something cannot be done. I recognise the difficulties the Minister will have to face, but if those people who do not believe in, and will not go to, the ordinary medical practitioner can be allowed the fees which they pay to the unorthodox healer, it will give an immense amount of satisfaction throughout the country, and widen the scope of the means of healing for the community.I have a great deal of sympathy with the idea underlying the Amendment moved by the hon. Member for North St. Pancras (Mr. House). I agree with the Minister that the Amendment, in the terms in which it is phrased, would not be practicable in this Bill, but I thought the right hon. Gentleman was a little rough on the hon. Member who moved it, because it was perfectly obvious that it was moved, not with the intention of replacing imperfect words in the Bill, but in order to give the widest freedom to those who prefer various forms of healing.
If the House is unable to find a form of words, how am I to make a definition?
I always thought that one of the objects of a Minister was to show encouragement towards ordinary Members of the House. Nevertheless, what the Minister could perfectly well do—and this was the only object behind the Amendment—would be to consider more closely what sort of qualifications should be permitted for persons outside the medical profession, who give their services in the same way that services will be given, under the Bill, by the medical profession. What the Minister has said means that a man must take a medical degree, and that that should be the way out. I suggest to him that we have today among the nature curers, homeopaths, and osteopaths, a considerable number of——
The hon. Member is under a misapprehension. Homeopaths are qualified practitioners.
The most famous one at the present time is a Mr. Barker——
No, he is an osteopath.
No, hon. Members are thinking of a different Mr. Barker. I was discussing a Mr. Barker, of whose services I have made use, and he is a homeopath and not an osteopath, and I should not have made use of his services unless he was pretty good. Insistence on a medical degree, in many cases, would mean that a man who has today a very considerable practice in nature healing would have to waste time—and it would be a complete waste of time—in taking that course. It would mean that a great many of the people whom he was serving would be deprived of his assistance while he was taking a degree, which, if I may say so with respect, might be totally inapplicable to the kind of work which he was performing. Qualifications would, of course, have to be looked into, including the form and method of the studies which these people were continuing, but to come down to the rigid medical degree seems to me to be a course which would rather curtail that diversity of healing, which, in my view, and I do not pretend to be an expert, is of great importance. Sometimes some of these people fail with their cases where orthodox practitioners are more successful, andvice versa. That is not the fault either of the medical profession or of those outside bodies; certain cases are best suited to certain types of treatment. Under the Bill as it stands, people who know that they are getting the results—it is largely a question of faith —will no longer be able to get them unless they pay more than they would if they came under the ordinary State medical scheme. I know that the Minister has sufficient ingenuity to find a proper form of words to meet the case, and I hope that he will accept my challenge and show that he is more intelligent than the humble hon. Members who are speaking today and that he will accept the view that it is important that these people should be brought into the scheme. The hon. Member who moved the Amendment has served a very useful purpose.
5.0 p.m.
I wish to support the Amendment because, whilst I have no animus against orthodox medical science, I quite understand the difficulties confronting the Minister in regard to definition and qualifications of unorthodox practitioners, and it seemed to me that he was at variance with himself in certain of the arguments he put forward. He said that, in the past, there were certain unorthodox practices which have now been accepted as orthodox medical science. If that is so, on that premise, why does he not encourage them, or set up a court of inquiry into the furtherance of this new science of nature cure? This science has saved the lives of many people. There may be quacks among its practitioners, but if the Minister lends his usual energy to the setting up of an examining body, or a court of inquiry, to examine the matter, such a body could confirm or otherwise the value of that science. It seems to me that the Minister's outlook today is not in accord with his usual progressive freedom of mind.
The only other point I wish to make is the one touched upon by the hon. Member for Wavertree (Mr. Raikes) in regard to the recognised principle on the part of a patient of faith, either in the person who is treating him or in the treatment he prefers. It is a well known fact that if a man turns his face to the wall in despair, he is bound to die, whatever the treatment accorded him. Therefore, the stricture which the Minister is placing upon the patient, whether because he has to pay something in addition to the normal contribution of 8d. or not, is restricting a man in regard to his freedom of choice, and preventing him from achieving a better prospect of regaining his health to the full. On those grounds, those of us who support this Amendment ask the Minister to reconsider this question with a view to instituting a court of inquiry into the matter and the establishment of some joint body composed of nature cure practitioners and others who, as we know, are so widely divided on this matter of qualifications. If the Minister did that, he would be rendering a service, not only to the practitioners, but to the people with whom we are concerned—the working class people whose needs those practitioners so largely meet.While I have a certain sympathy with the arguments put forward on this matter, I look upon it impartially. I would not mind going to a nature curer if I thought he was better than another practitioner, but it is clear that no responsible Minister, either in this Government or any other, could possibly accept an Amendment of this kind. We admit that very fine cures are achieved by nature curers and osteopaths, but we do not hear very much about their failures. Their failures are strewn on the path, unknown and unsung. It is very easy to shoot at 20 birds in a tree in the hope of killing one of them, and I have no doubt that a nature curer may be able to find some obscure system by which he can cure one person out of 20. But it should be realised that a tremendous amount of harm has been done by some of these unorthodox treatments. In many cases, such treatments have delayed orthodox treatment and have resulted in a great loss of lives in this country. Curable cases have become incurable, through the time wasted in trying unorthodox treatment be fore applying orthodox means. Illnesses which could be cured in their elementary stages, are allowed to develop until they become incurable. It is no exaggeration to say that the result has been the loss of hundreds of thousands of lives in this country, mainly through sheer ignorance.
It is now being asked that these people should be recognised by the State. In this country, as in every other country, there must be some kind of yardstick by which to measure these things. If a man wants to be a solicitor he has to be recognised by the Law Society. In the same way, all the medical men in this country, to whatever class they belong, have to go through a rigid training and examination, and are strictly controlled by a disciplinary body. They are precluded from doing a large number of things which nature curers enjoy. They may not advertise a marvellous cure in the Press, as can the unorthodox practitioners, which brings in a large income. If these practitioners are recognised by Statute as legally qualified men, they will, if they like, be able to operate, to administer anaesthetics and to write certificates of death—of which a great number will be required. The hon. Member who moved this Amendment is clearly an enthusiast for nature curing. According to his premises, it can mean everlasting life without any mortality. Let us hope that he will have the advantage of a nature cure in his old age.It seems to me that this is a very modest and helpful Amendment, and I am surprised at the great length of the discussion upon it. I can quite appreciate the Minister's difficulties, but it seems to me that he would be very well protected by the terms of the Clause itself because, in the first line, it states:
"Regulations" means regulations made by the Minister under the Bill. That, surely, safeguards all responsible people allowed to come in under this Clause. Neither the Minister nor the opponents of this Amendment deny that there are in this country responsible people who are doing splendid work by these methods. Their qualifications and the results of what they have done can be tested. Surely if the Minister has power under this Bill to make regulations to decide who shall come into the scheme and who shall not, there is all the safeguard that can possibly be wanted. It is not denied that many people have benefited by the ministrations of these people, and unless they are allowed to come into the scheme this will not be the best possible health Bill in modern conditions. This Amendment proposes to leave open the door for making use of the abilities of these people who have been of such tremendous benefit to thousands of our fellow citizens. We ought not to be pernicketty in excluding these people. Rather should we take every opportunity of including them if we possibly can. I suggest that the very terms of this Clause give to all who hold a responsible position an opportunity of deciding who shall come into the scheme and who shall not. Therefore, this is a perfectly safe Amendment which would be of tremendous benefit, and of great encouragement to these people with new ideas. What has been our experience of medicine in the past? It has been one of continual change. The ordinary practice of doctors today was jeered at and laughed at in the past. Do not let it he said of a Bill introduced in 1946, coming from a Government of this sort, that we failed to accept new ideas, if it is possible to bring them in safely and with benefit to the community."It shall be the duty of every Executive Council in accordance with regulations…"
rose——
I hope the House will soon be willing to come to a decision.
I have a particular interest in this matter because just 20 years ago I asked this House to institute an inquiry into the Whole question of what I called irregular practice. I think that inquiry is very necessary. I am not in the least prejudiced in the matter, but before we can recognise one branch of irregular practice—and not a very old or very well established branch—we should know something more about its scientific background. I have studied this matter very considerably. Schools of naturopathy in this country are very few and very ill-equipped, and examinations are just puerile. I say that from my personal observations, and they ought to be much better. It is quite likely that there is something very sound in some of their theories, but I do not think that we ought to accept them on trust without knowing something more about them. One of the features of this practice today is that the best known schools which give training are not in this country. Osteopathic schools are entirely confined to America. When I brought my Motion before this House, Mr. Neville Chamberlain, who was then the Minister of Health, said that he could not possibly recognise examinations carried out in another country, and that when the osteopaths decided to follow courses of study which were recognised as suitable for medical practice in this country there would be no difficulty in getting them recognised.
5.15 p.m. I think the Minister is right to resist the recognition of this method until we know a great deal more about it. The theory and practice of osteopathy were examined with the utmost possible care in another place some seven or eight years ago. They had something like 12 or 15 sessions, and a very large number of practitioners and people who claimed to have benefited by it gave evidence. The result of that inquiry is very significant. Half way through, very unexpectedly and quite suddenly, the champions of osteopathy were overwhelmed by the evidence and threw in their hand. Nothing has been done since then to continue the investigations into osteopathy. There has been no investigation into naturopathy, and it is time there was one. Until an established scientific inquiry has been instituted there should be no recognition of any section of irregular practice. I think there ought to be a basic examination to ensure that practitioners of irregular practice should know something 'of the action of drugs, even if they do not deal with them, and of the technique of operations, etc. At present, quite properly, the qualified practioner does not consult with the unqualified practitioner. The result has been that the irregular practitioner is an isolated person—a Robinson Crusoe on his island—and he has no contact with other medical branches. He is a pariah. He is not recognised, and he does not get that immense impetus which one gets from meeting one's fellow workers. For all those reasons, I think it is premature to recognise any branch of irregular practice at the moment.
I suggest that the proposal by the hon. Member for Mitcham (Mr. Braddock) for further inquiry into the practice and the results of osteopathy ought to receive the sympathetic consideration of the Minister. Many of the older Members of this House will remember the inquiry to which my hon. Friend the Member for London University (Sir E. Graham-Little) referred, and which took place several years ago. At that time very widespread interest was taken in this House and outside in the practice of osteopathy. We had deputations in this House calling the attention of Members to what was happening in the United States in the practice of this side of medical activity. I think we ought to have further inquiry. I appreciate. the Minister's point of view and I am in entire sympathy with him. Nevertheless, I think more inquiry is necessary. After these long discussions to which my hon. Friend the Member for London University referred, a friend of mine endowed a clinic of osteopathy in London, with which I feel sure the right hon. Gentleman is familiar. Recently a movement has been inaugurated to establish in London a college of osteopathy. In view of these developments, and the widespread interest in the practice of this subject, mainly derived from people who have been trained in the United States, I think the Minister should make further inquiry into this practice which has conferred considerable advantage on people, and he ought to give further consideration to the possibility of including it in the ambit of the national medical service.
rose——
I hope the House will now be willing to come to a decision. We have had a very long discussion indeed.
I have not intervened in this Debate yet. I do so now for one reason, and I shall not take up much time, provided I am not interrupted. I have had a good many representations on this matter over a number of years from my constituents. I realise the great efficiency of the medical profession, but, from a number of experiences, I know that there are extensions of various treatments, which have been mentioned today. I listened with great interest to every word of the hon. Member for North St. Pancras (Mr. House) who moved this Amendment. I say, frankly, there can never he too much human knowledge in dealing with the ills of the people of this country. If there is any possibility, as I believe there is, of extending the knowledge of the medical profession in this way it would be a very good thing indeed to have a general inquiry into this matter.
The question of an inquiry, which has been mentioned, does not come within the scope of this Amendment. I have hesitated hitherto to interrupt hon. Members, but we cannot have a discussion on the advisability otherwise of an inquiry. It does not arise on this Amendment.
Of course, Mr. Deputy-Speaker, I willingly accept your Ruling as applied to this Debate. But from what I have heard during the Debate I am not quite happy and satisfied about the Minister's position. I sincerely hope that this Debate, which was opened by a speech of very high quality, will have some useful effect.
Amendment negatived.
I beg to move, in page 25, line 16, to leave out from "them," to the end of the line.
This Amendment is short and, I believe, non-controversial. I hope the Minister appreciates that he can shorten it a good deal at any time by taking a certain course. The object of this Amendment is to provide uniformity of medical service, I hope uniformity of legibility, certainly uniformity of style, and, I think most necessary, uniformity of cost. If I were the Minister of Health the first thing I would do under these regulations with regard to medical certificates would be to enact that all of them should be written so that anybody could read them. This is a great opportunity for the Minister, and it is a pity he limits it to certificatesWhy should not the Minister have power to make regulations regarding medical certificates under contract for service, or any other contract, or indeed any custom? It is wrong that these regulations should be limited to regulations that are required under an Act, such as regulations for medical certificates under the Education Act and under the National Health Service Bill. I will give the House an illustration of what will happen to a man who falls ill when at work. In order to qualify for his National Health Service benefit he will have to obtain a medical certificate, as required under the Bill. I presume it will be free. I imagine it will also be regulated by the Minister of Health, as before. That man will, at the same time, in many cases, also be under a contract of service, which covers him up to full wages for a period on production of a medical certificate. Unless this Amendment is accepted, it would appear that the man might well go to his doctor and have to pay a substantial fee for that medical certificate, which may not be in the same form. Therefore, it seems wrong that there should be these two different avenues of treatment. In my experience I have often found people deterred from taking the correct action, in many cases, because of the fear of these varying charges for medical certificates. Whatever the Minister does, I hope that in his reply he will tell us whether he intends to make these medical certificates free to applicants. It is desirable that such a step should be taken. If he takes that step, I suggest that, to be just and generous, all such medical certificates should be free; that is to say, certificates which are in connection with a claim for sickness benefit, whether it is under an Act, under a contract of service, or under a custom. The Amendment is really very little more than drafting. I think it would improve the Bill. I assure the Minister that it has the support of all the major local authorities in the country, and on those grounds, I hope he will consider it favourably and accept it." under or for the purposes of any enactment."
I beg to second the Amendment.
I hope the Minister will accept this Amendment, because certificates should be available free. They are very often required by juniors obtaining jobs. In many cases a medical certificate is required, not under any particular enactment but for general purposes. It should be made quite plain that the provision of these certificates is free, and, without any question, should be given by the medical practitioner. I do not know what is in the mind of the Minister in saying in the Bill that certificates should only be issuedif certificates are required for many purposes, and not particularly under any Act. I hope the Minister will accept this very small Amendment to delete these words, and in that way ensure the giving of free certificates by medical practitioners to those who need them for very many purposes other than under any enactment." under or for the purposes of any enactment ",
I sympathise with a great deal of what is in the minds of the hon. Members who moved and seconded this Amendment. When I have spoken I think perhaps they will realise that quite a substantial degree of their case has been met. At the present time, the issue of certificates, without charge, is limited to certificates connected with insurance work. The language of the Bill extends that very much, and further certificates will be issued for the purpose of any enactment under which certificates are required. That extends the obligation of the doctor. To go further, and to suggest that a person should be allowed to receive a certificate from a doctor whenever he wanted it, and for whatever he wanted it, is going rather too far. The trouble is, the obligation of construing the word "reasonable" is left to the doctor or to the patient. At the moment it is:
That is easily capable of construction, but once the words "under or for the purposes of any enactment" are left out, then the difficulty of definition becomes insuperable. Having widened the obligation of the doctor as far as we have, it would really be most unfortunate if we widened it still further, and I am certain that it would meet with a considerable degree of resistance from the profession." reasonably required by them under or for the purposes of any enactment."
5.30 p.m.
If a charge is to be made for a medical certificate, who will receive the charge if the doctors come under the State? At present no charge is made for a doctor's note when a person leaves a hospital, but charges are made in certain cases. For instance, a woman may need a special or surgical corset, but she cannot get one made unless she can produce a doctor's note. Would the Minister say that a note of that sort, concerning something which is absolutely necessary from the medical point of view, should be the subject of a charge, and who would be responsible for collecting it or keeping it?
If the doctor was entitled to make a charge at all, then he would receive the payment; if, however, the certificate is required in circumstances such as those described by my hon. Friend, it would be a medical certificate within the scheme and no charge would be made.
The Minister has dealt very sympathetically with the Amendment, and I hope he will have another opportunity of considering the problem, perhaps in another place. With that end in view, I beg to ask leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Clause 34—(Distribution Of Medical Practitioners Providing Services)
I beg to move, in page 25, line 21, to leave out from "application," to "in," in line 22.
This Amendment raises wide questions on which we think it proper that the House, as distinct from the Committee upstairs, should have a chance of expressing its views and coming to a decision, because in our view this Clause, and those which are consequential upon it or go with it, are perhaps the biggest blot on the whole Bill. They have the most formidable and alarming possibilities with regard to the future of the medical profession and its independence and freedom. Accordingly the proposal which I now put before the House is to exclude from Clause 34 the words which limit the right of doctors to get on the list in an area to those who were in practice in that area before the appointed day, so that any doctor will be entitled to go on any list in any part of the country where he offers his services provided that he is not personally objectionable on some ground or other. As the case was presented to us during the Second Reading Debate, we were told that it was essential, in order to achieve a proper distribution of doctors, that there should be some control over this matter. We disagreed with that, but at that time we took it that this really was the basis of all these objectionable Clauses. But when we got upstairs in Committee a very different picture was presented, because it then appeared that the basis of all those objectionable Clauses was the ideological one that there was something intrinsically evil about the purchase and sale of goodwill, and that this Clause controlling the movement of doctors was a consequence, and no doubt. a necessary consequence, of the abolition of the doctor's right to sell his goodwill and of the new doctor's right to buy it. Therefore the picture is very different today from that which the House had to deal with at the time of the Second Reading. I think this is so important that I might quote from the OFFICIAL REPORT of the proceedings in Committee. The right hon. Gentleman the Minister then said:" Even if it were not necessary for the proper distribution of the general practitioner service to abolish the sale and purchase of practices, I should still do it, because it is an intrinsic evil-"
Hear, hear.
I will deal with that argument at the proper time. He then went on:
Accordingly the case now presented to us is that, in view of the first principle, it was therefore necessary——" Having decided as a first principle to abolish the sale and purchase of practices, it was then necessary to secure the machinery for the appointment of doctors."—[OFFICIAL REPORT, Standing Committee C, 19th June, 1946; c. 631–632.]
I said "a first principle," and then "not "therefore."
But "then" must mean "therefore."
I admire the right hon. and learned Gentleman's forensic skill, but there is all the difference in the world between saying "the first principle" and "a first principle." It was not the primary principle, it was merely one of the cardinal principles.
My more pedestrian mind does not appreciate the difference between a primary and a cardinal principle, but whichever it is, I think I should be right in putting the argument this way: At least the right hon. Gentleman said that one of the main reasons for bringing in this control of the movement of doctors was because it was necessary following on the abolition of the right to deal in goodwill. I do not think the right hon. Gentleman really made any case, at any stage, for this being necessary as a measure by itself. Suppose you left the law with regard to goodwill where it stands at present; the right hon. Gentleman has not made a case that control of the movement of doctors is necessary, and therefore I say that this whole objectionable part of the Bill depends upon ideological and not upon practical reasons.
I propose for a few minutes to examine the matter from a practical point of view. Why is it necessary to put Clause 34 in the Bill in its present form? Why is it not enough to allow the registration of the doctor in any case where he is not subject to some personal disability or objection? The jurisdiction which this Clause seeks to confer upon the adjudicating body is to determine in the first place whether there is already an adequate number of doctors in the area. I do not know, Mr. Deputy-Speaker, whether you will allow us to discuss separately the Amendment which deals with the question of whether the word "adequate" ought to remain in the Bill——May I suggest that both Amendments should be discussed together?
If you please, Mr. Deputy-Speaker, I shall do so. One does not know what "adequate" means; it may vary from time to time, and I can see this system of control being used in an extremely strict way because, if you take the view that adequacy is a relative matter, and that because there are 50 per cent. too few doctors in area A, and 25 per cent. too few in area B, therefore in comparison with A, B is already adequately doctored—and that is a perfectly possible way to interpret this—it will mean that all areas will be regarded as adequately doctored except the few where the deficiency is glaring. If that is the view which is taken, and it can be taken under the Bill as it stands, then that means that in fact there is no freedom of movement left to the medical profession. Unless they choose to go to one of the very few of the grossly under-doctored areas they will be told, "No, all others are relatively adequate, and you cannot go there without permission."
I suggest to the House that any such strict limitation of movement as that is wholly uncalled for, even in circumstances as they exist today. Circumstances as they will exist when this Bill comes into operation will be very different. It will be obvious to everybody that, once we have 100 per cent. of the population entitled to free service, and available for capitation fees, and once we have something over go per cent, of the population —I think that is about right—actually going on doctors' lists, then areas which at present are not very attractive will become some of the most attractive areas financially, and there will be very little difficulty, indeed, in getting doctors to go to what are now difficult areas. There will be a certain number of difficult areas which, owing to scattered population or other local circumstances, cannot attract doctors without some other contribution being added beyond the capitation fee; but there might be a cure in those circumstances by the giving of a proper additional salary. I believe it to be true that only a small minority of areas in the future will not attract doctors on the basis of pure capitation fees, plus a small basic salary if that is insisted on; but we can cure the problem without any of these restrictions. Offer a little more salary, and the doctors will go there. It will take a few months longer to sort itself out, but it will sort itself out, and do it very much better, in the long run, than it is done by this Clause. We think there is no justification for this jurisdiction being conferred upon this Medical Practices Committee. But the objection, as was shown by the Debate upstairs, goes a long way beyond that. None of us on this side was able, by reading the Bill, to discover its inner meaning until we came to this Clause in the Committee stage. I must say I received something of a shock when I discovered what the right hon. Gentleman had in mind. I think that, for the purposes of clarity, it will be as well if I say what I now understand to be the right hon. Gentleman's meaning. I cannot find it in the Bill, but I know that the Bill is so vague that it will cover this. Let me see if it is right. In any area anywhere, as I understand it, if a partner dies, the first thing that happens is that the local executive council advise the Medical Practices Committee that there is a vacancy, if they think that another doctor should come into the area. If they think that, for the moment, another doctor should not come into the area, nothing further is done. But assuming that another doctor should come into that area, to replace the man who has died or retired, then the local executive council advise the Practices Committee, which, I think, advertises the vacancy. There was a great deal of feeling on the other side on that, that that should happen in every case. I am not sure whether that was the Minister's view or not, but that appeared to be the line on which opinion was moving. Then we wait for applicants. Time is passing while all this is going on. Then we find that, although, admittedly, this is not an over-doctored area there are, perhaps, four applicants; and that it has been decided that there is a vacancy, but certainly not four. The existing partners—three of them, let us say—are not allowed to choose the partner they want to come into their partnership. The question is to be remitted to the local medical committee. True, it is composed of medical men; but this may be quite a large district, and one knows that, even in the medical profession, there may be differences of opinion about matters of this kind. 5.45 P.m. The right hon. Gentleman went so far as to say in the Committee, with regard to the choice of the new men to come into existing partnerships:That is to say that no doctor in any area is to be allowed to say, however under-doctored it may be—this is apart altogether from the question of distribution; but it comes under this Clause—the remaining three partners are not to be allowed to say, "We want John Smith as the fourth." No, they must take a man selected for them by the committee of their medical colleagues in the district. I am not quite sure that this is fully recognised by the public as yet because, as the Minister knows, the proceedings in Committee upstairs do not receive a great deal of publicity, though, no doubt, they are read by quite a few people. Is it necessary that this very elaborate system of control should be put upon the medical profession? If hon. Gentlemen opposite think that control of this kind is desirable for its own sake, then I join issue with them. I do not stop to argue with them, because it seems to me to be a question of fundamental difference between us. If they think this kind of thing is for the good of the profession and for the good of the country, irrespective of whether it is necessary to cure existing evils, then I join issue with them. If they say it is necessary to cure existing evils, then I say they are wrong in fact, and that nobody has yet produced any fact which would justify the extremely elaborate system of control. We tried upstairs to get the Clause limited to something more reasonably equivalent to the interests of hon. Gentlemen opposite. Hon. Gentlemen opposite see a great deal more maldistribution in future than we do, because we think it will sort itself out, if the salary is worked properly. But even supposing they are right, and that the adjustment of salaries will not cure the problem, then the Clause goes far beyond what is necessary to cure this. It is not inspired by any question of maldistribution. It is inspired by a desire that there should be some collective control over movement in this profession. If hon. Gentlemen opposite think that that freedom of doctors, to go where they like and serve whom they like, is not in the public interest, and that, equally, the freedom of partners to choose the men with whom they are to work, is not in the public interest, then I say hon. Gentlemen opposite have a curious view of the public interest. If one wants to encourage doctors—and I believe the right hon. Gentleman does—the first essential is to make quite certain that we give the utmost possible freedom to people to come together into partnerships; and not try to dictate to the existing partners whom they are to take in future. This is a clear dictation, saying, "You must take so-and-so or you do not get anybody else." It is quite clear that the Minister wants to dictate to them." I hope that individual selection by individual doctors will progressively disappear, and that collectively the profession will make the recommendation.''—[OFFICIAL REPORT, Standing Committee C, 19th June, 1946; C. 640.]
