House Of Commons
Monday, 21st April, 1947
The House met at Half past Two o'Clock
Prayers
[Mr. SPEAKER in the Chair]
Private Business
Luton Corporation Bill
Read a Second time, and committed.
Kingston-Upon-Hull Provisional Order Bill
"to confirm a Provisional Order made by one of His Majesty's Principal Secretaries of State under the Public Health Act, 1875, relating to Kingston-upon-Hull," presented by Mr. Ede; read the First time; and referred to the Examiners of Petitions for Private Bills, and to be printed. [Bill 63.]
Oral Answers To Questions
Railways
Carriage Of Bicycles
1 and 2.
asked the Minister of Transport (1) the total number of bicycles carried by British railways in the last year;
(2) the total amount paid by the railways for damage to bicycles in the last year.As it is not the practice of the railway companies to segregate bicycles from other traffic in their records, it is not possible to state either the number carried or the amount paid in compensation for any damage which they sustained.
Passenger Service Cuts (Savings)
3.
asked the Minister of Transport how the saving of engine miles by the reduction at passenger train services on the four main line railways has been utilised; and to what extent
Some cuts were made in passenger services to save coal, others to release locomotive power and line capacity for coal trains. It is not practicable to express the results in figures.
Is my right hon. Friend satisfied that there is no appreciable increase in light engine miles, which would indicate an increased wastage in engine miles?
I am afraid I cannot answer that question definitely. If my hon. Friend will put that question down, I will endeavour to give him the information.
Reservation Of Seats
4.
asked the Minister of Transport in view of the restriction of summer passenger train services on the four main line railways, if the practice of advance booking of seats on certain trains will be continued.
I regret that owing to the reduction in railway services during the summer months, the reservation of seats on trains will, with certain exceptions, be discontinued from 16th June next, when the summer time tables come into force. The arrangements will be announced later.
Will my right hon. Friend say what the exceptions are, or will they be announced later?
They will he announced with the full information.
Refreshment Rooms, Manchester
11 and 12.
asked the Minister of Transport (1) the average number of people per hour over the whole week using the L.M.S. station at London Road, Manchester, between 10 p.m. and 1 a.m.; and the railway company's staff which it is estimated would be required to keep the refreshment rooms open until 1 a.m.;
(2) if he is now in a position to state the decision of the L.M.S. Railway Company in regard to keeping the buffet and refreshment rooms at London Road Station, Manchester, open until 1 a.m. each morning, including Monday morning, for the purpose of serving hot drinks to travellers, including soldiers.
A census of passengers was taken on 15th April. Eight hundred and thirty-five passengers were counted between 10 p.m. and 11 p.m., 350 from 11 p.m. to midnight, and 697 from midnight to r a.m. Two additional attendants have now been engaged and arrangements have been made for the refreshment rooms to remain open until 1 a.m. from today.
I am much obliged.
Is my right hon. Friend aware that the refreshment rooms at the London terminal stations are not open during the night? Can he make some inquiries, especially in view of the coming holiday period, to see if it is possible to have refreshment rooms kept open all night, for the benefit of passengers who may have to wait many hours for their trains?
It is always more useful to have one's attention drawn to a specific case than to a general statement, which may cover a wide and unnecessary field.
Is the Minister aware that the whole refreshment service on the railways is utterly inadequate, not only in Lancashire but at all termini, and will he make it his business to have a special inquiry into the best means of serving the public with refreshments?
I am aware of that general deficiency. That is why we propose to nationalise the railways.
Pension Payments (Lms)
16.
asked the Minister of Transport if he is aware that the L.M.S. Railway Company has reduced the ex gratia payments to retired servants of the old Glasgow and South Western Railway Company because of the increased pensions now being paid under the Government's national insurance scheme; and, as those pensions were granted by the Glasgow and South Western Railway Company prior to the passing of the Railways Act, 1921, and were for services rendered, what action he will take to ensure that the L.M.S. Railway Company carry through the obligations imposed by the Railways Act, 1921.
I am informed that no alteration has been made by the L.M.S. Railway Company to pension payments to men who retired from the Glasgow and South Western Railway Company, that is, before 1925. The second part of the Question, therefore, does not arise.
Is the Minister not aware that I have already supplied him with the information that these pensions have been reduced?
No, I am not aware of that. This is the information submitted to me. If my hon. Friend says that there is definite information to the contrary, I will personally look into the matter.
But I have already supplied the Minister with the information.
Lptb (Negotiations)
6.
asked the Minister of Transport why the L.P.T.B. have given no reply to a submission from the Railway Workshop Staffs joint Negotiating Committee made three weeks ago.
I am informed that the London Passenger Transport Board were already considering a general submission from the bodies with which they are accustomed to deal, when a submission purporting to be on behalf of supervisory grades was received from the Negotiating Committee. The Board found it necessary to seek further information from the Negotiating Committee as to the staff represented by them.
Roads
Frost Damage
7.
asked the Minister of Transport whether he has any information as to the extent of damage caused to public roads by the recent frosts; and what will be the cost of repairing them.
Information as to the damage which has been caused to the public roads by the recent frosts is not yet complete, but it is already clear that the cost of repairs will be heavy. For eight counties it is estimated at between £250,000 and £300,000.
Reconditioned Cars (Ex-Servicemen)
13.
asked the Minister of Transport if he is aware that ex-Servicemen with 100 per cent. dis- ability pension can no longer obtain a reconditioned ex-Service motor car however deserving the case may be; and if he will reconsider his decision with regard to this matter which is causing hardship and concern.
The supply of surplus ex-Service cars suitable for economical reconditioning is steadily declining and there is still a long waiting list of disabled ex-Servicemen whose applications were accepted before the list was closed in November, 1946. It is not certain that cars will become available for all of these applicants and I cannot therefore agree to accept further applications and raise hopes which have little prospect of being realised.
The Minister has used the words, "I am not certain." Will he consider this matter all over again in the case of those men with 100 per cent. disability who wish to earn their living by utilising reconditioned cars?
I can assure my hon. Friend that I have given long, continuous and serious consideration to this problem with every desire to meet the need. The cars are not there and I do not think it is desirable to keep the people waiting in hope when I feel that there is no substantial prospect of meeting their wishes
Keynsham By-Pass
14.
asked the Minister of Transport when it is expected that work will be commenced on the proposed new section of the Bristol-Bath road to by-pass the village of Keynsham; whether the construction of a road bridge or a hydroelectric dam plus roadway over the River Severn has been considered in relation to the former project; and what modification will be necessary in the plans for the bypass road in either case.
I cannot say when work can be started on the proposed Keynsham by-pass. The plans are being drawn up with due regard to the proposed Severn Bridge, but are not likely to be affected by any proposals made for a hydro-electric scheme.
Pedestrian Crossings
18.
asked the Minister of Transport whether, in the interests of road safety, he will initiate ex- periments with coloured surfaces for pedestrian crossings and, if they prove helpful, bring them into general use.
A number of experiments have already been made using coloured surfaces for pedestrian crossings and my right hon. Friend is at present reviewing the results.
Would my hon. Friend consider experimenting with the use of luminous paint for these crossings? It would, at least, enhance their visibility during the hours of darkness.
I rather doubt whether that is practicable, but I will certainly have it looked into.
Would the Minister consider selecting the colours red for danger, and blue for safety?
Toll Road (Condition)
21.
asked the Minister of Transport if he is aware of the dangerous road conditions between the villages of Horton and Leek; that for many years the parish council have been trying to get his Department to use powers to acquire a private road for which toll is charged; and if he is prepared to make an immediate investigation into the parish council's requests.
I have already written fully to my hon. Friend on this subject. As I explained in my letters, I have no jurisdiction over this private road and no power to acquire it compulsorily.
Is my right hon. Friend aware that this is a matter of paramount importance to these villagers who, for some 20 years, have been trying to get this toll road open and, since we are a Government of legislators and not antiquarians, will my right hon. Friend look into the matter?
As I have already told my hon. Friend, I have looked into it and have no powers to deal with the problem.
Who would have power?
Portsmouth Road Improvement
23.
asked the Minister of Transport what is the estimated cost of making a new arterial road near Windmill Hill between Horndean and Petersfield on the Portsmouth road; and why this work is being done at the present time when labour and materials are urgently needed for new housing estates.
A second carriageway, with footways, is being constructed on this stretch of the Portsmouth road, at an estimated cost of £100,000, in the interests of safety. Civil engineering labour only is being employed.
Is the Minister aware that this is the loneliest and least frequented part of the Portsmouth road, and what conceivable justification is there for spending labour now on this work when it is so urgently required elsewhere?
I do not think that that is the case. This is a rather heavily trafficked road and the present carriageway varies unduly. As a matter of fact, this extension is also to be used for certain road research work.
Road Junctions (Improvement)
24.
asked the Minister of Transport if he will make a statement on the recent safety experiments carried out on roads in Oxfordshire; and what further steps are being taken to introduce the system elsewhere.
Before the war the layout of a number of road junctions in Oxfordshire was improved with the aid of a grant from the Road Fund, and it is to this work that I assume my hon. Friend is referring. The principles adopted in the improvement of these road junctions are generally accepted and I have no doubt that, as circumstances permit, highway authorities will carry out similar work to secure greater safety on the roads.
Shipping
Passages, West Africa
15.
asked the Minister of Transport how many officials, business men and missionaries, respectively, including members of their families, are awaiting sea passages to West Africa; and how long those at the head of each list have been waiting.
There are 1,630 men, women and children awaiting passage to West Africa, of whom 904 are classified as official and 605 as commercial passen- gers, and 121 as missionaries. In the official and commercial lists the longest wait has been since October, 1946, and among the missionaries since August, 1946.
What about business men?
They do very well
Do the figures show that the fifty-fifty division between officials, on the one hand, and business men and missionaries, on the other, needs adjusting, or is it absolutely fair?
One is always prepared to look into matters of this description and to adjust them according to varying circumstances when we are supplying civilian transport. In relation to the rest of the demand on shipping, I do not think that this particular route suffers unduly.
Does not the Minister think that, for once, hard working British officials in West Africa should have some slight priority for their wives and families to go out there?
We are indeed very anxious to meet that but, when the accommodation is so strictly limited, they cannot possibly have priority.
Can the Minister say how long these people on the waiting list are likely to remain waiting, and what steps are being taken to increase the amount of transport available so that they may be taken off the waiting list and given passage?
We increase the facilities whenever possible but the demand rather tends to grow instead of lessen.
Southampton Approaches
22.
asked the Minister of Transport what steps are being taken to improve the navigational aids in the approaches to Southampton.
The restoration of the navigational aids at the Nab Tower, which were reduced to meet war requirements, started last July when the radio beacon then operating was discontinued to allow work to be started on the new beacon. This new beacon will come into operation on 15th May. Work on the reinstallation of better lights and fog signals at the tower has also started and Trinity House are satisfied that, on the com- pletion of this work, the approaches to Southampton will be adequately marked. The Southampton Harbour Board inform me that the navigation aids within the area under their jurisdiction have always been maintained to the satisfaction of the interests represented on the Board, which include the Admiralty, Trinity House and the various shipping interests using the port.
In view of the mishap which occurred to the "Queen Elizabeth" last week, can the Minister say why so much time has been wasted in getting the navigational aids into full working order?
I understand that there is no suggestion that the mishap was due to the causes to which the hon. Member refers.
Does what the Minister said mean that the aids to navigation are not satisfactory now and that the criticisms which have been made against Southampton are, in fact, justified?
No, it does not mean anything of the kind. If the hon. Member will read my reply carefully, he will see that that is the case.
Ministry Of Supply
Second-Hand Tractors (Price Control)
25.
asked the Minister of Supply if the price control regulations limiting the prices of second-hand tractors have been observed at all the auctions held under the auspices of his Department.
Yes, Sir, except in isolated cases.
How can there be isolated cases? Surely, one law must obtain for Government Departments as well as private individuals at these auction sales?
That is so. There were one or two small slips and mistakes.
Statutory Orders
26.
asked the Minister of Supply the percentage increases over prices current in August, 1939, which is permitted in respect of commodities therein specified by S.R. & O., 1947, No. 336.
About 145 per cent., Sir.
In view of that answer, will not the right hon. Gentleman agree that the explanatory memorandum is a rather modest understatement?
I prefer understatement to overstatement.
27.
asked the Minister of Supply if his attention has been drawn to a misprint in the explanatory note of S.R. & O., 1947, No. 255; how many copies of this Order have been printed with this misprint; and what steps has he taken to correct it.
Yes, Sir. The word "long" was printed instead of "longer" in the phrase "now no longer applicable." The mistake was too trifling to justify reprinting the 5.000 copies issued.
Electrical Steel Sheets
28.
asked the Minister of Supply if he is aware of the shortage of electrical steel which is needed, inter alia, for the manufacture of goods exportable to hard currency countries; and if he will increase the supply of such steel by importing it or allowing British firms to manufacture it.
Yes, Sir. It is hoped to expand United Kingdom production of electrical steel sheets by over one-third by the end of this year, and to import substantial quantities from the U.S.A., Germany and Belgium.
Aluminium
29.
asked the Minister of Supply why, pending the completion of a fair contract for the purchase of virgin aluminium ingot, he is paying a provisional price to the British Aluminium Company which is not only well below their bare cost of production but well below the price at which the metal could be purchased in any part of the world today.
The provisional price is equivalent to the landed price of aluminium purchased under Government contract from Canada.
But surely that is not the price prevailing in Canada even when landed? Cannot the Minister pay a fair price as soon as possible?
A price is being negotiated, and pending negotiations being completed, a provisional price is being paid. The provisional price is the landed price from Canada.
Oil-Well Drills
30.
asked the Minister of Supply how much oil-well drilling equipment has been delivered by Woolwich Arsenal to the British Oilfield Equipment Company; how much has been accepted by them as satisfactory; and how much rejected.
A considerable quantity of this equipment has been delivered and none of it has been rejected.
Can the Minister say whether this equipment has been put into service and if it has proved satisfactory in the oil lines?
That is the business of the purchaser and not of my Department.
Armaments (Steel Allocation)
32.
asked the Minister of Supply the quantity of steel used in the manufacture of armaments, including warships, during 1946; and what quantity is it proposed to allocate for this purpose during 1947.
I regret that it would not be in the public interest to give details of this kind.
Although my right hon. Friend cannot disclose these matters, can he assure the House that every care will be taken to keep the quantity allocated for that purpose to a minimum and to see that none is used in the manufacture of obsolescent weapons?
Yes, Sir.
Motor Cars (Doctors)
33.
asked the Minister of Supply whether he is aware that the efforts of the motor industry to give preference in the delivery of motor cars required by doctors have proved ineffective and that many doctors urgently in need of motor cars for their professional duties are unable to obtain them; and if he will consider, with the industry, enforcing a scheme of covenants similar to the scheme prohibiting resale of motor cars within 12 months, whereby motor dealers are obliged to give priority of delivery to such doctors.
No, Sir. The motor in- dustry is honouring its undertaking to give preference to the delivery of cars required by doctors, while having regard to the claims of the other priority users, nurses and midwives.
While I fully appreciate that the motor industry is honouring its undertakings, may I ask if my right hon. Friend is aware that the supply of motor cars for doctors comes from the dealers and not from the manufacturers, and would he not arrange with the manufacturers that dealers enter into covenants with manufacturers to give priority to doctors who are in need of cars?
I have not had any complaints about this, but in view of what my hon. Friend says, I will certainly take it up with the industry.
Is the right hon. Gentleman aware that the same acute shortage applies to district nurses as well as country doctors, and will he also take them into consideration?
Yes, Sir, but there are not enough to go round. That is the trouble.
Will the right hon. Gentleman also take into account the position of veterinary surgeons in remote rural areas?
Is my right hon. Friend aware that in regard to midwives and district nurses, there is a scheme in force between the Ministry of Health and the industry which works very well, but that there is no such scheme for the doctors?
British Aircraft (Cost)
34.
asked the Minister of Supply why the cost of aircraft bought in the U.S.A. for the use of British corporations can be announced, whereas the figures for British-built aircraft are not disclosed.
I do not think that this would be desirable.
May I ask how any Member of this House or any one in the country can properly assess the relative advantages of buying aircraft in America or this country if they are not to know the cost of British aircraft?
It is a long established rule that negotiations would be prejudiced by disclosure of prices when contracts with individual firms were made, and I would ask the hon. Gentleman not to press this.
It is not a question of a Government contract but the price for an article that a national corporation is paying. Why can we not have this information?
As I have explained, it has been felt to be prejudicial to the public interest to disclose the prices of articles purchased from particular firms—[HON. MEMBERS: "Why?"]—but I am quite willing to look into it.
Is the Minister aware that he could get the best built aeroplanes at the cheapest rate if he would set up a factory in Scotland?
Could not my right hon. Friend review the whole question of the issue of statistics and information on the production of civil aircraft so that the matter might receive the natural public interest that it deserves?
I will certainly look into it, but I must make the reservation that the public interest comes first.
Supply Depots (Mps Visits)
33.
asked the Minister of Supply if he will issue a general permit which will enable Members of Parliament to visit dumps controlled by his Department at any time without previous notice.
No, Sir; I am afraid that would not be practicable, but if hon. Members will let me know when they wish to visit a particular depot I shall be glad to make arrangements.
Obviously my right hon. Friend would do so and I thank him for it, but would he say why an hon. Member should not just drop in and look round?
Many of these dumps are small and in remote places with only an industrial staff and no means of identifying hon. Members, and I cannot see that any good purpose would be served.
Why should the right hon. Gentleman wish to drop an iron curtain over his dumps?
On the contrary, I have offered to let it up at any moment.
Would the Minister provide equal facilities for visiting "joints" as well as dumps?
Does not the giving of notice negative the purpose for which the visit is made?
What is the purpose?
Disposals Department (Staff)
36.
asked the Minister of Supply when it is expected that the work of his Department will allow of a reduction in the staff of 194 men and 88 women employed in the Disposals (S) Department, Hans Mansions.
The staff will be progressively reduced during the present year.
Mild Steel (Light Sections)
37.
asked the Minister of Supply whether he is aware of the scarcity of light sections of mild steel, particularly of flats ⅛ in., 3/16 in., and ¼ in.; what is the cause of the shortage; and what steps are being taken to overcome it.
Yes, Sir. There is a very heavy demand and a serious shortage of semi-finished material, due largely to the difficulty of obtaining imports. We are doing all we can to improve the position, but I am afraid that no early relief is possible.
Is the right hon. Gentleman aware that so far as home-produced light sections are concerned, it is largely a matter of arranging the necessary incentives? Would he please consider the matter from that point of view?
I am sorry, but I do not quite appreciate the hon. Member's point.
Is the right hon. Gentleman aware that the real point is that it pays the men at the moment to produce the larger sections to a greater extent than the light sections? Would he please look into it?
I will certainly look into it.
Mining Machinery
38.
asked the Minister of Supply in view of the export of mining machinery during /946, if he will make a statement of the intentions in connection with the export of similar machinery during 1947, in view of the urgent need for immediate delivery to collieries of conveyor belting, cables, heavy electric motors, cutters and conveyors.
Full account will be taken of the urgent need of the collieries for mining machinery when the export quota for 1947 is fixed.
Does my right hon. Friend not agree that coalmining in this country is more important to our economy than goldmining is abroad, and would he see that none of our productive effort is diverted to goldmining in preference to coalmining machinery?
Machinery for our coal mines will come first.
Steel Industry, South Wales (Government Decisions)
39.
asked the Minister of Supply if he is now in a position to make a statement on the modernisation and development of the tinplate and sheet-steel industry in South Wales.
Yes, Sir. I have considered the recommendations of Iron and Steel Board on this important scheme which, I am glad to say, has now reached a stage at which decisions can be taken on its main features.
The Government accept the Board's recommendations for the construction by the companies concerned of a new continuous hot strip mill with coke ovens, blast furnaces, steel melting shops and ancillary plant at Margam, near Port Talbot. Further, the Government agrees with the Board as to the need for new cold reduction and finishing plants for tinplate and steel sheet. The precise location of these is under consideration by the Government in the light of the Board's recommendations and the sociological factors involved and I hope to make a further statement about them shortlyIs the Minister aware that this will have a most heartening effect in South Wales? Can he tell us when the scheme is likely to be in full operation, and what effect it will have on national production?
It will not be in fill, operation for some three years. [HON. MEMBERS: "Oh!"] It is a very big scheme, probably the biggest scheme ever carried out, and I am afraid I could not answer the second part of the supplementary question without notice.
May I ask whether this heartening scheme is being carried out by private enterprise?
Yes, Sir.
May I ask the Minister if the scheme is in any way substantially different from that put forward a couple of years ago, and have not the deliberation's of the Iron and Steel Board only caused a further delay?
I think the thanks of the Government and of the House are due to the Iron and Steel Board for the extremely expeditious way in which they have handled this matter. The scheme did not go to them until about six weeks ago, and their recommendations were in my hands the day before Easter. For a £50 million scheme, I do not think that is bad going.
Ministry Of Works
Bricks Subsidy
40.
asked the Minister of Works the total cost of the subsidy on housing borne on his Vote during the past year, exclusive of the figure of 4207,500 on Belgian bricks.
In addition to the subsidy in respect of Belgian bricks, special arrangements have been made for the supply of fletton bricks to Scottish local authorities for sale at the average ex-works price for Scottish bricks. This has involved a subsidy payment on my Department's Votes of £62,000 to date.
Will the Minister say why this information was not revealed before? Why is it necessary to put down a Question before these building subsidies can be brought to light?
This is included in the Department's Vote and, as far as I know, the information was given.
London Statues
The following Question stood upon the Order Paper in the name of Mr. WILSON HARRIS:
41. To ask the Minister of Works whether he will cause a statue of Queen Elizabeth to be erected in the vicinity of Whitehall.
May I say, Mr. Speaker, to avoid ambiguity, that the Question I put down on the Paper specified Queen Elizabeth Tudor?
The answer to the Question is, "No, Sir."
The right hon. Gentleman is very difficult. Is he aware that this lady could make a good claim for being regarded as the greatest Sovereign this country has ever known? Is he aware that a Committee of both Houses, of which Lord Macaulay was a member, recommended that a statue be erected in these precincts; and that there exist today, as there did not in Lord Macaulay's time, several hon. Members of this House who would serve admirably as models for such a statue?
That is a matter of opinion. As far as I can see, there are other more notable omissions than Queen Elizabeth.
Should not this question be addressed to Madame Tussaud?
Will the right hon. Gentleman take into consideration the successor of Queen Elizabeth, King James the Sixth of Scotland and First of England?
If my memory serves me right, I said "No, Sir" to that Question some time ago.
42.
asked the Minister of Works when the statue of General Gordon will be replaced in Trafalgar Square; and whether he has any further information regarding the statue of King Charles I.
The repairs to the statue of King Charles I have been completed and the statue will be restored to its pedestal in the course of the next few weeks. A decision about the statue of General Gordon will be reached shortly.
Does the right hon. Gentleman mean that there is some doubt about it, and does he realise the possible political consequences of preferring to put the first British Governor-General of the Sudan under a bushel instead of in a candlestick?
Will his head be on or off?
Removal Of Erections (Licensing)
59.
asked the Minister of Works if he will revise the regulation which requires that the value of the materials in a small building, such as a garden shed, which it is proposed to move from one site to another, must be included in the total cost, which has the effect of bringing the operation within the scope of licensing by the local authority.
No revision is necessary. It it is desired to move an existing building from one site to another all that has to be taken into account in computing the cost of the work is the cost of dismantling, the cost of transport, if any, and the cost of re-erection.
Does this also apply to the sale of new garages in concrete, steel, aluminium, and timber, which are being extensively advertised?
This does not apply to new erections, but to existing ones.
Vacuum Flasks (Permits)
60.
asked the Minister of Works if he is aware that the hon. Member for Maldon made representations to the Board of Trade on 14th January on behalf of the Witham, Essex, branch of the National Federation of Building Trades Operatives who were in urgent need of permits for vacuum flasks; that his Department, as agent for the Board of Trade, recommended on 4th February that the matter be referred to his regional officer at Cambridge, and gave an assurance that it would receive immediate attention; that the union branch secretary concerned applied to the regional officer on 24th February, but has so far received neither the permits, nor an acknowledgment of his letter; and if he will expedite the issue of these permits, and improve these arrangements generally.
The permits were issued on 26th March. I regret the delay which occurred in this case and the arrangements for dealing with such applications have been improved.
Is my right hon. Friend aware that these permits were sent When this Question originally appeared on the Order Paper, but that only four were sent instead of the 11 asked for? Are not all these workers equally entitled to these permits?
My information is that all were sent, but I will look into the statement my hon. Friend has made.
May I appeal to the Prime Minister to look at the purport of this Question, and to consider wiping out altogether the permits branch of the Board of Trade, which does not do anything besides create alibis and a lot of mischievous work for a lot of people who do not really matter to human society?
Requisitioned Nursing Home, Middlesbrough
63.
asked the Minister of Works if he will make a statement regarding the release of the Ardencaple Nursing Home in Middlesbrough.
A scheme for rehousing the Ministry of Labour staff from Ardencaple in part of the employment exchange, has now been agreed, and arrangements are being made to prepare the accommodation for occupation as quickly as possible. Ardencaple will be released as soon as the space is ready, which I hope will be in three or four months' time.
Will the Minister be good enough to keep an eye on these people, because I have had similar replies for two years and they will not leave without some kind of ejectment order being obtained against them? I hope my right hon. Friend will take some steps in time to see that they are got out of these premises.
I will do my best.
Building Licence, West Didsbury
65.
asked the Minister of Works whether his Department, or the local authority, gave the licence for 1,198 of reconstruction work on the property The Headlands, Moor Road, West Didsbury; and whether this is a usual amount for such reconstruction work on a private house.
The licence was issued by the local authority. The amount of the licence was agreed by the local authority after inspection and was the minimum considered necessary having regard to the size and condition of the property.
Roofing Tiles
66.
asked the Minister of Works whether he is aware that the housing programme of the Ramsey Urban District Council is being seriously delayed through lack of roofing tiles; and what steps he will take to expedite delivery to the contractors concerned.
Yes, Sir. Arrangements have been made which should result in tiling being resumed immediately.
Wire Netting
67.
asked the Minister of Works whether, in view of the increasing importance of food production in this country by all who can take part in it, he will consider making rabbit netting available to those cultivating smallholdings and gardens on the certificate of the A.E.C's.
My officers are already prepared to authorise the issue of wire netting for this purpose when supplies are available.
Can the Minister give any idea when the supplies will be available?
No, Sir, I am afraid I cannot; that is a matter for the Ministry of Supply.
Requisitioned Premises, London
70.
asked the Minister of Works how many hotels, large houses, small houses and flats, respectively, in the London civil defence region are at present requisitioned by the Government; and how many of each category have been released for use as dwelling accommodation since 30th September, 1946.
Government Departments hold on requisition in the London civil defence region 40 hotels, 854 large houses, 409 small houses and 1,479 flats. The in- formation required by the second part of the Question is not immediately available but I will arrange for it to be circulated in the OFFICIAL REPORT as soon as possible.
Production Campaign (Elderly People)
45.
asked the Prime Minister whether, in view of his appeal to men and women in the older age groups to remain in industry, he will see that Government Departments adopt a more tolerant attitude to retention in, and application for, employment in the public service.
Departments have been instructed that, while the current manpower shortage persists, they should continue to employ men and women beyond the normal retiring age in all cases where they are willing to remain and are fully fit and efficient in their grade and where there is real need to retain their services. If my hon. Friend has any evidence that this instruction is not being carried out, he will no doubt furnish particulars.
Will the Prime Minister consider requesting the Service Departments to adopt a similar attitude to those who, otherwise eligible, are generally excluded from remaining in the Service on account only of age?
I will certainly consider any questions that arise in regard to the Services.
Fishermen's Training Scheme (Boys)
47.
asked the Minister of Agriculture if he is aware that boys over the age of 16 years are not accepted for the Fishermen's Training Scheme; that the fishing industry is in need of crews; and if he will consider allowing candidates over 16 years of age to take advantage of the training facilities and grant deferment from military service in such cases.
The Fishermen's Training Scheme is operated by the trawler owners and the local education authority at Grimsby, who have fixed the present age limit, the raising of which is, I under- stand, under consideration. Arrangements have been made for suspending the calling up of youths employed on trawlers based on ports in England and Wales which fish in the near and middle waters.
Agriculture
Colorado Beetle, London
50.
asked the Minister of Agriculture why no action was taken for 36 hours after his Department had received a report on 29th March of the discovery of a Colorado beetle on spinach purchased at a London store; and what steps he is taking, in view of the increased imports of vegetables from the Continent, to ensure that immediate action is taken in such cases in the future.
The report of this discovery was made by telephone on the evening of Saturday, 29th March, during a period when the flood situation in the Fens was most menacing, and was unfortunately directed to an officer of my Department concerned with flood precautions. This error, which is regretted, occasioned a delay of some two hours, and steps are being taken to avoid similar errors in future. The beetle was, however, collected by the police later the same evening for transmission to the Ministry's laboratory for identification. Subsequent action when, as in this case, a Colorado beetle is found on imported produce is directed towards ascertaining the origin and distribution of the produce and examining the remainder of the consignment, and involves inquiries of salesmen and others concerned with the importation and distribution. Such action was taken in this case at the earliest possible moment after the beetle had been identified at the laboratory.
Can the Minister say what was "the earliest possible moment" in this case? Was it longer than 36 hours, because a beetle, or several beetles at large, can do a lot of damage in that time?
As I informed the hon. Gentleman, the delay was only two hours, not 36.
But it was much longer by the time it was identified in the laboratory.
The inspection was only delayed by two hours, after which the police were able to receive the Colorado beetle, which was immediately transmitted to the laboratory.
There may have been 700 others in the same consignment.
Only one was reported, anyway.
Mobile Canteens
52.
asked the Minister of Agriculture if, in view of the need for increased food production and of the fact that agricultural workers have no canteens, he will consider, with the Minister of Food, the possibility of authorising county A.E.Cs. to institute mobile canteens to provide cooked meals for farmworkers.
The possibility has been considered on several occasions but as indicated by my right hon. Friend the Minister of Food on 8th July, 1946, in reply to a Question by the hon. Member for Woodbridge (Mr. Hare), we have been driven to the conclusion that a mobile canteen service for farm workers would be impracticable.
Is the Minister aware that the only solution of this unfair position is that extra rations should be allowed to the farm workers direct, instead of these fantastic schemes for canteens?
I do not agree that they are fantastic.
Is the Minister aware that during the floods there have been considerable numbers of mobile canteens circulating amongst the flood workers? What is the objection to doing the same thing for agricultural workers who will be working under very much the same conditions in similar scattered areas?
As the hon. and gallant Gentleman is aware, agriculture is a widely scattered industry, and it would require a very large number of floating canteens to provide the service indicated. I am afraid the loss of manpower would be almost equivalent to the gains we could get in food production.
Seed Potatoes
54.
asked the Minister of Agriculture whether he is aware that farmers in East Anglia are still experience- ing delays in receiving their supplies of seed potatoes from Scotland; and what steps are being taken to overcome such delays.
My right hon. Friend the Minister of Transport arranged with the railway companies as far back as 24th March that the highest possible priority should be given to movement of Scottish seed potatoes, and they are at present being delivered to growers in England and Wales as fast as they can be dressed out of the clamps. 1n the week ended 5th April the quantity of potatoes moved from Scottish farms reached the record figure of over 28,500 tons, and deliveries are being continued at this level. The effect of the earlier paralysis of seed dressing and transport must, however, inevitably continue to be felt. There is enough once-grown seed to meet all demands that cannot be supplied from Scotland or Northern Ireland, and growers who are ready to plant, and cannot get delivery of Scottish seed might be well advised to accept such alternative supplies.
Bearing in mind the late start which these deliveries necessarily bad this season, will the right hon. Gentleman keep a careful watch on this matter so as to ensure that Scottish supplies arrive in time for planting?
I can assure the hon. Gentleman that the transport of Scottish seed potatoes has the highest possible priority and will, I hope, continue down to the end of planting time.
Is the right hon. Gentle man aware that Scottish farmers are very anxious to get their seed potatoes away to England but have been held up by lack of transport? I know it is all right now.
Of course they were held up because they could not dress the potatoes, but transport is now available for them.
Is the right hon. Gentleman aware that the brand known as "Majestic" seed potatoes is most widely used in East Anglia, and in fact, that these potatoes are not being sent by rail at all but by boat? Is he further aware that it takes some three weeks to get delivery on a farm in East Anglia by this method as opposed to five days by rail direct? Will he, therefore, do all he can, in view of the particularly difficult circumstances, to see that these potatoes are sent by rail and not by boat?
I can assure the hon. Gentleman that we are very anxious that the seed potatoes should be delivered, and that the Ministry of Transport has provided the highest priority, whether by rail, road or sea.
Green Woodpecker (Protection)
55.
asked the Minister of Agriculture whether he will consider obtaining the removal of the great green woodpecker from the list of protected birds, in view of the fact that it is a great enemy of bees, damages timber and also because its old nests offer shelter to grey squirels and jays.
No, Sir. I am advised that the green woodpecker does much more good than harm, and that it would be folly to remove it from the list of protected birds.
Has the Minister has any personal experience of the less desirable qualities of the great green woodpecker?
No, but I am credibly informed that the great green woodpecker is largely insectivorous, feeding on weevils and other injurious larvæ of many kinds. It is especially fond of ants and woodlice, which alone would make it worth preserving.
Is the right hon. Gentleman aware that this is the only living thing in the British Isles which has been able to preserve its sense of humour under this Government?
Flooding (Preparation Of Reports)
57.
asked the Minister of Agriculture if he will institute a public inquiry to determine the cause and prevention of flooding in the valleys of the Lea and the Stort.
With my hon. Friend's permission I propose to answer this Question in general terms. My Department is in close touch with the flood situation in all areas, and is collecting all possible evidence as a basis for future policy and planning. Engineers will no doubt be asked to present detailed reports to their catchment boards as soon as they are free of their present urgent preoccupation with the reinforcement of river banks and the dispersal of water from the flooded areas, and I shall ask boards to present full reports to my Department. After these have been studied, together with the reports of my own officers and have, where necessary, been discussed with the boards concerned, it will be possible to consider whether any form of inquiry, either generally or in any particular case, is necessary or desirable.
Is the right hon. Gentleman still intending to place these boards under the Transport Commission?
Will the right hon. Gentleman bear in mind that, His Majesty's Government having accepted the principle that these floods all over the country have been a national disaster, it is only right that the House should have an opportunity of debating the matter at the earliest possible moment?
The hon. and gallant Member should address that question to the Leader of the House.
Prisoners Of War (Drivers)
58.
asked the Minister of Agriculture if he will reverse his decision against the employment of German prisoners of war as lorry drivers to transport their fellow prisoners to and from their agricultural labours in Kent; and if he is aware that his refusal to agree to the utilisation of the prisoners in this capacity has added considerably to the housing shortage in Ashford, Kent.
County war agricultural executive committees are under instructions not to employ prisoners of war as lorry, drivers where British drivers are available. As regards the second part of the Question, the Kent committee occupy one house in Ashford as a hostel for their drivers. Every endeavour is being made to find alternative accommodation so as to enable the premises to be released, but I should not be justified in attempting to solve this problem by sanctioning the displacement of British by prisoner labour.
Can the right hon. Gentleman say whether the appropriate trade union is opposed to the employment of prisoner lorry drivers and, if so, will he represent to them that there are at present 850 families unhoused in Ashford, Kent, who urgently need this accommodation?
Those 850 families could not be placed in that particular house.
Does the right hon. Gentleman not realise that I understand that?
I am sorry if the hon. Gentleman thought I was flippant in any way about my answer, but he referred to 850 families, whereas I had referred to only one house occupied by these drivers. I am not sure what the attitude of the trade union is to the prisoners driving lorries, but what I am concerned about is that prisoners shall not be used if British labour is on the job.
Where prisoners are employed, is it not possible to give instructions that they shall work, and not stand about?
If the hon. Member will supply me with information of what he alleges, I will look into it.
Oh, there are many cases.
If the hon. Member will give the information, I will look at it.
Trieste (Property Seizure)
74.
asked the secretary of State for Foreign Affairs whether he is aware of the protest made by the United States Government against the seizure and carrying off of Italian property in the zone at present occupied by the Yugoslav armies in Trieste, without com pensation to the inhabitants and whether instructions have been given to the British Ambassador at Belgrade to support the protest of the United States Government, in view of the fact that this portion of Trieste constitutes, under the Treaty of Peace with Italy, part of the International Zone.
As my right hon. Friend the Minister of State informed the hon. Member for Abingdon (Sir R. Glyn) on 31st March, His Majesty's Government addressed a Note to the Yugoslav Government on 24th March, protesting against the seizure and removal of property of Italian nationals by the authorities in the Yugoslav zone of occupation in Venezia Giulia. My right hon. Friend is aware that the United States Government have made a similar protest.
Is the hon. Gentle. man aware that these people were already robbed and despoiled when the Yugoslav troops first occupied Trieste, and they are now being deprived of all that remains to them?
We have nothing to add to what we have said in our Note.
Council Of Foreign Ministers (Press Conferences)
75.
asked the Secretary of State for Foreign Affairs, whether he is aware that Mr. F. Lesser, the "Daily Worker" correspondent in Moscow, has been refused admission to the daily Press conferences held at the British Embassy; and whether he will state the reasons for this action.
A Press conference is held by the chief Press officer of the United Kingdom Delegation after each meeting of the Council of Foreign Minister. I am informed that Mr. Lesser regularly attends these conferences. In addition to these open conferences, the chief Press officer is available for consultation by representatives of the Press individually, or by arrangement with the journalists concerned, in groups. It is open to Mr. Lesser or any correspondent if there is difficulty in fitting him into a group to avail himself of an individual interview. As a correspondent resident in Moscow, Mr. Lesser continues to maintain his usual contacts with the Press attaché and other members of the staff of the British Embassy
Is the Minister aware that I received a communication from this journalist to the effect that he was not permitted to attend some of these conferences, and would not the Minister agree that this journalist would be aware whether he did or did not attend? Therefore will he look into the matter once again?
I am not saying that there are not informal conferences which Mr. Lesser has not attended. All I am saying is that at all open conferences he is, of course, perfectly entitled to attend, and I understand that he attends them regularly.
Unrra (Non-Contributory Countries)
77.
asked the Secretary of State for Foreign Affairs what countries have not contributed to U.N.R.R.A.; and what countries have received assistance from U.N.R.R.A.
So far as my right hon. Friend is aware, Afghanistan, Argentina, Eire, Portugal, Saudi Arabia, Siam, Spain, Sweden, Switzerland, Syria and the Lebanon have not contributed to U.N.R.R.A., of which, however, they are not members. On the other hand, of these countries the Argentine, Eire, Portugal, Sweden and Switzerland have all made contributions to relief outside U.N.R.R.A. The countries which have received major assistance in proportion to their size and need are Albania, Austria, Byelo-Russia, China, Czechoslovakia, the Dodecanese, Greece, Italy, Poland, San Marino, Ukraine and Yugoslavia. Small emergency assistance has been received by Ethiopia, Finland, Hungary, Korea and the Philippines.
International Police Force
78.
asked the Secretary of State for Foreign Affairs what progress is being made towards the establishment by U.N.O. of an international police force.
I would refer the hon. Member to the reply on the subject given to my hon. Friend the Member for Stafford (Mr. Swingler) on 24th February last, to which I have, at present, nothing to add
In view of the great interest that is being taken in this question and of its importance, can the hon. Gentleman say whether any real progress has been made and whether the representatives of the U.S.S.R are taking part in the deliberations?
The answer to the second part is "Yes." The answer to the first part is that I regret that very little progress is being made.
Can the hon. Gentleman say whether His Majesty's Government are taking any steps to earmark a section of the Air Force for the service of U.N.O as the Charter provides?
That would be another question.
Is His Majesty's Government's representative on the Security Council encouraging the Chiefs of Staff Committee to get on with the fundamental basis of operation for an international security force?
The arrangement is that the Military Staff Committee is accountable to the Security Council, but our Chiefs of Staff representative would not receive his instructions from our Security Council representative.
Does the Minister realise that the proposal to create the United Nations police force differs from that under Article 43, and will he also state why it is that Britain does not take the lead in the creation of the United Nations police force?
I am aware of the distinction my hon. Friend has made. I assumed that the Question referred to Article 43 of the Charter, and as far as provision of that Article goes, I can say that His Majesty's Government are taking the strongest lead in this matter.
Food Supplies
Parcels (Export Restrictions)
84.
asked the Minister of Food what changes will be made with regard to restriction of goods to be sent to Germany now that so many commodities have been taken off points.
Although certain foods have been taken off points, it is still necessary, in view of the supply position generally, to maintain the existing restrictions on the types of foodstuffs which may be sent overseas in parcels. However, as there has been no change in the consumer's allowance of points for each ration period, the amount of points food from which people can, if they wish, make up parcels has not been reduced.
Anglers' Catches, Eire
89.
asked the Minister of Food whether he will so relax restrictions as to allow individual anglers who may be visiting Eire to bring or send to this country their catches of salmon and trout.
We should certainly like to do so and are consulting with the Eireann authorities to see if there is a practical way of permitting the genuine private angler to bring in some fish of his own catching. I will write later to my hon. Friend.
Milk Cartons
91.
asked the Minister of Food if he is aware of the threatened breakdown in the distribution of milk, particularly tuberculin-tested milk, by reason of the impending shortage of the special cartons used for this purpose; and whether any steps have been, or will be, taken to make available sufficient cartons to maintain the uninterrupted distribution of the increasing production of tuberculin-tested milk.
95.
asked the Minister of Food whether he is aware that the manufacturers of milk cartons for the delivery of supplies of tuberculintested milk are experiencing difficulty in obtaining the necessary raw materials for their manufacture; and what steps he proposes to take to ensure that there shall be no reduction in the supplies of these milk cartons to the farmers who own dairy herds producing tuberculin-tested milk.
I am aware of the present shortage of milk cartons which is due to the stoppage of the paper mills during the fuel crisis. I am in close and constant consultation with my right hon. and learned Friend the President of the Board of Trade as to the action to be taken to remedy the position.
Will the hon. Lady treat this as being of the greatest urgency because of the use to which these cartons are put for the distribution of the highest possible quantity of milk, and that it is a serious thing for a certifier producer to be without them?
