House of Commons
Tuesday, December 10, 1946
The House met at Half past Two o'Clock
PRAYERS
[Mr. SPEAKER in the Chair ]
ARBROATH GAS PROVISIONAL ORDER BILL
Read the Third time, and passed.
ORAL ANSWERS TO QUESTIONS
BRITISH ARMY
Gun Site, Middlesbrough
asked the Secretary of State for War what steps he is taking to relinquish immediately the gun site at Middlesbrough, particulars of which have already been sent to him, required urgently as part of an industrial development area of that town.
The question of an alternative site is now being discussed by the Middlesbrough Corporation and the regional planning officer of the Ministry of Town and Country Planning. Until an alternative site is found and approved, I am not prepared to relinquish the present site which is owned by my Department.
Is my right hon. Friend aware that this matter has been before his Department since last July and that no satisfaction has been obtained by the local authority who require this land for industrial purposes? Is he further aware that this is not an isolated example in his Department, and will he see that this sort of obstruction is removed and that the dead hand of bureaucracy is not allowed to obstruct in this manner?
I do not know what type of obstruction my hon. Friend refers to We own the land, certainly, and I think we had better leave it to the Ministry of Town and Country Planning to assist us in this matter.
Does my right hon. Friend realise that the Government have spent large sums of money in these areas, and that inaction in his Department is holding up development in this area in Middlesbrough which is set aside for industrial development? Is my right hon. Friend also aware that another Department is lounging in luxury in a maternity home, so that the proper people cannot get into this home? Will my right hon. Friend set a good example and get rid of these people without any further delay? There is no excuse whatever.
All I can say is, the War Office are not lounging in luxury on this particular site.
Is my right hon. Friend aware that employment in Middlesbrough in the future will be affected by this decision of his Department, and can he not hasten the relinquishment of this site?
I will do all I can to help.
Colour Bar
asked the Secretary of State for War if he has now had an opportunity of conferring with his Service and Colonial colleagues on the maintenance of a colour bar against men seeking regular engagement in the Army; and if he will now make a statement.
I am in consultation with my colleagues in the Service Departments and at the Colonial Office, but I am not in a position to make a statement at present
Can my right hon. Friend say when he expects to be able to make a statement?
I would not like to say at the moment, but negotiations are going on very satisfactorily.
Personal Cases
asked the Secretary of State for War why, in view of the fact that soldiers sentenced during the war for offences constantly have their cases reviewed and the sentences often remitted, Mr. M. Waxman, 20, Sillwood Road, Brighton, who is 41 years of age. is now being called up on an enlistment order dated 14th March, 1941, which he failed to obey, although he served from 1942 to 1944 with credit in the Merchant Navy; whether that service will be taken into consideration; and if the man will be immediately released to carry on his present job.
Mr. Waxman failed to report on 27th March, 1941, after having had an enlistment notice served on him. His whereabouts were recently discovered and he was ordered to report on 21st November to the General Service Corps Depot. The question of what disciplinary action should be taken in his case is now under consideration. The fact that during his period of absence he served in the Merchant Navy will be taken into account in determining his final date of release.
Is the right hon. Gentleman aware that there is no proof whatever that this man received his calling-up papers? He says he never did. In view of the fact that he has done excellent service, which nobody denies, and today is doing a job which is of no use to anybody, is this really not just "red tape" or victimisation? The man, who is 41 years of age, could do a lot of good work, but at present he is of no use to anybody.
I admit that he did good service while he served in the Merchant Navy, but the fact remains that he avoided his military service, and I think he ought to do his share along with many others who did their-share during the war.
He has done about three years' service.
asked the Secretary of State for War why the additional pension of 5d. per day payable to ex-Regular soldiers on attaining 55 years of age has been refused to Mr. R. A. Clout, 1, Upper Roedale Cottages, Brighton, late Royal Sussex Regiment, in view of the fact that his birth certificate, which has been forwarded to the Record Office, shows that he was born on 15th August, 1891.
As has already been explained to the hon. and learned Member, when Mr. Clout originally enlisted in September, 1910, he declared his age to be 18 years I month. The general rule is that the age originally declared by a recruit is accepted for Army purposes, in- cluding pension, and Mr. Clout will therefore not qualify for the additional pension until August, 1947.
Is the right hon. Gentleman really defending the position, that this ex-soldier is to be deprived of the 3s. a week to which his age entitles him, on account of a mistake made by someone in his attestation nearly 40 years ago, when he was 17 years of age?
I do not accept the statement that a mistake was made. Quite often recruits on enlistment declare an age which satisfies them, and during their service often have an advantage thereby
asked the Secretary of State for War whether he will review the case of Arthur Davis, who was sentenced to death on 16th December. 1944, but whose sentence was later commuted to penal servitude for life.
I am giving careful consideration to this case, and am awaiting a special report.
Is the Minister aware that those of us who have examined the evidence over the past months are pretty certain that there has been a serious miscarriage of justice in the circumstances, and will he reconsider the matter?
This case presents rather sad features, but I would certainly not accept what my hon. Friend says.
asked the Secretary of State for War whether he is aware that 14573189 Gunner M. Essex, who has been sentenced to 164 days' detention, was under close arrest for 64 days prior to sentence; and, in view of the loss of pay and privilege suffered by the soldier during this period, if he is prepared to review the sentence.
The sentence will be reviewed shortly and I will inform my hon. Friend of the result.
Is my right hon. Friend aware that the number of cases of soldiers being kept for a considerable time in detention before they are brought to trial seems to be increasing, despite the end of the war and will he look into it with a view to speeding this business up?
I thought my hon. Friend was referring to a specific case, and I have given him a specific answer.
Demobilisation
asked the Secretary of State for War if consideration will be given to Army personnel of demobilisation group 50 completing the remainder of their service in the United Kingdom.
It is already difficult for us to meet our inescapable commitments abroad, and the bulk of trained men in the later age and service groups are already serving overseas. Men of group 50 are not due to start release until possibly some date in June, to bring them home early would increase further the gaps in our overseas establishment which cannot be filled.
In view of the very long delay in the demobilisation of these men, will the right hon. Gentleman consider trying to get men home even one or two months earlier, to enable them to make the necessary arrangements for their entry back into civilian life?
I can assure the hon. and gallant Member that demobilisation is a constant preoccupation in my mind. But I cannot add anything to the answer I have given to his Question.
asked the Secretary of State for War if men who volunteered for service in the R.N. or R.A.F., and were afterwards compulsorily transferred to the Army, will be released with the R.N. or R.A.F. groups to which they originally belonged.
No, Sir. I would refer the hon. Member to the replies given by my predecessor on 23rd October, 1945, to my hon. and gallant Friend the Member for Chelmsford (Wing-Commander Millington) and on 17th December, 1945, to the hon. Member for Newbury (Mr. Hurd).
Is my right hon. Friend aware that nothing produces a greater sense of grievance than unequal treatment between man and man; and when two men have joined the Forces at the same time why should not they be released at the same time, when the circumstances are as stated in the Question?
I do not think that purpose would be met entirely in the way the hon. Gentleman suggested.
Will the Minister not look at this matter again in the light of what I have said?
Is the right hon. Gentleman aware that, so far as the Navy is concerned, large numbers of ratings were transferred to the Army during the last eight weeks of hostilities, many of whom had three, and in some cases four, years' service behind them; and will he look at it again in view of the obvious unfairness?
This matter has been looked at before, but I will certainly give it another look to refresh my memory.
asked the Secretary of State for War if he is aware that Appendix A to Part I Orders, M.E.L.F., dated r8th November, 1946, included guarantees by General Miles Dempsey, Commander-in-Chief, M.E.L.F., that by 31st December. 1947, every man in the Army with more than three years' service would be released, that by 31st December, 1948, every man called up before 1st January, 1947, would be released, and that the balance of rate of release would be 17,200 per month from January to March, 1947, and 25,800 per month from April to June, 1947; and whether these undertakings were given with his knowledge and sanction.
I have not seen the document referred to, but I am aware that a misstatement was made. The fault lay in a passage in a telegram, which was sent by my Department to all commands, which was misleading, and, in fact, misled the Middle East Command. A correction, unfortunately, arrived only after the Commander-in-Chief had issued a statement based upon the misleading telegram A fresh statement has now been made. I must express my regret for this mistake, but the facts governing release are as stated by my right hon. Friend the Prime Minister in this House on 26th November, and in a broadcast the same evening.
Is the right hon. Gentleman aware that this statement was made in order to relieve the anxiety of men in this command, and that it did, in fact, create far greater confusion and dismay than existed before? What steps will he take to prevent a recurrence of such a happening in the future?
I have already taken as careful steps as I can take to prevent mistakes like this occurring again. All I can say is that I most deeply regret that it happened.
Did the right hon. Gentleman see the telegram before it went off? If not, will he make sure that when announcements are going to be made to the troops he will check them before the things go out?
I am afraid I did see the telegram, but I did not recognise the mistake. It was recognised only in the Middle East Command. All the other commands got it aright. It was not an absolute mistake; it was a partial mistake.
A near miss.
Is the right hon. Gentleman aware that it has always been the custom, when a Government Department has made a mistake in that way, that the people concerned have always had the advantage of the mistake?
I should like to agree to that assertion, but it would mean that something like 100,000 men would have to be released out of their turn.
Will the right hon. Gentleman make arrangements for any announcements about the speeding up of demobilisation to be made by the Government, and not by serving officers? It only adds to the confusion.
asked the Secretary of State for War whether he will now give the date on which the men previously stationed in Greece, in release Groups 42 and 43, due to be released before 18th November, were in fact released; and what explanation there is for the delay in providing shipping to bring these men from Greece earlier.
I regret that I am unable to give the exact dates of release of men stationed in Greece in Groups 42 and 43. Men in Group 42 sailed, however, from Greece on 16th October, and were obviously in plenty of time for release by 18th November. Men in Group 43 were due to sail on 9th/10th November, but owing to a breakdown of shipping then-departure was delayed until 13th November. In spite of this unforeseen occurrence, the release of none of these men should have been delayed more than four days.
Is the right hon. Gentleman aware that on 5th November I raised this question with him, about a ship coming out of Piraeus without these men, and that he explained that these men had until 18th November before they were due for release? Is he aware that they were not, in fact, released for several days after 18th November?.
I think I said no more than four days after their release date.
asked the Secretary of State for War if he is aware that, despite repeated assurances of impending improvement, troops serving in East Africa Command are still not being repatriated in time to receive disembarkation leave before demobilisation; and what steps he is taking to meet this grievance.
No assurances have been given that men overseas who are due for release would be returned in time to receive disembarkation leave before release. As I stated last week in reply to my hon. Friend the Member for Clitheroe (Mr. Randall) the situation is as described by my predecessor in a reply on 16th October, 1945, of which I am sending my hon. Friend a copy.
asked the Secretary of State for War whether, in view of the retarded rates of release for 1947, he will ensure that the lower limit of groups eligible for United Kingdom leave from the Middle East and India is proportionately lowered
As and when the War Office announces details regarding retarded dates of release, overseas commands concerned automatically take action to ensure that if necessary, groups previously ineligible become eligible again.
asked the Secretary of State for War on what date it is expected that Group 46 men now in Singapore will embark for home.
Actual sailing dates of men embarking overseas for release are a matter for the command concerned, but I have no reason to think that men in Singapore will not arrive in time to be released in the period allotted to their groups. Group 46 is due to be released in this country between 23rd December and the end of January.
Units, Singapore (Complaints)
asked the Secretary of State for War (1) if he is aware of the complaints and unrest in the 800 Special Intelligence Company, Singapore, particulars of which have been sent to him; and what action he proposes to take;
(2) if he is aware of the complaints and unrest in the 19th Air Formation Signals, Elein Camp, Singapore, of which particulars have been sent to him; and what action he proposes to take.
I am not aware of any special complaints or unrest in these units, although I am well aware of the feeling of disappointment about release, and of the uncomfortable conditions of service in the Far East. I would refer the hon. Member to the full statement on release made on 26th November by my right hon. Friend the Prime Minister, which has been widely publicised.
In view of the fact that these two cases are typical, will the right hon. Gentleman try to persuade the Prime Minister to hold inter-departmental conferences so that all the Departments concerned can go into the chaotic state of administration in Singapore, and try to send out some really responsible administrator?
I do not accept the hon. Gentleman's suggestion that there are chaotic conditions in Singapore.
Will the right hon. Gentleman circulate the statement of the Prime Minister in some dozens to all Members of Parliament, because we are getting day to day inquiries about the matter?
I should have thought the hon. and gallant Gentleman, with his long knowledge of the House, would have known where to obtain copies of the statement. It is in the Vote Office
Would the Minister bear in mind that the supplementary questions put by my right hon. Friend the Member for Warwick and Leamington (Mr. Eden), which are half the story, are not included in that statement, so we have to get a copy of HANSARD and go over the whole thing again?
B.A.O.R. (Timber Cutting)
asked the Secretary of State for War on what grounds orders have been issued for the drafting of soldiers of B.A.O.R. to the Hartz Mountains for cutting timber for use in the British housing programme.
Timber is urgently needed for building houses in this country. Cut timber has been accumulating in German forests for lack of men and transport to move it away. In so far as they can be spared from their primary military tasks, troops are therefore helping to move this timber and to cut more. It has been explained to them that they are thereby helping to provide houses for civilians in this country, an object with which I understand they have some sympathy.
Does the right hon. Gentleman appreciate, that while it is true that the soldiers have much sympathy with the object of building houses in this country, they feel it is quite wrong that demobilisation should perhaps be delayed by reason of this work being done; and would it not be possible to achieve a compromise whereby the Army provides the necessary transport and German civilians provide the necessary labour, on a proper remunerative basis?
I think the hon. Gentleman has a somewhat vivid imagination. This does not delay demobilisation in Germany.
But the men think it does.
Is the right hon. Gentleman aware that there is so much timber lying at Hamburg that there is insufficient shipping to bring it over to this country? What is the point of using British troops to cut timber if we cannot get it away?
Most of the troops that are at the moment engaged on this task are engaged in clearing the timber to this country.
Is my right hon. Friend aware that the suggestion of the hon. Gentleman the Member for Hertford (Mr. Walker-Smith) is quite impracticable, owing to the great shortage of labour in Germany?
Why not use the prisoners?
Pay and Record Offices, Edinburgh
asked the Secretary of State for War whether he is aware that, under the proposed scheme for Army administration, there will be no fewer than 13 area Army records and pay offices in England and only one such office in Scotland; and whether, in these circumstances, he will reconsider his decision to close down the Army records and pay offices in Edinburgh.
I would refer the hon. and gallant Member to the written reply I gave yesterday to the hon. Member for South Edinburgh (Sir W. Darling), of which I am sending him a copy.
Arising out of that reply, at which I have already had an opportunity of looking, will the Minister expedite a decision in this matter, as there is a great deal of dissatisfaction about it in Scotland?
Yes, Sir. We are doing our best. As I said in my reply yesterday, we are now searching for available sites.
Will my right hon. Friend look at the possibilities of the use of No. 1 Camp at Duddingston, which both the colonel in charge of records and the men consider suitable for this purpose?
I will certainly look at that.
Psychologists and Psychiatrists
asked the Secretary of State for War on what grounds a decision has been made to remove qualified psychologists and psychiatrists from officer selection boards, in view of the fact that these experts devised the successful techniques now in use.
The function of the Service psychiatrist is to advise the executive authorities when matters of mental health and adjustment are in question. It is open to the presidents of officer selection boards to consult the Service psychiatrists, or specialists in other branches of the medical profession, if they find reason to do so. Psychiatrists and psychologists are both consulted in the formulation of the technique adopted by officer selection boards.
Have psychologists and psychiatrists been dropped, or have they not been dropped? The answer does not make that point clear.
They have not been dropped, but they are not now necessarily members of these selection boards.
Does the right hon. Gentleman know that the presence of psychologists and psychiatrists on these boards during the war won the confidence of the serving men, and did, in point of fact, increase the number of other ranks who applied for commissions? Will he look into this matter again, so that confidence is not undermined?
No, Sir. As long as the services of psychiatrists are made available, if necessary, that is all, I think, my hon. Friend can ask for. I may tell him that there was a good deal of objection to these psychiatrists among the men.
Is the right hon. Gentleman aware that all other ranks did not share the view of the hon. Member, and that some of them referred to the psychiatrists as "trick cyclists"?
Was that on the part of senior officers or other ranks?
I am well aware of that, but I think we ought to get this question in its correct perspective. Psychiatrists were of great value in many cases.
asked the Lord President of the Council when it is intended to publish the Report of the Ministerial Committee's Expert Committee on the work of psychologists and psychiatrists in the Services; and if he is aware that publication is now urgently necessary in view of an Army Council decision to remove psychologists and psychiatrists from officer selection boards.
It is intended to publish the report as soon as possible. With regard to the second part of the Question, I would refer my hon. Friend to the reply just given by my right hon. Friend the Secretary of State for War to Question No. 21.
Will my right hon. Friend define what "as soon as possible" means? Does he really anticipate being able to publish this report during the course of the next few weeks or the next few months?
I do not think it is wise for me to define "as soon as possible" in this particular instance.
Overseas Sick Personnel (Visits)
asked the Secretary of State for War if he will make a further statement on extending the scheme to provide free priority passages to next of kin to visit serving men on the danger list who are stationed outside Europe.
There are a number of practical difficulties in extending this scheme beyond Europe, but I am hopeful that we may overcome them. The matter is under active consideration, and I will make a further statement as soon as that consideration is completed.
May I express the hope that that consideration will soon be made, in view of the fact that, at present, there is no difficulty in getting priority passages if people can pay for them; that serving men are posted all over the world, irrespective of the financial needs of their families; and that these priority passages are purely on a money basis?
I share my hon. Friend's hope.
Bellahouston Park, Glasgow
asked the Secretary of State for War when he proposes to rehabilitate Bellahouston Park, Glasgow, and make it available for public use.
I expect that the whole of Bellahouston Park, Glasgow, will become redundant to my Department's requirements during the first half of 1947. It is not the normal practice for the Department to carry out physical rehabilitation, but to pay monetary compensation under Section 2 (1) ( b ) of the Compensation Defence Act, 1939.
Compassionate Releases
asked the Secretary of State for War what factors are taken into consideration in determining Class C releases other than compassionate circumstances.
Only compassionate factors are taken into account in deciding whether a soldier should have compassionate release. In the case, however, of men applying for release on "one man business" grounds, their age and service groups are taken into account in deciding whether the release should be temporary or indefinite.
Is the right hon. Gentleman aware that cases of an extremely compassionate nature, admitted by his Department to be so, are being rejected because the soldier is too young, or has too short a period of service? How can he possibly justify this as the basis for judging compassionate leave?
I really think my hon Friend is under a misapprehension. They are not extremely compassionate cases to which he referred, if the only compassionate ground is that of a one-man business.
Candidates for Commissions (Recommendations)
asked the Secretary of State for War if he will reconsider the instruction that candidates who apply for commissions under Group II of the Army Council Instruction must be recommended by their commanding officer, brigadier, major-general and army commander, in view of the fact that suitable men volunteering are vetoed by the commanding officer alone, as in the case of Major Morrison of the R.A.
The seniority envisaged for officers accepted in Group II can only be justified if the officers are outstanding. The system of recommendation of Group II candidates by commanding officers and higher commanders is a reasonable one and I do not think that any officer of the required standard will fail to be recommended. In the case of Major Morrison it was not his commanding officer who rejected his application.
Is the Minister aware that this man was outstanding, and was recommended by the other three, but the Fuehrer of the Army said "No," and that was the end of it, and evidently the Minister accepts it too?
I do not know how far the term "the Fuehrer of the Army" could be interpreted, but I should have thought that if it could be, I should have been considered to be the Fuehrer of the Army.
Families, B.A.O.R. (Return)
asked the Secretary of State for War how many wives of B.A.O.R. Servicemen have already returned to this country.
Just over 3,200 Army families have gone out to B.A.O.R. Of these, 18 families have returned and 12 more applied to return up to 4th December. These figures include 27 returning after short visits or because the husband has been posted to another Command and one where the husband has died.
Is the Minister fully assured of the complete wisdom of this scheme at the present time?
I am completely assured.
Ranker Officers
asked the Secretary of State for War how many of the officers promoted to the rank of lieutenant-general and major-general, respectively, as announced in the Gazette of 3rd December last, commenced their service career in the ranks.
None of the four, Sir, but the proportion may rise somewhat in future years.
Will my right hon. Friend say when we may expect a really concrete sign that the principle of equal opportunities for all in His Majesty's Armed Forces of the Crown will begin to operate?
My hon. Friend will know that it is the policy of the War Office to commission officers almost entirely from the ranks, but it will take some time, I am afraid, before we can expect generals coming from the ranks.
Poles (Military Training)
asked the Secretary of State for War how many Polish troops in this country are undergoing military training and for what purpose; and whether pre-O.C.T.U. training now being provided for Polish troops at a camp in Yorkshire is devised for training officers for the Polish Resettlement Corps or for the British or Polish armies.
No military training is provided for Poles in this country. Pre-O.C.T.U. training used to be carried out by the unit now stationed at the camp referred to but it is now used merely as a holding unit, although its title has not been changed.
Polish Camps (British Troops)
asked the Secretary of State for War how many British troops. are employed in this country in camps provided for Polish troops and the Polish Resettlement Corps; whether these men are required to carry out orders given to them by Polish officers and non-commissioned officers; and if he will release them from these duties and so speed up demobilisation.
A total of 33b officers and 715 other ranks are employed on advisory or administrative duties in camps for Polish troops and the Polish Resettlement Corps. In view of the nature of their duties they are not required to carry out orders given by Polish officers and non-commissioned officers.
The majority are older men who have recently accepted short service commissions and engagements specifically for extra-regimental employment such as this. They are therefore not due for early release and even if they could be employed on other duties their numbers are so small that their transfer would not materially affect the rate of release. Moreover their removal would cause a breakdown in the entire scheme of Polish resettlement.
Dartmoor Ponies (Preservation)
asked the Secretary of State for War whether the importance of preserving Dartmoor ponies will be taken into account in connection with his Department's plans for Dartmoor.
Yes, Sir, specific precautions are taken to preserve the Dartmoor ponies.
Will the right hon. Gentleman assure the House that no action has been taken which will in any way interfere with the famous and unique breed of ponies?
We are certainly doing all we can to see that they do not become extinct, at any rate through the Army's activities.
Can the right hon. Gentleman say whether the decision is likely to be taken to evacuate the whole of Dartmoor?
That, I should have thought, was an entirely different question.
Regular Officers (Retirement)
asked the Secretary of State for War whether he will now consider relaxing the regulations which prevent Regular officers who held commissions prior to 1939 from exercising the right to retire, which was a condition of their original engagement.
Retirement is now already allowed in certain cases and the ban on retirement is being progressively lifted. At present regular substantive lieutenant-colonels and majors may retire or resign on reaching the age limit of their corps as laid down in the Army Pay Warrant. Individual compassionate cases are treated on their merits.
Will the right hon. Gentleman give further consideration to this matter, because there are many younger officers who want to make their way in life and who do not know when they will get out, and who are not being released?
I should have thought that the younger officers would still have a good time to serve in their military careers.
PRISONERS OF WAR
German Merchant Seamen
asked the Secretary of State for War how many German merchant seamen are still detained as prisoners of war in this country; and how many of them were brought from Canada to this country in June, 1946, and promised immediate repatriation.
1,852 German merchant seamen are at present held in this country, including 373 who were brought from Canada in June. 1,100 are being repatriated in December and the rest in January and February No promise of immediate repatriation was made to the men brought from Canada.
Is my right hon Friend aware that some of these men are really aliens and not Germans at all, and if I give him particulars will he give me an assurance that the prisoner of war who communicated with me will not be punished for doing so, as has happened before?
I think my hon. Friend can be assured that we are not too hard on prisoners of war in general, whether they write to my hon. Friend or not.
Families (Assistance)
asked the Secretary of State for War whether he will make arrangements so that camp money saved by prisoners of war may be changed into sterling and handed over to the Save Europe Now Committee, and the proceeds used for the purpose of sending clothing and voluntarily saved food to the friends and relations of the prisoners of war.
Prisoners of war can assist their families in Germany by remitting part of their credit balances: they do not require sterling for this purpose. With regard to sending parcels of clothing and food, arrangements have been made with the Save Europe Now organisation, whereby prisoners may send a parcel as a Christmas gift to their relatives or friends in the British controlled zone of Germany, containing articles of their own property, or such as are available for purchase in camp canteens, but it would not be desirable or practicable for prisoners to give their own rations for this purpose
Is my right hon. Friend aware that, to my knowledge, in several camps quite considerable sums have been collected for this purpose; and will he explain to the House why it is impossible to permit the prisoners to exchange their camp money for sterling in order to send it to one of the relief societies? Is it the Treasury?
No, Sir. I should have thought that the prisoners could send all the money they want to direct to relatives or friends.
They cannot.
The whole purpose of this organisation is to enable people in Germany to get some benefit by such efforts.
I know, but is not the right hon. Gentleman aware that they are forced to change their money at the wrong rate of exchange when they do this; and why cannot he come to an arrangement with his right hon. Friend the Chancellor, so that these people who are completely at our mercy have a square deal? May I have an answer?
I think my hon. Friend exaggerates a little. These prisoners, as he will see from an answer I shall give to a later Question, are being dealt with as fairly as we possibly can deal with them.
Christmas Rations
asked the Secretary of State for War if extra rations for Christmas will be given to German prisoners of war in this country.
I regret this is not possible.
Does the right hon. Gentleman presume to deny to our defeated enemies the compassion which we all need for ourselves?
Extension of Amenities
asked the Secretary of State for War whether, in the light of representations since made to him, he will reconsider his recent decision in regard to the suggestion of the hon Member for Bedford that German prisoners of war should, where invited to do so. be allowed to enter British homes on Christmas day.
asked the Secretary of State for War if he will now allow German prisoners of war at present in camps in this country to accept invitations during the Christmas period to visit homes of those living near the camps.
asked the Secretary of State for War what relaxation is being made this Christmas time in the rules relating to fraternisation with prisoners of war in this country.
Arrangements are being made to allow well-conducted prisoners of war to take unescorted walks within a radius of five miles of their camp or billet until lighting-up time, to converse with members of the public, and, subject to permission from their commandant, to accept invitations to private houses within the five mile radius.
Is the right hon. Gentleman aware that it is most gratifying to find that he has so well caught, in advance, the spirit of Christmas?
May I ask the right hon. Gentleman if we are to understand that these arrangements apply only to Christmas? Or are they to be continued after Christmas, and is this a new arrangement, a step towards the end of non-fraternisation?
It deals not only with Christmas time, but after Christmas. I think those hon. Gentlemen who have a sense of proportion will admit that this is a considerable advance.
As there are many cases of farmers who have had prisoners of war who have worked well for them and who are outside the five mile limit, will that limit be relaxed in those cases?
That is just why I have come to this decision; many prisoners billeted on farms have had these facilities for some time.
Arrests, Witney
asked the Secretary of State for War in what circumstances four German prisoners of war, working at Bicester, were arrested at Witney, attempting to sell motor-car tyres to a civilian.
The Germans were arrested by the civil police. The investigations to which I referred in my reply to the hon. Member last week are not yet complete.
Is the right hon. Gentleman aware that the dumps at Bicester Central Ordnance Depot are said to be practically unguarded, and that many of the trucks which are now driven by Germans go through and the Germans help themselves, as in this case?
I should not like to think that Germans are helping themselves at our Ordnance Depot at Bicester, but in regard to the first part of the supplementary question, that is just one of our difficulties at the present moment—to provide adequate manpower for the Army.
Another reason for sending them home.
ARMS STANDARDISATION (ANGLO-U.S. DISCUSSIONS)
asked the Prime Minister what stage has been reached in the discussions for the standardisation of British air, land, naval weapons and munitions to fixed U.S. sizes and patterns that were initiated by him, in pursuance of views expressed by the Canadian Prime Minister at the Empire Conference last April through the Anglo-American Joint Chiefs of Staff Committee; and whether any measures are in contemplation for the standardisation of training manuals, exchange of officers and joint use of naval and air bases by the U.S.A. and the British Commonwealth and Empire.
I would refer my hon. Friend to the reply made yesterday by my right hon. Friend the Lord President of the Council to the hon. Member for Mile End (Mr. Piratin), and to the remarks I made in my speech in the Debate on the Address on 18th November. The principles there outlined are those which govern the policy of the Government in these matters. The only point I would add is that the statement in the first half of the Question as to the views expressed by the Canadian Prime Minister in April is without foundation.
In view of the failure of the Prime Minister to answer the last part of the Question, either on 18th November or through the Leader of the House yesterday, would my right hon. Friend, in view of the rising disquiet on both sides of the Atlantic as to the present situation take a further opportunity of making a full statement on the nature and extent of the Anglo-American military conversations?
I do not think there is any apprehension, except that I gather the Questions asked by the hon. Member are apt to cause apprehension in some quarters. I thought that my statement on the Address dealt very fully with the whole question.
Is the right hon. Gentleman aware that had standardisation been achieved in 1940 our enemies might have been discomfited?
The hon. Member is not asking for information. That is surely a purely hypothetical question.
Will the right hon. Gentleman tell the House with what pleasure he would welcome any indication that other foreign Powers are prepared to be as internationally minded as America?
If the hon. Member had followed what I said in the Debate on the Address, he would have seen that I would welcome it.
Would the Prime Minister, now that he is able to answer the question himself, as was not the case yesterday, give the House a categorical answer to the question as to whether Field-Marshal Montgomery, when he was in the United States during the summer, did not discuss questions of standardisation on a much wider basis than that of our necessary Forces in Germany?
That does not seem to me connected with the Question on the Order Paper.
In view of our 20 years Treaty with Russia, can the Prime Minister say whether we are having parallel conversations with that country?
We should welcome any such conversations with Russia, but we have not been very successful in getting any from that side
Could the right hon. Gentleman say what possible advantage could accrue from an arbitrary refusal to standardise to any but the potential enemies of this country?
EMPIRE FOOD GIFTS
asked the Prime Minister whether, in view of the fact that 688,876 cases of food totalling 16,914 tons have been sent for distribution to this country from other parts of the Commonwealth and Empire, in addition to large quantities of meat, he will take this opportunity of publicly thanking the donor countries who have given such practical expression of their good will towards the people of this country.
My right hon. Friend the Minister of Food has written personally to thank many who have organised the sending of gifts of food, and for each consignment a letter of thanks is sent by his Department. In addition, many thousands of recipients have written individual letters of thanks, which, I feel sure, provide the most effective expression of our appreciation of the great generosity shown to us by our friends and kinsmen overseas. I welcome, on behalf of the Government, and of this House, the opportunity of adding my own sincere thanks.
May I ask the right hon. Gentleman whether, in placing on record thanks to the donors of gifts, he will also give thanks for the generous contributions made by the Dominions to guarantee the normal rations we enjoyed throughout the war?
In agreeing with my hon Friend, I would point out that that has already been done; no doubt he will have heard it on several occasions
NATIONAL FINANCE
German Zone Fusion (Effect)
asked the Chancellor of the Exchequer what contribution in dollars he expects to make for the fulfilment of British responsibilities under the proposed arrangements to feed the British and U.S. zones of occupation in Germany.
asked the Chancellor of the Exchequer what proportion of the estimated sum of £125,000,000, for the reconstruction of Germany and of the current annual expenditure of £80,000,000, it is estimated will be spent in dollars or other hard currencies in each of the years 1947, 1948 and 1949.
I cannot say yet. Much will depend on Article 8 of the Agreement.
Will my right hon. Friend assure the House that whatever our dollar expenditure is under the Agreement in Germany, no dollars will be diverted from the purposes of industrial re-equipment at home?
Yes, Sir, I can give that assurance.
asked the Chancellor of the Exchequer what estimated saving to the British taxpayer will result, in 1947, from the proposed fusion of the British and U.S. zones of occupation in Germany?
I cannot say yet, but the prospect of some saving to the British taxpayer is one of the strongest reasons for the fusion of zones.
asked the Chancellor of the Exchequer whether he will give an assurance that, should it be necessary to reduce planned British imports from the U.S.A. during 1947 as a result of the agreement to finance imports into the British and U.S. zones of Germany, the necessary cuts will be made in films and not in foodstuffs.
This is a hypothetical position, which may never arise. If it does, we shall take account of all relevant considerations.
Is the right hon. Gentleman aware that concern has been caused by apparently inspired Press statements which have suggested that it may be necessary to cut British food imports next year, and will he remember that British housewives would rather have their weekly can of pork from Chicago than a weekly can of dope from Hollywood?
Would the right hon. Gentleman also bear in mind that we cannot eat films?
Have not films become the opiate of the people under the present Administration?
Transport Nationalisation (Guaranteed Stock)
asked the Chancellor of the Exchequer whether in view of the anxiey caused to holders of Government guaranteed securities due to the treatment of L.P.T.B. 3 per cent. Guaranteed Stock, he will give an assurance that the terms of issue will be observed in the case of all other Government guaranteed securities.
The guarantee would be implemented if default were to take place on this or any other Government guaranteed security.
Does the right hon. Gentleman realise the far-reaching nature of the repercussions of this particular decision, and does he realise the effect it might have on money raised under Section 2 of the Borrowing (Control and Guarantees) Act?
I have not noticed any particular repercussions of great magnitude in Stock Exchange quotations.
Will not the Chancellor of the Exchequer agree that the Treasury guaranteed these stockholders 3 per cent. on their money until 1967, which they are not going to get, and therefore, in their view, there has been a repudiation of that guarantee?
I hope that reasons to show they are wrong will be given when the Transport Bill is debated.
They will get too much anyhow.
Exchange Arrangements (Switzerland)
asked the Chancellor of the Exchequer what are the revised exchange arrangements for British tourists to Switzerland which he has agreed with the Swiss Government; and when will they come into operation.
The Swiss Government have recently informed me that the extent of British tourist expenditure was causing them some embarrassment, and that they wished to exercise some control over it. I saw no reason to object to their proposals, especially in view of the increasing facilities for spending holidays in other countries. I will, with permission, circulate details in the OFFICIAL REPORT.
Can the right hon. Gentleman say how long these onerous restrictions are likely to be continued?
Indefinitely, I should think, or at any rate long enough for hon. Members to explore the possibilities of the French Alps the Italian Alps,. the Carpathians, the Pyrenees and the Highlands of Scotland.
Is it not important also to allow them to see something of Russia?
I am sure that the hon. Member could put in a request for that.
Following are the details:
As from 18th December, a special Swiss certificate will be required for the allocation of funds for tourists and for their conversion into Swiss francs. These certificates will be issued by the Swiss Tourist Traffic Federation, at an office to be opened in London, by reference to the total amount of Swiss francs allotted for this purpose. Tourists will be required to apply for their certificates either direct, or through their travel agents. Under the new arrangements, tourists will no longer be able to obtain in Switzerland the full countervalue of their credit document in cash. They will receive vouchers enabling them to pay for their hotel and travelling expenses in Switzerland, and a reasonable amount in cash. The normal procedure for obtaining the necessary visa-; remains unchanged, and the present arrangements with banks and tourist agencies in this country are not affected! It is not intended to impose similar limitations on Swiss visitors arriving in this country.
Foreign Exchange (Invalids)
asked the Chancellor of the Exchequer what additional allowances of foreign exchange are granted to sufferers of tuberculosis who wish to go into a Swiss sanatorium for treatment.
Medical expenses are allowed, and a subsistence allowance which varies according to the length and place of stay
Can the right hon. Gentleman give an assurance that there is no upper limit on the amount that may be so spent?
