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Commons Chamber

Volume 537: debated on Wednesday 16 February 1955

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House Of Commons

Wednesday, 16th February, 1955

The House met at half-past Two o'clock

Prayers

[Mr. SPEAKER in the Chair]

Supreme Court: Prize, &C, Deposit Account, 1939–1954

Account ordered,

'of the Receipts and Payments of the Accounting Officer of the Vote for the Supreme Court on behalf of the Admiralty Division in Prize for the period from 3rd September. 1939, to 31st March, 1954, with a Copy of a Letter from the Comptroller and Auditor General thereon.'—[Mr. H. Brooke]

Oral Answers To Questions

Transport

Vehicle Design (Safety Standards)

1.

asked the Minister of Transport and Civil Aviation if he will direct the Road Research Laboratory to draft a code of standards of safety in vehicle design dealing with visibility, controllability, braking, lighting, and fitments; if, upon receipt of such a draft code, he will review the Motor Vehicles (Construction and Use) Regulations; and if he will then take steps to bring those Regulations into line with such code.

As my hon. Friend will be aware, the Road Research Laboratory is the responsibility of my noble Friend the Lord President of the Council, and it is not, therefore, for me to give any such direction as is suggested. I am, however, in close touch with the Lord President and the Laboratory, and make full use of the results of the Laboratory's work in this and other directions.

Is it not the case that the Road Research Laboratory has in recent years made some very valuable investigations and reports on this subject? Does not my right hon. Friend think that it would be wise, having regard to the change in the design of cars during recent years, to bring these Regulations up-to-date?

The process of keeping them up-to-date is a continuing one, but I share my hon. Friend's obvious appreciation of the extremely valuable work which the officers of the Road Research Laboratory are doing.

International Driving Documents

3.

asked the Minister of Transport and Civil Aviation if he will try to arrange that possession of international certificates for motor vehicles and international driving permits shall no longer be necessary for motorists visiting any country in Western Europe.

The elimination of these documents is one of the aims of the 1949 Convention on Road Traffic, and should be achieved in Western Europe when all the countries concerned have become parties to that Convention.

Can my right hon. Friend say when the other parties who have not yet ratified the Convention are likely to do so?

I am afraid it is very difficult to speculate when foreign Governments will take action of that sort.

Driving Tests, Heston And Isleworth

5.

asked the Minister of Transport and Civil Aviation the average time that persons living in Heston and Isleworth and who wish to take the driving test have to wait between applying for the test and being tested.

Unlighted Cars (Parking)

6.

asked the Minister of Transport and Civil Aviation whether he is now able to announce his decision in reference to car owners leaving them without lights on the street if within 100 yards of public lighting.

I cannot at the moment add anything to the answer I gave to the hon. Member's Question on 26th January.

Will the Minister say when he will be able to bring in these regulations, in view of the fact that it was never necessary to have them at all?

I am not quite sure whether the hon. Gentleman wants me to introduce regulations or not, but the position is that I have now received the views of the organizations which, as I indicated in my earlier statement, have to be consulted, and I am considering them.

Is the Minister aware that the suggestion contained in the Question will be very widely welcomed, and that, in the meantime, there is a discrepancy in treatment by the police in different areas which is causing a very unfortunate situation for motorists?

It is because of that that I initiated action on this matter, but I think the hon. Gentleman will appreciate that it is wise in these matters to take the views of the various interests concerned before actually drafting the regulations.

Vehicles (Rear Mudguard Flaps)

9.

asked the Minister of Transport and Civil Aviation if he will take steps to make compulsory the fixing of rubber flaps on the rear mudguards of road vehicles.

Mud flaps are not wholly effective and are often unnecessary. The Regulations already require the provision of wings or other similar fittings to catch so far as practicable the mud or water thrown up by the wheels, and I do not think that any further compulsory requirements would be feasible.

Is my right hon. Friend aware how dangerous it is to drive on a wet road, with mud being thrown back on to the windscreen, and how much easier it is to follow a public service vehicle or a petrol lorry, which have these mud flaps? Does not my right hon. Friend think it is dangerous to have mud thrown back on one's windscreen?

I do not think that the contribution mud flaps could make, additional to what can be made by the wings, would justify my introducing further compulsions.