Yes, Sir.
Is the hon. Lady aware that this matter is very serious, and that I have written several letters on the subject to the President of the Board of Trade? Will she join with me and other Members in getting the President of the Board of Trade to move in this matter?
We recognise the seriousness of the position, but I would remind my hon. Friends that there are other factors concerned. For cartons we need not only paper but wax and, unfortunately, the United States have curtailed its export.
Will the hon. Lady impress upon the President of the Board of Trade the importance of this matter and ask him to look at it from the proper angle—that it is a matter of great importance that these cartons should be provided?
Yes, Sir
Is my hon. Friend aware that many of the suppliers have no alternative means of delivering the milk?
Butchers' Margin
92.
asked the Minister of Food why his Department in a recent Press announcement maintain that, prior to the withdrawal of the manufacturing meat allocation, a 10 per cent. margin was allowed to butchers for cutting and manufacturing purposes, in view of the fact that the present list of retail prices was worked out so that there was no margin at all for cutting and that the manufacturing allowance which has been withdrawn was, in fact, only 5½ per cent.
The statement that butchers have no margin for cutting losses is incorrect. The wholesale/retail price structure was compiled to provide a butcher with £76 worth of meat at wholesale prices to supply £100 worth of rations at retail prices after allowing for all cutting and drying out losses. Butchers were, however, allocated £80 worth of meat until last August when, following an increase in wholesale prices, their allocations were adjusted to £82 worth of meat. In addition, until the recent cut they had a 5½ per cent. manufacturing allowance, making a total allocation of £87 10s. worth at wholesale prices or over 10 per cent. more than they needed for the ration.
Whoever prepared that arithmetic for the hon. Lady, is she not aware that the net effect of this recent cut is that the average butcher in Britain is not able to supply his customers with half a pound of meat per ration book per week, and is she aware of the serious effect of that upon the dietary of the average family? Will she look at it again?
I think the butchers in this country know full well that if they find themselves in difficulty they can apply to the deputy meat agent, who is an official of my Department, and he will give them a temporary allowance.
Green Vegetables (Price Control)
94.
asked the Minister of Food whether he has considered the petition sent to him by 600 housewives in Welwyn Garden City, asking for the reimposition of price control of green vegetables; and what answer he proposes to make.
Yes, Sir. A reply to the petition to which my hon. Friend refers was sent on 16th April and I am arranging for a copy to be supplied to him.
Would my hon. Friend say whether or not she agrees that the current prices of green vegetables are a scandal? Is it not time that something was done to put them under price control again?
The answer will reach my hon. Friend tonight, and if he studies it he will find that it gives full details.
Will the reply be favourable to the request for the reimposition of price control, because this is an important matter? Is it not time that some steps were taken to deal with it?
I think my hon. Friend will find that the answer is along the lines of the statement which my right hon. Friend made in the House recently.
The answer to the question should be very simple. It asks for the reimposition of price control, and surely the answer is either "Yes" or "No."
The answer is "No."
Civil Service (Increase)
97.
asked the Financial Secretary to the Treasury what the percentage rise has been since 1st January, 1946, in the numbers employed in the Civil Service in England and Scotland, respectively.
Between 1st January, 1946, and 1st January, 1947, the number of non-industrial civil servants employed in England, Scotland and Wales rose by 4½ per cent. Separate figures for England and Scotland are not available.
Is the Financial Secretary aware that we have come to the stage when one out of nine of the employed population is in the public service, and would he bring to the notice of the various Departments the need for reducing this figure at the earliest possible moment?
Broadcasting (Frequency Modulation)
98.
asked the Postmaster-General if he has given consideration to the advantages of pulse width over frequency modulation; and whether he has given any lead to set manufacturers as a result.
Consideration has been given to the respective merits of frequency modulation and other types of modulation, including pulse modulation, for broadcasting on very short waves. At the present stage of technical development it is considered that frequency-modulated broadcasting offers the best prospects and the Government have approved the British Broadcasting Corporation's plans for the development of this system. Radio manufacturers have been advised accordingly.
Business Of The House
Motion made, and Question put,
"That the Proceedings on Government Business be exempted, at this day's Sitting,
Division No. 124.]
| AYES.
| [3.33 p.m.
|
| Adams, Richard (Balham) | Greenwood, A. W. J. (Heywood) | Rankin, J |
| Adams, W. T. (Hammersmith, South) | Grierson, E. | Reid, T. (Swindon) |
| Alpass, J. H | Griffiths, D. (Rother Valley) | Ridealgh, Mrs. M. |
| Anderson, F. (Whitehaven) | Gunter, R. J | Robens, A. |
| Attewell, H. C. | Guy, W. H. | Roberts, W. (Cumberland, N.) |
| Attlee, Rt. Hon. C. R. | Hale, Leslie | Rogers, G. H. R. |
| Austin, H Lewis | Hall, W. G. | Ross, William (Kilmarnock) |
| Ayles, W H. | Hamilton, Lieut.-Col. R. | Salter, Rt. Hon. Sir J A |
| Ayrton Gould, Mrs B | Hannan, W. (Mary | Sargood, R |
| Bacon, Miss A | Hardman, D. R. | Scollan, T |
| Balfour, A. | Harris, H. Wilson | Shackleton, E. A A |
| Barnes, Rt. Hon A J | Harrison, J. | Sharp, Granville |
| Barton, C | Hastings, Dr. Somerville | Shawcross, C. N. (Widnes) |
| Battley, J. R. | Haworth, J. | Silverman, J. (Erdington) |
| Bechervaise, A. E | Henderson, A. (Kingswinford) | Skeffington, A. M. |
| Belcher, J. W. | Herbison, Miss M. | Skeffington-Lodge, T. C |
| Benson, G | Hicks, G. | Skinnard, F W |
| Beswick, F | Hobson, C R | Smith, C (Colchester) |
| Bing, G. H. C | Hoy, J | Smith, Ellis (Stoke) |
| Blackburn, A. R | Hubbard, T. | Smith, H. N. (Nottingham, S.) |
| Blenkinsop, A | Hudson, J. H. (Ealing, W.) | Snow, Capt. J. W. |
| Boardman, H. | Hughes, Hector (Aberdeen, N.) | Soskice, Maj. Sir F |
| Bowles, F. G. (Nuneaton) | Hughes, H. D. (Wolverh'pton, W.) | Sparks, J. A. |
| Braddock, T. (Mitcham) | Hynd, H (Hackney, C.) | Stephen, C. |
| Bramall, E. A. | Irving, W. J. | Strauss, G. R. (Lambeth, N.) |
| Brown, George (Belper) | Janner, B. | Stross, Dr. B. |
| Buchanan, G. | Jay, D. P. T. | Stubbs, A. E. |
| Burke, W. A. | Jeger, G. (Winchester) | Summerskill, Dr. Edith |
| Callaghan, James | Jeger, Dr. S. W (St. Pancras, S.E.) | Taylor, H B. (Mansfield) |
| Champion, A. J | Jones, Rt. Hon. A. C, (Shipley) | Taylor, R J. (Morpeth) |
| Chater. D. | Jones, D. T (Hartlepools) | Taylor, Dr. S. (Barnet) |
| Chetwynd, G. R | Key, C W | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Cocks, F S | Kinley, J. | Thorneycroft, Harry (Clayton) |
| Coldrick, W | Lewis, J. (Bolton) | Thurtle, E. |
| Collick, P | Lipson, D. L. | Tiffany, S. |
| Collindridge, F | Lipton, Lt.-Col. M | Tolley, L. |
| Cook, T. F | Longden, F. | Tomlinson, Rt. Hon. G |
| Cooper, Wing-Comdr G | McAdam, W. | Usborne, Henry |
| Corlett, Dr. J. | McGhee, H. G | Vernon, Maj. W. F. |
| Corvedale, Viscount | Mack, J. D. | Viant, S. P. |
| Crawley, A. | McKay, J. (Wallsend) | Walkden, E. |
| Daggar, G. | Mackay, R. W. G. (Hull, N.W.) | Walker, G. H. |
| Daines, P. | MacMillan, M. K. (Western Isles) | Wallace, C. D. (Chislehurst) |
| Dalton, Rt. Hon. H. | Manning, C. (Camberwell, N.) | Wallace, H W. (Walthamstow, E.) |
| Davies, Edward (Burslem) | Manning, Mrs. L. (Epping) | Weitzman, D |
| Davies, Ernest (Enfield) | Middleton, Mrs. L | Wells, P. L. (Faversham) |
| Davies, Harold (Leek) | Mikardo, Ian | Wells, W. T. (Walsall) |
| Deer, G. | Millington, Wing-Comdr. E. R | Westwood, Rt. Hon. J. |
| Diamond, J | Mitchison, G. R. | White, C. F. (Derbyshire, W.) |
| Dobbie, W. | Morris, Hopkin (Carmarthen) | Whiteley, Rt. Hon. W |
| Dodds, N. N. | Moyle, A. | Wilkes, L. |
| Driberg, T. E N. | Naylor, T. E. | Wilkins, W. A. |
| Dumpleton, C. W. | Neal, H. (Claycross) | Willey, F. T. (Sunderland) |
| Dye, S. | Nichol, Mrs. M. E. (Bradford, N.) | |
| Edwards, A. (Middlesbrough, E.) | Parker, J. | Willey, O. G. (Cleveland) |
| Edwards, W. J. (Whitechapel) | Paton, Mrs. F. (Rushcliffe) | Williams, J. L. (Kelvingrove) |
| Evans, E. (Lowestoft) | Paton, J. (Norwich) | Williams, Rt. Hon. T. (Don Valley) |
| Field, Capt. W. J. | Pearson, A | Williams, W. R. (Heston) |
| Fletcher, E. G M. (Islington, E.) | Peart, Capt. T. F. | Willis, E. |
| Follick, M. | Piratin, P. | Wyatt, W. |
| Gallacher, W. | Pritt, D. N. | Yates, V. F. |
| Ganley, Mrs. C S | Younger, Hon. Kenneth | |
| Gibson, C. W | Pursey, Cmdr, H | |
| Gordon-Walker, P. C. | Randall, H. E. | TELLERS FOR THE AYES:
|
| Greenwood, Rt. Hon. A. (Wakefield) | Ranger. J | Mr. Simmons and Mr. Michac |
| Stewart. |
NOES
| ||
| Baldwin, A. E | Channon, H. | De la Bère, R. |
| Beamish, Maj. T V. H | Clarke, Col. R. S, | Digby, S. W. |
| Boothby, R | Clifton-Brown, Lt.-Col. G. | Duthie, W. S. |
| Bowen, R | Crookshank, Capt. Rt. Hon. H. F. C | Elliot, Rt. Hon. Walter |
| Bower, N. | Crosthwaite-Eyre, Col. O. E. | Erroll, F. J. |
| Boyd-Carpenter, J. A. | ||
| Braithwaite, Lt.-Comdr. J G | Crowder, Capt. John E. | Fleming, Sqn.-Ldr. E. L |
| Bullock, Capt. M | Darling, Sir W. Y. | Fraser, H. C. P. (Stone) |
from the provisions of the Standing Order (Sittings of the House)."—[ The Prime Minister.]
The House divided: Ayes, 190; Noes, 80.
| Fraser, Sir I. (Londale) | MacAndrew, Col. Sir C | Savory, Prof. D L |
| Galbraith, Cmdr. T D. | McCallum, Maj. D. | Scott, Lord W. |
| Gammans, L. D | Macdonald, Sir P. (I. of Wight) | Shepherd, W. S. (Bucklow) |
| Glyn, Sir R. | McKie, J. H. (Galloway) | Smith, E. P (Ashford) |
| Gomme-Duncan, Col. A | Macpherson, Maj. N. (Dumfries) | Snadden, W. M. |
| Grant, Lady | Maitland, Comdr. J. W. | Spearman, A. C. M |
| Grimston, R. V. | Manningham-Buller, R. E | Spence, H R. |
| Hannon, Sir P. (Moseley) | Marshall, D. (Bodmin) | Stanley, Rt. Hon. O. |
| Headlam, Lieut.-Col. Rt. Hon Sir C | Mellor, Sir J. | Stewart, J. Henderson (Fife, E.) |
| Hinchingbrooke, Viscount | Moore, Lt.-Col. Sir T. | Strauss, H. G. (English Universities) |
| Hollis, M. C. | Morrison, Maj. J. G. (Salisbury) | Stuart, Rt. Hon. J. (Moray) |
| Holmes, Sir J. Stanley (Harwich) | Morrison, Rt. Hon. W. S. (Cirencester) | Sutcliffe, H |
| Hutchison, Lt.-Cm. Clark (E'b'rgh, W.) | Noble, Comdr. A. H. P | Taylor, Vice-Adm. E. A (P'dd't'n, S.) |
| Jeffreys, General Sir G. | Orr-Ewing, I. L. | Teeling, Willlam |
| Keeling, E. H. | Peto, Brig. C. H. M | Touche, G. C. |
| Kerr, Sir J. Graham | Prescott, Stanley | Walker-Smith, D. |
| Legge-Bourke, Maj. E. A H | Ramsay, Maj. S | Ward, Hon G. R. |
| Lindsay, M. (Solihull) | Renton, D. | Wheatley, Colonel M. J. |
| Lucas, Major Sir J. | Robertson, Sir D. (Streatham) | |
| Lucas-Tooth, Sir H | Robinson, Wing-Comdr. Roland | TELLERS FOR THE NOES:
|
| Mr. Drewe and Mr. Studholme |
Orders Of The Day
National Health Service (Scotland) Bill
Order for Consideration, as amended (in the Standing Committee), read.
3.40 p.m.
I beg to move,
This recommittal Motion is necessary because the Amendments referred to in it involve, or may involve, an additional charge either on the Exchequer or on certain local ratepayers."That the Bill be recommitted to a Committee of the whole House in respect of the Amendments in Clause 5, page 4, line 5; Clause 22, page 22, line 4; Clause 22, page 22, line 14; Clause 29, page 24, line 7; Clause 64. page 52, line 25; Clause 79, page 59, line 40; of the New Clauses [Power of local health authorities regarding research] and [Power of local health authority to contribute to expenditure on co-ordination of services]; and of the Amendments in Schedule 11, page 78, line 16; Schedule 11, page 80, line 31, and Schedule 11, page 83, line 3, standing on the Notice Paper in the name of Mr. Secretary Westwood."
On a point of Order. Is not this procedure somewhat unusual? We are being asked to recommit these various Clauses, and to make what are perhaps fundamental changes in the Bill as at present printed, and then to give the Bill its Third Reading. Is this in accordance with the normal procedure?
It is quite a normal procedure, particularly as the Amendments involve possible financial charges, otherwise they would have been out of Order. It is perhaps unfortunate that they were not thought of before, but that is the position. Without recommitting the Bill, we cannot make these Amendments.
Is it not unusual that new Amendments, involving charges, should be taken on the same day as that on which we are being asked to complete our consideration of the Bill and give our decision upon its Third Reading? After all, the Bill has not been brought in at very short notice, and we can only conclude that these omissions are the result of inadequate discussions on the part of the Government with the Parliamentary draftsmen.
Question put, and agreed to.
Bill immediately considered in Committee.
[Mr. HUBERT BEAUMONT in the Chair]
Clause 5—(Accommodation For Private Patients)
3.45 P.m.
I beg to move, in page 4, line 5, after "cost," to insert:
During the Committee stage, the right hon. and learned Gentleman the Member for Hill head (Mr. J. S. C. Reid) suggested that the wording of Clause 5, which was to the effect that the whole cost of accommodation set aside for fee-paying patients should be covered by the charges to be made to those patients, made it impossible for any endowments which might exist, or might be given in future for the benefit of such patients, to be set off against the total cost in calculating the charges to be made. I do not imagine any existing endowments are likely to be made available for the benefit of this class of persons, but I appreciate that future endowments might be made for this purpose. As a result of close examination of the Clause, I am convinced that there is a real doubt whether endowments can be applied in future in this way. The Amendment removes that doubt, and makes it clear, as I have always intended, that the charges to be paid by the patients are to cover the cost falling to he made out of public funds."so far as falling to be defrayed out of moneys provided by Parliament."
This was a good point which was made by my right hon. and learned Friend the Member for Hillhead (Mr. J. S. C. Reid), and the Secretary of State for Scotland has gone as far as possible to meet it.
Amendment agreed to.
Clause, as amended, ordered to stand part of the Bill.
Clause 22—(Care Of Mothers And Young Children)
I beg to move, in page 22, line 4, to leave out Subsection (2), and to insert:
"(2) Where the aforesaid arrangements provide for the supply of anything that may be prescribed, not being a drug, a medicine, or an appliance of a type normally supplied, the local health authority may recover from any person so supplied such charge as the authority may determine having regard to the cost of supply;
This Amendment has been put down in the light of criticisms which were expressed during the Committee stage. This new Subsection differs in two respects from the existing Subsection. Firstly, it will not now be possible for a local authority to recover a charge in respect of anything which has not been prescribed by regulation made by the Secretary of State for Scotland, and subject to annulment by either Houses of Parliament. Even those regulations cannot prescribe, as something for which a charge can be made, any drug, any medicine, or any appliance above the normal standard. Secondly, it is now made clear that the procedure will be for the local health authority to fix a standard charge reflecting the costs involved. There will be no question of considering the special circumstances of any patient, unless the patient pleads inability to pay that stan- dard charge. As I have already explained, the kind of article for which charges may be authorised, include such things as layettes, cots and meals for children attending day nurseries. It is not the Government's intention to authorise charges for the supply of anything which is provided as an integral part of health treatment. The line is a difficult one to draw. In many cases the most effective contribution which could be made to the health of a family would be to provide them with a new house. Under the Clause in the form now proposed, the House of Commons will determine where the line is to be drawn. At the present time, certain articles are provided at special terms by the Ministry of Food for expectant mothers and young children. The most important of these is milk. As long as milk continues to be a rationed article, it is unlikely that local authorities can also supply milk. Other articles supplied by the Ministry of Food include orange juice and cod-liver oil. Neither milk nor orange juice are supplied free of charge, except in cases of financial need assessed on a means test basis, by the Assistance Board acting as agents for the Minister. When the supply difficulties disappear, it will be a matter for consideration to what extent commodities of this kind should be provided by the local authorities, rather than nationally.Provided that the authority may remit the said charge in whole or in part if in the circumstances of any particular case they consider it reasonable to do so."
The Committee spent a considerable amount of time on this problem, and I am not at all sure that the solution which has been found is very clear or very satisfactory. I am not clear to what extent the present wording differs from the wording to which the Committee took exception. The Secretary of State for Scotland said that milk would be exempted under:
That is to say local authorities may recover from any person the cost of milk. Am I right?"anything that may be prescribed, not being a drug, a medicine, or an appliance, etc."
Yes.
What about orange juice and cod liver oil?
I mentioned those.
The local authority can also recover from any person in the case of cod liver oil. Does the right hon. Gentleman think that that meets the views that were expressed hen we discussed this matter in Committee? As regards the necessity for providing appliances, that is certainly right, I think. The local authority may recover such charge as they may determine, having regard to the cost of the appliance. But there is nothing which discourages the mothers of young children so much from applying for such things as cod liver oil and orange juice as the extraordinarily long and complicated regulations. Particularly is this so in the case of priority milk. I think it right that we should consider whether these do not themselves act as a deterrent to the mothers of young children. The preoccupation of a young mother with young children does not leave her much time to go into these forms and the minutiae of the extremely meticulous procedure which is laid down by the Treasury. The right hon. Gentleman has a certain amount of latitude to reply on this, as we are still in Committee, and I cannot help feeling that we shall not be inclined to part with this provision as it stands at this stage. I do not believe that the right hon. Gentleman has hit on a solution which meets our wishes in this matter.
I have endeavoured to reach a reasonable solution. At the moment, responsibility for providing cod liver oil and milk is national, and we are dealing only with local authority responsibility. I pointed out, in submitting an Amendment to the Standing Committee stage, that as supply difficulties disappear, we shall have to consider to what extent the kind of commodities we are now discussing should be provided by the local authorities, rather than nationally. At present, the supply of these commodities is provided through the Assistance Board, and is based on the ability of the individual to pay in accordance with the charges which have been fixed. I do not know what will happen in the future, but I want to encourage the use of these commodities. I have tried to get a reasonable compromise, following the pledge I gave in Standing Committee, and it is for the Committee now, and, finally, the House to say whether I have been reasonable.
As one who raised this matter in Standing Committee, I would like to express my appre- ciation of what my right hon. Friend has done to meet us. The suggested Subsection is undoubtedly a great improvement on the original Subsection. I cannot help feeling, however, that it is not even yet altogether satisfactory. Am I correct in assuming that the local authority can still exempt milk and orange juice from charge?
The local authority is not empowered to provide those things.
Then the local authority must charge until such time as other instructions are issued.
Yes.
It would have been an improvement if the local authority had been allowed to make purchases of these commodities, and to distribute them through their health centres. We are grateful for what my right hon. Friend has done, but we want to see everything that is necessary for the health and well-being of the people who attend these centres, exempted from the means test.
Would it not solve the Minister's problem and, at the same time, give much wider cover to local authorities and the people concerned, if a comma were put in to the Bill after the word, "appliance"? The Subsection would then read:
That would seem to cover the question raised by my right hon. and gallant Friend the Member for the Scottish Universities (Lieut.-Colonel Elliot), and the hon Member for North Edinburgh (Mr. Willis). Suppose an iron lung was required—they are now being used in connection with certain types of disease—and had to be brought from a distance. Would it have to be paid for by the person who needed it? Surely it would be free.… not being a drug, a medicine or an appliance, of a type normally supplied. …"
That is not an appliance supplied by a local authority, and is not covered here at all. What are covered here are purely personal appliances.
Then why put it into the Bill? Why introduce the words, "local health authority"?
An iron lung is not an appliance within the meaning of this Subsection. It is not something which is provided for everyday use. It comes within the general hospital service.
Under the definition Clause, which we went through very carefully in Standing Committee, I cannot see how the word "appliance" can be said not to include an iron lung. Surely something should be laid down to show definitely what is the obligation of the Government or the Secretary of State, and what is the obligation of the patient and the local authority. I would like an answer on that point.
4 p.m.
the Minister will remember the strong feeling there was when this matter was discussed in Standing Committee. The right hon. Gentleman, with his usual consideration for the views of the Committee, has tried to meet us, but he has still failed to fulfil the demands which we made. When we were discussing this matter, the view was expressed that many things might be provided, towards the cost of which people could be expected to make a contribution, but we all felt that it would be very bad if there was any limitation on the supply of orange juice, milk or cod liver oil. I think that it would be better if the Amendment read:
It is obvious that if families felt that they were in a position to make a contribution for anything extra supplied, they would do so. But in any case where there is the slightest difficulty, then on the application of the parents, guardians, or doctors, or whoever it may be, the local authority, without any charge, or any threat of a charge, should supply priority milk, orange juice, etc., which is required and which is outside the particular drugs, medicines or appliances specified. The Minister should apply his mind to finding the surest and safest way of supplying needy patients, and also children—especially children—with what they require to build them up, rather than to finding how he can get re- payment to the local authorities. If he did so he would get a better solution."Where the aforesaid arrangements provide for the supply of anything that may be prescribed, not being a drug, a medicine, or an appliance of a type normally supplied, the local authority may, on application, supply these particular things free of cost to the person concerned."
I am surprised at the Amendment which the Secretary of State has put forward. While it may be the best which he can get from his colleagues, it is very far from being what we should like. I was astonished to hear that anyone who wanted to escape payment for things that may be prescribed by a doctor would have to go to the Assistance Board. Is that correct?
indicated dissent.
I thought the right hon. Gentleman said that the Assistance Board was to carry it out. What will be the position in Glasgow, where people for many years have had doctors prescribing cod liver oil, orange juice, or milk, which has been given free? We are now heralding with great trumpetings this new Health Bill which asks them now to pay for what they formerly got free. To ask for payment for orange juice is an amazing thing, especially when the ordinary practitioner can prescribe vitamin C tablets, which cost a little more, without payment. I think that since this matter left the Scottish Grand Committee, those who have been considering it have taken a more conservative attitude than was shown previously and do not want to concede all that we desire. On the question of appliances, I should have thought that no Health Bill was worth while which did not give an appliance such as a truss in a case of rupture, free of cost. Apparently, the local authorities will give one anything if one pays for it; but what I am concerned about is what people will get for their ordinary contributions.
Surely appliances which are normally supplied would cover a truss?
No, it will not cover a truss. The doctor may prescribe a truss, but if it costs a certain amount, the patient will have to pay according to his income. Then, with regard to an invalid chair, supposing an ordinary contributor to the scheme develops an illness, and an invalid chair becomes necessary and is prescribed by the doctor. Will this scheme cover the provision of such a chair without the patient having to pay for it? The main things, however, about which I am concerned, are the three items which have been mentioned, and I think that if a doctor prescribes them as being necessary for the health of the patient, the patient should not have to pay for them.
The Secretary of State must realise that hon. Members are not quite clear about what is meant by the Amendment, and that some further definition is required. We understand what is wanted, but the focal authority may not know what is intended. I think that
is a phrase which is comprehensible to us, and that the Minister is trying to say that where appliances of a rather unusual character are supplied, the patient should be required to make some contribution towards the cost. What are these special types of appliances which are not, in the words of the Bill, "normally supplied"? If I were the representative of a local authority listening to this Debate, I should not know the answer. Surely, the Secretary of State can give us a list of the things which he has in mind. I do not think that the question of a truss comes into this matter. We are dealing here with children and nursing mothers. But there may be other appliances which the county councils would like to have on their lists, and it should be stated definitely that if patients are supplied with certain things, they will be charged for them. I do not think that it is unreasonable to ask the Secretary of State to assist us in this matter."drugs, medicines and appliances as normally supplied"
I do not think that any further definition is required. The amended Subsection is a great improvement on the old Subsection, and it is perfectly clear. Under the old Subsection, a charge could be made
In this Amendment it is made clear that a charge would only be made for articles excluding those not being of a type normally supplied."in respect of any articles provided."
May I congratulate the hon. and learned Member for North Aberdeen (Mr. Hector Hughes) on finding something on which he can support the Minister? I cannot take the optimistic view which the hon. and learned Member takes about these words. I was surprised at the way in which the Secretary of State, on this occasion, seeks to cast his responsibilities on to the local authorities. The Secretary of State, having recommitted this Bill, is asking us to agree to a new Subsection in lieu of the old Subsection, which specifically named the Secretary of State. He is now moving a Subsection in which the name of the Secretary of State does not appear. I join with the hon. Member for West Fife (Mr. Gallacher), and other hon. Members, in asking the right hon. Gentleman or the Joint Under-Secretary to give us some idea of what they have in mind. What are the medicines or appliances which the local authorities can decide to give free to patients—many of whom may not be in very flourishing circumstances?
In addition to cod liver oil and orange juice, I would mention tomato juice. We all know that tomato juice is being recognised more and more by the medical profession as beneficial for people who are in normal health. How much more is the juice of this excellent fruit needed for persons who are not in good health, for young children and nursing mothers. With regard to appliances, I think that the right hon. Gentleman should give us some enlightenment on what he has in mind. I am glad that we have had an illustration on the question of a truss. I speak with some knowledge of the rural areas, and I know that in the old days agricultural labourers often suffered from very bad ruptures. In those days they were fitted out with iron trusses. I suppose that is the kind of truss which the Secretary of State had in mind when he drafted this new Subsection, which says:an appliance of a type normally supplied."
This Clause deals with mothers and young children.
Perhaps the hon. Gentleman is not aware that there are many young children who suffer from rupture almost from birth. Is it the Minister's intention that only the most crude kind of truss shall be made available without charge, or will more up to date appliances—I have never had to wear one myself—be among the things which local authorities can provide? The Committee is entitled to more explanation than we have had so far, and I hope that the right hon. Gentleman, if he is unable to do anything to clear up our doubts today, will be able to give us satisfaction, by way of greater clarification, in another place.
4.15 p.m.
I am rather amused at the suggestion by the hon. Member for Galloway (Mr. McKie) that I as Secretary of State for Scotland am seeking to place my responsibility on the shoulders of the local authorities. If the hon. Member will read the Bill—
I have read it.
I am perfectly sure the hon. Member has not, because Part III of the Bill, which includes Clause 22, is the part dealing with services provided by local health authorities. It was never suggested that this was to be a service provided by the Secretary of State. This is a responsibility of the local authorities; we are imposing upon them a duty to do certain things, and I have given full consideration to what I thought were the views of the Committee. For instance, invalid chairs have been mentioned. The answer on that is that it would be the local authority's duty to provide an invalid chair, but it would equally be its duty to see that a person able to do so should pay for such a chair. On the other hand, the Amendment makes it perfectly clear that where there is any inability to pay on the part of the patient, he can get these things free.
Will the Secretary of State tell us who determines the need of the patient?
The local authority. Surely we can place a certain amount of responsibility on the local authority? Here are new duties which are being imposed upon them; I have had consultations with them on this as on other subjects, and the local authorities will not agree to provide free all those things which are not part and parcel of a health service.
Will there be a uniform standard of need?
It will be for each local authority to determine. There will be never uniformity of standards so far as local authorities are concerned, but we shall gain experience as a result of the administration and if we find that local authorities are not playing the game, it will not be impossible to get the necessary power to take reactionary authorities by the scruff of the neck and make them do what progressive authorities are doing. I have endeavoured to meet what I thought were the reasonable claims made when we were discussing this in Committee. Reverting again to the point about the invalid chair, if a person is able to pay for it, he will have to pay, if the local authority so determines. The point raised by the hon. Member for West Fife (Mr. Gallacher) is however met; if it is a case of a needy patient, it will be the duty of the authority to provide the invalid chair without charge. I am all out for seeing that those who require these things shall have them, but neither I nor the Government will be party to compelling local authorities to provide everything free under this Clause, irrespective of the real need of the patients themselves. I have done everything possible to meet the claims put before me in Committee, and I hope the Amendment will now be agreed to.
I would like to make certain that I understand what is provided. We are first dealing with the care of mothers and young children, and I think I followed the right hon. Gentleman correctly; he said that anything normally supplied, would be supplied without charge but, where the cost was excessive, a charge would be made fo it, although that charge might be remitted in whole or in part.
In fairness to the hon. and gallant Gentleman and to my hon. Friends behind me, I ought to make it perfectly clear that here we are dealing with children and expectant mothers, so that the invalid chair does not come into it much. The chief item here is what we call in Glasgow "maternity bundles"—I do not know what they are called elsewhere, but they include the things that are absolutely necessary to the expectant mother. Those things will be free to every woman without any means test at all, as a result of this Amendment. Before, there had to be a test. In regard to drugs, it is intended to give all the necessary drugs free, but there are certain things referred to by the right hon. and gallant Member for the Scottish Universities (Lieut.-Colonel Elliot), such as cod liver oil, for which a small charge is made. This Bill does not propose to make any alteration in those charges, but if in future this or any other Government decides to make them entirely free, it will be for the Secretary of State in future regulations to bring them into line with the rest. That is what the Clause does; it brings a range of articles for the expectant mother outside any test, and gives them free to all.
The hon. Gentleman said that the invalid chair would not come into this part of the discussion, and that it was not important because we are dealing here with children and expectant mothers. But the invalid chair does come into it, because unfortunately one of the after-effects of a birth may be paralysis, and the only type of apparatus—
In order to save time, may I tell the hon. Gentleman—
We cannot have two hon. Members on their feet at the same time. The hon. Member rose to put a question, but he seems to be making another speech.
I am sorry if my question sounded like a speech, and I will try to put it briefly. In cases such as I have mentioned the invalid chair is a piece of apparatus normally supplied; where does it come in here?
The answer is quite simple. Any trouble or illness arising as a result of childbirth which is not covered by this Clause, will come under the general health service. Here we are dealing with the expectant mother, and not with any illness which may or may not appear after the birth of the child.
I am sure the Committee is grateful to the Joint Under-Secretary for his lucid explanation. He has fully confirmed the view I was expressing, but I would like to go a stage further, and find out what happens in other cases. Young children and expectant mothers require such things as have been mentioned by my right hon. and gallant Friend the Member for the Scottish Universities (Lieut.-Colonel Elliot)—milk, cod-liver oil, orange juice, and things of that nature. These I understand are supplied not by the local authorities but by the Ministry of Food, and the local authorities cannot therefore remit any charge made for them. Whether or not it is possible for the Ministry of Food to do so I do not know, and I would like to have an answer on that. Where these things are necessary for children or for their mothers, they should be available free to those who have not the means to pay for them, and perhaps some arrangement could be made whereby some small bulk supply could be made available to the local authority to enable them to meet urgent needs. The local authority knows the circumstances far better than the Ministry, and might be allowed to remit the charge in proper cases.
I should be willing to consider that suggestion, which might possibly be covered in the regulations. I would like the Committee to note that nothing can be charged for at all under the proposals we are now discussing until it is covered and prescribed in regulations to be made by the Secretary of State, and subject to annulment by either House of Parliament. This was to safeguard the position and make sure that certain things which did not come within the regulations would automatically be free.
That does not apply to food.
I was saying that I was willing to consider these suggestions, and see if we could cover it. I am determined that those who really need these things and who are in any financial need shall have them provided. I presume that is also the desire of hon. Members on both sides of the Committee. I will take the points made into consideration when we are dealing with the regulations, and having given these explanations I trust the Committee can now come to a decision.
Amendment agreed to.
I beg to move, in page 22, line 14, to leave out Subsection (4).
This Amendment should be read in connection with two later Amendments dealing with the Schedule, to which I shall not refer at the moment as they come on later. This Amendment deletes from the Bill the provision which sought to make the local health authority the local authority for the purposes of Part I of the Children and Young Persons (Scotland) Act, 1937. The effect of that provision would have been to require the local authority to refer to their health committee those functions which relate to the supervision of foster children boarded out privately for reward. Since the Bill was drafted, however, the Clyde Report on the care of homeless children has been received, and consideration is being given to it. In connection with that report, legislation was promised by the Prime Minister, and I think it is preferable to take this point out and deal with it in the legislation on the subject of foster children in accordance with the recommendations made by the Clyde Committee.The Secretary of State, taking the Report of the Clyde Committee into consideration, is thinking of handling the care of young children rather under the Home Department than under the Health Department. It is of course a very interesting development that is foreshadowed there, and one in which hon. Members in various parts of the Committee feel a great deal of interest. When does the right hon. Gentleman think he will be able to introduce legislation of the type he has in mind? Would there be a joint Bill, or a separate Bill for Scotland?
4.30 p.m.
We should have to consider that. I do not know whether it could be done in a United Kingdom Bill, but it it were possible, I would like to have a separate Bill for Scotland. The right hand and gallant Gentleman knows that sometimes, in order to save the time of the House, there is a United Kingdom Bill in which the interests of Scotland are not sacrificed. Sometimes it is advisable to follow that course. I do not make a pledge that there would be a separate Bill, but I hope to deal with the whole problem in the new legislation which was suggested by the Prime Minister in answer to a Question in the House recently.
I would not insist upon separate provisions for Scotland in this instance, because I know there is pressure on the Government's programme at the present time, but I think this is the first time we have had a pronouncement from the Secretary of State on the attitude he intends to take toward the Clyde Report and the means he intends to use to implement it. I am sure the Committee and the local authorities in Scotland will be very interested to hear this. Could the right hon. Gentleman give a further undertaking to issue some memorandum or White Paper on the subject fairly soon, because the local authorities would wish to have an opportunity to consider it? In Scotland, so far as the boarding out of children is concerned, we consider ourselves more progressive than England, although there have been cases in Dundee and elsewhere of great brutality towards young people, which would make it necessary to have some sort of safeguarding provisions such as the Clyde Committee had in mind. If the right hon. Gentleman could give an undertaking that there will be some sort of memorandum which the local authorities can consider, we will not detain the Committee longer on this Amendment.
I can give the right hon. and gallant Gentleman an assurance that I will have the fullest consultation with the local authorities. Thereafter, if it should be necessary to issue something by way of a public statement, I should be only too willing to do so. I am trying to carry the local authorities with me in this great problem, a problem which, I think, we shall be able more easily to solve as a result of the good work that was done by the Clyde Committee.
I hope there will be some public statement, since the matter is one that has created widespread interest and on which many Questions have been put in the House. I am sure the opinions of outside persons, as well as the opinions of local authorities, would be valuable. I do not press the right hon. Gentleman further now, but I ask that there should he some sort of statement which people can begin to consider now.
Amendment agreed to.
Clause, as amended, ordered to stand part of the Bill.
Clause 29—(Appointed Day For The Purposes Of Part Iii)
I beg to move, in page 24, line 6, to leave out "sections twenty and twenty-one," and to insert:
The purpose of this Amendment is to bring into operation immediately on the passing of the Measure, without waiting for the appointed day, the new Clause which I shall be moving later on authorising local health authorities to contribute to expenditure incurred by a body set up locally to advise on the co-ordination of the health services in the area. It is desirable that arrangements for ensuring coordination should be able to operate in the planning stage before the services come into operation on the appointed day, as well as after the appointed day when the services are running."section twenty, section twenty-one and section (Power of local health authority to contribute to expenditure on co-ordination of services)."
Would it not be convenient to the Committee if we were to discuss, together with this Amendment, the new Clause? As the right hon. Gentleman knows, I am very much interested in this particular matter, but it is conceivable that other Members may not be so fully conversant with the matter, and perhaps, therefore, we ought to consider the whole subject, of which this Amendment is part.
I think it would be better to have a full discussion on the new Clause. This Amendment is to make possible the moving of the new Clause.
Amendment agreed to.
Clause, as amended, ordered to stand part of the Bill.
Clause 64—(Superannuation Of Officers)
I beg to move, in page 52, line 25, at the end, to insert:
"(2) If the Secretary of State and the appropriate Minister are satisfied that any Act for the time being in force in England and Wales or in Northern Ireland makes provision with respect to the superannuation of persons employed in health services in England and Wales or in Northern Ireland which is substantially similar to the provision made under this Section, they may make regulations with respect to the rights and liabilities of any person who leaves employment in England and Wales or Northern Ireland entitling him to participate in superannuation benefits (whether provided under the said Act or otherwise) and enters into employment in respect of which superannuation benefits are provided under regulations made under Subsection (1) of this Section or into the employment of a local health authority in respect of which superannuation benefits are provided under the Local Government Superannuation (Scotland) Act, 1937, as extended or modified by the regulations or under a local Act scheme as so extended or modified, and vice versa, and with respect to the rights and liabilities of the Secretary of State, the appropriate Minister and other authorities concerned.
The Subsection which this Amendment proposes to insert authorises the making of reciprocal arrangements between Scotland and England and Wales, or Northern Ireland, to safeguard the superannuation rights of persons who are transferred to employment in health services in Scotland, or transferred from health services there.In this Subsection the expression the appropriate Minister' means, as respects England and Wales, the Minister of Health, and as respects Northern Ireland, the Minister of Health and Local Government for Northern Ireland."
This is a very interesting development. This olive branch held out to Ulster will be welcomed in all parts of the Committee, and not least in the bosom of my hon. and gallant Friend the Member for Ayr Burghs (Sir T. Moore). There have been arguments of the most vehement kind addressed to the House about the inadvisability of including Northern Ireland in our programme of legislation. I am glad to see that those arguments do not meet with any response in the bosom of the Lord Advocate. I understand this Amendment has to be read together with a later Amendment which makes the Bill no longer applicable only to Scotland, so that we are here legislating for the United Kingdom. This savours, I think, a little of sharp practice, because if this provision had been in the original Bill, the Bill could not have gone to the Scottish Grand Committee. Consequently, the matter was carefully left out of the original drafting of the Bill, and has been introduced at this stage. However, a friendly attitude towards Northern Ireland, bringing it into the comity of the nations, is greatly to be welcomed. I should like to ask whether this power exists in regard to other Services. Is this a new departure, or why has it been specially introduced in this case? Is there any chance of reciprocal services, health services and others, being extended further, not merely to various parts of the United Kingdom, but to other parts of the Empire? That matter is very much in people's minds just now. I should be glad if the right hon. Gentleman could tell us what are the provisions with regard to other Acts, and whether this is sui generis or common form.
I am not sure about the application of this provision in other Acts, but I think it applies in connection with the Education Act. It was also contained in the English National Health Service Act, and I informed the House, on Second Reading, that I could not bring in a superannuation Clause because it would have prevented the Bill from going to the Scottish Grand Committee. I entirely agree with the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) that this provision is in the right direction, since it allows for the transfer between England and Scotland and Scotland and England, and Ulster, of all those who are engaged in public health services.
As the Secretary of State said, the matter could not be referred to on Second Reading, and we have not had an opportunity of discussing it. I do not think it is going too far to ask the Government, on the Committee stage, to tell us what are the analogies. Surely, that is a reasonable request to make, considering that the Secretary of State has had this matter in mind ever since the Second Reading of the Bill.
I have said that the English Bill makes the same provision as the Scottish Bill. That was a sufficient argument for doing what I have done.
The right hon. Gentleman mentioned the Education Act. Does it, or not, apply in that case? I am indebted to the right hon. Gentleman for sending to his officials to make inquiry, and I hope we may have the benefit of hearing the answer.
I will give the answer. I have already indicated that it applies as far as education is concerned. It also applies in the case of the police and the Local Government Act.
Amendment agreed to.
Motion made, and Question proposed, "That the Clause, as amended, stand part of the Bill."
I welcome the reciprocal arrangements contained in this Clause with regard to England and Wales, and also concerning persons coming across the Channel from Northern Ireland. I particularly welcome the arrangement with regard to Northern Ireland, since Northern Ireland contains the nearest constituencies to some parts of my constituency. I do not grudge them anything that will make their position more satisfactory. When the Measure was before the Scottish Grand Committee, two points were put to the Secretary of State and the Joint Under-Secretary of State with regard to classes of persons who, as I understand, are not provided for under the Clause as originally drafted, or as it has been amended on recommittal. First, there are those officials or servants of voluntary institutions or hospitals which had no proper superannuation fund. A kind of fund existed, but it was not on a really actuarial basis. There was a moral responsibility of voluntary institutions to make proper provision.