There will certainly be an upper limit, in the sense that expenditure must be reasonable, having regard to the length of stay, the course of treatment, and so on.
If a very long stay is necessary, will special facilities be granted?
Yes, Sir, providing proper medical evidence is furnished, but I must tell the hon. Member that there has been some abuse of this health travel—there has been some humbug, which is not in the interests of the country.
As the Question refers to tuberculosis, may I ask whether this also applies to other illnesses?
Yes, Sir, if it can be shown that Switzerland is so much better than other places, but do not let us crab our own country too much.
Local Loans Redemption (Reinvestment)
asked the Chancellor of the Exchequer whether he will now make a statement on the response to the calling of 3 per cent. Local Loans and the offer in exchange therefore of 2½ per cent. Treasury Stock and when the present offer of the latter stock will be withdrawn.
Out of a total of £429 million of 3 per cent. Local Loans Stock, holders of £304 million have asked that their redemption money should be invested in the tap issue of 2½ per cent. irredeemable Treasury Stock. Cash subscriptions to the tap issue so far amount to £120 millions. This is very satisfactory and well up to my expectations. Already we are almost home, and I shall not keep the tap open much longer.
Entertainments Duty (Exemption)
asked the Chancellor of the Exchequer what steps are taken to ensure that the remission of Entertainments Duty at certain theatres is reflected in reductions in the price of seats, and is not used to increase theatre rents and profits.
Reduction in the prices of seats is not a necessary condition of exemption. The test is that the body providing the entertainment should not be conducted for profit.
France (British Securities)
asked the Chancellor of the Exchequer the total value of the British securities which he is taking over from the French Government; and how he proposes to dispose of these securities.
The total value will depend on the amount of securities offered by the French Government to His Majesty's Government, which the latter agree to accept. They will be marketed with discretion.
Does the Chancellor of the Exchequer realise that most of the securities are of a highly speculative nature, and great as is his reputation as a speculator, does he not think it would be better to get rid of them as quickly as possible?
Not at the cost of causing their prices to fall.
Will the Chancellor of the Exchequer say whether he is going to follow the same pattern as the £126 million raised in America, in 1941, which led to the disposal of certain securities to the great disadvantage of this country?
Purchase Tax (Nurses' Cars)
asked the Chancellor of the Exchequer whether he will consider exempting from Purchase Tax motor cars bought by public subscription for district nurses.
No, Sir. As I have previously explained, this would not be practicable.
While regretting that reply, may I ask the right hon. Gentleman if he will look at this matter again, in view of the great public service carried out by these people?
We cannot pick and choose between deserving cases, and I admit that this is a very deserving case—[HON. MEMBERS: "Why not?"] I will discuss that in more detail when the next Budget comes along. It is impracticable, as I have tried to explain before, to vary the Purchase Tax according to the usage afterwards made of the taxed article. The tax is collected at the wholesale stage, and it is administratively not possible to ascertain whether the article sold will be used by a district nurse or anyone else.
War Damage Value Payments
asked the Chancellor of the Exchequer when he proposes to make payment of value payments under the War Damage Act; and whether he is prepared to increase their amount, in view of the change of values since 1939.
I propose that value payments under the War Damage Act should be made in the course of next year. I have so informed the War Damage Commission, and have requested it to consider urgently, under Section 11 of the Act, whether there should be an increase in these payments.
While thanking my right hon. Friend for his reply, which will be received with great relief in all areas which have suffered war damage, and not least in the City of Plymouth, may I ask whether those to whom value payments have been made in whole or in part will benefit under any escalator provision which he may suggest? Further, can he say whether members of local authorities, Members of Parliament and aggrieved persons will be able to state a case to the Commission before a decision is reached on this question?
The War Damage Commission are a statutory body and determine their own procedure in this matter. I have asked them to go into the matter urgently, and give me a report. It is for the Commission to decide in what form, if at all, they will receive evidence whether it be from Members of Parliament or any other people. As regards the first part of my hon. Friend's supplementary question, I am expecting that the Commission will make a report in due course.
Will the right hon. Gentleman make it clear that the interest due on these payments will also be paid at the same time?
Yes, Sir, the interest is due to be paid, at 2½ per cent., which is the current rate, from the date of the damage taking place until the date of the payment being made.
Can my right hon. Friend say whether the owner-occupier will also benefit under the new scheme, whether the people who have had their houses entirely destroyed will benefit, or whether the scheme applies only to partial damage?
I am speaking of cases in which a value payment is due to be made. It covers all value payments; it does not cover cost of works payments.
My right hon. Friend told us in July that only 36 per cent. of the cases had been settled in areas outside London, and that only 16 per cent. of the cases in London had been settled. Is he hopeful of reaching his target by the end of this year?
I said, "next year". I would not have any hope of settling them by the end of this year. The number of agreed cases is now over 50 per cent., and the process of agreement is proceeding rapidly.
In view of the wide interest in the statement which the right hon. Gentleman has just made, will he consult the Lord President of the Council to see whether an opportunity might be given to debate this important subject early in the New Year?
That is a matter for my right hon. Friend the Leader of the House. He is the dictator in these matters.
In fixing value payments, will regard be had to the amount of mortgage interest which has had to be paid by those who have lost their property, and to the rent which they have had to pay for new properties?
That is one of the many matters which might be considered by the War Damage Commission. I should think that to take into account the actual rent paid in each case would make the scheme administratively impossible, but that on the broad scheme the incurring of liability for rent would be a matter which the Commission might, if it so desired, take into account.
Is the 2½ per cent. interest subject to Income Tax?
Yes, Sir, if the recipient has an income which is enough to pay tax upon.
Can my right hon. Friend say whether, among the factors which the Commission will be able to take into account, will be the fact that some owners of blitzed property have received a 60 per cent. increase on 1939 values under the Town and Country Planning Act? Will the Commission be able to make a comparable increase? Should not the Treasury, in this matter, be as generous as local authorities were compelled to be under the Town and Country Planning Act?
I am disinclined—and I think the House will agree—to give a lead to the Commission on any points of detail. It is a statutory body, and has a clearly defined duty under the Act. I have asked the Commission to perform a duty under the Act, and I would not like to suggest that it should, or should not, operate in this or that way.
Export Receipts
asked the Chancellor of the Exchequer the total balances of hard and soft currencies, respectively, earned by this country through exports in the first 10 months of 1945 and 1946, respectively.
With permission, I will circulate in the OFFICIAL REPORT figures of our estimated receipts from exports to certain groups of countries in the first six months of 1945 and 1946. Figures for the third quarter are not yet available.
When the right hon. Gentleman is circulating the details in the OFFICIAL REPORT, would he consider circulating to Members a sample of the hard and soft currencies?
Following are the figures: ESTIMATED RECEIPTS FROM EXPORTS AND RE-EXPORTS OF THE UNITED KINGDOM. Country 1st half 1945. 1st half, 1946. (£ millions) (£ millions) U.S.A. 18 22 Canada 11 14 Central and South America. 8 17 Sweden, Switzerland, Portugal. 3 17 Sterling area 93 192 Rest of world 35 97 Total* 168 359 * Excludes exports and re-exports to Germany or on account of U.N.R.R.A.; excludes exports of equipment, etc., from U.K. to British companies operating abroad: includes diamonds
Forward Exchange Facilities
asked the Chancellor of the Exchequer (1) how many requests for forward exchange facilities in soft currencies have been received by the Bank of England between VJ-Day and the last convenient date; in how many cases have such facilities bean afforded; and in how many refused;
(2) the number of applications and the value of such applications that have been made in the last 12 months to the Treasury for permission by Americans or U.S. undertakings to make investments in the United Kingdom.
This information is not available.
Old Age Pensions (Means Limit)
asked the Chancellor of the Exchequer if he has considered the protest of the Longbenton Urban District Council, Northumberland, a copy of which has been sent to him, against the scale under the Old Age Pensions Act, 1936, for the calculation of means, which is considered as unreasonable under the present day cost-of-living and penalises unduly applicants who have been thrifty; if he will consider amending the scale for the benefit of these aged people; and if he will give the number of persons now receiving pensions under this Act who are receiving less than the full rate, due to the means test.
I have considered these representations. Under the National Insurance Act, passed this year, the rates of pension and the means limit have been substantially increased, and I cannot see my way to propose further changes The answer to the last part of the Question is, 22,084 on 30th September last.
CIVIL SERVICE (MANPOWER)
The following Question stood upon the Order Paper:
—To ask the Chancellor of the Exchequer, whether, arising out of the Governments present legislative programme, he will give an assurance that steps will be taken by a complete overhaul of the Civil Service to prevent the increase of employment of civil servants throughout the country rising to 1,000,000 from the present figure of 950,000
On a point of Order. May I apologise to the House, Mr. Speaker, for not having been able to take into account the revised figures in regard to the number of unnecessary civil servants? The figure is far higher than the one I have stated in my Question.
On the contrary, the figure is far lower. The hon. Gentleman's original figure is wrong. The total non-industrial Civil Service numbered 709,449 on 1st July. The matter is being kept under close review by His Majesty's Government, who intend to ensure that the call made on the national manpower for the public services is kept at the minimum consistent with the proper execution of approved policy.
Is not the right hon. Gentleman aware that the greatest problem we have before us today is a shortage of manpower? Has not the Lord President of the Council, the dictator there, told us exactly so, and will he not do something so as not to use more officials than necessary?
STATIONERY OFFICE (SCOTLAND)
asked the Financial Secretary to the Treasury whether the fact that the Scottish Housing Advisory Committee's Report on Reconditioning was received by the printers in July, but is not expected to be ready for publication until the middle of January, indicates that the existing printing works of His Majesty's Stationery Office are quite inadequate, and that some expansion is urgently needed, he will consider setting up printing works in Scotland for the printing of Reports and White Papers dealing with Scottish affairs and any other official documents, such as telephone directories and electoral registers which relate exclusively to Scotland.
No, Sir.
Why not?
I think the hon. Member is labouring under a misapprehension. If he would like to see me afterwards, I will explain the whole thing to him.
TRADE AND COMMERCE
Steel Sheets (Export)
asked the President of the Board of Trade what quantity of steel sheets under 3 mm. in thickness has been exported during each of the last three months to the U.S.S.R., Germany and France; and how many tons of similar steel sheets are in stock awaiting shipment to these countries.
During August to October, the only exports to these countries of steel sheets of a thickness under ⅛ inch, which is just over 3 mm., were six tons to France in August and four tons in September. No information is available of stocks awaiting shipment.
Will the hon. Gentleman give an assurance that while the grave shortage of steel sheets exists none will be exported in future?
The reply I have given, indicates that we are aware of the necessity of keeping steel sheets in this country.
American Cotton
asked the President of the Board of Trade if the prices at which the Government have been selling U.S. cotton to Lancashire spinners during the first nine months of this year were above or below the actual landed cost of such cotton in this country.
Nearly all the United States cotton used in the first nine months of 1946 was obtained under Lend-Lease, and actual landed cost therefore cannot be stated.
asked the President of the Board of Trade what offers for American cotton have been invited on the December basis of New York futures; and how does he reconcile that fact with the announcement on 30th October that no use is being made of any futures market.
Notices inviting offers of American cotton on the basis of New York December futures were issued by the Cotton Control on 5th and 17th July, 12th August and 17th September. No quantities were stated, and it is not considered desirable to give quantities bought. In accordance with normal selling practice in the United States, offers by shippers of American cotton are made at prices related t6 New York futures quotations. The Control itself does not deal in futures.
Is not that making use of the New York Cotton Exchange, and is it not, therefore, in contradiction to the information given to this House that use was not being made of the American futures market?
The information given to the House on 31st October was that the Government are not buying or selling futures at any time. It is, of course, true that when anybody wants to buy cotton in the United States from American traders, those traders, in calculating the price at which they are willing to sell, take into account the future price quoted at that time in the American market
MINE ACCIDENT (CUMBERLAND)
asked the Minister of Fuel and Power whether he has any information as to the cause and extent of the accident at Lowca Colliery, Whitehaven, and the number of killed and injured.
I regret to inform the House that an explosion occurred about 8.30 a.m. yesterday morning in the No. 2 East District of the Main Band Seam at Harrington No. 10 (also known, as Lowca) Colliery, Cumberland. Rescue operations were commenced without delay. Of 16 persons working in the District one was got out alive, though suffering from shock and bums, and 12 bodies have so far been recovered. The rescue work is hampered by falls and derangement of the ventilation caused by the explosion, but everything possible is being done to locate the three remaining men. Until it is possible to make a complete inspection of the areas affected, the cause of the ignition cannot be determined.
I am sure the House will wish to join with me in recording its sincere sympathy with the relatives of those who have lost their lives in this tragic accident.
I am grateful for the information and for the sympathy which has been extended to the relatives. Will the Minister see that everything is done to alleviate distress to the families of the men concerned?
Yes, Sir Everything possible will be done to see that the interests of suffering families are safeguarded. I should like to take the opportunity, Mr. Speaker, of paying tribute to the rescue team who came so willingly to the scene of the accident.
BUSINESS OF THE HOUSE
May I ask the Leader of the House whether he has any interim statement to make about Business?
I am much obliged to the right hon. Gentleman. [ Laughter. ] May I assure the House that I was not seeking to make a joke? On Friday, we shall ask the House to agree to take the Second Reading of the House of Commons (Redistribution of Seats) Bill. This Bill is being presented today, and copies will shortly be available in the Vote Office.
I would like to put myself on the same footing. Neither courtesy nor discourtesy is rationed at the present time. I understand that conversations have taken place about this Bill which are likely to make its progress less difficult than was at one time assumed?
I ought to say that it is quite exceptional for a Bill to be presented on a Tuesday and put down for Second Reading on the following Friday. I do not wish this to be held as a precedent against the Opposition, but it was convenient that conversations should take place between the Government and other parties, and that has necessarily delayed the printing of the Bill. We hope that it will be largely an agreed Measure. It was because we wished to handle it in a conciliatory way, that delay has been caused, and I assure the right hon. Gentleman that we regard the circumstances as exceptional. I would not, for that reason, quote this as an instance against the right hon. Gentleman on any future occasion.
May I ask your guidance, Mr. Speaker, with respect to Thursday's Debate, which was announced yesterday? We are due to discuss the Army, with special reference to the Territorial Army. I should like your guidance as to whether we can discuss that subject on the assumption of the continuance of compulsory national service. Unless we can discuss it on such a basis, I find it difficult to see what can be the value of our discussions.
I must confess that I do not quite know the answer. It is clear, as I told the right hon. Gentleman yesterday, that once we embark on the question of compulsory service, we are entering into legislation, and therefore out of Order. How to combine the two would seem to me to be a matter for consideration between the two Front Benches. Would it be possible to suggest that some Motion might be drafted?
I was going to suggest that a Motion should be put down. It would not be necessary, I suggest, to discuss the merits or otherwise of compulsory national service on Thursday, but unless there is an assumption, on which we can debate, I cannot see what value our discussions can have.
I understood that the Debate was to be within the limitations, broadly, of the statement made by the Secretary of State for War. I think that is how it ought to be. It is a matter of the internal organisation of the Territorial Army, and I think it would be rather doubtful to anticipate legislation of which the Government have given notice. We had one discussion on conscription during the Debate on the Address. We shall have another on the Bill, which we are all looking forward to with great interest. But I think myself that it would be a mistake to bring in the issue a third time on a matter which really arises out of the internal organisation of the Territorial Army, according to the announcement of the Secretary of State for War
I do not think that is quite the issue. In so far as we on this side of the House are concerned, we have no desire to debate on Thursday the merits or otherwise of compulsory military service. I cannot see how, unless we assume the continuance of compulsory military service, or are given some other basis for our discussion, we can usefully debate the statement of the right hon. Gentleman.
Of course, the right hon. Gentleman and his friends in making their argument—and others too, possibly— would be entitled to say that they had a right to argue the case on certain assumptions implicit in the announcement of legislation in the King's Speech. What is clear from Mr. Speaker's Ruling is that, if they mention legislation, or get on to the merits of legislation, they will be out of Order. I do not know, but I do not think that it would be convenient to put down a Motion
Is it not rather unsatisfactory to approach a Debate of this kind without anybody seeming to know at what point the speakers will be pulled up? There is no question of partisanship, but we would like to know, when we are discussing the conditions of the Territorial Army, whether we are discussing those conditions with reference to the great new fact that there is to be a prolongation of compulsory military service. If that cannot be discussed, it would be like dis- cussing the affairs of a family without being allowed to mention either the husband or the wife. Are we to have an intelligent Debate and not one to be pulled up at each point? I suggest to the right hon. Gentleman that the matter is easily settled by putting down a Motion, instead of having a Debate on the Adjournment. There could be a Motion in the most general terms, to approve the policy of His Majesty's Government in relation to the Armed Forces, or to approve the policy laid down in the speech of the Secretary of State for War. Something of the most general character would suffice, but we must have a sensible Debate.
If the Debate on Thursday is to be confined to the Territorial Army, does the right hon. Gentleman anticipate that discussion can possibly be confined to the limits of the Territorial Army as it existed up to 1939? Is it not obvious that many Members will stray on to the proposed new scheme outlined in the King's Speech and in the Prime Minister's statement? For that reason, may I ask the Leader of the House to reconsider the whole matter? Many of us are definitely opposed to conscription, and for that reason would take very grave exception to the matter being determined in a Debate of that kind.
I am sure my hon. Friend is trying to be helpful. The Debate will be about the Army and the Territorial Army in relation to the announcement made by the Secretary of State for War. Quite frankly, we have had one Debate on conscription, and we are to have a Bill. Therefore, I really do not think it would be convenient to have a Motion upon the whole issue again, in such a short time. If I may suggest it—I may be wrong, but you, Mr. Speaker, will say whether I am out of Order or not—perhaps the difficulty could be got over in this way. It could be argued that in our view no Territorial Army can be successful, unless there are x hundred thousand members in it, and then argue, on that, what we want to do with that number of members.
Can my right hon. Friend say whether the Government have had an opportunity of discussing the Third Report of the Select Committee on Procedure, which drew attention to the inconvenience that arises out of the Rule that we cannot on the Adjournment Motion discuss matters which involve legislation; and whether the Government are making any recommendations in that regard?
No, Sir, we have not.
Will it not be a very ragged Debate on Thursday if we cannot get down to the essential point of how the Territorial Army is to do its job and that it can only do its job if there is a big flow into it of people who come under conscription? A second point I should like to put is that, in any case, a discussion on the constitution of the Territorial Army is going to be a very narrow Debate on a very arid subject. In those circumstances, would it not be possible to go into other matters of Army administration, which are of concern, such as conditions in India, leave in advance of Python and that sort of issue?
On the last point, the subject will be the Army and the Territorial Army and, therefore, my hon. Friend would be in no difficulty, subject to your Ruling, Mr. Speaker, in discussing matters of Army organisation. With regard to the earlier point, I still think that, subject again to your Ruling, Mr. Speaker, it would be competent to argue that the Territorial Army should be of a certain strength, and if that strength were given that it should be disposed of and organised in a certain way. That would not, in itself, raise the issue either of conscription or legislation.
On that point, may I say that the Territorial Army has hitherto been a volunteer force? In the future is it to be partly compulsory and partly volunteer? I understand that that is so. That is the entire point we wish to discuss. Is it not obvious that the mixture of the two will affect the whole constitution, internally, of the Territorial Army? How can we take part in a discussion if we run out of Order, every time an hon. Member happens to stray across this purely imaginary limit?
If I had known that the Opposition wanted to discuss the issue of conscription, it might have been different. With great respect, I am not clear from what the right hon. Gentleman says whether it rather borders on that now. If that is so, we might have taken another view as to whether this day should be given or not. If I may say so—and again I may be wrong—there is involved not only the issue of legislation being debated on the Adjournment, but I am not sure whether the issue of anticipation does not also arise, as it has been announced in the King's Speech that a Compulsory Service Bill is to be introduced. On that point I am not quite sure.
If I may suggest it to the House, it seems to me that there is not, after all, a great margin between the two views and as another week elapses before this Debate takes place—[HON. MEMBERS: "No, it is on Thursday."] I am much obliged. There is however, an interval between now and the Debate, and perhaps consultations will take place. I had no notice that this matter was going to be raised today and, therefore, I was not able to look into the matter carefully. I do not know whether anything can be done between the two Front Benches.
Perhaps it would be most convenient to discuss the matter through the usual channels. May I say, with great respect, that we have no wish to have a row about conscription or non-conscription, but we do wish the Debate on the Territorial Army to take place with regard to the actual facts upon which it would be reconstituted.
As long as it is not taken that I am contemplating a Motion, I have no objection to discussion through the usual channels to try to find a way out of the difficulty. If we can, I, and I am sure, my right hon. Friend the Chief Whip, will be happy to cooperate.
The right hon. Gentleman is not excluding the idea of a general Motion, which does enable the matter to be discussed in its entirety?
I have to look beyond the general Motion to what would follow.
I am sorry about that.
So am I. As the right hon. Gentleman appreciates, it is the duty of the Leader of the House to have in his mind all the elements of the House, as well as the official bodies.
I should like to make a suggestion to the Leader of the House. While it is right and proper in ordinary circumstances that the general Business for the convenience of the House should be discussed through the usual channels, there are two questions obviously involved here. One, suggested by the Leader of the House, is the organisation of the Territorial Army, which is a very important matter. But underlying it there might be a discussion on a fundamental issue in which the whole Constitution of this country is involved, namely, conscription in time of peace. Therefore, I suggest that the right course to adopt, in view of the rule against anticipation, is to postpone the discussion until the Bill comes before the House.
I, personally, have no objection to that course, but I have promised this discussion to the Opposition. Obviously, I cannot withdraw from that promise without the consent of the Opposition.
Will the Leader of the House keep an eye on the Debate which is to take place today, and in which there is a considerable demand for time on the part of those who wish to speak? In those circumstances will he consider suspending the Rule?
I would prefer to do it on a Thursday on a Scottish Bill. Sometimes when the Rule is suspended on Thursdays, our Scottish colleagues are not all here to take part in the Division. I think that the well-known capacity of our Scots colleagues for economy in their speeches—which is very admirable—will get us through in the ordinary time tonight.
I must take exception to the remark of the Leader of the House. The Scottish Members have as good a record as any other Members of this House. In a Debate like this, when so many Members have so many matters to bring up in connection with their constituencies, the Leader of the House should be prepared where necessary to consider suspending the Rule.
I would like to ask your advice, Mr. Speaker, about a matter you mentioned a moment ago. I understood you to say that an arrangement might be made, through the usual channels with regard to the Debate on the Territorial Army. The right hon. Gentleman the Leader of the Opposition made it clear that all he desires to do is to discuss the subject on Thursday in the light of conscription—
It is the only way it can be done.
—and, therefore, anticipating what the decision of the House will be at a later stage. Can you, Mr. Speaker, give us some guidance as to whether that is in Order or not, if the usual channels come to an arrangement which prejudges a decision of the House?
Intelligent anticipation is always in Order. The rule about anticipation only applies when a Bill has been produced. Then, of course, one may not anticipate what the result will be. Until that anticipation is in Order.
One may not anticipate it on a Motion for the Adjournment, but if a definite Motion is put down this House can address itself to it.
It is quite obvious that in a discussion on the Motion for the Adjournment any hon. Member can talk about anything, but he must not ask for legislation nor must he demand alterations to existing legislation. In the present instance he is entitled to assume that next year we shall have another Finance Act to raise taxes to pay for the Territorial Army. I do not see why, in a Debate on the reorganisation of the Territorial Army, there is anything wrong in assuming that certain laws will go on.
Is my right hon. Friend aware that there is no change in the suggestion of the Government on the Territorial Army from the position existing before the war, because in the last year before the war it was intended that it should be on a compulsory service basis. Surely we could discuss it on that basis, which exists at the moment and which existed about the time the Territorial Army was suspended?
May I ask the right hon. Gentleman if he will bear in mind the fundamental issue that there is a desire in a broad section of opinion inside the Labour Party that—apart from any conversations which may take place between the Front Benches—we should face up to the situation, "Shall there be conscription for the Territorial Army in peacetime or not? We should like to have it out with the Front Bench on Thursday.
I always admire the North country frankness of my hon. Friend and respect it, but we have "had it out" once, and had a Division. It has yet to be "had out" again—
On the Territorial Army.
But the right hon. Gentleman says that sooner or later it will be related to that, and it will have to be argued out on the Bill. I should have thought that there was plenty to talk about in the organisation of the Army and the Territorial Army without getting into these deep waters on Thursday.
If hon. Gentlemen are to get up in succession and endeavour to make speeches about the future life of the Territorial Army, and how it draws its strength and carries on its affairs, and at every moment when they refer to the fact, even by implication, that a system of compulsory service is to be enforced, they find themselves offending against the Rules of Order, then I say that the Debate is needlessly upset and interfered with by the decision. I hope we may have a discussion through the usual channels and that the Government will not close their minds to putting down some innocent Motion, which avoids the Rule which now covers Debates on the Adjournment.
We have had a longish discussion, and there is another matter upon which the right hon. Gentleman wishes to ask a question.
With very great respect, Sir, you imply that we have had enough, but in fact we have not had anything— or at least nothing has been reached so far that has in it the slightest meaning. I venture, Sir, to ask you whether you are now in a position to give a Ruling on the point which arose last week as to whether the question of the Roosevelt statue is one to which Ministerial responsibility can be assigned?
I have given careful consideration to this matter. The question is whether the design of the statue to be erected can be discussed on a Motion for the Adjournment of the House. It is a fundamental rule governing Debates on the Adjournment that only such matters can be debated on this Motion as involve the responsibility of the Government, and I am advised that under the Act which was passed last Session the Minister has no responsibility for the design itself. There is, however, an Act of 1854 which places public statues within the Metropolitan Police district under the control of the Commissioners of Works and Buildings, and this Act states as follows: No public statue shall be erected in any public place without the written assent of the said Commissioners. I am advised that this Section applies to the Roosevelt Memorial Statue and that it could not be erected without the assent of the Minister of Works, whose responsibility extends to the design of the statue. I must rule, therefore, that the question of the design of the statue is in Order on the Motion for the Adjournment. At the same time, the House should remember that the conditions of this particular memorial are now regulated by Statute and that any proposal for varying them would involve legislation and cannot be discussed on the Motion for the Adjournment.
I gather from your Ruling, Sir, that we should be entitled to discuss the question of the design of the Roosevelt statue on the Adjournment provided that nothing that we say indicates the need for further legislation. That being so, the responsibility of the Minister—if I interpret your meaning rightly, the Minister of Works—is not in dispute. He is undoubtedly responsible, and therefore I suppose that in a Debate on the Vote for the Minister of Works, the matter could be discussed in Supply, if the Opposition choose to ask for such a Vote. Is that so?
Unquestionably: what is allowable on the Adjournment is, I think, allowable in Supply.
Only more so, and in that case we should not be hampered by saying that we did not like this or that form. I am very much obliged to you, Sir, for your Ruling, and I venture to ask the Leader of the House whether, if an occasion should arise when the Opposition decide to ask for a Supply Day—
Hon. Members: Next Thursday.
—on which the Vote of the Minister of Works will be set down, the Government will agree that this question, into which so many variants of opinion enter, could be decided by a free vote of the House.
Before the Leader of the House replies, may I support what the right hon. Gentleman has just said, and point out that as the work upon the present statue is proceeding, this matter is one of great urgency? Would the right hon. Gentleman the Leader of the House therefore consider allowing this Debate on Thursday, in place of that already proposed?
With regard to what happens on Thursday, as I have already given the day to the Opposition I cannot take it away unless the Opposition think it would be nicer to discuss the Roosevelt statue instead of the Territorial Army. If they think so, that is all right, but I cannot coerce the Opposition. The day has been given, and it is for them to decide. I do not suppose that the statue will be started within the next few weeks, but I thought that the suggestion of the righ hon. Gentleman that this might be taken on a Supply Day. was a very admirable one. We should certainly be willing to cooperate to that end, but I am bound to say that at the end of the day the question whether this House of 640 hon. and worthy Members is necessarily an authoritative body on a matter of architectural beauty is for hon. Members to consider. I only recall that there was once a battle about a famous bridge in London, and I personally did not think that the House was a good judge of architectural merits.
I was, and am still, a supporter and admirer of the bridge in question. I think it is an admirable monument to the right hon. Gentleman, and I hope he will continue to be worthy of it. I would not venture to suggest that the Business for Thursday should he altered, but I am glad that it is agreed and covered by your authoritative Ruling, Mr. Speaker, that this question is a matter of Ministerial responsibility and that if the House think fit they can discuss it and deal with it as they choose.
PERSONAL STATEMENT
My attention has been called by the noble Lord the Member for Horsham (Earl Winterton) to the report in HANSARD of a speech of mine made in the House on 18th November. With your leave, Sir, and with the leave of the House, I would like to apologise both to the noble Lord and to the House for a misprint which occurs in it. As a result of the omission of one word and the misprinting of another, I am made to appear to suggest that the noble Lord was present in the House when the Army Regulation Bill was discussed in July, 1871— [ Laughter ]—or, alternatively, that the question of the sale and purchase of commissions was still an active issue as late as 1905. Of course, neither suggestion is true. The last thing which a new Member of this House would wish to do is to be intentionally discourteous to the noble Lord, and I hope the House will pardon any clumsiness in speech on my part which may have led to my being misreported.
May I, Sir, in accordance with a well-grounded precedent, thank the hon. Member for his most courteous correction and say that the only reason why I asked him to make it was that I feared some speaker on a subsequent occasion might have stated that I was in the House and made no effective protest by way of espying Strangers when one of your predecessors had a few words with King Charles I.
NEW MEMBER SWORN
David Emlyn Thomas, Esquire, for the Borough of Merthyr Tydfil (Aberdare Division).
HOUSE OF COMMONS (REDISTRIBUTION OF SEATS) BILL
"to relax the rules set out in the Third Schedule to the House of Commons (Redistribution of Seats) Act, 1944, so far as they relate to the application of the electoral quota and, in consequence thereof, to postpone the enumeration date for the purposes of the initial report under section three of that Act," presented by Mr. Ede; supported by Mr. Westwood, Mr. Oliver and Mr. Thomas Fraser; to be read a Second time upon Friday, and to be printed. [Bill 20].
NATIONAL HEALTH SERVICE (SCOTLAND) BILL
Order for Second Reading read.
4.7 p.m.
I beg to move, "That the Bill be now read a Second time."
In inviting the House to give a Second Reading to this Bill I feel it well that we should briefly consider the background of its preparation, and the need for its introduction as the next step forward towards a positive health policy for Scotland. The beginnings of the health services in Scotland can be traced to the fear of pestilence, and this fear supplied the leading motive for nearly all health efforts in Scotland up to about the beginning of this century. It can be summed up so far as this policy is concerned in the words, "a public policy directed rather to the preservation of the untainted, than to the recovery of the sick."
A good illustration of this policy was the decision of the magistrates of Aberdeen —it is true that it is a long way back, but, still, it give? us some indication of what the policy was at that time in a particular area—in the year 1585, to erect three gibbets—one at Mercat Cross, another at the Brig of Dee, and a third at the haven mouth—so that any infected person arriving in the burgh, or any person who gave shelter to an infected person, if a man should be hanged, and if a woman should be drowned Much progress has been made since that time. [An HON. MEMBER: "What is being done now?"] We have had a century of legislation, each piece of legislation carrying us forward to the health services of today—health services which are in operation for the care of the sick poor, the industrial health service, the school medical service, the maternity and child welfare service, national health insurance, and not least of all, particularly as it affects Scotland, the Highlands and Islands medical service. Arising out of the Dewar Committee's Report, Parliament in 1913 passed the Highlands and Islands Medical Service (Grants) Act, which today provides grants for doctors, nursing services, hospitals, specialists, ambulances and other means for the prevention, the treatment and the alleviation of illness and suffering in the Highlands and Islands, and recognising that an adequate medical service is an essential element for the wellbeing of the citizen, the State, so far as that part of Scotland is concerned, has been subsidising these services since 1913.
Despite the progress we have made as the result of previous legislation, there remains a large mass of sickness and defects of various kinds as revealed by the records of medical inspection of school children, sickness returns of the insured population, and other figures. The Committee on Scottish Health Services, of which I had the honour and privilege to be a member, and which reported in 1936, pointed out that: In an investigation in Glasgow about 10 per cent. of school children were found to have ailments that could not be classified as minor; in the course of a year over 20 per cent. of the insured population are incapacitated for work, and the average time lost among the insured population is more than ten days per annum. Of the men applying for enlistment in the Army and presented for medical examination, 38 per cent. were rejected on medical grounds. There is, in addition, much subnormal health and many minor defects that, although not recorded in any tables, represent diminished reserve and capacity for living and may be the precursors of manifest disease. The vital statistics of Scotland are disquietingly less favourable than those of England and Wales and several other European countries. Having all these facts before them, the Committee to which I have already referred came to the conclusion and again I quote: Changes in the size and distribution of the population, in social and economic conditions, in the habits and outlook of the people, and in the actual causes of death and ill-health require a readjustment of health effort. The existing health services are not fully adapted to modern conditions and outlook, and it is inherent in their more or less haphazard and sectional growth that they do not constitute a national health policy. The first essential, in order to avoid over-lapping, to secure a full return for expenditure, to keep the services in line with changing conditions, and to secure that emphasis is distributed according to the social value of the varied services, is to integrate the separate services into a national health policy. The general aim of this policy should be to promote the fitness of the people. The need for such a policy is, among other considerations, reinforced by the fact that the people of Scotland are far short of an attainable standard of fitness, the huge communal cost of ill-health and the prospect of a declining population. Policy should be comprehensive in scope and should cover the whole field of morbidity. Now when that Committee considered the general practitioner service, it was conclusively proved that many persons, especially women and children, do not in fact receive adequate and timely attention because those responsible could not afford to pay for the services of a private general practitioner. Let me quote from evidence of the medical officer of health for Dundee. This is what he said: One of the most important criticisms of the organisation as it exists at present is that advice and treatment are not immediately accessible to every individual unless the payment of medical fees is a matter of little or no moment. This witness went on to state: This fact has been brought home to me on numerous occasions when visiting in the district for the purposes of housing. During the winter months particularly, one finds in numerous dwelling houses children who are obviously ill and in need of medical attention. He also said that no doctor was in attendance and the reason, admitted or obvious, based upon the inquiries and the work on which he was engaged, was always connected with finance. He added: Usually we find that there has been delay in sending for medical advice owing to the expenditure involved. That Committee gave me an insight into health administration in Scotland and the opportunity of getting a grounding for the work which I have to do in this House now, to get this Bill through in time. It further found that the inadequacy of general medical attendance adds to the cost, interferes with the efficiency, and prevents the sound development of many of the medical services provided by Statute. We came to the conclusion—and here I quote again from the Report— that: as part of a policy for the promotion of the health of the people it is necessary to secure that as far as possible all members of the community should have available the services of a general medical practitioner. On grounds of administrative expediency as well as on grounds of national policy it has become imperative for the State to frame a policy to meet the needs of— I want to emphasise the next two words— at least the dependants of insured persons and others in similar economic circumstances and to lay down the lines along which the medical services should develop. Those two words "at least" were placed in the report because there were members of that Advisory Committee who believed that it was essential to have an all-comprehensive service providing a family practitioner for all who needed his or her services. We could only get agreement, so far as that part of the report was concerned, by agreeing to the insertion of the words "at least." To put it another way, that was to be the minimum towards which we were to strive, and it certainly did not satisfy at least seven members of that Committee, who finally signed a reservation so far as the provision of family practitioner service was concerned.