Flashing Indicators

10.

asked the Minister of Transport and Civil Aviation if he will make an order for the discontinuance of flashing car indicators.

The Road Research Laboratory is making an investigation into the use of various types of flashing indicators, and I will review the whole question when I receive its report.

Has my right hon. Friend not experienced difficulty when following these flashing lights, particularly as one's foot might slip and put on the foot brake? They are very misleading. On the other hand, indicators that go straight out tell one surely whether a car is going to the right or to the left. Is it not a fact that, in the past, winks have led many a man into trouble?

As to the last part of my hon. Friend's supplementary question, I must bow to his superior knowledge. As regards the main part of it, he will recall that these indicators were authorised only on 1st January, 1954, with a view to assisting the export trade. In view of the investigation to which I have referred, and in view of the short time that these indicators have been operating, I ought to keep an eye on them a little longer.

Is not the Minister aware that these flashing car indicators have, in that short time, added a great deal to the confusion for even the most sober driver who is following behind them? Will he bear in mind that the sober driver already has to contend with traffic lights, flashing beacons, and what not? Please do not add to his difficulties.

There is a good deal in what the hon. and gallant Gentleman has said, but he will appreciate that these indicators are of different types and that the objections apply more strongly to some than to others.

Headlamp Dipping

15.

asked the Minister of Transport and Civil Aviation whether he is now in a position to make a further statement about the steps he proposes to take on the question of universal headlamp dipping.

Early in 1952, when the attention of the right hon. Gentleman's predecessor was drawn to the matter, we were told that his predecessor was awaiting the result of an international conference in America. The right hon. Gentleman himself told me four months ago that he was considering the matter. When are we likely to get some satisfaction for the drivers of public service vehicles, who believe that to make this practice universal would lessen the danger of driving at night?

We try to proceed jointly with other countries. I understand that the report of the International Committee is expected this spring. To a considerable extent, I share the hon. Gentleman's impatience.

Why has the right hon. Gentleman to wait for other countries? Most of them drive by the right while we drive by the left. We are going further left—in case the right hon. Gentleman does not realise it. Will he consider saying in his instruction that all motorists must extinguish their nearside headlight and deflect the offside light? That is the only safe way.

I would not go as far as the right hon. Gentleman. As he will appreciate, it is possible to be dazzled on the left as well as on the right.

In the meantime, will my right hon. Friend deal with the similar problem of the unnecessary use of fog lights? The police never seem to check on the number of cars on the road that only use the left-hand sidelight, which is extremely dangerous. I never heard of the police checking on either of these two points.

I will gladly look into the suggestions made by my hon. Friend, but police enforcement is more a matter for my right hon. and gallant Friend the Home Secretary than for me.

Omnibuses (Rural Areas)

19.

asked the Minister of Transport and Civil Aviation what steps are being taken by the licensing authori- ties in an endeavour to maintain adequate omnibus services in the rural areas.

There is constant informal consultation between operators and licensing authorities, which frequently results in existing unremunerative country services being preserved and new or experimental services promoted. Licensing authorities also assist, for example, by authorising, where desirable, variations in timing and routing, the combining of services, and the running of buses without conductors.

Is it not a fact that, in spite of the efforts of the licensing authorities, bus services are being withdrawn from rural areas all over the country, and will my right hon. Friend see whether other steps cannot be taken to assist the operators to make these services pay?

I agree with my hon. Friend that there is cause for a good deal of concern in this matter, but he will appreciate that I have no powers to compel the operation of services, and that probably the best method of dealing with this matter is along the lines outlined in my original answer.

Does not the right hon. Gentleman think that, in the light of his experience, and the Government's decision of last July that these bus undertakings are commercial undertakings and not public service undertakings, we are bound to have a continual withdrawal of these services until we have a nationalised public service, run for the public convenience?

I do not altogether like the implication of the hon. Gentleman's suggestion that a nationalised service must necessarily be unremunerative.

Will my right hon. Friend invite the attention of the Chancellor of the Exchequer to this problem in order that he may consider it very deeply?

I am sure that my right hon. Friend is aware of all the relevant considerations.

Military Drivers (Driving Test)

50.

asked the Minister of Transport and Civil Aviation whether he is aware that county councils are refusing to accept as evidence of an applicant having passed a driving test the production of a War Office driving licence; and whether he will ensure that this evidence, when properly completed and in order, is accepted.