May I interrupt the hon. Gentleman to say that in the Standing Committee I answered that point very fully, as I think the hon. and gallant Member for Pollok (Commander Gallbraith) will agree. The right hon. and learned Gentleman the Member for Hillhead (Mr. J. S. C. Reid) applied his mind to this subject, and in answer to him—and he said he was quite satisfied—I said that we took over all the normal superannuation, but in the case of hospitals which might be taken over where there was no financial responsibility, but only a moral responsibility, we proposed to take over those persons also. Wherever there is anything like a moral responsibility—never mind a financial responsibility—we propose to take over these people and safeguard their rights in this respect.
4.45 P.m.
I thank the hon. Gentleman for his remarks, but he must not think I have not refreshed my memory, for I have taken the opportunity this afternoon to look up what was said on this point in the Standing Committee.
There was another point of even greater substance which was also raised in Standing Committee, and on which we did not receive the same adequate assurance as the Joint Under-Secretary of State was good enough to give upstairs and which he has repeated this afternoon. That has largely cleared my mind in regard to the moral responsibility resting on those institutions to make proper provision as far as they can for superannuation allowances, to former employees being carried on by the right hon. Gentleman and others who are concerned in the operation of this vas: comprehensive Measure. Considerable dissatisfaction has been expressed in Scotland with regard to part-time workers, especially those employed by the insurance committees. In sorrow, not in anger, I record the fact that the right hon. Gentleman did not see fit, when he was drafting this long Amendment, to go a little further and introduce a new Subsection which would have given effect to the widespread desire expressed during the Committee stage, and would have relieved the anxiety of many deserving people in Scotland—as I say—part-time workers, particularly those employed by insurance committees. They are people who in the next five years, while this Measure is being brought into full operation, will have to work increasingly long hours. No provision whatever has been made, apart from the acceptance of a kind of moral responsibility. I suppose I shall be assured that there is such a responsibility. But nothing tangible has been done, or is being done, in this Clause, to give legal effect to the protection which these people should have. We believe that the great and gallant work which they have done for many years richly entitles them to such provision.The effect of this Clause is to make the conditions of those engaged in the health service in Scotland, England, Wales and Northern Ireland identical. The tendency, regrettable though it may be, will be to encourage a further drift to the South. One of the main problems in Scotland for many centuries has been the loss of some of our ablest and best people in that way. What is here being done may be in the interests of the United Kingdom, but viewed more narrowly, in the interests of Scotland, it will encourage a further leakage of population. The tendency already exists to make England and Wales more attractive. By this Clause, which is, presumably, intended to help the National Health Service in Scotland, we shall encourage a loss of population from Scotland. There is already a manpower shortage, which will be increased. This will make easier this one-way traffic, which so many people in Scotland think is deplorable. That problem is raised in an acute form by this Clause.
I am all for the unification of conditions generally in this island so far as they can be unified. But there are disadvantages from which Scotland suffers, and which will be enhanced by such legislation as this. I do not take the narrow Scottish nationalist view, but here we are engaged in training people in the best health service in the world, in that hard atmosphere which is native to Scotland, and we are making it easier for them to leave Scotland than for them to settle there. If that is the intention of the Secretary of State, this Clause facilitates it. If it is his intention to secure, for Scotland, the best and ablest men, and attract them to Scotland, this Clause will not produce the desired result. This Clause says, in effect, "It is better to get out of Scotland; conditions are better in England." The Joint Under-Secretary of State shakes his head. If I am mistaken, I shall be glad to be corrected. If I understand the implications of the Clause, unquestionably the effect will be to tend to decrease the number of persons willing to remain in the service in Scotland.Does what the hon. Member has said mean that he does not believe in the transference of superannuation rights from Scotland?
I believe in a general wide interchange, but I am opposed to having Scotland placed at a disadvantage by such an interchange. That would happen if exactly the same superannuation rights were given for the pleasure of living in, say, the pleasant locality of the hon. Member's constituency, instead of the rather bleaker parts of Scotland. Though the money figures are the same, in practice, the tendencies and advantages would be detrimental to Scottish interests. That is why I do riot oppose but question the implications of this Clause.
The Joint Under-Secretary of State gave a definite undertaking in Standing Committee regarding the employees of insurance committees. That assurance was subsequently confirmed in writing, to my self at least, by the Secretary of State for Scotland. It was to the effect that these part-time employees would be absorbed, as conditions made it possible, and that their surperannuation, such as it was, would be no worse under this Measure than it is under their present circumstances. In case there should be any dubiety amongst members who were not present in the Committee, I feel it only right to make that clear. At the same time I, like my hon. Friend the Member for Galloway (Mr. McKie), think that the assurance might have been inserted in this new Subsection. The assurance has already given great comfort to the employees of the insurance committees, and it would have removed any sense of fear or doubt if the necessary words had been included in the Amendment.
We have gone a considerable distance towards meeting the hon. and gallant Member's point, and, in practice, what we propose may possibly work cut better than a rigid line laid down in the Bill, that is, if it is left to the interpretation of the Secretary of State for Scotland. The hon. Member for South Edinburgh (Sir W. Darling) thinks that what we are proposing is unfair to Scotland. What would happen, if we did not make this provision? There might be a most capable Scotsman in the English, Welsh or Northern Ireland service, who might want to return and serve his country. Obviously, unless he could have his superannuation rights guaranteed, he would not return. This provision is far from being of disadvantage to Scotland. Not long ago I had an experience of the value of such a provision, in connection with work for which we wanted a man who had served the Ministry of Works well. He was a Scotsman. One of the things he wanted to safeguard was his superannuation rights if he returned to Scotland. That is sensible and proper, and that is all we are doing. We think that this provision is in the interests of the Scottish service.
Question put, and agreed to.
Clause, as amended, ordered to stand part of the Bill.
Clause 79—(Short Title And Extent)
I beg to move, in page 59, line 40, after "Act," to insert:
The Subsection to which this Amendment refers is that which has just been inserted in the Bill by the last Amendment. This Amendment is consequential."except subsection (2) of section sixty-four".
Amendment agreed to.
Clause, as amended, ordered to stand part of the Bill.
New Clause—(Powers Of Local Health Authorities Regarding Research)
Without prejudice to any other powers of a local health authority, such an authority may, with the approval of the Secretary of State, make such provision for conducting, or assisting the conduct of, research as appears
to the authority desirable for purposes relating to their functions.—[ Mr. Westwood.]
Brought up, and read the First time.
I beg to move, "That the Clause be read a Second time."
In a discussion with representatives of local authorities in Scotland, I was asked to include in the Bill a provision which would enable authorities to carry out research connected with their own health service functions. The kind of research which they had in view would include, for example, inquiries into the value of various forms of care or after-care services that might be provided by the local health authority under Clause 27 of the Bill; studies in the effectiveness of various forms of care given at child welfare centres, and, especially, inquiries into the effects of environment on health. I considered it reasonable that local health authorities should have this power, and I promised them that I would endeavour to introduce, and secure the agreement of the House to, a new Clause to that effect. The Clause I am now moving makes the necessary provision. The Clause resembles the corresponding power which is conferred upon education authorities by Section 78 of the Education (Scotland) Act, 1945, which is now, under the consolidated Act, Section 27 of the Education (Scotland) Act, 1946. It will be necessary for the local authorities to get the approval of the Secretary of State to make provision under this Clause. The reason for this is because the expenditure involved will rank for grant under Clause 51 of the Bill, and the Bill makes it possible for me to co-ordinate the activities of different authorities, and to secure that a particular piece of research is not unnecessarily duplicated. For those reasons, I trust that the Committee will agree to the new Clause.Clause 17 of the Bill makes it possible for the Secretary of State to
"conduct, or assist by grants or otherwise any per son to conduct, research into any matters …" etc., relating to causation, diagnosis, and treatment. Subsection (2) says: "A Regional Hospital Board and a Board of Management shall have power to conduct …" etc. I should have thought that those powers covered local authorities also. Would they not?
The local authorities did not think so. That is why I acceded to their wishes. I thought it was a reasonable request that they made. That is my reason for asking the Committee to accept the new Clause. Having the power to bring about co-ordination, I shall be in a position to avoid overlapping.
I am still not convinced that these wide powers, in Clause 17, do not in fact cover the matter. The Clause says that the Regional Hospital Board and the Board of Management
I see a certain danger of overlapping in this matter. The Secretary of State was careful to give us a somewhat detailed series of examples of the things he had in view, by which, I take it, he means technical inquiries of a nature to facilitate the carrying out of the duties of the authorities, to assist"shall have power to conduct or assist by grants or otherwise any person to conduct research. …
that is, limited to their functions. I feel that there is a certain amount of danger of local authorities beginning to think that, to be carrying out research has a certain amount of "snob" value, and that if they are not doing it, they are not really progressive local authorities. That would be very wrong. The real danger is that of a large number of authorities competing for the very limited number of persons who can carry out these researches. That may diminish the amount of valuable work done. The Secretary of State is taking this power upon himself, because he has the duty of assisting by grant any such activity carried out by the local authority."the conduct of research as appear to the authority desirable for purposes relating to their functions"
5.0 P.m.
There seems to be a slight misunderstanding. I am not taking these duties upon myself. They are duties, or work, to be carried through by the local authorities.
The Secretary of State is taking the duties of co-ordination upon himself. He will have a very big job and he is extending it with every Amendment that he makes. I hope that he will take a serious view of his responsibilities under this Clause. The real danger is not that we may have more work done as a result of it, but that, by reason of the number of people competing, actually we may have less work done. As the Secretary of State has said, power has been granted to the local authorities under their education duties and it would be difficult to refuse them their powers in connection with this save that, of course, their main powers in connection with health services are being taken away from them by this Bill. They have clawed back this small piece from the Secretary of State though in fact it is only a small fraction of the main powers of supervising and tending the sick which they have already taken away. I think it is an inadequate exchange.
I should have said myself that this was one of the very few cases in which I should have been justified in agreeing that the Secretary of State having powers. Under this Bill I think that he has far too many powers to interfere, to approve and to amend. But here I think it right that the Secretary of State should exercise an overall authority in connection with research. I think however that the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) is absolutely right. He knows much more about this than most hon. Members. From the local authority point of view in Scotland in regard to this business of research, town councils and county councils have a sort of bee in their bonnets. I am a local authority man. I want local authorities to have all power but it is a dangerous thing for them to be able to sail blindly into any action in connection with research. It appears to me that a great deal of time might be wasted. I think that if the Secretary of State had put into Clause 17 in the fourth line, after the word "any" the words "local authority or" that would probably have done all that was necessary. The right hon. Gentleman realises our doubts; I do not know whether he feels disposed to satisfy us.
I think that this way is the right one. If I had thought that the other way was the best, I would have come to the Committee and made a proposal of that kind. I have already pointed out that this proposal is made as a result of discussions with the local authorities. This is their desire. In many instances, we should not get results unless the local authorities were prepared to carry out investigations in connection with aftercare, and, so on. I am sure that they will do useful work. It will be my duty to see that there is no overlapping. I think this will serve a useful purpose.
Research work generally is rather expensive. I wish to make certain who will pay for the research work done by local authorities. If it is to be paid for locally, are the authorities likely to receive any assistance from the central fund?
I have already pointed out that the reason why it was necessary for the Secretary of State to give approval for the actions taken under the Clause, was because the expenditure would rank for grant under Clause 51.
I support the hon. Member for East Fife (Mr. Henderson Stewart) in his suggestion that the Secretary of State might have rested on the powers he has under Clause 17. The introduction of this deliberate mention of local authorities in regard to carrying out research, will, in a sense, act as a stimulus to them. As the Secretary of State has consulted local authorities, it may be that he has some particular case in mind. If that is so, and if he would tell us what he has in mind, possibly it would make us all agreed on this point. Clause 17 gives him the fullest power to make grants to any person including the local authority. [HON. MEMBERS: "No."] Perhaps the Secretary of State would reply to the point and also to the other question which I have raised.
I have already pointed out the type of service which was in our minds when we discussed this matter with the local authorities. I have mentioned research, including various forms of care or after-care services that may be provided by the local authority, and the child welfare centres. These were two illustrations of the type of work in connection with which they would like to have power to carry out research in order to enable them still more effectively to carry out the duties which devolve upon them under the Bill.
I think that in recent years the word "research" has become like the word "Mesopotamia." It is almost impossible to say anything against research. Do not let the Committee be deceived. This research is concerned not only with child welfare. It is research in its widest sense. "Research" is not defined in the Bill. Any busybody who manages to impress a local authority can, possibly, induce the Secretary of State, as a result of clamour, to set up a wide far-reaching research of an uneconomic and wasteful character. Have we not already sufficient powers, as the right hon. Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) has pointed out, under Clause 17? I am quite willing that the Secretary of State should have these powers in order to grant permission to any person to conduct research. I am willing that the regional hospital board and the board of management shall have these powers. They seem amply to cover the potentialities of the most eager researcher anywhere.
I understand the policy of giving in to the local authorities. Some local authorities, suffering from some refusal by the Secretary of State, seek the insertion of this Clause. This means that an infinite variety of persons, that any one of the local authorities in Scotland, can, by clamour, induce the Secretary of State to give authority to set up research which might be inexpensive in the beginning, but eventually far-reaching in its cost. I am all for research, but to allow anyone without let or hindrance to set up research is unfortunate. In the days when Scottish medical services were vigorous and energetic, if people wanted to do research, they backed it with their own money. This research is no longer to be backed by the money of the man who believes in it. It is now to be backed by the ratepayers' money. That is a very different business. The Committee should not be prepared to entrust this responsibility to almost any local authority to whom the idea occurred that they should set up research of some kind. In all local authorities there are persons who have a good deal of leisure, and who contribute a great deal to public affairs. This Clause will give such persons the opportunity to find a hobbyhorse and ride it if not to their own death, then to the death of the ratepayer. I do not think the Secretary of State should press this Clause, especially in view of the fact that he has ample powers already.
I think the hon. Member for South Edinburgh (Sir W. Darling) is presuming far too much upon the alleged irresponsibility of local authorities and of the Secretary of State for Scotland upon whom rests the final power to authorise this research. I should like the Secretary of State to tell us whether the rejection of this Clause would mean that certain research, already being carried out by local authorities, might have to stop.
Yes.
I ask hon. Members to consider the work which is being done by local authorities. It includes care and after-care of mothers and young children, home nursing, and health visiting. A certain amount of research is necessary in connection with these matters. It is research that comes, not by any new specially created body, but in the actual course of the work that the authorities are doing in both towns and rural areas. It is vital that this sort of research should be done, and I welcome the Clause.
I have had letters from the various associations of local authorities but I cannot recall any item in them dealing with research. Perhaps the Secretary of State would tell us whether the request for this Clause came from any particular association?
It came as a result of discussion with representatives of local authorities. They were not discussions carried out in the ordinary way with those associations—
Individual authorities?
As a result of discussions. I am rather surprised by the line taken by the hon. Member for South Edinburgh (Sir W. Darling). I thought that he was just as keen on local authorities as I am. He seems not to have read this new Clause. It will be impossible for the local authorities, irrespective of what is said in Clause 17, to do anything they like. They must have the approval of the Secretary of State. I tried to point that out when I was moving the Clause. This safeguards the position in regard to the possibility of overlapping. I think that we have discussed the matter fully and that we are now justified in coming to a decision.
The hon. Member for Kilmarnock (Mr. W. Ross) asked a question to which I think a reply should be given, because it would be useful to all hon. Members. He asked what research, which is not covered already by Clause 17, would suffer if the right hon. Gentleman did not get this new Clause.
5.15 p.m.
That was not the question put by my hon. Friend the Member for Kilmarnock (Mr. W. Ross). His question was whether there was a possibility that research which is now being carried on by local authorities might be stopped. My answer was that it might. I still give the same answer. I cannot give details of what research is being carried out by certain local authorities; all I can say is that it might be stopped if we did not provide the power in this Clause. There is the additional fact that if they claim for research which is carried through, and the Secretary of State approves the claim, they will get grants, but I am not sure that they get any grant for any research at the present time.
There is one point I want to have quite definitely cleared up in view of what has been said in relation to Clause 17. No doubt the right hon. Gentleman did not put m that Clause without having made full inquiry as to what is covered legally by the word "person." Does that cover a local authority? I should have thought they were legal persons as much as a limited company, and I would like to know if that is correct.
My advice is that it was not covered, and therefore I had to bring in a new Clause to enable local authorities to carry through research with my approval, so as to avoid the possibility of overlapping in other spheres where research is being carried out. I was assured that Clause 17 did not cover what is now suggested in the new Clause I am asking the Committee to accept.
Question put, and agreed to.
Clause read a Second time, and added to the Bill.
New Clause—(Power Of Local Health Authority To Contribute To Expenditure On Co-Ordination Of Services)
A local health authority may contribute towards expenditure incurred by any body including representatives of the authority among its members and approved by the Secretary of State that may be set up to advise on the local co-ordination of any of the services referred to in Section two of this Act.—[ Mr. Westwood.]
Brought up, and read the First time.
I beg to move, "That the Clause be read a Second time."
One of the chief criticisms of the Government's health service was that it was organised in three divisions, and that we who were responsible for the proposals in the Bill might not secure a fully integrated service. The three divisions are the hospital and specialist services, which are administered by the regional hospital boards and the boards of management; the general practitioner services administered by the executive councils; and the local clinics services which are administered by the local health authorities. We are sometimes asked what guarantee there is that the arrangements made by these three different agencies will dovetail together so that there will be no overlapping or, what might have been even more difficult, no gaps in the facilities offered to patients. In the Bill as it stands, there are three important factors which will help to make sure that the service works as a whole and not three independent parts. In the first place, the Secretary of State is in a position to secure that the general lines on which the three divisions of the service are administered are in keeping with one another. This the Secretary of State can do through his power to control directly the work of the regional hospital boards and boards of management which act as the Secretary of State's agents. He has to approve the proposals submitted by local health authorities for the discharge of their duties, and he has to control by regulations the activities of the executive councils. In the second place, there is a considerable element of common membership, and there will be, among the various local authorities concerned. The local health authority will appoint a substantial portion of the members of the executive council provided for in the Bill, and it is consulted in the appointment of the regional hospital boards and the boards of management of the hospitals. In the third place, every patient will in future have a right to the services of a general practitioner, one of whose functions will be to see that the patient turns at the appropriate time to the particular part of the health service organisation which can cater for his current needs. In practice, day to day co-ordination will be secured by close contact between the personnel responsible for administering the three divisions of the service, and to facilitate close liaison the Secretary of. State—I have always had it in mind and I presume any other Secretary of State would be in the same position—will be in the position to encourage the establishment of non-statutory local committees in which representatives of all three divisions of the service would take part. These committees would not have any executive powers but they would meet regularly to discuss the whole field of health service for the area and thus ensure that each division of the service was-constantly in touch with the trends of development primarily affecting the other divisions and that any findings of such a committee would go forward as recommendations for consideration by the responsible executive bodies concerned, the regional hospital boards, the executive councils or the local health authorities as the case may be. I do not consider it desirable to add to the number of statutory bodies whose creation is required by the Bill when it becomes an Act but I accept the suggestion made to me in local authority quarters—it was particularly strongly represented by the county of Fife—that it would be an advantage to provide some statutory pointer to the desirability of establishing non-statutory committees by voluntary action. So far as the hospital organisations and executive councils are concerned, appropriate provisions can be made by regulations and in regulations. For local health authorities, however, any provision would have to be made in the Act itself. If I inserted a provision in connection with the power of local authorities to appoint representatives to such a committee, it might actually throw a doubt on the power of the local health authority to appoint a representative to other bodies. That is one of the difficulties we always face when we try to pass legislation in this House. We must not put something into an Act of Parliament that may lead to doubts about some other Acts. At the present time the local authorities have the power to send representatives to the committee of management of a nursing association providing services under Clause 25, and so on. Without specific statutory provision, a local health authority could not make any contribution towards expenditure incurred by a co-ordinating committee. I do not expect that such a committee would incur much. There might be such items as cost of accommodation for meetings and the circulation of documents which could most suitably be shared by the three executive authorities concerned. This new Clause authorises a contribution to expenditure of this kind. It is therefore proposed for insertion in the Bill as the most appropriate provision to give a lead to the establishment of these non-statutory co-ordinating advisory committees. It is necessary to stipulate that contributions towards the expenditure of such bodies should be made only where the body has been approved by the Secretary of State, for such expenditure will rank for grant under Clause 51. With this explanation, I trust the Committee will give me the new Clause.As the Secretary of State said, the initiative in this case came from Fife. A few of my friends in Fife—the hon. Member for West Fife (Mr. Gallacher) will agree with me—took the view that despite the safeguards the Secretary of State referred to earlier, there is likely to be, at any rate for some considerable time, a tendency for these three bodies to sail according to their own charts. They will want their own individual independence. The history of all bodies of that kind shows that at the beginning, and sometimes for long years afterwards, they tend to exaggerate their own position and are reluctant to cooperate with other people and to recognise that they are just one part of a much larger service. The view of my friends in Fife was that if they had somebody to co-ordinate the activities of these three bodies—not a statutory body but an advisory body—it would be a good thing, and most hon. Members would agree.
The only difficulty we have had with the right hon. Gentleman is over the framing of the actual Clause. The Fife County Council produced one or two alternative drafts which were put to the right hon. Gentleman but he has not thought fit to accept them. We think it strange in relation to a very simple thing—the right to set up an advisory committee—that we have to start off by saying:But if the right hon. Gentleman is advised by the draftsmen that this is the only way of doing it, I am afraid we must accept it. Personally, I do not mind what the form of words is so long as we secure the object, and if we can provide in Fife and other counties as small body of representative people to watch the activities of these three organisations so that they work together, everybody will be satisfied and great advantage will accrue."A local health authority may contribute towards expenditure …"
When the Secretary of State started I had high hopes that he would produce something which I could consider of real value to the Bill. The question of co-ordination throughout this health services scheme is one on which I spoke at several of our Committee meetings upstairs. I had high hopes that the Secretary of State would say that a real committee was being set up locally which would in fact be able to get on with the job. However, as he developed the explanation, it seemed to me that the strength that might have been there gradually faded away. We find a coordinating committee which has no executive power in any way. Something stronger is needed. The Committee needs certain powers in order to get things done. The type of committee which is proposed will not enable us to get much further on than we were before. The recommendation for this committee may have come from one county, but I can assure the Secretary of State that there is strong feeling in other counties that something stronger is needed locally to co-ordinate the three services.
There is implied in the Fourth, Fifth and Sixth Schedules a degree of coordination in the interchange of members of these particular bodies in their committees, but nowhere in the Bill is direction given for these bodies to work together as a team. So far as the Secretary of State has gone, it is a straw in the wind, showing the right direction, but I would like to see a good thick branch instead of a straw.
5.30 p.m.
The Secretary of State said that it was his intention to encourage the formation of these bodies. He went on to say that there was nothing to involve local authorities in expenditure at all, that is to say, that there are powers within the Bill which would enable such of the bodies concerned, to make the necessary contribution. He then gives local authorities power to contribute, and I think he has done that because of a recognition that the local authority has a vital and necessary part to play in this matter, and that it is ultimately the local authority's responsibility. Although it is not in the Bill as it now stands, I feel we shall come to a final recognition of the necessity for an executive local authority co-ordinating body.
There is one point I would ask the right hon. Gentleman to clear up. The local health authority does not need to contribute to any such body as may be formed; indeed, the safeguard so far as they are concerned is that unless the body is in accordance with their wishes, they will not contribute anything. That is a sound safeguard. I want to make quite certain however, that in no circumstances will they be directed to contribute to such a body that is set up and approved. I would have preferred it, if in accordance with one of the recommendations, the local authority initiated such a committee. It should have been the initiating, coordinating body; it should have been able to put up a scheme to the Secretary of State and, where that scheme of coordination was approved, it should have been authorised to contribute. That is the way it should have been done.May I deal with that point, if it will shorten the discussion? There is no compulsion upon the local authority to contribute because the Clause says "A local health authority may contribute." So it will be left to them to determine whether they will or will not contribute. I understand it has been fully discussed by the County Councils Association representatives, and they certainly were not prepared to take obstructive, negative or positive action with regard to this new Clause.
I should have thought that if the co-ordinating body were required—and from what the right hon. Gentleman has said, there does not seem to be much doubt in his mind as to that—it should be something far stronger than he has suggested. I cannot see how a voluntary body of this nature, dealing with three statutory bodies, will be able to exercise any influence whatever. It will have no position, no authority. All it can do is to attempt to argue these three other bodies into agreement. I am all in favour of having voluntary bodies, but I cannot see what chance a voluntary body has of exercising any pressure whatever on three statutory bodies which, presumably, it exists to coordinate. If the right hon. Gentleman really feels that such committees are necessary, he should go further than he has gone.
Question put, and agreed to.
Clause read a Second time, and added to the Bill.
Eleventh Schedule—(Consequential Amendments And Repeals)
I beg to move, in page 78, line 16, after "sixty-nine," to insert:
The purpose of this Amendment is to correct an error which has come to light since the Committee stage. Section 69 of the Public Health (Scotland) Act, 1897, authorises local authorities to bury dead bodies under the direction of a sheriff, a magistrate or a justice. At present that Section is exercised by the town councils of small burghs as well as by the major health authority, such as the Town Council for Glasgow, except in relation to infectious diseases, and it is not our intention to transfer this duty from small burghs, but the Schedule as it stood had that effect. The Amendment puts the matter right by limiting the functions of the local health authority to the existing functions of the major health authority relating to infectious disease, and leaving town councils of small burghs as the authorities otherwise responsible.(so far as relating to infectious diseases."
I am glad that this error has been detected. The size and complexity of the Measure makes us a little uneasy in case there may be more undetected errors lurking in it somewhere. I would call the attention of the Committee to the fact that, even after many days of consideration, we still find ourselves faced with unexpected pitfalls in this Bill. As the Secretary of State says, no one wishes to deprive the small burghs of the powers which they are exercising here. I can only say that it is another argument for careful and meticulous consideration by Parliament of these Statutes which, I am afraid, they are not getting in every case.
This Schedule, which we are asked to amend, is a comprehensive one. It refers to 12 Acts of Parliament, most of them specifically relating to Scotland. The right hon. Gentleman gave us the reason for this Amendment rather quickly and it was difficult, especially for me as an amateur, to follow the whole implications of his argument. I did my best, but he went so quickly—and I am not saying this in any disrespectful way—that we are left a little in doubt as to what effect this Amendment will have. Also I would support what my right hon. and gallant Friend the Member for the Scottish Universities (Lieut.-Colonel Elliot) said, that though the right hon. Gentleman, or his advisers in the Scottish Office, have discovered this one defect, there may be many others. Can the right hon. Gentleman outline to me what are the exact functions of the local health authority or local authority—whatever the proper term is—under the Public Health (Scotland) Act, 1897, relating to infectious diseases and why it is so necessary to introduce these amending words into the Eleventh Schedule in order to make quite sure what is the position of the local authorities? Is the right hon. Gentleman in a position to give me some elucidation on that point?
I do not think I can permit the right hon. Gentleman to go into that.
Amendment agreed to.
I beg to move, in page 80, to leave out lines 31 to 34.
This and the next Amendment on the Order Paper are consequential on an Amendment which has already been accepted in Committee.Amendment agreed to.
Further Amendment made: In page 83, leave out lines 3 to 5.—( Mr. Westwood.)
Schedule, as amended, agreed to.
Bill reported, with Amendments; as amended (in the Standing Committee and on recommittal), considered.
Clause 5—(Accommodation For Private Patients)
5.42 p.m.
I beg to move, in page 4, line 8, at the end, to insert:
During the Committee stage of the Bill, I was strongly pressed to delete the provisions enabling charges to be made in respect of certain blocks for hospital accommodation. The main criticism was directed against Clause 5, which permits the Secretary of State to set aside accommodation for the use of patients prepared to pay the whole cost of the accommodation and services provided for them. Now this provision relates specially to private patients of doctors working on the spot in hospitals within the service. Its object is in the interests of patients receiving hospital treatment free of cost within the service to encourage front rank specialists to come into the service. This the Clause seeks to do by enabling the specialists to treat patients of their own who wish to continue as private patients in accommodation as physically convenient as possible to the specialist's work for ordinary patients within the service. The number of specialists is thought to be considerably short of the numbers required to provide a fully efficient service for the whole population. No specialists are to be compelled to come into the new service, and it is important, therefore, that as Secretary of State I should do everything possible to encourage them to spend the maximum time within the Service. I appreciated the motive which led to certain objections to the retention of the Clause, and in the light of discussions I have had with the Scottish specialists since the Committee stage, it is clear to me that the success of the new service would be prejudiced if this facility were not extended to the specialists. In these circumstances it seemed to me that, on balance, the right thing to do was to retain the Clause, but I made it clear to the Committee when we were discussing this matter, that there was no question of so operating this Clause as to reduce the number of beds available free of charge below the number so available immediately before the new service came into being. Scottish specialists, indeed, appreciate—because I have discussed it with them since the Committee stage—that this is out of the question, and they have never suggested that it should be done. Therefore, I am glad to propose the insertion in the Bill of the proviso incorporated in the Amendment, which will provide an absolute statutory safeguard against any trespass of this kind. 5.45 P.m. The reason why the Amendment refers, as regards accommodation available before the appointed day, not only to accommodation available free of charge, but also to accommodation in local authority hospitals, is that accommodation in local authority general hospitals provided in accordance with schemes made under Section 27 of the Local Government (Scotland) Act, 1929, is not technically free of charge, for Section 28 of that Act in effect required a local authority to recover a charge in respect of persons maintained by them in institutions other than infectious diseases hospitals. I am prepared to admit that there is nothing in the Amendment to limit the proposal to such accommodation set aside for private patients. Because it is impossible to draft a sufficiently flexible provision, apart from Subsection (1), this Amendment is proposed. I fully recognise that for a long time to come it will not be possible to set aside more than a very small proportion of any new hospital accommodation, or equivalent accommodation in existing hospitals. In trying to meet the position which was put before me in Committee, I have tried to get a reasonable compromise, safeguarding the position of the specialists and likewise, as far as possible, the available free accommodation in our hospitals."Provided that no accommodation shall be so set aside unless there will remain available, as part of the hospital and specialist services, for other patients at least as much accommodation as was immediately before the appointed day available free of charge or at hospitals vested in local authorities, being accommodation which became part of the hospital and specialist services on that day."
There are two quite separate things here; the proposal made by the Secretary of State and our Amendment, at the end, to add:
I do not know if you are calling our Amendment, Major Milner?"and provided that accommodation previously used for paying patients shall be so set aside unless the result of so doing shall be to diminish the accommodation hitherto available free to patients."
Yes.
The Amendment makes it possible for the proviso to apply both ways. The Secretary of State said that it is not right that the transfer should diminish the number of free beds now available. That is quite right, we accept that position, but it should also hold that the transfer should not diminish the number of paying beds available. This matter was argued at great length in Committee. I think it was the general feeling, at least it was not confined to one side of the Committee, that paying beds and free beds ought to be mixed, and not segregated into purely nursing homes on one side, and hospitals on the other. That would lead to a slur being placed on the free hospital beds, which is not desired by anyone. The case was brought out that many hon. Members and many town councillors had had experience of paying beds. In particular the name of a former hon. Member very dear to us, Mr. Maxton, was mentioned. He was occupying a paying bed in Glasgow Infirmary, and was obtaining services—
That is dealt with under Clause 4.
This is a general point. The point is that free beds and paying beds would be available. It is quite true that this is a special kind of free bed. We did not make any point about the matter on Clause 4, but Clauses 4 and 5 were discussed together, and a good deal of the discussion overlapped. It is a good thing for the prestige and working of the free beds that the widest possible scope should be given to paying beds as well. That holds in the case of the specialist beds, for which the Secretary of State is arguing, and of the general beds. Our contention is that there should be an undertaking that the provision of free beds should not impinge on the provision of paying beds. Otherwise, there would be a danger that the paying beds might be crowded out, and they would move over to specialist places like nursing homes, and the places where it would be possible for all to be treated would thereby diminish. I do not know whether the Secretary of State would indicate whether he will accept our Amendment—
indicated dissent.
I think the right hon. Gentleman is a little unreasonable in that, and I think he might address himself to our argument. I am not quite sure of my position, and whether I can speak again on my Amendment. I am merely speaking at present to the Secretary of State's Amendment, subsequent to which I wish to move my own Amendment. I think it would be a little unjust if I were deprived of permission to speak to my own Amendment. I am speaking to his Amendment, under which there would be a proviso that the free beds should not be diminished by the provision of paying beds. That I accept, and propose subsequently to move my Amendment—[HON. MEMBERS: "No."] The procedure of moving an Amendment is well known, and I gave warning that I intended to move my Amendment. I think I am entitled to obtain an expression of opinion from the Secretary of State on this. I am at present offering my support and the support of my hon. Friends to the proposal he has put forward, and as a Scotsman I am asking for a "giff gaff"—I am asking a reasonable thing, that if I support him on his proposal, he will support ours. He does not refuse, he merely indicates dissent. The Secretary of State brings forward a proposition to which we on this side will attach our heartiest support. We have a further proposal to put forward at a later stage, and hope that it will meet with the approval of the Secretary of State, and if not, with the approval of the House.
I rather thought the right hon. and gallant Gentleman would move his Amendment, but he has not done so, and, therefore, it will be necessary for someone else to do so.
I am rather in your hands, Mr. Deputy-Speaker; no one rose to continue the Debate on either side and therefore—
On any side.
On any side, and I was supporting the proposition on the Paper. At a later stage I hoped to have the opportunity of moving my Amendment to that Amendment. Surely the Government Amendment would be put first, and then the Amendment in my name would be put?
I think the right hon. and gallant Gentleman has now exhausted his right to speak, and someone else must move his Amendment.
In that case, one of my hon. Friend's will be in a position to speak to the Amendment to the proposed Amendment which is in my name.
I want to draw attention to a mistake which has been made by the right hon. and gallant Member for the Scottish Universities (Lieut.-Colonel Elliot). He kept making it in Committee, and I think he was making it deliberately. He keeps saying that if we do not have private beds as well as open ward beds, a situation will arise in which the nursing home stands out in certain respects as superior to the ordinary hospital. The confusion he is making is in mixing the idea of private rooms with what he wants, paid private rooms. No one in the House does not understand the need for private rooms in the big hospitals. Wards should be as small as possible, and there is also a need and a desire for private rooms. The right hon. and gallant Gentleman referred to the late Jimmy Maxton. There is no one who would not have been prepared to see that everything possible was done for Jimmy Maxton. We would all have done all we could to help him in his trial and tribulation, and to ensure that the very best and most highly skilled attention was given to him. But, I want to ask the right hon. and gallant Gentleman if Jimmy Smith—the ordinary labourer—is not entitled to the same care and attention, or should we get special attention? Is not the ordinary labourer, Jimmy Smith, entitled to a private room if it is felt necessary and to the same skilled attention as the late Jimmy Maxton?
I think the hon. Member for West Fife (Mr. Gallacher) is himself confusing two things, and he continues to confuse them, sometimes I think intentionally. He does not allow for the fact that certain people, of whom the late Mr. James Maxton was one, were using facilities which were of the nature of hotel facilities over and above the skilled attention the hon. Member was mentioning. That is to say, Mr. Maxton was reading papers, receiving constituents, and attending to correspondence. When I was in hospital there was the same thing, an element of hotel accommodation, as well as hospital accommodation. I was anxious to have that, and was willing to pay, as was the late James Maxton, who was willing to pay. It was right and proper that we should pay for those things, but not right that the community should have to pay.
The right hon. and gallant Gentleman introduces something very special in regard to Jimmy Maxton and himself. But Jimmy Maxton was not in a position to receive constituents or deal with correspondence. Do not tell me that; I saw him in his last stages, and I know that he could not do so. But that is not the proposal for which the right hon. and gallant Gentleman or his associates are asking one or two special advantages, but a proposal that certain rooms should be reserved for people who have money, and can afford to pay. That is the proposition. I say that if there are two cases, one a labourer and the other a lord, they should be treated on their merits, not from the point of view that one happens to have money, and the other has not. There should be no payment of any kind for private rooms. If anyone is in a private room and wants something which is entirely outside hospital treatment, it may be that an arrangement can be made. But that has nothing to do with what we are discussing now. The average patient in a private room in a hospital is not going there to use it as an hotel. We want private rooms for those who require them, and there should be no payment for the private room any more than for the ward.
6.0 p.m. I have said before that there were all kinds of cases where it was desirable for their own sake or for the sake of other patients that they should be in private rooms while it was desirable that others should be in a ward accommodating a number of patients. I do not think that we should have wards of 20 or 30 beds, for it is more comfortable and more congenial if the wards have six or eight beds at the most. We should try to sort the patients in such a manner as to enable them to be helpful to one another in the wards. There are some who would prefer private wards and there are others who would be better off in public wards, but there should be no question of any rooms in any hospital being set aside as a priority for those who have money as against those who have none. All of us here will unhesitatingly agree that it is highly desirable and essential in the development of hospital accommodation that there should be private rooms as well as public wards, but these rooms must remain free for everyone. I would advise the Secretary of State that when the Bill is in another place he should go a little further than this Amendment and completely ban payment for private wards. I am certain that if there are private wards in all our hospitals and a complete bar on payment, we will be able to provide conditions that will steadily eliminate any idea of separate nursing homes, because the hospitals themselves will be able to build up such a reputation and gradually to expand in such a manner that there will be widespread demand for hospital accommodation, both of a public and of a private nature, according to the needs of the particular case.Do I understand that the hon. Gentleman would leave the nursing home position untouched and that everybody would be accommodated in the hospitals? Is that his contention?
My contention is that as far as the hospitals are concerned there should be no charge of any kind for a private room. I say that there should be no consideration for the proposition that any room in a hospital should be set aside as a priority for someone who has got money against someone who has not got any money.
On a point of Order. Is any of this discussion relevant to this Amendment by the Secretary of State? As far as I understand it, we have already ruled out for the moment the question of the Amendment later to be moved by the Opposition, and we are only discussing now the merits of this Amendment by the Secretary of State. I do not think that anything said so far by either of the two hon. Members who have spoken, with all due respect to them, is really relevant to the Amendment.
Further to that point of Order. May I point out that in this Amendment the Secretary of State provides that under certain conditions there will be private rooms for hire, and I want him to reconsider that in another place.
I am sorry but the Amendment of the Secretary of State deals with nothing of the sort. The original Bill provides that such accommodation is to be available and the Secretary of State has moved that the accommodation shall only be set aside upon conditions. That is the question which at the moment we are discussing.
I am glad, Major Milner, that you gave that Ruling, for our guidance, because I want to make it quite clear that I am attacking the Amendment of the right hon. Gentleman and that I am not speaking to the Amendment to the Amendment to be proposed by my right hon. Friend. I think that the Secretary of State has been a great disappointment to hon. Members on this side of the House. We thought we had encouraged hint to be strong and courageous in fighting our battles, in fighting the opposition in the Cabinet and in fighting his own opposition. When we thought we had got him up to the state of Joe Baksi, he got two strong punches, one from the hon. Member for Motherwell (Mr. A. Anderson) and one from the hon. Member for West Renfrew (Mr. Scollan) and he capitulated so that we have the Amendment which we are now considering. Candidly, I cannot see why it was necessary to introduce this at all. I do not think that it has made the position very much different because Clause 5 and its corollary Clause 4 are very much of the same kind and the Debate ranged over the two of them.
The Clause left the Committee sound, foresighted and based on good economy. Now the Secretary of State has yielded to the clamour from his more determined and aggressive supporters, and has rendered the Clause as it stood far less valuable for the purpose for which he had intended it. My argument on this is that it was sound economy to have the Clause as it stood, because it practically ensured that all accommodation would be taken up and possibly it would even make a profit, thereby saving the taxpayer from having an unnecessary impost pressed upon him at a later date. My right hon. Friend mentioned the case of a very dear friend of, all of us, but let us take the normal person who is in hospital. Let us take, for instance, a Cabinet Minister—On a point of Order.
If the hon. Gentleman did not continually raise these points of Order I am sure we should proceed a little more quickly. The hon. and gallant Member for Ayr Burghs (Sir T. Moore) is going beyond the Amendment.
Thank you very much, Mr. Deputy-Speaker, for your guidance for the hon. Member opposite. He is new to the House and he will soon learn. In the meantime, if I may respectfully say so, we are discussing the question whether there should be accommodation left in hospitals for those willing to pay provided the number of free beds is not disturbed. There are conditions under which paying beds are almost a necessity in the best interests of the State. For instance, take the case of a Cabinet Minister who has gone into hospital suffering from some illness or some disease. He is recovering, but he is not well enough to leave the hospital. He wants his secretaries to go there in order that he may carry on the duties of his high office of state. If he has not got a separate room, for which he is able and willing to pay, the State must inevitably suffer. The same applies to trade union officials, to high business executives and in many other directions in our national life. So I say that it is essential to have the qualification that there should be a definite number of paying rooms.
To descend to a lower scale, there may be the case of a man whose wife has to go to hospital. He has a little reserve of money, and with it he wants to get her some of the amenities and privacy that only can be procured by taking a private room. All of those arguments are quite sufficient to convince anyone, even so unpredictable and inconvertible a Member as the hon. Member for West Fife (Mr. Gallacher), that it is desirable to have these paying rooms. There is only one other point that I wish to stress further and that is, what is wrong with the Clause as it stands, and what is the necessity for this Amendment? As I read the Clause, anyone who is unable or unwilling to pay is not denied accommodation, and the only security we want is to ensure that those who are able to pay and for whom it is necessary to have reserved accommodation in the interests of the patient or of the State as a whole shall have access to that private accommodation with the attention, if necessary, of the tried and trusted family physician who has attended the family for years. That is a perfectly legitimate request, and it should be encouraged by the right hon. Gentleman and not prevented. I am deeply disappointed and grieved that he has not maintained that strength of character that he showed in Committee and that he has yielded to this clamour which means so little to the State as a whole and to the best interests of the country.I welcome this Amendment. It seems to me that it ensures that the accommodation which is at present free of charge will remain free, and to that extent the Amendment is a good one. However, I want to ask my right hon. Friend whether, in setting down in the Bill the amount of accommodation that will be free, is he not thereby limiting the amount of accommodation that will be free when we come to extend our hospitals? Is there any danger—and I think that this is an important point—that this might become the maximum amount of accommodation available free of charge? If my contention is correct I think my right hon. Friend should look at it again.