A subcommittee of the Scottish Health Services Committee reported on the Highland and Islands medical service. They reported that they found it to be so satisfactory that it might provide valuable pointers for consideration of future medical service in Scotland as a whole. I mention that because they were so impressed with the success of the Highlands and Islands medical service, to which I will refer later, that they were assured in their own minds that it could give us the necessary pointers towards having a full and comprehensive service in Scotland.
As to the policy of having a free, all-embracing, family practitioner service, the Royal Commission on National Health Insurance recommended the separating of the medical service from the insurance structure, and the placing of it on public funds. Ten years later, in their reservation to which I have already referred, six members and myself out of the 18 members of the Scottish Health Services Committee recommended the abandonment of the contributory system so far as the medical side of insurance is concerned, and we further suggested that those with whom the direction of policy rests should in planning the future bear in mind that the "ultimate solution" of the Royal Commission cannot be much longer postponed and that they should seek the favourable moment to bring simplicity and logic into this part of our health policy.
We found a serious shortage of hospital facilities, that the shortage militated against the ideal of early treatment, that adequate hospital service is essential for the public health, and that steps should be taken to provide it. It is true that the Scottish Health Services Committee also said that it was in the interest of the State to foster the voluntary hospital system, but this was qualified by the statement that it would be unwise to extend their financial commitments much further than at present. To secure an adequate hospital service under modern conditions —and to safeguard the voluntary hospitals—hospitals of all kinds, we went on to state, must be viewed as a whole, and over wide regions, and must be regarded as forming one service.
The Bill which is now before the House —a Bill drafted and directed towards providing for Scots people a comprehensive Health Service—places for the first time on public authorities—central and local— the responsibility for seeing to the provision of all facilities needed for the health of the whole population. The essential aims and objectives, on which I think there is general agreement, although we may disagree on how we are to attain these objects, might be summed up in this way. In the first place, it is to be the statutory responsibility of some public authority to provide every necessary form of health care—the family doctor, the specialist, the hospital, rehabilitation and convalescence, dental treatment, the care of sight and hearing including the provision of artificial aids, special priority services for expectant and nursing mothers, young children and school children, and so on. There is to be full provision, not only for the treatment of illness, but also, what is no less important, for the prevention of illness, and the promotion of health, without which we cannot have a positive health service.
In the second place, the service—or any part of it—will be available to every man, woman and child in the country. Although part of the cost is to be met from insurance funds, there will be no insurance qualifications,' nor any other kind of test based upon means, residence, or anything of that kind. In the third place, the new service is, for all practical purposes, to be free of charge. This does not mean that it will not be an expensive business to provide the service, although less expensive than to allow ill-health to continue unchecked. But the cost will be met mainly from the national Exchequer, and partly, also, from rates and insurance contributions; so that the patient will not in future have to pay in accordance with the extent to which he finds it necessary to call in the service to his aid
So much for the aims of the new Service. And now a word about the organisation which the Bill proposes to attain these aims. Central responsibility for the new Service as a whole is to rest with the Secretary of State. By his side, to give him expert advice on all aspects of the Service, there is to be a Scottish Health Services Council, with members drawn from all relevant fields of experience. Standing committees of that council will be set up in connection with particular parts of the Service, including any additional members necessary to cover particular sub-divisions of the expert field. Responsibility for the hospital and allied services is also to rest in future with the Secretary of State. For this purpose all existing hospitals, local authority, and voluntary, are to be transferred to him. The administration of these services is to be entrusted to an organisation I propose to set up under the Bill, a specially created regional and local organisation. Five regional hospital boards will act as agents of the Secretary of State, undertaking the general administration of the services in their areas. In turn, to act as agents of the regional boards for the control and management of particular hospitals, boards of management are to be set up. On these regional boards and boards of management members with all appropriate kinds of experience and local interests will find a place. For the general practitioner services, executive councils are to be established, drawn mainly from local authorities, and from representative professional committees in each area. The doctors and dentists will be encouraged to work from health centres, which will be staffed and equipped so as to enable them to carry out their work in the most effective way. Responsibility for these health centres will, in Scotland, rest in the first place with the Secretary of State. In order to improve the distribution of doctors throughout the country, there will be provision for debarring additional doctors from entering the Service in an area already adequately covered. Sale and purchase of medical practices coming within the new Service will be forbidden, and compensation will be paid. Remuneration, while mainly by way of capitation payments, will also include a basic salary dement, which can be adjusted in accordance with the different needs of particular areas
The right hon. Gentleman is now touching on an important point. Who is to decide whether a particular area is adequately covered or not? Is the Secretary of State to have advice?
The hon. and gallant Gentleman may rest assured that I will have the best and most competent advice to guide me on what is, I admit, a very important point.
Can my right hon. Friend explain a point about compensation? General practitioners in my constituency have agreements with their assistants in which the assistants have the right, either to go into partnership, or, if the practice is sold, of first priority. Some of them have built up quite considerable assistants' practices. Is any consideration to be given to those people, now that the general practitioners are to sell out to the Government?
I would prefer that these particular points should be raised in Committee, when we shall have fuller time to deal with these very important questions. That is one of the reasons why I endeavoured to keep this as a Scottish Bill, so that we shall be able to thresh these matters out in detail in the Scottish Grand Committee. The lump sum for compensation is £66 million. I shall be referring to it later in my speech. It will be available for the whole of the medical practitioner services in Great Britain, and Scottish doctors will be entitled to their fair share.
The only point I have in mind, in raising the matter, is that, unfortunately, no provision is made in the White Paper, or in the Bill. These men are suffering great hardship in this respect, that if they claim the right to practise in the area where they have been practising, the General Medical Council will come down on them for a breach of the rules of etiquette.
I do not want here to go into Committee points. It would be impossible for us to deal with all the points of detail on the Second Reading of the Bill. These are matters which can be discussed when we reach the Committee stage. I repeat that the sale and purchase of medical practices coming within the new service will be forbidden, and compensation will be paid As I have pointed out, remuneration, while mainly by way of capitation payment, will also include a salary element.
For a considerable range of local services, responsibility will rest, as at present, with the major local authorities, that is, the county councils and the town councils of our large burghs. In addition to their present maternity and child welfare duties, authorities will have a new duty to secure the provision of a home nursing service, and also wide powers to undertake preventive and after-care services, including the provision of domestic help needed on health grounds. The decisions, taken by the Government, were taken in the light of a great mass of information about the views and suggestions of the various interests concerned. As Secretary of State I made it my business to see that circumstances peculiar to Scotland were kept in view.
In settling the final form of the Scottish Bill we have had the advantage of many interesting and valuable discussions that have taken place on the English Measure. I have also had the further advantage of discussions with the Scottish interests concerned on the basis of the Bill introduced into Parliament last Session. The Bill now before the House owes much to the great mass of knowledge and experience that has been brought into play in recent months, and I wish, from this Box, to express my sincere thanks to those busy men and women in Scotland and elsewhere, who have been of assistance to me. On some questions we have differed. That I suppose was inevitable. But I have never looked in vain for helpful advice and comment from those whom I have consulted in Scotland. The final result of all this consideration and these discussions is now before the House. I do not propose today to go over all its provisions in detail. In the course of Debates in this House and in another place during recent months the general principles on which this Bill, like its English counterpart, is based, have been subjected to close examination and scrutiny. As a result Parliament endorsed the Government's proposals and, so far as they relate to England and Wales, has written them into the Statute Book. Scottish Members of Parliament and Scotsmen in another place took a prominent part in these Debates.
I propose therefore to devote the rest of what I have to say mainly to the points of difference between the proposals in the Scottish Bill now before the House and those which were embodied in the English Act. Conditions in Scotland are different in many important respects from conditions south of the Border. Scotland has her own legal system, her own traditions, and her own system of local government. The geographical distribution of her population is different. It is necessary, therefore, to adjust the application of general principles to suit Scotland's particular circumstances and needs. As regards the general practitioner division of the Service, the only important difference concerns health centres. In Scotland, where conditions in different local areas vary so widely, and the country as a whole is not an unmanageable unit, I thought it best that the early steps in health centre development should be undertaken directly by the Secretary of State. In this way I think that the lessons of the early years can best be learned and generally applied. The Scottish local authorities have not indicated any serious objection to this course, and the medical profession in Scotland prefer that it should be so. While the Bill enables the Secretary of State's functions in relation to' health centres to be delegated to local authorities, I personally do not intend to exercise that power in the early and experimental years of this service. I would emphasise that the family practitioner's contract, in the health centre as outside, will be with the executive council proposed to be set up by this Bill.
In Scotland, as in England, I contemplate that, although payment by capitation fees should represent the larger part of the doctor's remuneration, there should also be an element of basic salary. I see in this method of adjusting remuneration to varying conditions in different parts of the country. That the doctors in Scotland should look upon this fearfully I say quite frankly is a surprise to me, for basic salaries by another name have for the last 30 years been an essential feature of the Highlands and Islands medical service, to which so many tributes have been paid by the doctors themselves and by many committees of inquiry. I see in the basic salary element, too, a means of reducing competition between doctors for patients which, like most good things, is good in moderation but bad when carried to excess. As in England, sale and purchase of medical practices coming within the new service in Scotland will be prohibited. Doctors in Scotland who suffer loss in consequence of this prohibition will, as I have already indicated in reply to the intervention of my hon. Friend, have their share of the £66 million the Government are providing by way of compensation.
A bribe
If it is suggested that it is a bribe, then if doctors do not want to take any of it, they are not compelled to do so.
Where does it come from?
Where everything comes from—from those who produce the wealth of this country. So much tor the family doctor. Looking at it from the patient's point of view, the next stage is when the services of a consultant specialist are needed. Generally speaking, up till now the great majority of the community have been unable to get specialist advice except by attending the out-patient department of a hospital or by going into the hospital as a patient. In the new service, for which this Bill provides, the family doctor will be able to call in a specialist whenever his opinion is required. The specialist service must be based on the hospitals and it will be the responsibility of the hospital boards, but they will make arrangements with the executive councils to ensure the close association of the specialist and the general practitioner.
This brings me to the hospital administration itself. I have already quoted the view of the Scottish Health Services Committee that it should be one service and organised on regional lines. It seems to me that while everyone accepts the need for a regional hospital system, it is not equally appreciated that no system of this kind is possible so long as there are two different forms of hospital administration and ownership. In Scotland the voluntary hospitals have always had a very prominent place. As in so many other fields, voluntary effort has blazed the trail. But is it really possible for them to continue as they have done up till now? Their costs in all directions have greatly increased and are still increasing as services become more and more elaborate and highly specialised. With any form of National Health Service, it would only be right that they should be paid for their treatment of patients who took part in chat Service. The payments for service to the State would bulk increasingly large in the revenue of the voluntary hospitals. The State could not go on handing over these large sums of money without having control.
This control, I submit, can be exercised only by the State, because the local authorities would not be a suitable instrument. Many local authorities have neither the resources nor the experience necessary to run hospitals. I do not think that we can look to local authorities any more than to voluntary bodies, to provide an efficient hospital service in the new conditions which now obtain. The very fact that there are so many independent units creates hopeless difficulties. In Scotland there are about 250 hospitals belonging to the 55 local authorities, and about another 220 voluntary hospitals, practically every one of which has a separate governing body. That means to say, we have about 250 hospital authorities, all with their own interests and ideas. With this multiplicity of authorities we get over-lapping, unnecessary competition and worst of all, gaps in the hospital service.
Hospital services are developing in such a way as to make a new and comprehensive authority with a large area and large resources behind it a practical necessity. The hospital surveyors, both in their general introduction to the survey, and in the surveys themselves, over and over again speak in terms of comprehensive units—large infectious diseases hospitals instead of small ones, and the advantages of putting large infectious diseases hospitals side by side with general hospitals, the amalgamation of special hospitals for eyes, ears, nose and throat, or cancer with the general hospitals. These are the lines on which the hospital service must develop, according to the best technical advice we can get, and there is a very striking unanimity about the recommendations of all the surveyors, both in Scotland and in the comparable surveys in England and they have not been seriously challenged. There is no possible chance, I submit, of securing all these developments so long as the general hospital is a voluntary one and infectious diseases is the responsibility of a local authority. If, in a particular area, there are two unsatisfactory and small general hospitals, one run by a voluntary body and the other by the local authority, how can one work towards a new single and comprehensive unit. It would be absolutely impossible.
To an increasing extent we are having to provide services which demand wide areas of up to half a million or a million people. The orthopædic service is an example, where it has already been necessary to set up joint regional councils. A proper cancer service, and the new branches of surgery, like plastic and brain surgery, need an organisation covering a million, or perhaps even two million people. Even in the older fields of medicine and surgery, there has been in the past too great a concentration of the specialist skill in and around the teaching hospitals. In face of all this, I have no doubt whatever that anyone beginning from scratch would come down in favour of the sort of hospital organisation that this Bill provides, with one ownership, and one administration. Why then should we bogle about making the change, provided that we can, and I am sure we can, preserve all that is essentially good from the past? These proposals are, as fax as I can judge from my discussions—and I have had many in Scotland—generally acceptable to those who have to work in the hospitals and even to some of the local authority and voluntary hospital people, whose responsibilities are being taken away. There is, as I have said, much to preserve from the past. Some of the voluntary hospitals have set a very high standard and in recent years some of the Scottish local authorities have achievements to their credit which will stand comparison anywhere. I will be told that we shall be losing the benefits of the voluntary spirit, and the freedom and enterprise that are supposed to be peculiarly associated with it. I ask the House why should we? We shall have the same doctors and nurses, the same independent medical schools, many, I hope, of the same people on the regional boards and boards of management, and the same endowments will be available, even more than they are today, for new developments and for research. Voluntary bodies have no monopoly of enterprise or freedom.
It will be a closed shop.
I have taken great care in framing this Bill to avoid any undue concentration of authority. The maximum of independence and responsibility will be left with the Boards of Management. The Bill places definite duties on them and the regulations under it and the schemes for delegation which the Regional Board have to make will carry this process still further. In the same way, when I have appointed the Regional Boards, laid down the broad lines of hospital policy, and approved their budgets, I intend, so far as I can, consistently with my overall responsibility for the Service, to leave them to get on with their job.
Now I would deal with three features of my hospital proposals that are peculiar to Scotland. In the first place, whereas the English Act puts the responsibility for the ambulance service on the local health authorities, the Scottish Bill puts it on the Secretary of State. I am convinced that in Scotland, where the local health authorities are smaller in area and population, this is the right thing to do. The next main difference concerns the teaching hospitals. From an early stage of the Government's discussions on the National Health Service, I have been clear in my own mind, that the English arrangement was unsuitable for Scotland. Although the number of hospital beds in Scotland is only about one-tenth of the total for the United Kingdom, Scotland is training about one-third of the medical students. That is a remarkable achievement. It follows, therefore, that the teaching hospitals bulk very large in the hospital service—so large, indeed, that if they were taken out of the regional ambit, the core of the hospital service would have gone.
I have tried, therefore, to frame an alternative scheme with the same general aim, of course, of safeguarding the position of medical education. In doing so, I have had the benefit of consultations with the representatives of universities and I think they would accept generally that the provisions in the Bill will enable them to discharge their responsibilities to their own satisfaction. The Bill lays a clear duty on the responsible Minister, and through him on the regional boards and [he boards of management, to make available all the necessary facilities for clinical teaching and research. It provides that when a regional board is drawing up its scheme for constitution of boards of management for hospitals in particular groups of hospitals it must consult the university. The object of this consultation is to establish in which hospitals teaching is to be carried on, because wherever teaching is carried on, the Bill provides for the university and the teaching staff to be suitably represented by their own nominees on the board of management of that hospital. There is also provision for a medical education committee in each region consisting of nominees of the university, members appointed by the regional board and other members, who would include, for example, members to represent the medical teachers themselves and chosen after consultation with the Royal Colleges and other bodies who speak for them. This medical education committee will advise the regional board on all matters relating to the hospital service which affect medical education.
This brings me to the third point of difference. This Bill provides that in Scotland all the boards of management, whether of teaching or non-teaching hospitals, will, in the first place, retain the endowments of their particular hospital or hospitals. In the new conditions, when many endowments will not be needed for their original purposes, particularly where they were left for the general upkeep of a hospital, some review and reallocation is necessary. There are people who seem to think that it is something quite revolutionary to interfere in any way with endowments. The House may be interested to know that more than 70 years ago, in 1872, Parliament set up the Colebrooke Commission to deal with Scottish educational endowments, and the first Educational Endowments Commission was set up ten years later to review and adjust the use of endowments in accordance with the policy which it laid down. I might point out that these Commissions did not consist of members of my party. They contained between them some very well known Scottish names—Rosebery, Stirling Maxwell, Campbell of Stracathro, Elgin and Balfour of Burleigh, and I do not know that any of those took out a membership card of the Labour Party to which I belong. There is, therefore, nothing very revolutionary or particularly Socialist in what the Bill proposes.
The method of reviewing, and where necessary adjusting, the application of endowments follows very closely the precedent of the Educational Endowments Act of 1928 and the Hospital Endowments Commission is modelled closely on the Educational Endowments Commission set up under that Act, of which I myself was a member. Because of my knowledge gained there, I thought it would be quite a good thing to bring that same principle into operation in dealing with the hospital endowments in Scotland.
Surely, the right hon. Gentleman is not asking the House to assume that endowments for education are on a par with an endowment for hospitals given in memory of the treatment of some beloved relative? Is there not a fundamental difference between the two? If the Secretary of State is going to quote instances of endowments, why not quote the case of Henry VIII and the monasteries?
I am not so interested in Henry VIII and in acts in which he participated as I am in this Bill, which I hope to see an Act of Parliament in the very near future. I gave that as an illustration, in an endeavour to prove that the principle is not a new one.
Surely, the right hon. Gentleman is not commending it on this occasion?
I believe that these methods, which are in accordance with a well tried Scottish precedent which has worked satisfactorily for Scottish education, will be generally acceptable and will have equally satisfactory results for the hospital service. I am confident, too, that the Endowments Commission will do its work in such a way as to encourage future benefactors to give their money to the hospitals in the future, just as they have done in the past. Our experience in education has certainly confirmed this view. I might add that the first Commission, the 1882 Commission, dealt with endowments of an annual value of £200,000. The second one between 1929 and 1936 dealt with endowments of an annual value of about £750,000. The annual value of the Scottish hospital endowments is not exactly known, but it is probably about £300,000 so that experience suggests that the Commission will have no serious difficulty over the size of their task.
I am not giving, nor do I intend to give any instructions on this subject to anybody, but perhaps I might quote from a great benefactor's letter to his trustees, because what it says of the particular town of which he writes might well apply to the future use of hospital endowments: Remember you are pioneers, and do not be afraid of making mistakes; those who never make mistakes never make anything. Try many things freely but discard just as freely. As it is the masses you are to benefit it follows you have to keep in touch with them and must carry thorn with you. Not what other cities have is your standard; it is the something beyond this which they lack, and your funds should be strictly devoted to this … I can imagine it may be your duty in the future to abandon beneficient fields from time to time when municipalities enlarge; their spheres of action and embrace these. When they attend to any department it is time for you to abandon it and march forward to new triumphs. 'Pioneers always ahead ' would not be a bad motto for you.
He was a millionaire capitalist, was he not?
We will not argue about that. These were the words of a famous Scotsman who was a Scotsman before he was a capitalist. They were written by Andrew Carnegie with reference to the burgh of Dunfermline in the county of which I am proud to be a citizen.
The third main division in which the new service is organised comprises the clinic and domiciliary services entrusted to the local health authorities. The only important differences from England are the omission, from this field, of responsibility for health centres and for ambulances, which I have dealt with already. The transfer of hospitals away from the local authority field will, it is true, diminish the direct interest of local authorities and their medical officers of health in the treatment of disease. But this by no means implies that the local authority concern with health services has been so reduced that it is not worth while their continuing in the health field at all. The most important health function of the local authorities in future, as I see it, is the social side of health care. This is linked with their broad duties in connection with the control of infectious diseases. The medical officer who knows his district intimately, who knows the conditions under which the people live, will in future have great opportunities in the expanding field devoted to prevention of disease and promotion of health in community life.
The local authorities have another part to play in the new service. Locally they represent the consumers. For this reason, therefore, they nominate one-third of the members of the executive councils responsible for the general practitioner services. They are consulted in the appointment of regional hospital boards and boards of management, so that a link with these bodies also can be established through common membership. In this way the local authorities can do much to help in linking together the various parts of the new service.
I referred earlier to the Highlands and Islands medical service. I know that the Scottish people want me to say something in connection with that. I am often asked what will become of that service in future under proposals contained in this Bill and it might help if I explained the position now. What, in fact, is happening is that the Bill is extending to all Scotland many features hitherto operating in the Highlands and Islands only. Thus, instead of supplementing the income of general practitioners by annual grants paid under direct contracts between the practitioner and the Department, basic salaries will be paid under contracts between the practitioners and the executive councils, on which representatives of the practitioners themselves sit. In place of limited grants in aid of hospitals, of surgical and other specialists, and of ambulance services, full public responsibility for these services is taken over by the Secretary of State. To the local health authorities is given the duty of seeing that a domiciliary nursing service is provided, which I hope they will generally do by entering into financial arrangements with district nursing associations under which those associations can carry on their valuable work. But while this is so, I do not forget that there will be a continuing need for special consideration of circumstances in the Highlands and Islands, and I contemplate setting up a standing advisory committee of the Scottish Health Services Council to advise me on questions of special importance in that area. In framing the necessary regulations under this Bill, it will be our earnest desire to have full and free discussions with all the interests concerned, including the organisations of professional men and women on whose good will and cooperation the success of the Service depends.
Finally, there are two relatively important points on the Bill to which I invite the attention of the House. By Clause 76, we seek to delete from the Nurses (Scotland) Act, 1943, the provision which made it impossible for anyone starting on a course of training after 4th August, 1948, to qualify for admission to the Scottish roll of assistant nurses. The new service will make increased demands upon the services of nurses of all types, and we consider it essential that all channels of recruitment to the profession should be kept open. The position will, however, be kept under review, and if in, say, ten years time it should be considered undesirable to continue the recruitment of assistant nurses, the Government of the day will, of course, be free to come to Parliament for further legislation.
The second point is one which may have puzzled many hon. Members. In the Bill as introduced last Session, the Clause dealing with superannuation— Clause 64—included a Subsection making provision for the transfer of persons between employment in Scotland and in employment in England and Northern Ireland. That Subsection does not appear in the present Bill. The reason is that its inclusion meant that the Bill was one which did not apply solely to Scotland and so would not have automatically been referred to the Scottish Grand Committee. That is a contingency which, hon. Members representing Scottish constituencies will agree, we could not have contemplated. The Subsection has, therefore, been omitted from the Bill as introduced this Session, but it is my intention to move its insertion again at an appropriate stage in our proceedings.
When this Bill has found its way to the Statute Book, my work will not be done. Indeed, it will be just begun, because there will be a great deal to do before the machinery of the new service can be ready to operate. Therefore, I seek the cooperation of hon. Members, in the proceedings in the House and upstairs, in securing as speedy a passage for the Bill as is consistent with the proper consideration of all it implies. Of one thing I am sure, that whoever might have undertaken this great task of building a Health Service in Scotland, he would have been bound to make mistakes. I cannot hope to be an exception to that rule, and in so far as defects become apparent while the Bill is going through its various stages, hon. Members will not find me reluctant to accept improvements, from whatever source they come. In framing the proposals in this Bill, I have only one objective in mind, to provide Scotland with a Health Service that will, in years to come, be a source of strength to her own people and the admiration of all others.
On a point of Order, Mr. Deputy-Speaker. I notice that on the Order Paper there is a reasoned Amendment to the Bill, and to that Amendment there is the name of a Member of the Government, the hon. Member, for Ardwick (Mr. Joseph Henderson). I would like to ask you whether there is not something strange in the Government introducing a Bill and a Member of the Government supporting; reasoned Amendment for its rejection.
I gather there must be a misprint in the Order Paper. It will be looked into.
I was going to point out, Mr. Deputy-Speaker, that attached to the Amendment is the name of the hon. Member for Ardwick (Mr. Joseph Henderson); it should have been the hon. Member for Cathcart.
5.7 P.m.
I beg to move, to leave out from "That", to the end of the Question, and to add instead thereof: this House, while welcoming the idea of a comprehensive Health Service for Scotland, decline? to give a Second Reading to a Bill which concentrates so large a proportion of the control of the service in the hands of the Secretary of State; which permits endowments and benefactions to be diverted to purposes other than those defined by the donors; which interferes with that close personal relationship between doctor and patient which plays so great a part in achieving success in medical treatment; and which gravely threatens both the training of the student of medicine and the research upon which the future advancement of medical science depends. I think there is general agreement in all parts of the House that the time has come for a great expansion of the health services of Scotland and therefore, I do not propose to follow the right hon. Gentleman the Secretary of State for Scotland in the first quarter of an hour of his remarks further than to say that he referred at some length to the Hetherington Report of 1936. He will, of course, remember that these Committees were set up by Governments of a different complexion from that which is now in office, and their reports could have been, and would have been, carried into effect by a Conservative Government, or a Unionist Government but in a very different way from this Bill.
Which is the right name, "Conservative" or "Unionist"?
The real question which divides us is not the objective, but the form in which the machinery should be devised and the spirit which ought to underly the Bill to be introduced. I think it is not unimportant to follow the right hon. Gentleman, although on a rather different line, and to ask how has this need arisen? I was a little surprised by the right hon. Gentleman appearing to take the view that the progress of medicine in Scotland had followed on the development of legislation. Almost all his remarks about progress in Scotland in the last years related to legislative development, but I believe that for the last two centuries or more, Scotsmen, on their own initiative, have done far more than their share in developing both the art of medicine and the sciences which underlie that art. We must thank a host of men and women of past generations for their devotion and service in developing the health services of the country very much more than any legislation which has been passed during that time. The quality of their work, I am sure the right hon. Gentleman will agree, has been good, and indeed, in most cases, magnificent; but I think there are three factors which we have to bear in mind now—there may be others—when we come to expand and build upon their work. First of all, there have been great developments in medical science and the art of treatment. Secondly, there is need for a great expansion of the services. We all agree that a large number of people in the country have not, in fact, had full access to all services, and it would have been our aim, as it is the right hon. Gentleman's aim, to put that right, but in a different way. Thirdly, there is the element of ever-rising cost which here, as in so many other aspects of our national life, is leading to all kinds of unexpected and embarrassing developments.
We therefore require coordination and more expenditure. We all agree that that cannot be done without bringing the State in, for assistance. The question is, what form should State assistance take? Indeed, the question is, should it be State assistance, or State control and management? The Bill lays down control and management. I venture to suggest that the proper course would have been assistance. The great problem with which we are confronted, as the right hon. Gentleman properly said, must be considered against a background. I should have thought the proper background was the history and tradition of Scotland, and the character and past achievements of our people, and not, as in the Bill, a background of theory or of tidy paper planning. Scotsmen and Scotswomen are a very varied people, but most certainly those in responsible positions are reliable people; they do better work if they are given independence and responsibility than if they are kept subject to control, whether it be by the Government or anybody else. Therefore, the first step and the first principle of the Bill ought to have been to keep Government control at a minimum.
My first objection to the Bill is that, on the contrary, it puts far too much power into the hands of the Secretary of State. He comes in as the ultimate ruling authority in almost every Clause. The right hon. Gentleman said that the Bill avoided undue concentration; I cannot think how we could have had more concentration of authority in the hands of the Secretary of State. The Bill leaves far too little scope for initiative and responsibility on the part of those who are to run the services. So much so, that it is questionable—I hope that this will not be the result—whether what is left in this respect will attract the best voluntary service. I hope it will. I hope that the right hon. Gentleman will loosen very much the controls in the Bill, so as to attract voluntary service. The Bill does not however hold out much hope. The work will have to be done by the right hon. Gentleman following a different policy from that which inspired the wording of the Bill.
There is also far too little scope for variety of organisation and for emulation between different kinds of institutions. The right hon. Gentleman is, I think, totally wrong when he says that uniformity of planning of institutions leads to efficiency. It does no such thing. The more varied the types of institution which can be fitted into a scheme, the more likely it is that we shall get progress as time goes on. Centralisation is bound to lead to rigidity. It leads to rigidity for the reason that those who are administering at the centre, able men though they be-if they had not been able men our administration would have broken down long ago under the strain put upon it by the right hon. Gentleman—are bound to have a large measure of caution in trying out new ideas. It is true that boards are set up under the Bill, but those boards, as is made clear on every page, are merely the agents of the Minister. They have always to be looking over their shoulders to see what the Minister and his permanent advisers have in mind. We cannot get the same flexibility, the same power of progress in those circumstances as we should if we gave people more authority.
Particularly is that so within the ambit of the Bill. From what I know of the matter, medicine is a realm in which, more perhaps than in any other, new ideas and new lines of approach are being developed every year, almost every week. I am making an understatement when I say that those new ideas and proposals do not always come from people who are in authority. Too much authority is very liable to stifle at birth promising ideas and proposals before they have even been tried out. The argument which was put forward in this connection by the Minister of Health and which the Secretary of State attempted to support today, was that he cannot be responsible for adequate services unless he has direct control of those services in every respect. That argument makes complete nonsense of his responsibility for education, and for the whole of our system of local government. If that is to be the line on which future legislation is to be developed—that no Minister is willing to assume responsibility unless he has complete control—it must lead to such centralisation in London as to make all effort by local authorities nugatory. Therefore I hope that the right hon. Gentleman will try, between now and the Committee stage, to reconcile his position in the Bill with his position as Minister responsible for Scottish education. It is not a very easy thing to do.
Let me state in the broadest outline what I think should have been the underlying plan. Of course, the Government must take a hand in the general planning of the services. We are all agreed about that. It could have been done no doubt through regional planning bodies. That is a perfectly good and easy proposal. Of course, the Government must have full opportunity to get all information they want, and to be able to advise, if necessary, where there is trouble. There should be provision for remonstrance and, if necessary, for stepping in and taking control, but only in the last resort. The Government ought to keep out of the practical business of running the services. They should not pretend that they intend to have a universal grip on the services if, in fact, they do not intend to exercise that grip. Let their theory correspond with their practice. We shall see, when we come to the Committee stage, whether the Government are prepared to give additional authority to those bodies which the Secretary of State say he does not want to control.
This is the case particularly with the teaching hospitals and the universities. If there is one sphere in this field where the Secretary of State ought to keep out, it is that of medical education: Scotland has long been the home of an international school of medicine, but I see nothing in the Bill to recognise that fact. The Bill raises a whole host of important issues which could not possibly be adequately discussed between 5 p.m. and 10 p.m.—all the time that remains to us after the Secretary of State has opened the Debate. It would be quite wrong of me to take up time in discussing issues on which I have already expressed my views in this House in another connection Therefore, if I do not attempt to cover, or even to refer, to the whole ground, it must not be taken that I have abated my objection in any way to the proposals which I do not mention. I shall, therefore, restrict my remarks to two major issues, the position of the doctor, and the position of the voluntary hospitals, particularly the teaching hospitals. Those are topics, it so happens, in regard to which the position in Scotland either differs, or is to be made by the right hon. Gentleman to differ, from the position in England.
With regard to the doctors, our cardinal objection has always been that this Bill injures the patient by undermining the independence of the medical profession, and almost all the objectionable provisions which do that, centre around the Clause which makes it possible to control the distribution of doctors. If there is no need for that control, all these other irksome restrictions should go by the board. A case was made in regard to maldistribution in England, and many figures were given. We were told of an area, South Shields, I think, where there were as many as 4,100 persons per general practitioner, and of another area where there were as few as 1,200 patients per medical practitioner. We said that such a case of maldistribution could be put right in other ways, very much more easily than by the scheme in the English Bill. But we have heard nothing about any such case with regard to Scotland, and I hope that whoever replies may be able to give us some evidence to support this, the most important Clause from the point of view of the medical profession, perhaps, in the whole Bill. Such information as I have been able to get, negatives the need for any such Clause in the case of Scotland.
There are at present 3,000 unemployed doctors. Will the right hon. and learned Gentleman explain that system?
I cannot understand the relevancy of the hon. Lady's interjection because the purpose of this Clause is not to facilitate the movement of doctors, but to prevent it. If the hon. Lady is contemplating a direction, that doctors shall go to a certain place, then I must point out—to give the right hon. Gentleman the Secretary of State for Scotland his due— that that is not in the Bill.
Yes, it is in the Bill.
Then let us leave that to the Committee stage. Let me put the facts as I understand them—they may be in-accurate—to the right hon. Gentleman. I believe figures have been produced for Scotland in relation to 31 areas. The average number of persons in Scotland per general practitioner is, as near as may be, 2,000. In England the figure is a good deal higher and, therefore, the problem is more difficult, but in Scotland we have more doctors per thousand of the population than there are in England. The problem in Scotland is, therefore, easier. I can only find three areas in the whole of Scotland which, in comparison with the others, can be said to be really under-doctored, and those are the three areas of Greenock, West Lothian and Angus. Those are not so very far away from the average. We could cure all that is wrong in those areas by adding another 50 doctors or thereabout. Where, then, is the case for restricting the movement of the medical profession in Scotland? There is none. If the right hon. Gentleman can produce figures which controvert those figures, we shall listen to them with interest.
Is this control of the movement of the medical profession in Scotland based on facts which require it, or is it based on some theory which the Government think ought to be put into operation—some form of control required not by facts but by doctrine? If it is required by doctrine, we can argue about it. If it is required by facts, let us have the facts. But let us know which it is. I am not sure that everybody realises how irksome is this control. In every area, and not only in the few areas which are under-doctored or over-doctored, according to the English system—and I suppose it is the same in this case—there is to be advertisement of every vacancy; then there will be applications to the executive council, and they will be referred to the local medical committee and to the partnership if there is a partnership. They will go back to the committee, then to the executive council, up to the medical practices committee, and ultimately there may be an appeal. All this time there will be patients waiting to be treated. There is to be all this rigmarole before a doctor can come in. Indeed, the doctor cannot even buy the house of his predecessor without going to the medical practices committee to get permission, unless he wants to risk prosecution.
I am very interested in the right hon. and learned Gentleman's description of how the bureaucracy will control the movements of doctors and thus curtail their services. Would he explain how the present control keeps 3,000 of them out of work? They cannot get practices.
I agree with what the right hon. Gentleman the Secretary of State said in that connection. That is one of the reasons why we say we want a more comprehensive service, because in the past in Scotland there have been people who thought they could not afford medical attention when they should have had it. If under this Bill we had 100 per cent. service with capitation fees, there would be work for those 3,000, and they should be allowed to find their own work, which they very soon would. [HON. MEMBERS: "Oh!"] They are much more likely to find the right place for themselves than if they are directed by some central body. A central body will not increase the amount of money available to the medical profession. All it will do will be to pre-. vent people who want to go to certain places from going there.
If the right hon. and learned Gentleman were a doctor, I wonder if he would choose Greenock?
I agree with the hon. Member for Western Renfrew (Mr. Scollan) that we have not heard anything about the position of assistants, and I hope we shall do so before the proceedings on this Bill are finished. I shall not say anything about basic salary, good will or about the Highlands and Islands scheme, as these depend upon considerations which do not in the least apply in Central Scotland.