The Minister wants to dictate?
Certainly.
Certainly not.
Yes. He wants to dictate, because he wants this Bill, and he wants to institute a system of dictation to partnerships, whereby certain persons— other doctors, no doubt—but certain persons shall say to existing partnerships, "You cannot have the man you want. You must take the man we think you ought to have." That is a perfectly fair picture of what the Minister said upstairs. [HON. MEMBERS: "No."] If the right hon. Gentleman wishes to modify it now, I shall listen to him. My colleagues and I listened to him in Committee. We tried in the course of the Committee proceedings to get this proposal into our heads. It was not in the Bill. It was not referred to on Second Reading. This is the best that I can make of it, having read, two or three times, what the Minister said in Committee. What I have just said is the best I can make of what he said. If he now tells us something different, it will be interesting.
I think that this Clause is unnecessary, because it is possible to cure the matter much more easily, in another way—by adjusting salaries. It is not really necessary, even in the Minister's view, because it comes in as consequential on this ideological decision about goodwill. Even in the simplest form, namely that you apply control only where there is plainly an over-doctored area, it would be objectionable. The Minister picked me up at once when I ventured the opinion that there were to be certain open areas, as I call them, and certain closed areas, the closed areas being the apparently over-doctored areas. I checked over that and as far as I can discover there are to be no open areas in the sense in which I used the expression, and no areas where doctors can walk in without the "by-your-leave" of this committee. If there is no part of the country to which a doctor is to be allowed to go without getting the permission of some committee——In the public service.
If there is no part of the country to which a doctor in the public service is to be allowed to go without getting the permission of some committee, then we are miles away from any question of maldistribution, because maldistribution would lead to differentiating setting aside over-doctored areas which cannot be entered without permission, from under-doctored areas where everyone is welcome. That is not to be the case. In this wide sense, it is really another example of right hon. and hon. Member opposite desiring to have control for its own sake.
I am reminded that I should say a few words about the subsidiary Amendment. If we have to accept this Clause, I suggest that the right way to do this would be to have a quota for each area. That quota would not be fixed in the way I suggested it might be fixed in the earlier part of this discussion, namely, by considering every area in relation to every other area. A fair quota should be fixed by the executive council who know the circumstances. If the Minister desired, there could be some power with the central committee to override the executive council. I would not object to that, but we ought to have a quota for each area, and be able to say that if any area is below that minimum quota, all this elaborate control does not apply and anyone, in the public service, can walk in. The quota is a difficult thing, and we may find that we should have to let people in above the quota, because one or two doctors might be semi-retired and so on. Nevertheless, we ought to have a quota in each area for six full-time doctors, or 20 full-time doctors, or whatever number is appropriate, and then not let in any more until all the other areas are up to strength.Who is to adjudicate between the areas?
Obviously, the executive council, because they are the people responsible in this matter. If the Minister prefers that the executive council should be subject to provision by some more central body, that is another matter. We wanted to object to the whole principle of the Clause, but if that view is not accepted, at least we want to get rid of some of the serious and widespread difficulties. I think this Amendment will do so.
My hon. Friends and hon. Members opposite who were Members of the Committee will recollect that this subject received the most attention from the Committee. We argued it at considerable length, and in so doing filled a number of volumes of HANSARD. The issue is perfectly clear. The right hon. and learned Gentleman the Member for Hillhead (Mr. J. S. C. Reid) is trying to claim that there was a contradiction in what I said in the Second Reading Debate and what I said in the Committee. There is no contradiction at all. In the first place, I said on Second Reading that the buying and selling of practices in itself was, to us, repugnant. He may disagree with that, and he probably does, but it does not matter, because that is our view. That was the first principle. There was another first principle, and that was that we should seek to bring about an equitable distribution of a general practitioner service. That is another first principle, and it does not matter which of these principles we take. If we take the former—what we regard as the objectionable character of the buying and selling of practices—it necessarily implies that we must now set up machinery for the distribution of general practitioners, because general practitioners will no longer distribute themselves all over the country by the buying of practices. On the other hand, if we take as our primary principle, that we wish to bring about a proper distribution of a general practitioner service, we must abolish the buying and selling of practices, and then the method of obtaining a successor is abolished, and we must again have a principle of redistribution.
I explained this at some length in Committee, and I am surprised that the right hon. and learned Gentleman is returning to the charge, because there is no contradiction at all. Both principles follow, and both are, in fact, of equal status. The right hon. and learned Gentleman must not make the mistake of supposing that there is a democracy among facts; some facts are more important than others. It is to our first principles we attach great importance, either of the two principles involved, the elaboration of the machinery for distribution and the appointment of doctors. What then have we done? We have suggested, in the first instance, that the selection of doctors shall be by the local executive council, because, as I said in Committee, it is necessary that the new doctor shall be a person who is agreeable to the colleagues with whom he is to work. That is particularly the case when we come to group practices. Therefore, when the medical practices committee inform the executive council that a vacancy has occurred, either by inadequacy of the general practitioner or by the death of a general practitioner, the vacancy is, first of all, made known. I am astonished, when the right hon. and learned Gentleman talks about delays taking place, because far less delay will take place under this machinery than takes place at the present time. The medical practices committee will have available at the centre a complete picture of the situation throughout the country, and any doctor wishing to enter into contract will be able to see where any vacancy exists at any moment. Therefore, he would be able to decide to what particular place he wished to go, and to which executive council he wished to make application. I understand, therefore, that once that happened, the local executive would consider the application, and the local medical committee would make representations; and, in the case which the right hon. and learned Gentleman has mentioned, the partner, as far as he could, would obviously influence the appointment. It is true that he would not himself be the final determinator. We do not want him to be the final determinator. I will come to an important point on that in a moment. It is true that the doctors would be normally consulted, in which case, I would point out to hon. Members, the doctors have a greater privilege than the members of any other profession. They would, in fact, be consulted. Then the executive council would make the appointment, and the medical practices committee would confirm the appointment. 6.0 p.m. I explained in Committee that the reason why it is necessary that the appointment should not be valid until the medical practices committee had validated it was because it was always necessary to have a reserve power against any irregularity. It may be that locally someone has been appointed who ought not to have been appointed. Some undue influence may have been exerted. I agree that to have an appointment of an individual doctor made by the medical practices committee would indeed be a bureaucratic centralisation, but the appointment has to be validated by the medical practices committee, and that always leaves open the possibility of the medical practices committee being appealed to in the event of there being some irregularity about the appointment, but normally that would not happen. What is the actual implication of the Amendment? It would, of course, wreck the Bill—wreck the whole scheme. The right hon. Gentleman made it clear that that was his intention, because he does not like it. There is a complete conflict of opinion between us. What he suggests is that the doctors themselves should have the right, in any part of the country, to enter the public service at their own will, claiming something which no other profession has. When a person enters the public service, surely a nation is entitled to say where it wishes this service to be given. It is only some doctors who would claim that, at any time, they should be allowed, without any principle of distribution being exercised at all, without anything being asked of them, to attract public money——The right hon. Gentleman is taking away from them the right which they have now, and they have never asked for that right to be taken away.
The hon. Member is quite right, but I wish to point out that doctors are not yet in sole control of the country. It is we who have decided that we are going to have a public health service, and, therefore, what we must do is to construct the principles which make that service practicable. Certainly the doctors have not asked as a body for a national health service, but the doctors have supported the national health service, and the proper organisation of the National Health Service implies that we must make available to the whole population an equal share of the doctors, and the only way in which that can be accomplished is by having a proper distribution of general practititioners. If doctors are allowed to go anywhere, the task imposed upon the scheme would be formidable and almost impossible to exercise, because we would never know where the doctors were going until they had gone. Under this Amendment, not only can they go at any time, but they can go anywhere they like—enter the public service and immediately attract public money——
Will the right hon. Gentleman indicate what sort of machinery there is for regulating where teachers go, for example?
I think that the hon. Member had better take one of my hon. Friends outside—any hon. Friend—and he will receive precise information.
Could I have an answer to my question?
The answer is that the teacher is appointed, and if he is not wanted he is not appointed. If the hon. Gentleman wishes to press the analogy, what the teacher would suggest is this: "I am," he would say, "a properly qualified teacher, and I would like to live at Folkestone. Can I go to the Folkestone education authority and say, 'You must employ me'?"
He will, of course, have negotiations with the Folkestone education authority, but the Board of Education, or some central body, has no right to say to the Folkestone education authority, "No, you will not employ that person."
Oh, yes, it has. The hon. Gentleman, instead of answering my argument, is merely exposing the dark caverns of ignorance in his mind. Of course, the State exercises control over it; it refuses to pay grants to an education authority for over-employment of a staff. The hon. Gentleman has given the whole case away. It is only some of the doctors who have insisted that they themselves, without any argument at all, and without any other consideration, shall determine where they shall give their services in the public service. I am not saying that if they do not enter the public service they should be under restraint. They may put up their plate wherever they liked, but if they wish to receive remuneration from the public service the State is entitled to attach conditions to the remuneration, and one condition is that the doctor shall serve where his services are most needed. Rather, I will put it differently, because it is much better for the doctor than that: The doctor shall not serve where his services are not needed. In other words, it is a negative control over distribution. I should have thought, therefore, that the whole situation was perfectly reasonable. It is well understood. It was argued on Second Reading in some detail; it was argued in Committee upstairs, and the more the scheme is examined, the more it stands up to criticism. I must, therefore, resist this Amendment.
The right hon. Gentleman is of course quite right in saving that this part of the Bill has caused the greatest controversy between the two sides of the House. It did so to some extent on Second Reading, and it did upstairs in Committee, although the right hon. Gentleman exaggerated the number of days which it actually occupied. This Clause and the next Clause took altogether less than three mornings. Nevertheless, he is quite right in saying that this is one of the crucial points which divide us on this Bill.
I think that anyone who reads the speech of the right hon. Gentleman on Second Reading, and also reads the proceedings upstairs on the 14th day of the Committee, will agree with the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid) that there was a great difference in the approach of the right hon. Gentleman, in the emphasis that he laid on what governs his mind in this matter; one wonders whether the provisions of Clauses 34 and 35 were in his opinion necessary for producing a proper distribution of the medical profession, or whether, on the other hand, they were rendered necessary by his own objections to the right of the doctor to goodwill. It is perfectly true that upstairs the right hon. Gentleman, as he explained himself, was challenged on this point, as he was again this afternoon, and he then said there could be more than one primary purpose and that he regarded both of these objects as primary purposes. I suggest to him that, if he is to have several primary purposes, he should certainly have one more, and that is that the doctors entering the public service should be happy in their professional work, and that they should enjoy as much sense of freedom, and not as little, as is compatible with the necessary arrangements. I should have thought—in fact, the right hon. Gentleman has admitted it—that if this whole scheme is to succeed and if this Bill is to be the great advance that I know many hon. Members opposite sincerely believe it will be, the thing that, above all, is necessary is that a great many people, as well as some of the best people, shall enter the medical profession, and not only enter the medical profession but be willing to enter the national health service, I ask what chance is there of that, if this ancient and honourable profession is deprived of some of the essential freedoms which govern the actions and influence the choice of so many people who adopt it. I ask what chance is there of a successful partnership when the freedom of partners to choose each other is limited and denied. It really is producing a sense of unhappiness and misery in the service which will go very far indeed towards prejudicing the success of the whole scheme. Let me deal with the two questions separately. First, the goodwill is involved in this Clause, but I will only deal with that as far as it was dealt with in the preceding speeches, because it is more relevant to the next Clause than to that with which we are dealing. Belonging to the profession to which I belong, I had a fairly open mind on the question whether a professional man should or should not be able to sell his goodwill, In the profession to which I belong there is no sale of goodwill and the question seems to me to be really what is in the public interest. Is it or is it not in the public interest that doctors should have this right? I must say that, had I had any doubt of the answer, that doubt would have been laid at rest by seeing what is involved in the Minister's Own view if goodwill is to be abolished. Any one reading Clauses 34 and 35 will become very conscious of the disadvantages of that prohibition. I believe that many hon. Members on both sides of the House will not take the view of the right hon. Gentleman, that to deprive the doctors of their right to build up and enjoy their own goodwill is a desirable thing, but they genuinely believe that something of this kind is necessary in order to secure better distribution of doctors. 6.15 p.m. I believe it is a general desire throughout the House that there should be a proper distribution of doctors. The question is what is the way to bring that about. I should have thought the commonsense view would be that we should see what distribution of doctors is brought about by the coming into force of the National Health Service, which will greatly alter the existing distribution, without anything else being done at all, just as the coming into force of the first National Insurance Act did. Steps should then be taken to see that we attract a sufficiency of medical practitioners to those districts where there are still far too few. I say far too few, because over the whole country there will be too few. The right hon. Gentleman in his speech talked about what a monstrous thing it would be if doctors entering the public service themselves were to say where they would practise. in the public service. Of course, that really disguises the fact that the people who would really make the choice, if the medical profession were given freedom, would be the public themselves. What many of us here think is that the best judges of whether a district is or is not over-doctored are the public in that district. The resistance to the proposals in this part of the right hon. Gentleman's Bill is so much in the public interest, that I am delighted that the doctors are resisting them, because I can see a great deal in them which might have attracted the less good elements in the medical profession. I gave an example upstairs, which I should like now to give to the House if the House will allow me. There may be in all parts of the House hon. Members who practise at the Bar. I ask them to remember the time shortly after their call, and their start in their profession, and to imagine that it had been open to some professional body of the Bar to say, "London is now an over-barristered area." [HON. MEMBERS: "Hear, hear."] I am delighted to hear the cheers from the opposite benches because it strengthens my point. If any district were over-barristered it would be London, and if we adopted for the Bar what it is proposed to adopt for the medical profession, no additional barrister would be able to practise in London, and those in London would be freed from further competition and free to enjoy complete security and livelihood without any additional effort on their part. I think in the interest of the public, and in order to have a good legal profession, the existing legal profession should always have competition. I think the same thing may apply to the medical profession. I do not believe it is in the public interest in this new service that any district can say "There are enough doctors here and there are other districts which have less." If that were so, then the new entrant would have to go to those other districts, and the doctors in the barred district would be freed from all stimulus to maintain their efficiency. This is the very crux of the Bill in the view of a great many of us. I know there are hon. Members opposite who are convinced—and I give them credit for the genuineness of their views—that to deprive members of the freedom they have hitherto enjoyed is a right thing in itself. There are others—and I think they must be very few if they have studied the evidence—who have thought, even apart from that conviction, that they must do something as drastic as this, in order to secure a proper distribution of doctors. No doubt by studying their correspondence and meeting their friends—because there is not one of us in this House who has not friends in that great profession—they have formed a view as to what the doctors are feeling. The thing that has struck me is how little the objection to this Clause depends on the political views of the doctor concerned. I am glad to say that I know some doctors who have no strong political views, but I know some other doctors who share the political views of hon. Members on the other side of the House, though they do not share the approval which those Members are giving to this Clause. In fact, some of them go so far as to say that they would not enter this service because they are not satisfied that they could efficiently continue in their profession when they are deprived of something absolutely essential to their happiness and efficiency, namely, a sense of freedom. I believe the great defects of these two Clauses are quite unnecessary to the National Health Service which the right hon. Gentleman is setting up. I do not believe they can possibly be explained by any necessity to secure good distribution of doctors, for the reason that redistribution of doctors will automatically occur by reason of the mere passage of this Bill into law, and the under-doctored areas can be dealt with in the way which the right hon. and learned Member for Hillhead and others have already suggested. The only explanation of this provision is the desire, which the right hon. Gentleman admits as one of his primary desires, to do away with the doctor's goodwill. I do not believe that that is in the public interest. I am certain it is causing great unhappiness in the medical profession, and I believe it is ruining what certainly should be the third of the right hon. Gentleman's primary purposes—since he has no objection to any number of primary purposes—and that is the happiness and sense of freedom of the doctors who enter the profession.
I make no apology for the continuation of this Debate because this is one of the crucial Clauses of the Bill. There are one or two parts of the Bill that have got out of proportion and I suggest to the House that Clause 34 is one of them. It is possible to find reasons why these provisions for the direction of doctors have been put in this Bill, but I am reasonably certain that the argument that compulsory powers of direction are necessary in order to secure proper distribution of doctors cannot be substantiated either by the expanded National Health Insurance Act or by the proposals in this Clause. If we take the National Health Insurance Act which does provide the medical service for half the population of this country we find, in fact, that the doctors have broadly distributed themselves, naturally and without direction, in the area where the services need them. I know that figures can be given which will show that Bournemouth, Harrogate, Bath or the more pleasant places have a larger proportion of doctors than any other parts of the country, but we need to take the individual doctors and ascertain such facts as their age, their condition of health and so forth. If those statistics are worked out, as they were worked out by the Central Medical War Committee, we find, in effect, that these medical practitioners have gone in a great many cases to these places for personal reasons, and not mainly on the grounds that they could make a better living there than anywhere else.
I do not know whether hon. Members opposite have also appreciated the fact of the complete exemption for assistants which is given in this Clause. So long as a man is not going as a doctor but only as an assistant, this Clause does not apply. Therefore, on the basis of the Clause itself, there is a considerable loophole which will enable medical practitioners to take assistants' posts in order to go where they desire to go. I suggest that as assistants are exempt from this Clause, they will go where a job is offered to them, and on the experience of the Insurance Act the need for direction in order to secure the proper distribution of the medical practitioners is not proved. Looking for other reasons why this altered structure has been dealt with, one admits at once that it has probably been erected in order to prevent the sale of practices. If that is the reason, it should be put into the forefront of the arguments in favour of this Clause, and not the unjustified argument that the Clause is needed to get adequate distribution. I think that the argument against the abolition of the sale of practices has probably been put sufficiently cogently, but surely it amounts to this, that a man who has the freedom to sell his own practice, human nature being what it is, is likely to be the man who will give the greatest attention to building up that practice and who will give the best medical services. When one adds together direction, plus the abolition of the sale of practices, plus the desire to put as many general medical practitioners as possible into health centres on a basic salary, I think one gets very much nearer to the real intention behind the. Clause. As I see it, whether that be the real intention or not, the effect of it certainly will be that, within five or 10 years, a large proportion of the medical practitioners of this country will have become salaried servants of the State. If that is the intention, it should be brought out and should be explained by the Minister. To disguise it, as it is disguised here, on the ground that these powers are necessary in order to secure adequate distribution of medical manpower is simply to ignore the facts as they are.I want briefly to reinforce what has been said about the position of partnerships as they will be effected by the Clause, unless the Amendment is accepted. I think I can best do that, shortly and simply, by taking what I think will be a typical case that will arise. Let us suppose that, in a certain area, a vacancy occurs because one of the partners practising in a particular firm or partnership has either died or retired. Let us suppose there are four applicants for that particular area. Naturally, the existing partners will look carefully at the applicants. They know that only one can be selected, and it is very likely they will consider that one of those men is a congenial person. I think we shall all agree, as certainly the Minister will agree, that the whole essence of partnerships is that the people should get on well together and be congenial one to another. The existing partners may select that person.
What has to happen? The executive council make the selection, and if the partners want a certain person to be selected, they have to go to the executive council, or to the local medical committee, and say, "We want So-and-So." They have in some way to make their position known to the executive council. But the executive council may reject that person and put in his place someone who is utterly and completely uncongenial. I do not think there is any doubt about that. The Minister said that probably it' would not work out in that way, but it might do so. The executive council might say, "Doctor X is perhaps not so congenial to you, but he has been waiting to get into the area for a long time; he is a doctor with many good qualifications, and we are going to select him." If they do that, and if the doctor is determined to practise in that area, one of two things can happen; either he will go into the partnership and all the partners will be thoroughly unhappy, or he will not go into the partnership, and gradually it will break up. If, on the other hand, the executive council selected the person whom the partners desired, and the local medical committee confirmed that selection, one of the other doctors who wanted to go into the area might complain and say that some unfair influence had been exercised by reason of the other partners having approached the executive council. There might be an objection and an appeal to the Minister. Therefore, in this way there would be far more appeals to the Minister. I feel that this Clause, as it stands, will have exactly the reverse effect from that which the hon. and right hon. Gentlemen opposite want. It will be inclined to break up existing partnerships and prevent them from carrying on. That is one of the reasons I support the Amendment.6.30 p.m.
I did not have the opportunity of sitting on the Committee upstairs and, therefore, I would like to express a view on this matter now. The Minister has said that this Clause is absolutely vital to his Bill, and that if it is wrecked then, in effect, the heart of the Bill will be destroyed. I want to make it plain at the outset that I do not want to destroy the Bill, but I do not think it has yet been demonstrated that this Clause, in its present form, is essential to the working of the scheme. In making that complaint, I am not hostile to the Bill, but a supporter of it, and I want to discuss the merits of the argument which is now before the House.
Is this Clause necessary, or can it be amended, with advantage to the scheme? It ought to be possible to discuss that dispassionately, whatever side of the House one sits on. In opening the discussion, my right hon. and learned Friend above the Gangway said that the Minister had rather changed from one leg to another in his support of the Clause. He said that originally the weight of the emphasis was laid on the necessity to secure an equitable distribution of doctors, and that at a later stage the emphasis was shifted to the undesirability, as a matter of principle, of medical practices being bought and sold. The Minister replied to that that whether there had been a change of leg or not did not matter, because whether you start from the principle that the buying or selling of practices is itself undesirable, or from thedesideratum of securing an equitable distribution of the supply of doctors, you are bound to be driven to the same conclusion—that either principle involves the elaboration of machinery concerning the distribution of the supply of doctors. The comment I would like to make on that is that, whichever of those two principles you start from you are driven, through the elaboration machinery, to secure an equitable distribution of doctors. But that is not the point. The point is: Is this the machinery we are driven to, or is there some other less objectionable machinery that could be found? The Minister quite properly makes the point—and nobody can complain of it—that if, under the Bill, doctors are to become State servants, if they are to attract remuneration from the State, it is unreasonable for the doctor himself to expect to determine where he should serve. In the same way that a teacher is posted by the employing authority to where he is needed, and the civil servant is posted by the employing authority, the State, to where he is needed, so, says the Minister, the doctor cannot object to being posted where he is needed——
On the contrary, I said that the doctor should be stopped from entering into the public service in areas where the public service does not need it.
I was about to deal with the point of negative, rather than positive, direction. Let me amend what I said. The Minister says that the doctor has no right to complain if the employing authority, which now becomes the State, says that he shall not work where he is not wanted. [An HON. MEMBER: "Does the hon. Member object to that? "] I am just about to tell the House. I have never seen such eagerness to wait upon the words which fall from my lips. There are three ways of securing the desired result of the equitable distribution of doctors. One conceivable way is to give the Minister power of positive direction——
I, too, have been waiting for the words to fall from the hon. Member's lips, because I was wondering what relationship the speech he is now making has to the Amendment. The Amendment says, in effect, that the doctor should enter the public service where he likes. I should have thought myself that that is the point to which the hon. Member's speech should he addressed.
Up to now every argument I have addressed has been to meet the argument made to the House by the Minister. I suggest that we are agreeing with the objective which the right hon. Gentleman wants to get in his Clause, namely, the equitable distribution of doctors. It is being suggested, in this Amendment, that there are other and better ways of getting that equitable distribution than the way which is proposed by the Clause.
On a point of Order. That is precisely, in my submission, Mr. Speaker, what is not in the Clause. In the Clause there is provision for the distribution of doctors by certain machinery. The Amendment seeks to leave out that machinery, and if that is done what is then left is theipse dixit of the doctor himself. I suggest, Sir, that it is not in Order to roam over all kinds of alternative methods of distributing doctors.
The right hon. Gentleman is, in the main, correct. We are discussing an Amendment, and not the Clause as a whole. Further, we are on the Report stage, and we must stick to the Amendment very closely.
With great respect, Sir, I think your predecessor ruled a short time ago that we were discussing this Amendment and the following three. Amendments on the Order Paper together. That being so, I think that would enable us to discuss the position of doctors fairly fully, without going very far. I draw your attention to that, in case it might ease the position.