I should like to make one or two remarks on this question. First let me make it clear that we are not discussing the question of free places. The right hon. and gallant Member for the Scottish Universities (Lieut.-Colonel Elliot) put the question fairly and properly. The principle of free places is accepted. That is the Bill. What the Secretary of State for Scotland is now doing is simply saying that the number of free places which will be available will at least be the present number. The argument as to whether the principle of free places is a good thing or a bad is not for this Amendment at all. It is for the general Clause itself. The only issue here, is, is it advisable to lay down in the Statute that a number of free places should not be encroached upon?
The hon. and gallant Member for Ayr Burghs (Sir T. Moore) expressed regret that my right hon. Friend the Secretary of State has slipped from what he thought was the path of virtue. I understand the hon. and gallant Gentleman fully. He thinks that everyone who does not follow him as a leader has slipped from the path of virtue, he being more virtuous than all the rest of us. Not being a virtuous person myself, I do not want to follow him. I prefer a person with a few faults than a person with none at all. The Secretary of State in Committee gave way to many people and very properly, too. He is quite entitled to consider those of us on his own side of the Committee who make representations. He hears those representations and he thinks if they are a reasonable way of meeting apprehensions he should accept them. As to the last point made by the hon. Member for North Edinburgh (Mr. Willis) we do not think that this proposal conveys what he thinks. We do not think it is the maximum but rather that it is the minimum and that whatever is done in the future must be an extension of that number.Is it not likely, in actual practice, to develop into becoming a maximum?
We do not think so. We rather take the opposite view. However, in all these things, whether a maximum or a minimum, it depends greatly on the vigilance of the House of Commons. We take the opposite view, and the only safeguard we have on this question of maximum and minimum is the vigilance of the House. I agree with the hon. and gallant Gentleman the Member for the Scottish Universities, that this safeguards the present number of free places, and we say that that will be the minimum number of free places for Scottish people in the various hospitals.
6.15 p.m.
May I ask the hon. Gentleman one question? At the present moment there are in Scotland a considerable number of hospitals that have set aside a certain section of their accommodation for fee-paying patients. Does this mean that the number of beds so set aside will remain the same?
That point will arise in connection with a later Amendment. What we are doing here is simply this. Suppose, for the sake of argument, that there are 5,000 free beds in Scotland at the present time—I am using this number merely for the sake of illustration, and in fact there may be 10,000—and that there are 500 paying beds. When this Measure is passed at least 5,000 free beds must continue to be provided. The fee-paying beds may be eaten into, but the 5,000 free beds may not be decreased.
I beg to move, as an Amendment to the proposed Amendment, at the end, to add:
I think I am speaking for all the Members of my own party when I say that we are absolutely in agreement with the Amendment which has been moved by the Secretary' of State. We desire to see preserved the number of free beds now in existence. We also desire, however, that there should be preserved at the same time the number of fee-paying beds in existence when the appointed day arrives. That is the whole purpose of our Amendment. We believe that there is a very great need at the present moment for these fee-paying beds, and the case has been argued in Committee and again this afternoon. We are firmly of the opinion that persons have the right to additional accommodation if they require it and are willing and able to pay for it. In introducing his Amendment the right hon. Gentleman said that it was necessary to have free beds for the purpose of attracting the specialist to the service. I think that is abundantly obvious, but how he expects to attract the specialist if the number of fee-paying beds is to be reduced I cannot well imagine. I should have thought it logical that the Amendment which the right hon. Gentleman has moved and that which I am now moving were part and parcel of the same thing. We cannot reduce the free beds; at the same time, we cannot reduce the fee-paying beds. Let me just remind the House that there have been wings set apart in hospitals with money provided specially for that purpose for the class of persons who cannot afford to go to nursing homes yet can afford to pay for fee-paying accommodation in our big hospitals. I think there is every reason why they should be kept as fee-paying beds under these circumstances, and it is for these reasons that I move my Amendment."and provided that accommodation previously used for paying patients shall be so set aside unless the result of so doing shall be to diminish the accommodation hitherto available free to patients."
I beg to second the Amendment to the proposed Amendment.
I do so for the very important reason that I want to preserve in this matter a certain amount of choice for the sick. If the Government Amendment goes through unsupported by the subsequent Amend- ment moved by my hon. and gallant Friend, I do not see that that choice will be adequately preserved. The proportion given by the Joint Under-Secretary of State for Scotland was 5,000 free beds and 500 paying beds. I accept those figures merely as a basis for discussion and not as accurate figures, but they are, after all, a reflection of the circumstances in Scotland as regards sickness, and if there are 500 persons who elect to put themselves to some financial inconvenience to purchase what they think a reasonable advantage I contend that their right should be preserved. It may be a whim on their part, but none the less if they choose to pay for privacy I think they are entitled to have that advantage. Others may prefer to spend their money on other things, but it would seem to be a denial of the right of the individual to say, "You may spend your money on this or that improper or proper thing, but on this one thing you shall not spend it." If a man's wife is ill and he wants to buy for her some privacy which ordinarily she will not receive, it seems to me a denial of elementary liberty that a poor man is not allowed to exercise his desire to benefit his wife in that way. While I am adamant that there shall be 5,000 free beds and that that number shall not be encroached upon, I think that if there is to be a National Health Service Bill for Scotland meeting all the needs of the Scottish health services, this important matter of privacy cannot justifiably be overlooked. I hope that the Secretary of State, who has gone so far and, I think, acted so wisely in putting down the new Clause, will accept this Amendment to his proposed Amendment. We hope that through the years there will be rising standards of approach to sickness, and that there will be increasing sensitiveness and delicacy in these matters. I am sure that it is not the desire that sick people should be treated en masse. If the free bed system is abolished there will be a tendency to treat the sick en masse and I think it desirable that persons who resist or who are disinclined to accept this wartime kind of treatment and are prepared to do so—without any additional expense to the taxpayer—should be allowed to purchase the advantage they desire. This would give the Bill that completeness and fullness which the Secretary of State desires. For this reason, I hope the right hon. Gentleman will accept the Amendment. He has already accepted the principle in Clause 22 in connection with the Amendment we have taken this afternoon. He allows that whereas something in the nature of a drug, a medicine or an appliance of a normal type—that is to say, the apparatus of healing—will be supplied free it shall nevertheless, be permissible in the case of an article of abnormal type for the local authority to supply that article at the charge of the recipient. If one admits the wisdom, validity and commonsense of supplying an appliance of a slightly superior or different type at the charge of the patient, what is the difference between that and supplying the privacy which the private room might confer upon a suffering person? I hope the Secretary of State will follow the logic of his own new Clause and accept the Amendment which has now been moved by my hon. and gallant Friend.I think it might be for the convenience of the House if I intervened at this stage to explain my attitude to the Amendment to the proposed Amendment which has been moved. When I moved my own Amendment I made it perfectly clear that it was my intention under the Clause to set aside a limited amount of accommodation for private patients, following on the discussions I had with specialists who were in the position of serving patients who were provided for under this particular Clause. Some hon. Members appear to have become confused with Clause 4; the Amendments which are now before the House deal with Clause 5, which concerns the patient who is to pay the full cost—the private patient.
I have already pointed out that it is my intention to set aside under this Clause a limited amount of accommodation for private patients but the best use of some of that accommodation would probably not be served in many instances if the Amendment to the proposed Amendment were carried. For instance, it might become advisable to put the beds in the main pool available without charge or available for patients who wish to pay a little extra under Clause 4, to which no Amendment of any kind has been moved today on the Report stage. If I were to accept the Amendment now before the House it would limit my choice of the accommodation to be set aside whereas I suggest, as the one charged with the responsibility of the administration of this Bill and this Clause in Scotland, that the Secretary of State's discretion in the choice of accommodation to be set aside should be free. It will be my intention to choose for this purpose the accommodation which will most effectively serve to bring the specialist into the closest association with the hospitals generally while maintaining in use the accommodation specially needed for the treatment of ordinary patients. I have discussed my Amendment with the profession itself, and I asked them if they would consider it any breach of faith with them if I safeguard the position so far as free bed accommodation was concerned. That is the basis of my Amendment which is accepted on both sides the House, and it seemed to me completely to satisfy the specialist with whom I conferred following the discussions in Committee. I cannot accept the Amendment moved by the hon. and gallant Gentleman, and in this connection there is one final point which I had not yet mentioned since I wished first to deal with the arguments that had been put forward. I certainly could not administer Clause 5 in the best possible manner if that Amendment were accepted by the House. I am also very doubtful about its wording and am of the opinion that it is defective. For example, it does not define the meaning of "paying patients" in relation to the period before the appointed day. People may begin to ask, "Does it include patients who pay for accommodation in the hospitals set up under Section 8 of the Act of 1929 on purpose to preserve the position so far as concerns free accommodation?" The House will know that in the Amendment which I moved provision was made for counting these places as free places because they were already in hospitals which were controlled by the local authorities. Thus, for the reasons I have given, I cannot accept the Amendment to the proposed Amendment, and in fact, I think the Amendment itself is not properly drafted.The points we have been discussing on these two Amendments are points which have been discussed by boards of managements of the larger hospitals during the last 30 years. I myself joined the Board of one of the big London hospitals nearly 20 years ago and was particularly interested in the financial side. There the question was asked as to the extent to which we should provide wards for paying patients and private bedrooms. It was a big London hospital and one of the points we had to consider was that practically the only class of the community which did not come in as patients comprised those responsible for providing something like three-quarters of the funds which kept that hospital going.
The Bill we have before us is called a "National Health Service Bill" and one of the questions we have to consider is whether under it the hospitals of Scotland will cater for all classes or just for those who happen to be of a particular interest for the time being. A national health service should cater for all classes. If there are patients who wish to pay for their hospital service, I see no reason why we should not cater for them. Whether it is right or wrong that they should pay, or whether it is right or wrong that they should have privacy, is another matter which does not really concern us. If this is to be a national health service, it is just as right that the State hospitals should cater for this class as it was for the voluntary hospitals, who in the past found it worth their while to provide these paying wards. In those earlier days when we provided private rooms and wards, they gave just as much satisfaction to our specialists as the free wards.6.30 p.m.
May I point out that the noble Lord is talking about Clause 4 and not Clause 5?
I am addressing myself to the second Amendment under discussion, which suggests that we should be allowed to retain as many paying beds as existed before the Bill became an Act. I see no reason why, in this so-called National Health Service Bill, these people should not, in future, have the same opportunities in the hospitals of Scotland as they have at present. I do not see any special reason why we should deny them what they have enjoyed in the past.
The Secretary of State for Scotland referred to his intention of setting aside what he described as a "limited" amount of accommodation for fee patients. The purpose of the Amendment to the proposed Amendment is to retain the present ratio of free and paying beds. The reason why the Amendment is put down is because it is felt that, in view of the present acute shortage of hospital accommodation, we shall be driving paying patients out to nursing homes if we reduce the proportion of paying beds. If this is to be a national service, then it should cater for all classes of the community. The first point is the question of how much of the accommodation is to be set aside for paying patients. There is a second point, and that is that it is possible for this Clause to become a dead letter, if we reach the point where there are sufficient beds for all demands. The question will then be whether it is desirable that this practice should continue, and whether it is desirable that there should be the possibility of obtaining a little extra benefit by way of payments. No one denies that if there are medical grounds for a separate room, the patient should have one whether he pays for it or not. Without an Amendment such. as this, it is possible for the Secretary of State for Scotland to eliminate fee-paying patients altogether to the detriment—
All this discussion is on the question of whether or not patients should pay certain amounts, whereas this Clause deals only with private patients of doctors.
The hon. Member is quite correct. The Amendment deals with accommodation, and not with payments.
It seems a nice distinction. The House must address itself to the general demand for accommodation, and if private patients cannot be accepted in private hospitals, then they must go elsewhere. I submit, therefore, that this is germane to the discussion. I would also point out that the Amendment contains the words "for paying patients." I wish to ask the Secretary of State his views when there are sufficient beds to meet all demands. Will he then stop paying patients? If he did that, there would be a loss of revenue to the State. These paying patients can help in meeting the overheads of hospitals, and for that reason alone it is desirable to include some such Amendment as this. The Secretary of State for Scotland has criticised the Amendment in detail. He has said that the question of paying patients relates both to Clauses 4 and 5.
I did not say anything of the kind. I said that the Amendment would require some explanatory Clause as to what was meant by "paying patient." I was not dealing with beds but with paying patients, and I tried to point out that as far as paying patients are concerned, I have safeguarded the position, because all patients are paying patients so far as the local authorities are concerned.
That may be so, but we should like an explanation of the attitude of the right hon. Gentleman. Will he accept the spirit of our Amendment, and if not, why not? On the question of the type of accommodation, if I understood him aright, he said that this Amendment would tie his hands and limit his power to set aside certain types of accommodation for these people.
Division No. 125]
| AYES
| [6.39 p.m.
|
| Agnew, Cmdr. P. G. | Grimston, R. V. | Nield, B. (Chester) |
| Astor, Hon. M. | Hare, Hon. J. H. (Woodbridge) | Orr-Ewing, I. L. |
| Beamish, Maj. T. V. H | Headlam, Lieut.-Col. Rt. Hon. Sir C | Peto, Brig. C. H. |
| Birch, Nigel | Hogg, Hon. Q. | Pickthorn, K. |
| Boyd-Carpenter, J. A | Hollis, M. C | Prior-Palmer, Brig. O |
| Bullock, Capt M. | Hutchison, Lt.-Cm. Clark (E' b'rgh, W.) | Ramsay, Maj. S. |
| Carson, E. | Jeffreys, General Sir G. | Robinson, Wing-Comdr. Rolano |
| Clarke, Col. R. S. | Kerr, Sir J. Graham | Ropner, Col. L. |
| Conant, Maj. R. J E. | Lambert, Hon. G. | Scott, Lord W. |
| Corbett, Lieut.-Col. U. (Ludlow) | Langford-Holt, J. | Shepherd, W. S. (Bucklow) |
| Crosthwaite-Eyre, Col. O E. | Legge-Bourke, Maj. | Snadden, W. M |
| Crowder, Capt. John E. | Lipson, D. L. | Spence, H. R. |
| Cuthbert, W. N. | Lucas, Major Sir J. | Stanley, Rt. Hon. O. |
| Darling, Sir W. Y | Lucas-Tooth, Sir H. | Stewart, J. Henderson (Fife, E.) |
| Digby, S. W. | MacAndrew, Col. Sir C | Strauss, H. G. (English Universities) |
| Dodds-Parker, A. D | McCallum, Maj. D. | Stuart, Rt. Hon. J (Moray) |
| Drayson, G. B. | Macdonald, Sir P. (I. of Wight) | Sutcliffe, H |
| Duthie, W. S. | McKie, J H (Galloway) | Taylor, C. S. (Eastbourne) |
| Eccles, D. M. | Maopherson., Maj. N. (Dumfries) | Teeling, Willlam |
| Elliot, Rt. Hon. Walter | Maitland, Comdr. J. W. | Thorneycroft, G. E. P. (Monmouth) |
| Fletcher, W. (Bury) | Manningham-Buller, R. E | Thornton-Kemsley, C N |
| Foster, J. G. (Northwich) | Marlowe, A. A. H. | Walker-Smith, D |
| Fyfe, Rt. Hon. Sir D. P. M | Marshall, D (Bodmin) | Ward, Hon G. R. |
| Gage, C. | Mellor, Sir J. | Wheatley, Colonel M. J |
| Galbraith, Cmdr. T. D. | Moore, Lt.-Col. Sir T. | Williams, Gerald (Tonbridge) |
| Gates, Maj. E. E. | Morrison, Maj. J. G. (Salisbury) | |
| Gomme-Duncan, Col. A | Morrison, Rt. Hon. W. S. (Cirencester) | TELLERS FOR THE AYES:
|
| Grant, Lady | Neven-Spence, Sir B. | Mr. Drewe and Mr. Studholme. |
NOES
| ||
| Adams, Richard (Batham) | Blackburn, A. R. | Comyns, D. L |
| Adams, W. T. (Hammersmith, South) | Boardman, H. | Cook, T. F. |
| Alpass, J. H | Bowen, R. | Cooper, Wing-Comdr G |
| Anderson, F. (Whitehaven) | Bowles, F. G. (Nuneaton) | Corlett, Dr. J. |
| Attewell, H. C. | Braddock, Mrs. E. M. (L'pl. Exch'ge) | Corvedale, Viscount |
| Austin, H. Lewis | Braddock, T. (Mitcham) | Crossman, R. H S |
| Awbery, S. S | Brook, D. (Halifax) | Dagger, G |
| Ayles, W. H. | Brooks, T. J. (Rothwell) | Daines, P. |
| Ayrton Gould, Mrs. B | Brown, George (Belper) | Davies, Edward (Burslem) |
| Bacon, Miss A | Bruce, Maj. D. W T | Davies, Harold (Leek) |
| Baird. J | Buchanan, G. | Deer, G. |
| Balfour, A | Butler, H. W. (Hackney, S.) | Diamond, J |
| Barstow, P. G | Chamberlain, R. A. | Dobbie, W. |
| Barton, C. | Champion, A J | Donovan, T. |
| Battley, J. R. | Chater, D. | Driberg, T. E. N. |
| Bechervaise, A. E. | Chetwynd, G R | Dumpleton, C. W. |
| Benson, G | Cocks, F S | Edwards, N. (Caerphilly) |
| Berry, H. | Coldrick, W | Evans, E. (Lowestoft) |
| Beswick, F. | Collindridge, F | Field, Capt. W J. |
| Bing, G. H C. | Collins, V J | Follick, M. |
| Binns, J. | Colman, Miss G. M | Foot M. M |
It would definitely tie my hands to the extent of setting aside accommodation for fee-paying patients. That might not be to the advantage of the fee-paying patients, because it ties my hand to the existing accommodation previously used, without taking into consideration the new health service to be provided.
Even that would not be to the disadvantage of the fee-paying patients, because the gist of our Amendment is that accommodation should be set aside.
Question put, "That those words be there added to the proposed Amendment."
The House divided: Ayes, 81; Noes, 222.
| Gallacher, W. | MacMillan, M. K. (Western Isles) | Smith, S. H. (Hull, S.W.) |
| Ganley, Mrs. C. S. | Macpherson, T. (Romford) | Snow, Capt. J. W. |
| Gordon-Walker, P. C. | Manning, Mrs. L. (Epping) | Soskice, Maj. Sir F. |
| Granville, E. (Eye) | Messer, F. | Sparks, J. A. |
| Greenwood, Rt. Hon. A. (Wakefield) | Middleton, Mrs. L | Stamford, W. |
| Grenfell, D. R. | Mikardo, Ian | Steele, T. |
| Grierson, E. | Millington, Wing-Comdr. E. R. | Stephen, C. |
| Griffiths, D. (Rother Valley) | Mitchison, G. R. | Stewart, Michael (Fulham, E.) |
| Griffiths, Rt. Hon. J. (Llanelly) | Montague, F. | Stross, Dr. B. |
| Guest, Dr. L. Haden | Moody, A. S. | Summerskill, Dr. Edith |
| Gunter, R. J. | Moyle, A. | Swingler, S. |
| Guy, W. H. | Nally, W. | Sylvester, G. O. |
| Hale, Leslie | Naylor, T. E. | Taylor, H. B. (Mansfield) |
| Hamilton, Lieut.-Col, R. | Neal, H. (Claycross) | Taylor, R. J. (Morpeth) |
| Hardy, E. A. | Nichol, Mrs. M. E. (Bradford, N.) | Taylor, Dr. S. (Barnet) |
| Harrison, J. | Nicholls, H. R. (Stratford) | Thomas, D. E. (Aberdare) |
| Hastings, Dr. Somerville | O'Brien, T. | Thomas, I. O. (Wrekin) |
| Haworth, J. | Paget, R. T, | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Herbison, Miss M. | Palmer, A. M. F. | Thorneycroft, Harry (Clayton) |
| Hewitson, Capt. M. | Parker, J. | Thurtle, E. |
| Hobson, C. R. | Parkin, B. T. | Tiffany, S. |
| Holman, P. | Paton, Mrs. F. (Rushcliffe) | Titterington, M. F. |
| Holmes, H. E. (Hemsworth) | Paton, J. (Norwich) | Tolley, L. |
| Hoy, J. | Pearson, A. | Tomlinson, Rt. Hon. G. |
| Hubbard, T. | Peart, Capt. T. F. | Turner-Samuels, M. |
| Hudson, J. H. (Ealing, W.) | Piratin, P. | Ungoed-Thomas, L. |
| Hughes, Hector (Aberdeen, N.) | Porter, G. (Leeds) | Usborne, Henry |
| Hutchinson, H. L. (Rusholme) | Proctor, W. T. | Vernon, Maj. W. F. |
| Hynd, H. (Hackney, C.) | Pursey, Cmdr. H | Viant, S. P. |
| Irving, W. J. | Randall, H. E | Walkden, E. |
| Jay, D. P. T. | Ranger, J. | Walker, G. H. |
| Jeger, G. (Winchester) | Rankin, J. | Wallace, G. D. (Chislehurst) |
| Jones, D. T. (Hartlepools) | Reeves, J. | Wallace, H. W. (Walthamstow, E.) |
| Jones, Elwyn (Plaistow) | Reid, T. (Swindon) | Wells, P. L. (Faversham) |
| Jones, J. H. (Bolton) | Richards, R. | Wells, W. T (Walsall) |
| Jones, P. Asterley (Hitchin) | Robens, A | Westwood, Rt. Hon. J. |
| Keenan, W. | Roberts, Goronwy (Caernarvonshire) | White, C. F. (Derbyshire, W.) |
| King, E. M. | Rogers, G. H. R. | White, H. (Derbyshire, N.E.) |
| Kinley, J. | Ross, William (Kilmarnock) | Whiteley, Rt. Hon. W. |
| Lee, Miss J. (Cannock) | Sargood, R. | Wigg, Col. G. E. |
| Leonard, W. | Scollan, T. | Wilkes, L. |
| Leslie, J. R. | Scott-Elliot, W. | Wilkins, W. A. |
| Levy, B. W. | Shackleton, E. A. A. | Williams, D. J. (Neath) |
| Lewis, A. W. J. (Upton) | Sharp, Granville | Williams, J. L. (Kelvingrove) |
| Lewis, J. (Bolton) | Shawcross, Rt. Hn. Sir H. (St. Helens) | Williams, W. R. (Heston) |
| Lipton, Lt.-Col. M. | Shurmer, P. | Williamson, T. |
| Longden, F. | Silverman, J. (Erdington) | Willis, E. |
| McAdam, W. | Simmons, C. J. | Wills, Mrs. E. A |
| McAllister, G. | Skeffington, A. M. | Wyatt, W |
| McGhee, H. G. | Skeffington-Lodge, T. C | Yates, V. F. |
| Mack, J. D. | Skinnard, F. W. | Younger, Hon. Kenneth |
| McKay, J. (Wallsend) | Smith, C. (Colchester) | |
| Mackay, R. W. G. (Hull, N.W.) | Smith, Ellis (Stoke) | TELLERS FOR THE NOES:
|
| McLeavy, F | Smith. H. N. (Nottingham, S.) | Mr. Hannan and |
| Mr. Joseph Henderson. |
Proposed words there inserted in the Bill.
Amendment made: In page 4, line 9, after "provided," insert "also."—[ Mr. Westwood.]
Clause 7—(Endowments Of Voluntary Hospitals)
I beg to move, in page 7, line 34, at the end, to insert:
The point to which this Amendment is addressed was raised in Standing Committee, when the Secretary of State promised to examine it. He did not feel able to accept the proposal we originally put forward, because he thought it would be unduly restrictive, and we have, therefore, put forward a considerably modified proposal, The original proposal was that the liability should be connected with the actual endowment. The right hon. Gentleman said then that it would have been impossible to attach endowments to liabilities because, in many cases, there liabilities might not have been attached from the particular endowments in the legal sense. There is, no doubt, strength in that contention, but we do not think that the proposal set down here is one to which he could reasonably take objection. It is the purpose of the Secretary of State to maintain the practice of citizens taking an interest in, and subscribing to, endowments for hospitals. I think that they will be all the more tempted to do so if they feel that the endowment which they are giving remains—even if its purpose is to be changed—reasonably connected with the purpose which they originally put forward, and with the cause which they originally intended to support. For instance, I think it not unreasonable that an endowment given for an ear, throat and nose hospital should not be used for the reduction of, let us say, debt on a children's ward, or a cancer hospital. That would be calculated to defeat the object which the right hon. Gentleman has in mind. Here, I think we have found a useful half-way house between the somewhat sweeping proposal first set down in the Bill, and the perhaps rather extreme Amendment which we on this side moved in Standing Committee. Perhaps the Under-Secretary can indicate whether he is likely to look with favour on this proposal?"Provided that the liabilities referred to by this Subsection shall be such as are reasonably connected with the individual property or properties being taken over."
I am sorry that we cannot see our way to accept the Amendment. We have looked at it—I hope not unsympathetically—but in this field we do not know the liabilities concerned. The Amendment would limit us, and we think that the Secretary of State ought to be left free in this matter. I agree that this Amendment modifies the position but it will, nevertheless, restrict us in this field.
I merely asked the Under-Secretary for an indication of his views. I hope that what he has said will not be taken as the termination of my remarks. I am sure that that was not his intention—
I thought that the Under-Secretary had made his speech in reply.
If that were so then I am doubly fortunate, Sir, because I do not have to encounter the hon. Gentleman s powerful debating ability. When he says that we are moving here in the unknown, that is true, but it works both ways. He is moving here by way of giving inducement to people to support hospitals in the future, but he is moving in a field which is not so unknown as all that. If there is one thing we can say about Scottish hospitals it is that they are, on the whole, solvent. Scottish hospitals are under-built and over-endowed, as compared with English hospitals, which are over-built and under-endowed.
The hon. Gentleman is not taking a great risk, and it seems a pity that we should rashly write into this Bill words which undoubtedly will have the effect of discouraging people from giving assistance to a particular cause. Like it or not, it is reference to a particular cause which will most easily elicit support. Look at the ready response to the Fens disaster, and to the agricultural disaster fund. If you say, "Subscribe to the Government," how many people do you find writing handsome cheques in support of the Government—no matter what its complexion? There are a few people who leave conscience money to the Chancellor of the Exchequer, or the residue of their estates to be applied to extinguishing the National Debt, but, on the whole, all that is regarded as a high degree of eccentricity. There are those who leave money to hospitals, or to a particular hospital in which they have received treatment. The late Mr. H. G. Wells, who suffered from diabetes, and who received great benefit from the insulin cure, devoted himself to obtaining subscriptions for the treatment of persons suffering from diabetes. We have heard of appeals at Christmas time for wireless sets for the blind. These are the sort of things which elicit support. But if the Government say, "We can give no guarantee. We are taking over all the liabilities; we shall take over all the advantages," then I say—The right hon. and gallant Gentleman should remember that this is subject to a regulation, which can be debated.
I might give the right hon. Gentleman a Roland for his Oliver by saying that he has behind him the Hospital Endowments Commission. He is not giving away very much, and if he gave us this he would still retain that powerful concealed weapon, which can review and revise. This Amendment says that in taking over the endowments of the voluntary hospitals and discharging the liabilities transferred to the Secretary of State, the Government should have reasonable regard, in using the surplus, to the purpose for which that surplus was originally devoted. The Secretary of State retains the advantage of the enormously powerful Hospital Endowments Commission which is a perpetual, and not a temporary, body to which he falls heir at a later date. If we cannot convince the hon. Gentleman about this I do not see how we can con- vince him of anything. I therefore beg him to consider whether, in another place, he might not find some words which would carry out the admitted desire of the whole House, that endowments should not be unreasonably or irrationally divorced from the original intention of the owners.
With your permission, Mr. Speaker, and the permission of the House, might I say that the right hon. and gallant Gentleman has put forward a reasonable request? I will consult with my right hon. Friend on this matter, and we will look at it again between now and the consideration of the Bill in another place. Without giving any binding promise, I can give the assurance that we will consider it with an open mind.
7.0 p.m.
With that very forthcoming proposal, which I agree is not a pledge but an indication to give this matter consideration between now and another place, I beg to ask leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Clause 8—(Hospital Endowments Commission)
I beg to move, in page 9, line 5, to leave out from "to," to the end of the Subsection, and to insert:
The right hon. and learned Member for Hillhead (Mr. J. S. C. Reid) is largely responsible for our putting down this Amendment. It shows plainly the effect which his speeches have had in Committee. When this matter was considered in Committee there was some criticism that we were not making the position sufficiently clear. I trust that this wording makes the position abundantly clear."(a) the spirit of the intention of the founder or donor of the endowment to which the scheme relates and in particular to conditions intended to preserve the memory of any person or class of persons; (b) the extent to which the original purpose of the endowment is sufficiently provided for by a public service or otherwise; and (c) the interests of the hospital and specialist services."
We on this side of the House are prepared to accept the Amendment. The words are the same as they were in the original, but the placing and lay-out are different and it makes for greater clarity.
Amendment agreed to.I beg to move, in page 9, line 31, to leave out from "and," to the end of the Subsection, and to insert:
During the Committee stage, the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid) somewhat severely criticised the wording of this Subsection, as giving the Secretary of State far too great a latitude to modify the provisions of the Tenth Schedule when applying them by regulation to inquiries in connection with endowments. He took the view that we were taking power to do things by regulation which ought to be put into the Bill. The right hon. and learned Gentleman said, "What you may do may be good or bad, but let us know in the Bill, and do not act in this matter, by regulation." I gave a guarantee upstairs that we would look at the matter again. Having examined it, we have come to the conclusion that we can set this out in the statute. The House is now in the position of knowing exactly what is proposed, and this abolishes the need for regulations. In view of that, and with the substitution of the Commission for the Secretary of State, we abolish the expenses Clause. We think that is right, because if the Secretary of State had retained the power of expenses, he could have been criticised here. We have abolished that particular right in connection with expenses."the provisions of the Tenth Schedule to this Act shall apply to any such inquiries held by the Hospital Endowments Commission with the substitution of the Commission for the Secretary of State in paragraphs 1 and 2, and the omission of paragraphs 6, 7 and 8 of the said Schedule."
We feel that this Amendment very fairly represents the feeling of the Committee, and we propose to accept it without further Debate.
Amendment agreed to.
I beg to move, in page 9, line 34, to leave out from "approve," to "any," in line 36.
The House will not need to be reminded that this Subsection deals with the setting up of the Hospital Endowments Commission on which a duty is placed to review all the hospital endowments and, thereafter, submit schemes to the Secretary of State. The part to which we take objection is that which provides that the Secretary of State may by Order approve,any scheme which is submitted to him. We say that the Subsection should read:"with or without modifications, which may include additions or exceptions,"
It is extraordinary that the Bill should set up an Endowments Commission and give it duties to perform, and that at the end of the day, the Secretary of State should take power in his own hands completely to alter a scheme. The Commission is, after all, a judicial body. When this matter was debated in Committee, the Lord-Advocate confessed that he had a considerable amount of sympathy with the Amendment, and agreed that the Commission was an independent Commission with a sort of judicial authority. We did not feel that the findings of such a Commission should be submitted to the arbitrary decisions of the Secretary of State. It may be that the Amendment is not the best that could be devised to meet our objections, and we might be satisfied if we were informed that, should any major alteration have to be made by the Secretary of State, it would be communicated to this House, so that we would have an opportunity of saying something about it. But for the Secretary of State to take these powers entirely to himself, where a judicial body is concerned, is, we think, highly improper."The Secretary of State may by order approve any scheme submitted to him by the Hospital Endowments Commission or may remit to the Commission to frame and submit a new scheme."
I beg to second the Amendment.
I am very anxious to meet hon. Members opposite on this point, because I have always felt the force of what they have to say about it. The trouble is that if this Amendment were accepted it would mean that the Secretary of State would have no latitude at all. He would have either to approve or disapprove, and there might quite well be a deadlock; a scheme might go backwards and forwards from the Secretary of State to the Commission and so on. One wants to avoid a deadlock, because similar types of deadlock have been experienced in regard to the Educational Endowment Commission. I have had one or two discussions with the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid) on this matter. He pointed out that under Clause 71 the orders approving schemes of this kind will come before the House, and the point which the right hon. and learned Gentleman took was that it was desirable for the House to know whether, and if so to what extent, any modification had been made in the Endowments Commission's scheme. The Secretary of State is therefore prepared to concede this. If any substantial modification is made which has not been agreed by the Commission, the order, when laid before Parliament, will be accompanied by an explanatory White Paper setting out what the modifications are. If hon. Members opposite would be satisfied with that, it would, I think, be a useful compromise on the matter.
Who is to settle whether it is substantial or not?
That, I think, would have to be left to the Secretary of State, otherwise some very trivial matters, such as the dotting of an "i" or the crossing of a "t", which would be technically modifications, might come up. Something must be left to the Secretary of State, but if this proposal commends itself to hon. Members opposite, it seems to be the only possible compromise. Failing that, there is the possibility of a complete deadlock and the tossing about of a scheme between the Secretary of State and the Endowments Commission, with no possibility of coming to an agreement.
There is the difficulty about who is to settle whether a modification is substantial or not. I do not see why we should not insist that, substantial or otherwise, it does come before this House, because one presumes that unless it is substantial there is not likely to be any difference between the Secretary of State and the other authorities. It is unlikely that there will be any point between them which cannot be settled unless it is substantial, and I think we need more information on this question before we are asked to forego the Amendment.
I do not think the right hon. and learned Gentleman has done himself justice in his explanation. The Amendment we have proposed really would get over the cumulative deadlocks which he so rightly fears. What does the Clause now give the Secretary of State power to do? It gives him no less than seven or eight options—he may by order approve, he may approve with modifications, he may approve without modifications, he may approve with or without modifications which may include additions, he may include or not include additions or exceptions, and he then, failing in all these, may remit to the Commission to frame and submit a new scheme. Surely if the Secretary of State really means business, and I have the impression that he does, he will not want to entangle himself with all these alternatives. The Amendment makes it quite clear that the Secretary of State may by order approve any scheme submitted to him by the Hospital Endowments Commission, or he may remit to the Commission to frame and submit a new scheme. Surely that double option, that two-way choice, gives him all the latitude he wants, and to embarrass him with other opportunities will merely prolong the intricacies of what may well be a very lengthy process. In his own interests, therefore, the Secretary of State would be well advised to accept the Amendment.
7.15 p.m.
I am not quite clear from what the right hon. and learned Gentleman has said whether it is his intention to write into the Bill before it goes to another place the undertaking that he has given regarding modifications which may be made.
The answer is "No," but I am impressed by what the hon. Member opposite has said. I agree that it is unlikely that a deadlock will arise unless the divergence between the Secretary of State and the Commission is serious. I think, therefore, I can safely undertake on behalf of the Secretary of State that if there is a divergence of opinion, that divergence will be put in the explanatory White Paper.
Until the concluding words of the Lord Advocate I was hoping that he was going to say he was convinced, and would accept the Amendment. After all, as my hon. Friend the Member for South Edinburgh (Sir W. Darling) said, nobody can say that the powers of the Secretary of State are small and limited. In addition to everything else, as soon as the Hospital Commission disappears—and its time is limited by Statute—the Secretary of State himself becomes the Hospital Commission, and can write any scheme he desires. There is therefore no real danger of continuing deadlock. The case always used is the case of the Man College at Troon, but Scotland was very greatly advantaged by the fact that a man left an enormous sum of money to the setting up of the Man College, which is a very fine building. The purpose of all this is to induce people to take part in the Secretary of State's own scheme, but if the Secretary of State ties a string so very obviously to every sixpence he leaves lying about, and the strings can be seen leading from them to the Secretary of State who can be seen pulling those strings, and pulling the sixpences away.
When you stoop to lift them.
Yes, when you stoop to lift them—the hon. Member for West Renfrew (Mr. Scollan) has had experience of this process, and nobody can say that it is anything other than a very frustrating experience to those who try to take advantage of the sums offered to them. We had an almost identical speech from the Lord Advocate in the committee room upstairs, and he then said he had a considerable amount of sympathy with the point that the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid) made. He thought he might see whether some form of words could be evolved. Indeed he succeeded in a very remarkable feat—his blandishments were so great that he persuaded my right hon. and learned Friend the Member for Hillhead to conclude that he was about to accept the principle of the Amendment and put forward some form of words of his own, where upon my right hon. and learned Friend withdrew his Amendment. Until the very last words of the right hon. and learned Gentleman just now, I myself had the illusion that the same process was being repeated. I do not wish to delay the House, but I really think that we ought to divide upon this point.
Question put, "That the words proposed to be left out stand part of the Bill."
The House divided: Ayes, 234; Noes, 76.
Division No. 126.]
| AYES
| [7.19 p.m.
|
| Adams, Richard (Balham) | Hall, W. G. | Reeves, J. |
| Adams, W. T. (Hammersmith, South) | Hamilton, Lieut.-Col. R | Reid, T. (Swindon) |
| Alpass, J. H. | Hardy, E. A. | Richards, R. |
| Anderson, F. (Whitehaven) | Harrison, J. | Robens, A. |
| Attewell, H. C. | Hastings, Dr. Somerville | Roberts, Goronwy (Caernarvonshire) |
| Austin, H. Lewis | Haworth, J. | Rogers, G. H. R. |
| Awbery, S. S. | Henderson, Joseph (Ardwick) | Ross, Willlam (Kilmarnock) |
| Ayles, W H. | Herbison, Miss M. | Sargood, R. |
| Ayrton Gould, Mrs. B | Hewitson, Capt. M. | Scollan, T. |
| Bacon, Miss A | Hobson, C. R. | Scott-Elliot, W. |
| Baird, J. | Holman, P. | Shackleton, E. A A. |
| Balfour, A. | Holmes, H. E. (Hemsworth) | Sharp, Granville |
| Barstow, P. G | House, G. | Shawcross, C. N. (Widnes) |
| Barton, C. | Hoy, J. | Shawcross, Rt. Hn. Sir H. (St. Helens) |
| Battley, J. R | Hubbard, T. | Shurmer, P. |
| Bechervaise, A. E | Hudson, J. H. (Ealing, W.) | Silverman, J. (Erdington) |
| Benson, G. | Hughes, Hector (Aberdeen, N.) | Simmons, C. J. |
| Berry, H. | Hutchinson, H. L. (Rusholme) | Skeffington-Lodge, T. C |
| Beswick, F. | Hynd, H. (Hackney, C.) | Skinnard, F. W. |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Irving, W. J | Smith, C. (Colchester). |
| Bing, G. H. C. | Jay, D. P. T. | Smith, Ellis (Stoke) |
| Binns, J. | Jager, G. (Winchester) | Smith, H. N. (Nottingham, S.) |
| Blackburn, A. | Jones, D. T. (Hartlepools) | Smith, S. H. (Hull, S.W.) |
| Boardman, H. | Jones, Elwyn (Plaistow) | Snow, Capt. J. W. |
| Bowen, R. | Jones, J. H. (Bolton) | Solley, L. J |
| Bowles, F. G. (Nuneaton) | Jones, P. Asterley (Hitchin) | Soskice, Maj. Sir F. |
| Braddock, Mrs. E. M. (L'pl, Exch'ge) | Keenan, W | Sparks, J. A. |
| Braddock, T. (Mitcham) | King, E. M. | Stamford, W |
| Brook, D. (Halifax) | Kinley, J. | Steele, T |
| Brooks, T. J. (Rothwell) | Lee, F. (Hulme) | Stephen, C. |
| Brown, George (Belper) | Lee, Miss J (Cannock) | Stewart, Michael (Fulham, E.) |
| Bruce, Maj. D. W. T | Leonard, W | Stross, Dr. B. |
| Buchanan, G. | Leslie, J. R. | Summerskill, Dr. Edith |
| Burden, T. W. | Levy, B. W. | Swingler, S. |
| Butler, H. W. (Hackney, S.) | Lewis, A. W. J. (Upton) | Sylvester, G. O. |
| Chamberlain, R. A. | Lewis, J. (Bolton) | Taylor, H. B. (Mansfield) |
| Champion, A. J. | Lipton, Lt:-Col. M. | Taylor, R. J. (Morpeth) |
| Chater, D. | Longden, F. | Taylor, Dr. S. (Barnet) |
| Chetwynd, G R | McAdam, W. | Thomas, D. E. (Aberdare) |
| Cobb, F. A. | McAllister, G. | Thomas, I. O. (Wrekin) |
| Cocks, F. S. | McGhee, H. G | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Coldrick, W. | Mack, J. D. | Thorneycroft, Harry (Clayton) |
| Collins, V. J. | McKay, J. (Wellsend) | Thurtle, E. |
| Colman, Miss G. M | Mackay, R. W. G. (Hull, N.W.) | Tiffany, S. |
| Comyns, Dr. L. | McLeavy, F | Titterington, M. F. |
| Cook, T. F. | MacMillan. M. K. (Wester | Tolley, L. |
| Cooper, Wing-Comdr. G. | Macpherson, T. (Romford) | Tomlinson, Rt. Hon. G |
| Corlett, Dr. J. | MaHallen, J. P. W. | Turner-Samuels, M. |
| Corvedale, Viscount | Manning, Mrs. L. ( | Ungoed-Thomas, L. |
| Cove, W. G. | Messer, F. | Usborne, Henry |
| Grossman, R. H. S | Middleton, Mrs. L. | Vernon, Maj. W. F. |
| Daggar, G. | Mikardo, Ian | Viant, S. P. |
| Daines, P | Millington, Wing-Comdr. E. R. | Walkden, E. |
| Davies, Edward (Burslem) | Mitchison, G. R. | Walker, G. H. |
| Davies, Harold (Leek) | Moody, A S. | Wallace, G. D. (Chislehurst) |
| Deer, G. | Morris, P. (Swansea. W) | Wallace, H. W. (Walthamstow, E.) |
| Diamond, J | Moyle, A. | Wells, P. L. (Faversham) |
| Debbie, W. | Nally, W. | Wells, W. T. (Walsall) |
| Dodds, N. N. | Naylor, T. E. | Westwood, Rt. Hon J. |
| Donovan, T. | Neal, H. (Claycross) | White, C. F. (Derbyshire, W.) |
| Driberg, T. E. N. | Nichol, Mrs. M. E. (Bradford, N.) | White, H. (Derbyshire, N.E.) |
| Edwards, N. (Caerphilly) | Nicholls, H. R. (Stratford) | Whiteley, Rt. Hon. W. |
| Edwards, W. J. (Whitechapel) | Oldfield, W. H. | Wigg, Col. G. E. |
| Evans, E. (Lowestoft) | Oliver, G. H. | Wilcock, Group-Capt. C. A. B. |
| Fairhurst, F. | Paget, R. T. | Wilkes, L. |
| Fletcher, E C M. (Islington, E.) | Palmer, A. M. F. | Wilkins, W. A. |
| Follick, M. | Pargiter, G. A. | |
| Foot, M. M. | Willey, F. T. (Sunderland) | |
| Ganley, Mrs. C. S. | Parker, J. | Williams, J. L. (Kelvingrove) |
| George, Lady M. Lloyd (Anglesey) | Parkin, B. T. | Williams, W. R. (Heston) |
| Granville, E. (Eye) | Paton, Mrs. F. (Rushcliffe) | Williamson, T. |
| Greenwood, Rt. Hon. A. (Wakefield) | Paton, J. (Norwich) | Willis, E. |
| Grenfell, D. R. | Pearson, A. | Wills, Mrs. E. A |
| Grierson, E. | Pearl, Capt T. F. | Wyatt, W. |
| Griffiths, D. (Rother Valley) | Porter, G. (Leeds) | Yates, V. F. |
| Griffiths, Rt. Hon. J. (Llanelly) | Proctor, W. T. | Younger, Hon. Kenneth |
| Guest, Dr. L. Haden | Pursey, Cmdr. H | |
| Gunter, R. J. | Randall, H. E | TELLERS FOR THE AYES:
|
| Guy, W. H | Ranger, J | Mr. Collindridge and |
| Hale, Leslie | Rankin, J | Mr. Hannan. |
NOES.
| ||
| Agnew, Cmdr. P. G | Hare, Hon. J. H. (Woodbridge) | Neven-Spence, Sir B |
| Astor, Hon. M. | Headlam, Lieut.-Col. Rt. Hon Sir C | Nield, B. (Chester) |
| Beamish, Maj. T. V. H | Hogg, Hon. Q. | Peto, Brig. C. H. M. |
| Boyd-Carpenter, J. A. | Hollis, M. C | Poole, O B. S. (Oswestry) |
| Carson, E. | Hudson, Rt. Hon. R. S. (Southport) | Prior-Palmer, Brig. O. |
| Clarke, Col. R. S. | Hutchison, Lt.-Cm. Clark (E' b'rgh, W.) | Ramsay, Maj. S, |
| Corbett, Lieut.-Col. U. (Ludlow) | Jeffreys, General Sir G | Robinson, Wing-Comdr. Roland |
| Crosthwaite-Eyre, Col. O. E. | Lambert, Hon. G. | Ropner, Col. L. |
| Crowder, Capt. John E | Langford-Holt, J. | Scott, Lord W. |
| Cuthbert, W. N. | Lipson, D. L. | Shepherd, W. S. (Bucklow) |
| Darling, Sir W. Y. | Lucas, Major Sir J, | Snadden, W. M. |
| Digby, S. W. | Lucas-Tooth, Sir H. | Spence, H. R. |
| Dodds-Parker, A. D | Lyttelton, Rt. Hon. O | Stewart, J. Henderson (Fife, E.) |
| Drayson, G. B. | McCallum, Maj. D. | Stuart, Rt. Hon. J. (Mcray) |
| Duthie, W. S. | Macdonald, Sir P. (I. of Wight) | Studholme, H. G |
| Eccles, D. M. | McKie, J. H. (Galloway) | Sutcliffe, H. |
| Elliot, Rt. Hon. Walter | Maclay, Hon. J. S. | Teeling, William |
| Fletcher, W. (Bury) | Macpherson, Maj. N. (Dumfries) | Thorneycroft, G. E. P. (Monmouth) |
| Foster, J. G. (Northwich) | Maitland, Comdr. J. W. | Thornton-Kemsley, C. N. |
| Fyfe, Rt. Hon. Sir D. P. M. | Manningham-Buller, R. E | Thorp, Lt.-Col. R. A. F |
| Gage, C. | Marlowe, A. A. H. | Walker-Smith, D. |
| Galbraith, Cmdr. T. D | Marshall, D (Bodmin) | Ward, Hon. G. R. |
| Gates, Maj. E. E. | Mellor, Sir J. | Wheatley, Colonel M. J. |
| Gomme-Duncan, Col. A | Moore, Lt.-Col. Sir T. | Williams, Gerald (Tonbridge) |
| Grant, Lady | Morrison, Maj. J. G. (Salisbury) | |
| Grimston, R. V | Mott-Radclyffe, Maj. C.E | TELLERS FOR THE NOES:
|
| Mr. Drewe and Major Conant. | ||
Clause 9—(Supplementary Provisions Relating To Transfer Of Hospital Property And Liabilities)
I beg to move, in page 12, line 21, to leave out "and," and to insert "or."