I pass on, therefore, to the other subject with which I should like to deal, namely, the hospitals. I believe that both the voluntary hospitals and the local authority hospitals could be continued under satisfactory arrangements with good results and with advantage to the community. On the subject of endowments, I see no reason why the right hon. Gentleman should take what I believe to be extremely drastic powers. Let me deal with the teaching hospitals. I am amazed that the right hon. Gentleman should treat them so much less favourably than they are treated in England, and for such flimsy reasons. I should have thought that the success and prestige of the great infirmaries in Scotland would entitle them to better treatment than is given in England, rather than worse. For practical purposes, they are being abolished as independent institutions. Let me for a moment contrast the differences between Scotland and England in this respect. In England a board of governors is in direct contact with the Minister, and is directly responsible to him. They get grants direct from the Minister. They themselves settle the conditions of service of their servants and officers. They are in direct relation with the universities and they keep all their endowments. In Scotland those who look after the Royal Infirmary or the Western Infirmary will in future be mere boards of management, mere units in a large scheme. The boards will, be appointed by the regional boards and will be answerable to them, and all the officers of the infirmaries will be officers of the regional boards. The conditions of those officers will be settled by the regional boards, and the grants will have to be applied for through the regional boards. How can it be said that there is any independence left to an institution of that character?
What independence have they now?
I regard with some apprehension the fact that, in future, there is to be no direct relationship with the universities. The Secretary of State, not the board of governors, is to settle the teaching facilities granted to university students. Appointments are not to be made between the board of governors and the university, but a mixed body, an appointments committee, is to be set up. I believe it will be much more difficult under this scheme to make sure that beds are allotted to the men who are wanted by the universities as professors than it would have been, even under the English scheme. The great infirmaries in Scotland are being reduced to the level of minor institutions; they will not be anything like as efficient for their patients. This may well be disastrous for their position as centres of the great schools of medicine. How are we to keep in these minor bodies that standing which we must have, if we are to retain the position which Scotland holds in international medicine?
The right hon. Gentleman said that these bodies must be taken under the wing of the regional body because they occupy such a large part of the number of beds. Does he think that in England the teaching hospitals, with their boards of governors, are not integrated in the general scheme? Has he read the English White Paper? Has he consulted with his colleagues? This is what the English White Paper says: The fact that special administrative and financial arrangements may be made for teaching hospitals does not mean, however, that these hospitals are not to form an integral part of the hospital service as a whole. If the teaching hospitals in Scotland, with independent boards of governors, can be made an integral part of the hospitals as a whole—as his colleague believes they can in England—what more does he want? Therefore, I say the right hon. Gentleman has deprived the Scottish infirmaries of their status, for no reason at all. His colleague does not seem to have much doubt about the necessity for preserving that status. Let me reads what the Minister of Health said during the Committee stage of the National Health Service Act: I was exceedingly careful to devise a scheme for the administration of teaching hospitals which would leave them with the utmost autonomy, consistent with the general hospital service. Why has not the Secretary of State done that? Then the Minister of Health said— and I think he was a bit optimistic here. but this was his view— … the transfer of the hospitals to the Ministry will not make St. Thomas's Hospital any less St. Thomas's, Bart's any less Bart's, or Guy's any less Guy's."—[OFFICIAL REPORT. Standing Committee C, 14th May, 1946: c, 215–217.] It will make the Royal Infirmary and the Western Infirmary a great deal less than they are today, if this scheme is carried out. I say Scotland has been most un fairly treated in this respect.
I now come to the endowments. Can any hon. Member in this House suspect the Minister of Health of undue tenderness to charitable institutions? It was not for that reason that he left the teaching hospitals in England with their full endowments. It was obviously because he realised that, if they are to maintain their status as teaching bodies, they must have every penny they can get, free from red tape and regulations. Under Clause 8 of this Bill, all endowments of the Scottish teaching hospitals are subject to re-allocation. The right hon. Gentleman would not have introduced that noticeable departure from the English Bill, unless he had intended it to be made full use of: he would not have done that, unless he had intended that a great deal of the endowments were to be taken away from the teaching hospitals. He would not have included that otherwise. The Bill is extremely vague on the subject, but if we look at the White Paper it is pretty clear what is wanted. The right hon. Gentleman thinks that pocket money for other hospitals is more important than the promotion of the interests of the teaching hospitals. This is what he says: In making the schemes, the Commission is to take into account the spirit of the intention of the founder of the endowment, the extent to which its original purpose is now otherwise fulfilled, and the interests of the hospital service generally. Thus it will be possible for boards to which few or no endowments are initially transferred, to receive such resources at a later stage. If that does not mean that the endowments which ought to be left for teaching purposes are to be taken away for pocket money, I do not know what it means. This Commission, which the right hon. Gentleman values so much, is not really an independent commission at all. He selects all the members; he does not need to give them instructions, because he knows who is being selected. He takes power to appoint a Member of Parliament if he wants to; he takes power to control the Commission by modifying the scheme, or, if he does not like them, remitting it; he can supersede the Commission if he - thinks they are in default, and at the end of the day he takes over all their functions himself. Is that a fair way to put forward a commission as a judicial independent body?
Does the right hon. Gentleman say that our infirmaries are less important than the English teaching hospitals? I am sure he does not. Does he say that they are better endowed? He cannot. The figures which I have—and I believe them to be accurate —are these. The teaching hospitals in London have £8 million of endowments, and the teaching hospitals in Scotland have £3½ million. That is not more than sufficient, if Scotland is to maintain its position in competition with London. But London is to keep the whole of the £8 million, and Scotland is to lose such proportion of the £3½ million as may be determined. What rhyme or reason is there in that? How can we afford to have this cut, and yet be able to maintain our position in the world? If it is necessary to divert the funds of the teaching hospitals in order to get pocket money for the others, the right hon. Gentleman should go to the Treasury. The Government are taking over, in the great hospitals in Scotland, property worth millions of pounds —worth probably a good deal more in proportion to the population than in England. If only a few thousand pounds are wanted, why not go and ask for it, rather than rob the teaching hospitals? Surely, that would have been the right course to adopt?
For years these great infirmaries will not know how much of their endowments are to be left to them. This examination by the Endowments Commission is to take a minimum of five years, according to the Bill. How can they plan ahead when they do not know how much of their funds they are to have left at the end of the day? It would be bad enough to tell them now what is to be taken away. But to leave them under this suspense for, it may be, the next five years, makes it impossible to establish a proper scheme in Scotland under this Bill.
I have taken too long already, and I close by saying that the English Bill was bad enough, but this Bill is a great deal worse. This is only another instance of the way in which Scotland is being less favourably treated by this Government than England. My objections to this Bill are summed up in the reasoned Amendment in the name of my right hon. and hon. Friends and myself, which I now move.
5.40 p.m.
We have just begun the discussion of the most important Bill to affect Scotland during this Session of Parliament. I daresay that before it reaches the Statute Book it will be very carefully examined by all who are interested in this great subject of public health. The Secretary of State, in moving the Second Reading of the Bill, expressed the hope that there would be cooperation between the Scottish Members to make it as good a Bill as we possibly could. He seemed to indicate that he would welcome suggestions to improve the Bill. It is not the first time I have heard an opinion of that kind expressed. I remember that when the last great Bill dealing with Scotland was before the House, namely, the Bill of 1929 that made such a great change in the local government system in Scotland, the same hope and belief was expressed on Second Reading; but when we got to the Committee stage we found that the Secretary of State was not prepared to make any concessions. I hope that this time the Secretary of State will be prepared to look at suggestions, no matter from what quarter they come. Personally, I want to see this Bill made as perfect as it possibly can be.
But there are certain fundamental principles that we on this side are bound to observe. I noticed in the speech by the right hon. and learned Gentleman the Member for Hillhead (Mr. J. S. C. Reid), to whom we have just listened, that we have had the Opposition's point of view very clearly expressed. They welcome the expansion of the health services in Scotland; they welcome the assistance that the Treasury is proposing to give for the development of these health services,"but while these things are welcomed there is one thing that is not welcomed, and that is public control. They never welcome public control from that side of the House. So far as we on this side are concerned, if public money has to be expended, there must be public control. It is all very well for hon. and right hon. Gentlemen opposite to say that we are curbing initiative, that we are not developing our Scottish character as we ought to do, by these Government regulations, restrictions and directions. One cannot have it both ways. If there is a demand for public money, and if public money is required for the development of these services, then there must be some public control.
I have examined the Bill very carefully, and I agree with one of the objections raised by the right hon. and learned Gentleman opposite—that there is too much of the Secretary of State in the Bill, and too little of the local authorities. From Clause 20 to Clause 29 we have a series of Clauses dealing with the local health authority, but when it comes to the setting up of the various committees that have to work this scheme, there is not so much of the local authority there. I think that the Secretary of State has gone just a little too far to conciliate the professional classes, the doctors, dentists, pharmacists and others. He has given them far more say in these committees than he ought to have been prepared to give. I am not sure whether, when we reach the Committee stage, there may not be an attempt made to have less control by the Secretary of State and more control by the local authorities. Up to now the local authorities in Scotland, the county councils and the town councils, have been our local health authorities, and it seems to me that this Bill is going to remove a very considerable amount of the control that they have exercised in the past. The proposed representation of the professional classes on the various bodies to be set up is a very much larger proportion than is justified. I dare say that the agitation that has been carried on by the doctors and others has had its effect on my right hon. Friend, and that he has gone as far as he possibly can to placate those various interests.
The right hon. and learned Gentleman dealt with the position of the doctors, and objected to their being directed here and there. But there must be some control if we are to have so much public money spent on the development of these services. After all, who will direct the doctors here and there? They are to be directed almost wholly by their own representatives, by the medical men. There is one thing that I cannot understand with regard to the medical practices committee, which it is proposed to set up. I believe there are to be a chairman and five members of the committee, who will have the responsibility for saying whether a place is over-staffed with doctors or understaffed, and of sending doctors where they will be most required. While three members are definitely mentioned as being doctors, I fail to find, in either the relevant Clause or the Schedule, who are to be the two others on the committee. Perhaps the right hon. Gentleman will look into that point and tell us exactly who are to compose the medical practices committee, which will have the job of saying how doctors are to be distributed, and what services they are to undertake
So far as the general principles of the Bill are concerned, I am heartily in support of this Measure. The powers of the Secretary of State, and the diminution of the powers of the local authorities, are matters we shall have to discuss in Committee. They are largely Committee points. But as far as the general principle of the Bill is concerned, I welcome it wholeheartedly. It is high time we had a very extensive improvement in the medical health services in Scotland.
There is another point I want to raise with the right hon. Gentleman the Secretary of State. We are proposing to shift power for dealing with public health from the local health authorities to committees, boards and commissions. When we are considering the question of regions for hospital management—and I agree that there ought to be larger areas for the control of the hospitals—what is to be the controlling factor and who are to exercise the control, I want my right hon. Friend to make sure that we shall have more harmony among the various authorities that are brought in than we have had under the Local Government Act of 1929. We have had a sort of cooperation between the small burghs and the county councils. We shall have in practically all areas where we have these regional councils set up for dealing with hospitals, county interests, large burgh interests, and small burgh interests. We may have, as a result of this Measure, the same conflict that we have had in connection with the Local Government Act. It must be known to every Scottish Member of this House that there have been a great deal of dissatisfaction, and continual bickering between the small burghs and the county councils. Is that to be the result of this forming of regions for the control of the hospitals, or are we to have an assurance that between the county councils and the large burghs— because the conflict will start between the county councils and the large burghs which will be brought into the regions for the control of the hospitals within their areas—there will be more harmony under this scheme than there was as a result of the passing of the Local Government Act of 1929?
Perhaps in the county that I come from we have had more trouble between the small burghs and the county councils than anywhere else in Scotland, for the reason that we have more small burghs than any other county in Scotland, and it may be because I am living alongside and among these difficulties that I know the feeling existing between the small burghs and the county councils. Now we are to have these local health authorities set up in which there will be at least three interests represented, and, unfortunately, the three interests are not harmonious interests; they are all out for the same thing, but they are antagonistic. When there are three interests, the county councils, the small burghs and the large burghs, all competing with each other and insisting upon having their way, I should like to feel that the Secretary of State is sure that he can obtain a more harmonious working than we have had under the Act to which I have previously referred. It will only be through getting harmonious working between the various local authorities that we shall get the best results, there is no question about that.
So far as this scheme is concerned, the need for larger areas for the control of hospitals is obvious, and I agree that in that direction there are adequate safeguards in this Measure, even for the voluntary hospitals, which I do not think have any reason to complain of the control outlined in this Measure. I agree that we should examine very closely the powers that are to be exercised by the Secretary of State for Scotland, and at the same time I should like to see greater power given to the local authorities. I know that many other hon. Members wish to take part in the Debate this afternoon, and I do not want to take up much more of the time of the House, but it is a matter of very great importance to the people of Scotland that this Measure should be brought into operation is speedily as possible. We are assured of medical and surgical grants from the Exchequer; we are to have a contribution from the National Insurance fund, but there is another contribution to which we shall have to pay some attention, and that is the contribution which will be made by the local ratepayers. The local ratepayers will be interested to a very considerable extent, and that again is one of the reasons why I should like to see the powers of the local authorities increased under this Bill.
Do not let us disguise from ourselves the fact that this scheme, when it is brought into operation, will call for very considerable increases in local rates, despite the substantial Treasury grant. Local rates have been rising for years past, and we know something of the complaints of local ratepayers about these recent increases. We must be prepared to face even the local ratepayers, and say to them that they cannot expect to get the benefits that a scheme of this kind will bring unless they are prepared to make their contribution. We require to say to our local ratepayers what we had to say to the workers of this country when the National Insurance Bill was before this House, namely, that the benefits proposed are worthy of the sacrifices that we are asking the workers to bear. We are asking them to increase their contributions to National Insurance; we shall get substantial aid in the working of this scheme, and we shall have to be prepared to face local ratepayers and tell them that this scheme is worth while if it will remove from them a great deal of the anxiety they have had in the past. I do not want to embark upon that side of it, but it is a fact that when a working class family is affected by the illness of the worker, who is laid off his work, from that moment there is anxiety in the home, and it is increased when specialists have to be brought in or when special treatment has to be given to the worker who simply cannot afford it. I know that today many families in this country are making great sacrifices in order to get facilities which ought to be provided for them, and which it is proposed to provide for them in this Bill. It is because of the benefits that will follow as a result of this Measure that I want to see it on the Statute Book, and in operation, as soon as possible.
I hope that when we come to the Committee stage we shall find the Opposition not simply referring, as the right hon. and learned Gentleman did this afternoon, to our trying to frame a scheme because of the ideas that we on this side of the House entertain. There are ideas on the other side, and I have referred to them before; there is the idea that public money should be given to develop these schemes, but that everybody is to be free and there is to be no restriction or control, no overriding authority on the part of the State. State money certainly, but no State control—if that is the attitude which the Opposition adopt in Committee, I am afraid that we shall have no more harmonious discussions on this than we had on the other Measure to which I have referred, and of which the right hon. and gallant Gentleman who has just been elected as Member for the Scottish Universities (Lieut.-Colonel Elliot) had some experience himself. I think he was in rather a subordinate position, but he was in office in 1929 when that famous Act was before the House, and he knows the part that was played by his chief and by himself, and by others on this side of the House who had ideas, just as we now have ideas. If we can get away from our doctrinaire ideas on both sides, we may be able so to frame this Measure that it will be of infinite value to the people of Scotland.
5.59 p.m.
The Bill now before the House is not, of course, a product of Scotland, nor on the other hand is it a product of that great host of selfless people who constitute the main health service of our country at the present time, the ordinary general practitioners. It is, in fact, a replica except in detail of the English Bill which was before the House some months ago. It is the product of diligent Bill artificers, working in the murky recesses of a Whitehall office. The right hon. Gentleman, in an eloquent speech in introducing the Measure, referred to his desire to keep the best of the past, and perhaps I may be pardoned if I say something of that great past, and something of the history of such things. Great Britain, in the past, has occupied a leading position in the progress of medical science, and some of the brightest stars that shine in the firmament of medical history have shone from universities and voluntary hospitals of Scotland. I should like to speak at some length on that glorious history of British medicine, but there would be a revolt on the part of my fellow Members if I did anything of the kind.
Perhaps I may be allowed to say a few words, and recall one or two points concerning a particular section of medical history, namely, surgery. The historians of surgery, all over the world, divide that history into two parts, firstly, the dark ages of pre-Listerian days, and, secondly, the development in the whole field of modern surgery. Scotland played its part, even in the dark ages. Was not the very first textbook, in English, upon surgery the work of Peter Lowe of Scotland; and did not operative surgery in those dark days rise to great heights under Liston and Syme of Edinburgh? These pre-Listerian workers were terribly handicapped. Even the simplest operation in those days meant a deadly danger to the individual operates} upon. All hospitals were infested by the microbes which give rise to what were called hospital diseases—hospital gangrene, erysipelas and so on. To get onto the operating table, even for a simple operation like an amputation meant a very serious probability of death. All that was changed by the work of a young professor in the University of Glasgow, working in the wards of its great voluntary hospital, the Royal Infirmary. It was that great man Lister who was able to see beyond the work of Louis Pasteur, who showed how putrefaction and fermentation were due to living microbes. He was able to see beyond that work and visualise the microbic cause of hospital diseases and indeed of all kinds of wound infection. He tackled the problem, and he worked it out with some of his great assistants like William MacEwan of Glasgow. The result was the foundation of modern surgery. Without this marvellous development, there could not have even been contemplated those complicated abdominal operations which are now an everyday occurrence, and which have jerked many persons back from the very edge of the grave. I might have gone on at length on this subject, and I might have spoken about other aspects of medical science, such as obstetrics, in which again Scotland gave a great lead; and medicine too in the restricted sense. One of the great divisions of medicine is that which comes under the name of "tropical medicine," of which the very founder is acknowledged to be Patrick Manson, who hailed from the University of Aberdeen.
What has all this to do with the Bill before the House? It has a great deal to do with it, because these great figures, these great leaders in medicine and surgery, were the inspired teachers of the generation of doctors that was to come. The success or failure of any enactment, however good or bad, is tremendously influenced by the character of the men who have to carry its provisions into effect. We have at present the very finest material coming into the science of medicine. I know something about that, because among the 7,000 or so students who passed through my laboratory, were to be found those belonging to practically every one of the faculties, except perhaps law. I have not the least hesitation in saying that it was the medical students who were the pick of the whole lot.
It is sometimes said that the young man is an idealist, and that he is attracted into a particular profession by his ideals. That is not my experience of the young student. He is a thoroughly practical young person. He is looking ahead, and he tries to feel that there lies before him something great by way of a career. This is the raw material which is coming forward, but what about training? It is the leaders of the professions who are at present doing that training in the voluntary hospitals. Why do they do it? It is because they realise that if they take a teaching post, even if it is an honorary post, in a great hospital, they will have the opportunity to inspire the students they train, and they will be paid back, indirectly, by forming a great clientele of practitioners who will come back to consult them later on. It is worth while at present for the great leaders to play that part in teaching, and it is worth while for the able young men to enter that profession. The type of man who goes into a university, or other school of medicine, and, later, into the profession, is not the type of person who is interested in a salaried service, in which promotion goes merely by seniority He is a young man who is ambitious, who has a good idea of his own capacity, and who will only go into a profession in which he thinks there is a fine future.
Before I sit down, perhaps I might correct, or modify, one point. I have been speaking of the great voluntary hospitals as being the laboratories in which leaders of the sciences such as Lister, in the Royal Infirmary, Glasgow, are carried out. But we must not forget that all over the country there is a vast amount of modest research being done by the ordinary country practitioner. The ordinary general practitioner, perhaps with the aid of his local cottage hospital, is working away quietly and modestly, doing work which, in the aggregate, is of the greatest importance. I would quote one case, that of Edward Jenner, a general practitioner in a great dairy district in Gloucestershire. He had the wit to look beyond a remarkable fact, namely, that dairymaids do not die of smallpox. He saw beyond that strange fact, and he invented vaccination, which has not only Deen adopted in every civilised country in the world, as a remarkable preventative of a disease which in the old days was so deadly but, has, in its turn led to immunisation which today protects us from such other diseases as cholera, typhoid and diphtheria. Edward Jenner made that great step in the science of medicine and public health and I would recall that he, unlike many in more recent times who have rendered great services to our people, did not go without any financial recompense from the Government of the day. He was given, I think, £30,000 for his services. I will go on no longer, except to say that in the few words I have spoken there has been perhaps the hint that I consider that if the Bill before the House is passed into law, it will become one of the greatest disasters to the health of our people.
6.16 p.m.
I welcome this Bill, because it makes provision, for the first time in Scotland, for adequate health services for our people. The fact that these services will be available to everyone, without limitation, will prove of inestimable benefit to many people. We find that the majority of our workmen get the services of a doctor, as a panel patient, for a weekly contribution, but those services do not apply to his wife or children. Time and again, it has been found that dependants have often refrained from calling in a doctor when his services were most necessary, because they did not know where the money would come from to pay the expenses. For that reason alone, it is important that this Bill should get its Second Reading today, and get through the House as quickly as possible.
A great deal has been said about the direction of doctors. I have spoken with many young medical students, and I have gathered that the majority of them welcome this Bill. They realise that through this Measure they will have security immediately they have finished their medical studies. We have heard about the number of doctors who are unemployed. It is a disgraceful thing, when so many doctors are needed today, that even one should be unemployed, far less about 3,000. Not only should they be used, but many more doctors should be used. I know many young students, leaving school, who would have preferred to take a medical degree, but who have gone into some other faculty. They did not take a medical degree, because they knew that if they took a degree that would lead to teaching they would almost surely obtain a position, whereas they were not so sure that if they took their medical degree there would be a position for them when they had finished. It is because of that part of the Bill which applies to doctors, and their distribution in the places which need them most, that many young people will no longer be deterred from taking their medical degree. There will be a good supply of doctors in districts that badly need them, and there are many places in Scotland which need more doctors than they have today, in spite of the remarks made by the right hon. and learned Gentleman the Member for Hill-head (Mr. J. S. C. Reid).
There are one or two things I want to ask the Secretary of State. I have gone through the Bill very carefully, and I see that provision is made for doctors entering the service, for dentists, pharmacists, and opticians. But in no part of it do I find any provision at all for masseurs or masseuses, or chiropodists. Will they be part of the service? I feel that the work they do in helping to keep the nation healthy and strong is of the greatest importance. Will they be part of the service which is to be free to our people, or must our people, who need their services, pay for them? I hope the Minister will assure us that masseurs and chiropodists will be a part of the health service. In regard to the committees about to be set up under this service, I wonder what part nurses will play. Are they to have adequate representation? I have no doubt that doctors are to have very adequate representation. If my miners get as good workers' control under the nationalisation of the mines, as the doctors are to have in this service, I shall be well satisfied. We must see to it that the nurses, upon whom a great part of this health service will depend for its smooth and efficient running, are given a part to play on these committees. We find today that there is a very grave shortage of nurses in Scotland, and that not only beds but wards are empty because there are not sufficient nurses for our sick people. I am not at all surprised that that is the case. The life which a nurse has had to live has not been very comfortable. Nurses should be able to make representations so that their lives as nurses may be made very much better than they have been in the past.
I would like to make one or two suggestions on behalf of the nurses which I am sure, if they have representation, they will make very adequately themselves. I think of the case of the young probationer who ought to spend her time in training and who should not be compelled to over-study in her spare time. Her first year in hospital is spent in scrubbing and polishing. That does not happen to the doctor who is to play his part in the medical service. Why should it happen to the nurse? The nurse should be fully occupied in learning those things which are so necessary if she is to do her job well. She should be given extra time for her studies, instead of having to make herself almost a hermit, if she is to get through her examinations. Instead of having to live in a room in a hospital, there should be a home for her just as there are clubs for business women, where she can have all the comforts which she would have in her own home. She should be treated as a responsible human being who is able to look after herself instead of being surrounded by rules and regulations during her off-duty time. Those are some of the things which I think will have to be done if we are to attract into the nursing profession the women whom we must have, and I hope that on these committees the nurses will have adequate representation.
There is a part of the Bill which deals with domestic help. I would have preferred to see in this Bill, instead of the provision that a local health authority "may" make such arrangements as the Secretary of State may approve the word "must" being used in that connection. I have never liked the word "may" in our legislation. I know only too well in teaching, that when the word "may" is applied to something affecting teachers or their children, some local authorities pay no attention whatever to it. Domestic help for people, as outlined in this Bill, is of the greatest importance to the working class woman and working class home. I would like, on the Committee stage, to suggest that the word "may" should be changed to "must," so that every local authority in Scotland will set up this system of domestic help for people who are sick, particularly when the mother of a family is sick and needs domestic help so much.
Under this Bill, there are to be supplied to our people spectacles, dentures and many other appliances. We are told that if someone wants something special in spectacles or dentures, they must pay extra for it. I would remind the Secretary of State for Scotland that we have to be very careful here. I had a meeting in my constituency not long ago and a woman came to me in great distress. She had needed spectacles. She was not at all well off, and she was advised to make application to the local authority for them. When she went, she said, "What kind of spectacles will you give me?" When I look round the House and see hon. Members wearing spectacles, I notice that they are nearly all like the pair which I am wearing.
This woman thought that she would get the type of spectacles which most people wear nowadays, but judge of her surprise, when she was given steel-rimmed spectacles, such as no one wears today. Every time she put them on, people would know at once that her spectacles had not been paid for by her but had been provided by the local authorities. A similar thing has happened under the present scheme for supplying dentures. I am not asking the Secretary of State to provide a man or woman with gold teeth or any such nonsense as that. But there have been very great developments in dentures so that one would scarcely know when a person was wearing a denture, and all I ask is that people under this scheme should have the best.
I have listened to the talk on voluntary hospitals and about our great Royal Infirmaries in Edinpurgh, Glasgow and elsewhere. They are indeed great but it is nonsense to suggest that when they come under the scheme, as they will, their greatness will be any less. When I was a student, I spent very cold days with boxes trying to get money for them. Time and time again, they have been unable to get the appliances which they ought to have. Under this scheme, whatever they need, they will be able to get and from being great they will become even greater
The same applies to research. I can think of some discussions which we have had on the Miners' Welfare Commission, of which I am a member. There are some diseases from which miners and miners only suffer. There has been very little research into the miners' disease of nystagma. What a little has been done to help those men who have suffered so miserably from that disease! The same is true of the pneumoconiosis. I have the spectacle, almost every week, of miners coming to me who are said by their own doctors to have this disease. The Royal Infirmary in Edinburgh has X-rayed them, and the doctors there have also said that they are suffering from this disease. Then they go before the Manchester Board and are told that they have not got it. There is no compensation for them. Their own doctor warns them that they must not work in the pit and they remain unemployed. Surely there must be some definite work of research in relation to that disease. These are only two of the many diseases on which research must be carried out. I shall never forget in Edinburgh one day, when I was paying my bill in a restaurant, seeing a box hanging up, which gave particulars of the incidence of tuberculosis in Scotland, and which said that every halfpenny helped in the fight against it. What a shocking state of affairs—that the right against tuberculosis must depend on people in restaurants putting halfpennies into a tin box. I say to the Secretary of State for Scotland that those who have been responsible for his Bill, in spite of anything which the Opposition have said against it today, will have the wholehearted support of the people of Scotland. Our people are beginning to know that this is a Bill which will give them a medical service and a health service which only the rich in Scotland can buy for themselves at the present time.
6.30 p.m.
I would not have intervened at this early stage after my return to familiar scenes had it not been that this is a Bill in which I myself am greatly interested and in which many of my constituents are very interested indeed. In fact, if the hon. lady the Member for North Lanark (Miss Herbison) really deceives the Secretary of State into the idea that the doctors are wholeheartedly in favour of this Bill, I am afraid she is encouraging him to build upon wrong foundations.
I did not say that.
I know the hon. Lady said that medical students were in favour of this Bill, but I am afraid he will not find that the medical students when they graduate are any more in favour of it than are those who, by an overwhelming vote, showed their extreme dislike of the provisions that are brought forward in the Bill. That vote is not merely the university vote, but includes votes such as the plebiscite taken by the British Medical Association. Whether it is true or not, that dislike is not due to the negotiations of the Secretary of State for Scotland, who is an accomplished negotiator, but is due to what I call ramstam and buccaneering methods which have succeeded in uniting a volume of opinion against a Measure, which is almost unprecedented in negotiable working undertaken by His Majesty's Government. We welcome the Secretary of State's view that he is prepared to make concessions under this Bill, and, indeed, we remember the appeal from the hon. Member for Dunfermline Burghs (Mr. Watson) that we should treat this in a statesmanlike fashion. There will be one simple acid test of that. There was a decision come to by a Committee on the English Bill on the question of the right of appeal. That was come to purely by weight of argument. It was reversed without any discussion when it came down to the House by the weight of the majority here. If the Secretary of State for Scotland will give us a pledge that, if the Committee so decides, he will concede that principle, we would believe he was going to treat this in the way of a Council of State, but judging by the derisive laughter both from himself and from the Under-Secretary of State for Scotland, who is to wind up—
I was not laughing at that, but at a man with the record of my right hon. Friend the Secretary of State having the attentions of others forced upon him.
I fail to see exactly what point that has in connection with the argument that has been brought forward, but if we are to take it that the Secretary of State has an open mind on this issue we shall look forward with hope to the course of argument in the Committee, because it is true, as has been said by many speakers tonight, that this Bill would be a very much better Bill if it followed the Scottish traditions instead of trailing, as it does, at the heels of the English Bill or indeed of the Welsh instigator of the English Bill. We in Scotland never had need of such great assistance from the Welsh that we needed to go on following meekly on their heels.
I do not want to interrupt a maiden speech, but the right hon. and learned Gentleman the Member for Hillhead (Mr. J. S. C. Reid) said that the Bill would be much better if it followed the English Bill.
No, he said that, bad as the English Bill was, this Bill was worse. He said that the Bills departed entirely from the Scottish traditions, as indeed they do, and not merely from the Scottish traditions, but from the findings of important and responsible Scottish committees, and not only from that, but from the findings of a committee on which the right hon. Gentleman the Secretary of State for Scotland himself sat, as well as departing from the report of a Commission set up by Mr. Tom Johnston to consider this very problem of the postwar hospitals in Scotland, in the setting up of which the present Secretary of State for Scotland, who was then Under-Secretary of State and responsible for the health of the country, had some responsibility. Now the findings of that Commission are thrown overboard without a word of apology by the Secretary of State for Scotland simply because the powerful Welsh figure in the background has said, "If you deviate by one jot or tittle from what I have decided in this matter so much the worse for you when I get you outside in the playground." It was the right hon. Gentleman and not I or anybody on this side of the House who said this according to the Hetherington Report, which in turn quotes from the evidence of the 1936 Health Services Committee Report. This is the quotation: Nothing emerging from the present inquiry has in any way lessened the force of the assertions of the Committee of the Scottish Health Services (1936)"— that is the assurance of the right hon. Gentleman— that the hospital services shall be developed by cooperation of voluntary and statutory hospitals. This inquiry went again over these matters. It was an inquiry upon which, as one would expect from a committee appointed by Mr. Thomas Johnston, both sides were well represented, while great figures in the Labour movement like Mrs. McNab Shaw and Mr. Neil Gunn were representatives. Their unanimous finding was for a completely different system of hospital administration in Scotland from that which is introduced by the right hon. Gentleman and recommended to the House. I would ask both him and the Joint Under-Secretary of State to justify their departure from this and explain why it is that the Hetherington Report has been thrown overboard and this new parentless—I should not like to use any stronger word—institution is brought in. Not a single authority in Scotland asked for it; not a single local authority asked for it. There are protests from local authorities already. Not a single medical association and not a single county town or burgh asked for it. There is nobody the Government can quote who asked for this proposal, but the right hon. Gentleman could quote, as indeed could I, many authorities who have asked for a scheme along the lines of the Hetherington Report.
What was the essence of the Hetherington Report? The essence dealt with exactly the point which was made, I think with force, by the hon. Lady the Member for North Lanark and also by the hon. Gentleman the Member for Dunfermline Burghs, namely, that public money should involve public control. That is true. That committee draws out in detail arrangements by which public money entails public control, but to produce public control it was not necessary to take over, lock, stock and barrel, institutions which were then to be controlled. As I say, one must assume that people like Mrs. McNab Shaw, Mr. Neil Gunn and many others like Mr. Vallance, of the Scottish Department, whom I know well, were equally concerned with the public control of public money. They say without any hesitation that there should be grants to the voluntary hospitals which should be left under the control of the voluntary hospitals board. They could see no difficulty about combining that with a system of public control. The whole argument for this—and it is proved on the authority of a representative Scottish committee who were appointed to examine this very problem—is that there is no difficulty whatever about maintaining the voluntary hospitals system with adequate assistance from the Exchequer, and having public control of the kind wanted either on that side of the House or on this.
Indeed, one can take the matter further. The Secretary of State for Scotland has referred to the Highlands and the Islands system. All are agreed about that. There is nothing doctrinaire about us. If we have a better local service run by doctors wholly or in part paid a basic salary, we judge it on the merits, and if the merits are conclusive we have no hesitation in agreeing with the administration of that service. The Highlands and Islands medical service, small as it is, covers 150 doctors in all, with an intake of about six or 12 per annum, and is very well adapted to the circumstances in which it finds itself. It does not bear out the claims that have just been made by the right hon. Gentleman because to carry on that service they have not found it necessary to nationalise a single one of the hospitals. The hospitals in the Highlands and Islands are left under local control The Royal Northern Hospital at Inverness, the Lerwick hospital, those at Thurso, Fort William, Oban, Golspie, Stornoway, and the Cottage Hospital at Skye—all these are left under the control of local bodies, as indeed they should be. This suggestion that nobody can do anything unless the whole responsibility is taken over by the Secretary of State himself find no confirmation in practice.
The whole of the defects of the Bill derive from the egocentricity of the present Minister of Health—the fear of all subordinates, unless he is unable to order them about, to control them, to regulate them, to lay down the conditions under which they are to work, to resign, and to be remunerated, and those under which the payment of expenses, if any, is to be made. He lays down all these as things to be settled by him. Unless he can do this he fears his fellow men so much that he dare not undertake the responsibility. That never was our idea in Scotland, nor was it ever the idea of the hon. Gentleman the Member for Gorbals (Mr. Buchanan)—
Perhaps we have learned it from the right hon. and gallant Gentleman.
It may be that the hon. Gentleman has learned a great deal from me, and I hope he will learn still more. I have come back here with a fairly representative backing for the purpose of pressing these points upon him, and I hope to be able to press them yet further, and, it may be, to convince him, although I must say that as a true Scotsman he likes argument better than conviction so far as I have found up to now. The whole of the proposals which are brought forward can be summed up in the words "the taking over of a hospital not only from the voluntary bodies, but from the local authorities". It is nonsense to say that a serious inroad is not being made by this Bill into the duties of local authorities under a process which, of course, is going to be continued under other Bills brought forward by this Government with the same tendency to remove authority from the local body and transfer it to boards and commissions appointed wholly by the Minister. The same tendency may be seen in the provisions with regard to doctors, and there I would beg the right hon. Gentleman and the Under-Secretary of State to devote their attention, if they will, to the point that they are here erecting orthodoxy into a system into which it will be impossible for unorthodoxy to break through.