The hon. Gentleman has just said, "Without going very far," and those are the limiting words.
What we are discussing, it seems to me, is an Amendment to delete from Clause 34 certain lines which make it obligatory upon a practitioner to obtain the consent of a particular body before he can serve in a particular place. If I can show—or if I can argue, since I do not need to convince hon. Members on this side—that the Minister can obtain the results he wants with these words deleted, it does appear to me that this is absolutely to the point. I would ask the Minister to agree that in matters of this kind the less the degree of compulsion, negative or positive, the better, provided one can obtain the end desired. If that is true as a general principle, then I think that of all professions in the world it is true of the medical profession. There are some types of job which can be measured in output per man hour, and some which can be measured in other ways, but nobody can make a doctor a good doctor by compulsion. This is the sort of job where the mental attitude of the person concerned is of first importance and I therefore suggest that the Minister should not use compulsion, negative or positive, if he can get results in other ways. It is not so much a question of whether the individual who is going to attract money from the Government should be able to choose where he shall or shall not serve, but of whether from the point of view of obtaining the best results for the public health service, it is not better to rely on inducement rather than compulsion. [An HON. MEMBER: You might not get the same results at all."] We must not start on the assumption, "What's the good of anything? Nothing let's go out into the garden and eat worms." Surely we are entitled to tie up the ends, and I must say that the principle which has been advocated here is one which has been applied by many Departments of the Government. If there is a place to fill which is unpopular there is nothing more common in the public service than to offer some inducement to go to that particular place, either by way of a special allowance or in some other form.
On a point of Order, Mr. Speaker. In my respectful submission the hon. Member's argument goes entirely beyond the province of the Amendment. The hon. Member is arguing that we could do something which is not mentioned in the Clause and relates to an entirely different part of the Bill. He is saying that we could offer inducements to the doctors to get them to go where we needed them. In my submission all the hon. Member is entitled to argue is that the Clause, with the omission proposed in the Amendment, would achieve the purposes he has in mind, which could not be achieved under the Clause as it stands.
As a matter of fact I was on the point of rising. I do want to remind hon. Members that these interruptions often lead to various discussions which it is rather hard for the Chair to check. There was an interruption which the hon. Member took up very quickly, and it led him astray.
I deeply regret that I should have been led astray but may I not argue, Sir, that as in so far as the Amendment is directed to removing a specific part of Clause 34, I am in Order in arguing that if that part of Clause 34 were deleted, there are other means within this Bill whereby the same results can be achieved?
We must confine ourselves to Clause 34 as it stands with these matters deleted, otherwise we get too wide a Debate.
The point I am making, if I may put it to you, Sir, is that with this part deleted, and with Clause 34 to that extent modified, there will then be power under this Bill to obtain the result that the Minister wants by way of the equitable distribution of doctors.
Further to that point of Order, Mr. Speaker. If the hon. Member were permitted to argue that, then we should have a wide and roaming discus sion over all kinds of methods of attracting doctors, and relating to other parts of the Bill, so that, in my respectful submission, we should be getting back to a Second Reading Debate.
We must stick to the Clause and must not roam over the Bill; I am afraid I must rule the hon. Member out of Order.
6.45 p.m.
I did not intend to go beyond the arguments made by the spokesman who opened the Debate this afternoon, and they did appear to me to be highly relevant to the point at issue. To sum up, I do not think the Minister needs the powers under this Clause to obtain the results he desires, and inasmuch as my principle is to try to obtain the desired result with the minimum of compulsion—and I dislike compulsion for its own sake—I hope very much that the Minister will not persist in his opposition to the Amendment.
I should like to put forward one consideration to hon. Gentlemen opposite which I hope may help them to view this Amendment with sympathy, although I do not expect that any words of mine will gain their support for it. I have always taken the view that if any person takes money from the State, to a certain extent he sells his freedom, and much the same will apply in this case. The doctors will soon be entering into a public service and will be dependent on the Minister and the Treasury for their fees, and he who pays calls the tune. The consideration I put forward is that a large majority of these doctors did not ask to go on what I might call the public pay roll or to become employees of the State. For better or for worse, this House has decided that there shall be a State medical service in this country, and soon that will be the case. I feel, then, that we should give every consideration to the people who are entering this service and going on to the public pay roll even, perhaps, against their wishes. If we can obtain our proper distribution of doctors throughout the country without any compulsory powers, so much the better. I have listened to all the arguments, both in Committee and in the House, and although I am not going to repeat them now, I would say that I am not convinced that it is necessary for the Minister and various bodies to have these powers so as to get the necessary distribution. Until I am convinced I will not support such a proposal.
I listened to what the Minister had to say on this matter with great care and interest and I believe that hon. and right hon. Gentlemen on both sides of the House have one desire in their minds—to obtain a fairer distribution of doctors over the whole country. I will not deal with the question of practices, which was referred to by the Minister, except from the point of view of whether, under this Clause, with its prohibition of doctors going to an area, the system is likely to work in such a way that the areas concerned will be provided with a good and contented medical profession. I hope the Opposition may prove wrong; I hope that it will work, because I am convinced that the Government mean to shove this through "any old how." I say quite frankly, however, that I shall oppose the principle because I do not believe that it is right to apply the particular form of pressure laid down in this Clause, to a medical profession which, over a very long period, has endeavoured to serve the public well.
I am speaking not so much on behalf of the great industrial areas as from the standpoint of the West Country, where we have a very strong and independent point of view. There is a wide and strong feeling that the medical profession, and those who depend upon it for their health, will not be so well off as they were before, under the operation of the Clause as it stands. The Minister has made little or no attempt to remove that impression. In his speech just now he presented mere tactical arguments against the Opposition. Instead of trying to allay feeling against the Clause, the Minister has undoubtedly made the position much worse than it might have been, if he had used more conciliatory and helpful methods. For that reason, in a matter which is of such great public interest, he should have been able to work out, under the Clause a method which would give the publics a better and happier service.It must be considered right in all parts of the House, that there should be a discussion of reasonable length upon what is one of the most important and far-reaching proposals in the Bill. As these discussions have proceeded, we have got a clearer idea of what is in the mind of the Minister. He tells us now that the whole thing is based on two primary principles. The first is that the sale of goodwill between one general practitioner and another, and the method of the choice of successor, are inherently improper and, to the Minister, repugnant. I do not enter into that argument now, except to point out that if that principle was one of the primary motives for this far-reaching proposal, I am amazed that the Minister's conduct has not been more consistent. The House, and the public outside, should realise that the sale of goodwill as between dentists, and between specialists who change practices on that basis, is left entirely unchanged within the service, by the terms of the Bill.
The second principle is that there should be a better distribution of doctors. If my hon. Friends and I, upon this issue as upon all others, were satisfied with the prophecy of the Minister that this would be necessary after the appointed day, and after 100 per cent. of the population were entitled to benefit under the scheme, we should look upon the matter in a very different manner. Apart from the doctrinaire matter to which I have referred, and on which the Government's proposals are hopelessly inconsistent, the argument is based upon an appreciation of the future. We are told that when the general medical service of this country is organised upon an entirely new footing, the distribution of general practitioners will not be satisfactory. That is a prophecy. What the Minister calls "elaborated machinery" with most serious additions to the criminal law is being introduced into the Bill before the facts are known and before they can be known. I was very glad to hear the hon. Member for Rugby (Mr. W. J. Brown) pointing out what is indeed obvious, that the deletion of Clauses 34 and 35 would not wreck or damage the scheme at all. The Clauses are entirely severable. The Minister has complete power in other parts of the Bill to remunerate general medical practitioners in any way that he thinks right, in order to induce proper distribution. Therefore, to call this a wrecking Amendment is a misuse of language. I desire to say little more, since the mind of Members on this side of the House has already been made quite clear, but there are two other points on which I ought to comment. The Minister made one astonishing observation with regard to the effect of the proposals in relation to medical partnerships. The term "partnerships" indicates that they are associations of gentlemen or ladies who choose to work with one another. The Minister said that, in this matter, doctors would be in a better position than any other profession. I challenge the Minister to name any other form of professional activity in partnership, in which surviving partners have their new partners selected for them by a Central Practices Committee, such as is set up by the Bill. Doctors will be in a uniquely unfavourable position, because there is no other form of professional partnership in which, there being an acknowledged vacancy, partners cannot choose those with whom they want to work, out of those who apply. This proposal will, in our view, militate most seriously against the continuance of those partnerships or groups of practices which the Minister professes to be so keen to foster. The next observation I wish to make is on the complete fallacy of the Minister's observation as to the effect on the general medical practitioner in the public service who is drawing money from public funds —[An HON. MEMBER: "State service."] An hon. Member corrects me and says, "State service." That is what some people hope it will become, but the hon. Member may not be aware that the right hon. Gentleman always disclaims that term. The situation in regard to the public money which the general practitioner in this service will attract is wholly different from the situation in regard to the teacher, with one exception. If the Minister persists in his unwise proposal to give every one of these doctors a salary, then there is some parallel with other forms of public service. If every general practitioner on the list had a salary, it would be strange indeed to allow whoever went to a place to come on the list, and attract a salary which the Government Department considered unnecessary and uncalled for. If the Minister wishes to do what I am sure the majority of the medical profession wish, he will continue the system of payment by capitation fee. He would find that no more capitation fees and no more public money would be drawn from an area, whatever the number of general practitioners, except to this extent that as there are more and more attractive general practitioners in the area, closer to 100 per cent. of the public will avail themselves of the service. I cannot help imagining that the objective of hon. Gentlemen on the other side is that the population should, to the maximum possible extent, use the service. In other words, they want capitation fees for 100 per cent. of the population to be drawn by the doctors working in the area. How does it prejudice the Treasury or the taxpayer that that money is drawn by 25 rather than by 23 doctors? There is no additional public charge, as the Minister sought to suggest. My final point is this: The Minister blurted out—and quickly corrected himself—that the condition under which every doctor would serve in the future would be that he should serve where his services were most needed.It is not true.
The right hon. Gentleman corrected that, it is true. It is because vagueness such as is in the Clause leaves it perfectly possible for any Minister to introduce that situation, that we must divide against the Clause. If the right hon. Gentleman challenges me and says that that is not true, I reply that it is within the power of the Minister to deal with the whole question of adequacy, as my right hon. and learned Friend the Member for Hillhead (Mr. Reid) pointed out. If adequacy is dealt with on a relative and not an actual basis—and I gather that the Minister is refusing our Amendment which would leave it to local people to decide whether the number of doctors was adequate or not—the effect is to turn this negative form of direction into something which is, in substance and reality, direction in its most positive form.
7.0 p.m.
I wish to refer to what was said about partnership by the hon. Member for South Belfast (Mr. Gage) and the right hon. and learned Member for North Croydon (Mr. Willink). I understood them to say that if one of a well-established partnership of doctors dies or retires, the remaining partners cannot select whoever is to join the partnership. I can imagine some very embarrassing positions occurring. I am acquainted with a partnership of four. One is an old doctor, who is a married man, and the other partners are bachelors. When the old doctor dies, who is to be appointed? I am sure that the remaining three bachelors would prefer to have another man, but this committee might appoint a good looking young woman of 25 years. Things are not always equal in this life, though I have known many good-looking young women, who also had the brains to pass the final
Division No. 267.]
| AYES.
| [7.2 p.m.
|
| Adams, Richard (Balham) | Diamond, J. | Kirby, B. V. |
| Alexander, Rt. Hon. A. V. | Dobbie, W. | Kirkwood, D. |
| Allen, Scholefield (Crewe) | Dodds, N. N. | Lang, G. |
| Allighan, Garry | Donovan, T. | Lavers, S. |
| Alpass, J. H. | Driberg, T. E. N. | Lawson, Rt. Hon. J. J. |
| Anderson, A. (Motherwell) | Dugdale, J. (W. Bromwich) | Lee, F. (Hulme) |
| Anderson, F. (Whitehaven) | Dumpleton, C. W. | Lee, Miss J. (Cannock) |
| Anderson, Rt. Hn. Sir J. (Scot. Univ.) | Dye, S. | Levy, B. W. |
| Attewell, H. C. | Ede, Rt. Han. J. C. | Lewis, A. W. J. (Upton) |
| Austin, H. L. | Edwards, Rt. Hon. Sir C. (Bedwellty) | Lewis, J. (Bolton) |
| Awbery, S. S. | Edwards, N. (Caerphilly) | Lewis, T. (Southampton) |
| Ayles, W. H. | Edwards, W. J. (Whitechapel) | Logan, D. G. I |
| Ayrton Gould, Mrs. B. | Evans, John (Ogmore) | McAdam, W. |
| Bacon, Miss A. | Evans, S. N. (Wednesbury) | McAllister, G. |
| Baird, Capt. J. | Ewart, R. | McEntee, V. La T. |
| Balfour, A. | Fairhurst F. | McGhee, H. G. |
| Barnes, Rt. Hon. A. J. | Farthing, W. J.. | McGovern, J. |
| Barstow, P, G. | Fletcher, E. G. M. (Islington, E.) | Mack, J. D. |
| Barton, C. | Follick, M. | McKay, J. (Wallsend) |
| Battley, J. R. | Foot, M. M. | Mackay, R. W. G. (Hull. N.W.) |
| Bechervaise, A. E. | Forman, J. C. | Maclean, N. (Govan) |
| Bellenger, F. J. | Foster, W. (Wigan) | McLeavy, F. |
| Benson, G. | Fraser, T. (Hamilton) | MacMillan, M. K. (Western Isles) |
| Berry, H. | Freeman, Maj. J. (Watford) | Macpherson T. (Romford) |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Freeman, Peter (Newport) | Mallalieu, J. P. W. |
| Bing, G. H. C. | Ganley, Mrs. C. S. | Mann, Mrs. J. |
| Blackburn, A. R. | Gibbins, J. | Manning, C. (Camberwell, N.) |
| Blyton, W. R. | Gibson, C. W. | Manning, Mrs. L. (Epping) |
| Bottomley, A. G. | Gilzean, A. | Marshall F. (Brightside) |
| Bowles, F. G. (Nuneaton) | Gooch, E. G. | Mathers, G. |
| Braddock, Mrs. E. M. (L'p'l, Exch'ge) | Greenwood, Rt. Hon. A. (Wakefield) | Mayhew, C. P. |
| Braddock, T. (Mitcham) | Greenwood, A. W. J. (Heywood) | Medland, H. M. |
| Brook, D. (Halifax) | Grenfell, D. R. | Messer, F. |
| Brooks, T. J. (Rothwell) | Grey, C. F. | Millington, Wing-Comdr. E. R. |
| Brown, George (Belper) | Grierson, E. | Mitchison, Maj. G. R. |
| Brown, T. J. (Ince) | Griffiths, W. D. (Moss Side) | Monslow, W |
| Bruce, Maj. D. W. T. | Guest, Dr. L. Haden | Montague, F. |
| Buchanan, G. | Gunter, Capt. R. J. | Moody, A. S. |
| Burden, T. W. | Guy, W. H. | Morgan, Dr. H. B. |
| Burke, W. A. | Haire, Flt.-Lieut. J. (Wycombe) | Morley, R. |
| Callaghan, James | Hardy, E. A. | Morris, P. (Swansea, W.) |
| Champion. A. J. | Harrison, J. | Morrison, Rt. Hon. H. (Lewisham, E.) |
| Chater, D. | Hastings, Dr. Somerville | Mort, D. L. |
| Chetwynd, Capt. G. R. | Haworth, J. | Moyle, A. |
| Clitherow, Dr. R. | Henderson, A. (Kingswinford) | Nally, W. |
| Cluse, W. S. | Hewitson, Capt. M. | Naylor, T. E. |
| Cobb, F. A. | Hobson, C. R. | Nichol, Mrs. M. E. (Bradford, N.) |
| Cocks, F. S. | Holman, P. | Noel-Buxton, Lady |
| Collide, P. | Holmes, H. E. (Hemsworth) | Oldfield, W. H. |
| Collindridge, F. | Horabin, T. L. | Orbach, M. |
| Collins, V. J. | House, G. | Paling, Rt. Hon. Wilfred (Wentworth) |
| Colman, Miss G M. | Hoy, J. | Paling, Will T. (Dewsbury) |
| Cook, T. F. | Hubbard, T. | Palmer, A. M. F. |
| Cooper, Wing-Comdr. G. | Hudson, J. H. (Ealing, W.) | Pargiter, G. A. |
| Corbel, Mrs. F. K. (Camb'well, N.W.) | Hughes, Hector (Aberdeen, N.) | Paton, Mrs. F. (Rushcliffe) |
| Corlelt, Dr. J. | Hughes, H. D. (W'lverh'pton, W.) | Paton, J. (Norwich) |
| Corvedale, Viscount | Janner, B. | Pearson, A. |
| Cove, W. G. | Jeger, G. (Winchester) | Peart, Capt. T. F |
| Crossman, R. H. S. | Jeger, Dr. S. W. (St. Pancras, S.E.) | Perrins, W. |
| Daggar, G. | John, W. | Piratin, P. |
| Daines, P. | Jones, D. T. (Hartlepools) | Platts-Mills, J. F. F. |
| Davies, Ernest (Enfield) | Jones, J. H. (Bolton) | Poole, Major Cecil (Lichfield) |
| Davies, Harold (Leek) | Keenan, W. | Popplewell, E. |
| Davies, Haydn (St. Pancras, S.W.) | Kenyon, C, | Porter, E. (Warrington) |
| Davies, R. J. (Westhoughton) | Key, C. W. | Porter, G. (Leeds) |
| Davies, S. O. (Merthyr) | King, E. M. | Pritt, D. N. |
| Deer, G. | Kingdom, Sqn.-Ldr. E. | Pryde, D. J. |
| Delargy, Captain H. J. | Kinley, J. | Pursey, Cmdr. H. |
examinations as a doctor. Perhaps the Minister would say what would happen in a case like that, and how he would propose to overcome that difficulty.
Question put, "That the words proposed to be left out stand part of the Bill."
The House divided: Ayes, 277; Noes, 128.
| Randall, H. E. | Soskice, Maj. Sir F. | Watson, W. M. |
| Ranger, J. | Sparks J. A. | Weitzman, D. |
| Rankin, J. | Stamford, W. | Wells, P. L. (Faversham) |
| Rees-Williams, D. R. | Stewart, Capt. Michael (Fulham, E.) | Wells, W. T. (Walsall) |
| Reeves, J. | Stokes, R. R. | Westwood, Rt. Hon. J. |
| Reid, T. (Swindon) | Stubbs, A. E. | Whiteley, Rt. Hon. W. |
| Rhodes, H. | Swingler, S. | Wilcook, Group-Capt. C. A. B. |
| Richards, R. | Taylor, H. B. (Mansfield) | Wilkes, L. |
| Robens, A. | Taylor, R. J. (Morpeth) | Wilkins, W. A. |
| Roberts, Goronwy (Caernarvonshire) | Taylor, Dr. S. (Barnet) | Willey, F. T. (Sunderland) |
| Robertson, J. J. (Berwick) | Thomas, Ivor (Keighley) | Willey, O. G. (Cleveland) |
| Sargood, R. | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) | Williams, D. J. (Neath) |
| Scott-Elliot, W. | Thorneycroft, Harry (Clayton) | Williams, J. L. (Kelvingrove) |
| Shackleton, Wing-Cdr. E. A. A. | Titterington, M. F. | Williamson, T. |
| Sharp, Lt.-Col. G. M. | Tolley, L. | Willis, E. |
| Shurmer, P. | Tomlinson, Rt. Hon. G. | Wills, Mrs. E. A. |
| Silkin, Rt. Hon. L. | Turner-Samuels, M. | Wilson, J. H. |
| Simmons, C. J. | Ungoed-Thomas, L. | Wise, Major F. J. |
| Skeffington, A. M. | Vernon, Maj. W. F. | Woods, G. S. |
| Skinnard, F. W. | Viant, S. P. | Wyatt, Maj. W |
| Smith, C. (Colchester) | Walkden, E. | Yates, V. F. |
| Smith, Ellis (Stoke) | Walker, G. H. | Zilliacus, K. |
| Smith, S. H. (Hull, S.W.) | Wallace, G. D. (Chislehurst) | |
| Snow, Capt. J. W. | Wallace, H. W. (Walthamstow, E.) | TELLERS FOR THE AYES:
|
| Solley, L. J | Warbey, W. N. | Mr. Joseph Henderson and |
| Sorensen, R. W. | Watkins, T. E. | Mr. Hannan |
NOES.
| ||
| Amory, D. Heathcoat | Hogg, Hon. Q. | Price-White, Lt.-Col. D. |
| Baldwin, A. E. | Holmes, Sir J. Stanley (Harwich) | Prior-Palmer, Brig O. |
| Beamish, Maj. T. V. H. | Howard, Hon. A. | Raikes, H. V. |
| Bennett, Sir P. | Hulbert, Wing-Cdr. N. J. | Reid, Rt. Hon. J. S. C. (Hillhead) |
| Birch, Nigel | Hurd, A. | Roberts, W. (Cumberland, N.) |
| Boles, Lt.-Col. D. C. (Wells) | Hutchison, Lt.-Cm. Clark (E'b'rgh W.) | Robertson, Sir D. (Streatham) |
| Boothby, R. | Jarvis, Sir J. | Robinson, Wing-Comdr. Roland |
| Bossom, A. C. | Jeffreys, General Sir G. | Sanderson, Sir F. |
| Boyd-Carpenter, J. A. | Lambert, Hon. G. | Scott, Lord W. |
| Brown, W. J. (Rugby) | Langford-Holt, J. | Shephard, S. (Newark) |
| Buchan-Hepburn, P. G. T. | Legge-Bourke, Maj. E. A. H. | Shepherd, W. S. (Bucklow) |
| Butler, Rt. Hon. R. A. (S'ffr'n Wld'n) | Lindsay, M. (Solihull) | Smiles, Lt.-Col. Sir W. |
| Byers, Frank F. | Linstead, H. N. | Smith, E. P. (Ashford) |
| Challen, C. | Lloyd, Maj. Guy (Renfrew, E.) | Smithers, Sir W. |
| Channon, H. | Lloyd, Selwyn (Wirral) | Snadden, W. M. |
| Churchill, Rt. Hon. W. S. | Low, Brig. A. R. W. | Spearman, A. C. M. |
| Clifton-Brown, Lt.-Col. G. | Lucas-Tooth, Sir H. | Spence, H. R. |
| Conant, Maj. R. J. E. | MacDonald Sir M. (Inverness) | Stanley, Rt. Hon. O. |
| Corbelt, Lieut.-Col. U. (Ludlow) | Macdonald, Capt. Sir P. (I. of Wight) | Strauss, H. G. (English Universities) |
| Crosthwaite-Eyre, Col. O. E. | Mackeson, Brig. H. R. | Stuart, Rt. Hon. J. (Moray) |
| Crowder, Capt. John E. | McKie, J. H. (Galloway) | Sutcliffe, H. |
| Cuthbert, W. N. | Maclean, Brig. F. H. R. (Lancaster) | Taylor, Vice-Adm. E. A. (P'dd'fn, S) |
| Darling, Sir W. Y. | MacLeod, Capt. J. | Teeling, William |
| Davidson, Viscountess | Maitland, Comdr. J. W. | Thornton-Kemsley, C. N. |
| Dodds-Parker, A. D. | Manningham-Buller, R. E. | Thorp, Lt.-Col. R. A. F. |
| Dower, Lt.-Col. A. V. G. (Penrith) | Marlowe, A. A. H. | Vane, W. M. F. |
| Dower, E. L. G. (Caithness) | Marples, A. E. | Wadsworth, G. |
| Drayson, Capt. G. B. | Marshall, D. (Bodmin) | Wakefield, Sir W. W. |
| Foster, J. G. (Northwich) | Marshall, S. H. (Sutton) | Ward, Hon. G. R. |
| Fox, Sqn.-Ldr. Sir G. | Medlicott, F. | Watt, Sir G. S. Harvie |
| Fraser, Maj. H. C. P. (Stone) | Mellor Sir J. | Wheatley, Colonel M. J. |
| Gage, C. | Molson, A. H. E. | White, Sir D. (Fareham) |
| Galbraith, Cmdr. T. D. | Morris, Hopkin (Carmarthen) | White, J. B. (Canterbury) |
| Gammans, L. D. | Morris-Jones, Sir H. | Williams, C. (Torquay) |
| George, Lady M. Lloyd (Anglesey) | Morrison, Rt. Hn. W. S. (Cirencester) | Williams, Gerald (Tonbridge) |
| Glossop, C. W. H. | Neill, W. F. (Belfast, N.) | Willink, Rt. Hon. H. U. |
| Glyn, Sir R. | Neven-Spence, Sir B. | Willoughby de Eresby, Lord |
| Gomme-Duncan, Col. A. G. | Nicholson, G. | Winterton, Rt. Hon. Earl |
| Graham-Little, Sir E. | Nutting, Anthony | York, C. |
| Gruffydd, Prof. W. J. | Orr-Ewing, I, L. | Young, Sir A. S. L. (Partick) |
| Hannon, Sir P. (Moseley) | Osborne, C. | |
| Hare, Hn. J. H. (Woodb'ge) | Peto, Brig. C. H. M. | TELLERS FOR THE NOES
|
| Headlam, Lieut.-Col. Rt. Hon. Sir C | Pickthorn, K. | Mr. Studholme and |
| Hinchingbrooke, Viscount | Poole, O. B. S. (Oswestry) | Commander Agnew |
Clause 35—(Prohibition Of Sale Of Medical Practices)
I beg to move, in page 27, line 14, to leave out Clause 35.