This Amendment, which is slightly more than a drafting Amendment, attempts to meet a criticism made in Committee. The object of the Subsection is to prevent diversion of funds between the date of publication of the English Bill and the appointed day, and if there is a diversion of funds, the divertor must justify the diversion. Under the Clause as originally drafted, it was thought that the conditions were too strict and the conditions at the end of the Clause were cumulative. We now propose, by inserting "or," to make the conditions alternative. I venture to think this Amendment should meet the main criticism that was directed against the Clause.We are very grateful for, and accept, this Amendment, which we think is an improvement.
Amendment agreed to.
Clause 12—(Functions Of Regional Hospital Boards And Boards Of Management)
7.30 p.m.
I beg to move, in page 15, line 17, at the end, to insert:
This Amendment deals with the question of the functions of the regional hospital boards and boards of management under schemes which are to be brought forward either by the boards or by the Secretary of State. Again, the Secretary of State is engrossing to himself great powers. The purpose of his whole administration is to encourage and support the regional hospital boards and the boards of management. That is his declared intention, and I believe it to be his real intention. It is all the more necessary in his case because he has not left the teaching hospitals anything like so far out of the picture as they have been left out in the English Bill. The regional boards have much greater powers in Scotland than in England. This Clause says:"Provided that any scheme so modified shall be laid before Parliament."
And the Secretary of State "may approve," and here again we come to the words:"Every Regional Hospital Board shall, within such period as the Secretary of State may specify, submit to him a scheme …"
It does not seem an exacting request that if he has not approved a scheme which has been submitted to him by his own board, he should lay this scheme before Parliament. In fact, I cannot quite see what would be the Secretary of State's objection to this proposal. In the previous Clause we tried to deal with the words "with or without modification," arid he refused; he said that he must have his hands free. Here we have left his hands free. He is now empowered either to approve the scheme of the regional board or to disapprove it, to modify it or make exceptions, from it, but having done so it would be to his advantage, as well as ours, that it should be laid before Parliament. He has said in correspondence that he would draw attention to it, that he would make a report, that the point would be covered in some way. That is not sufficient for his own purpose. There is nothing worse than a rumour going round that there is some disagreement between the Secretary of State, or some powerful Minister and one of his own creations. If he can say that in the event of any disagreement the House can be sure that he will have to lay that disagreement before Parliament, everyone will see what has happened. I have no doubt that the Secretary of State would have his way; his scheme would be approved, but it would have come before the duly constituted representatives of the people, and the attention of Scotland as a whole would have been drawn to the fact that this disagreement had arisen, and had been resolved. I trust that the Secretary of State will find it possible to meet us in this matter, or, if he cannot meet us fully, he might say, in the reasonable way in which the Joint Under-Secretary met us a little earlier in the evening, "I undertake that I will examine this between now and the passage of the Bill through another place." The purpose of this and the subsequent Amendment is to say that the Minister shall not have power to modify either the painstaking arrangements which he has set up or, still worse, to dispense with the Statutes which are being laid down. If he does not meet us we must continue to press our argument, because at present the Secretary of State is overloading himself with powers which are not fair to the working of the creatures he desires to bring into full and proper operation."… with or without modifications, which may include additions or exceptions, any scheme submitted to him… "
After the persuasive arguments used by my right hon. and gallant Friend the Member for the Scottish Universities (Lieut.-Colonel Elliot) the Secretary of State should find no difficulty in accepting this Amendment. As I read the Bill, this is probably one of the most important Clauses and one of the most important Amendments in it, because it is on these schemes, as drawn up by the boards of management and submitted to the regional boards, that our health and the health of the whole community depends. In addition to that they will have wide powers—the appointment of officers, the maintenance of premises, the acquisition of equipment and furniture. All these are matters of vital importance to the community as a whole. It seems to me logical and, more than that, essentially reasonable, that such schemes or such modifications, if not approved by the Secretary of State, shall be subject to being laid before the representatives of the people concerned.
That does not impose any great strain on the Secretary of State. In fact, it removes some of the strain from him, because throughout this Bill he has been taking on the most fantastic obligations in practically every Clause. Indeed, so far as I can see, he will have enough work, in carrying out this Measure, to absolve him from carrying out any other duties whatever. I would suggest that he might, in his own -interests, relieve himself from some of the burdens, obligations and responsibilities, by agreeing to this Amendment and placing the responsibility where it should be—on Members of this House.The effect of this Amendment is really to give publicity to the scheme as approved. The objection to adopting this course is that it seems to introduce a too formal element into the relationship between the Secretary of State and the Regional Board. The relationship between the two is a close one, and the Board is, to all intents and purposes, the agent of the Secretary of State. In a relationship of that kind, it hardly seems desirable that the mode of publicity to be adopted should be by laying the scheme before Parliament. It seems to the Secretary of State that other methods of publicity might be utilised which would he more suitable to the changing or different circumstances which might occur in the event of any disagreement between himself and the Regional Board. He feels that he should not be tied down to one particular mode of publicity, and that other methods of publicising the situation, which would be more appropriate to the circumstances, could be devised, than this purely formal method, which merely means putting documents before Parliament, and nothing more. The best way of ventilating any such difficulties of this kind is in Scotland itself, or through the Press, or by some such method. In these circumstances, the Secretary of State thinks that this is too rigid and formal a method, and that the Amendment, therefore, should not be accepted.
I am very disappointed with the Lord Advocate's reply and with the rather peremptory way in which he has rejected this Amendment. He said that the idea behind it was to get publicity. I make him a present of the fact, but why should he object? He said that it proposed only one mode, and that there were many other ways of publicity open to people if they were dissatisfied with the way in which the regional board proposed to act. He suggested the Press. With great respect to the right hon. Gentleman, I submit that these schemes may be vast and far-reaching in effect. If there is any bone of contention, it should be settled here on the Floor of the House of Commons in the open forum of discussion. I would remind the Lord Advocate that the Secretary of State when we were discussing this Clause in Committee and we had a very brisk Debate on the subject, said he would undertake to look into the question of laying such schemes before Parliament. He did not say whether they would be subject to affirmative or negative Resolution, but he agreed to consider the matter to see whether he could agree to our proposals. I would like to see any such scheme submitted not merely for rejection but for affirmative Resolution. I would have been prepared to take half a loaf, which is better than no bread, but the Lord Advocate has denied me even that satisfaction.
I thought the Secretary of State would agree that this was a suggestion which would appeal to the general mass of the public in Scotland, particularly to the workers whom he specially claims to represent. It is their interests which will be specially concerned in this Bill. However, the right hon. Gentleman has decided in his wisdom—or, I think, his unwisdom—that he cannot agree to our proposals. I regret it very much. Indeed, I rather resent it, because we have had no word from the Lord Advocate to tell us why his right hon. Friend came to the conclusion that he could not accept this proposal to which, in Committee, he promised to give his serious attention. Perhaps the Secretary of State will see fit to give us the reason. I feel sure that my regret will be shared by a very large number of people, almost, I should think, the entire population of Scotland who have a very great opinion of our Parliamentary procedure. If the Secretary of State had agreed to this quite modest Amendment, it would have gone a long way towards reassuring the public that the functions of the regional boards in Scotland would have the thorough investigation which is deserved.I see one difficulty in this, and that is connected with publicity. It is obvious that one does not want the other authority to use publicity as a lever in any disagreement which they may have with the Secretary of State. On the other hand, if there is possible ground for disagreement it should not be hushed up and dealt with by any form of secrecy. The right hon. and learned Gentleman the Lord Advocate has told us that there are other kinds of publicity. He mentioned the Press. I am not certain how the Press comes in. Are the other authority to meet in public with all their discussion open to the Press, or how is information regarding any disagreement which might occur between the Secretary of State and the planning authority, to become public property? How will the information be presented to the Press? We want more information. It seems strange at a time like this, when we are getting all forms of Statutory Rules and Orders coming before the House to the tune of hundreds per year, that we should fall shy of these occasional and modest documents which we are asking the Secretary of State to supply and of which, in any case, it is desirable that the Scottish Press should be made aware.
7.45 P.m.
The Lord Advocate has said that the Secretary of State has in mind the use of other forms of publicity but, as the Clause stands, there is no guarantee that he would use any publicity whatever. As the Amendment is worded, its acceptance would at least ensure that the matter was brought to the attention of the House of Commons and thus given a certain amount of publicity. A particular reason why it should be brought to the attention of the House is because we presume that the Secretary of State intends to give the maximum latitude to regional boards in the control of their regions. If he disagrees with them, it should be on national grounds in order to work the various schemes together. If he cannot persuade them on those grounds, then the matter is a national one which, obviously, should be brought, by way of the House of Commons, to national attention. There are the strongest reasons for accepting this very simple Amendment which can do no harm whatever.
I wish to draw attention to the wording of the Clause under which it will be found that the Secretary of State may approve, with or without modifications, schemes that may be prepared by the regional boards. That implies pretty clearly that if he came to the state of mind where he had to say that they had to submit a new scheme, nearly everything would have been tried in the way of reason and adjustment in order to approve the original scheme. We have been told on many occasions by the Joint Under-Secretary of State that, so far as possible, any contentious point will be made available for Debate on the Floor of the House. I cannot understand why the right hon. and learned Lord Advocate feels that he must advise the Secretary of State not to accept this very simple Amendment, which seems to be perfectly fair.
He would be a very brave man indeed, who, representing a watering place in the South, interfered in a Scottish Debate, but I am tempted to ask a question by the remark made by the right hon. and learned Lord Advocate. He apparently holds the view that, rather than submit documents to Parliament, there is an alternative method in Scotland of publishing information in the Press or otherwise. I was hoping that the Secretary of State would explain exactly what form this publicity will take. Otherwise, it might mean the Scottish B.B.C.—but I very much doubt whether they will be willing to turn themselves into a channel of information for the Government. As a former Minister of Information and one who has listened to a number of Debates in this House about the Press, I am fascinated by this new topic raised by the Lord Advocate. Apparently the House of Commons is not really the best possible place to inform Members of Parliament about what happens in Scotland. The Secretary of State is here, and I feel perfectly certain that he will clarify this point and tell us exactly what are the proposals of the Government about publicity. If we have this, as a former Minister of Information, I shall feel greatly enlightened.
I shall do my best to enlighten the right hon. Gentleman, who, I am sure, has put this point forward in quite a fair manner. He is very anxious to discover exactly what is in our minds. I will be equally frank. I am one of those individuals who admit that Ministers do not know everything. I am always willing to take into consultation those whom I appoint, or for whom I am responsible in connection with administrative acts. This will be an administrative act. The Lord Advocate has made perfectly clear our view about bringing too formal a matter into the administration of this scheme. This seeks to provide that the Secretary of State shall not be in a position to deal with modifications.
I was wondering why the Secretary of State was refusing this Amendment. It is because he is arguing about a proposal we are not putting forward. We admit his power to modify the scheme. All we say is that we should like it laid before Parliament.
I am going to deal with that. It suggests that any scheme so modified, shall be laid before Parliament, but it does not leave it subject to any annulment by Parliament after it is laid before Parliament. That is the Amendment, and I can only deal with that. I am not at the moment worrying too much about those hon. Members who are away to the right of the Conservative Party. The Amendment does not seek to provide that the scheme, so modified, shall be open to annulment, and that is why the Lord Advocate has, quite rightly, assumed that it was for publicity purposes. There are better ways of publicity. I would suggest the Press, as was mentioned by the Lord Advocate. There must be other methods. I know of no objection whatever to publicity. I think it is necessary if the scheme is modified, that there should be publicity in connection with it. I agree that it is desirable and that there should be the fullest publicity in connection with these schemes. I will consider with the regional boards when the time comes what form of publicity would most usefully serve this purpose. That is why I said that I am one of those persons who do not claim to know everything. I am always willing to learn and gain experience. I will have full consultation with the regional boards as to the best method to get that publicity across. For these reasons I must resist
Division No. 127.]
| AYES.
| [7.53 p.m.
|
| Beamish, Maj. T. V. H. | Headlam, Lieut.-Col. Rt. Hon. Sir C | Poole, O. B. S. (Oswestry) |
| Bower, N. | Hogg, Hon. Q. | Prior-Palmer, Brig. O. |
| Boyd-Carpenter, J. A. | Hollis, M. C. | Ramsay, Maj. S |
| Bracken, Rt. Hon. Brendan | Hudson, Rt. Hon. R. S. (Southport) | Repner, Col. L. |
| Carson, E. | Hutchison, Lt.-Cm. Clark (E'b'rgh, W.) | Scott, Lord W |
| Corbett, Lieut.-Col. U. (Ludlow) | Langford-Holt, J. | Snadden, W. M. |
| Crosthwaite-Eyre, Col. O. E. | Linstead, H. N. | Spearman, A. C. M. |
| Cuthbert, W. N. | Lipson, D. L. | Spence, H R. |
| Darling, Sir W. Y | Lucas-Tooth, Sir H. | Stewart, J. Henderson (Fife, E.) |
| Digby, S. W. | McCallum, Maj. D. | Stuart, Rt. Hon. J. (Moray) |
| Dodds-Parker, A. D. | Macdonald, Sir P. (I. of Wight) | Studholme, H. G. |
| Dower, Lt.-Col. A. V. G. (Penrith) | McKie, J. H. (Galloway) | Sutcliffe, H |
| Drayson, G. B. | Maclay, Hon. J. S. | |
| Drewe, C. | Teeling, William | |
| Duthie, W. S. | Macpherson, Maj. N. (Dumfries) | Thorneycroft, G. E. P. (Monmouth). |
| Eccles, D. M. | Maitland, Comdr. J. W. | Thornton-Kemsley, C. N. |
| Elliot, Rt. Hon. Waltc | Manningham-Buller, R. E | Thorp, Lt.-Col. R. A. F |
| Fletcher, W. (Bury) | Marlowe, A. A. H. | Walker-Smith, D. |
| Foster, J. G. (Northwich) | Marshall, D. (Bodmin) | Ward, Hon. G. R. |
| Gage, C | Mellor, Sir J. | Wheatley, Colonel M. J |
| Galbraith, Cmdr. T. D. | Moore, Lt.-Col. Sir T. | Williams, Gerald (Tonbridge) |
| Gates, Maj. E. E. | Morrison, Maj. J. G. (Salisbury) | Willoughby de Eresby, Lord |
| Gomme-Duncan, Col. A | Nield, B. (Chester) | |
| Grant, Lady | Peto, Brig. C. H. M. | TELLERS FOR THE AYES
|
| Grimston, R. V. | Commander Agnew | |
| Major Conant. |
NOES
| ||
| Adams, Richard (Balham) | Cobb, F. A. | Guest, Dr. L. Haden |
| Adams, W. T. (Hammersmith, South) | Cooks, F. S. | Gunter, R. J. |
| Alpass, J. H. | Coldrick, W. | Guy, W. H. |
| Anderson, F. (Whitehaven) | Collins, V. J. | Hale, Leslie |
| Attewell, H. C. | Colman, Miss G. M | Hall, W. G. |
| Austin, H. Lewis | Comyns, Dr. L. | Hamilton, Lieut.-CoI. R |
| Awbery, S. S | Cook, T F. | Hardy, E. A. |
| Ayles, W. H. | Cooper, Wing-Comdr. G. | Harrison, J. |
| Ayrton Gould, Mrs. B. | Corlett, Dr. J. | Hastings, Dr. Somerv |
| Bacon, Miss A | Corvedale, Viscount | Haworth, J. |
| Baird. J. | Cove, W. G. | Henderson, Joseph (Ardwick) |
| Balfour, A. | Crossman, R. H. S. | Herbison, Miss M. |
| Barnes, Rt. Hon. A. J | Daggar, G. | Holman, P. |
| Barstow, P. G. | Daines, P. | Holmes, H. E. (Hemsworth) |
| Barton, C. | Davies, Edward (Burslem) | House, G. |
| Battley, J. R. | Davies, Harold (Leek) | Hoy, J. |
| Bechervaise, A. E | Deer, G. | Hubbard, T. |
| Benson, G. | Diamond, J. | Hughes, Hector (Aberdeen, N.) |
| Berry, H. | Dobbie, W. | Hutchinson, H. L. (Rusholme) |
| Beswick, F | Dodds, N. N. | Hynd, H. (Hackney, C.) |
| Bevan, Rt. Hon. A (Ebbw Vale) | Donovan, T. | Hynd, J. B. (Attercliffe) |
| Bing, G. H. C. | Driberg, T. E. N. | Irving, W. J. |
| Binns, J. | Edwards, N. (Caerphilly) | Isaacs, Rt. Hon G. A |
| Blackburn, A. R | Edwards, W. J. (Whitechapel) | Janner, B. |
| Boardman, H | Evans, E. (Lowestoft) | Jay, D. P. T. |
| Bowen, R. | Fairhurst, F. | Jeger, G. (Winchester) |
| Bowles, F. G. (Nuneaton) | Fletcher, E. G. M. (Islington, E.) | Jones, D. T. (Hartlepools) |
| Braddock, Mrs. E. M. (L'pl. Exch'ge) | Follick, M. | Jones, Elwyn (Plaistow) |
| Brook, D. (Halifax) | Foot, M. M. | Jones, P. Asterley (Hitchin) |
| Brooks, T. J. (Rothwell) | Gaitskell, H. T. N. | Keenan, W. |
| Brown, George (Belper) | Ganley, Mrs. C. S. | Kenyon, C. |
| Bruce, Maj. D. W. T | George, Lady M. Lloyd (Anglesey) | King, E. M. |
| Buchanan, G. | Gibson, C. W. | Kinley, J. |
| Burden, T. W. | Granville, E. (Eye) | Lee, F. (Hulme) |
| Butler, H. W. (Hackney, S.) | Grenfell, D. R. | Lee, Miss J. (Cannock) |
| Chamberlain, R. A | Grierson, E. | Leonard, W. |
| Champion, A. J | Griffiths, D. (Rother Valley) | Leslie, J. R. |
| Chater, D. | Griffiths, Rt. Hon. J. (Llanelly) | Levy, B. W. |
the Amendment. It would result in too much in the way of formalities in dealing with this matter, and could serve no useful purpose so far as Parliament is concerned, because it does not suggest that the scheme should be open to annulment.
Question put, "That those words be there inserted in the Bill."
The House divided: Ayes, 70; Noes, 235.
| Lewis, A. W. J. (Upton) | Proctor, W. T. | Sylvester, G. O. |
| Lewis, J. (Bolton) | Pursey, Cmdr. H | Taylor, H. B. (Mansfield) |
| Lipton, Lt.-Col, M. | Randall, H. E | Taylor, R. J. (Morpeth) |
| Longden, F. | Ranger, J. | Taylor, Dr. S. (Barnet) |
| McAdam, W. | Rankin, J | Thomas, D. E. (Aberdare) |
| McAllister, G. | Reeves, J. | Thomas, I. O. (Wrekin) |
| McGhee, H. G | Reid, T. (Swindon) | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Mack, J. D. | Richards, R. | Thorneycroft, Harry (Clayton) |
| McKay, J. (Wallsend) | Robens, A. | Thurtle, E. |
| Mackay, R. W. G. (Hull, N.W.) | Roberts, Emrys (Merioneth) | Tiffany, S. |
| McLeavy, F | Roberts, Goronwy (Caernarvonshire) | Titterington, M. F. |
| MacMillan, M. K. (Western Isles) | Rogers, G. H. R. | Tolley, L. |
| Macpherson, T. (Rumford) | Ross, Willlam (Kilmarnock) | Turner-Samuels, M. |
| Mallalieu, J. P. W. | Sargood, R. | Ungoed-Thomas, L. |
| Manning, Mrs. L. (Epping) | Scollan, T. | Usborne, Henry |
| Marquand, H. A. | Scott-Elliot, W | Vernon, Maj. W. F. |
| Messer, F. | Shackleton, E. A A. | Viant, S. P. |
| Middleton, Mrs. L | Sharp, Granville | Walkden, E. |
| Mikardo, Ian | Shawcross, C. N. (Widnes) | Wallace, G D. (Chislehurst) |
| Millington, Wing-Comdr. E. R. | Shawcross, Rt Hn. Sir H. (St. Helens) | Wallace, H. W. (Walthamstow, E.) |
| Mitchison, G. R. | Shurmer, P. | Wells, P. L (Faversham) |
| Moody, A. S. | Silverman, J. (Erdington) | |
| Morgan, Dr. H. B | Simmons, C. J. | Wells, W. T. (Walsall) |
| Morris, P. (Swansea W.) | Skeffington-Lodge, T. C | Westwood, Rt. Hon. J. |
| Moyle, A. | Skinnard, F W. | White, C. F. (Derbyshire, W.) |
| Nally, W. | Smith, C. (Colchester) | White, H. (Derbyshire, N.E.) |
| Naylor, T. E. | Smith, Ellis (Stoke) | Whiteley, Rt. Hon. W. |
| Neal, H. (Claycross) | Smith, H. N. (Nottingham, S.) | Wigg, Col. G. E. |
| Nichol, Mrs. M. E (Bradford, N.) | Smith, S. H. Hull, S.W.) | Wilkes, L. |
| Nicholls, H. R. (Stratford) | Snow, Capt. J. W. | Wilkins, W. A. |
| Oldfield, W. H. | Solley, L. J. | Willey, F. T. (Sunderland) |
| Oliver, G. H. | Williams, J. L. (Kelvingrove) | |
| Paget, R. T. | Soskice, Maj. Sir F | Williams, W. R. (Heston) |
| Palmer, A. M. F | Sparks, J. A | Williamson, T. |
| Pargiter, G. A. | Stamford, W | Willis, E. |
| Parker, J. | Steele, T. | Wills, Mrs. E. A |
| Parkin, B. T. | Stephen, C. | Wyatt, W. |
| Paton, Mrs. F. (Rushcliffe) | Stewart, Michael (Fulham, E.) | Yates, V. F |
| Paton, J. (Norwich) | Strachey, J. | Younger, Hon. Kenneth |
| Pearson, A. | Strauss, G. R. (Lambeth, N.) | |
| Peart, Capt. T. F. | Stress, Dr. B. | TELLERS FOR THE NOES
|
| Porter, G (Leeds) | Swingler, S. | Mr. Collindridge and |
| Mr. Hannan. |
Clause 15—(Health Centres)
8.0 p.m.
I beg to move, in page 17, line 27, after "may," to insert after holding an inquiry."
We do our utmost to meet hon. and right hon. Gentlemen opposite, and we are anxious to secure some way or other in which this question of bringing things before Parliament and the public can be properly carried out. The last time we tried to induce the Secretary of State to concede the point that a scheme would be more appropriately laid before Parliament than put out in some less formal way; this time we suggest that if he is taking action under the Clause in question, he might hold an inquiry first. This Amendment was put down, of course, primarily with the object of bringing the matter of the health centres before the public as a whole. As the Joint Under-Secretary knows very well, the paint of the health centres is one to which doctors attach great importance. He has adopted in this case a method which we think is superior to the one which was proposed originally, that is to say, that the health centres shall be looked after directly by the Secretary of State himself. However, we are a little uneasy about the provisions here for delegation, and I am sure that the medical profession as a whole would feel much more content if the Secretary of State could see his way to adopt the suggestion in this modest proposal, that before he throws over one of the main principles of his Bill—that is to say, that the health centres should be the charge of the Secretary of State rather than the local authority—he should give due notice of that by the holding of a local inquiry. It is not necessary to stress the point unduly. The case makes itself. It is the Secretary of State's Bill, it is the Secretary of State's proposal, it is the proposal to which those with whom he has been negotiating, the medical profession, attach great importance. It is a proposal which should not be modified without a good deal of careful thought, and certainly not without adequate notice. On all these grounds we think this proposal should commend itself to the Secretary of State.
I have made it clear on more occasions than one that I do not intend to delegate any of the health centre functions to local authorities in the early experimental years of the new service, and if and when, the stage of delegating functions is reached, the exact nature of the delegation in each case will have to be worked out in consultation with the professional people concerned and in agreement with the local health authority to whom the functions will be delegated. Delegation will not be an irrevocable act of administration, but it is an administrative act, and the arrangements for delegation in any particular case will probably be altered from time to time in the light of experience of their operation. I should like to know why it is suggested that there should be a formal inquiry before any variation in delegation arrangements is made. I suggest that the Amendment might be withdrawn on my giving the assurance that delegation will only take place on agreement with the local health authority concerned, and on terms and conditions acceptable to that authority; and that they will never take place; so far as I am concerned, without consultation with the executive council, the medical and other appropriate bodies interested in the area, especially the doctors and the dentists working at the health centre itself. The procedure of a formal inquiry would be far too elaborate and inappropriate a method of dealing with such consultations, and with the assurance I have given, which I feel sure would be a reasonable assurance so far as the professional side is concerned, I trust that the Amendment will be withdrawn.
I can only speak again with the leave of the House, of course, but I would say that the assurance given by the Secretary of State, although it did not go as far as we would like, is a reasonable undertaking, and on that I beg to ask leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Clause 27—(Prevention Of Illness, Care And After-Care)
I beg to move, it page 23, line 31, to leave out Subsection (2), and to insert:
This Amendment has been put down to meet the same criticism as was met in relation to Clause 22 (2) by the Amendment which was accepted on recommittal. The new Subsection (2) makes it clear that charges can be recovered only in respect of services which have been prescribed in regulations which will be subject to annulment by Parliament. The kind of services for which a charge might be made are in the supplying of extra foodstuffs, extra fuel, blankets, beds and bedding. Possibly also if night sanatoria are provided for convalescence, particularly for patients convalescing from tuberculosis who are well enough, provided their sleeping accommodation at night is healthy and adequate, to be discharged from hospital and to work during the day for an earning wage, some charge might have to be made in respect of the board and lodgings so provided. With that explanation. I trust the House will accept the Amendment."(2) The local health authority may recover from any person availing himself of any such service provided under this section as may be prescribed such charge as the authority may determine having regard to the cost of the service: Provided that the authority may remit the said charge in whole or in part if in the circumstances of any particular case they consider it reasonable to do so."
Amendment agreed to.
Clause 28—(Domestic Help)
Amendment made: In page 24, line 1, leave out Subsection (2), and insert:
"(2) The local health authority may recover from any person availing himself of domestic help so provided such charge as the authority may determine having regard to the cost of the arrangements: Provided that the authority may remit the said charge in whole or in part if in the circumstances of any particular case they consider it reasonable to do so."—[Mr. Westwood.]
Clause 30—(Executive Councils)
I beg to move, in page 25, line 27, to leave out "may," and to insert "shall."
This Amendment was moved in Committee, and I resisted it there, but I have looked at it again and it seems to me that the objection I took to it was rather theoretical and I am prepared to move it now.Amendment agreed to.
Clause 33—(Distribution Of Medical Practitioners Providing Services)
I beg to move, in page 28, line 16, at the end, to insert:
These words require the Scottish Medical Practices Committee to make a survey of each area, or part of an area, and report on the number of practitioners required for the service. We feel that those about to enter the medical profession should have some knowledge of over-doctored and under-doctored areas, so that they might make their arrangements accordingly. It would not be fair that they should be required to go forward in complete uncertainty whether or not they would be able to practise in the areas in which they wish to practise. We think this is a reasonable Amendment, and hope that it will be accepted."(b) for requiring the Scottish Medical Practices Committee to survey each area or part of an area and to report on the number of medical practitioners necessary to provide an adequate service."
I beg to second the Amendment.
I regret I cannot see my way to accept this Amendment. In the general way, a vacancy arising in a particular district will be advertised in the medical Press. This question cannot be merely considered as one of the number of doctors in a particular area. An area may be under-doctored or over-doctored for other reasons, and the question of the health of the doctors in the district has to be considered. The actual numbers might be misleading in some cases. We take the view that the best way in which to make vacancies known is by advertisement in the professional journals and that to map out the district on actual numbers would not always be desirable. We have no power of direction of doctors and there are other considerations, such as age, which have to be taken into account.
8.15 p.m.
Could the hon. Member deal with the point I made? The method which he has suggested gives no previous warning to a young man starting out in his profession. But such a student, perhaps in his fourth year, might have to make up his mind whether he is going abroad into the Colonial service, or to practise in, say, Argyllshire. The whole of his arrangements might be altered by the question of whether or not there was likely to be a vacancy in the area when he qualified.
But the medical profession is a well organised profession. The Scottish Medical Practices Committee would be in touch with the B.M.A., and all that the young man would have to do would be to consult with his tutors, and to keep in touch with the Scottish branch of the British Medical Association. An Amendment such as this is not necessary. Even now any doctor in the profession can find the number of doctors practising in a particular area.
I do not think the Amendment moved by the hon. and gallant Member for Pollok (Commander Galbraith) would achieve the purpose he desires. The young man of whom he spoke might be misled by information in regard to the areas. Populations are not static. In the county of Fife we may, and I hope in the next year of two we shall, have a huge influx of population. No good purpose would be served to say that at a particular date there were so many doctors in an area, when, within 12 months, those numbers may go all agley. It is much better for the young man, and for everyone, to continue with the present practice, and the Government will see that the young doctor knows the actual position not only in a particular area, but generally throughout Scotland. My right hon. Friend means to make his officials at all times accessible to the young doctor, who will have the exact picture of the country before him. We think this is better than arbitrarily publishing the numbers of doctors in different areas. It is better that the doctors through their organisation and individual doctors should have access to the people by actual interview with the officials, who can assist in placing them.
What the Parliamentary Secretary is telling us his right hon. Friend intends to provide is exactly what we are asking in this Amendment.
No.
It is entirely similar. It is achieving the purpose for which we have put this Amendment down and if the hon. Gentleman is giving us a firm assurance on that point—as I understand he is—I beg to ask leave to withdraw the Amendment.
I have consulted my right hon. Friend the Secretary of State and he says it is an assurance of how this is intended to work.
Amendment, by leave, withdrawn.
Clause 34—(Prohibition Of Sale Of Medical Practices)
I beg to move, in page 29, line 33, at the end, to insert:
There was a long discussion in Committee on the steps which were necessary to prevent what the Lord Advocate described as the black marketing of medical practices, and I think that all sides of the Committee agreed that safeguards should be inserted on the lines of those laid down in Clause 34 (3) in order to make it impossible for a medical practitioner or his executors to get something for the goodwill by charging more than the proper price for premises, a car, or anything like that. At the end of a rather long discussion the Secretary of State said:"For the avoidance of doubt it is hereby declared that if premises previously used by a medical practitioner are sold at a public auction by that medical practitioner or by his personal representative such sale shall not be deemed to be a sale of the goodwill or part of the goodwill of the practice of that practitioner."
He went on to say:The purpose of the Subsection is to make it as difficult as possible—if not impossible—by some means or other, in the sale of something that is not associated with the practice, to cover up the sale of that practice, and get behind what is the intention of the Government. That is the position briefly, and I have not the slightest intention of resiling from that intention."
It was clear from the discussion that the Committee were not at all sure what would be the effect of an auction sale. Indeed, the Lord Advocate himself when asked the question had to admit that he did not know the answer. The purpose of this Amendment is to eliminate at least one doubt from a field which is likely in any case to give rise to considerable dispute and even the possibility of litigation. In order to see the effect of this Amendment, I invite the House to consider the position which would arise if it were not accepted. Let us assume that there is still a doubt about the case of the auction sale. Let us assume that there are two parties to the transaction, either the practitioner who is going to sell a particular private practice or the executors or personal representatives of a practitioner. Both those parties and the would-be purchaser are conscientious people, who are most anxious not to infringe the law. They are most anxious not to incur these very severe penalties which might or might not amount to £500, and in addition the repayment of any amount which may have been got in such an underhand way, as well as a term of imprisonment not exceeding three years. Let us assume that they are genuinely anxious not to leave themselves liable to these penalties, and genuinely anxious, as I am sure they would be, to do what is right. The vendor instructs the agent to put up his premises for sale at a public auction. Supposing in the course of that auction which he attends, he observes that there is a doctor who is bidding for his property. What is the position? He does not want to run the risk of infringing the law or making himself liable to a heavy penalty or to imprisonment. Is he to stop the sale? There is the other man bidding for the property and the seller will not know until the hammer falls, whether the doctor is going to buy, or whether it is the other man, because they are both bidding one against the other. When the hammer falls, is he to repudiate the sale? The Lord Advocate is here and he will be able to tell us whether that would be a legal repudiation. I understand that once the hammer falls, a contract has been made, and, therefore, it would be quite impossible for that man to say he would not sell to the doctor—But there are two parties to this transaction. What about the would-be purchaser, the doctor who is anxious to buy the house which is offered for sale on the public market? If he is a prudent man, he will go to a firm of experts and before the sale takes place ask their advice as to what he ought to give. He will inquire what is the value of this property on the open market, and he may be advised that it is £2,500 or even £3,000. He goes to that auction in the knowledge that the expert view is that the property is not worth more than £2,500. Bidding starts at say £2,000 and rises to 2,300 and then to £2,500. Is he then to stop? It may go up to 3,000 or 3,500 It is astonishing how much properties are fetching now in the open market, whether they are sold by private treaty or by public auction. What is the position of this gentleman? Has he to stop because he knows he is getting above the amount he is advised by expert advisers is the true value of the property? It is a most difficult question. I have thought a lot about this since the Committee Stage. I did not receive advice from any outside body to put down this Amendment. It is the fruit of my own thought upon the matter for what it is worth, and I think it is in accordance with the request which was made by the Secretary of State on the Committee Stage in the words which I have quoted. I genuinely believe that this will do a great deal to remove at least one doubt from a field which is already full of doubts and difficulties. In all sincerity I commend this Amendment to the House."If the Opposition can give me any means whereby I could tighten it up, even to the inclusion of sales by auction, even to acquiring not only the practice, but the property and the choice of who is to use it, I am ready to consider them between now and the Report stage."—[OFFICIAL REPORT, Standing Committee on Scottish Bills; 5th March. 1947: c. 521.]
8.30 p.m.
I beg to second the Amendment.
I would recall to the House the position in which this matter stands. Clause 34, with which we are dealing, lays down in Subsection (2) thatto a fine which will deprive him of any profit, a further amount of £500 or three months in jail. We are today in a period of inflation; prices are going up all the time. It is therefore very difficult to lay down, by any rule of thumb, what shall be the value of a house, a motor car, a consulting room, or whatever else it may be. I suggest that this Amendment represents one of the fairest methods of allowing any doctor or his representatives—because they are included too—with a medical practice to sell to conduct the sale and carry it to a conclusion with the certainty that this is being done in a legal manner. This matter was raised in Committee, and there is no guarantee, even if the sale is carried out privately, that an excessive price is not being asked. The actual wording is:"anyone who sells or buys the goodwill of a medical practice shall be liable on conviction"
I do suggest that in the present circumstances of the country that is a very difficult figure to assess. Further, I suggest that this Amendment which is simple and clear, and which allows a doctor or his representative to sell what they have to sell at a public auction, is the fairest manner of dealing with the matter."the sale, letting or other disposition is substantially in excess of the consideration which might reasonably have been expected to be paid by a medical practitioner for the premises as such irrespective of goodwill. …"
I am sure the House is much indebted to the two hon. Gentlemen who have moved and seconded this Amendment for the great care and consideration they have given to it. Since the matter was raised in Committee I have looked carefully at it myself, and I think I may be able to satisfy the hon. Gentlemen as to the position. My view is that this Amendment is not necessary. It seems to me that where a doctor's house is sold at a genuine auction sale there could be no danger of prosecution. The fact that a sum was paid at such a genuine auction by a purchaser who had no prior agreement with the seller, would negative any suggestion that the price contained an element of goodwill. I cannot conceive of a genuine auction where the parties had no kind of prior agreement, in connection with which there could be any suggestion of prosecution.
On the contrary, this further trouble arises from the form of the Amendment. If it were accepted, I should be anxious because it might well afford an opportunity of evading the prohibition on the sale of goodwill, since if a purchaser and a seller put their heads together and agreed on what might be considered to be an absurd price, which would really keep out any ordinary non-medical person, they would thus be able to evade the statute and it would be very difficult, if not impossible, to get at them. There is that danger—that if the Amendment were allowed, it would open the door to that kind of thing. There is always that danger when one tries to legislate for a particular case of this kind, and it seems to me much better to leave it to the ordinary law. If we attempt to make this Amendment, I gravely fear that we should be asking for trouble. As I have said, I am perfectly confident that if the auction is genuinely carried through without any kind of prior agreement, there could be no question at all of prosecution.The right hon. and learned Gentleman said that this is an exceptional circumstance and that it is not in our interest to deal with it because of that fact, but I wish to point out that the Clause itself deals with a special circumstance. It is a unique and a special circumstance and I venture to say is one which will rapi pass. In five or ten years there will be no such occurrence of this kind and there will be no sales of property of this description. I think the Amendment has the justification that it does rough justice to the doctor in allowing him to get what he is reasonably entitled to as the value of his property. The Government have tried to fix a ceiling upon ordinary residential property; they have failed, although, quite rightly, they turned their best intelligence to this very difficult matter.