The hon. Lady the Member for North Lanark referred to defects in the tuberculosis service, but the tuberculosis service is a State service. She referred also to defects in the provisions for the investigation of pneumoconiosis and other miners' ailments, but she was complaining against actions which were being carried on by public bodies. The hon. Gentleman, my colleague in the representation of the Universities (Sir J. Graham Kerr) referred to the great advance which had been made in the University of Glasgow, with which the hon. Member for the Gorbals is also well acquainted—his own brother being a distinguished student. In those wards experiments were carried out by Lister in the teeth of medical opinion of the time. When Lister came to London he was greeted with every kind of abuse and contumely. That is the history of advance. I read a speech by Lord Moran pointing out that when he took official bodies round his hospital they were frozen and cold shouldered when they came to Almroth Wright's laboratories because Almroth Wright was a man of very independent views which he had no hesitation in ventilating. Yet, said Lord Moran. the discovery of penicillin, one of the greatest advances of our time, came as the result of Wright's work. This has raised the uneasiness of no less an authority than George Bernard Shaw— and when Mr. Shaw becomes alarmed about the progress of Socialism, then the rest of us may reasonably feel that there is cause for uneasiness.
I am afraid that the right hon. and gallant Gentleman is again misrepresenting what I said. When I spoke of those diseases peculiar to miners I was suggesting that in this Bill there would be much more money given for research. I was not complaining of what other voluntary institutions had done at all.
It was certainly not my intention to misrepresent the hon. Lady. It is true that she said that more money would be given, but her examples where the case of the subscriptions for tuberculosis in a restaurant and the treatment of men who were told by their private doctors to keep out of the pits and then, going before some public body, were told that they were not suffering from the disease in question at all. The danger in all those cases is not that we shall not have research. We shall, but we may get differing interpretations of research and certainly the orthodox interpretation is not always the right interpretation but is very often the wrong one. That is the danger of frozen systems such as that which we are clamping upon medical education and medical practice in Scotland. It has been mentioned by more than one hon. Member—and by the right hon. Gentleman himself—that the hospitals of Scotland train a third of the doctors of this island—one of our greatest invisible exports, medical skill. But then the right hon. Gentleman says that because of that it is difficult to fit our hospitals into this scheme. "Well, then," he said, "so much the worse for the hospitals. Let the scheme go through; we will jam the hospitals into it." Might he not have thought of the other thing? If the hospitals are difficult to fit in because of their very orthodoxy his case for—
In my consultations I have reached complete agreement with all the authorities I have consulted— universities, doctors, local authorities —and that so far as that side of my hospital proposals are concerned, the only objectors have been the representatives of voluntary hospitals.
The right hon. Gentleman is proving my case He says that all the orthodox people agree with him, but it is the rebels he has to consider. Where are they? That is the question of officialdom and bureaucracy in every age.
Is the right hon. Gentleman now pretending to say that unorthodoxy is found in the voluntary hospitals? Is it not rather the case that the voluntary hospitals have become absolutely the home and basis of orthodox medicine?
Surely, the hon. Member for Rochdale (Dr. Morgan), who himself has been a rebel in his time, knows that it is not to the people at the top that one looks for rebellion, but to the people below. I am saying that the Government are making an arrangement by which it will be impossible for the rebels to find any space or any access to the great systems of medicine or treatment which this Bill purports to set up. I know that many other hon. Members wish to speak on this Second Reading, and I do not wish to take up too much time, but let me simply quote as my last word the provisions under which the distribution of doctors is to be effected, and under which some people seem to think more doctors will be provided although, as the Secretary of State has rightly said, these are not provisions for producing more doctors but for putting a brake upon the distribution of those who are already here. Read the Seventh Schedule of the Bill, which says: 1. The Scottish Medical Practices Committee shall consist of a chairman, who shall be a medical practitioner, and five other members of whom three shall be medical practitioners actively engaged in medical practice. 2. The chairman and members shall be appointed by the Secretary of State after consultation "— "consultation," let it be noted, not "agreement"— with such organisations as the Secretary of State may recognise as representative of the medical profession. 3. The Secretary of State may make regulations— ( a ) with respect to the appointment, tenure of office and vacation of office of the members of the Committee; 1045 ( b ) for the payment to members of the Committee of remuneration or travelling and subsistence allowances. 4. The Secretary of State may provide the services of such officers as the Committee may require 5. The proceedings of the Committee shall not be invalidated by any vacancy in the membership of the Committee or by any defect in the appointment or qualification of any member thereof. We might add to that final statement that there shall be no appeal from a decision of the Secretary of State. The hon. Member for North Lanark said she would be very happy if our miners got as much control as was laid down in this Bill. Would she be happy, or would any hon. Members opposite be happy, if any of their professional unions were to be overridden by a body of which the members are chosen by the Secretary of State—and he will not always be a Socialist Secretary of State—
Why?
I understand that hon. Members below the Gangway have strong objections to some aspects of Government policy and that they very successfully did their best to prevent the return of a Member supporting the Secretary of State in favour of the hon. Gentleman the Member for Camlachie (Mr. Stephen). The present Secretary of State will not always be the Secretary of State for Scotland. The hon. Member for West Fife (Mr. Gallacher) "glowering frae him," as they say in Scotland, no doubt dreams of the day when he will sit in that place and when he will have the nomination of the chairman and members after consultation with such organisations as he may recognise as representative of this profession. From what I have seen of Soviet Russia, under his regime the rebels will have a pretty thin time. The proposals laid down here are proposals, first of all, which go directly contrary to the trend of Scottish thought, as it has been brought out over many years by many committees of inquiry. They go counter to that because of arguments which do not hold water. The recommendations of all these committees, representing labour as well as conservatism, have been examined and turned down. These proposals enforce a rigid system which will be of the utmost disadvantage to the patient and will go very far to militate against the future prosperity of the great schools of medicine for which Scotland has been famous. For these reasons alone—others would be unnecessary—I hope very much that the House will not accept the Second Reading of this Bill.
6.54 p.m.
We have just listened to a speech which was no doubt meant to be a serious contribution to the Debate but was simply a frivolous, attempted-facetious speech which did not really ring true. The right hon. and gallant Member for the Scottish Universities (Lieut.-Colonel Elliot) rather taunted me with being a rebel. I remember the days when he was a rebel as a member of the Glasgow University Fabian Society, and that was not very long ago either—
I thank the hon. Member for that. I felt that it was long ago, but if he feels that it was not long ago, I am all the more flattered.
Perhaps my measurement of 20 years is not long, but I remember the right hon. and gallant Gentleman being associated with the Fabian Society and he was a greater rebel than I was. Apart from the personal issue, what really has he said tonight? He talked about appointments by the Secretary of State. Did he not, when Secretary of State, appoint medical officers to his Departments? Were they always orthodox members of the profession, did they never have unorthodox or rather unusual views which he accepted as professional advice given to his Department, and did he not act on that advice? Surely every Secretary of State and every departmental officer has to take the advice of his expert and sometimes professional advisers. What is wrong about that? The right hon. and gallant Gentleman, who has had a period of meditation and contemplation and whom one would have expected in those days of quietude to have examined what took place on the Debates on the English Health Bill, comes here and talks about something which happened in Committee when the Government were defeated by one vote—and that vote was mine. He also says that on the question of the appeal to the courts, there was a vote but practically no discussion later in this House. Not only was there discussion in Committee but there was discussion here in which I was privileged to take part, and it was only after a very full discussion in the House on the Report stage that a vote was taken and, as I intended, I abstained from voting on the particular issue on the right of appeal to the court—
Perhaps the hon. Member did not hear me say that, totally against the weight of argument, the decision was taken by the weight of the majority, and I am perfectly sure of that because I read very carefully every line of those Debates—in the period of meditation which was terminated by the 18,000 majority which I was happy to collect in Scotland last week.
That is getting away with a minor point. The question as to the weight of the argument, is a matter of personal interpretation of the argument. I think—although I was against them— that the hon. Members who put up the arguments against the appeal to the courts put up a good case—
Why did not the hon. Member vote for it?
Because my case was better.
I always knew the hon. Member was Irish.
One can recognise a fine contribution when one has a stronger case. This Bill is a very good Bill in spite of what the right hon. and gallant Gentleman said. It is better than the English Bill. There are finer things in this Bill—
The doctors do not think so.
The doctors do think so. Many of the doctors are more intelligent than other professional men and even the right hon. and gallant Gentleman after his leisurely period of temporary oblivion. Certain things now come directly under the aegis of the Secretary of State for Scotland under this Bill. Health centres instead of being left to local authorities will be directly under the responsibility of this House through the Minister. It will be in his hands to see that the experiments that are made as to the ideal health centre are to be done with coordination, and good planning, design, personnel and work. I am particularly glad that, as in the case of the English Bill, he will have medical research in his own hands. I was afraid that Scottish research would fall under the patronage of the English Research Medical Council. Talk about orthodoxy—if one wants to see orthodoxy in excess, and sometimes in extremis, one must go to medical research in England —the Medical Research Council and so on. The unorthodox man scarcely has a chance. The rebel has not a chance of expressing his views or of getting into the inner councils of medical research—
The hon. Gentleman is now describing State organisation.
It is not a State organisation, as the right hon. and gallant Gentleman knows. The State provides the money and allows free rein to the professional bodies and appointed experts. The right hon. and gallant Gentleman knows that as well as I do.
This is a terrible attack on the Lord President of the Council, under whom that Committee worked.
It is not an attack on him. He is not an expert in medical research. To indulge in these playful contributions in a serious discussion does not help. Let me have a chance to say why I like this Bill. The Scottish mind does its research mainly on deductive lines as Buckle pointed out in his classic on Civilisation. I am not pretending that all Scotsmen have deductive minds and that none has an inductive mind, but in bulk and in appropriate proportion the tendency is that the predominance of their mind when considering a question of research or a difficulty under dispute is to do it on deductive lines rather than inductive lines. The right hon. Gentleman knows that quite well. In Great Britain now the great tendency in medical research is to do inductive research, to base theories and practical diagnosis and treatment on facts. Take the question of immunity. Immunity is that peculiar biological property by which not only large organisms, animal or vegetable, mainly animal, have the power of building up protective substances, but even those microscopic organisms, one cell of which we have to magnify 1,200 times under the microscope, have the same peculiar property—practically unexplored territory from the point of view of research—of protecting themselves against drugs which are inimical to their well being.
Penicillin, that exaggerated drug which has not yet found its level, is an instance. It is known that in certain diseases these organisms, when first treated, disappear like a flash under penicillin treatment but, as the treatment is tried again or repeated they acquire the power of being resistant to penicillin or to the new drugs like sulphanomides, so that after treatment, when a patient gets a second attack, he is in a worse position than before, if treated on the same lines as previously, because these drugs are then practically useless, the casual microbes having built up a resistance. There are other questions. Why should a man be peculiarly sensitive to certain forms of disease? Why should certain men have hay fever? Why should certain men be allergic to certain things? Why should certain men be unable to eat certain types of fish? Why should certain men react to the touch of certain plants? Why should they get reactions? Medical research in Great Britain has practically not touched those problems.
Very excellent work is being done in the laboratory referred to—the Sir Almroth Wright Institute of Research attached to St. Mary's Hospital, London. Dr. Freeman there is an absolute marvel, working on Wright's lines, though Sir Almroth himself is getting old now. He is one of many. We want to spend not a half million but millions on the question of why certain people are protected against certain diseases and others not, so that the whole thing can be built up from the preventive point of view. My former tutor, the excellent professor who now shares the representation of the Scottish Universities with the right hon. and gallant Gentleman who has just spoken, referred to Jenner and vaccination as an immunising agency against smallpox. We immunise against diphtheria. We are only on the fringe of the great problem of immunity, and it is because the Scots have this peculiarly deductive mind that I am so glad the Secretary of State will have under his aegis the right to prosecute medical and biological research by a method and on a subject which is so peculiarly suited to the brilliant development of the Scottish mind. This is a subject which is one of great fascination, for research is a marvellous thing, and the basic, problem of immunity and its therapeutic application is vitally important.
With regard to the ambulance service, instead of leaving it to the local authorities to make perhaps private arrangements, the responsibility is now placed in the proper quarter, on the Minister's shoulders, so that ambulances will be able to go wherever the patient is to receive treatment instead of there being a demarcation of boundaries. All that is to be the direct province of the Minister, so I feel this Bill is a good Bill. I know that certain people are pretending that the doctors are against it; I know that peculiarly-worded plebiscites are being taken, to ask doctors to oppose this Bill. There is not an argument that has not been put up by the doctors that cannot really be answered. No one who is opposed to a State medical service, or a full time salaried service, has ever been able to answer the point I made in the last Debate: why, if the doctors object to a full-time State medical service, do they employ their own assistants for years or decades on a full time salary basis attached to their practices?
May I make this further point? Many assistants under contract to doctors are now in a quandary because doctors are to be compensated for the goodwill of their practices. Will the assistant be allowed to remain in that district and practise? The General Medical Council still has the right of ethical professional supervision over those doctors, and can tell the assistant, "You signed a bond and, in the ethics of the profession, you cannot break that bond. Although the doctor has received compensation for the loss of his goodwill, according to your bond you cannot be allowed to remain in this district and practise." That is a point which I hope will be cleared up in the Bill.
There are other problems which this Bill will engender, but I feel sure it is a finer Bill than the English Bill. It has made special provision for the institutions for which I pleaded on the last occasion, the denominational hospitals, the Jewish and Quaker hospitals. That is a tribute to the broadmindedness of the Scottish intellect, as fine as Buckle's reference to their fine deductive minds. I hope my contribution has been a little more serious than the rather playful, academic and somewhat boyish speech which we heard from the right hon. and gallant Gentleman the Member for the Scottish Universities.
7.8 p.m.
Of course, this being a Scottish Bill it is a better Bill than the English or the Welsh Bills, but it is not good enough, and in spite of the reinforcements which the Government have called up, including the hon. Member for Rochdale (Dr. Morgan) who, I suspect was born in Wales, represents Lancashire in this House, but had the sense to be educated under the hon. Gentleman the Member for the Scottish Universities (Sir John Graham-Kerr)—in spite of that fact, we on this side of the House, though completely in favour of a comprehensive health service with free treatment for every man, woman and child in Scotland—
I am sorry to interrupt the hon. Gentleman, but I had better correct him at once. He said he thought I was born in Wales. My name happens to be Welsh, but I really come of Irish parentage. I was born in the West Indies, educated at a Scottish University, and all my subsequent appointments have been English, so I am a regular mongrel.
Force is given to my point that reinforcements are called up by the Government from all corners of the Empire in support of their not very good Bill—[An HON. MEMBER: "It is not the first time"]—and in spite of those reinforcements and the arguments that have been adduced in favour of the Bill, we feel on these benches that there are far too many unsatisfactory features about the Bill for us to be able to recommend it to the people of Scotland. Of course, we accept the desirability of regional organisation; indeed, we agree that Scotland is peculiarly suited to such an organisation, much more suited, in fact, than is England, because in Scotland you have the great teaching hospitals of Edinburgh in the South-East, of Glasgow in the South-West, of Aberdeen way up in the North-East, and Dundee in association with St. Andrew's University to cover the centre of Scotland, with the possibility that gives you of having your teaching hospitals in the centre with the cottage hospitals around the periphery.
If we had been in the position occupied by His Majesty's present advisers, we certainly should not have placed the teaching hospitals under the regional organisation. I desire to support everything which was said in that connection by the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid). There can be no adequate justification for placing these great teaching hospitals in an inferior position to that in which they have been placed under the English Bill, both in regard to administration and the conservation of their endowments. The repeated reference to rules and regulations made by the Secretary of State or by the regional hospital boards, make it clear that the day-to-day actions of those boards of management which will control the hospitals under the proposed organisation will make them subject to a system of remote and impersonal control which is quite unwarranted in the case of the teaching hospitals, and which is vastly different from the intimate and personal contact which today exists between the management, staffs, patients, and subscribing public in the case of the voluntary hospitals.
Reference has been made to the powers the Secretary of State is taking upon himself. May I remind the House that the Bill proposes to set up a health service council with 35 members appointed by the Secretary of State. It sets up a hospital endowments commission which is appointed for five years by the Secretary of State. It sets up five regional hospital boards, the members of which are appointed by the Secretary of State, who even in this case appoints the chairmen.
If the hon. Member will look at the Second Schedule to the Bill, he will find that the appointments are only made "after consultation."
I am grateful to the hon. Lady. I was coming to that point. I have noticed she frequently intervenes but, if I may say with respect, if she allowed the speaker to develop his argument it would be better, because in nearly every case the Member is not foolish enough to have omitted a point such as that. The Bill sets up executive councils in each county for the provision of personal medical services. In this case again, the chairman and 24 other members are appointed by the Secretary of State.
No, the hon. Gentleman is quite wrong. If he reads the Bill he will see that it says: An Executive Council shall consist of a chairman appointed by the Secretary of State and 24 other members of whom— ( a ) eight members and so on.
I will leave this list for the moment and accept the fact, of which I have been reminded, and of which I was aware, that provision is made for consultation with various bodies. But the principle is exactly the same. These bodies are to comprise appointed members, and not elected members. In this country we are a democracy, and believe in democratic methods, and in elections. Yet, in not a single instance in this Bill, either in the cases I have mentioned, or in other cases I might have mentioned, is provision made for the election by people of the locality of representatives they wish to represent them on the boards.
I am sorry to interrupt, but we had better get this perfectly clear. The Sixth Schedule says quite distinctly: An Executive Council shall consist of a chairman appointed by the Secretary of State and 24 other members of whom— ( a ) eight members shall be appointed by the local health authority. appointed by the Secretary of State and the other members shall be appointed by the Secretary of State, the local medical committee, the local dental committee and the local pharmaceutical committee. So the Secretary of State does not appoint all the members of the Executive Council.
The hon. Member for Rochdale was fortunate in catching your eye, Mr. Speaker, in the English Debate, and he has now ventured to intervene in the Scottish Debate. But I cannot give way any further because so many other Members on this side—
; Disease does cross the Border sometimes.
The point the hon. Member has made in intervening makes not the slightest difference to my argument, which is that those members are appointed, and not elected. This is a point worthy of consideration that the appointment of members by the Secretary of State, on by any other body, is no substitute for the elected representatives of the districts concerned.
I want to say something about the six specific responsibilities laid on the local authorities. Of these six, at least four— the responsibility for the care of mothers and young children, the responsibility for the midwifery services, responsibility for home nursing and responsibility for after care—are at present, in part at any rate, carried out by the district nurses. I want to pay tribute to this splendid body of women, so many of whom are members of the Queen's Nurses, with 60 years of selfless service behind them. These women play a great part, particularly in the rural areas, in looking after the health of the people of Scotland and, of course, of England, too. I have been glad to see that the local health authorities, of whom, in the country districts, the county councils will be the organisaions responsible, are empowered to work through voluntary organisations. If need be, they may contribute financially to the maintenance of these voluntary organisations. I hope they will do this, for here, at least, is an opportunity for the local voice to be heard.
Voluntary hospitals are to be transferred to the Secretary of State. By definition in Clause 78 of the Bill this includes nursing homes which are not run for profit. But the Secretary of State need not take over these nursing homes if they are not required for providing hospital or specialist services. It is quite clear that there is likely to be difficulty in finding enough pay-bed accommodation, and I urge that the existing facilities for the treatment of private patients, particularly in mental institutions, and in nursing homes run by organisations such as the Officers' Association, which has such a splendid nursing home in Edinburgh, should be interfered with as little as possible. I know that there may be a strong temptation for the Secretary of State to take them over. Some of them may be richly endowed. Therefore, I ask for an assurance from the Joint Under-Secretary, who will be replying to this Debate, that when he comes to look at things like this, the question He will put to himself will be this: Is it desirable and necessary to the successful working of the scheme that I should take over this or that institution?
The points I have made are rather of an administrative nature. I want to add a point which I think is really of an ethical character. Side by side with what, for want of a better term, one might describe as the technical approach of a doctor to his patient, there is a deeper relationship which rests upon a shared confidence, and upon the responsibility which the respect and trust of the patient imposes upon the doctor. The doctor is far more than a mere technician. He shares with the pastor, and to a lesser extent, I suspect, with the schoolmaster, the privilege and the responsibility of entering the inmost recesses of the hearts and minds of his patients. There is in old people and in sick people a sense of dependence which amounts, in greater or lesser degree, to an instinctive longing 10 be regarded as some one who is human, and therefore precious in the sight of God, and worth helping. All Divine teaching and human experience go to show the sovereign importance of the human will, and only a doctor knows how much the will to get well or the will to live depends upon a doctor-patient relationship which rests upon mutual confidence and trust. It follows that the doctor should undertake full responsibility for the care and the welfare of his patient without outside interference, and with full freedom of judgment in professional matters.
That ideal cannot be achieved in full. It is not achieved in full at the present time. The medical officer in the Armed Forces or the doctor in the Emergency Medical Service are cases in point. But side by side with the State servant there has hitherto been the stimulus of a widespread and virile private practice. That balance is now to be upset. It may indeed disappear altogether, for the hazards of competition with the State medical service may be such as to make it unlikely that many doctors will be able to take the risk of remaining outside the scheme. If that is the case throughout Scotland, which has rejoiced in its liberty and grown great because of its rugged independence, the vast majority of doctors will owe their first allegiance to the State instead of to the patient. The pressure of subservience will tend to blur the ideals and to dull the enterprise of the State servant, as it always has done down the ages. If I may put it more bluntly, the doctor-patient relationship will suffer when the doctor's prospect of advancement depends not upon his care of his patient, not even upon his skill in medicine, but upon the impression he can make upon his lords and masters in the hierarchy of the State medical service.
7.25 p.m.
I wish first to express my appreciation of the introduction by the Government of a Bill to establish a comprehensive health service for Scotland. I think the two main principles associated with the Bill are, first, the granting of the best possible medical service to every member of the community, irrespective of the size of the purse; and secondly, a proper allocation of the medical skill of the country, so that we can have an organisation that will bring the patient close to the medical chiefs, without the haphazard gambling that goes on at the moment. Therefore, I say that I appreciate the introduction of a Measure of this kind. Having said that, I want to be quite frank. I wish to be critical of certain of the administrative aspects of this Measure. A previous speaker proceeded on the lines I had intended to develop myself in criticising the number of boards that are to be appointed.
There are two main criticisms. The first is against the idea that the responsibility should rest entirely on the Secretary of State for Scotland. I speak with some little experience of a local authority. For many years I served on a number of important committees. One disturbing feature in recent years has been the tendency to hamper or cripple the local authority unless it has received sanction from the Secretary of State for Scotland. There is a strong democratic argument put forward for the Secretary of State for Scotland, but on examination that argument does not hold. The strong democratic argument is that the Secretary of State has to come before the House of Commons; in other words we have the complete expression of democracy in that the Secretary of State is answerable to Parliament. On a superficial examination that is the position, but on a closer examination the Secretary of State for Scotland today—there is no personal point in this —is shown to be responsible for the health services, for education, for the police, for agriculture and for fisheries. What is the position so far as ordinary Scottish Members are concerned? We have the opportunity on rare occasions to deal with Scottish affairs, and even then we have to face up to the intervention of Rochdale pioneers. Over a long spell we get one or two days. That, to me is, in the modern age, far from being democratic.
What actually happens is that the Secretary of State for Scotland is compelled, by the difficult problems he has to face, to draw round him a great team of permanent officials. He has to be guided very largely by the permanent officials. Whatever value that has, it has tremendous weaknesses, if it encroaches upon the control of democratically elected bodies. To take this Bill, it starts off with a Scottish Health Service Council, with 35 appointed members. There is also an Executive Council. My only suggestion to the medical profession is that, apart from their natural objection to change, they will, in the long run, have much more say in the development of the medical service in Scotland than they had in the past. But I wish to make the point that there are too many committees, all working under the guidance of the Secretary of State, right down to the one that deals with the localities. The regional boards will precede the local authorities in many directions. To whom are the regional boards responsible? To the Secretary of State for Scotland. They can submit reports to him, he can examine them, and if they are considered suitable or desirable by the Secretary of State, they will be published. But under the Bill he has power to refuse to publish any of the reports.
Who elects this body? It is true that the medical profession, the local authorities and other people will be consulted, but the members elected are responsible to nobody but the Secretary of State for Scotland. If a member of a local authority were elected to the body, he would not be responsible to that local authority; he would be responsible to the members of the Board and to the Secretary of State for Scotland. In addition, we have the hospital boards. I do not want to enter into a discussion on voluntary hospitals. Therefore, I will deal with the boards as such. The hospital board is responsible to the regional board. It has a certain autonomy and it can appoint and dismiss people and make certain purchases. There is, however, no permanent link that indicates the constant movement forward in unison of the hospital board and the regional board. Between these bodies come the local authorities who are responsible for many of the home services. The local authorities are responsible for watching the development of tuberculosis in the home and attempting to check it. The local authorities in the big areas are responsible for infectious diseases—
No.
I say that the local authorities will be responsible for watching in the district for the danger of infectious diseases. I do not put tuberculosis in the category of infectious diseases though we know it is an infectious disease. The local authorities are responsible for watching tuberculosis in the homes of the people. I say, therefore, that we have a link, which is not a very healthy link, between the local authority, the regional board, and the hospital board in trying finally to get the patient from the home into hospital. That is my reading of the Bill and I should be more than happy to be corrected. Why are the local authorities being set aside? Is it not admitted by anyone who has studied the history of social development that it sprang, first of all, from the small community? In cities like Glasgow and Edinburgh the development of the hospital services was not primarily the outcome of legislation. It arose from the work of far-sighted local reformers.
All that is being thrown to one side. I know from experience that if we hand this over to the regional boards, even the right of knowing what is happening in the hospitals will be difficult to enforce. Everyone of us knows that, even in local authorities, we find it necessary to complain not against bad management, but against institutions which are not properly managed, where there is haphazard administration. Perhaps the medical superintendent has not sufficient courage and capacity to handle his staff, with the result that the healthy development of the institution is impeded. As one of my hon. Friends says, as an aside, that remark also applies to the matrons. I would not like to be unfair to matrons, though I agree that they can be very hard, not only to the patient but to the staff. The only point I wish to make is that matters of that kind can be checked up by the local authority through the medical officer and the health committee. Under the regional board, I want to know how they will be able to check these things. I do not see any opportunity provided for that in the Bill. If the Joint Undersecretary could help us, I would be very happy.
I should have thought that in the extension of the health services greater responsibility would be placed on local authorities. The strong case against the local authorities comes from the Treasury. As soon as the Government hand out money, they must have some Minister responsible to the House of Commons. I do not understand that line of reasoning when it concerns the development of a democratic country. The Government appoint auditors to examine the books of local authorities and nobody else can do it but Government appointed auditors. The very people who are elected to this House of Commons, who feel they are capable of carrying out a responsibility on behalf of the community as a whole, surely should have some respect for the people appointed to local authorities by the same electors. I hope that if we cannot get any assurance tonight, at least the interjection of some of our complaints may cause the Minister to give the matter closer examination before we reach the Committee stage.
I know the difficulties which will arise in Committee. With the Government on one side, and the Opposition on the other, it does not matter very much what reasons are put forward. It is the weight that matters. Certain people will say, "We have already framed the Bill and we do not like the idea of amending it." As I said, in the only other speech which I have made in this House, I want to see this Government score a great success. I then uttered what I thought was a warning from an ordinary member of the community, that in the desire to develop State enterprise, there was a danger of encroaching unduly on the democratic machinery established down the generations. It is my fear in connection with this Bill that there will be an encroachment on local authorities in a manner which is not justified by our knowledge of the past. I ask the Joint Under-Secretary of State for Scotland to correct me on my point about infectious diseases and tuberculosis, if he so wishes. I hope he will not destroy the very fine machinery set up by local authorities, at least in the big cities. I think the local authorities have been of great value to this community, and that their work can be enlarged upon without encroaching upon the democratic rights of the electors.
7.37 p.m.
The hon. Member for Bridgeton (Mr. Carmichael) has spoken with great cogency. I trust that hon. Members opposite will have listened to him, for he speaks as one who has much the same approach as they have, but he happens to be free and not dominated by the Government Front Bench. I wish to approach the Bill as an ordinary citizen, not from the point of view of the doctors, from whom we have had several distinguished speeches today, nor from the point of view of the Front Bench. I want to approach the matter from the point of view of one who is responsible ultimately, as an elector, for the provision of these services. There is no difference of opinion in the House on the question that there should be a comprehensive health service. The question is how it should be provided. It is a matter of control.
The Secretary of State said the State should not go on handing out large sums of money without having control. Hon. Members opposite have echoed that remark. I would point out that the State does hand out large sums of money every day without having complete control. The State exercises supervision. It hands out large sums of money in subsidies to agriculture but it does not run the farms itself It hands out large sums of money to industry but it does not run the whole of our industry.
It will in time.
The party of which the hon. Gentleman the Member for West Fife (Mr. Gallacher) is a member may hope to do so, but the Government say they do not intend to do that. I want to consider the matter from the point of view of the elector who has to provide these services, to use them and to pay for them. In Clause 1 (2) of the Bill there is the phrase: The services so provided shall be free of charge. There is, however, a risk of there being a considerable over emphasis on the word "free." Surely, emphasis should rather be placed on the fact that all citizens are contributing, in one way or the other, to these services, and that it is in relation to their own effort that they will get good services. Everybody wants the services to be provided as sympathetically, as efficiently and as economically as possible. But what control does this Bill give to the elector over those services? What encouragement is there to him to exercise that control?
First of all, let us take the hospitals. Some are under the control of local authorities, and, when those local authorities are conscientious, the services are good. When those local authorities are less conscientious, or provide bad services, it is always open to the local authority elector to turn them out and to put in people who are prepared to spend more on those services. Then there are the voluntary hospitals which are financed by, bequests or gifts, or are maintained by public subscriptions from people who wish to get something for themselves a little better, perhaps, than their neighbours enjoy. That is a manifestation of robust and honest rivalry between districts. In my own constituency there are two small hospitals in two different burghs— Langholm and Moffat. One is entirely endowed and the other is supported by public subscription. Those hospitals are now to pass under the control of regional boards constituted and appointed by the Secretary of State, and working subject to his regulations and such directions as may be given by him. These regional boards have no representative element on them whatever, apart from the members appointed after consultation with the local health authorities. Then, the local hospitals are to be ran, either separately or in groups, by boards of management appointed in accordance with the scheme to be prepared by the regional hospital boards and approved by the Secretary of State. The Bill does not prescribe the proportion of local authority representatives on the boards, but I doubt very much whether they will be in a majority judging by the constitution set forth in the Schedule.
Perhaps it may be said that this set-up is essential in the interest of efficiency, and of the health of the people. If the right hon. Gentleman compares the state of health of this country 100 years ago with its state of health today, would he say that the present system has not worked? Have the Members of the Government so little confidence in the good sense of our people, and has the right hon. Gentleman the Secretary of State so much confidence in himself, that he must assume that he alone can provide hospital and specialist services? Could not a scheme for voluntary cooperation between hospitals have been worked out which would have commanded support?
In his speech, the right hon. Gentleman referred to the fact that one third of the students trained in Great Britain are trained in Scotland. He then went on to say that he wished to safeguard that position. But, surely, the greatest safeguard is the continuance of the system whereby out of the individual efforts in the country we have managed to reach a state where we produce one third of the doctors in the Kingdom? I believe that it would have been possible to have followed one of the schemes worked out, for example, by the British Hospitals Association. If the alternative had been given of having this Bill or of having such a scheme then, undoubtedly, the hospitals would have opted for the scheme which they themselves suggested. It is only because they have seen the progress of the English Bill through this House that by a kind of attrition they have come to the conclusion that they had better give way. But that is not their real view at all.
Perhaps the right hon. Gentleman took his cue from his right hon. Friend the Minister of Health who, according to a report in "The Times" of Monday, 28th October, told the British Medical Students' Association on 26th October: The scheme could not be articulated through self-motivating voluntary hospitals. He went on to say, on a slightly lower level: I could not provide a service through institutions which were able to deny my ultimate authority. So, right or wrong, the Minister's dictates must prevail. He who pays the piper calls the tune. But is the Secretary of State so sure that he knows the local needs better than do the local electors themselves?
I will now turn to a special topic which has not so far been mentioned—that of mental hospitals. I believe that there are more beds in mental hospitals in Scotland than in general hospitals. If there is one thing which is quite clear it is that it is essential that the independence of these mental hospitals should be maintained. There must be elasticity in their management, and a large measure of freedom must be given to them. The constituency which I represent is internationally famous for two things; firstly, its connection with Burns, and secondly, the fact that it contains the Crichton Royal Hospital. That hospital was founded about 100 years ago, and has an international reputation. About 58 per cent, of its patients are private patients. It is not because I think that our best services should not be reserved for Scotland that I mention this, but only 35 per cent, of those private patients come from Scotland. The point is that it is essential in the case of mental hospitals to allow the patients to choose where they will go. For obvious reasons, mental cases do not want to go for treatment just round the corner. It is essential for such patients to have the kind of life to which they have been accustomed and, in the case of the treatment of neurosis and various psychopathic conditions, it is essential that there should be no psychological shock in the way they are treated. I hope that the hon. Gentleman who is going to reply will deal with the mental hospitals' freedom of management, their elasticity as to which hospitals patients are sent, and the extent to which reservations are to be made for private patients in mental hospitals in comparison with other kinds of hospitals.
Local authorities are left with many duties. Among them they have the care of expectant and nursing mothers, sick visiting, home nursing and the after-care of the sick. All these services are under the direction of the Secretary of State in order to fit in with hospital and specialist services. That is nothing but an insult to local authorities. Surely, they would be anxious to fit in without directions or regulations. Whatever the hon. Member for Dunfermline Burghs (Mr. Watson) may feel about his own very independent county, given the problems, the local authorities will be anxious and willing to solve them in cooperation. If real responsibility is taken away from local authorities, that will to cooperate will be taken away.
I turn now to the question of the private citizens' approach to his medical practitioner. What are the ordinary citizen's, requirements of his doctor? First, I should say is availability of doctors; secondly, sympathy; thirdly, skill; and fourthly, privacy. With regard to availability, the Bill will not increase the number of doctors or dentists. The White Paper states that the Bill imposes no limits upon availability, but, in fact, it imposes very practical limits, and I want to mention some of them. It reduces the doctor's time for attending to patients. There will be an immense number of regulations, and forms to fill up, and there will be many more doctors engaged on administrative duties.
There will not be so many doctors practising in wealthy residential districts, like Bournemouth.
On the whole, the distribution of doctors throughout Scotland is far more even than it is in England. There will be a great deal more routine work for doctors. Far more will be employed in administrative duties. Let hon. Members look at the Schedules and see how many doctors will be involved in executive councils, boards of management, and so on. Moreover, a salaried service is being set up. I would like to quote from a letter that I received from a doctor, which says: The Bill takes away all incentive to become a good, or even a conscientious doctor. A wholetime salaried doctor, being a human being, will be no better and no worse in the matter of work than any other wholetime salaried officer. There is no doubt that he, too, will demand his eight-hour day and will down tools when the clock strikes the eighth hour each day. At the worst, he will not bestir himself to answer an emergency call out of hours; at the best he will not bestir himself mentally, and the standard of medicine throughout the country will fall to that of other totalitarian countries.
Does that apply to the local services?
That is a doctor's opinion on this matter. He is not a very old doctor, and has not very long been out of the student stage. Let us now consider the question of sympathy. With regard to the very important point about the choice of doctor, I would like the Joint Under-Secretary of State to say something about that in his reply, since it is not clear in the Bill and the White Paper. It is obvious that the doctor can choose his patient, just as the patient can choose a doctor, and there is also, of course, an arrangement with the executive council whereby a patient may be directed to a particular doctor. What is not said is whether the doctor is then obliged to take that patient.