This is the Clause which deals with the sale of goodwill. I do not want to repeat what was said in the previous Debate, and, therefore, I can deal very shortly with the more general points that arise. We do not agree that there is any intrinsic reason for abolishing the sale of goodwill. We would only agree to the abolishing of its sale if it achieved some practical benefit, and as yet we have been told of no practical benefit that it will achieve. I do not know whether we shall be told tonight. One odd thing I might mention in passing is that if the Minister thinks it is an intrinsic evil that doctors should sell their practices, I cannot quite understand why it is a good thing that dentists should sell theirs. If this Clause were promoted for practical reasons, I could understand there being a practical difference in the situation between doctors and dentists, but if, as we have been told, the sale of goodwill was decided on before embarking on the exploration of any practical difficulties or troubles at all, on purely intrinsic reasons, then I cannot see why the dentists have escaped from this, but they have. 7.15 p.m. Let me look at the practical reasons. There is really none in past history. There has been no difficulty so far as the patients are concerned. They are free, and always have been, to change from one doctor to another if they want, and if there is any practical difficulty about them having to fill up forms afterwards at any particular time of the year—though I do not think there is—that could easily be changed. After all, if a patient wants to change, he can change, and I am told he frequently does so. I am told that quite a number change before they see the new man at all, because they happen to know of another man in their district whom they would like to have as their second choice. There is quite a large turnover. From the doctor's point of view there is really no difficulty. I have never discovered anybody who could tell me about a doctor who was in any way embarrassed about buying a practice if he wanted to, because the money was not available. Moreover, it is proper that young doctors should start as assistants. The Minister has said so, and, therefore, there is no practical difficulty. The Clause ought not to occur in this Bill, which ought to be for the purpose of making practical improvements in our medical services and of removing blemishes which have practical disadvantages. We ought not to be mixing up medicine and Socialism. We ought to be looking at this from the point of view of the benefit of the people having proper medical services, and we ought not to be bringing in any sort of political ideas—Socialist or Conservative or anything else. I cannot help feeling that although the Minister has tried to put aside politics, and has sometimes quarrelled with his own friends in doing it with respect to other points in the Bill, he has allowed politics to overwhelm commonsense in this connection. Let us assume, however, that I cannot convince anyone opposite that the sale of goodwill ought to go on. My second point is that if we want to stop it, we do not need, and should not have, anything like so complicated or so oppressive a Clause as we have here. It would not be difficult to draft a Clause under which we could provide, more or less on the lines of Subsection (1) of this Clause, that there should be no direct sale, and we could also provide that other transactions which could be proved to be a mere cloak for payments which were really payments for goodwill, would be illegal on being so proved, and would entail penalties. On that argument the effect of the rejection of this Clause would be to compel the Minister to bring in a new and simper Clause in its place, if he thought one was necessary. Therefore, I think I am in order in saying not only that there is no need to abolish the sale of goodwill at all, but that if we do decide to do it, we ought to do it in a much simpler way. What would happen if we did that? I take it that the intention of the Minister is only to catch deliberate and serious offenders. I think that is his intention. It ought to be his intention. If he wants to adhere to the principle of stopping the sale of goodwill, he ought not to try to catch out people for having done something which is not really a serious defiance of the law which Parliament has enacted, but this Clause goes into all kinds of minute regulations which are solely in— tended to catch the man who is not a serious, deliberate offender. We can easily catch him. We can catch him with a very simple Clause, because we can prove intent against him, but what we do here is to bring in a lot of other transactions which really have nothing to do with goodwill, and if some sort of witch-hunt can find a trace of goodwill somewhere in the payment, we shall put the man in gaol or fine him a large sum of money. What will happen is that thousands and thousands of innocent transactions will be impeded—seriously impeded perhaps—in order that, here and there, an odd offender may be caught. Probably there will be only half a dozen prosecutions in the end. There may be as many as 20, but of those 95 per cent. would have been caught under the simplified Clause. For the sake of one or two people, scattered over England, it is suggested that we should introduce these impediments to all transactions. A doctor, or his widow, cannot sell his house to another doctor, or make any partnership agreement with another doctor, or take on another doctor as an assistant, without going to the committee under Subsection (10). He cannot do it safely. That means that he has to go to all the trouble of writing out——The right hon. and learned Gentleman will remember that Subsection (10) was put in as a consequence of my view that many of the arguments advanced by the right hon. and learned Gentleman were sound. Therefore, so far from being an impediment and an additional grievance, it is a protection.
It is not an additional grievance, it is a partial protection. But the original Clause was too silly for words, and the right hon. Gentleman recognised that. The right hon. Gentleman has done his best to meet us here and there without adopting our suggestion to make a very much more simplified Clause, which he could easily have done. I am pointing out that even his best is going to be so harassing to the medical profession in the future that Parliament ought to improve it. No doctor in future can sell his house to another doctor, no doctor can enter into a partnership, no doctor can engage an assistant, without going to this Medical Practices Committee.
He must give the committee a full and comprehensive statement of the full facts of the case. Perhaps a lawyer, or a Member of this House, who is accustomed to drawing up comprehensive and lucid statements, may not find that very difficult. But, a great many doctors, if asked to give a full and comprehensive statement of all the facts of the case, may find it very difficult. The right hon. Gentleman has provided for a certificate, but that becomes worthless under the proviso of Subsection (11) if it fails to disclose all the material circumstances. It is very difficult to say what a court, sitting several years later, would think were material circumstances. Therefore, to be safe, every doctor who enters into one of these bargains must make up a long and comprehensive statement of the facts. That is a monstrous imposition on a busy man. It would not be so bad if the Minister could guarantee that the Medical Practices Committee will act speedily. I do not know, Mr. Speaker, if you intend to call the Amendment in my name dealing with Subsection (10)—on page 30, line 291 at the end, to insert:If so, I shall not pursue that point." but if not so satisfied they shall as soon as possible inform the applicant of the reasons for their decision."
I thought that all these Amendments to Clause 35 could be considered together.
I shall refer to it then. The Minister cannot guarantee that an answer can be given in a fortnight, or three weeks. We all know what happens in the case of hon. Members' correspondence with Government Departments. If we get replies in two or three weeks, we are extremely lucky. Is this body, dealing with doctors who cannot take such steps as Members of Parliament can take if our correspondence is neglected, to guarantee to give a prompt answer to all these matters? I should not have thought so.
The Minister would not even accept what I thought was the extremely reasonable request that if they were against the applicant they would at least write and say "We are against you for this reason …", and then the man would know where he was. A man who has not had an answer for three or four weeks, does not know why the delay has occurred, whether the Committee will say at last, "Yes," or whether he has been refused. Is that the kind of thing we are to impose on every doctor in England and Wales, in order to catch an odd offender in 10,000? The right hon. Gentleman has lost all sense of proportion if that is so, apart altogether from the question of whether the sale of goodwill is or is not a desirable thing and ought not to be prohibited. We would vote against the Clause even on the narrower ground that it is such an imposition of hardship on all medical practitioners in England and Wales to achieve such a 'trifling result that no one must be allowed to do anything without some official having to overlook it. That is the frame of mind which must be behind this Clause. No sensible person would ever have drawn up the Clause unless obsessed by the idea that to allow two people to come together and make an agreement is in some way contrary to the public interest, unless they are overlooked by an official.But these doctors will have the help of organisations, the British Medical Association arid defence societies. They can get counsel's opinion in the same way as an ordinary trade union member.
The thing gets even worse. I put my argument on two points, first the trouble the doctor would have to sit down, when tired, late at night, and write out the whole story, and secondly, the delay he may encounter. Now the hon. Member for Rochdale (Dr. Morgan) suggests that he will have to go to the trouble and expense of employing counsel.
I said that it would be the natural thing for the doctor in those circumstances to consult with his professional organisation, and his defence society.
So every time the doctor, or his widow, wants to sell a house, or every time there is a partnership or an agreement with an assistant, he has to consult counsel, or a defence association, or something of that sort. He cannot do all these simple things without these expert assistants. If it means anything it means that——
indicated dissent.
But I gather from the fact that the hon. Member shakes his head, that it does not mean anything.
It means exactly this, that doctors are intelligent enough to have an organisation—a very intelligent one—which they can consult in any transactions of this kind.
Exactly, and now we are driven to this, that doctors are not to be allowed to enter into quite simple transactions without all the bother of consulting someone in London, perhaps 200 miles away. [HON. MEMBERS: "They do it now"]. I do not think that doctors consult defence organisations before they sell their houses. That is quite a new thing. That is a source of delay additional to the one to which I have referred, because presumably the doctor would consult the organisation before sending up the application to the Medical Practices Committee. So that there are two lots of delays instead of one, and one cannot enter into an ordinary commercial transaction to sell one's house until all this has been done. The thing is even more monstrous than I had thought. I am pretty sure of what the doctors will think about this when they realise what they are being let in for.
7.30 p.m.
I am really astonished at the heavy weather the right hon. and learned Gentleman is making about this. One would really have thought that we had not had a long Committee discussion on this matter.
We have not.
I am not talking about the hon. Member. I have not yet had the pleasure of listening to him. If he catches your eye, Mr. Speaker, I am sure that it will be instructive and entertaining. The right hon. and learned Gentleman has had the benefit and the ordeal of going through ail this in Committee, and yet he makes a speech of the kind we have just heard. If hon. Members will relate it to the Debate we have just had it will appear even more extraordinary. What happens? The State sets aside a very large sum—£66 million—which the medical profession agrees is extremely generous. [Interruption.] The hon. Member has not been in the House all day, and he must not permit his previous silence to make him garrulous now. The State sets aside that sum in compensation for the loss of goodwill. The State is, therefore, entitled to take precautions to see that any doctor does not get the benefit twice, that he does not still have the goodwill which he can exploit, when, in fact, a sum of money has been set aside, on his behalf, for that purpose.
In the recent Debate, hon. Members opposite argued—and I agreed with a great deal of what they said—that it ought to be possible for the local doctors to influence the appointment of the new doctors. We all agreed that where there is a group, a partnership that is desirable, because a new entrant should have harmonious and sympathetic circumstances, and, therefore, the local doctors should influence the nature of the appointment. A danger immediately arises that the new- corner can, in certain circumstances, give certain financial inducements to local doctors to influence his appointment. That we must at once try to prevent, because the doctors in that area have already had set aside, in respect of their goodwill; a large sum of money. The whole purpose of this Clause is the sale and purchase of practices having been abolished, not to permit the succession to the practice to be influenced by financial considerations. I admit that hon. Members opposite do not agree with the abolition of the sale and purchase of practices, but having taken that as a premise, having set aside £66 million of public money, it is surely reasonable for the State to evolve machinery to protect itself against abuse. I agree at once that the original Clause was drawn very tightly—microscopically so. It has been substantially amended in Committee. The doctor now needs to state to the medical practices committee the nature of the transaction that is made, the nature of the partnership agreement into which he has entered, a very simple matter indeed, or the nature and the amount of money which he has obtained for his house, provided the successor is a doctor. In the latter event, he has knowingly sold his house to a doctor, and therefore we want to discover whether, in fact, a substantial sum of money has been given for that house in excess of its reasonable value in order that another doctor may go there—in other words,, that the former doctor has not had the goodwill twice. The doctor has to obtain from the medical practices committee, mainly a professional body, consisting of his colleagues, a certificate to the effect that the transaction is a reasonable one. That is a defence in court against any action whatever. It is a defence against any action being taken. Surely, that it is a perfectly reasonable proposition, and every kind of protection is being given to the doctor in this case. The point was made, and there was substance in it, that a doctor might get himself into difficulty quite innocently. He might not know it was a doctor who was to succeed him, or the widow might have sold the house. There is a later Amendment in which I introduce the word "knowingly," to make it quite clear that there must be awareness of the offence before it has been committed. I should have thought that, in all those cir- cumstances, every kind of protection was being given in this matter. As I have already said, I think that the right hon. and learned Gentleman was really making heavy weather about it. I believe he will find that the introduction of this protective condition, the registration by the medical practices committee, has very largely reassured the medical profession. As the Bill was originally drafted, it was difficult for a layman to construe it, and some additional protection was necessary. But this registration is" an extremely novel procedure, because normally there is a Statute and a person who commits an offence under it can be prosecuted. In this case we have called in another kind of body altogether, a lay tribunal—lay in the sense that it is not legal—a professional tribunal, to assist doctors, and when that tribunal says that, in fact, the transaction has been a reasonable one the doctor is adequately protected under the Statute. It is only a doctor who has not taken that precaution who will get into trouble. It is only the doctor who, through neglect or for less worthy reasons, has not taken the precaution of getting a certificate from the medical practices committee, will find himself in difficulties. The right hon. and learned Gentleman said that upstairs I refused to accept an Amendment which would have had the effect of making the medical practices committee inform the individual who had applied for a certificate as to why the certificate had been refused. I did not accept that Amendment because it did not seem to me to have any practical import. In the ordinary way, if the medical practices committee did not wish to give a certificate immediately, it would ask for further particulars. That application for further particulars would, itself, disclose the matter in the agreement which had aroused the suspicion of the committee. That is the normal way in which these things are done. If I may say so respectfully, I do not think that the right hon. and learned Gentleman has taken sufficient credit to himself for some of the suggestions he has made, because I believe that some good can come from Nazareth, and I accepted them.I shall assume for the purpose of my argument that the prohibition of goodwill stands, and I will not argue that. I concede at once, as indeed did my right hon. and learned Friend, that that means that the right hon. Gentleman will need some provision in the criminal law to enable him to see that there is no abuse, after he has given compensation to doctors for the loss of their goodwill. However much I disagree with the whole policy, I concede that that must be the assumption on which we now approach Clause 35. I would express my belief in the Minister's good intention—I hope I am right. I still believe that he is wholly ignorant of some of the monstrous effects which this Clause will have. If ever there was a case when the right hon. Gentleman was entitled to the presence of the Law Officers on the Government Bench, it is on the discussion of this Clause that he deserves their help. I am not surprised that there is not to be found on the benches opposite during the discussion of this Clause one single lawyer. [An HON. MEMBER "It is commonsense."] A certain number of hon. Members say it is not necessary. Before they decide that, it would be better if they consulted some of their legal friends as to the effect of the Clause as it stands. I am not quite clear, Mr. Speaker, whether for the immediate purpose I ought to suppose that the Clause is as it now stands in the Bill, or as it will be if the right hon. Gentleman's own Amendments are accepted. I imagine I must consider it as it now stands.
The Amendments have not yet been inserted into the Clause. I assume they will be, but they may not be, and so I think we must take the first assumption as being the correct one.
I must deal with the Clause as it stands. I wish to be absolutely fair to the right hon. Gentleman the Minister. I think the Amendments that he is to move subsequently will make the Clause better. They remove some of the monstrous provisions but by no means all its ill effects. One of the great difficulties with which the right hon. Gentleman has not dealt is that he has assumed—and this was assumed by the hon. Member for Rochdale (Dr. Morgan)—that when a doctor or a doctor's widow went to a professional adviser for information as to what he or she could legally do under this Bill, the professional adviser would be able to give a clear answer. Unfortunately that assumption is wholly incorrect.
They never do.
That intervention, with characteristic wit which I appreciate, completely destroys the observation of the hon. Member for Rochdale. The professional adviser could not give advice with any confidence on certain perfectly simple transactions, some of which I will mention to the House. Suppose a doctor has died and the widow wishes to sell the house in which he has practised. It may be a house which for a long time, possibly for generations, has been known in the small town as the doctor's house because a doctor has continuously practised in it. The widow has no desire to get any sum to which she is not entitled, but there is no possibility whatsoever of saying with certainty that the price of that house on the market will not be affected by the fact that it has always been the doctor's house. If hon. and right hon. Gentlemen look at the provisions of Subsection (4) of this Clause they will find that the professional adviser cannot possibly give any advice to that doctor's widow as to how she can get rid of that house with any certainty that she is not infringing against the criminal law.
The right hon. Gentleman mentioned a certificate under Subsection (10). At what point is this certificate to be sought? If it is to be sought before the price has been agreed and the contract completed, then that contract may never mature. I wonder whether the Government have ever consulted any of those who are experts in dealing with matters of this kind. Anybody with experience will say that it is very difficult to negotiate in complete ignorance of what one can legally do. One cannot consult the Committee on the price until one knows what the price is. If a contract is completed and the price is wrong, an offence has been committed already, but, until one has completed the contract, how on earth can one consult this Committee to get a certificate? 7.45 p.m. Suppose the sale is to be by auction. Is that an improper way of selling a house? May it not be the very best way of selling a house, the way which might be most approved? In that case no price is known until the auction has been completed, but by that time there is a com- pleted contract and, if the price is too high, the offence has already been committed. [HON. MEMBERS: No."] It is no good laymen opposite saying "No." If they can produce any lawyer to say that I am wrong, I will be impressed. I am saying what anybody can see by studying the Clause as it now stands. I am absolutely convinced that if hon. Members opposite knew what this Clause really contained they would say it was monstrous. If they were told that this Clause as originally introduced represented what a good Socialist Government had done, and they really understood it, they would be revolted that such a Clause had ever been introduced. It has now been made a great deal longer by improvements inserted on the Committee stage, including in particular a new Subsection (10). It will be made longer still by the Amendments which the right hon. Gentleman is about to move, but even then it will remain a unique piece of criminal legislation and still will prevent doctors and their widows, and many others, entering into the most ordinary and innocent transactions with any certainty that they will not be made liable to the criminal law.I understood the hon. and learned Gentleman to base his objection to Subsection (4) on the assumption that a medical practitioner has died and his widow wishes to dispose of their house. Do I understand the hon. Gentleman is a little anxious as to whether the widow of the deceased practitioner might not involve herself in very unpleasant litigation? In what way does he relate his anxieties, which he has mentioned, to what appears to be in Subsection (4)? That refers to:
The medical practitioner has gone, he is dead, and the property, we assume, is the widow's. How can the widow be involved?… any medical practitioner or the personal representative of any medical practitioner…."
I am delighted at that intervention, because it shows the good heart of the intervener and the fact that he has no conception of what the Subsection says. The widow will be involved. In the case the hon. Member has put to me she will be the personal representative of the medical practitioner. She will be selling
" … premises previously used by that practitioner for the purpose of his practice."
Is the presumption that this house is no longer the house of a doctor but the house of a deceased practitioner's wife?
The hon. Member has made an intervention which indicates that he does not grasp the meaning of the Clause. Perhaps this Clause is very difficult to follow for a layman. This widow sells the house to another medical practitioner and receives a consideration. If
—if she does that, she is at once involved in a criminal offence. There is no way of ascertaining what is the price she can legally obtain, nor is there any method by which you can exclude with certainty the fact that that house may be more valuable by reason of its having been previously used for the purpose of a medical practice. Suppose that the advice given to her is to sell the house by auction. Nobody can tell what the house will fetch in the auction, but, if the transaction is completed, then an offence has been committed before the widow applies under Subsection (10). If she applies under Subsection 10 in advance, what is the price about which she is going to inquire? There are equal difficulties arising under the law of partnership. Under the Bill as it stands, I believe that, in a great many cases, a lawyer would be bound to advise a partner that the safest thing to do, and, possibly, the only thing to do in many cases, would be to dissolve the partnership before the appointed day. For this purpose, I am dealing with the Clause as it now stands. It may be that some of the Amendments to be moved by the right hon. Gentleman may slightly improve the Clause. If, for political purposes, any hon. Member of this House, or any anti-Socialist outside, wished to make a case against this Bill, it would be sufficient, I think, to print the whole of this Clause 35, and to show the nature of the vague and unknown threats that hang over the medical profession and others as a result of this wholly novel procedure. I think that no such use has been made of this Clause. Upstairs, as hon. Members who were on the Committee know, we continually tried to explain just how bad this Clause was, but the Minister tried to maintain that it was almost perfect, and, at the conclusion of one day, I implored him, as he obviously did not believe what we said, to be good enough to consult his own law officers. I imagine that he did so subsequently, and that, as a result, he has put down this series of Amendments on the Report Stage. Even improved as the Clause will be, I believe that the provisions with regard to the criminal code are extremely cumbrous and vague and will cause a great deal of inconvenience to a great many people in their ordinary transactions, while I doubt if it will catch anybody, ultimately, in its clutches, because of its complications. I agree with my right hon. and learned Friend the Member for Hillhead (Mr. Reid) that it would have been possible to meet what the Minister requires by a comparatively simple Clause—not completely simple, perhaps—making it quite clear that a necessary part of the offence was criminal intent. The complications of the Clause, however, are such that I ask hon. Members, before they decide that there is nothing in these points, to take this Clause and consult their professional friends. Let them get a solicitor or barrister and say, "What could a doctor or his widow do, clearly and lawfully, under this Clause?" They will find that there is no clear answer obtainable if their adviser tries to do his job. I ask the House to support the exclusion of this Clause from the Bill." the consideration for the sale, letting or other disposition is substantially in excess of the consideration which might reasonably have been expected if the premises had not previously been used for the purposes of a medical practice,"
I intervene to express my deep apprehension as to the effect of this Clause if it is included in the Bill. We fully realise, of course, that the Minister has certain powers to enforce the principle which lies behind this Bill; if that principle is to be accepted, I cannot quarrel with that, and I do not propose to go into the question of whether on the merits the principle itself is right or wrong. What does concern me is the manner in which this is being done, and I want to draw the attention of the House to Subsection (10), which, as the right hon. Gentleman himself rightly said, is an entirely novel principle. The whole Clause is a novel principle——
It is a novel Bill.
I entirely agree, and I am not against novelty, but, when introducing novelty into the law, we must be sure that it fits into the legal system which is already in existence. That is all I am putting to the House. Subsection (10) does alarm me, because it introduces an entirely novel principle on the question of the establishment of proof. It has been suggested that it is a necessary Subsection to remedy defects which already exist in the Clause. My contention, of course, is that this Clause should not be there at all, though this Subsection does something towards undoing the damage which the Clause itself does, but, even so, I am bound to say that I regard it as a bad legal principle. What, in effect, happens under Subsection (10) is that an outside tribunal is being asked to give directions to a court. That is the general effect. The person concerned can go to the medical practices committee and get a certificate, and that certificate, subject to the proviso whether it has been obtained by fraud or not, is binding on the court. That I regard as a dangerous principle. It is, in fact, working towards ousting the jurisdiction of the courts, because it means that, if the parties interested in a dispute under this Clause go to the court and produce a certificate given by some extraneous body, the court is bound by that certificate. That, as I say, is an extremely dangerous principle. The functions of the courts of this country are to do justice to the parties involved in disputes, and they should be able to do justice in any dispute, de novo, and determine where justice lies as between the parties. I object to the introduction of the principle that, where the parties appear before the court, the court has its jurisdiction limited by the fact that this extraneous body has already made a decision which is binding on the court.
Their jurisdiction is not limited, as it is not binding; it is merely admissible as evidence.
No, it is more than that. The hon. Member will find that it is binding on the court. I have no objection to documentary evidence being made admissible. We have made much progress in recent years on those lines, and it is a great advantage. The hon. Gentleman has evidently not grasped the real point. It is not merely that it is admissible, to which I would not object at all, but that it is binding.
Why?
8.0 p.m.
Because the Bill says so; that is my quarrel with it. The court cannot go behind the certificate. It is no good the hon. Gentleman asking why; if he will read the Subsection he will see that that is its effect. I deplore legislation by which outside bodies may give certificates which bind the court. I believe that when parties come before a court they should be able to put their testimony fairly and freely, and that the court should decide and not be bound by decisions made before the matter came before it. The hon. Member for South Tottenham (Mr. Messer) makes muttering moises——
Will the hon. and learned Member say where the court is bound?