While that is true of property generally, the unfortunate doctor is not to be permitted to have the true value of his property, because it may well be that the so-called enhanced prices received may be attributed, in the opinion of some, to be partly in the nature of goodwill. The Lord Advocate speaks of a genuine auction sale. I can inform the House that I was a licensed auctioneer for some years in Western Australia, and I recollect very clearly a circumstance of a relevant character. There were some 40 or 50 persons present at a sale and I was selling a harmonium. Only one person wanted it. To all intents and purposes this was to be a genuine sale, but I knew that only one person wanted the harmonium while the other 39 or so were there for the purpose of buying other things such as hens, poultry-coops and so on. How can one say what is a genuine auction sale? What are the standards of identification? How does the Under-Secretary or the Secretary of State discover when a sale is genuine or not genuine? How does he know when there is only one person who is interested and prepared to buy the property at a particular price? Do we want this Clause at all? If the Minister insists on it then I think he should, by accepting the Amendment proposed by my hon. Friend, protect the medical practitioner seeking to sell his house against a grave injustice placing him at a disadvantage compared with any other person seeking to sell a house. There is a tendency to look at this Bill in a very uneven way. Certain things are being built which will, I hope, last long after our lifetime; but other things are most transitional, and I think the right hon. Gentleman will see that this Clause deals with something of a most transitory character. It deals with something which, I think, will certainly not occur in five or six years from now. The sale of practices and buildings associated with them will disappear, and as the national health service becomes part of our statutory institutions this set of circumstances will be obliterated. But here we are embodying in the Bill for all the time that it lasts this particular prohibition. I venture to say that at no very distant date this House and the public will be astonished to read in Subsection (2) of Clause 34 the offences, and the punishments for those offences, to which persons who, hitherto, have been believed to be engaged in the honourable and noble calling of healing the sick and succouring the suffering, are liable for selling what is really their own property. I hope the Amendment will be accepted; I do not think it betters the position to any great degree but it certainly reduces the grave abuse and peril—abuse so far as the public is concerned and peril so far as concerns the medical practitioner. I hope that the Secretary of State for Scotland and his advisers will see their way to accept this Amendment, which has been given a great deal of thought, and is put forward sincerely in the hope that it will be useful to the Minister, and will be fair and just to the medical practitioners.I speak again by leave of the House. It appears to me that this Amendment would be acceptable to the Lord Advocate if, for the word "public," were substituted the word "genuine." His difficulty appears to be that he contemplates what is called a "rigged" sale. He is a lawyer, and he knows very well that the law gives ample protection against rigged sales. I have no doubt that to rig an auction sale is an offence in Western Australia as well as in Scotland. The House never ceases to be amazed and delighted at the versatility of my hon. Friend the Member for South Edinburgh (Sir W. Darling), who has instanced a sale at which there was only one purchaser. I am sure that the Lord Advocate will appreciate that if he does not accept this Amendment, or an Amendment with the alteration I suggest, he will drive Scotland back on the uncertainty of the present position. If he will only read again the Debate in Committee on this Clause, he will see that there is uncertainty, not only on this side, but among some of his hon. Friends. The hon. Member for Central Edinburgh (Mr. Gilzean) expressed in Committee the strong opinion that auction sales ought to be allowed, as is proposed here, to obviate the possibility of the prosecution of the vendor or purchaser. He said:
He intervened once or twice later on and made his point absolutely clear. He said:"There is another aspect, a very simple one. What is to hinder a doctor from going to a firm of auctioneers, and asking them to sell the property under the hammer."
That is exactly what we on this side of the House want to establish. In so far as this Amendment does establish that, we feel that we must stand by it and"If a person puts a house, or any other commodity, up for sale, then it appears to me that there could be no prosecution no matter what the price may be."—[OFFICIAL REPORT, 5th March, 1947; Standing Committee on Scottish Bills, c. 510 and 517.]
Division No. 128.]
| AYES.
| [8.45 p.m.
|
| Agnew, Cmdr. P. G. | Gomme-Duncan, Col. A | Peto, Brig, C. H. M. |
| Beamish, Maj. T V. H. | Grant, Lady | Poole, O. B. S. (Oswestry) |
| Birch, Nigel | Headlam, Lieut,-Col. Rt. Hon. Sir C. | Prior-Palmer, Brig. O. |
| Bower, N. | Hogg, Hon. Q. | Renton, D. |
| Boyd-Carpenter, J. A | Hollis, M. C | Ropner, Col. L. |
| Carson, E. | Hutchison, Lt.-Cm. Clark (E'b'rgh, W.) | Scott, Lord W. |
| Clarke, Col. R. S. | Shepherd, W. S. (Bucklow) | |
| Conant, Maj. R. J. E. | Kerr, Sir J. Graham | Snadden, W. M. |
| Corbett, Lieut.-Col. U. (Ludlow) | Langford-Holt, J. | Spearman, A. C. M |
| Crosthwaite-Eyre, Col. O E. | Linstead, H. N. | Spence, H. R. |
| Cuthbert, W. N. | Lipson, D. L. | Stewart, J. Henderson (Fife, E.) |
| Darling, Sir W. Y | Lucas-Tooth, Sir H | Stuart, Rt. Hon. J. (Moray) |
| Digby, S. W. | McCallum, Maj. D | Sutcliffe, H. |
| Dodds-Parker, A. D. | Macdonald, Sir P. (I. of Wight) | |
| Dower, Lt.-Col. A. V. G. (Penrith) | Maclay, Hon. J. S. | Thorneycroft, G. E. P. (Monmouth) |
| Drayson, G. B. | Macpherson, Maj. N. (Dumfries) | Thornton-Kemsley, C. N. |
| Drewe, C. | Maitland, Comdr. J. W. | Thorp, Lt.-Col. R. A. F. |
| Duthie, W. S. | Manningham-Buller, R. E | Walker-Smith, D |
| Eccles, D. M. | Marlowe, A. A. H. | Ward, Hon. G. R. |
| Elliot, Rt. Hon. Walter | Marshall, D. (Bodmin) | Wheatley, Colonel M. J. |
| Fletcher, W. (Bury) | Mellor, Sir J. | Williams, Gerald (Tonbridge) |
| Foster, J. G. (Northwich) | Moore, Lt.-Col. Sir T. | Willoughby de Eresby, Lord |
| Gage, C | Morrison, Maj. J. G. (Salisbury) | |
| Galbraith, Cmdr. T. D. | Neven-Spence, Sir B. | TELLERS FOR THE AYES
|
| Gates, Maj. E. E. | Nield, B. (Chester) | Mr. Studholme and |
| Major Ramsay. |
NOES
| ||
| Adams, Richard (Balham) | Blackburn, A. R | Corbet, Mrs. F. K. (Camb'well, N.W.) |
| Adams, W. T. (Hammersmith, South) | Blenkinsop, A | Corlett, Dr. J. |
| Allen, A. C. (Bosworth) | Boardman, H. | Corvedale, Viscount |
| Alpass, J. H. | Bowen, R. | Cove, W. G. |
| Anderson, F. (Whitehaven) | Bowles, F. G. (Nuneaton) | Crawley, A. |
| Attewell, H. C. | Braddock, Mrs. E. M. (L'pl, Exch'ge) | Grossman, R. H. S |
| Austin, H. Lewis | Brooks, T. J. (Bothwell) | Daggar, G. |
| Awbery, S. S. | Brown, George (Belper) | Davies, Edward (Burslem) |
| Ayles, W. H. | Buchanan, G. | Davies, Harold (Leek) |
| Ayrton Gould, Mrs. B | Burden, T. W. | Deer, G. |
| Bacon, Miss A | Butler, H. W. (Hackney, S.) | Diamond, J. |
| Baird. J. | Champion, A. J. | Dobbie, W. |
| Balfour, A. | Choler, D. | Dodds, N. N. |
| Barstow, P. G. | Cobb, F. A. | Donovan, T. |
| Barton, C. | Cocks, F. S. | Driberg, T. E. N. |
| Battley, J. R. | Coldrick, W. | Edwards, N. (Caerphilly) |
| Bechervaise, A E | Collindridge, F. | Edwards, W. J. (Whitechapel) |
| Benson, G. | Collins, V. J | Evans, E. (Lowestoft) |
| Berry, H. | Colman, Miss G. M | Ewart, R. |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Comyns, D. L. | Fairhurst, F. |
| Bing, G. H. C | Cook, T. F. | Farthing, W. J. |
| Binns, J. | Cooper, Wing-Comdr. G | Fletcher. E. G M (Islington, E.) |
vote for it, because we consider that unless we can have something like this, we are driven back on the uncertainty and unfairness of the present position.
Question put, "That those words be there inserted in the Bill."
The House proceeded to a Division.
(seated and covered): On a point of Order. May we have your guidance, Mr. Deputy-Speaker, on the question of whether an hon. Member, having said "Aye," should now move to the "No" Lobby.
It is open for the right hon. Gentleman to correct himself at the second call.
The House divided; Ayes, 70; Noes, 226.
| Follick, M. | Mackay, R. W. C. (Hull, N.W.) | Smith, C. (Colchester) |
| Foot, M. M. | McLeavy, F. | Smith, Ellis (Stoke) |
| Gaitskell, H. T. N. | MacMillan, M. K. (Western Isles) | Smith H. N. (Nottingham, S.) |
| Gallacher, W. | Macpherson, T. (Romford) | Smith, S. H (Hull, S.W.) |
| George, Lady M. Lloyd (Anglesey) | Mallalieu, J. P. W. | Soskice, Maj. Sir F. |
| Gibson, C. W. | Manning, Mrs. L. (Epping) | Sparks, J. A. |
| Grenfell, D. R. | Marquand, H. A. | Stamford, W. |
| Grierson, E. | Messer, F. | Steele, T. |
| Griffiths, D. (Rother Valley) | Middleton, Mrs. L. | Stephen, C. |
| Griffiths, Rt. Hon. J. (Llanelly) | Mikardo, Ian | Stewart, Michael (Fulham, E.) |
| Guest, Dr. L. Haden | Millington, Wing-Comdr. E. R. | Strauss, G. R. (Lambeth, N.) |
| Gunter, R. J | Mitchison, G. R. | Stress, Dr. B. |
| Guy, W. H. | Moody, A S. | Swingler, S. |
| Hale, Leslie | Morgan, Dr. H. B. | Sylvester, G. O. |
| Hall, W. G. | Morris, P. (Swansea W.) | Taylor, H. B. (Mansfield) |
| Hamilton, Lieut.-Col. R. | Moyle, A. | Taylor, R. J. (Morpeth) |
| Hannan, W. (Maryhill) | Nally, W. | Taylor, Dr. S. (Barnet) |
| Hardy, E. A. | Naylor, T. E. | Thomas, D. E. (Aberdare) |
| Harrison, J. | Neal, H. (Claycross) | Thomas, I. O. (Wrekin) |
| Hastings, Dr. Somerville | Nichol, Mrs, M. E. (Bradford, N.) | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Henderson, Joseph (Ardwick) | Nicholls, H. R. (Stratford) | Thorneycroft, Harry (Clayton) |
| Herbison, Miss M. | Paget, R. T. | Thurtle, E. |
| Holman, P. | Palmer, A. M. F | Tiffany, S. |
| Holmes, H. E. (Hemsworth) | Pargiter, G. A | Titterington, M. F. |
| House, G | Parker, J. | Tolley, L. |
| Hoy, J. | Parkin, B. T. | Turner-Samuels, M. |
| Hubbard, T. | Paton, Mrs F. (Rushcliffe) | Ungoed-Thomas, L. |
| Hughes, Hector (Aberdeen, N.) | Paton, J. (Norwich) | Usborne, Henry |
| Hutchinson, H. L. (Rusholme) | Pearson, A. | Vernon, Maj. W. F. |
| Hynd, H. (Hackney, C.) | Peart, Capt T. F. | Viant, S. P. |
| Hynd, J B. (Attercliffe) | Porter, G. (Leeds) | Walkden, E. |
| Irving, W. J. | Proctor, W. T. | Wallace, G. D. (Chistehurst) |
| Isaacs, Rt. Hon. G. A | Pursey, Cmdr. H. | Wallace, H W. (Walthamstow, E.) |
| Janner, B. | Randall, H. E | Weitzman, D. |
| Jay, D. P. T. | Ranger, J. | Wells, P. L. (Faversham) |
| Jeger, C. (Winchester) | Rankin, J. | Wells, W. T. (Walsall) |
| Jones, D. T. (Hartlepools) | Re | Westwood, Rt. Hon. J |
| Jones, Elwyn (Plaistow) | Reid, T. (Swindon) | White, C. F. (Derbyshire, W.) |
| Jones, P. Asterley (Hitchin) | Richards, R. | White, H. (Derbyshire, N.E.) |
| Keenan, W. | Roberts, Goronwy (Caernarvonshire) | Whiteley, Rt. Hon. W |
| Kenyon, C. | Rogers, G. H. R. | Wigg, Col, G. E |
| King, E. M. | Ross, William (Kilmarnock) | Wilkes, L. |
| Kinley, J. | Sargood, R. | Wilkins, W. A. |
| Lee, F. (Hulme) | Scollan, T. | Willey, F. T. (Sunderland) |
| Lee, Miss J (Cannock) | Scott-Elliot, W. | Williams, J. L. (Kelvingrove) |
| Leslie, J. R. | Shackleton, E. A. A. | Williams, W. R. (Heston) |
| Levy, B. W. | Shawcross, C. N. (Widnes) | Williamson, T. |
| Lewis, A. W. J. (Upton) | Shawcross, Rt. Hn. Sir H. (St. Helens) | Willis, E. |
| Lipton, Lt.-Col. M. | Shurmer, P. | Wills, Mrs. E. A |
| Longden, F. | Silverman, J. (Erdington) | Wyatt, W |
| McAdam, W. | Simmons, C. J. | Yates, V. F. |
| McAllister, G. | Skeffington, A. M. | Younger, Hon. Kenneth |
| McGhee, H. G. | Skeffington-Lodge, T. C | |
| Mack, J. D. | Skinnard, F. W. | TELLERS FOR THE NOES
|
| Mr. Snow and Mr. Daine |
Clause 35—(Compensation For Loss Of Right To Sell A Medical Practice)
I beg to move, in page 33, line 12, to leave out from "until" to "and," in line 14, and to insert:
This Amendment raises the question of compensation for the loss of right to sell a medical practice. It is laid down in the Subsection of the Bill as drafted, that compensation shall be paid in such manner as may be prescribed, and that except in such circumstances as may be prescribed it shall not be paid until either the retirement or death of the medical practitioner concerned. We had a long discussion on this matter in Standing Committee, when I referred to injustices and various cases where hardship might occur. I had a very reasonable reply from the Under-Secretary, but on one point I felt that he might have gone further, namely, on the point of semiretirement. I hope that the Government will consider this Amendment reasonable, because it provides for compensation to be paid at the age of 65, or on retirement or death. Most doctors, and other professional people, by the time they reach 65, begin to feel that they are entitled to take things a little easier, and I think it is reasonable that a doctor should be compensated for any loss he has suffered through being unable to sell his practice."the medical practitioner concerned has reached the age of sixty-five years, has retired or has died, whichever first occurs."
I beg to second the Amendment.
We discussed this matter exhaustively in Standing Committee, when I gave the hon. and gallant Gentleman opposite certain assurances that did much to allay his feelings. He has now put forward a modified proposal, and I hope to go some way towards meeting him. He and my hon. Friend the Member for Barking (Mr. Hastings), in Committee, said, "You may have a doctor who, because of overwork or ill-health, wishes, not to retire, but to sell his practice, and buy one which is half the value of his present practice, and go into semi-retirement." That was a reasonable supposition. That might happen to a doctor at any time, and not only a doctor at the age of 65. I was asked about the young doctor going abroad, and I said that he would get his money. I was asked about the young doctor giving up medical practice to go into local authority work, and I said he would get his money. I was asked about the young doctor who was overloaded with debt through buying his practice, and I said that he would get his money. We propose, now, to prescribe conditions so that a man who retires, because of ill-health, to go into a smaller practice, may get either the whole or part of his money at once. I have spoken to my medical representatives, and they thought that generally when a man of 65 retired it was not to go to a smaller practice, but to retire completely. The case which they thought should be met was the man who suffered a breakdown in health at 40 to 50 years of age, who did not want to retire from work but was seeking a somewhat easier life. I propose to meet the case of the hon. and gallant Member for Pollok (Commander Galbraith) by saying that we will meet that class of case, at any age, either by paying the whole or a portion of the sum to which he is entitled.
9.0 p.m.
I think that the Joint Under-Secretary has met us very fairly on this point and that we should be prepared to withdraw the Amendment. He might have done all that we aim to do by leaving out the words from "paid" to the end of the sentence. Otherwise, the words "retirement or death" are still left in the Bill and the Joint Under-Secretary says that he is not in fact going to stick to those words, but is going to take power by prescribing to pay out a portion of the value of the practice according to what seems to be just and equitable. That is perfectly satisfactory, and I hope that now, or in another place, he will be able to put that in the words of the Statute. I suggest that to leave out the words after "paid" would be the best way.
I cannot guarantee to do it or to refuse to do it. I will look at the matter again. The Secretary of State proposes to see that a man who has genuinely broken down in health and who wishes to retire shall receive payment.
We are very appreciative of the way in which we have been met on this matter. I am glad that we put down this Amendment so that the hon. Gentleman has been able to explain still further the course which his right hon. Friend intends to take. I hope that not only in the case of complete breakdown in health, but that where a man feels overburdened, he can expect to receive some compensation, so that he can go into a smaller practice. I beg to ask leave to withdraw the Amendment.
Amendment, by leave, withdrawn.
Clause 41—(Disqualification Of Persons Providing Services)
I beg to move, in page 38, line 40, at the end, to insert:
This is a result of a dual piece of questioning put to me by the hon. and gallant Member for Pollok (Commander Galbraith) and the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid), who took the view that a disqualified person should know the position in which he was placed. This is an Amendment to see that the person concerned will be properly notified and certified. It is in view of the commitment made in Committee to satisfy hon. Members opposite that this Amendment has been put down. I am sure that they will see that I have carried out the undertaking which I then gave in its entirety."and for the intimation to any person who is the subject of such an inquiry of the grounds upon which any disqualification has been imposed in his case."
We accept the Amendment, and we arc indebted to the right hon. Gentleman and to the hon. Gentleman for having put it down.
Amendment agreed to.
Clause 42—(Powers Of Secretary Of State Where Services Are Inadequate)
I beg to move, in page 39, line 46, at the end, to insert:
This again deals with the dispensing power of the Secretary of State, and we trust that it may be possible for him to meet us on this point. What it amounts to is that if the Secretary of State dispenses with any of the requirements of regulations made under this Part of the Act he should tell us about it, and I think that is reasonable. I will not deny that I also think it should be laid before us in such a form that it could be prayed against, if necessary. The Secretary of State has several times said that these are administrative acts and should not really be brought into the ambit of Parliamentary scrutiny, but considering that the regulations will have to be laid before and be approved by Parliament, either tacitly or after Debate, it does not seem unreasonable to suggest that if they are altered the alterations should similarly be laid before Parliament. I trust the Lord Advocate will not think that in such a case publication in the Press or otherwise would be adequate, for it really is not quite adequate to say that a thing which has been sanctioned by the King, Lords and Commons should be altered with no more notice than a paragraph in a daily paper. The Secretary of State will for his own protection require the backing of Parliament when he is taking these exceptional measures, and I suggest that from his own point of view as well as from the point of view of Parliament it would be useful if this Amendment could be written into the Bill.Provided that any order made by the Secretary of State dispensing with any of the requirements of regulations made under this Part of this Act shall be laid before Parliament."
This Amendment would seek to limit the time during which the Secretary of State could use these exceptional powers.
rose—
I think the right hon. Gentleman is taking the wrong Amendment. We are taking the first Amendment, which begins, "Provided that any order …"
I am sorry. I am afraid I cannot see my way to accept the Amendment. It was fairly well argued before, and for the reasons which were given in Committee I am afraid I cannot see my way to accept it.
I sympathise with the Secretary of State in the disquieting experience of suddenly finding that the Amendment has been "castled," so to speak, and that the argument is not quite germane to the Amendment. It is, I agree, a very disconcerting experience, but I do not think the speech appropriate to the refusal by Parliament to allow the Secretary of State to continue powers for 18 months is quite adequate to the proposal that the Secretary of State may have the power for ever and a day, if he pleases, so long as he informs us about it. I do not think it is quite true to say that it was fully argued out before. In referring to the arguments used the Secretary of State is thinking of the proposal about 18 months, which was argued out, and it is true that it was then said that he had got power under the National Insurance Acts to take steps to make sure that an adequate health service was maintained.
The right hon. and gallant Gentleman seems to be falling into the same error as the Secretary of State, and to be dealing with the Amendment that is not being called.
I was referring to that Amendment only in so far as it was necessary to explain that it was not the Amendment under discussion. On the Amendment now before us, I beg the Secretary of State, in view of the exceptional circumstances, to give the matter consideration in the interval between now and the time when the Bill reaches another place.
I speak again only by leave of the House, and as the right hon. and gallant Gentleman was honest enough to admit that on more than one occasion he had found himself in the same position as I was in, I will admit that I was in that position. The Amendment now before the House, as it is drafted, is altogether ineffective, because the Clause, as it stands, does not provide for the requirements of regulations to be disposed with by an Order. As I have indicated already, this question was fully discussed in Committee on an Amendment moved by the right hon. and learned Gentleman the Member for Hill head (Mr. J. S. C. Reid), and in that discussion I undertook to look into the suggestion that I might be obliged to draw the attention of Parliament to any case when a regulation approved of by Parliament was being dispensed with by an executive act of the Secretary of State.
I have fully considered this, in accordance with the promise which I gave in Committee, and I am sure that the right hon. and gallant Gentleman will agree with me that I took the trouble of writing personally to him to explain the position. I explained that there is no intention of operating the Clause, if the case for this operation ever arises, in any large-scale way—it would be quite an inappropriate exercise of the powers which Parliament will give me to do so—so that any arrangements made under the proposals now before the House would be limited to particular localities where special difficulties had been experienced. It seems hardly necessary to trouble Parliament with a matter of such limited application, and I agree that any exercise of the exceptional power which is conferred by the Clause itself will be a matter of considerable interest, and I have no hesitation—I hope I am right in assuming that it was for the purpose of getting this further assurance in the House that the matter has been raised—in giving an assurance that the circumstances of any such exercise would be recorded in the annual report of the Department of Health for Scotland, which is laid before the House,
Division No. 129.]
| AYES.
| [9.15 p.m.
|
| Agnew, Gmdr P. G. | Gates, Maj. E. E. | Neven-Spence, Sir B. |
| Beamish, Maj. T V. H. | Gomme-Duncan, Col. A. | Nield, B. (Chester) |
| Birch, Nigel | Grant, Lady | Peto, Brig. C. H. M. |
| Bowen, R. | Hare, Hon. J. H. (Woodbridge) | Poole, O B. S. (Oswestry) |
| Bower, N. | Headlam, Lieut.-Col. Rt. Hon Sir C | Ropner, Col. L. |
| Boyd-Carpenter, J. A. | Hogg, Hon. Q | Scott, Lord W. |
| Buchan-Hepburn, P. G T. | Hollis, M C | Shepherd, W. S. (Bucklow) |
| Carson, E. | Hurd, A. | Snadden, W. M. |
| Clarke, Col. R. S. | Hutchison, Lt.-Cm. Clark (E'b'rgh, W.) | Spearman, A. C. M |
| Conant, Maj. R. J. E. | Kerr, Sir J. Graham | Spence, H. R. |
| Corbett, Lieut.-Col. U. (Ludlow) | Linstead, H. N. | Stuart, Rt. Hon. J (Moray) |
| Crosthwaite-Eyre, Col. O. E | Lipson, D. L. | Sutcliffe, H |
| Cuthbert, W. N. | Lucas-Tooth, Sir H. | Thorneycroft, G. E. P (Monmouth) |
| Darling, Sir W. Y. | McCallum, Maj. D | Thornton-Kemsley, C. N. |
| Digby, S. W. | Macdonald, Sir P. (l. of Wight) | Tharp, Lt.-Col. R. A. F |
| Dodds-Parker, A. D. | McKie, J. H. (Galloway) | Vane, W. M. F. |
| Dower, Lt.-Col. A. V. G. (Penrith) | Maclay, Hon. J. S. | Walker-Smith, D |
| Drayson, G. B. | Macpherson, Maj. N. (Dumfries) | Ward, Hon. G. R |
| Drewe, C. | Maitland, Comdr. J. W. | Wheatley, Colonel M. J |
| Duthie, W. S | Manningham-Buller, R. E. | Williams, Gerald (Tonbridge) |
| Eccles, D. M. | Marlowe, A. A. H. | Willoughby de Eresby, Lord |
| Elliot, Rt. Hon. Walter | Marshall, D. (Bodmin) | |
| Foster, J. G. (Northwich) | Mellor, Sir J. | TELLERS FOR THE AYES
|
| Gage, C. | Moore, Lt.-Col. Sir T. | Mr. Studholme and |
| Galbraith, Cmdr. T. D | Morrison, Maj. J. G (Salisbury) | Major Ramsay. |
or in some corresponding publication. The power conferred by this Clause closely resembles a provision included in the National Health Insurance Act, and that provision does not seem ever to have been used in Scotland, but was, I think on three occasions during the war, used in England. For these reasons, I ask the House to reject the Amendment.
I think that what the right hon. Gentleman the Secretary of State said was that he intends only to make very small alterations, and therefore, it is not worth notifying the House of those alterations, but, after all, are we not dealing with regulations which have received the assent of, or at least been laid before, the House? If that is so, I do not think it is right or proper' that the Secretary of State by order ought to dispense with these regulations without informing the House. That is the view we take here, that it is not proper, it is not right, it is not in accordance with the dignity of the House that it should be treated in that way. For those reasons, we feel that unless the right hon. Gentleman is prepared either to accept the Amendment on the Order Paper, or to give us an undertaking that he will deal with the matter in another place, we shall require to divide the House on this Amendment.
Question put, "That those words be there inserted in the Bill."
The House divided: Ayes, 71; Noes, 228.
NOES
| ||
| Adams, Richard (Balham) | Guest, Dr. L. Haden | Ranger, J. |
| Adams, W. T. (Hammersmith, South) | Gunter, R. J. | Rankin, J. |
| Allen, A. C. (Bosworth) | Guy, W. H. | Reeves, J. |
| Alpass, J. H. | Hale, Leslie | Reid, T. (Swindon) |
| Anderson, F. (Whitehaven) | Hall, W. G. | Richards, R. |
| Attewell, H. C. | Hamilton, Lieut.-Col. R. | Roberts, Goronwy (Caernarvonshire) |
| Austin, H. Lewis | Hardy, E. A. | Ross, Willlam (Kilmarnock) |
| Awbery, S. S. | Harrison, J. | Sargood, R. |
| Ayles, W. H. | Hastings, Dr. Somerville | Scollan, T. |
| Ayrton Gould, Mrs. B. | Henderson, Joseph (Ardwick) | Scott-Elliot, W. |
| Bacon, Miss A. | Herbison, Miss M. | Shackleton, E. A A |
| Baird J | Holman, P. | Sharp, Granville |
| Balfour, A. | Holmes, H. E. (Hemsworth) | Shawcross, C. N. (Widnes) |
| Barstow, P. G. | House, G. | Shawcross, Rt. Hn. Sir H. (St. Helens) |
| Barton, C. | Hoy, J. | Shurmer, P. |
| Battley, J. R. | Hubbard, T. | Silverman, J. (Erdington) |
| Bechervaise, A. E. | Hughes, Hector (Aberdeen, N.) | Simmons, C. J. |
| Benson, G | Hutchinson, H. L. (Rusholme) | Skeffington, A. M. |
| Berry, H. | Hynd, H. (Hackney, C.) | Skeffington-Lodge, T. C |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Hynd, J. B. (Attercliffe) | Skinnard, F. W. |
| Bing, G. H. C. | Irving, W. J. | Smith, C (Colchester) |
| Binns, J. | Isaacs, Rt. Hon. G. A. | Smith, Ellis (Stoke) |
| Blackburn, A. R. | Janner, B. | Smith, H. N. (Nottingham, S.) |
| Blenkinsop, A | Jay D. P. T. | Smith, S. H. (Hull, S.W.) |
| Boardman, H. | Jeger, G. (Winchester) | Soskice, Maj. Sir F. |
| Bowles, F. G. (Nuneaton) | Jones, D. T. (Hartlepools) | Sparks, J. A. |
| Braddock, Mrs. E. M. (L'pl, Exch'ge) | Jones, Elwyn (Plaistow) | Stamford, W. |
| Brook, D. (Halifax) | Jones, P. Asterley (Hitchin) | Steele, T. |
| Brooks, T J. (Rothwell) | Keenan, W. | Stephen, C. |
| Brown, George (Belper) | Kenyon, C. | Stewart, J. Henderson (Fife, E.) |
| Brown, T. J. (Ince) | King, E. M. | Stewart, Michael (Fulham, E.) |
| Buchanan, G. | Kinley, J. | Strauss, G. R. (Lambeth, N.) |
| Burden, T. W. | Lee, F. (Hulme) | Stross, Dr. B. |
| Butler, H W. (Hackney, S.) | Lee, Miss J. (Canneck) | Swingler, S. |
| Champion, A. J. | Leslie, J. R. | Sylvester, G. O. |
| Cobb, F. A. | Levy, B. W. | Taylor, H. B. (Mansfield) |
| Cocks, F. S. | Lewis, A. W. J. (Upton) | Taylor, R J. (Morpeth) |
| Coldrick, W | Lipton, Lt.-Col. M. | Taylor, Dr. S. (Barnet) |
| Collindridge, F. | Longden, F. | Thomas, D. E. (Aberdare) |
| Collins, V J | McAdam, W. | Thomas, I. O. (Wrekin) |
| Colman, Miss G.M | McAllister, G. | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Comyns, Dr. L | McGhee, H. G. | Thorneycroft, Harry (Clayton) |
| Cook, T. F. | Mack, J. D. | Thurtle, E. |
| Cooper, Wing-Comdr. G. | McKay, J. (Wallsend) | Tiffany, S. |
| Corbet, Mrs. F. K (Camb'well, N.W.) | Mackay, R. W. G. (Hull, N.W.) | Titterington, M. F. |
| Corlett, Dr. J. | McLeavy, F | Tolley, L. |
| Corvedale, Viscount | MacMillan, M. K. (Western Isles) | Turner-Samuels, M. |
| Cove, W. G. | Macpherson, T. (Romford) | Ungoed-Thomas, L. |
| Crawley, A. | Mallalieu, J. P. W. | Usborne, Henry |
| Grossman, R. H. S. | Manning, Mrs. L. (Epping) | Vernon, Maj. W. F. |
| Daggar, G | Marquand, H. A. | Viant, S. P. |
| Daines, P | Messer, F. | Walkden, E. |
| Davies, Edward (Burslem) | Middleton, Mrs. L | Wallace, G. D. (Chislehurst) |
| Davies, Harold (Leek) | Mikardo, Ian | Wallace, H. W. (Walthamstow, E.) |
| Deer, G. | Millington, Wing-Comdr. E. R. | Weitzman, D. |
| Diamond, J | Mitchison, G. R. | Wells, P. L. (Faversham) |
| Dobbie, W. | Moody, A. S. | Wells, W T. (Walsall) |
| Dodds, N. N | Morgan, Dr. H. B. | Westwood, Rt. Hon. J. |
| Donovan, T. | Morris, P. (Swansea, W | White, C. F. (Derbyshire, W.) |
| Driberg, T. E. N | White, H. (Derbyshire, N.E.) | |
| Dye, S. | Moyle, A. | Whiteley, Rt. Hon. W |
| Edwards, N. (Caerphilly) | Nally, W. | Wigg, Col. G. E. |
| Edwards, W. J. (Whitechapel) | Naylor, T. E. | Wilkes, L. |
| Evans, E. (Lowestoft) | Neal, H. (Claycross) | Wilkins, W. A. |
| Ewart, R. | Nichol, Mrs. M. E. (Bradford, N.) | Willey, F. T. (Sunderland) |
| Fairhurst, F. | Nicholls, H. R. (Stratford) | |
| Farthing, W. J | Oldfield, W. H. | Williams, J. L. (Kelvingrove) |
| Field, Capt. W. J. | Paget, R. T. | Williams, W. R (Heston) |
| Fletcher, E. G M. (Islington, E.) | Pargiter, G. A. | Williamson, T. |
| Follick, M. | Parker, J. | Willis, E. |
| Foot, M. M | Paton Mrs. F. (Rushcliffe) | Wills, Mrs. E. A |
| Gaitskell, H. T. N | Paton, J. (Norwich) | Wyatt, W. |
| Gallacher, W. | Pearson, A. | Yates, V. F. |
| Gibson, C. W. | Peart, Capt. T. F. | Younger, Hon. Kenneth |
| Grenfell, D. R | Porter, G. (Leeds) | |
| Grierson, E. | Proctor, W. T. | TELLERS FOR THE NOES
|
| Griffiths, D. (Rother Valley) | Pursey, Cmdr. H | Mr. Snow and Mr. Hannan |
| Griffiths, Rt. Hon. J. (Llanelly) | Randall, H. E. | |
Clause 45— (Decision Of Disputes)
I beg to move, in page 40, line 31, at the end, to insert:
This Amendment arises from a promise given in Committee to the right hon. Gentleman, that if an inquiry were conducted it should be conducted under the procedure outlined in the Tenth Schedule. I ought in fairness to add that we have the usual safeguard against any appeals that may be considered frivolous, but apart from that, perhaps have the right given under the procedure outlined in the Tenth Schedule."who shall, whether either party to the dispute so requests, cause an inquiry to be held unless he as satisfied that, in the special circumstances of the case, an inquiry is unnecessary."
We agree that that is so, and I think the hon. Gentleman has faithfully carried out his undertaking.
Amendment agreed to.
Clause 57—(Power Of Trustees To Make Payments To Regional Hospital Boards And Boards Of Management)
I beg to move, in page 49, line 10, to leave out "such" and to insert "that".
This is a drafting Amendment.
Amendment agreed to.
I beg to move, in page 49, line 14, at end, to insert:
This Amendment is designed to meet a point raised in Committee. The effect is to make it quite clear that the decision whether to pay to the Regional Board or the Board of Management rests with:"as the trustees, having regard to the purposes of the trust may determine."
Two points were raised which I promised to meet, and I think the Amendment does that.…the trustees, having regard to the purposes of the Trust …"
Amendment agreed to.
Clause 63—(Qualifications, Remuneration And Conditions Of Service Of Officers)
I beg to move, in page 50, line 34, to leave out from the second "of," to the end of the Clause, and to insert:
"officers who are employed by any one oz more of the following bodies, that is to say—(a) any body constituted under this Act, (b) local health authority, (c) an education authority, (d) any such voluntary organisation as referred to in section sixty-one of this Act—
This Amendment is put down to meet a criticism expressed on the Committee stage that the Clause would have enabled regulations dealing with qualifications, remuneration and conditions of service to apply to officers who devoted only a very small part of their time to health service work, such as a town clerk of a large burgh. Technically this would have been the position although, of course, regulations would have related only to that small part of the officer's time. I never had any intention of making regulations applying to such officers, and the proposed redrafting makes it clear that the regulations apply only to officers more than half of whose employment is on health service.and who are so employed wholly or mainly for the purpose of the provision of such services as are referred to in section two of this Act, and no officer to whom the regulations apply shall be employed otherwise than in accordance with the regulations."
Amendment agreed to.
Clause 68—(Protection Of Certain Bodies And Their Officers)
I beg to move, in page 54, line 45, to leave out from "shall," to the end of the Clause, and to insert:
"apply in relation to a Regional Hospital Board, Board of Management, a local health authority and an Executive Council, in like marine as the said Section applies in relation to a local authority subject however to the following modifications—
This is designed to meet a point raised on the Committee stage. The period of time during which any action or proceedings shall be brought against any authority or officer is changed from two months to 12 months. That is to meet the criticism that two months was too short a time.(a) for any reference to that Act there shall be substituted a reference to this Act; and (b) for the reference to two months there shall be substituted a reference to twelve months."
Amendment agreed to.
Clause 71—(Regulations And Orders)
I beg to move, in page 55, line 22, to leave out Subsection (1) and to insert:
"(1) The following regulations and orders made under this Act—(a) all regulations (except regulations made under Section sixty-four or Section sixty-five); (b) all orders made under Subsection (2) of Section two or under Section eight or under Subsection (3) of Section thirty or under Section seventy-three; (c) such of the orders made under Subsection (1) of Section eleven as determine the areas for which regional hospital boards are to be constituted; and (d) such of the orders made under Sub section (7) or Subsection (8) of Section twenty as are required to be preceded by an inquiry;
shall be laid before Parliament immediately after they are made, and if either House of Parliament, within the period of forty days beginning with the day on which any such regulations or order are or is laid before it, resolves that the regulations or order be annulled the regulations or order shall cease to have effect, but without prejudice to anything previously done there under or to the making of new regulations or a new order.
This is a formal Amendment which is necessary because when the Bill was drafted it was done on the assumption that the Statutory Instruments Act would have been in operation before the Bill became law. This is not the case, and the Clause has had to be redrafted to meet the present situation.In reckoning any such period of forty days, no account shall be taken of any time during which Parliament is dissolved or prorogued or during which both Houses are adjourned for more than four days."
9.30 p.m.
We have two Amendments down on the Order Paper but they will not be in Order if Subsection (1) is dropped, and they would not apply exactly to the Subsection which it is intended to insert by this Amendment. However, before Subsection (1) is dropped, it might be worth while to say that we had hoped it would be possible to deal under that with the schemes submitted to the Secretary of State by a regional hospital board. I do not know whether the Secretary of State can make any pronouncement on that or not.
indicated dissent.
The Secretary of State indicates that he is unable to do so at the moment, but would he look at it between now and the passage of the Bill through another place? If so, I am quite willing not to move either of the Amendments.
indicated assent.
I would like a little more than a nod of the head, which it is difficult to report in HANSARD.
Usually HANSARD states that the Minister "indicated assent," and I have done so.
Amendment agreed to.I beg to move, in page 55, line 42, at the end, to insert:
Clause 8 deals with the Hospital Endowments Commission, and Subsection (6) empowers the Secretary of State by order to approve any schemes which have been submitted to him by the Hospital Endowments Commission. Important schemes will be put forward by that Commission, and we believe that in view of their importance it would be right that they should be submitted to a positive Resolution of both Houses of Parliament. Subsection (8), after the expiry of the powers of the Hospital Endowments Commission, empowers the Secretary of State himself to frame schemes in regard to endowments, and instead of approving them he confirms them. We consider that these also are important matters which should be submitted to Parliament."(3) No order shall be made by the Secretary of State under subsections (b) or (8) of Section eight of this Act unless a draft of the proposed order has been approved by resolution of each House of Parliament."
I beg to second the Amendment.
The importance of the matters dealt with in the orders covered by the Amendment does not seem to me to warrant adopting the affirmative Resolution procedure, which is usually kept for matters of major moment. There will probably be a considerable number of endowment provision schemes, so that the affirmative Resolution procedure might be taking up a fairly substantial amount of Parliamentary time, even in cases where no point of real importance was at issue so far as these schemes were concerned. The provision in the Bill that such orders may be annulled on the Prayer of any Member, I submit, gives Parliament full opportunity of raising a Debate on any question of sufficient importance to justify this course, and therefore I cannot accept the Amendment.
regret the decision of the Secretary of State in this case. It seems to us that the mere fact that there may be a, number of schemes under the Commission is rather an added reason for bringing them to the notice of Parliament. But we are all anxious to pass on to the concluding stages of the Bill and in that case, although I do not ask leave to withdraw the Amendment, we shall be content to have the Amendment negatived.
Amendment negatived.
Clause 77— (Expression "Asylum' To Cease To Be Used)
I beg to move, in page 57, line 26, after the second "to," to insert "such."
This arises out of an Amendment proposed in Committee when the right hon. and learned Member for Hill head (Mr. J. S. C. Reid) suggested that the treatment as described in the Bill might cover something out with the procedure under the Lunacy Act. This Amendment is to make it quite clear that we only wish to cover procedure under the Lunacy Act.Amendment agreed to.
9.37 P.m.
I beg to move, "That the Bill be now read the Third time."
This House has now finished its task of considering in detail the provisions of the Bill. The time has come for us to look at the provisions in the form they now take, and to decide whether the Bill is worthy of being passed to another place as a Measure with which this House is satisfied. A considerable number of improvements have been made and I am grateful to hon. Members on both sides of the House for the suggestions and helpful criticisms ey have put forward. What now does the Bill achieve? The main essential point is that the Bill places squarely on public authorities the duty to provide all necessary facilities needed for the health care of all our people. These public authorities fit into our democratic framework of Government in one of two ways; either as regional hospital boards and hoards of management they are acting on behalf of the Secretary of State who is responsible to Parliament, or, like the local health authorities, they are responsible directly to local electors. Over all, the Secretary of State has a duty, in the words of the opening Clause of the Bill,In this difficult and responsible job the Secretary of State will be guided by the Scottish Health Services Council and its standing advisory committees now provided for in the Bill. Its members will be chosen for their ability to give the Secretary of State necessary expert advice on all aspects of the problems that will arise. The hospital and specialist services stand in need, as many commissions and committees have told us, of having their various component parts fitted together into a unified service based on fairly wide areas and giving all people in all parts of the country access to any particular kind of specialist treatment they require. I suggest that this Bill certainly achieves that major reform. Inevitably this has meant the displacement of both the existing voluntary hospital system and the existing local authority hospital system. In the hospital organisation of the future I believe we have kept the proper place both for voluntary services and for local interest. Regional boards and hoards of management will be chosen from people with local interest in and knowledge of the hospitals they are to administer and will be chosen from people who come forward to give voluntary services on those bodies. On the financial side, too, the Bill makes it possible in my opinion for the very best features of the voluntary hospital system to be maintained. The generous benefactors of the past, who have put gifts of endowments at the disposal of our hospitals, have planned their benefactions to fit the hospital system of the country as they knew it, and we have kept faith with them I suggest by establishing an independent authoritative commission, which will settle the future use of these endowments, assisted in such manner as seems to the commission most in keeping with the hospital organisations of the future as envisaged in this Bill, having regard always, as enjoined by the Bill now before the House, to the spirit of the intention of the donors. These endowments and funds are not taken over by the State. They will not be used to relieve the State of any part of the expenditure which as the authority responsible for the hospital service in future it must meet out of current public resources. The endowments are left in the hands of the public boards of management and regional hospitals boards to be expended by these boards at their discretion in connection with their work. Future donations can be made to those bodies for the same kind of purposes. The hospital organisation set up under the Bill contains one other very important feature. We in Scotland are proud of our standing as a centre of medical education. If the standard of medical teaching given in Scotland is to be maintained there must be access for teacher and student to an ever wider range of practical experience and demonstration in the hospitals where clinical teaching is carried on, and so in that way are kept in touch with developments in medical science and encouraged to maintain the highest standards of treatment and care. The Bill now before the House places a specific duty upon the Secretary of State to provide facilities in the hospital service for the teaching of medicine. The organisation which the Bill provides makes it easy for the biggest number of hospitals to come within the teaching field and to share in the advantages which participation in that work will confer. This Bill I submit without trespassing by the State upon the responsibility of the teaching and the licencing authorities brings them fully into the administration of the hospital service far as it affects their responsibilities. As to the local authorities we have restated and enlarged their responsibilities for those local clinical and other services they are best fitted to administer. Building on the foundation that their duty is to watch over the incidence of disease, especially infectious disease, in their districts, the local authorities are now given the necessary power for important developments in the prevention of disease and the treatment of health in the community life. The Bill now before the House provides a system of grants which will I hope enable the local authorities to make the maximum use of the new powers conferred upon them. The third division into which the new Service will be organised deals with general practice. In some ways developments in this field will be those which will touch most closely the largest number of our people in Scotland. In future there will be available for everyone, and not only for people who pay insurance contributions, the care and attention of the family doctor of the patient's own choice without any need to stop and count the cost before turning to the doctor for his help. I believe that the proposals in the Bill will enable us to do this and they do not confer any power—as was pointed out earlier this evening by my hon. Friend the Joint Under-Secretary—to direct individual doctors to work in particular localities or at particular jobs. We must remember that the passing of the Bill will not produce more doctors overnight. I believe that the organised service the Bill provides, with the new system of remuneration we have in view and the abolition of the sale and purchase of practices, will improve the attraction of general medical practice as a career, and that when taken in conjunction with the other measures which the Government are introducing to bring further education within the reach of all, the result at no distant date will be an adequate number of doctors for the tasks that lie ahead. In the mental health field we have taken steps in the Bill which will link the provision of mental health care more closely with that of physical health care. Other important proposals, including a substantial Amendment of the lunacy laws of Scotland, were recommended recently by the Russell Committee. These are now being considered and I hope that I shall be able before long—"to promote the establishment in Scotland of a comprehensive health service designed to secure improvement in the physical and mental health of the people of Scotland and the prevention, diagnosis and treatment of illness,"
But they are not in this Bill.