Does the hon. Gentleman suggest that a poor working-class resident in the East End of London can choose the doctor he wants?
I do not see the relevance of that interruption. A poor working-class man can change his doctor, and I doubt very much whether, under this Bill, that will be possible. There seems, to be no provision for it. There is a prevailing idea—and it is a very good one—that medicine is a calling and not a career, but once it is made a salaried service, there is bound to be all the normal wirepulling of a career. There will be doctors place-hunting and seeking promotion, and this will destroy the relationship between the family and the doctor.
There is also the very important question of privacy. Health centres are to be set up. There is a great deal to be said for clinics in which doctors may be in partnership and each of them specialise in some aspect of medicine. Perhaps, in Scotland, we are not quite as advanced in that respect as other parts of the country, although I believe that Aberdeen, in this as in many other things, is very well advanced. Surely, the privacy of the patient will be mightily affected in several ways. He will go to the health centre, which incidentally will not be under the local authority, but one of the services provided by the Secretary of State. Probably he will have a medical history card filed away, with no guarantee that it cannot be seen by eyes that he would not wish to see it. The only eyes that he would wish to see his medical history card would be those of his own doctor, but once there is a medical history card, it may be called for on all kinds of occasions. Surely, it is a natural instinct, when one is sick, to crawl into a corner rather than to go round to a great public place for health services.
Lastly, with regard to the executive councils, I agree fully that there is far too much control throughout by the medical profession. The person who is really interested, and should have the control, is the patient, through his local authority, and, if you like, through an advisory council. But the executive council is only half local health authority, the other half being doctors, dentists and pharmaceutical experts. Surely, that is entirely wrong. There are two separate considerations. First, there is the control by the profession, from the disciplinary point of view, of its own members, and that should be in the hands of the profession, as it is, for instance, in the case of solicitors. At the present time, doctors have control. The hon. Member for Rochdale (Dr. Morgan) would not entirely agree with me if he were present, but surely, that control ought to be entirely in the hands of the profession, whereas if it really is necessary—I do not think it is—for there to be any control over the number of doctors in any given area, from the point of view of allowing them to come in or not to come in, it should be for the citizens, through the local authority, to say whether the medical services are being adequately manned or not. There should be, of course, medical advisers to give expert advice. I understand that is the way the Highlands and Islands scheme works, and I do not see why there should be any deviation from that system in this Bill. In conclusion, I would point out that we are being asked to surrender all our great teaching hospitals to a Secretary of State for Scotland whom we might describe as our first foreign citizen, and who is anxious to give us a health service which—
Would the non. Member tell us what he means by the expression "first foreign citizen"?
The Secretary of State for Scotland speaks with the accents of Scotland, but I believe he comes from across the Border.
A Member of his party was Secretary of State for Scotland for some time before my right hon. Friend occupied that position. He was the first foreign one. The first foreign citizen was, therefore, my right hon. Friend's former leader.
I accept that interruption in good part. The fact remains that Scotland takes note of it. The Secretary of State for Scotland is anxious to give a health service to Scotland. It is easy enough to give it with other people's money. I can assure the right hon. Gentleman that what he gives us is nothing to what he is taking away in spiritual values. He is depriving Scotland of that feeling of individual responsibility in the professions and of responsibility of local authorities towards private citizens. The right hon. Gentleman said in his speech that he is incorporating all that is best into the Bill. On second thoughts I think he would agree that that is not so. There are aspects of voluntary effort on the part of doctors in the voluntary hospitals and we can ill afford to do without them. They have built up the great medical services of Scotland to the pre-eminent position that they occupy today. I trust that when we come to the Committee stage there will be a considerable revision of some of these points in the Bill.
8.2 p.m.
I wish to make one point in reply to the argument of the hon. Member for West Aberdeen (Mr. Thornton-Kemsley). I am sorry that he is not in his place at the moment. His argument was thoroughly pedantic, and was based upon a strained meaning of the word "appointed." He sought to prove that the executive councils contemplated by the Sixth Schedule would not be democratic bodies because the word "appointed" is used in the Schedule. Therefore, they were appointed bodies and not democratic or elected bodies.
The hon. Member's argument will not bear a moment's examination. In the Sixth Schedule we find it provided that executive councils shall consist of 24 members. Of that number, five will be appointed in the true and proper meaning of the word. They will be appointed by the Minister. The other 19 will be elected. The executive council is to consist of a chairman appointed by the Secretary of State and 24 other members, of whom— ( a ) eight members shall be appointed by the local health authority. How does a local health authority appoint any persons? Surely, by electing that person by a majority of its members. Any person so appointed is, in fact, elected. Therefore, the eight members in sub-paragraph ( a ) will be elected members.
Sub-paragraph (b) says: four members shall be appointed by the Secretary of State. They will be appointed in the proper sense of the word, and not elected. Sub-paragraph ( c ) says: seven members shall be appointed by the local medical committee. What is the local medical committee? It is a committee of medical men appointed by local medical men. How does the committee appoint anybody? By electing them by a majority of its own mem- bers. Therefore, under sub-paragraph (c) the seven members who are to be appointed by the local medical committee will be elected members, though the word "appointed" is used.
I pass to sub-paragraph ( d ) which says: Three members shall be appointed by the local dental committee. The same line of reasoning applies here. Sub-paragraph ( e ) says: Two members shall be appointed by the local Pharmaceutical Committee. Exactly the same argument applies.
Therefore, we find that of the 24 members of the executive council, 19 are elected, although the word "appointed" is used. They are elected in the true meaning of the word "elected." The word "appointed" in those sub-paragraphs means "elected." Therefore, of the executive council, 19 will be elected and five will be appointed in the true meaning of the word. Therefore, the argument propounded by the hon. Member for West Aberdeen falls to the ground. It is, as I said, a thoroughly pedantic argument, based upon a strained meaning of the word "appointed," and is thoroughly unsound.
8.7 p.m.
I agree heartily with the provision of a comprehensive health scheme for Scotland, but I also agree with hon. and right hon. Gentlemen on this side of the House that the Bill is not the way to bring it into effect. I wish to emphasise most particularly, as did my right hon and learned Friend the Member for Hillhead (Mr. J. S. C. Reid) and other speakers, that the Bill gives the Secretary of State for Scotland quite remarkable powers. I am not being personal, but am referring to the holder of the office at any time. The Minister will have at his disposal powers, responsibilities, and patronage on a vast scale. The best proof of the powers which he has under the Bill is the fact that his title appears, as taking some form of power or responsibility, no fewer than 279 times in the Bill. That is a pretty fair show of the power which he is taking to himself. I maintain that to put such power into the hands of the Minister is a travesty of democratic government. Such action is becoming more and more frequent on the part of this Government, as Bill after Bill goes through the House. It is a process that must inevitably lead to totalitarianism, which is ultimately the end of all Socialist governments. Nobody can argue about that.
I would turn to Clause 22, which deals with dental priorities. I think that nursing and expectant mothers and young children should have priority of dental treatment. As a matter of principle, it is regrettable that this Bill does not deal with the adolescent, who is normally considered to be between 15 and 18 years of age, because I am informed on very re-liable authority, by dentists and others qualified to speak, that the biggest dental problems of today lie in that age group. If we must have this Bill, I cannot see why adolescents should not be included in this very important provision. I hope when the Joint Under-Secretary replies that he will have something to say about that point. I understand that in the case of the English Bill the Minister of Health said it could not be done because there was such a great shortage of qualified dental practitioners. I think it is a fact, although I am open to correction, that in Scotland we are very much better off in that respect, and I hope the Secretary of State will consider that point because it is very important. Although it may be said that under this Bill, children's teeth having been well treated earlier, the situation will improve, which is quite true, that state of affairs will not come about for a considerable number of years, and there is a vast task awaiting dental officers in connection with adolescents.
I would like to turn to Clause 37, which also deals with the question of dental services. It lays down that the area executive councils shall prepare lists of dental practitioners who shall undertake to provide general dental services. In view of the fact that Subsection (2), paragraph ( c ) says that regulations shall include provision. for conferring a right on any person to choose in accordance with the prescribed procedure the dental practitioner from whom he is to receive general dental services", I do not see why in a country like Scotland there should be lists of dental practitioners confined to the areas covered by these executive councils. Why should not there be one for the whole of Scotland? Why should a man living in Perth, for instance, who, perhaps, may have always been to a Glasgow dentist for treatment all his life, not continue to do so merely because it is said that that area does not come under the same executive council as Perth? If we are going to have dentists who are prepared to serve in this capacity, the patient concerned should have a choice of where he goes, anywhere in Scotland, and I cannot see that it would interfere with the Bill if he did. It is merely another niggling attack on the liberty of the subject.
I wish to turn to Clause 41, which deals with the tribunal set up to deal with complaints against doctors or dentists. This is a most glaring example of the immense powers of the Secretary of State. He appoints the chairman and members, admittedly after consultation with certain bodies, but from past experience we also know what little notice is taken, in practice, of advisory bodies by Ministers. I think it is a very great danger that the Secretary of State should appoint not only the chairman but also the members of this tribunal. Supposing I, as a medical officer, have appeared before this tribunal and I consider that I have been wronged by the tribunal, I am allowed to appeal. But to whom may I appeal? To the Secretary of State. I can never get away from him. There is no hope of getting beyond the Secretary of State. It is a fundamental right of every citizen of Scotland that he shall ultimately have the right of appeal to a really independent body which is a court of law. But under this Bill a medical officer can never get beyond the Secretary of State who will be judge, jury, prosecuting and defending counsel and everything else rolled into one. I cannot see why we should be denied what is our fundamental right in our country.
There is one other objection to this tribunal. That is that the members have what is tantamount to the power to strike from the roll of his profession a doctor or a dentist. That is a very great power, and I maintain that such a tribunal needs strengthening very considerably on the professional side, because only men of the same profession can decide whether a member of that profession has been guilty of undesirable conduct or inefficiency from the professional point of view. For one man—say, a dentist—to sit with other people who are not dentists in trial on a defaulting dentist is far too great a responsibility for that one professional man, and I think that such a tribunal should be very much strengthened.
I would now like to turn to Clause 67, and to the Tenth Schedule which is related to it, on the question of inquiries. I understand there is no equivalent Schedule in the English Act in the matter of inquiries. I hope the right hon. Gentleman or the Joint Under-Secretary will tell us a bit more about these inquiries; what is their object, and why they are necessary in Scotland and not in England. We have no indication of the powers of these inquiries; we have no indication what action may be taken following their deliberations; and there is nothing to show that there is any appeal against the decision of the inquiries. I would like to know—I am assured by people for whose opinion I have the greatest respect that I am wrong in this, but I would like it cut and dried in the House—whether it is possible for one man to come up before the tribunal already mentioned, and also before an inquiry for possibly the same offence. As I say, I am assured that that is not the case. But frankly, I do not like the look of it, and I hope that the Secretary of State will assure the House and the country that the situation of one man coming up before two bodies and being tried for one offence cannot possibly happen under this Bill, and that it will be put in the Bill in writing. If that were done I should feel much happier.
8.17 p.m.
The one main thing which several hon. Members on both sides have said is that it is desirable to have a comprehensive health service, that it is the thing which has been lacking. It did rather astonish me that, with his reputation on the "Brains Trust" and in past Debates in the House, that the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) did not appear to put forward any suggestion of his own, except a reversion to the admittedly unworthy past, or a maintenance of the status quo in place of what is proposed in this Bill. I thought that at times he became almost frivolous, in the funny philosophical way which they have at times on the "Brains Trust." He certainly did not measure up in any constructive way, in our view, to the requirements of a serious Debate of this kind, on a matter of fundamental importance to all the people of Scotland. The hon. and gallant Member for Perth (Colonel Gomme-Duncan) did us the honour of joining in this desire to establish a comprehensive national health service. But he did not tell us a different or better way of doing it, than by the method suggested in this Bill. He differed on details, which I think would be much more appropriately dealt with during the Committee stage of the Bill. He did not appear—because he concentrated on those details—to differ with us at all on principle, except on a few exceptional points.
I very much regret that I must differ with the hon. Gentleman. I mentioned matters of very great principle, such as the right of appeal, and various things of that kind. If the hon. Gentleman will go into it more carefully, he will find there are many matters of principle and not of detail.
On the matter of legal principle, I quite agree that point he made in the case of appeal is important. I am talking of the general principles of establishing and administering a national health service, which is a different and wider matter altogether.
The Highlands and Islands Medical Service has been drawn in by both sides of the House. It was generally approved by hon. Members on the other side who thought that nothing in this Bill should cause it to be altered in any way, and nothing else should be substituted for it in any service on a national scale. Hon. Members on this side have expressed pride, and I think justifiable pride in it. But we do know this—and, nobody is more conscious of it than the people in the Highlands and Islands, and the doctors there—that that service, good as it is does not measure up to the requirements of today. There is no possible gainsaying that. At least two years have passed since I had discussions with the representatives of all the doctors of the Western Isles, who were unanimously in support of the principles of a Bill improving and extending these services; and the principle of a national health service; and they were most anxious that the State should be in control of it, and not the local authorities, or some mixed dual control. They were completely relieved to know at that time that it was projected that, instead of dual or county council control, there would be direct control by the Secretary of State and the Department of Health. I cannot say how relieved they were. They knew that there would have to be administrative freedom, and through the use of that freedom there would be established throughout Scotland a vastly improved medical service including an improved Highlands and Islands Medical Service. I should like to pay this tribute to the men and women who run this magnificent service, for they have done magnificent work, and the men and women of the Highlands and Islands have great faith in their work, and have had great benefit from it. The extension and improvement of that service is one of the things that is most necessary if the health of the people of Scotland is to be maintained and built up, as hon. Members on all sides want it to be.
Those who have criticised this Bill have suggested nothing better to put in its place. I take it that the right hon. and gallant Member for the Scottish Universities who is an ex-medical practitioner of some distinction, was put up as the main spokesman against the Bill today. I must honestly say that he failed in his criticisms of the Bill, and he had nothing at all constructive in his criticism to suggest as an alternative scheme. I compliment the Secretary of State for Scotland and those who drafted this Bill, and those who have taken part in drafting it behind the scenes, on producing as nearly a perfect an instrument of legislation for the end in view as possible. I do compliment them for having brought forward a Measure which will give great satisfaction to the doctors and nurses and the people of the Highlands and Islands, which will improve the conditions of those in the service and enable them to give greater service in better conditions, improving as time goes on.
There was one principle laid down—an astonishing one—by the right hon. and gallant Member for the Scottish Universities, when he tried to flay verbally the Secretary of State for Scotland because he had not bound himself for all time, and bound Parliament with him, to the findings and report of the Hetherington Committee. It is a thing which Parliament has always defended itself against, being bound by a previous Parliament, or, at all events, by any report of an outside body. I resented, and I am sure the House as a whole resented, the implications of this attack upon the right hon. Gentleman the Secretary of State. After all, there was another great event that took place, a much greater one than this report by that committee, however important it may have been. There has been the General Election since then. The right hon. and gallant Member for the Scottish Universities did not happen to come in on the small flood of Opposition at that time. He has had the consolation of coming back here since. He should realise that we have a mandate from the people of Scotland and of this country to carry through this service. It is part of the programme we laid before the people of this country.
If I may refer to the result of the by-election in the Scottish Universities as being of some consolation to hon. Members opposite, the result at the Kilmarnock by-election is a really good stiffener to the Scottish Opposition by the people of this country. It ill becomes the right hon. Gentleman and his friends to criticise us on the grounds on which he criticised the right hon. Gentleman the Secretary of State. After all, the right hon. and gallant Member for the Scottish Universities advocated things himself in his day. and so did the leader of his party, which they have never implemented. The right hon. Member for Woodford (Mr. Churchill) advocated nationalisation of many things in his Liberal day. He advocated destruction of the Tory Party, and never carried any of his promises out.
He very nearly did at the last Election.
He did his best, but he did not quite succeed. He is still trying.
Since the Highlands and Islands service has been brought so much into the picture tonight, I want to say that that service is indeed as gallant a venture as has been described on all sides of the House. It is a picture of men and women doing their best against difficulties of transport and climate, inadequate buildings, lack of accommodation and specialist services and the rest, but still doing their best. It is also a picture of men and women doing their best while waiting hopefully, expectantly, that this new service will give them an incentive to do greater work still. They are not concerned primarily with profit, as are so many of the vested interests which are against this Bill—the newspaper advertisers, and. therefore, some of the newspapers themselves, the usurers—the sellers and buyers of practices—all the people who sell patent medicines, and all the other racketeers in the background of this opposition. It is not genuine opposition at all, but is organised by them through the most powerful vested interest instrument, the British Press, which they could possibly have for their destructive advocacy—an advocacy which admits nothing whatsoever except the status quo —which even hon. Members on the other side know must not be allowed to remain— in place of what we are trying to propose in this Bill.
Emphasis has been laid on this side of the House on the value of one provision in support of which I wish to join, and that is the provision for research in this Bill. I think everyone of us looks forward to the time when we shall be able to give our overworked medical men a little freedom from the drudgery of fee-grubbing, which occupies them in the present free enterprise competitive system which is advocated on the benches opposite, to the time when they can have a little real freedom, if they have a capacity or a special bent for research, to go ahead with it, to the time when we shall finance them so that in their work will not be continually worried with sending out students to collect pennies in tin cans every year as they have to do from the universities which the right hon. Gentleman represents. We look forward to the time when we shall see the State backing to the full a real attempt at fundamental research into the causes and prevention of those terrible afflictions, tuberculosis, cancer, the diseases of the miner, and the other industrial diseases which cause suffering—much of it unnecessarily, I believe—to hundreds of thousands of the people of this country. We on this side welcome this Bill, and we welcome it sincerely, not simply on the principle of counting heads behind the Government to which we alleged always to say "Yes"—though not in every case. We genuinely welcome it on behalf of our constituents, who are, after all, the consumers of the services we are trying to improve against the opposition of thoughtlessness and selfishness.
8.28 p.m.
I will not comment on either the last speech or a number of its predecessors, although there is ample scope for comment; the time is limited, and I would therefore concentrate on the Secretary of State and his proposals in this Bill. As the House probably knows, I had the temerity recently to criticise the Secretary of State and his colleagues in office for their inability, or fear, to stand up sufficiently for Scotland, and I pointed out that they were rather apt to be dominated by a ruthless and unsympathetic English Chancellor of the Exchequer—even thwarted at times—in what otherwise might have come out of their friendly and good hearts. My criticism has apparently borne some fruit.
Dead Sea fruit.
At any rate, we have got our own Health Service Bill, and not merely an uninspired paragraph or Clause in the English Act, saying that the Act applied to Scotland. Unhappily, however, my main criticism still holds good. I am sorry to have to say so, because the Bill that we are discussing—and I hereby disagree with my right hon. and learned Friend the Member for Hillhead (Mr. J. S. C. Reid)—follows much too slavishly the many objectional characteristics of the English Act. I want to make it clear that I think it is high time that Scotland had this comprehensive National Health Service, but at the same time, as our newly elected Member for the Scottish Universities (Lieut.-Colonel Elliot) pointed out, the Hetherington Report made it perfectly clear how this health service could be brought about without resorting to what I have stated to be the objectionable characteristics of the English Act.
The hon. Lady the Member for North Lanark (Miss Herbison) mentioned that many young doctors would welcome this Bill, and I suppose that was also in the mind of the Secretary of State. But, is it wise to offer nothing but security to our young men coming into this wonderful profession, turning them into civil servants who are only eager and anxious for security, instead of offering them the great challenge of an adventurous career? I do not think that we shall get the best health service in that way. I believe that the Government are clamping down the lifeless hand of bureaucracy on what might be and should be our greatest healing agency—
May I interrupt the hon. and gallant Member?
I am not going to give way, because I promised to finish my speech within a certain time. In any case, as the hon. Member knows, it might not be worth my time to deal with his query although I have no doubt it would be interesting to himself. I should like to refer to an extraordinary statement made in the Financial Memorandum. It says: The service will be free for all who care to use it. That is a lot of misleading nonsense. Of course the service is not free; it is paid for by those who use it, and by those who do not use it. We have to recognise that the taxpayer is still the milch cow for every Socialist experiment. With all that shrewd honest sense and genial bonhomie of the right hon. Gentleman, it is not yet realised by him that the Scots are a race of individualists, and that is demonstrated throughout the Bill to all who read it.
The hon. and gallant Gentleman is an Irishman.
I am not going to be led away. I do not apologise for the Irish blood in me, nor take credit for my Scottish blood. I thank God that it is half-and-half, and that I am more than qualified, therefore, to speak in a British House of Commons. With all good will, I would point out to the right hon. Gentleman that the Scots have taught the English practically all the sciences, education and medicine they know. If that is so, it is obvious that Scotland will not sit down and have English methods of administering these great arts foisted upon them, for the Scots have always been creative and not imitative. I realise the position in regard to this Bill and its withdrawal last Session, but I want to register in the mind of the right hon. Gentleman that he must be prepared to accept a vast number of Amendments before Scotland will accept the Measure.
In deference to your wishes, Mr. Deputy-Speaker, I pass very rapidly over the many convincing attacks I would have otherwise made against this Bill. However, I must refer to that time-honoured, —no, not time-honoured but moth-eaten— statement by the hon. Member for the Western Isles (Mr. M. MacMillan) about their mandate—it is becoming so boring, and it is also so untrue. I once again state the facts. The party opposite got a 48 per cent. party vote out of a 76 per cent. national poll, or slightly under 40 per cent. of the total electorate. Therefore, they have a mandate for nothing, except to guide this country as smoothly as possible from a war-time economy to a peace-time prosperity. Until hon. Members opposite begin to remember that, and realise their responsibility to the people as a whole, and not to one section, they will not get the popularity to carry them through another General Election. In any case, they certainly have not a mandate to interfere with the fundamental characteristics and attributes of the Scottish people. This Bill, however, is different from most other nationalising Bills that we have been up against, in that it deals with the affairs of life and death. The life of even one Scot is much more important to Scotland —and to England, as we know—that all the theoretical dogmas of an uninspired Socialist philosophy. So, we are determined, during the whole of the Committee stage, to resist, so far as possible, this lifeless control by the State over the means and methods by which the life and health of Scotland are determined.
We do not believe that regional boards can adequately replace the intimate contact and personal association of the local management boards, which hitherto have so happily functioned. We do not agree that individual endowments should be handed over to an impersonal endowments commission, with little or no appreciation of local requirements. This Bill may make that legal, but it will not make it moral. It is just as if a will were declared invalid as soon as the corpse was safely tucked into the coffin. That is the attitude of the Secretary of State in regard to endowments. He may make it legal, but he will never make it moral in the eyes of the Scottish people. Now I come to the Scottish doctor, known in the city slum, and in the Highland croft, as always the friend and kindly adviser. He is always welcome; he is always reliable. I ask the House and the Government whether the State servant can be acceptable as that man's successor, as successor to the man who is willing to turn out at any hour of the day or night, and go over rough country to serve his patient? Can the State servant take his place? Will the State servant carry out the intimate and never-ending services so closely associated in the minds of every Scottish person with their local doctor? Answering my own question, I would say that the medical profession as a whole must be free. The doctor must be free to serve his own patients in the district of his choice. The doctor and patient may have to subscribe to, and comply with, certain unwanted State regulations, but this fundamental freedom must remain.
I do agree that it is advisable, despite the wastage of doctors in administrative posts, to associate doctors as much as possible with local affairs, with which their work is so closely allied and interlocked. Under the Bill, there are created 10 different commissions, councils and committees. We remember the late Mr. Ramsay MacDonald's Government, with all their Royal Commissions, which cluttered up the whole process of Government. Do not let us clutter up this Bill with more committees or commissions than are absolutely necessary. Most of my speech has been directed towards the Secretary of State, because I believe that he is capable of absorbing good ideas. Whether he is capable of carrying them out is a different matter. But let him be prepared, in a friendly frame of mind, to accept the many Amendments that will have to be proposed during the Commitee stage, for he must remember that the Scots may be led but certainly will never be driven.
8.40 p.m.
I think that the issue which faces us tonight has been somewhat overclouded by the diversity of speeches that have been made. To me it is a fairly clear-cut issue as to whether or not this Government is to allow a system of laissez faire in the practice and organisation of medicine in this country to continue, or whether it is to introduce into that practice and organisation a planned system. Members on the opposite side, both above and below the Gangway, have sought tonight to evade that issue. The right hon. and learned Member for Hillhead (Mr. J. S. C. Reid) faced it in a half-hearted way by suggesting a "greater expansion." That was from the Tory Opposition. Below the Gangway, confronted with the same problem, the hon. Member for Dumfries (Mr. Macpherson), from the National Liberal point of view, suggested "voluntary cooperation." Neither of them rejected the idea of a comprehensive medical scheme, but both of them—and I presume that they represent their parties —rejected the idea of a definitely planned system of medical practice. They took whatever sort of funk-hole they could find in order to dodge the issue.
Some rather lurid pictures were painted, especially by the hon. Member for Dumfries, who suggested that when a person was ill, rather than go to a great public clinic for treatment, he would "prefer to creep into a corner." I think those were his exact words. That is exactly how my dog behaves when he becomes ill—he wants to creep away into a corner. That, I submit, shows exactly the type of mind that has been shown in the past with regard to other problems which we have had to face up to. It is sought to treat a human being as if he is a type of dog who, when he becomes ill, creeps away into a corner.
I suggest what will actually happen is that an individual when he reaches that stage in health, will not be allowed to be without a doctor, as he often is now. Under the system we propose to introduce, instead of having to creep into a corner, he will take to his bed, and a doctor will be brought to see him. The hon. Member for Dumfries suggested that we should have a terrible inquisition— medical certificates and so on. I wonder if he realises that that sort of thing is going on now very circumspectly. It goes on every day in our schools and all the records are kept circumspectly. There is no divulging by private doctors of the troubles of individuals. For six years, millions of young men and women were subjected to medical inspection, their records documented and carefully kept and there was no revelation. I believe that now, in the interests of the working population, it is going on in industrial establishments on Clydeside under the impulse of a public authority and not private enterprise. I refer to diagnosis by radiography. We were told of the dangers of uniformity creeping into our services. That took my mind back to those age-old arguments that any attempt to get the State to raise the level of human well-being was bound to lead to uniformity, and, therefore, was a setback.
I remember when the Carnegie grants were first introduced into Scottish educational life the boys and girls of the working classes, who were receiving a chance free which they never had before, were looked down upon when they accepted these grants, and those of them who went to universities were sneered at as "Carnegie students." Today, it is a definite part of our educational life, and no one can deny that the action on the part of those trustees contributed directly to raising the artistic, scientific and medical education of Scotland. I remember, too, when the 1911 Act was brought in by Lloyd George, almost the same re-mark's were used against it, as are being used against this present Bill tonight. I am certain that those arguments are present in the minds of many doctors today. I can remember rather vaguely that at that time, nearly every doctor in the city of Glasgow lived in rooms above his consulting room. His residence was upstairs and his consulting rooms were downstairs. Perhaps he lived even downstairs and his consulting rooms were there also. The Joint Under-Secretary of State for Scotland perhaps can remember that 1911 Act a little vaguely like myself. [An HON. MEMBER: "What age were you?"] We were just boys. It made the medical profession free as it had never been free at any time in its history. In a little while every doctor in Glasgow areas like Gorbals, Crosshill, Tradeston and other industrial areas, had moved out into the suburbs, where they acquired a suburban home with a motor car and only their consulting rooms in Glasgow were retained.
And do not forget the servants.
The medical profession have nothing to fear under this Bill. I should really like, Mr. Deputy-Speaker, to go on, but unfortunately coming on at this stage of the proceedings I have had to enter into a secret treaty. [HON. MEMBERS: "Shame."] If that is out of Order I beg to withdraw, substituting that I have made a voluntary conformity to a certain ritual and I must draw my remarks to a close. Before doing so, I should just like to say that I have gone to the trouble of making my own inquiries. I have not found one doctor opposed to the scheme unless the general practitioners, who more or less are a sort of reactionary lot, not as individuals but because they have an interest to preserve. Among young medical students coming out, among the young doctors and among specialists whom I have consulted, I have not found one to oppose this scheme. I should like to ask any Member of the Opposition to tell me why the British Medical Association is tonight refusing to publish the figures of the vote which it recently took with regard to the attitude of doctors to this scheme. I am told that the support given to it was so strong, that the B.M.A. received figures which they never anticipated, representing considerable and unexpected support for this Measure.
I must leave the other half of my speech for another occasion, but I am very sorry to do so because it strikes a slightly critical note. I hope that my right hon. Friend the Secretary of State, who looks round somewhat alarmed when he hears a critical note behind him, will forgive me. but I want to say that this Bill is striking in what it is going to do for the welfare of the people of our country. It is equally striking—in fact, this is its most striking feature—in that it separates the health services of the community into more or less watertight compartments where the question of coordination is left to cooperation between individual units. On that cooperation will depend the success or failure of this Bill.
Mr. Westwood indicated assent.
I am glad that my right hon. Friend agrees with me on that, and it is just because I believe that, in spite of the opposition, there is sufficient intelligence in the medical community of this country to ensure that they will cooperate in making this Bill a success, that I welcome it and assure my right hon. Friend that it will have every support from this side of the House.
8.52 p.m.
I extend my sympathy to the hon. Gentleman the Member for Tradeston (Mr. Rankin) for having entered into a vow to finish speaking at a certain time. If he has only delivered half his speech, the vow I have entered into prevents me from delivering any speech at all. Only a matter of minutes has been allocated to me.
I think it was the hon. Member for the Western Isles (Mr. M. MacMillan) who showed some feeling with regard to the criticism which was made against the right hon. Gentleman the Secretary of State for Scotland. I do not in any way wish to associate myself with that kind of thing. I feel that when the Secretary of State for Scotland comes to bid farewell to his public life—whether it be compulsorily or voluntarily—if he should be allowed sufficient time to throw back his mind to the part he has played, both for his party and as Secretary of State for Scotland, he will derive a tremendous amount of satisfaction from having submitted this Bill for its Second Reading and from having, with overwhelming support from his party, placed it on the Statute Book. After all is said and done, there is nothing so intimate to any of us, apart from our political views or outlook, as health. If we have not good health we have nothing at all. I am sure that we are all deeply and sincerely anxious to play our part in promoting the health of the community at large.
The Secretary of State said that Scotland had its own traditions, and the only regret I have in connection with this Bill is that the policy is running right across some of the best of those traditions. Take, for instance, the question of voluntary hospitals. I have not time to develop my argument but I was for 15 years a member of the governing body of the Victoria Infirmary, Glasgow, and for 17 years a member of the health committee of the corporation of Glasgow. In my work as a manager of the Victoria Infirmary, one of the great voluntary hospitals in that city, I was perfectly amazed at the work which these voluntary institutions did.
Every Scottish Member knows something of our great infirmaries, whose staffs and boards of management are imbued with one aim only—to contribute towards bringing health to suffering humanity. There are the Samaritan hospitals, and the cancer hospitals: the people in the eye infirmaries manfully battling against the midnight darkness of blindness; the hospitals for sick children in which men and women strive to allay and check the crippling of little boys and girls. Think of what is to happen to all these on the appointed day. What is to happen to all those 220 voluntary hospitals to which the Secretary of State paid tribute? These men and women are to be displaced. They are going to be sacked overnight—men and women who have built up one of those traditions of which I am sure the Secretary of State is extremely proud—the great traditions of the Scottish health services.
I want to say a word about the choice of patients and the direction of doctors. There is a peculiar relationship between the patient and the doctor. I cannot define it. When illness occurs in the home the doctor takes over, like the captain of a great ship. The husband who would perhaps very seldom take good advice from his wife, will take it from the doctor. The doctor controls, because of the peculiar relationship that exists between patient and doctor. I ask the Joint Under-Secretary when he replies to clear up a doubt which exists in many of our minds, as to whether the patient still has the right to nominate his own family doctor. I ask him also to tell the House whether, when that doctor retires, the doctor who takes his place will be a directed doctor and whether the patient will have the opportunity of transferring from him to another doctor should he so desire. I believe the patient should have the right to choose his own doctor, and if that is not allowed in this Bill it is a violation of the principles of liberty and freedom which have been cherished by Scottish people in the past. At the same time I would express my appreciation for all the splendid work the Secretary of State for Scotland has done in producing this Bill.
8 59 p.m.
In view of the great deal of fog which has now come into this Chamber— [An HON. MEMBER: "A Tory Scotch mist."]—it is as well that the Debate is drawing to an end or presently we shall be unable to see one another across the Floor of the House. As is natural, there have been many references to the same arguments that were used when we debated the similar Measure for England and Wales. I am afraid it may be necessary for me to refer to some of these arguments again. It does not seem to me from the trend this Debate has taken that there has been any narrowing of the gulf that existed between the Government and the Opposition on matters of principle when we had that previous Debate. As a result of that, some hon. Members may consider that this Debate today has not served any very useful purpose. I myself would demur from any such opinion, because today we are debating legislation for the Scottish people. We have been reminded by the Secretary of State himself that the view and the outlook and the habits of our Scottish people are in many ways different from those of our English neighbours, and in a matter which concerns so very intimately every man, woman and child in the country, as does this legislation, I think it well that the views of the Scottish people should be made known in this House.
I have no doubt at all that everyone is in general agreement as to the need for a more comprehensive medical service, and I could not very well understand the querulous tone which crept into the voice of the hon. Member for the Western Isles (Mr. M. MacMillan). I do not know whether the fog has been affecting him, but I was extraordinarily surprised that he seemed altogether to have forgotten the White Paper of the Coalition Government. He seemed also to have forgotten—and likewise the hon. Member for Tradeston (Mr. Rankin)—that all the parties to the Coalition Government gave an undertaking that they would introduce this comprehensive scheme.
I pointed out that I was not a party to the Coalition.
But I had hoped that the hon. Member had probably read or heard of the Debate that then took place. In these circumstances of agreement as to the need of a comprehensive Measure, it is unfortunate indeed that the Government could not have introduced a Bill which would have met with far more general acceptance. And I believe it would have been possible for that to have been done but for one fact, that the Socialists always like to pursue their theories although they well know that these theories cannot help the individual's health or increase the efficiency of any of the services which this Bill sets up.
Would it be very inconvenient if I interrupted the hon. and gallant Gentleman? What I was pressing there was resistance to the idea that a Parliament of the future should be bound by a previous Parliament, or a committee appointed by that Parliament, or by any body of that kind. I think this House has always insisted that that is most undemocratic and unconstitutional.
I can only reply to the hon. Gentleman that all the parties to the Coalition were bound to introduce a comprehensive medical service.
I agree with that.
If any proof is required as to the assertion I have just made, I think it may be found in the opposition which comes from the medical profession. They have been pressing for many long years now for a greatly extended medical service, and many of the constructive proposals contained in the Bill come from them. It has even been suggested in the course of this Debate that that opposition arises from selfish or unworthy motives, but I believe that any such opinion is a profound mistake, for I know of no other body of people who have served the community so selflessly as has the medical profession. I believe that their opposition arises from a feeling that the best has not been made of a great opportunity, and that while this Bill may give a service of wider scope, it will be far from producing the better service which the people desire, and that it will also be far from producing medical men of greater skill, of greater sympathy or of greater understanding and indeed, that its provisions may have the reverse effect.
Anyone who practises an art, and is to practise that art to the best advantage, must be free. After all, the practice of medicine is an art, and, therefore, it seems to me that the doctor must be free if he is to practise his art to the best advantage, to act in accordance with his conscience and in what he believes to be the best interests of his patient. His whole responsibility and loyalty should be to his patient and to his patient alone. In other words, he must be independent, and in that connection I regret very much indeed that under this Bill there is to be abolished the sale and the purchase of the goodwill of medical practices. Doctors are human beings; they have all the human instincts, and I believe one of these instincts is that when one has expended money on the purchase of anything, one endeavours to retain it and, if possible, to enhance its value.