If the hon. Gentleman will read Subsection (11) he will find these words:
" … and any document purporting to be such a certificate shall be admissible in evidence and shall be deemed to be such a certificate unless the contrary is proved…."
It only means that it is admissible as evidence.
I really would ask the hon. Gentleman to accept that it goes beyond admissibility. It goes a good deal further than that. The whole effect of the Subsection is to make the court incapable of going behind the certificate unless the conditions in the proviso are complied with. There is a condition in the proviso that if a certificate has been obtained by fraud the court can go behind it, but the court cannot open up the whole transaction on any other ground. This is a point, as are most other lawyers' points in this House, which is not easily acceptable to hon. Members. [An HON. MEMBER: "Nor are lawyers."] I know only too well that lawyers are not popular in this House when they endeavour to keep legislation on the right lines. I am not, as I have said, speaking on the merits of the Clause; I only wish to caution the House, as far as it is in my capacity to do so, against the danger of legislation which permits an extraneous body to put something before a court which binds it, prior to the dispute coming before it. It is a matter of general principle. I hope the House will agree that it is right that the court should have unfettered powers in dealing with a dispute, and that it should be free to open up the whole discussion and do justice between the parties concerned, and not be bound by something which has happened before.
The observations of the hon. and learned Gentleman are quite misleading. He did not say, of course, that the decision of the medical practices committee was made available after the transaction, but his whole argument was based upon that assumption. If he reads Subsection (10), he will find that the opinion is to be given
In other words, the opinion is to be given before and not after. Therefore, the medical practices committee are not ousting the jurisdiction of the court or dealing with a matter after a transaction has been entered into." … as to whether a proposed transaction or series of transactions …."
I quite agree with the point which the hon. Gentleman makes; the certificate is made before the proposed transaction is entered into. But if, thereafter, the transaction is entered into, the certificate becomes binding.
I am not addressing myself to that point; I am addressing myself to the point made by the hon. and learned Gentleman that the certificate given by the medical practices committee ousted the jurisdiction of the court. That certificate is given before, and not after, and, therefore, the whole argument goes by the board; there is no substance in it at all. That also answers the point made by the hon. and learned Member for the English Universities (Mr. H. Strauss), who said that no guilty intent "s required. What the certificate of the medical practices committee shows is that it is impossible, in those circumstances, for a medical practitioner to have a guilty intent. He submits the proposed transaction to an independent body which gives a certificate that it does not involve the goodwill. The speeches of both the hon. and learned Members are defeated by the simple word proposed "in Subsection (10).
As I understand it, the Minister has based his defence of this rather obscure and very far-reaching Clause on the ground that the State is going to provide £66 million as compensation and that, therefore, the Government have to be safeguarded. If he would accept that Amendment he would not be under the necessity of providing compensation at all, because the sale of practices would still be allowed. The intention of the Amendment is to remove Clause 35 altogether. Our chief objection to this Clause is that, by removing the sale and purchase of practices, the whole foundation of the independence of the doctor is being removed. He is being placed more and more in a position in which he can be swayed by the directions of the Government. That is something which I believe will, perhaps, come back and hit many patients very hard in the future. Today, the doctor possessing his own practice feels that he is independent of everyone other than his patient and, therefore, is in a positon to fight his patient's battle against anyone, whether it be the Minister, a Government Department or anyone else. That position will not exist when the basis of independence is removed from him and when he becomes, as I am sure it is the intention of the Government he should become, a mere servant of the State. But that apart, as has
Division No. 268.]
| AYES.
| [8.10 p.m.
|
| Adams, Richard (Balham) | Buchanan, G. | Dodds, N. N. |
| Allen, Scholefield (Crewe) | Burden, T. W. | Driberg, T. E. N. |
| Allighan, Garry | Burke, W. A. | Dumpleton, C. W. |
| Alpass, J. H. | Butler, H. W. (Hackney, S.) | Durbin, E. F. M. |
| Anderson, A. (Motherwell) | Byers, Frank F. | Dye, S. |
| Anderson, F. (Whitehaven) | Callaghan, James | Ede, Rt. Hon. J. C |
| Attewell, H. C. | Champion. A. J. | Edelman, M. |
| Austin, H. L. | Chater, D. | Edwards, Rt. Hon. Sir C. (Bedwellty) |
| Awbery, S. S. | Chetwynd, Capt. G. R. | Edwards, N. (Caerphilly) |
| Ayles, W. H. | Clitherow, Dr. R. | Edwards, W. J. (Whitechapel) |
| Ayrton Gould, Maj. B. | Cluse, W. S. | Evans, John (Ogmore) |
| Bacon, Mist A. | Cobb, F. A. | Evans. S. N. (Wednesbury) |
| Baird, Capt. J. | Cocks, F. S | Ewart, R. |
| Balfour, A. | Collick, P. | Fairhurst F. |
| Barnes, Rt. Hon. A. J. | Collins, V. J. | Farthing, W. J. |
| Barstow, P. G. | Colman, Miss G. M. | Fletcher, E. G. M. (Islington, E.) |
| Barton, C. | Cook, T. F. | Follick, M. |
| Battley, J. R. | Cooper, Wing-Comdr. G. | Foot, M. M. |
| Bechervaise, A. E. | Corbet, Mrs. F. K. (Camb'well, N.W.) | Forman, J. C. |
| Bellenger, F. J. | Corlett, Dr. J. | Foster, W. (Wigan) |
| Benson, G. | Corvedale, Viscount | |
| Cove, W. G. | Fraser, T. (Hamilton) | |
| Berry, H. | Crossman, R. H. S. | Freeman, Maj. J. (Watford) |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Daggar, G. | Freeman, Peter (Newport) |
| Bing, G. H. C. | Daines, P. | Gaitskell, H. T. N. |
| Blackburn, A. R. | Davies, Clement (Montgomery) | Ganley, Mrs. C. S. |
| Blyton, W. R. | Davies, Ernest (Enfield) | George, Lady M- Lloyd (Anglesey) |
| Bottomley, A. G. | Davies, Harold (Leek) | Gibbins, J. |
| Bowles, F. G. (Nuneaton) | Davies, Haydn (St. Pancras, S.W.) | Gibson, C. W. |
| Braddock, Mrs. E. M. (L'p'l, Exch'ge) | Davies, R. J. (Westhoughton) | Gilzean, A. |
| Braddock, T. (Mitcham) | Davies, S. O. (Merthyr) | Glanvilla, J. E. (Conaett) |
| Brook, D. (Halifax) | Deer, G. | Gooch, E. G. |
| Brooks, T. J. (Rothwell) | de Freitas, Geoffrey | Gordon-Walker, P. C. |
| Brown, George (Belper) | Delargy, Captain H. J. | Greenwood, Rt. Hon. A. (Wakefield) |
| Brown, T. J. (Ince) | Diamond, J. | Greenwood, A. W. J. (Heywood) |
| Bruce, Maj. D. W. T. | Dobbie, W | Grenfell, D. R. |
been pointed out by speaker after speaker from these benches, the whole of the provisions in this Clause are absolutely beyond the limit. I wonder how many hon. Members could say exactly what Subsection (4) means and could then read the other Subsections and come to a conclusion on what they mean.
It is true that the Minister has inserted the medical practices committee as a kind of safeguard, but I doubt whether a committee composed of nine members, seven of which are medical practitioners, is capable of judging all the things which can happen under the provisions of this Clause. It seems that a committee of nine Lord Chancellors would be a more appropriate body to deal with the matter. Again, the safeguard which is provided is practically removed altogether by the provision under Subsection (11) of the Clause. For these reasons, and because we believe that this Clause kills the independence of the doctor, and that it is utterly unworkable, we propose to vote against it.
Question put, "That the words proposed to be left out, to the word 'summary,' in line 29, stand part of the Bill."
The House divided: Ayes, 305; Noes, 110.
| Grey, C. F. | McLeavy, F. | Shawcross, C. N. (Widnes) |
| Grierson, E. | MacMillan, M. K. (Western Isles) | Shinwell, Rt. Hon. E. |
| Griffiths, O. (Rother Valley) | Macpherson T. (Romford) | Shurmer, P. |
| Griffiths, Rt. Hon. J. (Llanelly) | Mainwaring. W. H. | Silverman, S. S. (Nelson) |
| Griffiths, W. D. (Moss Side) | Mallalieu, J. P. W. | Simmons, C. J. |
| Gruffydd, Prof. W. J. | Mann, Mrs. J. | Skinnard, F. W. |
| Guest, Dr. L. Haden | Manning, C. (Camberwell, N.) | Smith, Ellis (Stoke) |
| Gunter, Capt. R. J. | Manning, Mrs. L. (Epping) | Smith, S. H. (Hull, S.W.) |
| Guy, W. H. | Marquand, H. A. | Smith, T. (Normanton) |
| Haire, Flt.-Lieut. J. (Wycombe) | Marshall F. (Brightside) | Snow, Capt. J. W. |
| Hale, Leslie | Mathers, G. | Solley, L. J. |
| Hannan, W. (Maryhill) | Mayhew, C. P. | Sorensen, R. W. |
| Hardy, E. A. | Medland, H. M. | Soskice, Maj. Sir F. |
| Harrison, J. | Messer, F. | Sparks, J. A. |
| Hastings, Dr. Somerville | Millington, Wing-Comdr. E. R. | Stamford, W. |
| Haworth, J. | Mitchison, Maj. G. R. | Stewart, Capt. Michael (Fulham, E.) |
| Henderson, A. (Kingswinford) | Monslow, W. | Stross, Dr. B. |
| Henderson, Joseph (Ardwick) | Montague, F. | Stubbs, A. E. |
| Herbison, Miss M. | Moody, A S | Swingler, S. |
| Hewitson, Capt. M. | Morgan, Dr. H, B. | Taylor, H. B. (Mansfield) |
| Hobson, C. R. | Morley, R. | Taylor, R. J. (Morpeth) |
| Holman, p, | Morris, P. (Swansea, W.) | Taylor, Dr. S. (Barnet) |
| Holmes, H. E. (Hemsworth) | Mort, D. L. | Thomas, Ivor (Keighley) |
| Horabin, T. L. | Moyle, A. | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| House, G. | Nally, W. | Thorneycroft, Harry (Clayton) |
| Hoy, J. | Naylor, T. E. | Timmons, J. |
| Hubbard, T. | Neal, H. (Claycross) | Titterington, M. F. |
| Hudson, J. H. (Ealing, W.) | Nichol, Mrs. M. E. (Bradford, N.) | Tolley, L. |
| Hughes, Hector (Aberdeen, N.) | Noel-Buxton, Lady | Tomlinson, Rt. Hon. G. |
| Hughes, H. D. (W'lverh'pton, W) | O'Brien, T. | Turner-Samuels, M. |
| Hynd, J. B. (Attercliffe) | Oldfield, W. H. | Ungoed-Thomas, L. |
| Irving, W. J. | Orbach, M. | Usborne, Henry |
| Janner, B. | Paget, R. T. | Vernon, Maj. W. F. |
| Jeger, G. (Winchester) | Paling, Rt. Hon. Wilfred (Wentworth) | Viant, S. P. |
| Jeger, Dr. S. W. (St. Pancras, S.E.) | Paling, Will T. (Dewsbury) | Wadsworth, G. |
| John, W. | Palmer, A. M. F. | Walkden, E. |
| Jones, D. T. (Hartlepools) | Pargiter, G. A. | Walker, G. H. |
| Jones, J. H. (Bolton) | Paton, Mrs. F. (Rushcliffe) | Wallace, G. D. (Chislehurst) |
| Jonas, P. Asterley (Hitchin) | Paton, J. (Norwich) | Wallace, H. W. (Walthamstow, E.) |
| Keenan, W. | Pearson, A. | Warbey, W. N. |
| Kendall, W. D. | Peart, Capt. T. F. | Watkins, T. E. |
| Kenyon, C. | Perrins, W. | Watson, W. M. |
| Key, C. W. | Platts-Mills, J. F. F. | Wetzman, D. |
| King, E. M. | Poole, Major Cecil (Lichfield) | Wells, P. L. (Faversham) |
| Kingdom, Sqn.-Ldr. E. | Porter, E. (Warrington) | Wells, W. T. (Walsall) |
| Kinley, J. | Porter, G. (Leeds) | Westwood, Rt. Hon. J. |
| Kirby, B. V. | Price, M. Philips | Whiteley, Rt. Hon. W. |
| Kirkwood, D. | Pritt, D. H. | Wigg, Colonel G. E. |
| Lang, G. | Pryde, D. J. | Wilcock, Group-Capt. C. A. B. |
| Lavers, S. | Pursey, Cmdr. H. | Wilkes, L. |
| Lawson, Rt. Hon. J. J. | Randall, H. E. | Wilkins, W. A. |
| Lee, F. (Hulme) | Ranger, J. | Willey, F T. (Sunderland) |
| Lee, Miss J. (Cannock) | Rankin, J. | Willey, O. G. (Cleveland) |
| Leonard, W. | Rees-Williams, D. R. | Williams, D. J. (Keath) |
| Levy, B. W. | Reeves, J. | Williams, J. L. (Kelvingrove) |
| Lewis, A. W. J. (Upton) | Reid, T. (Swindon) | Williamson, T. |
| Lewis, J. (Bolton) | Rhodes, H. | Willis, E. |
| Lewis, T. (Southampton) | Richards, R. | Wills, Mrs. E. A. |
| Lindgren, G. S. | Ridealgh, Mrs. M. | Wilson, J. H. |
| Logan, D. G. | Robens, A. | Wise, Major F. J. |
| McAdam, W. | Roberts, Emrys (Merioneth) | Woods, G. S. |
| McAllister, G. | Roberts, Goronwy (Caernarvonshire) | Wyatt, Maj. W. |
| McEntee, V. La T. | Roberts, W. (Cumberland, N.) | Yates, V. F. |
| McGhee, H. G. | Robertson, J. J. (Berwick) | Zilliacus, K. |
| McGovern, J. | Sargood, R. | |
| Mack, J. D. | Scott-Elliot, W. | TELLERS FOR THE AYES:
|
| McKay, J. (Wallsend) | Shackleton, Wing-Cdr. E. A. A. | Mr. Collindridge and |
| Maclean, N (Govan) | Sharp, Lt.-Col. G. M. | Mr. Popplewell. |
NOES.
| ||
| Agnew, Cmdr. P. G. | Cuthbert, W. N. | Glyn, Sir R. |
| Baldwin, A. E. | Darling, Sir W. Y. | Gomme-Duncan, Col. A. G. |
| Beamish, Maj. T. V. H. | Davidson, Viscountess | Grimston, R. V. |
| Boles, Lt.-Col. D. C. (Wells) | Dodds-Parker, A. D. | Hannon, Sir P. (Moseley) |
| Bossom, A. C. | Dower, E. L. G. (Caithness) | Headlam, Lieut.-Col. Rt. Hon. Sir C. |
| Bower, N. | Drayson, Capt. G. B. | Hinchingbrooke, Viscount |
| Buchan-Hepburn, P. G. T. | Fleming, Sqn.-Ldr. E. L. | Holmes, Sir J. Stanley (Harwich) |
| Challen, C. | Foster, J. G. (Northwich) | Howard, Hon. A. |
| Channon, H. | Fox, Sqn.-Ldr. Sir G- | Hutchison, Lt.-Cm. Clark (E'b'rgh W.) |
| Clarke, Col. R. S. | Fraser, Maj. H. C. P. (Stone) | Hutchison, Col. J. R. (Glasgow, C.) |
| Clifton-Brown, Lt.-Col. G. | Fraser, Sir I. (Longdale) | Jarvis, Sir J. |
| Corbett, Lieut.-Col. U. (Ludlow) | Gage, C. | Jeffreys, General Sir G. |
| Crosthwaite-Eyre, Col. O. E. | Galbraith, Cmdr. T. D. | Jennings, R. |
| Crowder, Capt. John E. | Glossop, C. W. H. | Keeling, E. H. |
| Kerr, Sir J. Graham | Mullan, Lieut. C. H. | Studholme, H. G. |
| Langford-Holt, J. | Neill, W. F. (Belfast, N.) | Sutcliffe, H. |
| Legge-Bourke, Maj. E. A. H. | Neven-Spence, Sir B. | Taylor, C. S. (Eastbourne) |
| Lennox-Boyd, A. T. | Orr-Ewing, I. L. | Taylor, Vice-Adm. E. A. (P'dd't'n, S.) |
| Linstead, H. N. | Osborne, C. | Teeling, William |
| Lloyd, Maj. Guy (Renfrew, E.) | Peto, Brig. C. H. M. | Thornton-Kemsley, C. N. |
| Lucas-Tooth, Sir H. | Pickthorn, K. | Thorp, Lt.-Col. R. A. F. |
| MacDonald Sir H. (Inverness) | Poole, O. B. S. (Oswestry) | Turton, R. H. |
| Mackeson, Brig. H. R. | Price-While, Lt.-Col. D. | Vane, W. M. F. |
| Maclean, Brig. F. H. R. (Lancaster) | Raikes, H. V. | Wakefield, Sir W. W. |
| MacLeod, Capt. J. | Reid, Rt. Hen. J. S. C. (Hillhead) | Ward, Hon. G. R. |
| Macpherson, Maj. N. (Dumfries) | Roberts, Maj. P. G. (Ecclesall) | Wheatley, Colonel M. J. |
| Maitland, Comdr. J. W. | Robinson, Wing-Comdr. Roland | White, Sir D. (Fareham) |
| Manningham-Buller, R. E. | Sanderson, Sir F. | White, J. B. (Canterbury) |
| Marlowe, A. A. H. | Scott, Lord W | Williams, C. (Torquay) |
| Marples, A. E. | Shephard, S. (Newark) | Williams, Gerald (Tonbridge) |
| Marshall, D. (Bodmin) | Shepherd, W. S. (Bucklow) | Willink, Rt. Hon. H. U. |
| Marshall, S. H. (Sutton) | Smiles, Lt.-Col. Sir W. | Willoughby de Eresby, Lord |
| Medlicott, F. | Smithers, Sir W. | Winterton, Rt. Hon. Earl |
| Mellor, Sir J. | Snadden, W. M. | York, C. |
| Molson A. H E. | Spearman, A. C. M. | |
| Morris, Hopkin (Carmarthen) | Spence, H. R. | TELLERS FOR THE NOES:
|
| Morris-Jones, Sir H. | Strauss, H. G. (English Universities) | Sir Arthur Young and |
| Morrison, Rt. Hn. W. S. (Cirencester) | Stuart, Rt. Hon. J. (Moray) | Major Conant. |
I beg to move, in page 27, line 2g, to leave out "summary conviction," and to insert "indictment."
This is carrying out a promise given in Committee by my right hon. Friend. It ensures that all trials will involve trial by jury and not by summary jurisdiction.Amendment agreed to.
Further Amendment made: In page 27, line 37, leave out Subsection (3).—[ Mr. Key.]
I beg to move, in page 28, line 4, after "practitioner," to insert "knowingly."
This is carrying out another promise made in Committee, and involves, together with the Amendment that follows, in line 8, the necessity for proving both knowledge and purpose before a prosecution can succeed.Amendment agreed to.
I beg to move, in page 28, line 8, to leave out "so as to enable," and to insert "with a view to enabling."
This deals with the question of partnerships. It means where a partnership has been entered into before the coming into operation of the Clause there cannot be any offence in accepting any instalments that have been agreed to just previously.Amendment agreed to.
I beg to move, in page 29, line 4, at the end, to insert:
This Amendment applies to assistant agreements. It is the same principle as that applying to partnerships." and the said sale shall be deemed for the purposes of this section to have been effected—
- (i) in a case to which paragraph (a) or paragraph (b) applies, at the time when the consideration was given or, if the consideration was not all given at the same time, at the time when the first part thereof was given; or
- (ii) in a case to which paragraph (c) applies, at the time when the agreement was made."
Amendment agreed to.
Further Amendment made: In page 29, line 18, at end, insert:
" and the said sale shall be deemed for tae purposes of this section to have been effected at the time when the remuneration was fixed "[Mr. Key.]
I beg to move, in page 29, line 41, to leave out from "that," to the end of line 43, and to insert:
This Amendment deals with the sale of the equipment of an outgoing to an incoming doctor. If the sale is such that it can be clearly shown the price is a reasonable one, then there cannot be held to be any connection with the goodwill in that sale." no part of the consideration was given in respect of the said goodwill or part thereof "
Amendment agreed to.
I beg to move, in page 31, line 3, at the end, to insert:
The Amendment deals with the goodwill of the partnership. When a change takes place it involves that part of that goodwill can be reckoned as part of the goodwill of the partnership practice." (13) For the purposes of this and the next two following sections, references to the goodwill of a medical practice shall, in relation to a medical practitioner practising in partnership, be construed as referring to his share of the goodwill of the partnership practice."
Amendment agreed to.
Clause 42—(Disqualification Of Practitioners)
I beg to move, in page 36, line 8, at the end, to insert:
Before it can be properly decided what is the right tribunal to decide any issue, the issue must be known. Under the Bill at present it is not too clear what the issue is in this connection, and it is still less clear after what the right hon. Gentleman said in Committee. Clause 42 deals with a tribunal which has to decide whether medical practitioners, chemists, dental practitioners and opticians, ought to continue to belong to the national service, or whether they should be refused a continuation of their contracts. Quite rightly, I think, the Minister provides that, in the first instance, that question should go to a tribunal. Somebody has to inquire into it. Provided there is another step beyond the tribunal—and I think we are both agreed there should be some other step—it does not much matter that we should define too narrowly the precise nature of the case before the tribunal. But it does matter very much that we should define the ultimate criterion of judgment when we come to the last stage, and when we come to the question who is to decide at that stage. There are two obviously different points of view. It may be said, on the one hand, that no doctor, optician, or other servant of the public is to be deprived of his place in the scheme unless something has been proved against him. It may be said, on the other hand, as the Minister said in one speech, that it is so essential for the Minister to have full responsibility for the proper services of the community that he is to be entitled to dispense with the services of anybody in whom he has no confidence, whether or not anything definite has been proved against that person. Those are two quite different lines of approach, and it is of vital importance for the doctors to know what is to be the ground on which they can be turned out of this service. As the service becomes more important and more nearly approaches a 100 per cent. service, turning out of the service means professional death, because they can never practise their art outside the service if everyone is inside it. Accordingly, if the Minister's anticipations are right, to deprive any doctor of his place in the public service is, in fact, to say that he can never exercise his medical skill again, and that' if he is to make any living at all, it must be as an unskilled labourer or something of that kind, or at least in some job which does not require any of the skill which he has spent his life acquiring. 8.30 p.m. This is, accordingly, a most important issue for the doctors, and we must have a definition of that to which they are to be subjected. What causes me some doubt is what the Minister said in the course of the proceedings on 26th June, and I should like to ask him which of the pronouncements he then made he now agrees with, because plainly they cannot all stand? In column 770 of the OFFICIAL REPORT of the Committee, the right hon. Gentleman said:" by reason of his failure properly to provide the services which he has undertaken."
That must mean, whether he has been proved to have carried out any of his duties unsatisfactorily, and that I would accept as right. He then goes on, in col. 772:" What we are discussing here is, whether a person who has contracted to carry out certain duties carries them out satisfactorily to reasonable people."
—again an investigation into a question of fact, a question regarding past actions on the part of the doctor, have they or have they not been right? That again I accept as correct. But when we go a little further down that column, we come to quite a different conception, and I hope the Minister will now disclaim it, because he says:" Whether a doctor has carried out his job in a proper way to the satisfaction of the lay and professional people involved."
This is where he begins to go wrong:" Parliament imposes upon the Minister an obligation to provide a service."
We said "No," and the Minister replied:" Under the Amendment, the courts will decide the instrument through which he will give the service."
I hope the Minister did not mean what he said. The local executive is to decide nothing of the kind. The local executive has to decide whether a man has fallen short in certain specific respects. What worries me is that it would be perfectly possible, under the form of words in the Bill, for a doctor to be dismissed by the Minister merely because the Minister thought he was a bad influence, without anything having been proved. I hope, therefore, that the Minister will expound what he now says, though I am afraid he will not, because he goes on to say:" Certainly. That is exactly what the effect will be… The local executive decides that a man is a bad influence."
A high court judge, in our conception, would not have to consider that." Then the High Court judge may say that he is a good instrument."
We are not discussing that at the moment.
What we are discussing at the moment is the issue which the tribunal, whatever it may be, has to decide.
The only thing which is in the Clause is the tribunal, and the right hon. and learned Gentleman is now discussing language I used with regard to what the judge would decide.