I accept your correction, Mr. Speaker, and will leave the subject immediately. These, briefly, are some of the points which I now invite the House to consider. The preparatory work connected with the Bill is already under way, and if the Bill is passed in substantially in its present form, we hope to fix 1st April, 1948, as the appointed day.
9.47 p.m.
I beg to move, to leave out from "That" to the end of the Question, and to add instead thereof:
As the Secretary of State has just said, it is true that we are coming to the end of a long process, and it is right at such a time to congratulate those who have been in charge of the Measure on the assiduity and skill with which they have piloted the Measure through the House. If I may say so, this is particularly so in the case of the hon. Gentleman the Joint Under-Secretary of State, to whom the Committee upstairs has been indebted for his knowledge of the Bill and the care he has taken to acquaint himself with the views of hon. Members on the subject. In fact, he is suffering—as not infrequently occurs in such cases from a certain degree of the very illnesses of which he is attempting to cure the rest of Scotland, and indeed we might perhaps say to him this evening, "Physician, heal thyself." At the same time we are glad to see him back amongst us restored to health and, as I say, we thank him for the care he has taken of the interests of the whole Committee and of the House in the piloting of the Bill tonight. For all that, however, we cannot say that we find ourselves in agreement with hon. and right hon. Gentlemen opposite. They have taken steps which we think will not be fulfilled in the hopes which they have of them. After all, the steps which hon. and right hon. Gentlemen are taking could be justified only if the medical system of Scotland had been a signal failure instead of being, as it admittedly is, one of the great scientific and practising successes of the world. The whole of Great Britain, the whole of the Empire, is indebted to the medical system of Scotland. It is a system which, both in the past and in the present, has been the Mecca of students from all over the world. It has standing to its credit some of the most resounding medical discoveries from the working out of a system of antiseptics and the discoveries made in the science of anaesthetics, down to Sir Alexander Fleming's discovery of penicillin. We can show a roll of names of fame in medicine second to none in the world Whatever one may say of the new system proposed, either on training, or on doctor-patient relations, it will have a hard task to equal, let alone surpass, what has been successfully put through under the system now being swept away—it is not too much to say that that is what is being done this evening. It is our intention to divide against the Third Reading, and to divide on this reasoned Amendment. It is unfortunate that owing to the telescoping of so many stages of the Bill, beginning with the Committee stage and passing on through the whole of the Report stage to the Third Reading, it has not been possible, within the Rules of Order, to place our Amendment on the Order Paper. Beginning briefly with the argument that the Bill is inadequate, the Secretary of State has stated that he is faced with a shortage of doctors, and still more with a shortage of nurses. This is, far and away, the main limiting factor in the practice of medicine just now. It is not that the people of Scotland cannot get sufficient medical advice, but that they have the greatest difficulty in carrying out the medical advice given in half a hundred ways. There is the field of hospitalisation. The people of Scotland are only too willing to accept medical advice, to seek treatment, to hospitalise themselves, to take rest, to take good food, to take better housing and to take half a dozen recipes any of us could write down. It is not the advice, but the power to fulfil the advice, and we say that this is an inadequate Bill in that it does not take a sensible step towards carrying out the object we all have at heart."this House, while it would welcome an adequate and comprehensive health service foe Scotland, declines to give a Third Reading to a Bill which centralises control of institutions in the hands of the Secretary of State and deprives local authorities and voluntary bodies of the powers of administration which they have hitherto exercised to the great advantage of the people of Scotland, which takes and retains for the Secretary of State the power of diverting trust funds and benefactions in despite of the declared wishes of donors and subscribers, and which gravely threatens the future of the practice of medicine in the widest sense and the research upon which its progress depends."
Why did not the right hon. and gallant Member take such steps when he was in office?
The hon. Member for one of the English divisions will, no doubt, have an opportunity to speak later.
May I interrupt the right hon. and gallant Gentleman and tell him that I am one of his constituents?
I am well aware that the hon. Member is one of my constituents, but it is not simply on that ground that I would ask him to hold his peace and allow me to develop my argument. The Bill centralises the control of institutions, both local authority and voluntary, in the hands of the Secretary of State. Nobody can deny that. The right hon. Gentleman spoke of the new set-up of local authorities which was being produced, and claimed that in some respects he was giving additional power to them. That is true, but he is also withdrawing from them, as part of the great process which is going on now, a great field of activity, which has been a traditional field of activity of local initiative and effort. The danger is immediate and pressing. During the Committee stage, the hon. Member for West Renfrew (Mr. Scollan) actually advocated nominated members as being greatly superior to elected members. That is the sharp edge of a very thick wedge indeed. The hon. Member said:
that is, the representatives—"Is any hon. Member going to tell me that because they"—
That is a dangerous doctrine."are not elected once a year they are not as capable of administering the service locally as would be persons who were elected every three years? … What we want is to have people given a job locally, who are capable and who have the necessary experience, and who are not subject to the whims and fancies of somebody electing them once in every three years.' —[OFFICIAL REPORT, Standing Committee on Scottish Bills, 28th January, 1947, c. 48.]
On a point of Order. Is it in Order, Sir, for the right hon. and gallant Gentleman to discuss something which is not in the Bill, something which is merely the expression of opinion of an hon. Member?
I wondered where the right hon. and gallant Gentleman was leading to but I thought it was part of the general argument and therefore in Order.
It is not only in the Bill; it is one of its cardinal features. The Bill says, in so many words, that the elected representatives are to be taken away, and replaced by nominees of the Secretary of State I do not think that there could be anything more germane to, or more directly concerned with, the Bill than these provisions. My comment on the provisions is merely a comment on something which has been written into the Bill. If I was concerned with the comment of a Private Member I would have no objection at all, but from tonight, these provisions become the law of the land so far as we in this House are con- cerned. The comments of the hon. Member were in favour of such provisions.
As the right hon and gallant Member is quoting from something I said in Standing Committee, would he not agree that when the Minister appoints someone to do a particular job it is necessary that he should appoint someone with experience, knowledge, and ability to do that job, and not leave it to the hazards of election?
There we have it. You will see, Mr. Speaker, that every word I said has been completely justified by the statement which the hon. Member opposite has just made. The statement that somebody nominated by the Minister is adequate to, or indeed superior to, the representative elected by popular election is the thin end of a very thick wedge. The other end of that wedge is Fascism.
The right hon. and gallant Gentleman is using a very peculiar argument. Is he arguing that the elective system should run through the whole hospital system? If so, why have not the voluntary hospitals adopted it through all these years?
I am addressing myself to the argument by the Secretary of State that he had increased the power of the local authorities, and I was pointing out to the Secretary of State in my defence of the local authorities that he had removed powers from the local authorities and had substituted for them nominated persons—and that was brought forward from the other side of the House as a positive advantage, which we have just heard repeated. We say that that has deprived local authorities and voluntary bodies of the powers of administration which they have hitherto exercised to the great advantage of the people of Scotland. None would deny that. That these powers have been exercised to the great advantage of the people of Scotland is certainly true, and it is also true that the people of Scotland are being deprived of them by this Bill in this field, and by other Bills in other fields. The inroads being made on the local popularly elected administrations have been the subject of adverse comment, not only from this side hut from the other side of the House during the passage of many Bills now before the House. We go on to say that the Hill takes and retains for the Secretary of State the power of diverting trust funds and benefactions and that these powers are not merely exercised for the time being by the Hospital Endowment Commission but that the Secretary of State takes power to extend the life of the Endowment Commission so far as he wishes, and when the Commission passes away the powers vest themselves in the Secretary of State himself.
In spite of all this, the Secretary of State says that he hopes that it will he possible for people to continue to give large sums as they have done in the past for the special advantage of particular institutions. I hope that it may be so. I have not in any way attempted to sabotage this effort. I have appealed for support, and I have appealed widely' for support for the great Royal Infirmary of Glasgow in spite of the effects of this Bill. None of us would deny that support of the hospitals will be a very much more difficult task in the future with a Commission. Our next point is that it may threaten the future of the practice of medicine. We have had statements on this Bill and on the English Bill which made it perfectly clear what was afoot. The Under-Secretary of State for Health for England speaking in the House said:That is the attitude of mind that will creep in and which will be followed by grave inroads into the relationship between doctor and patient as we have known it. We have testimony of this from many quarters. We have had it from the hon. Member for Rochdale (Dr. Morgan), who, discussing this Measure, said:"This is not some private arrangement between a private practitioner and a private individual. … If a dustman cannot find a job with a particular local authority because no vacancy exists, he does not start to howl about being subject to bureaucratic direction because he has to go and seek work elsewhere." —[OFFICIAL REPORT, 30th April, 1646; Vol. 422, C. 213.]
He was not aware of any Government medical service which had been a success. These are the directions in which the Government tonight ask the House to allow it to authorise it to encourage it to move. We say that along these lines we fear not an advantage but a disadvantage to the people of Scotland, and to medical teaching in Scotland will arise. Lastly, we say, without any hesitation, that the principles upon which we are asked to act will gravely threaten not only the practice of medicine but the research upon which this practice depends. We have as much evidence as we should wish. The Secretary of State himself will be well acquainted with the hospital which wrote to him asking for permission to go ahead; it had gathered money, it had long waiting lists, it was anxious to extend and develop, but it was told to wait—the Regional Board was coming into existence, let nothing be done now. Where was this hospital? It was in Greenock, in the town which hon. and right hon. Gentlemen opposite use as the pivot, indeed as the only justification, of their contention that some areas in Scotland are under-doctored as compared with others. When the citizens of Greenock gather their own money and seek to go ahead developing their own medical service, without anything more than the permission of the Secretary of State, the answer they get is "Wait, wait, the Bill is not yet law, the Bill has to become law, the Regional Medical Board has to be set up, and a new plan has to be made." While the grass grows, the steed starves; and while these plans are waiting to be carried through, the practice of medicine to help the people of Scotland is being held up. Lastly, as to scientific progress itself, let us take one aspect of scientific research with which we are intensely concerned just now—the feeding of the people. Investigations were done in that direction by great authorities such as Sir John Orr, with whom I had the honour of working myself, and in many cases results were brought out inconvenient to the Government of the day, yet those results showed —here are the books which show it—that even before the war sufficient food was coming into the country for 2,900 calories a day for every single soul in it. Now we are told that the people of this country are better fed than ever before because the figures still 2,900 calories. When we try to ascertain how it is made up and how it is distributed, we find that it becomes a political question. We find that the whole resources of the Government are turned on to defend their position and to explain how the people are better fed than they were before. It is with the utmost difficulty that we extract from the Government the fact that the average intake per head is not 2,900 calories, which is the gross figure; last December it was 2,390, which has fallen this December to 2,300, although the International Food Board [An HON. MEMBER: "Which part of the Bill does this come under?"] It comes under the subject of research, which is one of the main claims which the Secretary of State has made in putting forward this Measure. We have carried a new Clause dealing with it this evening, and undoubtedly it is one of the most important subjects to the people as a whole. I say that the stereotyping of research into a Government system, where pro and anti claims are brought forward, where the subject becomes political as it inevitably does when these things come up to the Cabinet and concern the fate of Ministers, is a strong argument against the whole system which the Secretary of State brings before us. It is an argument which I fear will find itself extended into other fields than that of food, which I have taken as an example. It is not my desire to detain the House. [HON. MEMBERS: "Oh."] Does anybody suggest that I have dilated too long upon a subject of the greatest importance to the people? Does anybody suggest that we have taken too long tonight, that we have not co-operated to the utmost with the Minister in bringing forward his Measure? I say that these things, which received far greater and longer consideration in the case of England than they have received in the case of Scotland have received by no means too long consideration here tonight. We could easily have continued the Debate for many, many hours, and indeed for days, in discussing what we have passed over in a few hours, this evening. The hopes of the Secretary of State are admirable hopes which all of us share. The action he has taken is action in which, although it has many points with which we disagree, we shall cooperate as far as we possibly can so far as it can advance the health of the people of Scotland; but we feel deeply and sincerely that the right hon. Gentleman has embarked upon a line not only bad in itself, but one that will lead to very much worse things to come. We say that he and Scotland will regret many of the steps that are enshrined in this Bill to which he is asking the House to give sanction tonight."I shudder when I think of the Colonial medical services of which I know; I tremble when I think of the prison medical services and pension services.''—[OFFICIAL REPORT, 30th April, 1946; Vol. 422, c. 134–5.]
10.11 p.m.
I wish to associate myself and my hon. Friends with the Amendment that has been moved. I say without any hesitation or condition that, in our view, a great expansion of the health services of Scotland is desirable as soon as possible, and as far as this Bill aims at an expansion of those services, it is a good Bill. The objective is not one about which there is any question, and as the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) said, we shall all do everything we can to help; but it is the machinery adopted in the Bill for arriving at that objective which seems to us to be, to put it mildly, doubtful.
The Secretary of State is an extraordinary man. He makes speeches in Scotland and in the House in which he gives us the impression that he does not really understand what he is doing. He talks in Scotland as though the various nationalisation Measures that have been passed have given Scotland a measure of control over its destiny. Everybody knows that is not true. Tonight the Secretary of State has given us the impression that the spirit of the voluntary hospitals and the local authority hospitals continues to illuminate the whole of the new services he is bringing into being at this time. That is the very opposite of the truth. The truth, as we see it, is that the right hon. Gentleman is killing the very spirit that has made great the medical and hospital services of Scotland in the past, and we are convinced that by taking, as he does, ultimate control of the action of these new bodies, he is destroying once and for all part of the greatness of our race and something that has, perhaps more than anything else, made famous the medical services of our country. Why does the Secretary of State do this? Under the Scottish Education Act he assists, he advises, he urges, he exercises a measure of guidance upon Scottish education, which, however, is run in its details by the local authorities. Why does he break away from that long-established Scottish precedent and, in this case, take control and exercise actual dictatorship over this great Measure of health services in Scotland? This is an entirely new thing. It is against all the principles and traditions of our country. By all means, let the Secretary of State guide. I recognise that the State, as the State, has great functions to perform, but one of the functions is not the intimate day-to-day control of detailed services of this kind. I believe this goes to the very roots of our Scottish system and destroys those roots. I stand for local authority control to the fullest possible extent. I believe that voluntary effort has helped to make our country great. I believe that when you kill that voluntary effort, you do something disastrous to Scotland. For those reasons, if for no other, I and my Liberal friends oppose the Third Reading.10. 15 p.m.
While I do not propose to follow closely the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot), I wish to say that he is not alone in paying tribute to the success of the medical system. Equal tribute is paid to it on this side of the House. I am saying that because I am assuming that when he spoke of the medical system, he referred to the system under which our medical students were trained. So far as that aspect of it is concerned, we do not yield one inch to him in our appreciation of that service. This Bill will not in any way interfere with the training of students and in the preparation of the doctors of the future. It will not interfere with them in the least in that preparation, but it will do something which the system the right hon. and gallant Gentleman tonight supported, does not do at the moment.
What happens today to the young doctor when he comes out? He faces a system of complete anarchy. There is no organisation; neither his university, his medical school, the British Medical Association nor any other organisation, which takes the slightest interest in placing that young lad in any medical post. That is a fact, and any medical man will admit that. He is left to fight his way into a practice, or to become an assistant to a doctor, and to accept for his services a salary from a doctor who may himself resist the very idea of the application of a salary to his own profession.
Is the hon. Member aware that he is flatly contradicting a statement which was made earlier this evening by the hon. Member for Rochdale (Dr. Morgan)?
No, I am not in the least aware that I am contradicting any such statement. I am stating a fact which is known to any young doctor who seeks to start in medicine today. If he refuses to accept such a situation, then he is faced with a capital outlay, which it is impossible for him to meet at the present moment without help in seeking to start in practice on his own account. I hope that under the Bill that system of anarchy will be stopped, and that we will be able to absorb at once, into active useful work in the hospitals of the future, every young doctor who leaves the universities. The right hon. and gallant Gentleman also made another statement with which I disagree. He stated that there was a shortage of doctors today. The fact, so far as I understand it, is that at the moment there is such a plentitude of doctors that they simply cannot be placed in private practice.
Not in Greenock.
One swallow does not make a summer.
I rise to put before my right hon. Friend a particular point, on which I hope he may be able to give the House some assurance tonight. I, with other Members in the House, will wish the Bill well when it goes to another place, in its passage to the Statute Book, but there is one point which I would like to put before my right hon. Friend. It concerns the local authority services. At present we know that these are unified services. In the Bill they will be segmented and the patient may come under two, or even three, authorities. In the case of the T.B., the midwifery or the infectious diseases service, he, or she, will come under the hospital service, the general practitioner service and the local authority service. Those are the three authorities who will have control at one stage or another. It is important that there should be a link connecting the three. I suggest that my right hon. Friend should use his powers under the Fourth Schedule to appoint persons such as he may think fit. I hope that he will utilise the position of the medical officers of health in our large burghs and in the counties as the link through the regional hospital board and the boards of management to connect the three different units, and thereby bring about a co-operation in that service which he will find in practice is necessary in order to achieve the success which every one desires. I hope that we may have some assurance on that point tonight, and that the Bill will have a safe and speedy passage on its way to the Statute Book.10.23 p.m.
In considering this Bill, I join with my hon. Friends on this side of the House in stressing our support for a national health service for Scotland. Unfortunately, we shall be forced to divide tonight, not on the broad principles, which we have always supported, but because there are, in our opinion, certain glaring defects in this Bill which destroy much that is good of the past, limit the possibilities for the future, and give us instead, a rigidity of administration which is quite unsuited to the living human art of caring for the sick. Our present health services, of course, have certain defects, but it is true to say that they have shown a natural growth over a period of years, and also have demonstrated our genius for adaptation to new circumstances.
Surely our aim in politics, when we are trying to weed out what is bad of the past, is to safeguard against too much' destruction, in case we forget to conserve what is good of the past in our search for the new. That is why many hon. Members on this side of the House very much regret the transfer of all hospitals to the Secretary of State. In my own city of Aberdeen I know that the local authority hospitals and the voluntary hospitals have worked together in the closest harmony with great success. The voluntary hospital has provided an outlet for voluntary effort and private generosity. That is something of value which should be preserved. Regularly once a year we have campaigns to try to extract funds from the Aberdonian, which is an enjoyable, magnificent and successful achievement. This has resulted in our local people taking a very personal interest in our own institutions. It is true that today we find that the private benefactors are withholding their bequests. That is of great detri- ment not only to local interests but also to the administration of the whole health service, and incidentally it will come back in the end on the taxpayer. I only trust that in the search to co-ordinate the hospital services the teaching hospitals will really be given a measure of independence. Therefore, I would like to say how much we welcome the Clauses in the Bill which have openly acknowledged the value of voluntary effort. I refer particularly to those Clauses dealing with the home nursing and health visiting services. It is true that our country has been admired the world over for our extraordinary capacity to date to join together voluntary and State effort, and now we have openly acknowledged the value of the district nursing services, which to my mind will be of very lasting benefit to the medical services of Scotland. There is, however, one question which perhaps more than any other in consideration of this Bill has very gravely concerned not only the professional people but the ordinary men and women in Scotland today. That is, above all, the provisions regarding the personal relationship between the doctor and the patient. I will not agree with the Secretary of State when he says that freedom of choice of doctor will not in any case be vitiated, because I feel that with the abolition of the sale of the goodwill of practices and the element of the basic salary we are laying the way open to the full State salaried service which is the acknowledged aim of hon. Members opposite. I personally cannot see how hon. Members on the benches opposite can on the one hand dedicate themselves to a full State salaried service and on the other accept the principle of the freedom of choice in doctors, because to my mind, the two things will not add up in the future. Therefore, one regrets that the Secretary of State has seen fit by insidious means to lay the way open to enter into the sanctity of a professional man's relationship with his patient, because there is not doubt that he will in future be confronted with divided allegiance to the State who appoints him, and his Committee, on the one hand, and on the other, his personal responsiblity to his own patients. This Bill is perhaps unique among those passed by this Government in that it rests for its success almost entirely on the human element, and on the patient in the case of sickness and pain where perhaps the will to recover can be as much stimulated by a medical adviser known to him through years of experience as by all the resources of medical research. I suggest that the recovery and cure of the patient is not only due to the superbly organised hospital or to every device of skill and knowledge surrounding disease; it is surely also due to the fact that a doctor over a period of years has built up a very intimate understanding of his patient's background, his character, his family life and difficulties, and also his place of work. We are coming to a state of affairs where we have made the provisions in this Bill so wide that we shall find doctors unable to remain out with the scheme, patients unable to pay private fees as well as insurance contributions, and when patients call at the health centre they may find that the particular doctor they went to see is working on another shift. While we support this Bill in principle, we arc forced to vote against it because we feel that in its passage through Committee, although it has obtained much of good, it has also contracted much of evil. Nevertheless we wish the Secretary of State all good fortune in the very great administrative powers that he has given himself, and which we, on these benches, consider to be inordinately large. Furthermore, we on this side, do trust that the Secretary of State will use his discretion in trying to make the minimum use of these powers so that he may give us as flexible and as human a service as he possibly can. On that, the future of medical science undoubtedly depends.10.31 p.m.
The hon. Lady the Member for South Aberdeen (Lady Grant) has treated us to a dissertation on medical services which has been subtle and interesting, but it was certainly not objective and did not deal with the kernel of the problem. She has spoken as one with a superficial knowledge of medical practice as it affects the bulk of the people in this country today. The fact is that the people of Scotland have not, for years, been getting a good medical service, and despite all that has been said on the other side in the course of the Debate on this Bill, and despite the grace with which the hon. Lady has dealt with the subject, in repeating the slogans of the Conservative Party, she has not touched the real problem. However, I pass from the gracious speech of the hon. Lady and return to the remarks of a speaker who, at any rate, should have some knowledge of the deeper problems of medical science; I refer to the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot). When I think of the right hon. Gentleman in past years—vitriolic in his vituperations of the Tory Party—and when I see him in his present pathetic condition, I can only say that he has deteriorated in his present environment. I agree that I have condemned certain medical services, but I have done so because the medical profession wants democratising from the top to the bottom, starting with medical education.
rose—
The hon. Gentleman's corporeal rotundity is not matched by his mental profundity.
I want to say that I like this Bill. It is a better Bill than the English Bill. The right hon. and gallant Gentleman said I had disapproved of certain medical services. Why should I not? I want this Bill because under it the Secretary of State, for the first time, has a duty to provide an excellent medical service, and he is doing that duty by taking responsibility through Parliament and by saying "I am going to provide a medical service as democratic as I can through the different bodies—through the executive councils, and through the local authorities." I say that you cannot have a better service. Now, for the first time, the health services of this country are being unified, both the hospital system and the general practitioner system and research. It is astonishing that the right hon. and gallant Gentleman who had a great university education and who represents a university, should make statements which can be riddled. The right hon. and gallant Gentleman talked, for example, of research and mentioned food. Long before Sir John Boyd Orr started research into food there was a certain medical officer of health of Stockton, who showed that good housing was not sufficient, unless people had good food as well.Does the hon. Gentleman suggest that Dr. McGonigle began to work on nutrition before Sir John Boyd Orr?
No, but he made his researches and came to his conclusions long before Sir John Boyd Orr made his and they have been proved right. Up to the present they have not been challenged. Far be it from me, who served my apprenticeship under the very excellent tutelage of a Scottish university to which I am always grateful for the great opening it gave me in my own general and medical education—far be it from me for one moment to deny the pre-eminence of the Scottish schools that are known all over the world. But does the right hon. and gallant Gentleman say that, because Scottish schools have been pre-eminent in the past they must always remain so under the old system? Things are changing. They were talking of research while the Scottish population was dying in slumdom and poverty and the death rate was higher than in England. Really, I am surprised at the right hon. and gallant Gentleman. Does he not want changes in medicine? Does he not want the general practitioner to' be better educated? Is he satisfied that the general practitioner, having once passed his examinations, should not necessarily open his book again in 20 or 30 years? Does he not wish for a system under which the young general practitioner could keep up to date and should be asked to give the people the best of modern medicine? Can that be achieved unless the hospitals are organised in one system—both local authority and voluntary? Is he satisfied that it can be done unless the research system is democratised? I am really surprised that a Member for the university for which he speaks—my own university could come here and speak as he has spoken.
With regard to the lunacy law, the great question in Scotland is that of safe custody. Protective custody is a matter of rivalry between the big city corporation and the official side, on legal and other important matters. That matter cannot be settled until we have a really decent system. I am glad the Secretary of State is taking into his hands the question of medical research. I hope he will put some democratic people, even non-medical people, on the medical research body because if he does he will find that the democrats will be useful from the point of view of representing the working classes more than the medical men who are trained as research workers. I am glad, too, to think that the health centres will also be kept under the purview of the Secretary of State. All the arguments used against the Third Reading of this Bill are trivial, naive, annoying, taunting, and meant to be delaying. Hon. Members talk about the shortage of doctors and nurses but that shortage originated from the tactics of the party opposite. The whole relationship of doctor and patient will improve under the proposed system. The whole medical system of this country will be improved by a Bill such as this. I can only say this in passing: There is some objection on the opposite side to trust funds being used in a way different from the donor's intention. But have not trust funds been misapplied before? Have members opposite forgotten that Henry VIII seized the monasteries? There is nothing new about it. Surely if a trust fund, because of present circumstances, can no longer be used beneficiallly, in the way for which it was donated, then it should be used for another purpose. My final word is this. This is a most important Measure. First England has had such a Bill; now Scotland is to have one. I hope that the vote tonight will not betray any deterioration of the Tory Party; that many of them will abstain from voting against a very good Measure which will do a great deal of benefit to the health services of Scotland and will redound to our credit.10.42 p.m.
I had not intended speaking on the Third Reading of this Bill but the remarks of the hon. Member for Rochdale (Dr. Morgan) require some answer. When, many years ago, I first joined the board of a London hospital I was rather surprised to discover that on the board of management there were no doctors. We had of course a medical board which worked under the board of management. I inquired why there were no doctors on the management board, and I was told that the patients did not like it and that the medical officers did not like it either. When I listened to the speech of the hon. Member for Rochdale tonight I thought of that situation. I was also told that in the ordinary course of events, those doctors who worked at medicine were not necessarily good at administration and that if they were good at administration, very likely they knew very little about medicine. I hope that the hon. Member for Rochdale is a high-class physician.
In connection with this Bill which we are going to pass tonight whether we like it or not, and in regard to which some of us are going to support an Amendment, I do believe that this House has lost a very great opportunity. We have lost the opportunity of giving to Scotland something which she wants, and something which she deserves, something which she is not going to get under this Bill. In the past, the hospital services of Scotland have been managed either by a collection of private individuals or by local authorities, and it does look as if, under this Measure, from now onwards there will be an ever-decreasing opportunity for those bodies who, in the past, have done reasonably well, and increasingly well, over a period of years. There will be less and less opportunity for them in the future. It looks to me as if those who are to be nominally in charge of the hospital system of Scotland in years to come will have immense responsibility, and very little power. There is nothing more awful for any body of citizens than to be confronted with responsibility and no power. Under this Measure, which is apparently going on to the Statute Book, we are giving to those in charge of the hospital services the responsibility, and to the Secretary of State we are giving the power. In Clause after Clause we give the power, the direction, into the hands of the Secretary of State. When I first glanced through the Bill I wondered why the Secretary of State demanded all this power. Was it that he did not trust those who were to be given the responsibility? Was it that he desired ever-increasing patronage—because, of course, this Bill will give him unbelievable possibilities of patronage? Or was it merely a part of the system to which we have become so accustomed during the last two years? I am not quite certain in my own mind which it was. It is probably a combination of all three. But one thing of which I am certain is that this Measure is not going to give to Scotland what she hoped she was going to get, and what I think we all consider she deserves, and what many of us hoped it would be in our power to give her.10.47 p.m.
The Debate, so far, has shown that hon. and right hon. Members opposite are singularly unaware of the deep feelings and innermost thoughts of the great majority of the Scottish people. I think it is perhaps natural that it should be so. The noble Lord who has just spoken is even proud that he is not "of" the Scottish people.
I do not understand the hon. Member. Does he suggest that I am not of the Scottish people? Does he suggest that I am a Welshman perhaps, or a foreigner?
No. I think the noble Lord need not get so angry or truculent. I was merely making reference to a little incident which happened in the Scottish Committee when, by a mere accident, and purely by a slip of the tongue, one hon. Member referred to the noble Lord not with due formality and decorum as "the noble Lord," but as "the hon. Member." The noble Lord was indignant, and not only corrected the hon. Member, but in high dudgeon walked out of the Committee and left us to our deliberations.
Mr. Deputy Speaker, I state quite positively that there is not one word of truth in what the hon. Member for Rutherglen (Mr. McAllister) has just said. On that particular occasion I complained to the Minister in charge—
This is quite irrelevant on Third Reading.
With respect, Mr. Deputy-Speaker, a definite charge has been made, and I feel that I am entitled to answer it. I feel that I must inform the hon. Member for Rutherglen that on that occasion I did, in answering the Minister in charge, tell him that certain of us were not able to meet the extra hours which he was requesting us to sit. I among others had other work to do elsewhere, and a quarter of an hour after I had finished speaking, when due to go elsewhere, I left to keep my other appointment.
This is not true at all.
Really, this is quite irrelevant to the Third Reading of this Bill.
On a point of Order.
No, this kind of irrelevancy spoils a Debate, and I think we should now leave it and get on with the Third Reading.
I was making a simple point. I leave the noble Lord out of the question which he has raised and put it in this manner. There is in Scotland a landed gentry and a landed proprietorship. There are industrialists and people of great wealth. But there is also the vast bulk of the Scottish people, who are not landed gentry, are not Scottish nobility and have not any great wealth.
Where did the hon. Gentleman get his information from?
The right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot) raised a fundamental issue. He said that this Bill was in some senses unnecessary, because what Scotland needed and what the Scottish people needed was not more doctors or more doctoring, but good food and good housing. They did not want more medical attention and more prescriptions; what they wanted was more hospitals and more hospitalisation. With all that I would entirely and emphatically agree, but I was a little surprised that the right hon. and gallant Gentleman dared to raise such a profound issue on the Third Reading of this Bill. Of course, the people of Scotland need good food; of course, the people of Scotland need better housing; but in the course of the long years before the war when the right hon. and gallant Gentleman was in power in this House his contribution to the improvement of those conditions were not such as to cause the people of Scotland to raise a monument in his honour. He raised the question of the wider aspect of medicine. I am not satisfied with the Bill as it now stands when it comes to the wider aspect of medicine, but the point that he and other speakers on the other side of the House have missed completely is that the basic factor of this Bill removes one great fear from the minds of the Scottish people. The Scottish people always had the fear of unemployment. They have always had the fear of great poverty, but beyond that and other hazards of life, the Scottish people have had the special fear of what is going to happen when somebody falls ill. This Bill if it does nothing else, deals with that aspect, because the people of Scotland will now know that they will be entitled to a decent medical service, without respect to the amount of the money they earn or whether they are in employment or not. That seems to me a great advance, a great democratisation, not of health but of medicine.
The hon. Member for South Aberdeen (Lady Grant) used a charming phrase—and it was a pity that such a charming phrase and such charming eloquence were -devoted to a condemnation of this great Measure which is for the advancement of the medical care of the Scottish people—when she referred to "the living, human art of caring for the sick. "That is what this Bill is primarily concerned with" the living human art of caring for the sick." I cannot speak as the right hon. and gallant Gentleman the Member for the Scottish Universities spoke or as my hon. Friend the Member for Rochdale (Dr. Morgan) spoke, as a medical man. I can only speak of medicine from the receiving end—as a patient. I was a patient for five long months in one of our great voluntary hospitals. I have the greatest admiration for the men and women who have administered and conducted the medical side of these great institutions. But when the right hon. and gallant Gentleman and the hon. Lady refer to the charitable drives in Glasgow and Aberdeen to help these hospitals to maintain themselves, as if these drives were things of which we ought to be basically proud, I cannot help feeling a little astonished. As a student I took part myself in these charity day drives in Glasgow; indeed, I was one of the chief organisers of one of the first of them. But what a dreadful way it was to raise money for our hospital services for thr care of our sick, for this "living human art" of which the hon. Lady spoke. What a shocking way to maintain our services. Surely there can be no argument to gainsay that, properly financed and properly organised, our hospitals will he able to care for the sick better than they were ever able to in the past. I think that this is, in the main, a very great and a very good Bill. I would agree with the right hon. and gallant Gentleman the Member for the Scottish Universities in one respect: we do want to widen medical research but, as my hon. Friend the Member for Rochdale said, we want to widen it beyond the bounds at present envisaged by the General Medical Council or the British Medical Association. I have refrained throughout the various stages of this Bill from saying one word on a subject to which I attach great importance—nature cure and nature cure practitioners. 1 refrained from mentioning this matter because I did not want unduly to waste the time of the Committee or the House. But I hope the Secretary of State for Scotland—although he has been unable to make any provision for the inclusion of these services in the Bill as it stands—will enter into consultation with the accredited representatives of these people, and see what can be done towards giving proper professional status to the best of these practitioners. It is true that they arc in an embryo stage as a profession, but every profession has had to go through that stage and I hope that the Secretary of State will—as I am sure he will—receive deputations of these people and try to evolve some scheme whereby the nature cure practitioner, the masseur, the physiotherapist, the homeopath and others—can be brought into the working of our national health scheme. In that spirit I commend the Bill to the House for its Third Reading and hope that the House will decisively reject the appalling Amendment which the Tories have put down.10.58 p.m.
The hon. Member for Rutherglen (Mr. McAllister) described this as a great and good Bill. I hope I am not striking an unusual note of the negative if I disagree with him. I see no greatness and little good in it. It is a collection of bureaucratic pieces of machinery. Let me draw your attention, Mr. Deputy Speaker, to what this "great and good" Bill is. It is the setting together of eight committees for the purpose of looking after the health services of Scotland. The eight committees are the Scottish Health Services Council and Advisory Committees; the Hospital Endowments Commission; the regional hospital boards, medical education committees and boards of management; the Scottish Medical Practices Committee; and the tribunal which is to be set to look after the doctor-criminal class which is being created by this Bill. This is not a great and good Bill; it is a piece of bureaucratic patchwork rather badly collected together in a volume of some 80 pages. It is not a great and good Bill because it changes nothing. It modifies administrative form—it may make it better or it may make it worse—but there is nothing great or good about it. We have had health services in Scotland for many centuries. This is merely codifying, co-ordinating if you like, but I am not aware that recodification and coordinating necessarily make for better health services.
A Socialist generally thinks that unless a thing is neatly adorned, grooved and tongued together, it is not a good thing. They are appalled at the prolific wastefulness of the world, but unfortunately that is how the world is made, with the Creator expending 10,000 spawns in order that one herring may eventuate. The good Lord is wasteful, extravagant and clumsy, according to Socialist planning. I would make it clear that there is a good health service in Scotland; otherwise the population would not be as vital as they are.But it is not a tidy arrangement. The unregulated and unco-ordinated system was a living move, and it was an improving system, with each hospital stimulated by the criticisms of local people who knew its best and its worst. That lively system seems to me to be more fruitful than the kind of thing proposed by the Scottish Health Services Council. If that is true of the voluntary hospitals, it is even more true of the local authority hospitals, which have had a far shorter time in which to develop and expand themselves. I agree that the local authorities are troublesome to the Secretary of State, and to Lord Provosts and others, but because a body is troublesome, that is no reason why it should be swept away. The only orderly place in the world is a well-managed cemetery. Everyone lies quiet there, and there is no disturbance. The Secretary of States rules unchallenged; but I do not want him to rule unchallenged over our hospitals and other institutions. Doctors are of infinite variety; some good, some indifferent, and some, doubtless are bad, although I have never met them. This rich human variety, this manifestation of the profound quality of differences in human nature cannot be made better by being bound together under the Secretary of State. I want this disparity to continue. I know that under it, great and fruitful progress can be made. If it is true of the doctors, it is also true of the nursing association and the ambulance services. This multifarious and unco- ordinated service, active and vital, interwoven together produces a plan for a health service for Scotland. The hon. Member for Tradeston (Mr. Rankin) looks on this as a tradition of anarchy, but he has his nose too close to the ground. If only he would raise it above ground level, he would see some purpose and order, otherwise there would be no Scotland at all. This Measure is a proposal to convert the lively, vigorous institutions of the health services of Scotland, into a series of eight committees, one of which has the unusual powers to fine a doctor £500, or send him to gaol for three months. Let us look at the most important part of the Bill. In the very beginning, we read that it shall be the duty of the Secretary of State, not to "provide", but to "promote" a comprehensive health service in Scotland. Whose duty is it today to promote a comprehensive health service in Scotland? It is the duty of every single citizen in Scotland, and the citizens of Scotland are transferring their moral, personal and financial responsibility to the Secretary of State. Formerly it was the duty of the people to provide a health service for Scotland, but now it is the duty of the Secretary of State. In this unification, in this complete centralisation and co-ordination, Scotland may be happy and healthy, but I do not think it will be as progressive as it has been in the past."By their works ye shall know them."
11.5 p.m.
I am glad to be able to participate in the discussion on the final stage of this Bill, and to join in the tributes which have been paid to the Secretary of State and the Under-Secretary. The Standing Commitee did a good job in helping to shape this Measure, and, during our discussions there, the right hon. Gentleman and his colleague listened with the greatest possible attention, and gave to every Member all possible help as we went through the various Clauses. My hope now is that we shall get the results that we desire from the operations of this Bill in Scotland. Always, in these matters, we find ourselves up against the old Tory tricks. The hon. Member for East Fife (Mr. Stewart), who is a crypto-Tory, and the hon. Lady the Member for South Aberdeen (Lady Grant) both started off with one of the most ancient Tory tricks which Members opposite put up whenever we are discussing reforms. Their line was, "We recognise the need for a comprehensive health service in Scotland, but not in this form." We can go back generation after generation and find that sort of thing coming from the Tory benches.
The right hon. and gallant Member for the Scottish Universities (Lieut.-Colonel Elliot) said that the world owed a debt to Scotland for her medical services, and the hon. Member for East Fife declared that never had there been medical services like those we had in Scotland. Yet we have, in Scotland, the poorest health of any people in any country in Western Europe. [HON. MEMBERS "Oh."] Yes. Take the most recent statistics for maternal and infant mortality, and it will be found that we have the worst record of any country in Western Europe, with the exception of Spain and Portugal. What about tuberculosis, and other infectious diseases? Have hon. Members opposite, who talk so much about Scotland's wonderful medical service, had any association with working class streets and working class homes? Where was all this fancy medical service when our children in the slums were dying? I remember that when I was a lad we used to talk about some of our companions being in a decline—which was what we used to call tuberculosis in those days. They used to die slowly before our very eyes. Where was all this wonderful medical science? Where is it today? What about the relationship between the doctor and patient? If a doctor has 1,000 patients he has to run from one house to another a few minutes here, a few minutes there, in order to get his work done. The workers in any working class district do not choose a doctor because of his higher qualities or higher skill, but choose the nearest doctor, it is proximity that decides who will he the doctor. This Amendment is an attempt at procrastination. Hon. Members opposite want to hold things back as long as they can. They want to hold back reform. That has always been the line of the Tories. They use any and every method to hold up any advance. They cannot make a frontal attack, so they try to attack from the flank. I only hope that the doctors, dentists, opticians, nurses, domestic staff, and the administrative bodies and the Secretary of State, all engaged in great service to humanity, will harmonise the work so that the people of Scotland will get the very best and highest results from this great Measure. One thing is essential. There is so much power in the hands of the Secretary of State that it requires an intelligent and imaginative Secretary of State who is in close touch with the people. That means that the Tories are barred. We cannot have a Tory Secretary of State. I hope that ensuring that co-ordination will be regarded as one of the biggest jobs. I discussed this with the medical officer in my own constituency, and some of the members interested in health, and the difficulty of co-ordination is something that concerns them very much. I hope it will be brought about. Scotland is a beautiful country. We often hear that said. We are inviting tourists to come to Scotland. But the most beautiful thing we could have would be a strong, robust, and healthy people. While I have been sitting here, I have remembered the lines of Sir Walter Scott:"Breathes there the man, with soul so dead, Who never to himself hath said,
That is not enough. I would add:This is my own, my native land!"