Military drivers who pass the official driving test are issued with Army form A2039, and this is accepted by county councils. Councils cannot, however, accept the driving permit (Army form A2038) sometimes issued to soldiers, as the issue of this permit does not depend on passing the official test.

Lorries (Conditions)

55.

asked the Minister of Transport and Civil Aviation if he has considered the evidence sent by the hon. Member for Cardiff, South-East, concerning breaches of the law; and if he will make a special investigation into the hours worked by private enterprise lorry drivers and the condition of their lorries.

Yes, Sir. I have seen the newspaper cutting which the hon. Member was good enough to send me. It does not identify any case in which a charge could be brought. I do not accept the implication that there is a general disregard for the law either by private enterprise employers or by their employees.

As this was not a newspaper cutting except in a technical sense—it was a detailed newspaper article written by a special investigator for a reputable newspaper in the North of England—does not the Minister think that he has a responsibility for doing a little more than dismiss it in this way? Does not the article reinforce the allegations which are made constantly to us? Has he not a responsibility for asking his licensing authorities throughout the country to go into these matters to see how well-founded these charges are?

The hon. Gentleman knows that the article, which is most interesting, contains no specific allegations on which proceedings could be brought, because it does not identify individual cases. It is rather a flimsy foundation for a general charge against both sides of an important industry. But my licensing authorities are always anxious to secure that the law is observed, and work extremely hard to that end.

Is the Minister aware that in all the technical Press—whether it be "Motor Transport" or "Headlight" or any of the other papers—there have appeared recently a large number of cases indicating that there is a breach of the law in this respect? Is he deceiving himself into believing that there has not been an increase in this practice since the 1953 Act came into force?

As I have said, I am always ready to consider evidence in respect of particular breaches of the law, but the hon. Member knows perfectly well that it is not possible to proceed in this kind of matter, involving possible prosecutions, on the basis of general allegations, however sincere.

Roads

Accidents

2.

asked the Minister of Transport and Civil Aviation to what extent his Department analyses road accidents in relation to make and model of car involved; and what conclusions have been drawn from such analyses as to dangerous features in vehicle design.

Statistical analyses of vehicles involved in road accidents by make and model are not undertaken by my Department. Some work is being done on analyses of this kind by the Road Research Laboratory, but I understand that it cannot yet report any precise results.

My technical officers are, however, constantly on the watch for the disclosure, in service as well as in accidents, of faults in vehicle design which may affect safety. Such faults are brought to the notice of manufacturers where necessary, and many improvements have been secured.

24.

asked the Minister of Transport and Civil Aviation when the statistics for road accidents for 1954 will be published; and if he will make available to the House the statistics of road accidents for the first six months of 1954 immediately.

Figures for the whole year 1954 should be published this month. I am circulating in the Official Report a summary of the figures for January to June, 1954.

Will the right hon. Gentleman tell me why he has not yet published the statistics for 1953? The answer which he gave a few weeks ago was, in my judgment, rather an excuse. Shall we get the statistics for 1953 before we get those for 1954, because we can better assess the blame when we have the full statistics? I congratulate the right hon. Gentleman's Department on the statistics that it has published, because when they are published they are very full.

I am obliged to the hon. Gentleman for the last part of his supplementary question. The figures for 1953 have been published. What I think he is concerned about is the rather elaborate statistical analysis of the figures for these years, and an elaborate statistical analysis takes a little time.

The following are the figures:

CASUALTIES FROM ROAD ACCIDENTS IN GREAT BRITAIN, JANUARY-JUNE, 1954
——DiedInjuredTotal
SeriouslySlightly

Pedestrians

Under 152332,9389,19612,367
15 and over7334,0989,86614,697
Total9667,03619,06227,064

Pedal Cyclists

Under 15409193,6664,625
15 and over2533,73813,16817,159
Total2934,65716,83421,784

Motor-assisted

pedal cyclists

183569461,320

Motor Cyclists

Drivers3634,93510,05515,353
Passengers601,1333,0904,283
Total4236,06813,14519,636

Other motorists

*

Drivers1752,4388,74811,361
Passengers2293,94016,84221,011
Total4046,37825,59032,372

Horse Riders

2152744
Total Children under 152914,37015,44920,110
Total Adults1,81520,14060,15582,110
Total All road users2,10624,51075,604102,220

* Includes a small number of persons killed or injured in horse-drawn vehicles.