And I quoted it as showing that the right hon. Gentleman has the wrong view, in this part of his speech, about the essential nature of the issue which will go before the tribunal, because he would not have used those words if he had the right view about it. Then he goes on with a somewhat alarmingly authoritarian expression:
I do not want to use words which would offend the right hon. Gentleman, but that is a somewhat more authoritarian line of approach than we are accustomed to in this country. I do not want to get involved in questions of phraseology; let us come down to a definite question, which I hope the right hon. Gentleman will answer: Is a doctor to be turned out because something definite has been proved against him with regard to his past actions, or is he to be turned out because his superior has no confidence in him without anything having been proved against him? That is the point, and it is in order to get that point cleared up that we have put down this Amendment. If the right hon. Gentleman will say that he agrees with the first half of my question, that will be very relevant to the next discussion of what the ultimate tribunal will be, and it would lead, I think, to his acceptance of the Amendment, because the Amendment would make clear what seems to us to be somewhat obscure at the moment. At any rate, whether the right hon. Gentleman accepts the Amendment or not, if he accepts the principle we shall be pretty well satisfied; but if he will not keep the door open, if he insists that he can turn, or somebody on his behalf can turn, a doctor off the list into the wilderness, without any proof of his having committed some error in the past in his actions as a doctor under the scheme, then we must resist to the uttermost. I hope, therefore, that the right hon. Gentleman will be able to say, that what he first said upstairs was right, and that what he said in the second place was wrong. I was left in a state of considerable apprehension at the end. I am bound to say that I thought that the right hon. Gentleman really had it in mind to keep power to turn a doctor off the scheme because he was not a good servant of the people, in his view—because he had no confidence in him — without having proved, to the satisfaction of somebody inquiring into the matter, that he had committed some fault." But we cannot admit that the courts should interpret whether the doctor has, in fact, been a good servant to the people."—[OFFICIAL REPORT, Standing Committee C, 26th June, 1946; C. 770, 772 and 774.]
My relations with the right hon. and learned Gentleman on this Bill have so far been reasonably cordial, but I am bound to say that, as the discussion on the Report stage continues, he appears to mistake the House of Commons for a court. He raises the most arid distinctions: he tries to find the most microscopic crevices, and he tries to construct upon them an edifice of argument—if one can construct an edifice on a crevice. But that is precisely what he is doing, and his edifice of argument continually collapses into the crevices. He has attempted to create a distinction, which does not exist at all, because I used the words "bad servant" and because I used the words "bad influence." What is wrong with them? What does the right hon. and learned Gentleman really mean? A doctor is appointed. Before the doctor can be removed, something has to be proved against him. It is not enough for the Minister to dislike the colour of his hair.
He may not have any.
It is not enough for the Minister to dislike the sound of his voice, or his politics. Something has to be proved against him, which makes him, in respect of his being a doctor, a bad public servant. What is wrong with that?
Nothing.
There never was anything wrong with it. It is the right hon. and learned Gentleman who has created these difficulties. What the right hon. and learned Gentleman is attempting to try to do is to develop a line of argument which can be expanded when we come to the next Amendment. That is really what the right hon. and learned Gentleman is up to. I can give him a categorical assurance. First, I cannot accept the Amendment. What it says is:
What has the doctor undertaken? Service as a doctor. That is what he has undertaken. The point here is not his failure to be a doctor. It is his failure to be a servant, as well as a doctor that matters. He may not be tending his patients properly, although he may be a good doctor. There are all kinds of reasons that may make him a very bad person to employ. The tribunal must take all these things into account. But they must always be concrete reasons; they must always be particular; they must always be capable of ponderable description; otherwise the Minister could remove a doctor on suspicion. That would be quite wrong. But there was never any such intention. Therefore, it seems to me that the language of the Clause is the best kind of language to be used in these circumstances. It says if his continuance on the list" by reason of his failure properly to provide the services which he has undertaken."
That, surely, establishes the whole case. I am sure that the right hon. and learned Gentleman will accept that, because it is certainly specific, and then perhaps we can get on to the other Amendment in which he desires to fasten his teeth." would be prejudicial to the efficiency of the services in question."
The right hon. Gentleman was very hard on my right hon. and learned Friend the Member for Hillhead (Mr. J. S. C. Reid). My right hon. and learned Friend and my right hon. and learned Friend the Member for North Croydon (Mr. Willink) are doing very valuable service on this Bill, for the medical profession. If they find any possible loophole or any injustice which may arise, they are also doing good service to the Opposition.
I have been a far greater protector of the medical profession than hon. Members opposite.
I wish to take the right hon. Gentleman up on one sentence he used. He said that the penalty here may not be against a medical man as a doctor, but as a servant. The right hon. Gentleman has repeatedly said, in the House and outside, that medical men are not the servants of the State under this Bill.
May I correct that? The hon. Member does not expect me to pass judgment upon a doctor as a doctor, does he?
I am asking the right hon. Gentleman to answer my question.
May I put the hon. Member in the correct posture? I am not claiming that I have the right, because that is a matter for the General Medical Council, to pass judgment upon a doctor as a doctor. A doctor is not only a doctor, but he is a servant of the National Health Service. In that Service he has to render certain services, and if he falls short of what is required, he is not a proper servant, and is therefore liable to be removed. Does not the hon. Member agree with that?
I only wanted to be clear, because the right hon. Gentleman made public a statement that the doctor is not a servant of the State.
I did not say servant of the State, but servant of the Service.
Having listened to what the right hon. Gentleman has said, and got a fair understanding of what he wants, which is to be able to deal with a doctor if he is inefficient, not in a medical sense but in the sense that he may not be attending a reasonable number of patients, or if his behaviour is bad, I can agree with the right hon. Gentleman up to that point. I am not a lawyer, nor have I had the training of arguing with lawyers—I am innocent of the law—but it seems to me that these words—
—would make it clear that a doctor has an obligation to carry out the various things which are necessary. I should have thought that these words would have strengthened the Bill and that the right hon. Gentleman, instead of having little quarrels with my right hon. and learned Friend the Member for Hillhead (Mr. J. S. C. Reid), would have said, "This is an excellent Amendment which carries out what I wish." The whole of his arguments bore that out. It appears to me that he made an argument in favour of the Amendment, which was almost better than the arguments of my right hon. and learned Friend in proposing it. Between the two of them, they have convinced me that it is a most excellent Amendment. I realise what a little butter, now and then, to the Opposition can do, and so I ask, Would it not be wise on this occasion for the right hon. Gentleman to accept the Amendment? It would strengthen his Bill, and he could say, "Look what I have done, I have accepted this very fine Amendment, excellent in every way; it strengthens the Bill and the Bill is much better than it was before." I will make him a present of that suggestion. I feel quite sure that, even if he does not accept the Amendment here, it will be accepted in another place. I am much indebted to him for making it clear to me that this, at any rate, is a first class Amendment." by reason of his failure properly to provide the services which he has undertaken "
8.45 p.m.
I think it is rather unusual for the right hon. Gentleman to agree in principle and then to give no reason for rejecting the Amendment. It seems to me that the right hon. Gentleman ought to accept the Amendment, because he has accepted, I think, the view that notice of particulars of specific charges of things done or left undone by the doctor will be given before the hearing takes place before the tribunal.
I have made my statement, and what I have said stands on record. I must not now be catechised by the right hon. and learned Gentleman, and be expected to accept from him, as though they were mine, a form of words I have had no opportunity of examining.
I do not think that is a very cooperative attitude——
On a point of Order, Mr. Deputy-Speaker. I thought we were on the Report stage. Is the right hon. and learned Gentleman entitled to make a second speech?
The right hon. and learned Gentleman is entitled to make a second speech as the mover of the Amendment.
I believe that the right hon. Gentleman has assured us that notice of particulars of specific charges of things done or left undone will be given to the accused doctor in advance of the hearing before the tribunal. I believe that he intended to assure us that the ordinary rule with regard to the onus or proof will apply, and the doctor will not be dismissed from the service unless these charges, or some of them, have been proved against him as a matter of fact. On the footing that that belief of mine is well founded, I beg to ask leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
I beg to move, in page 36, line 20, at the end, to insert:
When this matter was discussed in Committee a very extraordinary situation arose. An Amendment was proposed to leave out "appeal to the Minister" in the case of a dismissal of a doctor, and to insert "a High Court judge." The first necessity was to remove from the Bill the words "appeal to the Minister." Owing to one of the unfortunate by-products of all-night Sittings, some of my hon. Friends were not there, and hon. Members opposite who had not devoted themselves with the same assiduity to the Business of the House, were able to attend the Committee looking very fresh and conspiratorial." (4) An appeal shall lie to the Minister from any direction of the Tribunal under the last foregoing Subsection, and the Minister may confirm or revoke that direction."
Will the right hon. Gentleman add the third ingredient, which was, I believe, that a certain transfer of votes took place?
We have not yet assimilated the second. As I said, looking rather conspiratorial they managed to secure a majority for leaving out the words "appeal to the Minister," but the Committee frustrated itself when it came to the second Division.
The Minister frustrated it.
No, the Minister could not frustrate the Committee. I would not dare. As I said, the Committee frustrated itself by then refusing to insert the words "appeal to the High Court" so that the total result of the Committee's labours was to deprive the doctors of one of their remedies. That is the situation as it stands at the present time, and I am moving to re-insert the words "appeal to the Minister." This is a matter of some importance and I wish to ask the indulgence of the House whilst I develop the argument which lies behind the Amendment I am moving.
The Minister and the doctor, or rather the executive council and the doctor, are, in some respects, in employee and employer relationship, and it would be perfectly proper in accordance with constitutional precedents and certainly it would be perfectly proper by the principles which the party opposite have always defended, if the employer could dismiss the employee without any redress at all by the employee. That has always been the position. Indeed, it is because individuals, professional and otherwise, were liable to be dismissed at the caprice of their employer without any redress that trade unions and professional organisations came into being. They were for the protection of the individual and both exist more freely and more powerfully at the present time than they ever did and they operate normally for the protection of the individual citizen. That protection still exists for the individual, whoever he may be. In establishing this great service it seemed to me that it would be very difficult, if not impossible, for doctors who are removed from that service to obtain a livelihood outside, and that special protection should be given to the individual against any possibility of injustice. Let me describe, concretely, the kind of protection the doctor would receive under the scheme, if this Amendment were carried. In the first place, there would be a medical sub-committee of the local executive council, consisting as to 50 per cent, of professional representatives. A complaint is made against a general practitioner. That complaint is first examined and reported upon by that sub-committee of the executive council. I know that is not in the Bill, but that is how, in practice, it will work out, and will be determined by Regulation. I have said a great deal of this in Committee, as Members will see if they look up HANSARD. So, there is the original scrutiny. Then the executive council consider the complaint. That council consists, again, as to 50 per cent. of their membership, of professional persons almost all—with the exception of dentists and chemists—doctors, members of his own profession. Eight would be representatives of the local health authority, experienced persons, and four appointed by the Minister. A semi-professional body would first consider the allegations against the doctor. We will suppose that that body have decided that the allegations are well founded, and that the doctor should be removed from the list. The doctor then has the right of appeal to the tribunal. This is an entirely original advance; it does not exist now at all. At the moment the doctor has only the right of appeal against the local committee straight to the Minister. In no other profession is there this tribunal. I interpose the tribunal between myself and the local executive because it seems to me that the local executive council might, for one reason and another, be prejudiced. The doctor might be an awkward person; he might have all kinds of idiosyncrasies. Therefore, it seemed to me that before the appeal came to the Minister there ought to be a review of the circumstances, more objectively, by the national tribunal. The chairman of the tribunal would be a legal person appointed by the Lord Chancellor, not a dentist or a doctor, as the case may be, but another person. The doctor would be able to put his witnesses before that council to be cross-examined, to give evidence in person, and employ all the panoply of a legal tribunal. If the tribunal decided that the local executive were correct in their decisions the doctor has a further appeal, to the Minister, who will then institute an inquiry. Remember that we are not discussing the doctor as a doctor. Let me eliminate from Members' minds all thought about the General Medical Council. We are not discussing that at all. We are discussing what we discussed in the previous Amendment. That being so, is there any possibility of injustice being done to a doctor after that microscopic examination? The doctor would still have certain rights of appeal to the court. He could appeal on any one of three grounds, or all three together. First, that the procedure laid down for his trial had not properly been carried out; second, that one of the tribunals had exceeded their powers; and, third, that the principles of natural justice had been violated. There is no inhibition against appearing before the court, because we are not dealing with a State servant; we are dealing with a person who is in contract with a local executive. I have examined all the schemes which have been published, and to which Members opposite have been a party, and I find that the scheme provided under the Bill gives more protection than any scheme which I have seen. In no scheme and in no White Paper was a tribunal ever suggested. A tribunal is an invention of my own for the purpose of protecting the doctor against any possible injustice. What is being suggested by hon. Members opposite? The suggestion—it is a most novel one—is that instead of the doctor appealing to the Minister, he should have the right to appeal to a judge of the High Court. I submit that this would be putting the judiciary in a queer relationship with the Legislature. How can a judge of the High Court better decide than the executive council whether a doctor has been an efficient servant of the service? How can he decide that? What particular merit has a High Court judge over these persons with all their experience?9.0. p.m.
If the matter came before a High Court judge, would it not be a question of fact?
A question of law, and indeed, the evaluation of the facts is a matter that only persons with experience of the service could do. The evaluation of the actual quantitative arraignment of the facts is something that the High Court judge can do better than most people, because he is accustomed to weighing evidence; but the qualitative significance of those facts in the health service is a matter which only those who know the health service can do. Otherwise, one would be elevating the position of a High Court judge to a ridiculous eminence. Let me develop the argument still further. The demand that a High Court judge should be the protection of the doctor, instead of what I have described, is based upon the contention that if a doctor is denied employment within the National Health Service, it is practically a sentence of professional death. Therefore, it is argued, the punishment is so severe that we ought to provide for the utmost protection against the possibility of injustice—which, indeed, I claim is provided in the scheme. But if the High Court judge is to decide the matter, where does the responsibility of Parliament come in? Parliament places upon the Minister of Health the responsibility for providing a health service. It provides the Minister with the instruments through which that service is to be given, but if one of the instruments is to be selected by the High Court judge, where does Parliament come in? Let me give an illustration. Suppose that a doctor was dismissed for negligence by the local executive council; suppose that the tribunal had upheld the dismissal——
What sort of negligence?
I have already described that—why does not the hon. and learned Member hang on to the meaning? Suppose that the doctor appeals to the High Court judge against the decision of the tribunal and the High Court judge, in his wisdom or otherwise, decides that the man is to be restored to the list, and suppose that, a week afterwards, a child dies in circumstances clearly pointing to negligence by the doctor, and a Question is put on the Order Paper of the House of Commons to the Minister of Health; what would be the Minister's reply? It would be: "I did not appoint the doctor; it was the High Court judge." That would be an utterly absurd and ridiculous situation. It would be putting the judiciary in a relationship which the British constitution never intended. Let me develop the argument still further. As hon. Members will remember, in the Standing Committee I attached the greatest possible importance to this. The argument of hon. Members opposite has been that, as the State gets its hands more and more upon industry and more and more citizens become employees of the State, it is necessary that the citizens should be protected against the actions of the State. I entirely agree. But who is to protect them? The judiciary? [An HON. MEMBER: "Yes."] Then the hon. Member is trying to get the British judiciary into the absurd position of the American Supreme Court it would become supreme above the legislature. It would not only interpret the law, but select the instrument for the legislature.
It would become the executive.
That is the absurdity into which hon. Members opposite have landed themselves because, as usual, they have followed the headlines of the newspapers and have not followed the principles of the case. There is far more in this. If hon. Members opposite argue that, the State having become entirely monopolistic in respect of the medical profession, the courts must therefore decide whether a person should be dismissed from this service, why do they not apply this to every private monopoly?
Why not?
They would not do it because in that case they would have to appoint over a thousand judges. Let me take any private monopoly in the country, the provincial newspapers, for example. If a person is dismissed from that monopoly, is it not a sentence of professional death? I have never heard hon. Members opposite suggest that no person should be dismissed from his employment for inefficiency unless he has the right of appeal to a High Court judge, nor did I see any signs of indignation on the part of hon. Members opposite that the miners should be arbitrarily dismissed. Why should not the miners have an appeal to a High Court judge? That is what I said upstairs when I talked about the judicial sabotage of Socialist legislation, and it is exactly what I meant. In other words, the courts of the land would become industrial tribunals arbitrating between employers and employees. That is the situation into which hon. Members opposite would lead us.
I warn hon. Members opposite that they will not receive thanks from the medical profession; the medical profession do not want this and they have not quarrelled so far with the procedure contained in this Bill for their protection. Indeed, it is far better than what they have now. I am bound to tell the House that it would be impossible for a Minister of the Crown to accept from the House of Commons responsibility for the efficiency of a service if all the employees in that service were able to appeal to the courts. Industrial discipline would entirely break down in such circumstances, and, therefore. I must resist the principle of appeal to the High Court and must insist upon the Amendment. I am bound to reject the absurd, false, and superficial principles lying behind the contention of hon. Members opposite.I should inform the House that the next Amendment, in the name of the hon. and learned Member for Carmarthen (Mr. Hopkin Morris)—in page 36, line 20, at the end, to insert:
has not been selected, but it may be discussed at the same time as the present Amendment." (4) Any person aggrieved by a direction of the Tribunal either under the preceding subsection or under Subsection (7) of this Section may within one month after the date on which notice is given to him by the Tribunal of their direction appeal against the direction in manner provided by Rules of Court to the High Court, and in any such appeal the High Court may make such order or give such direction in the matter as it thinks fit "—
I listened to the right hon. Gentleman discussing the defeat of his proposals with regard to the first part of this Clause, and while his claim that this was due to all-night Sittings was partly true, I feel that he should have gone further and have said that it was defeated because those of us who opposed this Clause were supported by Members of his own party.
Supported by sufficient of them, in the absence of all the others, to give a majority.
That is true, but what the right hon. Gentleman did not say was that on the Amendment to insert the appeal to the High Court one thing was clearly demonstrated by the Minister himself—his influence, powerfully and firmly exercised. Fortunately, his name comes high in the alphabet so that he was one of the first to vote, and I think it was a good exercise in party discipline to hear him say "No" on that occasion in Committee, which at once brought to heel all the voters who supported the Amendment. I do not think they changed their minds. [HON. MEMBERS: "We will see."] Yes, we will see. I want to know in what way the Minister's arguments were directed to the Amendment. What does the Amendment seek to do? The right hon. Gentleman spoke about there first of all being an inquiry by the executive council. No inquiry on the part of the executive council is provided for in the Bill.
I am sure that the hon. and learned Gentleman does not want to misinterpret the whole situation. Does he imagine that a responsible body like the executive council will proceed to the dismissal of a doctor without, first of all, examining very carefully any charges made against him?
Whether they examine the matter or not, there is nothing in the Bill which in any way provides for anything in the nature of an inquiry or trial by the executive council. If the executive council thinks there should be a trial it must report the facts to the tribunal. The first stage of a trial is taken by the tribunal and not by the executive council. Let we show the importance of this point. The Minister spoke of an appeal from the executive council to the tribunal and then from the tribunal to the Minister. There are no such appeals. There is one appeal only; from the tribunal, as it stands, to the Minister. There is no appeal in any sense of the word from the executive council, which has held no proper inquiry. Therefore, there can be no appeal. There is merely a report of the facts from the executive council to the tribunal.
The first inquiry is before the tribunal. Suppose the tribunal decides that a doctor should be removed from either one list or a whole number of lists. The statement made by the right hon. Gentleman was that we are not dealing with doctors at large, from the standpoint of the General Medical Council, but from the point of view of the service. I agree, but is it to be doubted that it is a very serious professional matter to a doctor that his name should be removed from a list? What is the position? Suppose a doctor is dismissed. What is the right reserved to him? Is there anything wrong that that doctor should bring an action for wrongful dismissal before the High Court in the ordinary way? The right hon. Gentleman said, perhaps rightly, that he is affording greater protection in the Bill than has hitherto been afforded or contemplated in these cases. That is really no defence. The practice has grown up in recent years of excluding the courts and reserving the right to Ministers alone. That has been a steadily growing practice, among all parties alike. As I listened to the right hon. Gentleman I thought he ought to be the last to defend the old Baconian position in this country. I should have thought that he would not defend that position. He represents a progressive side in the House, defending what? Something which is really a sixteenth century position in its modern form. [HON. MEMBERS: "No."] Oh, yes. In the last resort the Minister is the employer. What will happen as a result of the Bill? Partly as the result of war legislation we have had, as we had before, a tendency among Government Departments to exclude the courts of law, with the result that the liberty of the subject is seriously affected. This is not merely a legal point but a matter of the right of the subject. Let me give an instance of what I mean. I take the Military Service Act. A provision was made therein that a man could, if he chose, be a conscientious objector. Tribunals were set up to try the issue whether he was a genuine conscientious objector or not, but a provision in the Act made the final appeal that to the appeal tribunal and the courts were completely excluded. What was the result?9.15 p.m.
Who presided over the appeal tribunal?
Various chairmen——
Who were they?
They were not lawyers in the appeal tribunal. In the original tribunal, yes. The result would not bear examination. There were a number of tribunals throughout the country, and the decisions of the tribunals on points of law varied considerably from one to another. There was no security that the law was interpreted in one part of the country as in another. As a result of that, it was a matter of luck what happened to the appellant before the appeal tribunal. If there had been an appeal to the courts on points of law, there would have been direction to the tribunals and the liberty of the subject would have been safeguarded. The right hon. Gentleman is running away on a false path when he says that it is putting the judiciary above Parliament. It does not. The powers of the judiciary would be given under this Bill. It is a great pity that the right hon. Gentleman could not see his way to accept this Amendment. It is not a question of whether a man should be restored, but of giving a direction. The issue before the High Court would be, if the doctor chooses, to determine whether he was wrongfully dismissed or not——
But a wrongful dismissal in this case would involve a judgment whether in fact the doctor had been a proper servant.
And are the right hon. Gentleman and his Department afraid to put that issue before the court?
The answer is that the trbunals appointed under the Act are far more competent to determine that matter than a judge of the High Court.
That is the argument of the prerogative of the Executive. There was the old issue of the prerogative of the Crown——
Nonsense.
That was the issue between Coke and Bacon. Now we are getting a new doctrine—the prerogative of the Executive. I hope the House will divide, and I hope to get some support in the interest of the freedom of the subject from the other side of the House, because it is of as much interest to hon. Members opposite as to hon. Members on this side.
The speech of the right hon. Gentleman discloses that divergence of approach to this problem which distinguishes those who are for and those who are against this Amendment. It is clear that we who are in favour of giving the appeal to a court, are looking at it as a disciplinary code, whereas the right hon. Gentleman is concerned only with administrative action. That is all that is actuating the right hon. Gentleman's mind. He is trying to think of the way in which he can facilitate the duties which he has to discharge under this Bill. But although he referred to the possibilities of sentence of professional death, he had no regard to the actualities involved in the action which he may take under this Bill. He fell back on the well-known political trick of destroying a case which was never made against him. The right hon. Gentleman said, "If we do this, what about the miners?" We said nothing about the miners, and there is no question of miners. Here we are dealing with doctors, who have been, to use the Minister's own words, put under sentence of professional death by the tribunal." What the right hon. Gentleman is doing is to deny them the right of appeal to a court of law. That, I well understand, is within the right hon. Gentleman's conception of the way in which things should be run in this country today.
Will the hon. and learned Gentleman reply to the point which the hon. Member below the Gangway dodged? That is, in the event of a person dying℄—
I was coming to that.
I would like to ask the hon. and learned Gentleman℄—
Curiously enough, the right hon. Gentleman has just forestalled me. I was coming to that. It is perhaps interesting to follow the argument of the right hon. Gentleman to its logical conclusion. If one follows that up to the ease he put, which was that of a doctor who had been negligent, his appeal is allowed, and he continues in practice—of course, it is a well known trick of hon. Gentlemen opposite to fall back on the pathetic case of the child dying. But let him have his case. I am giving the right hon. Gentleman his case at its best. He asks, who would be responsible? He is saying that the Minister would be held responsible.
No, he could not be.
Under his own system, he would be held responsible. That is what I am putting to the right hon. Gentleman. On his own argument it will be his responsibility if the child dies. He pursued this argument by asking: "Who would have been responsible for the appointment of the doctor?" and he said, "Well, the court would have been responsible for the appointment of the doctor." That was the right hon. Gentleman's argument. Let me put to him the case of a man who is convicted of murder, who appeals to the court of criminal appeal, and whose appeal is allowed. Within a few days, perhaps, he goes out and commits another murder. On the right hon. Gentleman's argument the persons responsible for that murder are the judges of the Court of Criminal Appeal. That is the logical consequence of the right hon. Gentleman's argument. That is the very case he made. He has said, if you let this man℄—
Has there been a contract of service between the murderer and the population to provide more murders or less murders?