If that is so, and so long as our people are free to go where they will for their medical advice, it seems to me that a doctor who has purchased his practice will desire to retain it, and he can only do so if he exercises his utmost skill and gives his most sympathetic care and consideration to his patients. If he does these things, he will gain and retain their confidence, and, once he has done that— he is in an impregnable position—he need fear no one whatsoever. That is something of very great value to the public, because they know that their doctor can fight their case against any authority, no matter how powerful, without any fear whatsoever of the consequences. As my right hon. and learned Friend the Member for Hillhead (Mr. J. S. C. Reid) said, this Bill goes a long way to destroy that independence. No longer is the doctor to be the servant of his patient; he becomes the servant of his local executive council, and that is something very different when the whole population is insured to being in contract with his insurance committee. The doctor no longer looks to his patient for his livelihood because, as the right hon. Gentleman told us earlier this afternoon, it is the Government's intention that he shall be remunerated partly by a fixed salary, and partly by capitation. No longer can a doctor of right serve where he will, perhaps in a part of the country where he knows the people and will give his best service. No longer can he serve in partnership with those with whom he would desire to serve and, with whom, in my opinion, he might again give his best service, for he may be prevented from doing so by the medical practices committee. And no matter whether he retains the confidence of his patient or not, his name can be struck off the list of his local executive council, and also off the list of all other executive councils, not because he has committed any breach of etiquette, not because he is not a good doctor, but merely because it is decided that his retention in the service might be prejudicial to the efficiency of the service.
Yes, but that is for an offence.
What an extraordinarily wide ground of charges that introduces. Surely it opens the door wide to the possibility of victimisation. Particularly so when his case will be heard by a tribunal of three persons, none of whom need have any judicial experience whatsoever, appointed by the Secretary of State, who is the sole court of appeal. I can see one of these rebels of whom the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel W. Elliot) told us, worrying and nagging his local executive council until they came to the conclusion that his retention is prejudicial to the efficiency of the service. I can see that tribunal supporting it. I can see a very harrassed and worried Secretary of State saying, "A plague on this man who is always worrying people. Let him go." I think it is shameful that any man should be denied the right of earning his livelihood in his chosen profession, under a procedure such as that.
Like my hon. and gallant Friend the Member for Perth (Colonel Gomme-Duncan), I cannot understand why, when the punishment is so great, he should be denied the right of appeal to the courts of justice. There at any rate, his case would be heard by men experienced in the sifting of evidence, men entirely independent, men against whom a charge of partiality could not be brought. This Bill, as I have said, is undermining the independent status of the doctor. I believe that the provisions to that end, are really a step toward the fulfilment of the declared policy of the Socialist Party, which is to set up a rational, full-time, salaried and pensionable service. That is a policy from which, we were told by the Lord Privy Seal during a Debate on 2nd May, the party had no intention of retreating.
It may be useless for anyone standing at this Box to warn, or endeavour to warn, hon. Gentlemen opposite where the pursuit of that policy may lead the country, because many of them are blind to anything but their own doctrinaire ideas. But I believe that it is right that the remainder of the House and the nation should be warned. So I propose to quote to the House the words spoken in another place by Lord Moran on 22nd October last. The noble Lord, having said that he had been invited by the medical service of the Navy and the Royal Army Medical Corps to advise them on how to get keen men into those services, and keep them keen, used these words: The results of one's investigations came to this. It was impossible, with many brilliant exceptions, to keep the men as keen in a whole-time salaried service of that nature as in general practice, where the competition stimulant is present all the time. This Bill goes far to reduce the competition stimulant, and under the policy of the Socialist Party it would be removed altogether. In consequence of that, I say, let the country be warned that with the rejection of that stimulant they need not expect, in the future, the same good service they have had in the past. Further than that, let them be warned that this Bill goes far to destroy that intimate, sympathetic, personal relationship which has hitherto existed between a doctor and his patient, and which plays such a great part in the success of medical treatment.
My right hon. and learned Friend the Member for Hillhead dealt at some length with the treatment which had been meted out to the Scottish teaching hospitals. He pointed out that while the English teaching hospitals were to retain their individuality and independence, the Scottish teaching hospitals were to be reduced to the same level as all other hospitals, and placed under the control of the regional board. I think that is a great and profound mistake. I hope that when the Joint Under-Secretary replies, he may give us a fuller explanation of the reasons for the Government's decision in this connection than we received from the Secretary of State when he opened this Debate. This is a matter of the greatest importance, not only to Scotland but to the United Kingdom and to the Dominions, for the prestige of the Scottish doctor, as the result of his training, has, up to now, been such that there has been a world-wide demand for his services. Here I will use the figures which were used by the Secretary of State. In 1938–39, the last normal year, out of 13,000 medical students in the United Kingdom, 4,300 were in Scotland. That was, in part at least, due to the fact that the prestige of Scottish training in medicine stood so high. Why then interfere with the status of these great institutions, whose prestige is so high throughout the entire world? Before that is decided upon, I think we should have from the hon. Gentleman some definite proof that the change of status will be beneficial, and will give us more highly trained and skilled doctors.
There are two other matters in connection with the teaching hospitals to which I would refer very briefly. One of them has already been touched upon. I do not think that it is possible to get the best service unless we have something with which to compare that service. I am certain that, unless we have something with which to make a comparison, a service of this kind finally falls to a low and mediocre level. It may be that when the hon. Gentleman replies, he will say that this scheme allows for a great diversity through the regional boards and the boards of management, but I have spent long years in public service and I have always found that what eventually happens is that one gets down to an official pattern. Therefore, I suggest for that reason alone, so that a comparison may be available, the teaching hospitals should be retained in their present independent position.
There is another aspect. The teaching Hospitals have been the pioneers of medical research. However, it does not appear that they are to be allowed, in future, the same range or opportunities for conducting independent research. [AN HON. MEMBER: "Why not?"] If the hon. Gentleman will have the courtesy to wait while I develop my argument, he will find out. To a large extent, research depends on sufficient funds being available. That state of affairs has never existed in Scotland. It is proposed now that the endowments shall be reallocated, and in the White Paper we are told—I remind hon. Gentlemen of this and though my right hon. and learned Friend the Member for Hillhead has already used the words, I wish to repeat them—that it will be possible for the boards to which few or no endowments have initially been transferred to receive such resources later on. In other words, endowments are to be reduced and spread over the whole hospital system. I believe the teaching hospitals at present have the greater part of them. This, action is much more serious than appears at first sight. I would like to be corrected if I am wrong but if I understand correctly Clause 17 of the Bill, the Secretary of State has no power to make grants to the teaching hospitals. He has power to conduct research on his own account, and to make grants to persons and as a result of Clause 17 (2) it would not appear that he has power to make these grants to the regional boards or the boards of managements.
If that is so, then it would appear that research in the future will fall more or less under the control of the right hon. Gentleman and those whom he may choose. Research will only be undertaken into such matters as he may desire. I cannot see the Treasury allowing him to use public funds for independent research such as has hitherto been carried out. Surely the most curious of all the curious provisions in this Bill is that which is contained in Clause 8 (2) where it is laid down—
I have been reading Clause 17 with regard to research and I think the hon. and gallant Gentleman has got it wrong. That Clause says: … the Secretary of State may conduct, or assist by grants or otherwise any person to conduct, research into any matters relating to the causation … Does not that give him power to leave it in the hands of the people at present engaged, and to give them financial aid?
I have asked that question, in order that I may be given an explanation of the meaning of both Subsections of that Clause by the hon. Gentleman who is to reply. The hon. Member will no doubt notice, if he reads the following Subsection, that it specifically mentions the regional boards and the boards of management. It appears to me that that might well cut out the provisions of the first Subsection, but, in any case, I will wait for the hon. Gentleman to reply.
I was saying that one of the most curious provisions of this Bill is that contained in Clause 8 (2) where it is laid down that the Endowments Commission, composed of people of whom we have no knowledge whatever, are to frame and submit schemes to the Secretary of State for the transfer and for the application of the capital or income of such endowments. The following are the words which I would like the House to note: to such purposes as the Commission think fit. It seems to me that not only are we taking away research from those experts who have hitherto carried it out, but that we are passing it over to an unknown body to lay down the conditions under which the endowments are to be used. That is a matter of very great importance, and I submit that, unless we have some real assurance tonight, that this provision will be very drastically altered when we come to the Committee stage, this Bill should not be given a Second Reading.
Further, with regard to endowments— and I am again putting a question put by my right hon. and learned Friend—is it really anticipated that the endowments commission are going to take five or more years to get out their schemes because, if so, no hospital authority will know their financial position until the schemes have been finally worked out, and that will be highly detrimental to the whole hospital system. Is it really anticipated that the endowments commission will revoke or vary these schemes and introduce new ones from time to time? Because, if that is to happen, no regional board or board of management will know, when they undertake to make alterations or carry out some desired scheme, whether they will have the financial ability to carry it through. That policy will be very detrimental to the service.
When one reads this Bill for the first time, it appears to allow for a very large measure of independence, of initiative and of freedom to doctors, to patients and to the general public. But the more one looks into it, the more one sees that that is merely a facade, and truly, as hon. Members have said in the course of this Debate, at the end of everything, there is the Secretary of State controlling and directing, either through the provisions in the Bill itself or else through the orders and the regulations which he is authorised to issue. The Bill is a very wonderful example of bureaucracy at work. It is purely a bureaucratic scheme, and it leaves the machine entirely under official control. It may be tidy and it may be neat from the official point of view, but I do not believe that it takes human nature sufficiently into account, and it is with human nature that medicine has to deal. That is not only my own personal view; it is the view of my hon. and right hon. Friends. We are, accordingly, going to decline to give this Bill a Second Reading for the very good, detailed, and conclusive reasons that are stated in the Amendment which was so ably moved by my right hon. and learned Friend.
9.25 p.m.
We have had, as I think will be agreed by hon. Members on all sides of the House, a very well conducted and thoughtful Debate. I think all hon. Members will join with me when I say that the contributions which have been made by hon. and right hon. Members who have taken part in the Debate have had both force and thought behind them, whether or not we agreed with them. I can hardly take exception to a single word that has been said, apart from a remark by the hon. Member for Dumfries (Mr. N. Macpherson), who mistook a sneering lemark for cleverness. If the hon. Member were present now, I would advise him, being a much older Parliamentarian than he is, not to indulge again in that personal form of criticism. It is something which anyone could use against him, at any time, if they so desired, with much greater force. It is something that does not make for the better conduct of our affairs.
May I say, in defence of my colleague, that he made a remark in passing which was of a sort that could be taken in a dozen different ways? I think the Under-Secretary of State is taking it much too seriously.
I am stating my own view, and I thought that the remark was rather unbecoming. With regard to the Debate generally, what is the difference of opinion between us? On both sides of the House hon. Members are in favour of a comprehensive National Health Service. That was accepted by the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid), who moved the Amendment for the rejection of the Bill, and it was accepted also by the hon. and gallant Member for Pollok (Commander Galbraith), who wound up the Debate for the Opposition. It is a view which most people accept. Therefore, the common ground is that all of us accept the need for something other than the present system. Whatever else is to go on, we start by agreeing that the one thing which cannot go on is the present system. The Debate, therefore, takes the form, not of arguing in defence of the present system, but of arguing about what is to take its place. I am certain that I do the right hon. and learned Member for North Croydon (Mr. Willink), who occupied the post of Minister of Health in a previous Government, no injustice when I say that he had plans for the reform of the present system. The argument is not an argument in favour of the present system, with the panel doctor, the voluntary hospital, the local authority hospital, and so on. That is the present system, and we are all agreed that we will end that system. That has been said by the party opposite.
The clash now is not between those who defend the existing system and those who want to change it, but arises over the form which the change should take. So far, I have heard no proposal from hon. Members opposite for any change; all they have said is that our proposals are wrong. Indeed, hon. Members opposite have contradicted themselves in that, after saying that they want a change and an alteration, they have proceeded to argue in defence of the present system. On the general issues that have been raised, the hon. and gallant Member for Pollok spoke about the rebel doctor and his dismissal. His view is not my view about rebels. If ever there was a rebel in this place it was me, and look where I have landed. The general feeling I have always had about rebels is that if a rebel is sagacious enough in his work far from his being punished, the plums of office are usually held out to him.
I interrupt the Minister because I wondered whether it had occurred to him that one of the reasons for his appointment might have been to keep him quiet in opposition.
The hon. and gallant Member, too, is a rebel. I would only say to him that I would urge him to be a little more sagacious in his rebellion. There is the position. I am not afraid of the rebel. The short answer on this question of dismissals in the present case is that it is not a dismissal on grounds of professional misconduct. It is the right of dismissal that everybody has over any employee. The voluntary hospitals have the right to dismiss any doctor.
Who are these voluntary boards? Let us examine this matter. We have had an argument about voluntary hospitals. It may be as well to look at the matter. What is the voluntary hospital? We are being charged here with creating a body which is less democratic than the present system. I doubt very much whether there is such a thing as a voluntary hospital. Most of these hospitals have received grants from the State. When the right hon. and learned Member for North Croydon was in office, engaged in making general improvements in the system, as I am sure he would have done, it is estimated that the grants in question would have gone up to nearly 70 per cent. Therefore, where is the voluntary principle?
Let me take this matter further. I know the hospitals of my city. I agree that the great hospitals of my city—the Royal, the Western and the Victoria-have great records, but let not any man say that even they are voluntary. Every man, in every shipyard and factory, has to suffer a deduction from his wages each week. A sum is deducted willy-nilly from him, and woe beside the man who should try to refuse to allow it to be deducted. In theory he may be able to say "No," but in actual practice not one man could do so. If trade were bad, and he dared to say "No," it would end his contract, not only between him and the firm but with the rest of the men. This idea of voluntary running of the hospitals is considerably far fetched.
On this side of the House we are not concerned really with the voluntary side of the matter. We are concerned with the teaching hospital.
The hon. and gallant Member does not need to be frightened. I am coming to the teaching side of it, but at the moment I am dealing with the voluntary hospitals. They have ceased to be voluntary because of compulsory deductions and State grants. Who runs these hospitals? They are run by boards. There has been some criticism of the Secretary of State, but at least he is responsible to Parliament and he has to answer questions. Who compose the boards of voluntary hospitals? When I was a young man there were no workers' representatives upon most of the voluntary boards. I took part in an agitation in Glasgow in connection with one of the most afflicted sections of the community, the blind. In my native city, treatment of the blind was by voluntary institution, but we never had any representation on the board. The doctors connected with a voluntary institution could be dismissed by the board any day, any night without even an appeal to the Secretary of State for Scotland.
What does happen in fact? It happens in practice, and will happen, that the men who get elected to these boards will be decent, kindly men and, on the whole. capable men. They would never do that kind of thing, unless they had a sound case on which to answer if they were challenged. That is really the answer to the point about dismissals. It is not a defiance of the courts of law but an answer that, on these boards of public-spirited men people do their duty, and rarely cherish vindictiveness or wrongdoing in their relations with other human beings.
Let me now deal with the teaching hospitals. I am told, "You propose to place these great teaching hospitals under some form of State control." There are two or three answers to that suggestion; but first of all, it is as well to define what we mean by a teaching hospital. I am not a very orthodox Minister, and I hope my English colleagues in the Ministry of Health will not object if I say that I see in their Bill certain difficulties which we have sought to avoid, in that they have taken out teaching hospitals. The trouble starts when one tries to define a teaching hospital, and no one knows it better than the right hon. and learned Gentleman the Member for North Croydon. Let me take my own native city, for example, because the Royal and the Western hospitals have been quoted more than any others. Let me also refer to two other great hospitals, Stobhill and Mearnskirk hospital for tubercular treatment. I suggest there are none better in the length and breadth of the country, from the point of view of treating patients or teaching. Stobhill hospital, which has the very latest appliances, is linked- up with teaching and consulting specialists. Who is to say that even in the country hospitals, far from our cities, there is no capacity for teaching? But they are not only teaching hospitals; they are practising hospitals as well. We maintain that to leave out of this great new experiment 230 hospitals—almost half the total—would make a sham of the whole scheme.
In a State scheme or a local authority scheme, from every point of view it would be wrong to leave out the best hospitals. If we wish to make a success of the scheme we must not do what used to be done in the old days of the Poor Law, and leave out the best and only take on the worst. In enabling this scheme to succeed, the teaching hospitals are valuable not merely from the point of view of teaching, but from the point of view of raising the status of every other hospital concerned. We have not taken the teaching hospitals out. We have given them a status which, in most respects, will meet the requirements. From every angle the teaching hospitals will now play an active and capable part in the scheme.
I now come to other questions which have been raised in the course of the Debate, and I will deal, first of all, with the question of endowments. Hon. Members opposite have said that what we propose to do is a terrible thing. In fact, one hon. Member went so far as to put his hand on his heart and say that it was unethical and immoral. That leaves me cold. Most of these arguments leave me cold, because during my time in this House I have known Governments do much worse, without being charged with immorality or with acting against their Christian consciences.
What is the position about endowments? Endowments are left to hospitals of all kinds—teaching hospitals and others. What do we propose? In this Bill we say it may well be that some of the endowments may have ceased to have the same force and effect as the original donors wished, through passage of time, change of circumstances, and alterations in the treatment of disease. For instance, in our new set-up we may say to a hospital which now treats, say, partly cancer, or partly ear, nose and throat diseases, "There is another hospital charged with this work. We prefer, in the interests of everybody, instead of having this work spread over three or four different hospitals, to have it charged to one." The endowment may have been given to that hospital for that purpose. Surely, in that case, there is nothing wrong with an Endowment Commission, a neutral body? It is a body which will almost certainly—and this must bring joy to the heart of the right hon. and learned Gentleman the Member for Hill-head—include members of his profession, of at least equal status to himself.
I turn to the committees which the Secretary of State appoints. Here, however, we are talking of the medical profession, and its rights. Maybe I am touchy on these matters, but I do get rather annoyed with hon. Members in this connection. It may well be that the Secretary of State appoints them. But we have done nothing in this Bill to take away the responsibility of the Secretary of State to this House. I do not want to harp on the past too much, but I remember when we were dealing with the poor law people—the poorest people in this country, almost overnight we passed a Bill abolishing, or at least reducing, their rights—giving no poor person even the right of an appeal to the Secretary of State in many cases. At that time a commission was appointed, which was entirely out of the control of Parliament. For hon. Members to complain now about something, against which we have taken a great deal of care to safeguard, is, I think, stretching things too far.
Let me now deal with the case of the doctor. If ever there was a man who had a right to be neutral about the medical profession, it is myself. I have been looking around, and I think I have more connection with the medical profession than almost any hon. Member in this House. The other night I had six of my relations in the House, and I was the only one who had escaped being a medical man; they were all in it. I remember that my eldest nephew wanted to be a captain on board ship, but he looked around and said to me, in his broad Glasgow dialect, "Geordie"—because he is called after me—"no man ever made money by going to sea. My uncle Johnny is making money at medicine. Medicine for me"—and to medicine he went He went into regular medical practice with a State salary; he is doctor to the Clyde Trust. I say to hon. Members that the idea that a doctor will not perform his duty because he receives a salary is not becoming, or even fair, to the medical profession. Take the teacher. There is no more devoted public servant than the average school teacher, inside or outside his work. As to the doctor, give him a salary or give him a capitation fee, I say his love of his profession and his love of his work will not be dimmed because of either.
Let me turn now to the sale of practices. I want to be perfectly frank. I want to see the sale of practices abolished. What is this business of the sale of practices? Let me use another family illustration. I remember my young brother starting in practice in a working class district, putting up his plate on the door. He had a fearful struggle for years and years without any income. It was a life we should never ask a lad to go through. My niece was a doctor and married a doctor. Both wanted a practice. They bought a practice, yes; but they had no freedom of choice as to the place where the practice was. They had to buy a practice within the means at their disposal, and though they wanted to buy a practice in Scotland, and were natives of Scotland, the cheapest practice they could get, and what they thought was the best value, was situated in Hull. They settled in Hull, and every week they had the load round their necks of paying for the practice. It may not be flattering to my colleagues in the medical profession, but it is true that the sale of practices has not always redounded to the credit of the medical profession.
The right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) knows this. I almost called him the right hon. and gallant Gentleman the Member for Kelvin-grove. I must not say that I welcome him back, for had he fought for any constituency other than that of the Scottish Universities, I should have done my best to keep him from coming back. But if we must have a Tory from the Scottish Universities, he is as good a representative as I can get, and from that point of view I wish him well in the House; and I am sure that, from the personal point of view, I shall always be pleased both to listen to him and to learn from him. May I tell him what he probably knows; if he does not know it he probably knows there is something in it. One of the most disgraceful things I have known has been to see young doctors begging, getting up the money with which to buy practices; and then, when they have paid for them, very frequently they have found that they are not what they thought they were. After all; if a doctor buys a panel of 2,000 patients he does not know that all the 2,000 will remain to him. So I am glad to end the sale of practices. But I am glad to end it for another reason. I hope that young men entering the medical profession in the future will be entering on a great career in which they are as free as they can be to practice their calling, and will not be prohibited from being free by poverty or any other reason. On this question, the Government take the stand that a salary and a capitation fee is the best way of securing freedom for doctors, and allowing them to work at their calling in the best possible way.
The hon. Member for Bridgeton (Mr. Carmichael) criticised us for not giving as much power to local government as we ought. That is a valid criticism from some angles, but, on the other hand, we have to make an experiment. The medical profession had to be consulted in the matter. Nobody has asked more than he in his last speech that there should be some form of workers' control. The doctors are the workers here, and they must be given some rights. Therefore, the doctors were consulted, and on the whole they did not want the local authority setup. We took this as the best means we could devise of working a national scheme.
In reply to my hon. Friend the Member for Dunfermline Burghs (Mr. Watson), so far as the working of the Bill is concerned, it is our duty and our right to try to bring the local authorities into cooperation with us on every possible occasion, and so far as we can we will harness them to the work. The hon. and gallant Member for Perth (Colonel Gomme-Duncan) raised a question about dentists. I do not mean to be flippant towards him, but I think he has read the wrong part of the Bill. I think he has read the first Bill; there were two Bills, the one we produced before and this one Which we have re-introduced, and in this one we have altered only two words of the original language about dentists. It was put to us that dentists were rather unlike doctors in that their patients often came from some distance away. They might come from Auchterarder to Perth, or from say Greenock to Glasgow, and that meant that the dentists ought to be on the list of every committee. We have so altered the words in the Bill that one entry by a dentist will cover all local committees, so that people will have the choice of going from one place to another for a dentist.
It has been said by hon. Gentlemen opposite that this is a doctrinaire business. I say it is not doctrinaire. There are certain questions to which my hon. Friends on this side are devoted. One of them is education, and I would point out that it has not always been the practice of medicine that has attracted the Scottish doctors to the profession, but the opportunity the profession offered of a university education. How well I remember the scrounging and scraping that used to take place; people used to walk round Jamaica Bridge to save the penny for the ferry towards getting to Glasgow University. That was the spirit that was abroad; it was not merely the doctoring which attracted them, and in every field that spirit is still prevalent. I say it is not a doctrinaire matter at all. If we took away education, what would be the next subject in which our people are wholeheartedly interested? Public health—in the local councils, in their approved societies, in their trade unions, it is public health. They feel that the State in some form or another should play a more active part, both financially and in the coordination of the services, to see that everything is flowing freely and openly.
We have fought a great struggle in Scotland to get our universities free, and in the main we have won it. It is not wholly won, but partly won. We want, in the field of health, to make free every available resource to the humblest sections of the community. On this side, it is not a question of doctrine, but a genuine feeling that the sick ought to be cared for as never before. No one can defend the present state of affairs, in which a man who is unemployed cannot get spectacles or teeth in order to work. It is entirely wrong. The Secretary of State for Scotland has applied his mind to this Bill. He has met the doctors, and he has com-
promised. He has met the voluntary hospitals, the great teaching hospitals, the universities and the local authorities, and of course he has made adjustments. That is the way of British public progress. I have compromised, and in my public life I hope to continue to compromise. We have set out on a great adventure in Scotland, and I would sooner go out tonight on this great adventure and fail, than never have tried at all. In a great adventure, mistakes will be made, and in a year or two we shall find out things which are wrong. We have set out on one of the noblest of adventures, that of coordinating the health services and making them free to all, irrespective of wealth or position. Far from Members on the other side of the House dividing against this Measure, they might have reserved their points and challenged us in Committee, while giving a hand in this great adventure for Scotland.
Question put, "That the words proposed to be left out stand part of the Question."
The House divided: Ayes, 273; Noes, 123.
Bill accordingly read a Second time.
NATIONAL HEALTH SERVICE (SCOTLAND) [MONEY]
Considered in Committee, under Standing Order No. 69.
[Major MILNER in the Chair]
Resolved: That, for the purposes of any Act of the present session to provide for the establishment of a comprehensive health service for Scotland and for purposes connected therewith, it is expedient to authorise the payment out of moneys provided by Parliament of— ( a ) expenses incurred by the Secretary of State in the exercise of his functions under the said Act, the Lunacy (Scotland) Acts, 1857 to 1919, or the Mental Deficiency (Scotland) Acts, 1913 and 1940; ( b ) compensation payable to medical practitioners in respect of losses suffered by reason of any provision of the said Act prohibiting the sale of medical practices, the aggregate amount of such compensation not exceeding the amount apportioned to Scotland under the National Health Service Act, 194b, of sixty-six million pounds and interest on that compensation; ( c ) grants payable to local health authorities in respect of expenditure incurred by them in carrying out their functions as such authorities or in defraying expenses of any joint committee or board in exercising such functions, being grants not exceeding, in the case of any authority, three quarters of the expenditure so incurred by that authority; ( d ) sums required to defray the expenditure of Regional Hospital Boards constituted under the said Act (including the expenditure of Medical Education Committees and of Boards of Management so constituted in exercising functions conferred on them by, or delegated to them under, the said Act); ( e ) expenditure incurred by other bodies under the said Act; ( f ) remuneration, sums in respect of loss of remunerative time, and travelling and subsistence allowances payable to members of bodies constituted under the said Act; and 1106 ( g ) superaunuation benefits provided for officers employed in voluntary hospitals prior to the transfer thereof, to the Secretary of State under the said Act, for officers engaged in health services and for medical practitioners and dental practitioners providing services under the said Act; and to authorise the payment into the Exchequer of sums received by the Secretary of State under the said Act."—( Kings Recommendation signified. )—[ Mr. Westwood ]
Resolution to be reported Tomorrow.
PRICE CONTROL ORDERS
10.11 p.m.
I beg to move, That the General Apparel, Furnishings and Textiles (Wholesalers' and Retailers' Maximum Prices and Charges) Order, 1946 (S.R. & O., 1946, No. 1747), dated 29th October, 1946, a copy of which was presented on 5th November, be annulled.
Perhaps it might be for the convenience of the House to take this Motion together with the second Motion on the Paper, namely: That the Women's and Maids' Outerwear (Price Control, Mark and Manufacturers' Maximum Prices) Order, 1946 (S.R. & O., 1946, No. 1748), dated 29th October, 1946, a copy of which was presented on 5th November, be annulled. as they, more or less, relate to the same subject.
I would gladly agree to such a course provided I am able to reserve the right to divide the House on each Motion.
Certainly, that is understood.
For various reasons my hon. Friends and I have brought forward this Motion to annul an Order. Some of them are concerned at the price-fixing in the Order and certain allowances within the Order. But the main question which I personally wish to put to the Parlia- mentary Secretary to the Board of Trade is in regard to the definition of "wool" and "wool cloth" contained in the Order. I have no connection with the textile trade, but while I am not personally concerned with the weaving of cloth, I am vitally concerned with the question of wool and the good name of wool. On that point, I now wish to enlarge. The definition in the Order to which exception is taken is in Part III, paragraph 8 (vii) where the definition is: 'wool cloth means fabric, the textile content of which comprises more than 15 per cent. by weight of wool. In Paragraph 8 (viii) the definition of wool is: fibre from the coat or fleece of alpaca, camel, goat, hare, lamb, llama, rabbit, sheep, vicuna or yak and horse hair. I have here a short report, made by one of the greatest analysts in Britain, on animal fibres. He has been described by Mr. Justice Lawrence as the greatest expert in animal fibre. He says that the term "wool" can only be correctly applied to the natural cover of the sheep, and he adds that, technically, there is a great difference between wool and all hair in that wool even of the coarsest has a wave of its own whereas all hairs even the finest are straight. I should like to explain to the House that this definition to which we are taking exception is no new thing. We have Orders published by the Board of Trade since 1941 when it was brought in as a war emergency Measure. When it was brought in great exception was taken to it by the wool trade of this country and by our three great Dominions, Australia, New Zealand and South Africa because they are vitally concerned in this matter. The fact that Britain takes such a high proportion of wool from them and puts it on the markets of the world is of importance to them. Today with an export drive on, it is vital that there should be a proper description of what goes into our textiles.
Australia produces a great proportion of the world's wool and our Empire produces 80 per cent. of all the wool we need. I feel that it would not be good policy today to persist in allowing a description which admittedly—as I shall show in a moment—was used for administrative convenience in wartime. We should not persist with that in peacetime, however necessary it might have been under the stress of war.
May I remind the House of the importance of wool to this country? We have in another place the Woolsack, which was placed there by Edward III to remind Members of the House of Lords of the importance of our staple trade. To show the significance which is attached to this by our Dominions when, in 1938, it was discovered that the Woolsack was filled with horsehair, the International Wool Secretariat provided wool from the three Dominions so that it might be filled with the right material. That is significant of the feeling of the Dominions and the Woolsack is symbolical of the immense importance of the textile trade to Britain. Under this Order all sorts of things can happen. We can get a cloth which, according to the Order, could be described as a wool cloth but, which actually contains 85 per cent. cotton and 15 per cent. horsehair. My subconscious mind suggests that this should be called not wool cloth but "crypto-cloth"—a term which suggests in rather a subtle way a hair shirt and an austere existence. It is definitely wrong from every point of view that this Order allows us to make a wool cloth with only 15 per cent. of wool in it, and also allows us to mark it "wool cloth" when such a thing is actually' illegal under the Merchandise Marks Act. This Act is referred to in a caveat at the end of the Order which says: The definition of wool which is included in this Order have been adopted for administrative convenience but does not, in the view of the Board of Trade, affect for the purposes of the Merchandise Marks Act, the meaning of the term when used as a trade description. This explanatory note was inserted in 1944 as the result of objections which were raised in the House, The present Chancellor of the Exchequer was then President of the Board of Trade and he gave an assurance to the House on that occasion that the term that was used in these Orders had no permanent significance. That suggests that it was not intended to be permanent, and it is a question whether the definition has a definite significance.
I think we should now face the fact that we have at some time—unless we are always to be a shoddy nation as regards our clothes—to get rid of this definition of wool cloth I ask, "Why not now?" I hope the Minister will give me a reassurance tonight on this question which will enable me to withdraw this Prayer. We know that the Order cannot be revoked and nothing left in its place, but we should like an assurance that the Minister will look into the matter, together with others which may be raised, with a view to putting things right. These Prayers are not put down lightly but because I feel most sincerely that there is something wrong which should be investigated, and I feel that if the Minister could give that assurance it would strengthen the public belief or otherwise in the whole system of government by statutory rule and order. If, however, the Motion simply results in a negation, it would be government not by Order but by rule of thumb. I ask the Minister to give me an assurance tonight that the whole matter will be gone into and that very soon the whole thing can be put on a proper footing with a proper description of the term "wool."
10.20 p.m.
I beg to second the Motion.
The annulment of these Orders has been ably advocated by my hon. Friend the Member for Central Aberdeen (Mr. Spence). We on this side have noticed for some time now a certain embarrassment on the part of right hon. Gentlemen sitting opposite. Many of us thought that might be because of the difficulties in India, the messing up in Egypt and perhaps home affairs such as housing, but, having listened to the hon. Member for Central Aberdeen, it seems clear that the discomfort and embarrassment of right hon. Members opposite are due to the fact that their underwear, instead of being made of wool, is in fact made of horsehair. In those circumstances, and in order that that embarrassment may no longer be caused to right hon. Gentlemen opposite, I hope the Parliamentary Secretary will accede to the request of my hon. Friend and reconsider these Orders.
I approach this matter from a different angle. In my constituency there is a particular trade, that of the wholesale model gowns industry, which is very gravely affected by these Orders. It might be convenient if I very briefly described this trade. It makes up model garments and gowns; the models are sent throughout the world and throughout the United Kingdom, and from these models, stock orders are placed throughout the country. A very valuable export trade is being built up in this way. It is a new export trade for this country, and one of great potentialities and possibilities. Competition from America and Paris is keen, and at the present time further competition is coming from Zurich. It is therefore important that all possible help should be given if this new export trade is to be developed. Again and again, we have heard from the President of the Board of Trade and other Ministers of the importance of developing new types of export trade. Here is a new type of export trade, but the Order which deals with this matter will, I submit, seriously affect, if not altogether stop, this promising new development The reason is that in the Order certain limitations are placed on prices which greatly restrict the home trade. As everybody knows, when one is building up an export trade, one has to have designers, skilled workers and so forth and a sound volume of home business is necessary so that there may be a basis for a flourishing export trade. One might rightly ask the Parliamentary Secretary why it is necessary to impose ceiling price restrictions on one kind and another on this wholesale model gown trade under this Order. Every trade has its black sheep, and in this trade there are, no doubt, some who might be guilty of certain malpractices. I am advised that this new Order will not stop those malpractices but will very greatly harm honest, genuine firms who are doing straightforward, proper and advantageous business.
This Order annuls previous Orders. In the previous Orders the ceiling prices which were imposed were not sufficient to enable the wholesale model houses to use cloth of good quality, or the production processes necessary to give their cloth the treatment to which it is entitled. That is quite apart from the special orders now dealt with in this new Order.
Is the hon. Member referring now to allocations received under the utility specifications, or is he talking about the 12½ per cent. generally?
If the hon. Gentleman will allow me to develop my argument, he will see exactly what I am talking about. I have been talking of the wholesale model gown trade which makes these special models, and I was trying to explain that this trade can use various kinds of cloth, but, because of the ceiling of prices imposed upon it, there is a difficulty. Either the design of the garment is good and the quality of the cloth is not as good, or else the quality cloth goes to places which have not the skilled designers to make proper use of it. In fact, the ceiling prices are such that you cannot get a combination of quality and design in particular in the special orders to which shall refer shortly, of which a substantial part of the trade of these model houses is made up.
In order to prove what I am saying I have here details of a rather interesting questionnaire that has just been sent round by a paper called "Fashions and Fabrics" to some 300 retailers bearing upon this Order. This questionnaire, which was only handed to me an hour or two ago, has already been replied to by approximately half of those to whom it was sent out. Certain questions were asked, one of which was: Do you find that with garments supplied to you at the wholesale ceiling price of nine guineas, you are unable to satisfy your customers' requirements both as to quality of materials and quality of workmanship in the garments?
That was rather a leading question, was it not?