South Wales Radial Road

4.

asked the Minister of Transport and Civil Aviation if he has considered representations from the Heston and Isleworth Borough Council regarding the proposed South Wales Radial Road to the effect that steps should be taken to protect the interests of owners of property likely to be affected; and what action he proposes to take to meet this request.

Representations were received in my Department and have been referred to my right hon. Friend the Minister of Housing and Local Government for consideration in connection with the Middlesex Development Plan, which is now before him. Before the line of this road can be fixed, I shall have to publish a draft scheme under the Special Roads Act, 1949, and the statutory procedure provides for the lodging of objections.

Is it possible for the Minister to say when such a scheme is likely to be published? Would he bear in mind that the present uncertainty about the future of this road, which may take anything up to 20 years to build, is having an adverse effect on the value of property?

I can appreciate that, but I cannot add anything to what I said in my original answer.

Great West Road, Middlesex (Speed Limit)

7.

asked the Minister of Transport and Civil Aviation if he is yet prepared to impose a speed limit of 40 miles per hour on the Great West Road, Middlesex.

No, Sir. I propose to await the Report of the London and Home Counties Traffic Advisory Committee, which, as I recently announced, is at my request examining speed-limit questions in the London traffic area.

Will my right hon. Friend bear in mind that it is very difficult indeed for vehicles to pull up at traffic lights if they are travelling at between 70 and 80 miles an hour? There are frequently the most dreadful accidents on the Great West Road.

It is a difficult road, and that is just the sort of problem which has caused me to put all these difficult questions to my Home Counties Traffic Advisory Committee so as to get general proposals for dealing with them.

Would my right hon. Friend consider the great advantage of keeping the traffic flowing rather than slowing it down, and of expediting it rather than having it coagulating in clots because of traffic lights every few hundred yards, and then being released in a racing, struggling mass? Could he not arrange for the cutting down of the duration or frequency of the time allowed for crossing?

That is just the sort of point one has to consider on this subject.

Is not the real remedy for these difficulties in traffic flow in and out of London to have a large number of tunnels and overhead bridges for pedestrians, rather than to interfere with the road traffic?

I agree with the right hon. Gentleman that tunnels can be extremely useful. That is why a certain number of them are proposed in my programme.

Roundabouts

12.

asked the Minister of Transport and Civil Aviation if, in view of the improvement of the flow of traffic at Brent Bridge and Neasden Circus on the North Circular Road since roundabouts were replaced by traffic lights, he will reconsider all road improvement schemes involving the construction of roundabouts wherever the traffic is dense.

I agree that there has been an improvement. The roundabouts in question were too small, and it was not possible to enlarge them. But roundabouts of proper size are sometimes extremely effective, and I shall look at each case on the merits.

Will my right hon. Friend bear in mind that it is not only the volume of traffic at the roundabouts that makes them awkward, but the inconvenience to drivers? Is he aware that Hyde Park Corner is about the worst place on earth to drive round because traffic on each side has to be watched? Will he take that into account in future road improvements?

Certainly, Sir, but in the proper places roundabouts are useful and are the right answer.

Kerbs

14.

asked the Minister of Transport and Civil Aviation whether he is aware of the concern felt by motorists regarding the present practice of laying deep kerbstones along the sides of arterial roads especially where such roads are wide enough only for two lanes of traffic; and what action he proposes in this matter.

Yes, Sir. I am proposing to amend the general advice about kerbs as at present set out in Memorandum 575 of October, 1943, and Memorandum 653 of August, 1950.

While thanking the Minister for that answer, may I ask him to bear in mind the dangerous nature of these high kerbstones, particularly to motor cyclists? Would he advise county councils to institute more sloping kerbstones than are being used?

The purpose of the Memoranda to which I referred was to advise county councils. The circular will have the same purpose.

What the motorist wants is a kerb that he can get over. Is that idea embodied in the instruction?

The fact that a motorist wants to get over the kerb has a rather different effect on one's mind according to which side of the kerb one is. The needs of motorists are very relevant in this respect. A high, vertical kerb does add to danger on the roads.