"But raise our people strong and wise, With joyful health the common prize, For this, 'Wee Joe,' will stand."
11.13 p.m.
The hon. Member for West Fife (Mr. Gallacher) would presumably like to have a Communist Secretary of State to administer health.
"Wee Joe" will do.
I must confess I find it very odd that a certain number of hon. Members opposite, including the hon. Member for Rutherglen (Mr. McAllister), who claim to themselves great understanding of the Scottish people, pretend that hon. Members on this side have no cognisance whatever of the wants and difficulties of the Scottish people. May I tell the hon. Member that hon. Members on this side representing Scottish constituencies for the great part come from and live in those constituencies, and have almost daily contacts with their people? They probably know a great deal more about the feelings and opinions of the Scottish people than an hon. Member who lives in London and occasionally goes up to visit his constituency. I ask the hon. Member to give us the credit for knowing just as much as he does about the feelings and opinions of the Scottish people.
I cannot understand why the hon. and gallant Member has chosen to be so offensive. I spent the first thirty years of my life in a Scottish industrial town, and the people of Rutherglen knew when they elected me as their Member that I was not at that time, as I am not now, living in the constituency. I am probably in my constituency as often as any hon. Member on the other side of the House.
I cannot entirely agree with that, because I am certain that the hon. Gentleman is not in his constituency as often as many right hon. and hon. Members on this side. But that is not a matter which is in the Bill. In this Bill, we see the last of a service which, for years past, has been a very good service in the Highlands and Islands of Scotland. It is a service which the Secretary of State has told us will be swallowed up, and become part of the complete Bill.
I must correct that statement. I have never said such a thing during these Debates. Since the hon. and gallant Gentleman has made that remark, I hope that he will quote anything I have said. He usually tries to be very fair, and I do not think he would wish to have it believed that I had said something which, in fact, I have never mentioned.
I had a recollection that, on the Second Reading of this Bill, the Secretary of State said that the Highlands and Islands scheme would be included in the complete national service scheme.
I would ask the hon. and gallant Gentleman to withdraw that remark because there is no foundation in fact for what he has said. I made an exactly opposite statement. I said that this unique service had been so successful, that it was the basis of our scheme for the rest of Scotland.
If I am wrong, Mr. Deputy-Speaker, I will withdraw unreservedly. I will certainly look up the OFFICIAL REPORT to-morrow, and if I find I am wrong, I will withdraw what I have said. I, and my constituents, are under the impression that the scheme does disappear into the Bill.
The Secretary of State has taken to himself, as many right hon. and hon. Members have already pointed out, considerable powers, and he has also allocated to local authorities considerable powers. Yet I find that local authorities are much mystified over one or two parts of the Bill. There is the question of district nursing, which has been mentioned. I take it that, under this Bill, the local authority is to take over the Queen's Nursing Association, but my own local authority is unable to find out who is to take over the financial burden. Is it to remain with the voluntary organisation, because in the Bill it is stated that the local authority has the power to utilise the voluntary organisation to carry on the service if it is efficient.The hon. and gallant Member has not read the Bill.
I have read the Bill just as closely as the hon. Member for Rochdale (Dr. Morgan), who is always interfering and interjecting his remarks.
rose—
No, I cannot give way. The question of the nursing services and the ambulances was raised with me by my constituents this weekend. I have written to the Secretary of State about the ambulances, and I hope that, in his reply on this Third Reading Debate, he will say something on this subject. It would reassure the local authorities if they knew exactly what is being taken over. There is much uncertainty. In the Committee stage, Clause 25 was passed without discussion. It is only natural that the people of Scotland are not satisfied; they do not realise what is the position of the nurses. Again, we are not entirely satisfied as to the position regarding the ambulances. I, therefore, agree with the right hon. and gallant Gentleman the Member for the Scottish Universities (Lieut.-Colonel Elliot.) While we shall have to make the best of this Bill, there are several points upon which I, for one, like my hon. Friends, do not agree with it.
1I.21 p.m.
I had no intention of intervening in this Debate until what is termed a "reasoned Amend- ment" was moved by the Opposition. It seems to me absolute hypocrisy for Members on the Opposition benches to assure us, and possibly, the people who will read it in the newspapers tomorrow, that they are all ready for a really fine and good medical service in Scotland, and at the same time, in this House tonight, to move such an Amendment.
On a point of Order. Is it in Order for the hon. Lady to accuse Members on this side of hypocrisy?
It is quite in Order as far as it applies to a body of people.
By this Bill Scottish people will get a much better medical service than they have ever had, because we have a majority on this side of the House, and in spite of the reasoned Amendment we will be able to carry it through this House tonight. I was also surprised at the arguments put forward by some hon. Members. The hon. Member for East Fife (Mr. Henderson Stewart) and the hon. Lady the Member for South Aberdeen (Lady Grant) made great play with the work of our voluntary hospitals. I am willing to add my tribute of gratitude also to the voluntary hospitals for the marvellous work which they have done. But greater play was made with the effect of the charity drives in Aberdeen and other parts of Scotland. The hon. Lady said that these charity drives gave the people a chance to show their generosity. Surely, if the people are really generous, and really want a good medical service, they will still want to show that generosity. Surely, on the other hand we, as a Government, are responsible for giving our people the best health service we can possibly give them. We cannot take any risks of leaving the voluntary hospitals as they are today, just for the sake of giving those people the chance of showing their generosity. I have much greater faith in the people of Scotland than in the majority of the Members on the other side.
There is another point I would like to stress. I believe it is very wrong for hon. Members opposite to try to get the people of Scotland to believe that there is going to be any direction in regard to the choice of doctor. The hon. Lady said there was great concern among the ordinary people of Scotland on this point. I really wonder whether hon. Members opposite know the system in Scotland. There is not a bit of concern in the whole of my constituency which is a very big and a very mixed one, ranging from mining on the one side to a very good residential district on the other side. I have never come up against this problem, this fear, this concern that we are always being told is being felt by the ordinary people. It was suggested that if a patient went to one of the health centres and found that he could not have his own doctor, there would be great concern. But surely that is what is happening today? Our own doctor at home has Saturday afternoon off every week. If one of his patients is ill, he has to take one of the other three doctors in our village. If our doctor wants a holiday—and every doctor needs a holiday—we either have to depend on one of the other doctors or a locum whom he brings in. It seems to me that if we examine this health service which we are proposing to introduce we shall find there will be just as much right in the choice of doctor as we have today. And, as I think I said on the Second Reading, for the majority of people there is no great choice of doctor today. You have the doctor and if he decides under the present system to clear out of his district—and the majority of Scottish people are panel patients—you must accept the doctor who comes in his place. There is not much choice in that and I am quite certain that if we go to our people, as we do, on this side, and explain this to our people, we have nothing to fear from this reasoned Amendment which has been moved by the Opposition tonight. I was surprised to hear the hon. and gallant Member for Argyll (Major McCallum) exposing doubts about the continuance of the Highlands and Islands medical service. Opposition Members seemed to think that this a very splendid service indeed. Yet there are many things about that—almost a State salaried service.I do not want the hon. Lady to misunderstand me. I said that it was being merged into this Bill.
If hon. Members opposite think that that is a good and splendid service, then why move an Amendment against a service which is following on the same lines as that service? The hon. Lady the Member for South Aberdeen spoke of doing away with the sanctity of the re- lationship betwen doctor and patient—again hypocrisy. Can any hon. Member suggest one single line in this Bill as it has reached its Third Reading which will interfere in any way with the ordinary relationships between the doctor and the patient? If we take a specialist, the patient goes to a specialist whom he has never seen before. He goes to a voluntary hospital; he is treated by the specialist there whom he has never seen before, and yet the majority of patients who go to voluntary hospitals have the greatest faith in those specialists. I am quite certain that there is not a single thing in this Bill which is going to mar the service in our hospitals, or the service from our specialists or the splendid nursing staffs which we undoubtedly have in our Scottish hospitals. There is not a single thing in this Bill which is going to do anything to harm the relationship between patients and those people.
The hon. Member for South Edinburgh (Sir W. Darling), I see, is not in his place. He gave us many very fine, glowing adjectives. He talked about the bureaucratic patchwork of our medical services, the multifarious, unco-ordinated medical service which we have today, but which he considered a fine and good service. He also saw no greatness, and very little good, in what we propose in this Bill. My people know that when the provisions in this Bill are really implemented for the Scottish people, they are going to have the sort of medical service they have dreamed of for a long time, but which they saw no chance whatever of having when hon. Members now in Opposition were in control in this House. The ordinary wife of the ordinary worker who is not covered by his contributions today very often has to do without a doctor in Scotland when she ought to have one. Under this scheme she will be able to have a doctor as soon as she is ill. That is only one of the many advantages which are coming to the Scottish people. I welcome this Bill, and hope that the greatest speed will be shown in carrying out all its provisions for the Scottish people.11.31 p.m.
I admire the faith of the hon. Lady in the machinery of this Bill, but I do not admire to the same extent her assumption that she knows what are the motives of hon. Members on this side of the House. I cannot agree with her attitude when she describes the views of Member after Member on this side as "hypocritical." How can she know? Why should she deal in this way with hon. Members on this side who are doing their duty as legislators, and judging of the machinery which is set up in the Bill?. Of course, everybody in Scotland wants a Bill. The hon. Member for West Fife (Mr. Gallacher) said there was room for the Bill. Of course there is room for the Bill. There is a necessity for a Health Bill. I go further and say that if the National Government had been here at present, we should not have waited 20 months for the Third Reading of the Bill. [AN HON. MEMBER: "Sixty years."] That there should be a Bill is the natural result of the National Insurance Bill, and to that the Coalition Government was pledged. There should be a Health Bill, but what we say is that it should not necessarily have this particular machinery.
The old, old story.
The hon. Member says it is the old, old story. It is the old, old story of every Opposition which questions, not the purpose of a Bill, but the machinery set out in a Bill. That is exactly what we are doing. Our points of criticism are well known. In the first place we do not agree that because a financial contribution is made, therefore there should be full control. We do not agree with complete centralisation. We think that vital error in this Bill is this tendency to centralisation. That tendency is not confined to this Bill. If it were, the administration of the Bill might in the future be better. But Bill after Bill comes before this House now, throwing additional burdens on to the Secretary of State. How is he to fulfil all the various duties? How is Parliament to control his fulfilment of them? There is growing up too much bureaucracy, and the Secretary of State will not be able to know what is going on under these various Measures. This House of Commons should be giving a health service to the people of Scotland. But this will not be a health service; it will be a vast bureaucracy of red tape. [Laughter.] Hon. Members opposite laugh but they themselves in Committee criticised the tendency towards centralisation.
We have heard from the other side of the House complaints about the taking away of responsibilities from the local authorities. It is true that the local authorities are to get representation on the boards of management and on regional hospital boards, but they cease to have any control of the health services in their own areas or any control of the hospitals in those areas. Even the health services are to be controlled by the Secretary of State direct. I hope sincerely that it will not be long before the Secretary of State sees his way to pass the control of the health centres to the local authorities, for I believe that that is 'the sort of service that can and should be controlled as closely as possible to the people, which can best be achieved by their municipally elected representatives. I am well aware that criticism has been made in the past by doctors of local authorities running hospitals. I wonder whether the doctors will fare any better at the hands of the Secretary of State. I do not think they will. It is true that doctors have opposed control of the health centres by the local authorities. Again, I believe that they will find in the course of time, that local control is better than remote control, and being professional men they naturally prefer that the executive councils should be dominated by profesional men. Here again I believe that the executive committees should have a dominating influence on local authorities. Another of the faults we find with this Bill is that the Secretary of State has repeatedly stated that he cannot be responsible for the health of the people of Scotland unless the ultimate authority is reposed in him. It is for that reason that he intends to take over not only the endowments along with the hospitals— which incidentally he reserves the right to dispose of exactly as he pleases—but of the doctors, nurses and dentists themselves. Therefore, he is setting up three separate organisations controlled by him without local co-ordination. He may make neat paper schemes, but he cannot so readily provide the personnel. There is a nation-wide and Empire-wide shortage of doctors. The hon. Member for Tradeston (Mr. Rankin) says that there are doctors unemployed a present. Of course, there are, for they are waiting to see what sort of a Bill this is going to be before deciding what action to take. None the less, there is a shortage of doctors. The right hon. Gentleman is going to find that the creation of the right to free medical attention—with which I do not disagree—will increase the demand for doctors' services. He is also going to find that devoted as doctors are to their profession they are but human, and now that their livelihood will no longer depend on the number of patients they attend, the number of hours they work will fall. I am not saying that that the hours of work of a doctor should not fall, because it is most desirable in my view, but the question is: Is this the right moment to introduce this, when there is such a shortage of doctors?It is always the wrong moment with the hon. Gentlemen opposite.
The hon. Member says that it is always the wrong moment with us, but at the moment we are turning out more doctors in Scotland than ever we turned out before, and sooner or later the number will overtake the need that is now so apparent. In the same way, eventually, the number of hospital beds will overtake the need, too, but that is a matter of finance. Again, I say it is not necessary to take over and control the whole hospital service because the Government are going to make a contribution to the hospitals. As for the dental service I am afraid that the failure of the Secretary of State to meet the dentists is going to mean that for a long time we are going to be fearfully short of dental services.
To sum up, the objects of the Bill are entirely praiseworthy but the reasons why I oppose it are, first, because it takes away local initiative except in matters of home nursing, midwifery, the care of expectant mothers and children and infectious diseases; second, because it sets up three separate medical systems all responsible to the Secretary of State without proper co-ordination; and, third, because it seeks to bring a grandiose scheme into operation without sufficient reserves in personnel, doctors, dentists and nurses. I greatly fear that owing to the Government's desire to show quick political results they will bring chaos into the health services of Scotland.11.36 p.m.
The hon. Member for Dumfries (Mr. Macpherson) pointed to the necessity for this Bill when he indicated the legacy left to the Government from the past, in the shortage of hospitals and hospital beds, the shortage of nurses and nursing services and even the shortage of doctors. There was little incentive in the system in the past and little was done to try to improve the service and encourage people to come into the service. We still find legitimate objections by girls against coming into the nursing service. The conditions in the past did not attract girls except those who entered the service from the highest motives, and girls cannot afford to live on highest motives alone. We on this side of the House pay tribute with equal if not greater sincerity than hon. Members opposite, to the great work of the medical services and the voluntary services at the present time. Hon. Members opposite cannot outdo us in sincerity and enthusiasm and in genuine gratitude to the people who have manned the medical and nursing services and to a certain extent the administrative services. But that does not mean that we are going to sit down and not do anything in the way of moving forward. We have a mandate from the people for a national health service along the lines of this Bill.
It was the hon. and gallant Member fur Argyll (Major McCallum) who provoked me to speak and the responsibility is on his own head. He referred to the Highland and Islands medical service. He feared, for some reason that I cannot understand—because I think we got an assurance on the matter which he now says is in dispute—that this service would be swallowed up. There would be no complaint I imagine if the service were embodied in the new set-up, if as good or a better service were given us in its place. I do not think that the hon. and gallant Member can be strongly against the embodying of that service if we are to get a better service in return. I cannot honestly believe he was strongly against it I would like to ask him a question. I should like to know whether he has had any representations from the Highland and the Islands people or from doctors or nurses against a national health service. I have had none where I come from, and ours is a most characteristic area.I took the precaution last week to investigate the matter, and I have a most definite mandate from the people of my constituency to oppose any such service.
As far as the Outer Hebrides are concerned, I have not received any representations against the service. The doctors there more than two years ago, expressed themselves in favour of centralisation, having had a measure of centralisation from Edinburgh for some time. They have expressed themselves in favour of a national health service and they want to go into such a service. Further, they have signed a document to that effect. The nurses are in the same position, and undoubtedly the people are entirely for it. The people want an expansion of that service to the highest level we can give, on a national basis. I can only say that there was no serious opposition among the doctors and nurses administering that service, as among the people who have had the benefit of it for years. I want to pay tribute to them. If we can bring the general level up to that service, and if we can surpass it, we shall be going a long way towards providing the people with what they want.
We cannot dissociate the objections urged by hon. Members opposite, from the kind of objections they have to rationing. They have been accustomed to privilege and to treatment which one can buy. But those days have passed in the medical service, as in other things, and those objections are the least feasible of all objections which will be over-ruled tonight. So far as the area for which I happen to be one of the Members is concerned, I do not think there was any widespread feeling against this Measure. I am sure that the vast majority understood at the Election that a national health service would be introduced. I know they understood that, because I told them at the time. I am sure that the vast majority welcome it, and I congratulate the Secretary of State on having brought in this Bill. I congratulate him and his colleagues on the way they dealt with the Bill in Committee and I know that we are all behind them in asking for the Third Reading of the Bill.11.48 p.m.
We have now practically reached the end of our consideration and discussion of a matter which has been before the public for many years and on this occa- sion we should remember those who are in the forefront of the movement to bring about a comprehensive health service. I am referring to the work done by the medical profession over a long period of years. I think it is more than 20 years ago since they started to consider how the medical services could be enlarged. We were told by the right hon. and learned Member for North Croydon (Mr. Willink), during the Debate on the Third Reading of the English Measure, that it is now more than eight years ago since instructions were given by the then Minister of Health to start conversations and take proceedings which would eventually result in a Measure of this nature being introduced. I have no doubt that the Department of Health in Scotland were similarly employed over an equal period of time. One thing is absolutely certain, and that is that every party in this House has been completely committed to the introduction of a comprehensive medical service. We had the Government White Paper on the health services during the time of the Coalition Government, and in the last Parliament. The battle has been going on for a long time, and it has been somewhat hotly contested. It is not surprising, when one realises the very great and real differences of opinion which exists on how the best possible service should be provided. There are even wider differences than the organisation of the administration of a comprehensive service. I am certain that Members in all parts of the House wish to ensure that medical science shall continue to advance even more rapidly towards even greater efficiency and without in any way lessening that human touch, that understanding which is the pride of a very great profession.
The provisions of this Bill very gravely affect these things. During the past 100 years, the advance in medical science has been stupendous, but, still, the human touch has been maintained. I do not think that any other country which has developed medical science and surgery has reached a higher level than our own country. The complaint is not that the service has not been good; it is that the service has not been large enough to take care of all the people requiring its attention. These outstanding results have been achieved through free and independent institutions, and through a free and independent profession. I should have imagined that those responsible for framing the Bill, and setting up this new ser- vice, would have endeavoured to maintain to the greatest possible extent, and fostered by every means in their power, that freedom and independence. But the Bill proceeds in the opposite direction. The control of our great free hospitals, all local authority hospitals, institutions for reception, the treatment of illness, and for convalescence, now pass into the hands of one man—the Secretary of State for Scotland. The ownership of the physical essentials to the service—the lands, buildings, and equipment—are to be vested in him. Minor authority will be delegated to the regional hospital boards, and also to the boards of management, but nothing in connection with these lands, buildings, and equipment will be able to be altered without it having first received the approval of the official channels. At the end of every one of those channels will be the Secretary of State. In consequence of this great over-centralisation, I think we shall find that in a few years we shall hear, in this House, complaints about the inadequacy of hospitals, the out-of-date buildings, and stupid standardisation, such as we heard of in connection with naval establishments when we debated the Navy Estimates. Over-centralisation is the blemish on the whole administrative machine which is set up under this Bill. The most important body which the Bill creates is the Scottish Health Services Council. It is composed of 35 persons, who can be chosen from seven different categories. Each of those categories has an association of its own, which should know their ability, competence, and suitability for appointment to this great new Council. Yet every one of these appointments is retained in the hands of the Secretary of State—and in this matter I am not only referring to the present Secretary of State, but also to his successors— who will appoint only those whom he knows to be in sympathy with his policies and his views. No others, no matter how competent they may be, will have any opportunity of serving on this important body. I wonder whether, if these associations had been affiliated to the Trades Union Congress, the right hon. Gentleman would have dared to act in what I consider to be a most undemocratic way? I wonder whether the hon. Member for Rochdale (Dr. Morgan) believes that what I have described, and what is actually in the Bill, can be called "nomination" or even "democratic"? The regional hospital boards are also to be appointed by the Secretary of State. He is going, to appoint these gentlemen from five different categories of persons. Four of then, have associations of their own capable of pointing out who the best men are Not even the local health authorities are to have the right to appoint from their own body. The Secretary of State reserves the entire right of appointment, again, to himself. The boards of management are to be appointed by the Regional Hospital Boards which, as I have already said, are the creatures of the Minister; but the right hon. Gentleman still retains to himself the power to alter and to vary the schemes which the Regional Boards send forward and under which these appointments to the hospital boards are made. So far as the administration of our hospitals and specialists services is concerned, all authority rests in the hands of the Secretary of State under this Bill.Is not that the system now?
I am describing the system which is set up under this Bill. What a change this Bill is going to introduce. Here the hon. Gentleman will get his answer. It is going to bring about a revolution in the present system. Instead of free institutions combining with each other to produce the most efficient possible service for the benefit of the public, at liberty to pursue any course they think most likely to achieve that end, in a position to compare results with one another, to adopt rapidly any better system which has been proved by the experience of some kindred institution, we are going to have a completely centralised control which will inevitably bring in its train uniformity and standardisation, which will deaden, if it does not kill, both initiative and progress. I repeat to the right hon. Gentleman words which the right hon. and learned Member for North Croydon (Mr. Willink) spoke to the Minister of Health, substituting the name of the Secretary of State for that of the Minister. He said that the Secretary of State should be terrified of the powers which he is taking unto himself, and which are nothing short of directing the whole administration and management of every place where the citizens of Scotland can obtain hospital care.
The Secretary of State has today alluded to the very high regard in which Scottish medical men are held in every country in the world. That is undoubtedly due to the excellence of the training which they receive at our Scottish universities and also at our Scottish training hospitals, and it is also due to the traditions which were instilled into them from the very first day on which they started to prepare themselves to enter the medical profession. Hitherto these matters have been left in the hands of the universities and of the teaching hospitals, and none of us can pay too high a tribute to these institutions for the remarkable way in which they have performed their task. But the Secretary of State is not prepared to leave well enough alone. It seems he has got to have his finger in every pie, and he is taking unto himself the duty of providing facilities for clinical teaching and deciding what is necessary to meet these reasonable needs. The Secretary of State seems to think that that is being helpful. I have very grave doubts as to that. He is only going to be assisted by the advice which is given by the medical education committees to the Regional Boards, or so much of that advice as these Boards pass on to him, and then, again, that advice will have to pass through the filter of his own officials. It is obvious the advice he will receive will be only the advice of his own Department of Health. In any case, it is pertinent to inquire into what these educational committees consist of. To the extent of one-third they are appointed by the universities, and therefore, we can take it they are independent. To the extent of the remaining two-thirds they are appointed either directly or indirectly by the Secretary of State himself. I have the impression that the whole of this set-up is something of a pretence—something of a farce, and it would have been much more seemly if the Bill had stated that the medical education would proceed on lines laid down by the officials of the Department of Health, after consultation with such representatives of the universities as they chose to select for that purpose. The effects of these provisions on the prestige of our medical schools, and on the prestige of our doctors, time alone will show. All I would say to-night is that many of those to whom I have spoken, and who are people well qualified to judge, have received these proposals with grave misapprehension and even with dismay. Much has been said of the manner in which this Bill interferes with the independence of the individual doctor. I have stated before, and I repeat tonight, that one cannot expect the best from any medical man unless he is entirely free and independent. But this Bill saps the independence of the doctor at its very roots through the prohibition which it places on the doctor owning his own practice, and also from the salary element. The patient is going to suffer because the doctor will no longer owe one loyalty to the patient alone. The doctor will have two loyalties—perhaps opposing loyalties—to the patient and the authorities. The doctor is not going to have the benefits of greater skill and harder work, which are qualities entitling those who possess them to higher rewards, and the doctor is going to suffer in character to large extent. Prohibition on doctors practising where they will, and in partnership with those with whom they desire to take on that relationship, is wrong. No matter how it is cloaked in this Bill, all this is a measure of direction, and no matter how the Secretary of State may try to argue otherwise, it is a Measure highly repugnant to the people of Scotland. By forbidding the sale of goodwill, and by forbidding doctors to enter into partnership, and by introducing the salary element, it seems to me that the Government are preparing the way—and I would challenge the Secretary of State to deny it—for the achievement of their declared view—that is the establishment of a full time, salaried, State medical service. The country should know the facts, and I hope that the hon. Gentleman, in his reply, will give a fair answer. As Lord Moran said in another place, after having made a full investigation into the medical services of the fighting forces, it would be highly detrimental to the people of this country. My right hon. and gallant Friend the Member for the Scottish Universities (Lieut.-Colonel Elliot) and other hon. Members have spoken on this question of endowments. I would add this. These provisions are going to have a most depressing effect on all voluntary effort, and will bring no encouragement to benefactors. Not only in this field of medicine, but in all other fields as well, the Bill is full of discouraging influences to those who desire to give service on voluntary bodies or to serve local authorities. It is our belief that the benefits of a compre- hensive service are more than counter balanced by the harm that is being done to the public interest through the centralisation of control, through the unnecessary interference with the freedom and independence of the medical profession and of medical institutions, and through the incursion of officialdom into the field of medical education. Because we believe that the Bill will do more harm than good, we are going into the Lobby tonight in support of the Amendment, and against the Third Reading of this Bill.12.6 a.m.
We have come to the end of a Debate on the Third Reading of this Bill, which is an important one from the point of view of Scotland. I must confess that I did not think that the Third Reading would have engendered quite as much heat as it looked like doing at one period of the Debate. Far be it from me to deprecate the introduction of heat into Debates, or to object to one saying hard things to the other, though I do not like to see men who have always taught me benevolence, falling from the great grace they have always tried to teach me. I was somewhat disappointed with the hon. and gallant Member for Argyll (Major McCallum) in that respect. He wanted to know one or two things. First, let me say to him that I cannot understand his point in regard to the Highlands and Islands service. You have a State medical service now in the Highland and Islands, a State medical service, which, for devotion, self-sacrifice and capacity, is far ahead of anything connected with the private practice, or panel patients right throughout the length of Scotland. Let me say this to him: I propose to repudiate his somewhat brusque and unfair treatment of our people—
I hope the hon. Gentleman will remember that I gave way to several Members opposite. What I wanted to say was that you cannot deny that doctors in the Highlands and Islands medical scheme are private doctors who are semi-subsidised by the State—not totally subsidised.
It is a State-supported scheme.
Yes, State-supported.
I say that private practice could not last a minute—not a minute. The basis on which the scheme is built and maintained is a State subsidy, and without that, there would not be a private doctor in the Highlands today; and it is no use hon. Members riding away on that. Let me say one word about this argument which has emanated from somebody who opposed the scheme.
By one of the doctors, representing the others.
Let us be frank. Not a single servant in this scheme has made one representation of any kind against this Bill, either through the British Medical Association, which he could have done with complete freedom, or in any way to the Secretary of State or to the chief medical officer and, indeed, all the representations that we have received go to consolidate support of the step we are taking. Now let me turn from that to the ambulance scheme. Why should hon. Members ask me the same thing again and again. I dealt with that before. The ambulances will be a State service. I have explained that already. The district nurses will be the service of the local authority. Let me say a word or two on the other point. I wish that I could continue this Debate longer than is possible. [HON. MEMBERS; "Go on."]
Let us compare the present system with what we are proposing to do. People opposing this Bill talk as if the present system was a health system. The present system is only partially a health system. Let me for a moment or two examine this. I was very pleased with the hon. Lady the Member for South Aberdeen (Lady Grant) for her kindly indulgence tonight. It was much kinder than we could expect. We are city-bred and city born; and this is a democratic Assembly, 'his House of Commons, and when city bred men are elected Members of this House they are entitled to be here. Take the system you have got now. You have the panel system, the local system, that deals with the poor law and that which deals with infectious diseases. You have the voluntary system, and then you have the large category of other things about which nothing is done at all. Take the question of dental treatment. Who would deny that a dental system is as important as any other system in medical teaching? Yet we have no connection with dental treatment. What we have got is a higgledy piggledy system, that no one who knew anything at all about it would defend for five minutes. You have the system for free dental treatment. A person may be in a certain selected approved society which, with good fortune, can provide him with free dental treatment, or he may be in a very poor society, with recourse only to the poor law. The great mass of the people covered by National Health Insurance are denied any health treatment in regard to the dental side. Take the question of treatment by the doctor. The man is covered—the most important member of the family possibly. But no free medical treatment for the wife. No free medical treatment for the children. All out. And we come along tonight and we propose a Bill which creates a system, which says that a modern health service for the people shall be available without any test as regards calling or income, but available in its broadest and widest sense for the community as a whole. That is what we are doing tonight. What are the objections to it? The hon. Lady said that she is in favour of a national health service. She wants a national service but not this one. What kind does she want? I do not know. She surely does not want the present system. It is not a national service. And we have the spectacle of the pleading voluntary hospitals, giving people the chance of running about with a collecting box, asking for pennies. [An HON. MEMBER: "Cheap."] It is not cheap. It was said. Let me say this one thing; that the most disagreeable thing I know is to see these people running round with boxes. Mind you, it is not done for dealing with infectious diseases. There are no penny collections for those hospitals, no running about with tin boxes. There axe no voluntary associations for the infectious diseases: everything for them is done either by the State or municipality. Voluntary associations have nothing to do with tuberculosis. This, again, is dealt with by the State or the local authority.What about the Orphan Homes of Scotland?
That has nothing to do with the notifiable disease of tuberculosis.
Certainly it has. It has a large sanatorium.
When it is a matter of notifiable diseases the State deals with them; and the State does all. We see people on Saturday afternoons in Glasgow cadging pennies from other people for doing what should be a most elementary duty of the community—caring for the sick. Can it be suggested that that is a good way of running a system of society? We should never dream of looking after those injured in war in that way, and I think it is wrong in this connection.
Let me say a word or two about certain points which have been raised. One hon. Member raised the question of research. Far be it from us to lessen research. We are now going to increase the opportunities for research. We are going to make it possible for the local authority, if it cares to do so, to provide funds for research. We propose, through the State, to provide funds for research, and to allow the regional board to provide funds for this purpose. Indeed, we take it that under this Bill larger sums than ever before will be available for research. Another hon. Member said that within months there would be grumbles because there were not enough hospital beds or provision made. Of course there will be grumbles. I do not claim that within six months, or in a year, or in two or three years, this Bill will have solved the very acute shortage of hospital beds throughout Scotland. No one makes that claim. All I say is that if the voluntary hospitals were left to do it by voluntary effort, it would take much longer to deal with the matter, because the voluntary hospital in Scotland could not carry on unless up to 80 per cent. of its income were to come from local authority or State sources. It is a misnomer to call them voluntary hospitals. That name has long since been completely out of date. Now, regarding the question of the free choice of doctor, a great deal of this free choice of doctor does not work out in practice. Free choice exists as a great deal of by-play, but not in reality. I happened to be ill last month. Until then I cannot remember having been ill before. I had never had a doctor, but I needed one. What did I do? I went to the doctor nearest to my home. That is my free choice of doctor. Most people who go to a doctor do not go to him in the sense that they have a doctor with a label on him, as if he were a piece of merchandise. The fact is that in any great working-class district, a doctor is chosen for two reasons. The first is his availability at the particular moment at which his service is needed. A great deal of this family doctor business is nonsense. I should like to see a person residing in my Division walking up to Woodside Crescent, which is the Harley Street of Glasgow, and getting one of the doctors there to come and attend whoever is sick in that man's home. The thing would just be nonsense. In my district the choice of doctor is limited to the doctor who happens to practise in that particular area, seven, eight or nine of them altogether. In the State scheme the choice of doctor will be at least as wide, and in my view wider than is the case at the present time. There has been talk about doctors working a shift system. Plenty of the noblest doctors in the country at present work a shift system. The doctor in a hospital works a shift system. After all, the doctor in the hospital must have his time off and his freedom. One of the things that I have always wanted and planned for is to see the ordinary medical men get something like reasonable hours off work. If I may quote from a speech which I made in the old political days, I would say that one can get a policeman at any time to look after one's property but to find a doctor to look after one's health is a most difficult thing, particularly at times when epidemics break out. Then the doctors are overworked and it would be in the interests of both patient and doctor if the doctor could occasionally lie off from work and take a rest. As far as the shift system is concerned, it has been represented to almost every working-class representative from Glasgow, and even to the hon. and gallant Member for Pollak (Commander Galbraith), that on a Tuesday afternoon it is almost impossible to get a doctor, while on Sundays it is 'well nigh impossible. One of the things that always offended me in my public life is that the very poor person, who is chargeable to the poor law, can walk along and demand to get a poor law doctor and get him to attend to whatever his wants are. Similarly, a panel patient can go along to his panel doctor and get attention. When we come to the wife who is not too poor or who has no panel, things are different. All the right she has, is to beg the doctor to come and it is optional with him whether he comes or not. We think that that system should end, we think it can be ended through the far-sighted provisions which we are making in the Bill. Mention has been made of the medical service in the Highlands and the Islands. We propose to unify the health service in the Highlands and the Islands and extend it under this scheme, making it more useful than it is. On the general question, we think that this Bill can be made workmanlike and that it will be a good proposition. It is said that the Secretary of State will have too much power. I do not want to go over all that hon. Members have mentioned but I could not help recalling that in one night hon. Members opposite when they were in power—and I was here in this House at the time—rushed through a Bill by means of the guillotine which swept away the whole system of local administration and suppressed the local authorities. They took the poor people and put them into an institution not under a Scottish Board but under an Assistance Board run from London without any democratic representation at all. Then hon. Members opposite talk about the people who are to be appointed to these boards. The first people they appointed were discarded Cabinet Ministers. I am not saying anything against them because one of the discarded Cabinet Ministers was an excellent choice. Let us take this thing seriously. The arrangement which we have been discussing tonight in regard to hospital treatment under a regional board is, in our view, very easy and flexible. I admit that a great deal will turn on the humanity of the Secretary of State and his officials. Much of the success of this scheme will depend on the vigilance of the House of Commons and of the Secretary of State for Scotland. Whatever influence I have, whether it be for a long or short period, will be wielded on the side of the regional boards to make that system into a really sound authority even when mistakes are made. In this Bill we have set out on what I believe will be a great and noble task. The Secretary of State has undertaken a first-class job. I would only like to make two points in reply to questions raised by my hon. Friends on this side of the House One is in regard to the link-up with the local authorities. In that connection, we took the first step today in an Amendment which was adopted. In the course of time these things will work out in the proper way. The planning scheme was not made in a month or a week. It evolved in time and so will this scheme. Then there was the matter of the nature cure doctors. I have no particular objection to the nature treatment practitioners. I say that the nature doctors will have to find clients, and if they get clients who say that they want a nature doctor I will have no objection to the nature doctor treating them. This is the Bill which this Party has set itself the task of getting through
Division No. 130.]
| AYES.
| [12.28 a.m.
|
| Adams, W. T. (Hammersmith, South) | Greenwood, A. W. J (Heywood) | Parker, J. |
| Alexander, Rt. Hon. A. V. | Grierson, E. | Pearson, A. |
| Attewell, H. C | Griffiths, D. (Rother Valley) | Pritt, D. N |
| Awbery, S. S | Guest, Dr. L. Haden | Randall, H. E. |
| Barton, C. | Gunter, R. J. | Ranger, J |
| Battley, J. R. | Hale, Leslie | Rankin, J. |
| Bechervaise, A. E. | Hamilton, Lieut.-Col. R | Robens, A. |
| Berry, H. | Hardy, E. A. | Roberts, Goronwy, (Caernarvonshire) |
| Bing, G. H. C | Hastings, Dr. Somerville | Ross, William (Kilmarnock) |
| Binns, J. | Henderson, Joseph (Ardwick) | Sargood, R. |
| Blackburn, A. R. | Herbison, Miss M. | Scollan, T. |
| Blenkinsop, A. | Hewitson, Capt. M | Sharp, Granville |
| Braddock, Mrs. E. M. (L'pl, Exch'ge) | Holman, P | Shawcross, C. N (Widnes) |
| Bramall, Major E. A | House, G | Shurmer, P. |
| Brook, D. (Halifax) | Hoy, J. | Silverman, J. (Erdington) |
| Brown, T. J. (Ince) | Hubbard, T | Skeffington, A. M. |
| Buchanan, G | Hudson, J H. (Ealing, W.) | Smith, C. (Colchester) |
| Burke, W. A. | Hughes, Hector (Aberdeen, N.) | Smith, S. H. (Hull, S.W.) |
| Butler, H. W. (Hackney, S.) | Hynd, H. (Hackney, C.) | Snow, Capt. J. W |
| Champion, A. J | Jager, G. (Winchester) | Steele, T |
| Cocks, F. S. | Jeger, Dr. S W. (St. Pancras, S.E.) | Stewart, Capt. Michael (Fulham, E.) |
| Collindridge, F. | Jones, D. T. (Hartlepools) | Swingler, S. |
| Collins, V. J. | Jones, Elwyn (Plaistow) | Taylor, R. J. (Morpeth) |
| Colman, Miss C. M | Jones, J. H. (Bolton) | Taylor, Dr. S. (Barnet) |
| Comyns, Dr. L. | Keenan, W. | Thomas, D. E. (Aberdare) |
| Cook, T. F. | Kenyon, C. | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Cooper, Wing-Comdr. G. | King, E. M | Thorneycroft, Harry (Clayton) |
| Corbet, Mrs. F. K. (Camb'well, N.W.) | Kinley, J | Tiffany, S. |
| Corlett, Dr. J | Lee, F. (Hulme) | Ungoed-Thomas, L. |
| Crawley, A. | Lewis, A. W. J (Upton) | Wallace, G. D. (Chislehurst) |
| Grossman, R. H S. | Longden, F. | Wallace, H. W. (Walthamstow, E.) |
| Dagger, G. | McAllister, G. | Weitzman, D. |
| Davies, Edward (Burslem) | Mack, J. D. | Wells, P. L. (Faversham) |
| Davies, Harold (Leek) | McKay, J. (Wallsend) | Westwood, Rt. Hon. J. |
| Deer, G. | Mackay, R. W G (Hull, N.W.) | White, C. F. (Derbyshire, W.) |
| Diamond, J. | McLeavy, F | White, H. (Derbyshire, N.E.) |
| Dobbie, W. | MacMillan, M. K. (Western Isles) | Whiteley, Rt. Hon. W. |
| Driberg, T. E. N. | Mallalieu, J. P. W. | Wilkes, L. |
| Ede, Rt. Hon. J C. | Manning, Mrs. L. (Epping) | Wilkins, W. A |
| Ewart, R. | Middleton, Mrs, L. | Williams, J. L. (Kelvingrove) |
| Fairhurst, F. | Mikardo, Ian | Williams, W. R. (Heston) |
| Farthing, W. J. | Mitchison, Major G. R. | Williamson, T. |
| Field, Captain W. J. | Morgan, Dr. H. B. | Willis, E, |
| Fletcher, E. G. M. (Islington, E.) | Morris, P (Swansea, W.) | Wills, Mrs. E A |
| Foot, M. M. | Moyle, A. | Yates, V. F. |
| Gallecher, W. | Nally, W. | |
| Ganley, Mrs. C. S. | Neal, H. (Claycross) | |
| Gibson, C. W. | Nicholls, H. R. (Stratford) | TELLERS FOR THE AYES
|
| Greenwood, Rt. Hon. A. (Wakefield) | Palmer. A M. F | Mr. Simmons and Mr. Hannan. |
Parliament. I have been asked what is the future of the State medical service. All I say now is that tonight we pin our faith to this Bill. What will be decided in five years' or ten years' time will be decided first by the electorate and then by those who occupy the offices of State at that time. What I claim now for this Bill is that, for the vast majority of the Scottish people, there is now the chance of a health service better than ever was the case before and for that reason, we think, that it will make for a better Scotland, too.
Question put "That the words proposed to be left out stand part of the Question."
The House divided: Ayes, 143: Noes, 54.
NOES
| ||
| Agnew, Cmdr. P. G. | Hollis, M. C. | Shepherd, W. S.(Bucklow) |
| Beamish, Maj. T. V. H. | Hutchison, Lt.-Cm. Clark (E'b'rgh, W.) | Smith, E. P. (Ashford) |
| Buchan-Hepburn, P. G. T. | Kerr, Sir J. Graham | Snadden, W. M. |
| Carson, E. | Lucas-Tooth, Sir H. | Spearman, A. C. M. |
| Clarke, Col. R. S. | McCallum, Maj. D. | Spence, H. R. |
| Conant, Maj. R. J. E. | Macdonald, Sir P. (Isle of Wight) | Stuart, Rt. Hon. J. (Moray) |
| Corbett, Lieut.-Col. U. (Ludlow) | McKie. J. H. (Galloway) | |
| Crosthwaite-Eyre, Col. O. E. | Maclay, Hon. J. S | Studholme, H. G |
| Cuthbert, W. N. | Macpherson, Maj. N. (Dumfries) | Teeling, William |
| Darling, Sir W. Y. | Manningham-Buller, R. E. | Thornton-Kemsley, C. N |
| Drayson, G. B | Marlowe, A. A. H. | Vane, W. M. F. |
| Drewe, C. | Marshall, D. (Bodmin) | Ward, Hon. C. R. |
| Duthie, W. S. | Mellor, Sir J. | Wheatley, Colonel M. J. |
| Elliot, Lieut.-Colonel W | Moore, Lt.-Col. Sir T. | Williams, Geraid (Tonbridge) |
| Foster, J. G. (Northwich) | Morrison, Maj. J. G. (Salisbury) | Willoughby de Eresby, Lord |
| Fox, Sir G. | Neven-Spence, Sir B. | |
| Galbraith, Cmdr. T. D. | Peto, Brig. C. H. M. | TELLERS FOR THE NOES
|
| Comme-Duncan, Col. A. G | Price-White, Lt.-Col. D. | |
| Grant, Lady | Robinson, Wing-Comdr, Roland | Major Ramsay and Lieut.-Col |
| Headlam, Lieut.-Col. Rt. Hon. Sir C. | Scott, Lord W. | Thorp. |
Bill read the Third time, and passed.
Adjournment
Resolved: "That this House do now adjourn."—[Mr. Snow.]
Adjourned accordingly at Twenty-two Minutes to One o'Clock.