They could answer "Yes" or "No" to that question, and 107 people answered "Yes" while 36 answered "No." That is to say, the great majority of the people found that, with the garments supplied to them at that ceiling price, they were unable to satisfy their customers' requirements both as to quality of materials and quality of workmanship. The second question was: Is it a fact in your experience that there is a disproportionate quantity of garments of' ceiling price which are below the standard of value for the price charged? Again 114 replied "Yes," and some 19 replied "No." Those questions have been answered by a large number of retail houses and I think it is true to say that there is the evidence which proves the point I have been making, that the ceiling prices for this wholesale model garment trade are not high enough.
Now I want to deal with the actual effects of the new Order, in so far as special made-to-measure orders are concerned. When a special made-to-measure garment has to be manufactured, there is allowed an extra five per cent. on the price. This is quite inadequate to meet the payment to the skilled workers required for making these special garments. I understand there is a 15 per cent. allowance on utility specially made-to-measure garments, and I would like to know why there is this difference, which does not seem to be fair. Hon. Members may ask what is the proportion of trade for these made-to-measure orders. Are they few and far between, or are they a substantial part of the trade? Do many women want these specially made-to-measure orders, or can most of them be fitted from stock garments? For the answer I again quote from the questionnaire. Two questions are asked. The first is: Is there among your customers a really appreciable number who cannot be fitted from stock? In the replies 124 answered "Yes" and 27 answered "No" showing that a substantial number of customers have to be fitted specially, because of outsizes and awkward shapes, and, maybe, because of awkward shapes in the stock sizes. The second question was: Are you in a position to execute special order in your own workroom? To this 40 answered "Yes" and 137 said "No." That means that these special orders have to be executed by people like the wholesale model gown trade. This new Order and its limitation in price means that all these women who need these special orders, and must have them, simply cannot get them. I am confirmed in this view by a statement which the Parliamentary Secretary to the Board of Trade made a few weeks ago. I think the House will be interested to hear what he said when he was speaking to the British Mantle Manufacturers' Association. He said: One feature which gives us concern is the relative shortage of larger sizes of women's outer garments. In spite of the jokes on the music-hall stage, the subject is really not so funny. Something like one-third of the female population comes within the outsize range, and it can be a very great hardship to these women if, because of their size, which is largely due to the service they have rendered to the country producing children, they should suffer more than is necessary. So we have confirmation in the words of the Parliamentary Secretary of the point I am making—that a grave hardship is caused by the fact that these women will not be able to have these special orders. Before I move from that I want to give one or two examples to amplify what I have already said. A special order was placed by an overseas shipping house which is very well known —an Australian shipping house in Sydney. It was not possible to execute this order because the Australian who placed the order happened to be resident in this country at the time of placing the order.
Whose shipping house was it?
There was the loss to this country of a valuable order. I have here a list from a well known London retail house of individual orders which cannot be executed because they are special sizes, and under this Order it would be impossible for the wholesale houses to make them except at a severe loss. The result is that if the home trade cannot be satisfied, except at a loss in a substantial part of it, very high prices will have to be charged in the export trade We might say that that is a good thing. We might ask, Why should not these commodities be sold abroad at the highest prices we can get? I agree that that is a good thing now, but competition is getting keener. As I have said, Switzerland is now coming into the market, as well as Paris and America. It is all very fine while it is a seller's market, but with competition growing ever keener it will not be possible in the future to do this export trade and use the profits from the export trade to subsidise the losses on the home trade.
I want to deal shortly with the trade in wedding frocks, which under this Order is very badly hit. It will be impossible, under this Order, to make a special wedding frock. I suggest that the Parliamentary Secretary ought to consider placing these gowns in some form of special category I speak from experience in this matter, as recently I have had two daughters married. We were able to manage fairly well because for one of them, at the last moment, we found the wedding gown of her great-grandmother made in 1861. With alterations, that got us out of our difficulty. But no one wants to be married in a wedding gown which is only knee-length—[An HON. MEMBER: "An 1861 gown knee-length?"] Under this Order, that is the length to which it will have to be made. I have here a rather interesting cutting from a paper, in which is depicted a delightful wedding gown. The letterpress says: Here is a photograph of a wedding gown in rich satin with an embroidered lace collar and full length train, as shown at the Regent Street show of spring fashions. A delightful wedding gown it is—an imported wedding gown from the United States of America. Yet such a wedding gown cannot, under this Order, be made by our own wholesale manufacturers in this country, which seems quite crazy. Our own manufacturers are prohibited from making this sort of thing; yet we have to spend our hard-earned dollars to import such things into this country. While this was happening, the President of the Board of Trade made an important statement. On the one hand we are told we have to increase our export trade— which, it this wholesale model gown trade were given a fair chance, it would be able to do. On the other hand, we heard the President of the Board of Trade say that we are rapidly spending our dollars from the loan and that when these are spent, there will be no more available, except those which we earn. Why should we then, in this Order, prohibit people making these gowns, and yet allow such gowns to be imported from America, using dollars which are so urgently needed for other purposes? The restrictions under this Order are placed only on the wholesale model houses. The retail couture houses are not covered by any restrictions of this nature. This means that the wholesale model houses, which are, by far, the largest imployers of skilled labour, and by far the largest users of quality cloth, and the largest exporters of fashions, are badly hit.
I ask the Parliamentary Secretary to re-examine this Order, and see if it is not possible to do something to ameliorate these conditions. I would like to make a practical suggestion. Could he not set up some committee of experienced officials in his Deparment, who, together with members of this trade, could work out some scheme to control malpractices, and at the same time enable this trade to provide for the needs of the people of this country, those women who must have specially made gowns, as well as help our export trade? Could some form of licence be given to approved businesses in this trade? Would not that be one way of doing it? Could there not be some arrangement whereby, say, a 25 per cent. of export trade done would give a similar amount of advantage in the home trade, without controlled prices, if necessary? Could there not be some form of cost-plus basis, which is fair to this trade? I throw out these suggestions. They may be impracticable but the hon. Gentleman cannot tell me that men of good will from his Department and from the trade cannot work out some workmanlike practical scheme to meet the case of women who for no reason they can help, have awkward figures or are outsize and require dresses specially built for them. In this way the Department can help this promising export trade. If that is not done, one can only say the words of Ministers are the exact opposite of their actions.
10.40 p.m.
I would ask the Parliamentary Secretary to explain Order No. 1748. The First Schedule refers to a dress "made wholly or mainly of wool cloth" but on the other side, on page 4, we see that wool cloth can be made of horsehair. When one goes to buy a dress of this sort—or, as regards the other Order, night wear—there should be some assurance we are being given wool, and not some manufactured material, in accordance with the definition given in the Order which nobody can understand.
10.41 p.m.
I have a curiosity about these two Statutory Rules and Orders 1747 and 1748, and I welcome the opportunity of getting the Parliamentary Secretary to give me and the House, and the public at large, some information about these matters, which relate to the very important question of women's clothing. Although these Orders deal with outer wear, it will be understood that underwear is dealt with by other Orders and, in between the categories of outer wear and underwear, there is the intervening garment, such as the afternoon dress, the evening dress and the wedding dress. The first point on which I should like the help of the Parliamentary Secretary is in Order No. 1747. In page 5, paragraph 2, hon. Members will find what I think is one of the most remarkable things which has ever appeared in a complicated Parliamentary document. Paragraph 7 refers to alterations to made-to-measure garments which require adjustment. Perhaps somebody has rounded shoulders, or somebody needs a waist pinched, or there is a sleeve to be altered, a skirt to be raised or any other alterations to be made. This brings me to Part II of the Order in which on page 5 we find: The maximum charge to be made in the course of the business of a retailer who performs the service of carrying out or contracting to carry out alterations to goods within 3 months of the date of the sale thereof shall be the actual cost to the retailer of such alterations; so, however, that such alterations shall be separately charged, This paragraph is surely the most remarkable we have had since the days when the Postmaster-General established the penny post. This is what you may charge for the alterations: with respect to the alterations to a made-to-measure garment the total charge shall be 1d. I do not know, Sir, whether you have ever gone through the pantomime which is carried out at a ladies' retail dress shop—the reception by the shop-walkers, the conducting to the sales department, the visit to the fitting room, the assertion "It fits me not very well there" or "I want it taken in a bit there" or "I would like a little bit adjusted here" and so on. The saleswoman is generally accompanied by another assistant, who kneels properly, takes the measure, pins here and pins there. I see from this Order that this pantomime is under the direction of "R. Stafford Cripps, President of the Board of Trade." This elaborate business, of which you may have some conception, Mr. Deputy-Speaker, carried on behind the panel of plate glass, with all the shopwalkers, upholstery, and the like, is to be carried out under the orders of "R. Stafford Cripps, President of the Board of Trade"—for one penny. The Parliamentary Secretary is a mere child and innocent in this matter of women's clothes, but I beg him to offer us his halting and blushing assistance when he comes to deal with this matter.
In reference to page 6 of the Order No. 1747, I would like to follow my hon. friend the Member for Central Aberdeen (Mr. Spence) in his plea that the honesty and rectitude of British commercial practice should be restored by a Government which may not be honest in everything else, but might as well be honest in this matter. When you, Sir, buy something which is described as wool, you will not be deceived. If you are dealing with a co-operative society, who are faithful followers of His Majesty's Government, in buying wool, or a fabric which is supposed to be wool, you will know that the so-called woollen fabric is really the "fibre from the coat or fleece of alpaca, camel, goat, hare, lamb or llama." The lamb is the festive little animal seen in the springtime, on the Cumberland or Cheviot hills, but the llama is a different creature. That, however, is not the limit of the range of choice of this adulterated fabric which the President of the Board of Trade imposes upon you. It does not stop at lamb or llama; it goes on to "rabbit, sheep and vicuna" —but that is an error, because there is no animal called the vicuna. There is a wool called vicuna but I think I am right in saying there is no four-legged creature of that name. It is the product of the four-legged creature but not the nomenclature of the four-legged creature itself. However, Sir, if you do not buy vicuna, you may buy "yak and horsehair." Who am I to discourage choice in that selective range?
On the same page there are other descriptions with which I shall not weary the House. I would proceed to observe that at the bottom of that page there is a feature which, I think the House will agree, is regrettable. There are no fewer than seven cross-references to other Statutory Rules and Orders. I beg the Parliamentary Secretary to understand that these documents are read with a seriousness, which this House perhaps does not appreciate, by dull-witted tradesmen. Their effort to understand these Orders will be impeded by these seven references on page 5 to previous Statutory Rules and Orders. I think that is a matter to be regretted. I will next glance, if I may, at page 9, where hon. Members will see a pictorial device which I think does credit to the Department which is so much interested in industrial design. This extraordinary and cryptic device is called "the price control mark." It is only comparable in simplicity with the mark which is applied to convicts at Dartmoor and elsewhere. It does not add to the attractions of any product to have two parallel lines, running from right to left, or from left to right—dependent on one's political point of view—which in turn are supported by two black pillars on the left and two on the right with a round solid black mark in the centre indicating, I suppose, some abysmal depth to which we must inevitably sink in accepting price control.
I pass to Order 1748, which has been referred to by my hon. Friend the Member for Marylebone (Sir W. Wakefield). He referred to it with a feeling, an understanding and a knowledge which I felt the House appreciated. I want to point out to the House that when the United States' Constitution was set up, it was dedicated to the proposition that all men are equal. That proposition may be accepted by His Majesty's Government, but they certainly do not apply it to women's clothing, as they' say the maximum charge for women who happen to be a little more handsome than their sisters, a little more majestic, a little more commanding, a little more natural in their gestures is to be 15 per cent. more. This is a Socialist Government which has been expounding Socialist philosophy. Surely it wants larger and better people. Is it right to treat this question of lack of equality between the sexes, which I understand the Government contemplate very seriously, in this way? Is it right to approach the matter by making a charge of this kind? [ Interruption. ] I suggest it is not only ungallant, but unbusinesslike and undemocratic to charge women who are a little more handsome than their less elegant sisters 15 per cent. more for their garments. That is not in accordance with the democratic doctrine of the equality of men and women, and my argument, I hope, will be reinforced by the hon. ladies in this House, who may not speak for themselves in this matter, but may speak for their more handsome sisters.
This proposal of its 15 per cent. extra is not approved by the trade. They were most willing to agree to the principle adopted by the General Post Office, which charges the same postage on a parcel whether it is going from London to Croydon, or from London to Edinburgh. We in the manufacturing trade had hitherto accepted that over-all principle. It is probable that the little woman gains a little more than she should, because she needs less material although she requires more fitting. The large woman requires more material but is somewhat more easily fitted. The trade do not charge extra for additional size. There are in business a number of establishments known as "outsize houses", but they do not charge any more for outsizes than is charged for the ordinary sizes in the ordinary shops. Yet "R. Stafford Cripps, President of the Board of Trade", is so ungallant as to deny the equality of women, and to say that they must pay 15 per cent. more if they are anything like as handsome as my wife, for example, happens to be.
I am anxious to treat this subject exhaustively, if not exhaustingly. I do not conceal from the House that all these Orders are obnoxious and objectionable. Any attempt to fetter the free development of a great art is an unnecessary and unwarrantable interference with the liberty of the subject. Dressmaking is an art, and any attempt to limit it by an inch or by half an inch, or by a charge, on alterations, of a penny or two is an unwarrantable interference with the liberty of the subject. Dressmakers are artists in the same sense as those who paint great pictures or design great sculptures. No one would attempt, in spite of what we heard earlier in the day, to limit the size of the canvas or the colour of the paints which an artist could use in the presentation of his subject. But these Orders in effect do this in the case of dressmaking. They are aimed at taking the colour, the loveliness, the elegance, the grace and the beauty from life. If that is the intention of His Majesty's Government, they may achieve it, but I shall support this Motion, and, if necessary, vote against the Order.
10.55 p.m.
The hour is late and I believe that the weather outside is very unpleasant. Therefore, I do not propose to keep the House any longer than is necessary to make a brief reply to the various points raised by hon. Members opposite who have prayed against this Order. I do not propose, for instance, to follow the hon. Member for South Edinburgh (Sir W. Darling) through all his excursions and incursions, nor to argue with him whether or not it is right and proper to charge extra in some cases. I understood from previous speakers that the complaint against the Board of Trade was not that we were charging too much, but that we were allowing people not to charge enough. If his complaint is, in fact, that too much is being charged, I suggest that he should consult his hon. Friends whose names are coupled with his in support of this Motion to find out where he stands.
The hon. Member for Central Aberdeen (Mr. Spence), who opened the Debate, confined himself to a criticism of the definition of wool and wool cloth. I readily agree that, on the face of it, it seems unusual, to say the least, to include some of the items which he mentioned in a definition of wool or woollen cloth. But, in so far as it may have been inferred by any hon. Member that, in some way, the customer who wanted to buy wool cloth, or something made of wool cloth, was being cheated, I have to point out that we are here dealing with Orders which are used for the specific purpose of price control and that, so far as the customer is concerned, the customer still enjoys the protection of the Merchandise Marks Act. I agree that the Act does not afford the complete protection that one might like to see it afford. There is no compulsory definition of a particular item covered by that Act, and the only redress, of course, lies through the courts. I think I can say that we are aware of the deficiences of the Merchandise Marks Act and that, at some time in the future, something will be done to remedy them. But hon. Members on all sides know the nature of the legislative programme, and it would be wrong for me, when there are so many important matters to be discussed by the House, to hold out any hope of an early amendment of the Merchandise Marks Act. If and when the time comes for that to be done, I think it is pretty certain that this kind of commodity will be one of those which will be looked at very carefully.
As we heard, the definition of "wool'' includes many things—llama, rabbit, hair, yak and horse fibres. But these fibres are used by the wool industry, often in conjunction with other fibres. It we did not include them in the Order for the purpose of control under the definition of wool, they would either be free from control, which would open the way to abuse, or else we should have to list them separately, or evolve some other more cumbersome general description which would hamper the clarity and the effectiveness of the Order, and would give very great offence to the hon. Member for South Edinburgh, who dislikes all Orders as a matter of principle. We have had some complaints about the definition of wool applying to clothes which include only 15 per cent. of wool. But the fact is that the wool industry uses large quantities of other fibres, and the simplest practicable line of division between the products of the wool industry and, say, that of the cotton industry, is the line of demarcation of raw materials. The normal line of division, I am told by the experts, occurs at about 15 per cent. wool. Above that, it is wool, and below that it is cotton, rayon, or whatever else it may be. If we do not define wool or woollen cloth in this manner, I think we should have excluded from the control, important sections of the wool industry. Or, we should have fallen back on phrases and definitions such as "products of the wool industry." A firm in the wool industry would have been defined as one making a product of more than 15 per cent. wool.
I have been asked if I would give consideration to this question. I assure the House that the utmost consideration is given to any proposition put before me, and without committing myself to any specific line, I am quite prepared to say that I will go back to the Board of Trade and consult with those who know far more than I do on this subject, and if there is anything which can be done to assist the trade and the public, I shall be happy to do it. I will look into the whole question to see if we can assist.
What objection could there be to a description of a wool mixture?
If anything were described as a wool mixture there would be no definition of how much wool was in that wool mixture, and if one is to have a control, one must define what one is controlling. To describe it as a wool mixture is no different from describing it as a wool cloth. Worsted is a fibre and a mixture, and to call it a wool mixture, would not make the slightest difference.
The hon. Member for Marylebone (Sir W. Wakefield) spoke about the wholesale model houses. As he knows, I have had many representations on this subject, and I have been in contact with the proprietors of the reputable model houses. I have expressed my willingness to meet their views, but I have to confess that, after talking with them in an effort to find a solution, I have so far been unable to find one. But, if a way can be found, I assure the hon. Gentleman that I shall be glad to give the fullest possible consideration to it.
I would like to tell the House why this Order has had to be made. Maximum prices were fixed at the beginning of this year for women's non-utility outerwear in an effort to arrest the upward trend of prices. Only ready-made garments were controlled, and bespoke articles could be sold above the ceiling prices. But, within the next six months, there was evidence that some manufacturers were using this loophole to evade the control of prices. In reply to a question on 24th June, I told the House that I would ask the Central Price Regulation Committee to look into this matter, which was considered serious. As a result, we were told that some manufacturers were offering the bulk of their products as made-to-measure goods above the ceiling price for ready-made clothing, and that retailers were placing orders for these garments' under fictitious customers' names in order to qualify. The practice became so widespread, that retailers who refused to place these so-called special orders found themselves, to some extent, boycotted by the manufacturers and unable to obtain their needed supplies of ready made garments. Complaints had been received by local price regulation committees, and it was clear beyond a shadow of doubt that some manufacturers were supplying goods made in stock sizes as special orders. We were told by the retailers that the situation was serious and that there was a real danger of the whole price control mechanism breaking down if this practice continued. It was decided that it was necessary to make it not worth while for these manufacturers to continue with this evasive practice, and we have done that by providing that the ceiling price for ready made non-utility garments shall apply with an uplift of 5 per cent. to special orders.
We were approached by the "top end" of the wholesale trade—the wholesale model houses referred to by the hon. Gentleman. I myself spoke to them. I listened to their story and felt that, to some extent, a case had been made out. But when we got down to devising machinery which would deal adequately with the problem, we found that, so far as we could see, and acting with their assistance and on their advice, no satisfactory scheme could be devised. An hon. Member tonight has asked me to consider setting up a committee to define a genuine wholesale model house. That suggestion was made previously by the proprietor of one of the largest wholesale model houses in the hon. Member's constituency, but we could not see how it would be possible to differentiate between the sheep and the goats, or, if one prefers it, the yaks and the llamas.
The hon. Gentleman who asked why an extra 15 per cent. should be paid for something made from utility cloth and not from non-utility cloth, was in error in supposing that is the case. The extra 15 per cent. is paid in respect of outsize garments. We have recognised that somebody who is outside the normal range of ready made clothing is, obviously, a special order customer, and that some arrangement should be made and some inducement offered to the retailer and manufacturer to encourage the production of these outsize garments for women who must have them. So that in the case of the most genuine special order of all— the one that matters most because the woman cannot get anything else to wear —there is an uplift not of 5 per cent. but of 20 per cent., and I consider that is sufficiently generous to enable the manufacturer to produce his garments and, at the same time, to earn his living.
There is a further point. We are talking all the time of an uplift of 5 per cent. on the ceiling price. Many of the proprietors of wholesale model houses have told me that they can produce a number of their garments at below the ceiling price. If they can produce at below the ceiling price and sell at 5 per cent. above the ceiling price, the uplift they are getting in respect of the genuine order is something more than 5 per cent. according to the amount below the ceiling price at which they are producing the article.
I would not like it to be thought that it is merely the so-called austere people in the Board of Trade who came to the conclusion that this action was necessary. It is not just the result of the imagination of somebody in the building who felt that the manufacturers were getting away with something to which they had no right. In fact, the trade Press said that it was entirely due to the failure of the trade to control the black sheep within their ranks that this Order has had to be made. I suggest that when support for an Order of this kind is received from the trade Press, it indicates that there is a very real need for the Order to be made. I assure hon. Members who have asked for assurances, that I will consider the points which they have made, and, if it is humanly possible to improve upon what we have now arrived at in consultation with those who know most about this trade, I shall be only too pleased to do so. I cannot go further than that. It would obviously be impossible for me to say tonight that any particular course of action is to be undertaken. But I am willing to give consideration to this matter. I hope that that assurance will be accepted in the spirit in which it is given, and that the hon. Member will not press his Motion.
Has the hon. Gentleman given the fullest consideration to the claims of the Dominions in this matter? In making the declaration that these Orders must stay while price control remains, has he taken the Dominions fully into account?
What is the extent of the representations the hon. Gentleman has had from the Dominions on this matter?
The answer to the second question is that I have received no representations at all. Whether representations have been received in the Department I do not know, but they have not come to me. On the first question, I assume that the hon. Gentleman is referring to the wool content of the cloth, when he speaks of the interests of the Dominions. It must be assumed that manufacturers of woollen cloth use the materials that will produce the best results. I do not believe that people are walking about today wearing horsehair or yak fibres, but I am prepared to believe that manufacturers of woollen cloth will, for the purpose of improving their cloth, put into it fibres that will strengthen or improve the wool.
We have reason to know that three of the Dominions are vitally interested in this matter. One Dominion is known to feel very seriously about the definition paragraph in the Order. Will the hon. Gentleman give us an assurance that, when he looks into this matter, he will consult Dominions representatives and try to arrive at a fairer definition?
Certainly.
Will the hon. Gentleman explain to the House and to the public, as there is a great deal of mystification, what the Order means by prescribing a total charge of one penny for alterations to made-to-measure garments? I do not know, and the trade do not know.
I should have thought the answer would have been obvious to the hon. Gentleman. One easy way to circumvent the Order would be to pretend that alterations were necessary, and then to charge considerably more on the cost price. We do not intend that to happen.
In view of the hon. Gentleman's assurances, I beg to ask leave to withdraw the Motion.
Motion, by leave, withdrawn.
OIL PLANT, DOWLAIS
Motion made, and Question proposed, "That this House do now adjourn."— [ Mr. Joseph Henderson. ]
11.14 p.m.
I am extremely sorry that I am compelled to raise, at this time in the evening, a matter of vital importance to my constituency. Perhaps I need not assure the House that I have done everything humanly possible to bring about a satisfactory settlement of this troublesome matter before taking the course of raising it on the Adjournment.
On 25th November, I put on the paper a Question to the Minister of Food. When the time came for the answer, that answer was given by the Minister of Fuel and Power. The Question was this: if he will now reconsider his decision of three months ago to cease production at the oil plant, Dowlais, which rendered 180 men unemployed, having regard to the fact that his reason no longer holds good, because no step has been taken to use the plant or any part of it for the purpose which he alleged necessitated its closing down. The reply given by the Minister of Fuel and Power was: My right hon. Friend the Minister of Food cannot reconsider his decision to close this factory, which was taken originally on grounds quite unconnected with the supply of gas. The water gas plants in the factory are still required in connection with the scheme for the supply of gas for local industry. I regret the delay in the commencement of the work of adaptation. Three months ago the gas company was offered a loan under the Distribution of Industry Act covering the cost of the work and pressure is being put upon them to start the work without further delay "—[OFFICIAL REPORT, 25th November, 1946; Vol. 430, c. 226–227.] That was the reply of the Minister, and I need not say that to myself and my constituents that reply was as unsatisfactory as it was brutally frank. I should be surprised to learn that the Ministry of Food was consulted before the Minister of Fuel and Power made the statement that the decision by the Ministry of Food to close down the plant was originally taken on grounds quite unconnected with the supply of gas, that is, for local purposes. My reasons for saying this will be made clear later on. I shall only say at this stage, that the Ministry of Food abandoned their original reasons or excuses for closing down these works, because these excuses were found to be such that they should never have been made by any Ministry of any Socialist Government. In fact, they were not true.
The dissatisfaction so strongly felt by my constituents at the closing down of this plant is due entirely to the mishandling of the matter by the Ministry of Food and, may I say, by the abject way that Ministry acted upon the advice and instruction of the most powerful monopoly in this country. This plant was built out of public money at the beginning of the war. Its purpose was to process edible oils, and it is regarded as one of the most efficient plants of its kind in this country. It is highly mechanised and is capable of an enormous output, and it cost, I am informed, well over £1,000,000. The big monopoly, Messrs. Unilever, acted as the Government agents directly through the Ministry of Food, in running this plant. There are only three other comparable plants in this country, and these three are owned by Messrs Unilever. These three plants are still running today, but the plant publicly owned in my constituency has now been closed down for several months. Incidentally—and, may I say, I have been very well informed on this—this new plant at Dowlais is far more efficient and far more up-to-date than any of the other three plants.
When I received the first intimation many months ago that this Dowlais plant was likely to be closed down, I made immediate representations to the Ministry of Food. The only reasons I could get at that time for their decision to close it down were that the plant was established at Dowlais as a wartime measure; that the plant was situated too far from the nearest seaport; that there was a shortage of raw materials, and that the running of the plant was uneconomic. Those were the first reasons given to me by the Ministry of Food, reasons to which no Socialist would have the least difficulty in replying. Why should a plant of this kind, costing this country about £1,250,000, be scrapped because it was built in wartime? That could certainly never be a justification for it. Incidentally, there is no other plant such as this in Wales. I am told that there is no such plant within a hundred miles of South Wales; within a radius of 40 or 50 miles of this plant there is a population of about 2 million people; and the plant is capable of making a substantial contribution to the food supplies of this country.
Again, why should the plant be destroyed because it is situated a matter of 25 miles from the biggest port we have in Wales, or 28 miles from the second biggest port? The new industries which have been established in my constituency were given preference by the Board of Trade because they are largely exporting their products, and they are not considered to be too far from the nearest seaport. Further, this particular excuse of the remoteness of the plant from a seaport hurt me and my constituents badly, because it was precisely the excuse or pretext given to me and my constituents by those industrialists who nearly ruined my constituency in the interwar period.
On what grounds, may I ask, could the Ministry of Food be so utterly indifferent to this Government's policy in dispersing industry in this country, instead of the old cruel practice of dispersing population? It would seem that in regard to the development areas, the Ministry of Food has a political philosophy of its own, which is disturbingly reminiscent of the political philosophies of those Governments which wrought such ruin and suffering in this country. This plant was closed down, rendering 180 men unemployed in my constituency at a time when more than 6,000 of my people were unemployed. Some thousands of my people are still unemployed. As to the shortage of raw materials—another excuse made by the Ministry—I gave a short and, I think, rather effective answer. On behalf of my people, I made the simple request that the sharing of any raw materials available should be determined by the relative consequences that might result from the closing down of any one of the four plants, wherever they were placed in this country, and not by closing down a plant in my constituency merely upon the dictates of a powerful monopoly.
I should add that for a very good reason I had to ask the Ministry of Food whether it had or had not entered, or whether the Government had entered, into any secret commitment with Messrs. Unilever when the latter took over the working of this publicly-owned plant. Ultimately, after much hesitation, it was admitted that there were such commitments, and that the Ministry of Food were resolved to honour them. I am afraid, Mr. Speaker, that I rather strongly expressed my disgust, first at the obvious piece of blackmail perpetrated brazenly in the early years of the war, when this country and its people were fighting for their very existence, and secondly, I could not help feeling disgusted at the manner in which the Ministry of Food were honouring the terms and conditions of a blackmail contract. I am in possession of the terms and conditions forced on the Government by this monopoly, and I am advised that they could not be sustained in any court of law in this country The terms and conditions were wrung out of the Government and the country; these conditions are against the public interest, and I have a copy of them here. We were peremptorily prohibited from interesting any other firm in this great plant. A firm which had successfully survived this monopoly were interested in the plant, but they were told that very definite undertakings had been given to Unilevers—I quote—"that we," that is the Government, "will allow no other trader to have access to the plant."
I leave it to the House to place its own construction on those words, in relation to this plant, publicly owned, bought by the people of the country and paid for by the people of the country. This Government is pledged to some kind of control over monopolies and, even now, I invite them to investigate this anti-social act by one of the most powerful monopolies in this country. Naturally, the Ministry of Food at long last realised they were in extreme difficulty if not in an unsavoury predicament. The reasons for the dosing down of this plant which had been given to me, were at last abandoned by them. This is the reason why the representatives of the Ministry of Fuel and Power are here at this late hour. I want to thank the Minister of Fuel and Power for the efforts which have been made to help me and my constituents in this matter, but I am not impressed by the easy way they took over this unhealthy offspring of the Ministry of Food, but that is their funeral, not mine.
A new reason or pretext or excuse was given to me why the plant was closed down. It had been discovered that there was likely to be a shortage of gas for industrial purposes in my constituency and in a neighbouring valley, and that the only way of augmenting the gas supplies was by using what are described as the "blue water gas producers" attached to this plant. I was informed that the position was critical in regard to the shortage of gas and that industrial development would be held up in the near future in my constituency and in an adjoining valley unless these gas producers were brought into use—and that in the very near future. That was stressed to me over and over again, and the urgency appeared to be extraordinary. The Ministry of Fuel and Power were apparently seized of this urgency as long as six months ago. It seemed that certain small adaptations or adjustments would have to be made to these producers before they could be used. Also, about eight and a half to nine miles of piping would have to be laid down. Notwithstanding the urgency that was stressed by the Ministry of Fuel and Power, not a single stroke of work has been done so far as the gas producers are concerned. Incidentally, the 180 men are still unemployed, with a few thousand others.
I have taken up more time than I intended and I want the Parliamentary Secretary to the Ministry of Fuel and Power to make whatever reply he can. I am sorry for the Parliamentary Secretary. He should have been a little more alert and should not have had this foisted upon him. The protestations of urgency about the critical situation apparently have been forgotten. Nothing has been done, and my people are now stronger than ever in the opinion that, once again, all this talk was merely intended to cover the Government in their ignoble acquiescence to the dictates of this monopoly. Owing to the ridiculous way the Ministry of Food reacted to this, it will need a great deal more, before the minds of my people can be disabused. I conclude with a request, which I make in all seriousness, that this publicly-owned plant be restored forthwith. If not, I want the Government to know that there will be serious trouble. That is inevitable. My constituents, after the experiences they went through during the interwar years—and there are strong words that could be used—will not stand this nonsense any further. I must make these facts publicly known from the Floor of the House of Commons. The request I am making is that this plant shall be restarted forthwith. This might be taken as an intimation to all monopolies in this country that the Government do place the interests and the wellbeing of our people far ahead of the profit-seeking and anti-social concerns which wrought such ruin and destruction in the interwar years, and in no part of the country more than in my constituency.
11.36 p.m.
The hon. Member has spoken with his customary eloquence, and I am sorry there were not more Members in the House to listen to him. My only complaint is that he has left me just seven minutes in which to reply to him, and that is hardly adequate, in view of the serious charges which he has made, and which I repudiate at once. He told me that I had taken on a very unhealthy offspring. I do not think the child is quite as bad as that. It is disagreeable in certain respects, I am prepared to admit. It squalls a lot; but I think it will grow up all right. I can assure the House that our relations with the Ministry of Food are extremely cordial, and that the closest departmental cooperation exists. Nevertheless, our friendship is not of such a character that we would have acquiesced in the apparently dastardly act which the hon. Member suggests has been performed. The decision to close this plant was that of the Ministry of Food. But we have a close interest in the plant, which I will explain in a moment; and that is why I am here tonight. The plant was built in 1940 on strategic grounds, primarily as a strategic reserve, and because at that stage we had in this country a very large quantity of whale oil, far more than we normally have. The plant was used during the war. Nevertheless, despite these large stocks, it was used at a loss. It naturally was run at a much greater loss after the war in view of the fact that supplies of whale oil fell still further.
I must at once say that any suggestion that the decision, or proposal, to close this factory was dictated by Unilevers is wrong. They had nothing to do with it. The plant was run by the Ministry—and the Ministry runs incidentally all the other plants in the country, in the sense that they are financed by the Ministry. As I explained, Unilevers' opportunity of making a financial gain out of this was practicably negligible.
They are making money on the raw materials now.
They are also losing what they got for running the plant as agents. It is wrong to speak of secrecy. There was an agreement between the Ministry of Works, made in 1940, and with the Ministry of Food, made in 1941, and Unilevers. The first gave Unilevers, who were going to run the plant for the Government, the option of purchasing the plant, and also laid down that it could not be sold without their consent. The second ensured that certain secret processes—that is where the secrecy comes in—could not be disclosed to other persons. There is no reason why that should not be disclosed now. I can assure the hon. Member that it has nothing to do with the closing down of this plant. The suggestion that another firm might have come along and taken it if the Ministry of Food had not intervened and stopped them is equally absurd, for the Ministry of Food is the authority for deciding exactly where the whale oil goes. They are the only authority which can make that decision, not only in Dowlais, but throughout the country.
Which Minister is now responsible? Is it the Minister of Fuel and Power?
I have already said that the formal decision was made by the Minister of Food. I am now going to explain why we are interested. We are interested because we want to get gas in adequate supplies into the South Wales area—
You have got it.
—and because we were told by the Board of Trade that in the hon. Gentleman's own constituency there would be a need for at least 100 million extra cubic feet of gas per annum by the spring of 1947. It is a fact, and it is no good denying it, that gas in South Wales is a very serious problem, and that employment there depends on providing enough gas. In the long run, we shall deal with this problem by building gas grids and by developing coke oven gas. In the short period we have to improvise. It is not easy because of the shortage of plant, but here in the oil hardening factory we had plant which could be converted for industrial purposes. As soon as they heard that the Ministry of Food were proposing—the decision had not been finally made—to close the factory, the United Kingdom Gas Corporation, which happens to be the undertaking in the hon. Gentleman's area, asked if they could have the use of this plant in order, on the one hand to provide the extra factories which are going up in the Merthyr area with gas, and also to provide gas in the Bargoed district where the coke ovens were in a very bad way.
I have only time to say one other thing. There has been—and I readily admit it— a delay in the work of conversion. When I saw the hon. Gentleman at the end of July, as he will no doubt remember, I had expected that shortly afterwards the actual work of adaptation would be started. I am told that it has started this week. The hon. Gentleman will be able to confirm that when he gets back. It has nothing to do with the accident that he happened to have the Adjournment tonight. I can assure him that it is not for want of any effort on our part, and that we have done everything we can to overcome the difficulties in providing the necessary materials. All we can do at the Ministry is to urge, encourage and cajole the company concerned, and we have done our best to that effect. I think it is fair to say that they are responding, but there are difficulties about getting supplies of pipes and other materials. These materials will come along, I think, just in time, and we shall be able to supply the gas needed to provide the extra employment in Merthyr next spring and summer.
The Question having been proposed after Ten o'clock and the Debate having continued for half an hour, Mr. SPEAKER adjourned the House, without Question put, pursuant to the Order made upon 13th November.
Adjourned at Seventeen minutes to Twelve o'Clock.