Is it not an additional irritation to observe these kerbs going down, at considerable expense, on roads which we know are to be widened before long? Will my right hon. Friend look into this point?

Sometimes these kerbs are required for engineering reasons, as the road would collapse if we did not have them.

Parking Meters

16.

asked the Minister of Transport and Civil Aviation whether, in considering the introduction of parking meters, he will protect the interests of commercial travellers who might be adversely affected by such a system.

It is precisely in order to protect the legitimate interests of motorists, including commercial travellers. who wish to leave their cars for short periods in congested urban areas that the experimental use of parking meters is being commended to Parliament.

Flooding, Woodmansey

17.

asked the Minister of Transport and Civil Aviation what steps he is proposing to take to abate the flooding of Captain Newlove's farm and the surrounding area in Woodmansey in the East Riding of Yorkshire caused by the new culvert on the Hull—Beverley road which was built by the East Riding County Council in March, 1950.

As my hon. Friend is aware, full responsibility in respect of the flooding of Captain Newlove's farm has not been accepted by my Department. Experts representing both Captain New love and my Department have now agreed on a remedial drainage scheme and details of this are at present being prepared.

While thanking my right hon. Friend for that reply, may I inquire why nearly five years have elapsed before steps have been taken to deal with this matter?

The main reasons are two. In the first place, this began as a matter of litigation, and it was only after the settlement of the intended proceedings that it was possible to investigate the details and the rights of third parties also involved.

Dumfries—Carlisle Road (Accidents)

20.

asked the Minister of Transport and Civil Aviation how many road traffic accidents occurred on the experimental surface on the Dumfries—Carlisle, A75, road opposite Rockhall Mains Farm in 1952, 1953 and 1954; and how many claims against his Department have been made as a result of such accidents.

This length of road has not had an experimental surface. Accidents on it involving personal injury were five in 1952, 6 in 1953 and one in 1954. There was one claim against my Department in 1953.

Is my right hon. Friend aware that there is a notice at this junction of roads saying that it is an experimental surface?

Perhaps my hon. Friend will put down that question, because my information is that, whatever the notice says, it is not.

Footbridges, Westmorland And Cumberland

21.

asked the Minister of Transport and Civil Aviation which authority was responsible for the design and what was the respective cost of two footbridges recently constructed alongside the bridges carrying A.6 main road over the main railway line at Clifton in West-morland and over the River Eamont at the boundary of Westmorland and Cumberland.

These bridges were erected on my behalf by the Westmorland County Council. I accept full responsibility for them. Their cost was £1,406 and £3,400 respectively.

Will my right hon. Friend look into the design of these two bridges, because one is much more costly than the other and also much uglier, and since the uglier one is constructed alongside one of the most beautiful bridges in the North of England, it seems rather a pity that his Department, through its agents, should be responsible for work of this sort?

The "ugly one" was put alongside the beautiful one—by which, I presume, my hon. Friend means the second one mentioned in the Question—because the problem there is that the original one is a very fine ancient monument, protected by the Ministry of Works. It was thought desirable, whilst providing safe accommodation for pedestrians, not to alter its construction, and, therefore, we had to build another one.

"No Parking" Signs, Park Lane

22.

asked the Minister of Transport and Civil Aviation whether his attention has been drawn to the "No Parking" signs placed on the pavements outside the Dorchester Hotel in Park Lane; and whether he will cause these signs to be removed on the grounds that they have no validity and obstruct the pavements.

I have asked the Westminster City Council, as highway authority, to look into this.

Is my right hon. Friend aware that there are appearing over London many of these pavement signs which are quite illegal and obstruct the traffic, and also that signs are appearing on the sides of houses and business premises, saying, "No Parking," for which there is no legal validity whatever?

In the first place, action on that is for the highway authority, which in the case to which my hon. Friend refers is the Westminster City Council. I will gladly draw the attention of whatever highway authority is concerned to any case which my hon. Friend has in mind.

Expanded Programme, Cumberland

23.

asked the Minister of Transport and Civil Aviation the major improvements sanctioned for the county of Cumberland arising from the expanded road programme.

30 and 31.

asked the Minister of Transport and Civil Aviation (1) if he will authorise, during the financial year 1955–56, a road development scheme for west Cumberland; (2) what individual road schemes for west Cumberland he will authorise during 1956–57, 1957–58, and 1958–59,

I have nothing to add at present to my statement of 2nd February, for the reason then given.