I have no idea what contracts of murder the right hon. Gentleman has entered into. I am trying to deal quite seriously with the argument he made, that if you let this man go to a court, it will be held responsible for the appointment. That is fairly summarising his case, and he put it on the basis that ii an appeal was allowed by a court, it would be the court, or the appellate jurisdiction, which appointed the doctor. That is the way he was putting it. I think it is not unfair to draw the parallel of a person convicted of murder in those circumstances going out and committing another murder. It is precisely the same argument. The right hon. Gentleman also said—and I take him up on this point—that under the Bill as it stands, doctors are being put in a better position than they are in now. That is not true. A recent case has shown that a doctor has been in the position to go to the High Court and get redress from a wrong decision of the first tribunal.
That has nothing to do with it.
It is idle for the right hon. Gentleman to say that has nothing to do with it.
If the hon. and learned Gentleman will permit me to say so, he ought not to confuse the two issues. In that case we have made a clear distinction —I do not know whether the hon. and learned Gentleman was in, but if he was in he should have followed it—between the disciplines of the General Medical Council over the doctor as a doctor—that is for unprofessional conduct—and the disciplines necessary over the service provided by the doctor within the service. Therefore, to raise the case he has mentioned, is obviously done with a view to importing prejudice into the case. It is no argument.
The right hon. Gentleman says there is a clear distinction. I dis- agree. I say there is not a clear distinction. The mere fact that I have been exciting the right hon. Gentleman to spring to his feet at least three or four times shows that he himself is not very happy about this Clause.
indicated dissent.
Perhaps, after that, the right hon. Gentleman will leave me alone to deal with him. It becomes more and more apparent, as the discussion on these matters goes forward, that the right hon. Gentleman has very little regard for the decision of a court of law. I fully appreciate that the ultimate intention of the right hon. Gentleman, not only in the matter of this Bill but probably in the whole of his policy, is to oust the jurisdiction of the courts altogether. I have no doubt that he is working in that direction in this Bill, It is not without significance to note that the right hon. Gentleman—perhaps in the hurry of the moment—when he asked whether it would be right to permit a person who had been before the tribunal, used the words, "to run away and appeal to the court." Let me tell the right hon. Gentleman that people who go to the courts of law in this country are not running away "at all, but are seeking redress in the courts provided for them. They are going to the proper tribunals provided for their protection. That very phrase disclosed the divergence of opinion between those of us who believe in the administration of justice through the courts of law, and those who, like the right hon. Gentleman, do not believe in the administration of justice in that way, but in administration by Government Department. That is what the right hon. Gentleman is doing by the Clause. He is denying the right of appeal to those who have been virtually convicted by a court. Why does the right hon. Gentleman do that? He does it, as he does everything in this Bill, because it is administratively convenient. I wish to take the opportunity of warning the House that it will be a very sad day for this country when the liberty of the subject is subject to administrative convenience.
The hon. and learned Members for Brighton (Mr. Marlowe) and Carmarthen (Mr. Hopkin Morris) are both ornaments of their profession, but although they have introduced into this Debate an element of doubt about the liberty of the subject and the right of going to the law courts, I am perfectly sure they know very well that that is not involved in this issue at all. Under the Clause as it stands it depends purely on representations made by a certain body. Those representations are to go to the tribunal, and it is that tribunal which will hear the facts concerning the representations made. That is the vital point. The evidence as to the conduct of any doctor which will justify his removal, will be evidence of fact, and evidence of fact only, coming before that tribunal. The idea of introducing the right of appeal in cases of that kind is absolutely nugatory, and can only be done for the purpose of making lawsuits. The one thing that the court of appeal cannot do is to interfere with findings on fact. [Laughter.] The right hon. Gentleman cannot dismiss that by a guffaw. That is the actual position. No court of appeal will interfere with findings on facts derived from the evidence that has been given by witnesses before the tribunal. It is the tribunal that has the witnesses before it, not the court of appeal.
Is not the hon. and learned Member confusing an appeal from a county court with an appeal from the High Court to the Court of Appeal?
It seems to me that we are getting into an interesting discussion between lawyers, but I suggest to the House that we should stick to the Amendment.
With respect, Sir, may I say that the Amendment in the name of the hon. and learned Member for Carmarthen directs itself specifically to the question of an appeal to the High Court. Therefore, it is relevant to point out that no appeal to a High Court from a tribunal, on fact, will achieve the purpose the two hon. and learned Members have in mind. All I am saying is that no appeal court will, in those circumstances, reverse the findings of fact by a tribunal, and unless that power is conferred in all cases of appeal, then the appeal becomes otiose, and has nothing whatever to do with the liberty of the subject. In my submission, in a case of this kind, where the matter in issue is one of the conduct of a doctor, which is something known by the locality, and is represented to the tribunal in the locality, it must be obvious to anyone with commonsense that they are the proper body to deal with it.
9.30 p.m.
Some grave principle of law may be involved in a wrongful decision of the tribunal.
That is a medical view.
That is getting away with a cheap gibe.
If there should be some doubt about the matter, then there can be an appeal to the Minister, who can look into the matter fully. If there is any question of law, he has his advisers, and the matter can be dealt with in that way. That is the practical direct way of dealing with this matter, and I suggest to the House that the Amendment should L e supported.
I am sorry to have to repeat to the House an argument which I used upstairs in Committee, but it has not yet been put forward in this discussion, and it is worthy of consideration. If we accept, at its full strength, the argument which the Minister used, it will have been observed that he: based his case on rather airily abolishing the General Medical Council with a flourish of his hand. The time may come when the Minister will be in a position to do that but that time has not yet come. I seriously suggest that the difficulty in which the Minister will find himself is this: At the moment, he bases his case on the argument that one can differentiate between a professional offence, in respect of which the proper court is the General Medical Council, and an offence committed as a servant, in respect of which the proper court is the tribunal and other machinery provided under this Bill. I submit that it will be practically impossible, in 75 per cent. of the cases at any rate, to differentiate between these two.
Let us take a practical case that might very well arise. A doctor refuses to respond to a call to go out urgently to visit a patient. Is that a professional offence? I would say, "Certainly it is," and it is the sort of professional offence of which the General Medical Council have taken account time after time. But clearly it is also an offence in respect of the doctor's terms of service under this Act. It is idle for the Minister to say that in that sort of case one can easily differentiate as to the line of complaint to be followed. The patient may choose to complain to the local executive council, in which case by various stages the appeal finally goes, under the Bill as it now stands, to the Minister. But it is equally possible that the patient desiring to complain may choose to complain to the General Medical Council, in respect of what he regards as a professional offence, and what I am quite certain the General Medical Council would regard as a professional offence. Then, if he is dissatisfied with the decision of the General Medical Council, it is open to him to go to the High Court.No.
With great respect, it is open to him. At any rate, there are a number of people who have succeeded in taking their appeal to the High Court. If hon. Members choose to take another Act, there is the Pharmacy and Poisons Act, 1933, which provides disciplinary machinery for chemists, and quite clearly the appeal goes to the High Court which can re-hear a case. In the case of dentists, similarly, the appeal can go to the High Court. The case which I make in favour of this Amendment is that when y, have two channels of complaint, both equally available to the person who is making the complaint, one of them finishing in the High Court and the other in the Minister, we have a thoroughly unsatisfactory state of affairs. It is something which is quite out of balance and entirely dependent upon the choice of those two roads as to which is the final court of appeal. In those circumstances, I say the only tidy and just way of arranging the channel of complaint is to make those two roads lead to one place, namely, the High Court, so that ultimately whichever road happens to be chosen by the complainant, the result is the same and the case goes to the High Court for decision.
I am very sorry indeed that I shall have to vote against the Government or abstain from voting on this issue if it goes to a Division. I do not want to do that because I want this Bill very badly. I agree with every aspect of the Bill except this issue. I know of nothing in the Labour Party policy—I have been a Member of the Labour Party and the Fabian Society since I went to university in Glasgow in 1904—which tells me that an aggrieved person tried by a lower court should not have the right of every citizen to appeal to the High Court with trained judges accustomed to the sifting and proper adjudication of evidence. This Clause gives the Minister, through his tribunal, power—[Interruption]. I do not know whether the doctor is sanguineous or not, but I do not like the particular term which the Minister used because it is a repartee which can be thrown to and fro. It is a boomerang. I do not want to refer to red blood corpuscles. This tribunal can decide whether a doctor should be excluded if he breaks his contract or if he does not give good national service. I agree that some doctors might not be doing their job on certain occasions, just in the same way as some Ministers. I have known some Ministers in the past who have not done their job. I know men in other professions who frequently break their contracts and do not seem to be doing their job properly.
Take the case of a doctor making two, three or four mistakes. Under this Clause that doctor, by the decision of the tribunal, will be excluded from the list in which he practices and also from any other list from which any executive council wishes to keep him. I suggest that in these cases the aggrieved person should be allowed to have the right, which every common citizen should have, of appealing to a higher court. It is only the aggrieved person who thinks he has a very good case who will appeal. He would he better off to go before an experienced judge accustomed to weighing evidence over a period of years. I think that where a man's professional livelihood is involved, no progressive Government should refuse that man the right of appeal against a decision which he feels is unjust. He appeals from the judgment of the tribunal, if the tribunal has decided that he has not the professional proficiency necessary in order to remain on any list in his district. [Interruption.] Well, he can go to the Minister, too. If I am wrong, I will sit down, but I have been attending to this Bill for a long time. I have devoted my life to the policy of the Labour Party with regard to this Health Bill. I have been doing it for a considerable number of years—even before the present Minister came into Parliament—and I think I have a right to speak on this subject. As the matter stands, with regard to an aggrieved doctor, a decision against whom has been made that he cannot remain on his list, or on any other list devised by the executive council, I am going to stand up for my principles, and say that that man, in my view, should have the right to appeal to a higher court.It is obvious that this is an issue of first-class importance and one on which the Minister himself feels strongly. Indeed, it is the fact that, in the Committee, the argument appeared to go against him, with the result that the right hon. Gentleman was placed in a somewhat difficult position. In order to make clear what I understand the position to be, in contrast to the observations which the Minister has made, both in speeches and observations across the Floor of the House, may I say what I believe is the issue which we are discussing? This arises in respect of the disqualification of practitioners. I heard an observation thrown out that anybody can go to the courts. This is a question of the procedure under which practitioners may be disqualified, and the whole question will be——
It probably was a slip, but I am sure the right hon. and learned Gentleman does not really mean disqualified.
The Minister says so in the marginal note to his Bill.
But not in the way the word "disqualified" is used normally, but in another connection. It means removed from the list of the executive council.
It is so ambiguous. I say that I am using it in the meaning which it has in the Bill, and not in the sense of what is done by the General Medical Council. The right hon. Gentleman hardly has the right to interrupt me when I am using the word which he himself uses in his own Bill and in this very Clause. The marginal note to this Clause is:
and what is meant there is the prohibition of inclusion either in a particular list of doctors or of any list of doctors in the general medical service. The question we are discussing is what is to be the procedure when a medical practitioner, who has undertaken to provide a general medical service—I again use the wording of the Bill—has a complaint made against him with regard to that undertaking and the performance of those services. On the previous Amendment, the Minister told us that any such medical practitioner, before he could be disqualified in that sense, would be entitled to notice of the charges made against him—charges of omission or commission. 9.45 p.m. May I now interpose an observation or two about the most fallacious and erroneous remarks made by the hon. and learned Member for Gloucester (Mr. Turner-Samuels)? We are here considering an Amendment by the right hon. Gentleman introducing an appeal, and the hon. and learned Gentleman thought it right to rise, on his responsibility, no doubt, both as a Member of this House and as one of His Majesty's Counsel, and tell the House that any right of appeal was perfectly nugatory or otiose, and that on the Minister's Amendment to introduce an appeal. It was apparently intended to be an argument—that is the only sense I can give it, though it is not much sense—that an appeal to the Minister would be useful, but that an appeal to the court would be useless." Disqualification of practitioners."
The right hon. and learned Gentleman knows very well that it was nothing of the sort. I was talking to the proposed Amendment in the name of the hon. and learned Member for Carmarthen (Mr. Hopkin Morris) and was not referring in any way to the proposed appeal to the Minister. Indeed, I made it one of my arguments that there was an appeal to the Minister, and the right hon. and learned Member for North Croydon (Mr. Willink) must have heard me say so.
I think the Minister must be more and more confused because the whole question is whether there will be an appeal to the Minister. The hon. and learned Member for Gloucester says that there is one already, but I would comment on his observation that the Court of Appeal cannot interfere with a decision of fact. I do not think there is another member of the legal profession who would make such an astounding observation. Another observation was that these appeals would be delightfully local—where there would, no doubt, be local prejudice. That is entirely erroneous. There is no provision that hearings shall be local; there is one central tribunal and no provision for it to go on circuit.
I did not know that hon. Gentlemen opposite disliked novel situations. They are here creating a novel situation with regard to the whole of this profession, and the question we are considering is what are to be the rights of general practitioners who, some hon. Gentlemen opposite hope, will attend as soon as possible to 100 per cent. of the population to the exclusion of private practice to the maximum possible extent. In what circumstances and by what machinery are they to be taken off any or every list? How can the proceedings arise? Any person may make representations to the tribunal, which will consist of one lawyer, barrister or solicitor in the chair, one person selected by the Minister, and one professional gentleman out of a panel of professional people. That tribunal may make a grievous mistake with regard to the evidence and may order that a medical practitioner shall no longer appear on any list in the whole country. What are to be that practitioner's rights in those circumstances? We say that when procedure of that sort is adopted, with a court of first instance which is two-thirds non-legal and untrained in the law of evidence, there ought to be an appeal to a court of law. How is the Minister going to hear those appeals? [HON. MEMBERS: "Where is he now?"] He has gone away while we are discussing this important point. The Minister quite rightly said that, in a sense, we are discussing on this Amendment what we were discussing on the last Amendment. He did not complain of that fact, and, consequently, we are discussing a matter concerning issues which will come before such a tribunal and the apellant tribunal, whatever it may be—the Minister or the judge—and those are now going to be issues of fact. They are going to be issues, not whether the Minister dislikes the doctor, nor whether he has the wrong political views, but whether, in fact, he has been guilty of omissions or commissions in breach of his undertaking to render general medical service. What is the first objection of the Minister? The Minister says, "These doctors are the instruments of this service, and I cannot take responsibility for there remaining in the service doctors whom the High Court judge has decided have not been guilty of any breach of their undertakings." Let me expose the extraordinary character of that argument, because the Minister is prepared to keep as instruments in his service doctors of whom that has been found by the Tribunal. The Minister himself cannot launch an appeal to himself from the Tribunal. If the Tribunal has dismissed the charges the Minister has to keep the doctor, hut he says he is not willing to keep the doctor if the doctor is acquitted by a High Court judge. Was there ever such an amazing argument? How ridiculous becomes this fanciful story of the poor little child who dies a fortnight after the doctor has been acquitted of the charges that have been made against him. Then the Minister went on to say that a High Court judge could not decide the issue. Those were his words. The right hon. Gentleman said, there being substantial charges made against the doctor, a High Court judge could not decide the issue whether the doctor had failed to give the service which he had promised to give, but that the Tribunal could so decide. The issue is exactly the same for each, and it amazed me to hear the Minister say that this tribunal could decide the issue, but that the High Court judge could not. I simply could not believe my ears when I heard that observation.I cannot believe my ears now. When, in his discussions on these matters, did the right hon. and learned Gentleman make up his mind that it was desirable to appeal to the High Court, or even to have a tribunal?
I can still hardly believe my ears when I hear that interruption. The right hon. Gentleman knows perfectly well that nothing that I did proceeded beyond the stage of a White Paper which described itself as an outline of the service. Matters of procedure of this kind, of course, had not been considered in detail; and, if I had not ever thought of an appeal to a tribunal, is that a relevant matter when we are discussing what the appeal should be in this Bill? A more irrelevant observation or interruption I have never heard.
May I now go on to the Minister's next-point? The Minister said that if there was an appeal to the High Court judge from this tribunal, that would mean that the judiciary was overriding the Legislature. My hon. and learned Friend the Member for Carmarthen (Mr. Morris) answered that point most satisfactorily. The true position is that Parliament, in enacting statutes, should not make provisions which will allow the Executive to get rid of its instruments, when getting rid of them will bring ruin upon them. It is the responsibility of Parliament to Ensure that the judiciary in the future, as in the past, should control the Executive in proper cases. My definition of "proper cases" for present purposes would be "in all cases where there is a justiciable issue "—namely, an issue of fact triable by a tribunal. I was also surprised that the Minister, some of whose phrases we
Division No. 269.]
| AYES.
| [9.56 p.m.
|
| Adams, Richard (Balham) | Corbet, Mrs. F. K. (Camb'well, N.W.) | Greenwood, Rt. Hon. A. (Wakefield) |
| Allen, Scholefield (Crewe) | Corlett, Dr. J. | Greenwood, A. W. J. (Heywood) |
| Allighan, Garry | Corvedale, Viscount | Grenfell, D. R. |
| Alpass, J. H. | Crawley, A. | Grey, C. F. |
| Anderson, A (Motherwell) | Crossman, R. H. S. | Grierson, E. |
| Anderson, F. (Whitehaven) | Daggar, G. | Griffiths, D. (Rother Valley) |
| Attewell, H. C. | Daines, P. | Griffiths, Rt. Hon. J. (Llanelly) |
| Attlee, Rt. Hon. C. R. | Davies, Ernest (Enfield) | Griffiths, W. D. (Moss Side) |
| Austin, H. L. | Davies, Harold (Leek) | Guest, Dr. L. Haden |
| Awbery, S. S. | Davies, Haydn (St. Pancras, S.W.) | Gunter, Capt, R. J. |
| Ayles, W. H. | Davies, R. J. (Westhoughton) | Guy, W. H. |
| Ayrton Gould, Mrs. B. | Davies, S. O. (Merthyr) | Haire, Flt.-Lieut. J (Wycombe) |
| Bacon, Miss A. | Deer, G. | Hale, Leslie |
| Baird, Capt. J. | Delargy, Captain H. J. | Hardy, E. A. |
| Balfour, A. | Diamond J. | Harrison, J. |
| Barnes, Rt. Hon. A. J. | Dobbie, W. | Hastings, Dr. Somerville |
| Barstow, P. G. | Dodds, M. N. | Haworth, J. |
| Barton, C. | Donovan. T. | Henderson, A. (Kingswinford) |
| Battley, J. R. | Driberg, T. E. N. | Henderson, Joseph (Ardwick) |
| Bechervaise, A. E. | Dugdale, J. (W. Bromwich) | Harbison, Miss M. |
| Berry, H. | Dumpleton, C. W. | Hewitson, Capt. M. |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Durbin, E. F. M. | Hobson, C. R. |
| Bing, G. H. C. | Dye, S, | Holman, P. |
| Blackburn, A. R. | Ede, Rt. Hon. J. C. | Holmes, H. E. (Hemsworth) |
| Blyton, W. R. | Edwards, Rt. Hon. Sir C. (Bedwellty) | Horabin, T. L. |
| Bowles, F. G. (Nuneaton) | Edwards, John (Blackburn) | House, G. |
| Braddock, Mrs. E. M. (L'p'l, Exch'ge) | Edwards. N. (Caerphilly) | Hoy, J. |
| Braddock, T. (Mitcham) | Edwards. W. J. (Whitechapel) | Hubbard, T. |
| Brook, D. (Halifax) | Evans, John (Ogmore) | Hudson, J. H. (Ealing, W.) |
| Brooks, T. J. (Rothwell) | Evans, S. N. (Wednesbury) | Hughes, Hector (Aberdeen, N.) |
| Brown, George (Belper) | Ewart, R. | Hughes, H. D. (W'lverh'plon, W.) |
| Brown, T. J. (Ince) | Fairburst F. | Hutchinson, H. L. (Rusholme) |
| Bruce, Maj. D. W. T. | Farthing, W. J. | Hynd, H. (Hackney, C.) |
| Buchanan, G. | Fletcher, E. G. M. (Islington, E.) | Irving, W. J- |
| Burden, T. W. | Follick, M. | Janner, B. |
| Burke, W. A. | Foot, M M. | Jeger, G. (Winchester) |
| Butler, H. W (Hackney, S.) | Forman, J. C. | Jeger, Dr. S. W. (St. Pancras, S.E.) |
| Callaghan, James | Foster, W (Wigan) | John, W. |
| Chamberlain, R. A. | Fraser, T. (Hamilton) | Jones, D. T. (Hartlepools) |
| Champion. A. J. | Freeman Maj. J. (Watford) | Jones, J. H. (Bolton) |
| Chater, D. | Freeman Peter (Newport) | Jones, P. Asterley (Hitchin) |
| Chetwynd, Capt. G. R, | Gaitskell H. T. N. | Keenan, W. |
| Cluse, W. S. | Ganley, Mrs. C. S. | Kendall, W. D. |
| Cobb, F. A. | Gibbins, J. | Kenyan, C. |
| Cocks, F. S. | Gibson, C. W. | Key, C. W. |
| Collick, P. | Gilzean, A. | King, E. M. |
| Collindridge, F. | Glanville J. E. (Consett) | Kinghorn, Sqn.-Ldr. E. |
| Collins, V. J. | Gooch, E. G. | Kinley, J. |
| Comyns, Dr. L. | Goodrich, H. E. | Kirby, B. Y. |
| Cook, T. F. | Gordon-Walker, P. C. | Kirkwood, D |
admire, repeated a phrase that he used in the course of the Committee stage—a phrase which I thought he would like to forget—namely, that this would be judicial sabotage of Socialist legislation. The whole question here is, there being an issue whether or not a doctor has fulfilled his contract, which issue has been brought before a tribunal, two-thirds of which is lay and untrained, either by an executive council or any other person, whether that doctor is to have a right of appeal to the court or merely to somebody appointed by the Minister, for all we know equally untrained. We say that it is wrong, and we shall divide on this Amendment.
Question put, "That those words be there inserted in the Bill."
The House divided: Ayes, 296; Noes, 129.
| Lang, G. | Orbach, M. | Stross, Dr. B. |
| Lavers, S. | Paget, R. T. | Stubbs, A. E. |
| Lawson, Rt. Hon. J. J. | Paling, Rt. Hon. Wilfred (Wentworth) | Summerskill, Dr. Edith |
| Lee, F. (Hulme) | Paling, Will T. (Dewsbury) | Swingler, S. |
| Lee, Miss J. (Cannock) | Palmer, A. M. F. | Taylor, H. B. (Mansfield) |
| Levy, B. W | Pargiter, G. A. | Taylor, R. J. (Morpeth) |
| Lewis, A. W. J. (Upton) | Parker, J. | Taylor, Dr. S. (Barnet) |
| Lewis, J. (Bolton) | Parkin, B. T. | Thomas, Ivor (Keighley) |
| Lewis, T. (Southampton) | Paton, Mrs. F. (Rushcliffe) | Thomas, I. O. (Wrekin) |
| Lindgren, G. S. | Paton, J. (Norwich) | Thorneycroft, Harry (Clayton) |
| Logan, D. G. | Pearson, A. | Timmons, J. |
| McAdam, W. | Peart, Capt. T. F. | Titterington, M. F. |
| McAllister, G. | Perrins, W. | Tolley, L. |
| McEntee, V. La T. | Platts-Milts, J. F. F. | Tomhnson, Rt. Hon. G. |
| McGhee, H. G. | Poole, Major Cecil (Lichfield) | Turner-Samuels, M. |
| McGovern, J. | Popplewell, E. | Ungoed-Thomas, L. |
| Mack, J. D. | Portor, E. (Warrington) | Usborne, Henry |
| McKay, J. (Wallsend) | Porter, G. (Leeds) | Vernon, Maj. W. F. |
| Mackay, R. W. G. (Hull. N.W.) | Price, M. Philips | Viant, S. P. |
| Maclean, N, (Govan) | Pritt, D. N | Walkden, E. |
| McLeavy, F. | Pryde, D. J. | Walker, G. H |
| MacMillan, M. K. (Western Isles) | Pursey, Cmdr. H. | Wallace, G. D. (Chislehurst) |
| Macpherson T. (Romford) | Randall, H. E. | Wallace, H. W. (Walthamstow, E.) |
| Mamwaring, W. H. | Ranger, J. | Warbey, W. N. |
| Mallalieu, J P W. | Rankin, J. | Walkins, T. E. |
| Mann, Mrs. J. | Rees-Williams, D. R. | Watson, W. M. |
| Manning, C. (Camberwell, N.) | Reeves, J. | Weitzman, D. |
| Manning, Mrs. L. (Epping) | Reid, T. (Swindon) | Wells, P. L. (Faversham) |
| Marquand, H. A. | Rhodes, H. | Wells, W. T. (Walsall) |
| Marshall F. (Brightside) | Richards, R. | Whiteley, Rt. Hon. W. |
| Mathers, G. | Ridealgh, Mrs. M. | Wigg, Colonel G. E. |
| Mayhew, C. P. | Robens, A. | Wilcock, Group-Capt. C. A. B. |
| Medland, H. M. | Roberts, Goronwy (Caernarvonshire) | Wilkes, L. |
| Messer, F. | Robertson, J. J. (Berwick) | Willey, F. T. (Sunderland) |
| Mikardo, Ian | Sargood, R. | Willey, O. G. (Cleveland) |
| Millington, Wing-Comdr. E. R. | Scott-Elliot, W. | Williams, J. L. (Kelvingrove) |
| Monslow, W. | Shackleton, Wing-Cdr. E. A. A. | Williamson, T. |
| Moody, A. S. | Sharp, Lt.-Col. G. M. | Willis, E. |
| Morley, R. | Shawcross, C. N. (Widnes) | Wills, Mrs. E. A. |
| Morris, P. (Swansea, W.) | Shurmer, P. | Wilson, J. H. |
| Mort, D. L. | Simmons, C. J. | Wise, Major F. J. |
| Murray, J. D. | Skinnard. F. W. | Woodburn, A |
| Nally, W. | Smith, C. (Colchester) | Woods, G. S. |
| Naylor, T. E, | Smith, Ellis (Stoke) | Wyatt, Maj. VI. |
| Neal, H. (Claycross) | Smith, S. H. (Hull, S.W.) | Yates, V. F. |
| Nichol, Mrs. M. E. (Bradford, N.) | Smith, T. (Normanton) | Zilliacus, K. |
| Nicholls. H. R. (Stratford) | Snow, Capt. J. W | |
| Noel-Buxton, Lady | Sorensen, R. W. | TELLERS FOR THE AYES:
|
| O'Brien, T. | Sparks, J. A. | Captain Michael Stewart and |
| Oldfield, W. H. | Stamford, W. | Mr. Hannan. |
NOES.
| ||
| Baldwin, A. E. | Glyn, Sir R. | Maclay, Hon. J. S. |
| Barlow, Sir J. | Gomme-Duncan, Col. A. G. | Maclean, Brig. F. H. R. (Lancaster) |
| Beamish, Maj. T. V. H. | Grimston, R. V. | MacLeod, Capt. J. |
| Beechman, N. A. | Hannon, Sir P. (Moseley) | Macpherson, Maj. N. (Dumfries) |
| Boles, Lt.-Col. D. C. (Wells) | Hare, Hn. J. H. (Woodb'ge) | Maitland, Comdr. J. W. |
| Bossom, A. C. | Headlam, Lieut.-Col. Rt. Hon. Sir C | Manningham-Buller, R. E. |
| Bowen, R. | Henderson, John (Cathcart) | Marlowe, A. A. H. |
| Bower, N. | Hinchingbrooke, Viscount | Marples, A. E. |
| Buchan-Hepburn, P. G. T. | Hogg, Hon. Q. | Marshall, D. (Bodmin) |
| Byers, Lt.-Col. F. | Holmes, Sir J. Stanley (Harwich) | Marshall, S. H. (Sutton) |
| Carson, E. | Hope, Lord J. | Medlicott, F. |
| Challen, C. | Howard, Hon. A, | Mellor Sir J. |
| Clarke, Col. R. S. | Hutchison, Lt.-Cm. Clark (E'b'rgh W.) | Molson, A H E. |
| Clifton-Brown, Lt.-Col. G. | Hutchison, Col. J. R. (Glasgow, C.) | Morris, Hopkin (Carmarthen) |
| Corbett, Lieut.-Col. U. (Ludlow) | Jarvis, Sir J. | Morris-Jones, Sir H. |
| Crookshank, Capt. Rt. Hon. H. F C. | Jeffreys, General Sir G. | Morrison, Rt. Hn. W. S. (Cirencester) |
| Crosthwaite-Eyre, Col. O. E. | Jennings, R. | Mullan, Lieut. C. H. |
| Crowder, Capt. John E. | Keeling, E. H. | Neven-Spence, Sir B |
| Cuthbert, W. N. | Kerr, Sir J. Graham | Orr-Ewing, I. L. |
| Davidson, Viscountess | Lambert, Hon. G. | Osborne, C. |
| Davies, Clement (Montgomery) | Langford-Holt, J. | Peto, Brig. C. H. M |
| Dodds-Parker, A. D. | Legge-Bourke, Maj. E. A. H. | Pickthorn, K. |
| Dower, Lt.-Col. A. V. G. (Penrith) | Lennox-Boyd, A. T. | Poole, O. B. S. (Oswestry) |
| Dower, E. L. G. (Caithness) | Lindsay, K. M. (Comb'd Eng. Univ.) | Prescott, Stanley |
| Drayson, Capt. G. B. | Linstead, H. N. | Prior-Palmer, Brig. O. |
| Fleming, Sqn-Ldr. E. L | Lipson, D. L. | Raikes, H. V. |
| Fox, Sqn.-Ldr. Sir G | Lloyd, Maj. Guy (Renfrew, E.) | Reid, Rt. Hon. J. S. C. (Hillhead) |
| Fraser, Maj. H. C. P. (Stone) | Lloyd, Selwyn (Wirral) | Roberts, Emrys (Merioneth) |
| Gage, C. | Lucas-Tooth, Sir H. | Roberts, Maj. P. G. (Ecclesall) |
| Galbraith, Cmdr. T. D. | MacDonald Sir M. (Inverness) | Roberts, W. (Cumberland, N.) |
| George, Lady M. Lloyd (Anglesey) | Mackeson, Brig. H. R. | Robinson, Wing-Comdr. Roland |
| Glossop, C. W. H. | McKie, J. H. (Galloway) | Sanderson, Sir F. |
| Scott, Lard W. | Sutcliffe, H. | White, Sir D. (Fareham) |
| Shephard, S (Newark) | Taylor, C. S. (Eastbourne) | White, J. B. (Canterbury) |
| Shepherd, W. S. (Bucklow) | Taylor, Vice-Adm. E. A. (P'dd'tn, S.) | Williams, C. (Torquay) |
| Smiles, Lt.-Col. Sir W. | Teeling, William | Williams, Gerald (Tonbridge) |
| Smith, E. P. (Ashford) | Thornton-Kemsley, C. N. | Willink, Rt. Hon. H. U. |
| Smithers, Sir W | Thorp, Lt.-Col. R. A. F. | Willoughby de Eresby, Lord |
| Snadden, W M. | Turton, R. H. | Winterton, Rt. Hon. Earl |
| Spearman, A. C. M. | Vane, W. M. F. | York, C |
| Spence, H. R. | Wadsworth, G. | Young, Sir A. S. L. (Partick) |
| Strauss, H. G. (English Universities) | Wakefield, Sir W. W | |
| Stuart, Rt. Hon. J. (Moray) | Ward, Hon. G. R. | TELLERS FOR THE NOES:
|
| Studholme, H. G. | Wheatley, Colonel M. J | Commander Agnew and |
| Major Conant. |
I beg to move, in page 36, line 30, after "Tribunal," to insert "or the Minister."
We have just given the doctor the right of appeal from the tribunal to the Minister. This gives him the right of appeal to the Minister for the removal of disqualification.Amendment agreed to.
Further Amendment made: In page 38, line 5, after "Tribunal," insert "or the Minister."—[ Mr. Key.]
Clause 47—(Decision Of Disputes)
I beg to move, in page 39, line 30, to leave out from "Minister," to the end of line 31.
This removes from the Clause the appointment of a person to act on behalf of the Minister, and leaves the Minister to deal with the matter himself.This is not a point of primary importance, but it is one on which I hope the Minister will think again. He is now taking power to deal himself with disputes arising between members of the public receiving services and the executive councils, and the health authorities. He is to decide himself—no doubt, through one of his officers; and he has not told us anything about the method by which he is going to reach that decision. Now, I quite agree that it is a waste of time to have a public hearing, either if the matter is of such trumpery importance that the Minister can say that it is frivolous or unimportant, or if the parties do not want one. But, after all, many of these disputes are of great importance to the parties, and they are not easy. I have reason to know that when one can have a hearing, even of an informal character, before a person appointed to hear the parties, the parties go away very much better satisfied; because they feel that somebody has listened to them, and has made a report on the subject, and that justice has been done.
The one thing the people of this country do not like is having a case decided against them without their having had a fair chance of putting their points across the table to someone who is bound to listen to them. That is a very different thing from sending a letter to be read by somebody in an office. That does not give the same satisfaction to a person, as the hearing of his case across the table. I hope the Minister will assure us that he will make administrative arrangements, so that, whenever there is an issue of any importance at all, and whenever a party desires a hearing, the Minister will appoint somebody to hear the evidence and to hear the representations of the parties, so that they may know that their points have been dealt with properly, and not merely placed on a file in an office. I hope he will give that assurance.The right hon. and learned Gentleman is entitled to ask for an assurance here, but it is already on record. The Amendment I am moving is in fulfilment of a promise I made in Committee. I gave the assurance he asked for, and it is on record in HANSARD.
Amendment agreed to.
Clause 49— (Transfer To Minister Of Certain Functions Of Board Of Control)
I beg to move, in page 40. line 27, after '' Control," to insert:
This Amendment deals with two State institutions for mental defectives of violent or dangerous propensities managed by the Board of Control. The properties are partly held by the Prison Commissioners and by the Minister of Works. It is thought necessary that they should be wholly vested in the Minister." the Minister of Works or the Prison Commissioners. "
Amendment agreed to
Further Amendment made: In page 40, line 29, leave out "them," and insert "Board of Control."—[ Mr. Key.]
Clause 54—(Payments To Regional Hospital Boards, Boards Of Governors, Executive Councils And Other Bodies)
I beg to move, in page 44, line 39, after "defrayed," to insert:
I believe that the object behind this Amendment is in line with the intentions of the Minister, namely, that in Subsection (2) there should be words inserted which would create the position that the hospital management committees pay their own bills, and do not have to send all their bills to be paid by the regional hospital boards. As the Clause stands, it provides that all the expenditure of the hospital management committees—of course, the hospital management committees will be responsible bodies managing very large hospitals or groups of hospitals—shall be defrayed by the regional hospital boards. Is that really intended? I should have thought that the meaning was that cheques would have to be written out by the regional hospital boards. We should like to see these words inserted so that expenditures would be defrayed by hospital management committees out of sums paid to them for that purpose. The Minister has acceded to representations made by us that management committees should be given some independence and an autonomous life of their own. It seems to us that this is in line with the description of the proposals given in Committee." by that Committee out of sums paid to them for that purpose."
These words are unnecessary. The statutory position is that the regional boards are the authorities responsible to the Minister, and the management committees are the agents of the regional boards. It is, therefore, necessary to retain the language as it is here in the Bill, but, of course, regulations will be made to enable management committees in practice to do what the right hon. and learned Gentleman wants.
On that assurance, I beg to ask leave to withdraw the Amendment. Amendment, by leave, withdrawn.
Clause 55—(Accounts Of Councils Of County Boroughs, Regional Hospital Boards, Boards Of Governors And Executive Councils)
I beg to move, in page 45, line 24, at the end, to insert, "as such an authority."
This Amendment is designed to make plain that the accounts of councils of county boroughs to be subject to district audit are only those accounts which deal with local health authorities.Amendment agreed to.
Clause 59—(Power Of Regional Hospital Boards And Boards Of Governors To Accept Gifts)
I beg to move, in page.48, line 19, after "hospital," to insert:
This Amendment carries out the promise to allow hospital management committees to receive gifts." and a Hospital Management Committee."
Amendment agreed to.
Further Amendments made:
In page 48, line 22, after "Board," insert "or Committee."
In line 28, after "Board," insert "or Committee."
Clause 64—(Qualifications, Remuneration And Conditions Of Service Of Officers)
Amendment made: In page 50, line 5, after "last," insert "but one."—[ Mr. Key.]
Clause 65—(Superannuation Of Officers)
10.15 p.m.
I beg to move, in page 51, line 19, to leave out paragraph (g).
This Clause deals with superannuation benefits, and paragraph (g) reads:These are rather extraordinary words to insert in an Act of Parliament. I can think of no other example where such wide discriminatory powers have been given to a Minister. Already, in Clause 65, paragraph (a), it is laid down that the Minister may make regulations giving different superannuation benefits to different persons and also providing for a recovery of contributions. In paragraph (i) he takes a wide discretion for determination of all questions arising under the regulations. In my submission, these words are quite unnecessary. That is a terminology that the Minister often uses in dealing with an Amendment, and I think the best way for inc is to move the Amendment in order that the Minister may give an explanation, and may be able to suggest some other form of words to meet any proviso he has." For making special provision for special classes of persons."
I beg to second the Amendment.
I admit that the powers are wide, but I think that hon. Members will agree, when I describe what they are, that they are necessary. There is a very large variety of circumstances existing in voluntary hospitals. There will be some people attached to the hospitals who will have superannuation rights. There will also be a large number of people who have reasonable expectation of superannuation rights, but who, nevertheless, have not contractual superannuation rights. It is intended to provide for people in those circumstances, and that is the reason why this language is used.
On that explanation, I beg to ask leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Clause 67—(Consequential Provisions On Transfer Of Functions)
Amendments made:
In page 54, line 7, at the end, insert:
" to such extent as appears to the Minister to be necessary for the purposes of such transfer.''
In line 22, at the end, insert:—
"to such extent as appears to the Minister to be necessary for the purposes of such transfer."— [Mr. Key.]
Clause 68—(Inquiries)
Amendment made: In page 55, line 3, at the end, insert:
Provided that no local authority shall be ordered to pay costs under subsection (4) of that section in the case of any inquiry unless it is a party thereto."—[Mr. Key.]
Clause 71—(Miscellaneous Administrative Matters)
Amendment made: In page 55, line 31, leave out paragraph (d). [ Mr. Key.]
Clause 72—(Regulations And Orders)
I beg to move, in page 55, line 43, after "Act," to insert:
This Amendment fulfils a promise given in Committee that the Minister would make special orders determining the areas of the regional boards and separate orders for the constitution of regional boards." and such of the orders made under Sub section (1) of Section eleven of this Act as determine the areas for which Regional Hospital Boards are to be constituted."
Amendment agreed to.
Clause 76—(Interpretation)
Amendment made: In page 59, line 33, after "hospital," insert "by an order in force."—[ Mr. Key.]
Third Schedule—(Regional Hospital Boards, Hospital Management Committees And Boards Of Governors Of Teaching Hospitals)
I beg to move, in page 64, line 25, at the end, to insert:
In moving this Amendment with regard to the hospital management committees, I am appealing to the Minister to reconsider this point in the hope that his view may have changed upon it. It is an obvious criticism of this Bill as a whole, applicable in these particular instances, that there is an immense concentration of power in the hands of the Minister, or of his instruments, as he has called them. The hospital management committees, as this stands, are entirely nominated by the regional hospital board. The regional hospital board is an organisation which covers an enormous area—we do not know how large because the Minister has not yet told us what his regions are going to be or even on what principles he is going to determine their boundaries. We suggest—and I hope that the Minister is prepared to reconsider this matter—that it would give an added personality to the hospital management committees, when they have appointed up to a number of 20 or 30 persons, if they were free to add to their number to this very limited extent. They will discover, in the course of their work, people who are showing a great interest in the hospitals of the town or of the county. There can be no place for them on the committee, and what could be less harmful and on the other hand more advantageous, than to allow the advantage to the hospital management committee of adding three persons to their number from citizens whom they have discovered to be useful in these affairs, even before any vacancy has occurred? All of us in our experience have known very valuable instances of co-option and this seems to be a very good occasion for it, Earlier, the Minister suggested that a person who was co-opted always felt in an awkward position and he had to please those who had co-opted him or they would not co-opt him again. That is not an argument which impressed me at any rate. He also said that these valuable people to whom we are referring could always serve on a sub-committee. Why should they be relegated to serving on sub-committees? Why, if they are valuable to the hospital management committee, should they not under the constitution of this Bill be added to the numbers of that of the management committee in the way which we suggest? The old argument against co-option, of bringing non-elected persons on to an elected body, which is frequently advanced with regard to other examples of this question, does not apply here. This is a very small addition to those chosen as a hospital management committee, and these co-opted persons would be considered useful additions to the number. I think the Minister should reconsider the matter and give way on this small point." A Hospital Management Committee shall have power to co-opt not more than three persons to he members of the Committee."
This question was exhaustively considered in Committee, and the reasons why I cannot accept it now, are similar to those which I gave upstairs. The hospital management committee is appointed, and is responsible to the Regional Board for the discharge of its functions and the Regional Board is responsible to the Minister. It does not seem to be necessary in the exercise of the functions of the management committee that there should be co-opted members. Obviously there are people in the vicinity who always have some special interest and who do not want to take part in the general work of the management committee, but they have got an interest in some special object of service. In those cases the hospital management committee will appoint subcommittees and on those sub-committees the co-opted persons can serve. It seems to me a perfectly reasonable piece of machinery, and I do not see why one should attach pedantic importance to the management committee having the right of co-option when using the services of interested persons for the specialized work in which they themselves take a particular interest on sub-committees.
I am bound to say I am unimpressed by the Minister's argument, but I do not want to take up the time of the House further on the subject. I am sorry the Minister has not acceded to my request.
Amendment negatived.
I beg to move, in page 64, line 45, after "hospitals," to insert:
This Amendment is to empower these hospital management committees to be corporate bodies, with power to hold land." and Hospital Management Committees."
Amendment agreed to.
I beg to move, in page 65, line 18, at the end, to insert:
This Amendment is to ensure that members who serve on the committee and receive remunerative advantage for loss of time, will not be disqualified from being elected or voting as Members of the House of Commons." 4 It is hereby declared, for the avoidance of doubt, that a member or officer of any such body or committee is not, by reason of his membership or office, rendered incapable of being elected, or of sitting and voting, as a Member of the House of Commons."
Amendment agreed to.
Fourth Schedule—(Provisions As To Local Health Authorities)
I beg to move, in page 67, line 2, after "may," to insert:
This Amendment is to give local health committees control over the composition of the sub-committees." subject to any restrictions imposed by the local health authority."
Amendment agreed to.
Fifth Schedule—(Executive Councils)
Amendments made:
In page 67, line 20, leave out Dental Practitioner," and insert "Local Dental."
In line 22, after "the," insert "Local."
In page 68, line 9, leave out "Dental Practitioner," and insert "Local Dental."
In line 10, after "the," insert "Local."
In line 17, at the end, insert:
" 6. It is hereby declared, for the avoidance of doubt, that a member or officer of any such Council or committee is not, by reason of his membership or office, rendered incapable of being elected, or of sitting and voting, as a Member of the House of Commons."—[Mr. Key.]
Seventh Schedule—(Constitution Of Tribunal)
I beg to move, in page 69, line 5, to leave out "six," and to insert "seven."
Perhaps it may be for the convenience of the House if I discuss this Amendment and the two following Amendments in my name, together. The object of this Amendment is to meet a difficulty which has been experienced by the dental profession, which is feeling a little concerned about the position of some dental practitioners under the provision of this Schedule. There is provision in this Schedule for a panel from which an appropriate tribunal for each profession is to be drawn. It will be noticed that in the case of opticians two classes are provided for—the optician engaged in sight testing, and the optician engaged in dispensing. The Amendment seeks to provide for the representation of the two classes of dental practitioner. At the moment, there is provision only for the dental practitioner who has, presumably, to be an L.D.S. There is a group of dental practitioners registered under the Dentists Act, 1921, and it is not an unreasonable claim that they make, that should one of their group of dentists have to go before a tribunal the professional representative, in that case, should be one of the dentists registered under the 1921 Act. The purpose of the Amendment is to give the Minister power to have two dental men to draw from—one an L.D.S., and the other a 1921 dentist. I believe the argument against this will be that the 1921 dentists are a closed group, who will ultimately die out. If the Minister cared to press that to its logical conclusion he could say that the last of those men would be the only man on the tribunal waiting to judge himself, and that when he finally died he could no longer constitute a panel, because there would be no one to appoint. But I hope the right hon. Gentleman will not drive himself to that conclusion, because there are hundreds of these people in existence at the moment, and it will be many years before that position arises. May I also appeal to the right hon. Gentleman on another basis? This is the last Opposition Amendment on the Order Paper, and as, no doubt, he wishes to part with the Bill by leaving a sweet taste in the mouths of Members on this side of the House, perhaps he will accept the Amendment.I beg to second the Amendment.
I am almost persuaded by the seductiveness of the last remark from the hon. Member for Putney (Mr. Linstead), but I must resist that temptation. Surely, I cannot be asked to accept what is an illogical Amendment in order that we might end on a harmonious note. This class of dentists is dying out. Surely it is not suggested that a registered dentist on the tribunal would not be an effective member in considering one of his fellow dentists merely because he happened to belong to the 1921 class. It is slightly artificial. I must resist the Amendment, and I hope that the hon. Gentleman will not press it.
10.30 p.m.
As the Minister has been so forthcoming, I would press him this much further. He may feel that there is no need for the dental profession to take this point of view, but, in fact, they do take it. They feel that, when one of their cases is coming up, they want one of their own men there. One of the essentials of a tribunal of this kind is that it shall have the confidence of the people who are to come before it. It will make that little bit of difference to them to know that one of their men is sitting there. There is more in this than the Minister appears to think, and I do ask him to look at it again.
I will look at it administratively and see what the possibilities are.
I am very grateful to the Minister for what he has said. In those circumstances, I beg to ask leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Ninth Schedule—(Amendment And Repeal Of Enactments Relating To Persons Of Unsound Mind And Mental Defectives)
Amendments made: In page 81, line 8, after "of," insert:
" Section twenty-seven of the principal Act (which prescribes the mental hospitals into which rate-aided patients may be received)."
In line 8, leave out from "omitted," to "the," in line 10.—[ Mr. Key.]
Tenth Schedule—(Consequential Amendments And Repeals)
Amendments made:
In page 84, line 43, leave out:
" and Subsection (4) of Section three hundred and one."
In line 44, leave out "their," and insert "its."
In page 88, line 33, column 3, after "In," insert:
" Subsection (2) of Section I the words 'under Sections three hundred and one to three hundred and thirteen of the Lunacy Act, 1890, or' and in."—[Mr. Key.]
Bill to be read the Third time Tomorrow, and to be printed. [Bill 150.]
Isle Of Man (Customs) (No 2) Bill
Order for Second Reading read.
10.32 p.m.
I beg to move, "That the Bill be now read a Second time."
This is an annual Bill to confirm Customs Resolutions of the Manx Legislature. The last Isle of Man Customs Act received the Royal Assent on 20th December last year, after the autumn Finance Act. The Isle of Man has its own separate financial existence and levies its own Customs and Excise, but its Customs Resolutions are subject to confirmation by Acts of the Imperial Parliament. Certain Customs duties in the Isle of Man under certain Acts are imposed by the Governor, but others are proposed by Resolutions of the Tynwald, and the Customs in question are those which have been so proposed. The first Resolution with which the Bill is concerned was passed on 16th April, to bring the duties on coffee extract, etc., into line with the Imperial Customs. Clause I is intended to confirm that Resolution. On 25th June, a second Tynwald Resolution was passed which continued existing duties on various classes of goods set out in Clause 2, which is therefore designed to confirm those duties. The only question before the House is whether there is any reason to disagree with Resolutions which the Isle of Man have passed of their own volition. All that I ask the House to do is, by giving the Bill a Second Reading, to confirm those Resolutions passed for reasons which seemed good to the inhabitants of the Isle of Man. I therefore ask the House to pass the Bill without further inquiry, and give a blessing and confirmation to the desires of the Isle of Man. Similar Measures have been passed from year to year and have not often been the subject of discussion, and I ask the House to say that there is nothing in this Bill which calls for further consideration.Question put, and agreed to.
Bill accordingly read a Second time.
Bill committed to a Committee of the Whole House for Tomorrow.—[ Mr. Pearson.]
Adjournment
Resolved: "That this House do now adjourn. "—[ Mr. Pearson.]
Adjourned accordingly at Twenty-four Minutes to Eleven o'Clock.