Will the Minister really give us something more definite? Cumberland feels that it is being neglected. This is a large Development Area, and there is an enormous atomic energy factory. A major road is urgently needed in the area. Will he do something about it?

I have well in mind the needs of Cumberland and the facts to which the right hon. Gentleman has referred, but he will realise that there is no part of the country which could not make a similar request.

I have stressed that we have an enormous atomic energy factory in the area. Will the Minister bear in mind that he has already cut down the maintenance grant for trunk roads in the county for 1955–56, and as this will cause hardship, will he reconsider his decision?

There is no question of reconsideration. I have recently asked all highway authorities to submit schemes to me, and I have no doubt that Cumberland will take part in replying to that invitation.

May I ask my right hon. Friend to pay attention to the needs of west Cumberland? Not only have we there an important and developing industrial area but one that is virtually cut off from the rest of England. Its access either north or south is a very narrow and circuitous route between sea and hills. The need for this consideration is very pressing.

32.

asked the Minister of Transport and Civil Aviation if he will consult with the Cumberland County Council and the Cumberland Development Council with a view to the authorisation of a comprehensive road programme for west Cumberland.

I have already invited the county council to submit its proposals for classified roads and shall consult it, in the normal way, about trunk road schemes. The Cumberland Development Council is, of course, always free to express its views to me or the county council.

For the reasons I have given, will the Minister consult them in a special way? There is strong feeling about this matter. We are geographically isolated, and if the area is to develop it must have good road communications.

I am well aware of the problems of this area, and I shall be perfectly happy to listen to any recommendations or views that either of the bodies mentioned care to express.

Pedestrian Refuges And Crossings

25.

asked the Minister of Transport and Civil Aviation if he is aware that in built-up areas of our cities and towns there are few places for pedestrians to cross the roads; that pedestrian crossings have been reduced by about 66 per cent. since1951, so that now there are only two or three pedestrian crossings to every mile of main road; and if he will consider having placed in the centre of wide roads, posts or islands to assist pedestrians crossing the roads where no zebra or police-controlled crossings are in existence, and take steps to make it obligatory for local authorities to carry out these improvements in the interest of road safety.

The number of uncontrolled pedestrian crossings was reduced by about 60 per cent. in 1951, when striping was introduced. This step has greatly increased the respect for these crossings shown both by motorists and by pedestrians. The cost of constructing approved pedestrian refuges on classified roads is accepted for grant. The need for each refuge has to be judged on its merits, and I do not think a general power compelling local highway authorities to provide them would be desirable.

Is the right hon. Gentleman aware that in the City of Liverpool there were 571 pedestrian crossings in 1951, and that at the present time there are only 153 in 35 miles of double carriageway and very many miles of main roads? My reasons for putting the Question is the fact that there are only two or three crossings for every mile of main road. Where are pedestrians to cross the road in safety, if they are to avoid accidents?

I know that the hon. Gentleman does not agree with the reduction in the number of these crossings which was effected in 1951, but I think that he must give due weight to the fact that it is possible to cross much more safely at the existing ones than it was before these reductions took place.

Is the right hon. Gentleman aware that many old people have to cross roads 60 or 70 feet wide, which they are afraid to cross because there is no special place for them, and that they may have to walk a quarter of a mile to get to a safe crossing?

This is a difficult question, but we have to weigh against the desirability of having frequent crossings the even greater desirability of securing respect for those that there are. It is a matter of balancing one consideration with the other. I think that our policy is right, but I know that the hon. Gentleman does not.

Can the right hon. Gentleman do anything to encourage, where the road is wide enough, the placing of refuges to assist pedestrians to cross?

As I said in the last part of my main answer, this is a matter in the first place for the local highway authorities, and I have never found them unwilling to put forward reasonable proposals.

33.

asked the Minister of Transport and Civil Aviation how many persons were killed or seriously injured on zebra crossings during 1953 and 1954, respectively.

Eighty-nine persons were killed and 686 seriously injured on zebra crossings during 1953. The corresponding figures for 1954 were 80 persons killed and 785 seriously injured.

Do not these figures represent a very substantial increase in the number of people killed and seriously injured on zebra crossings in 1954 as compared with 1953? How does the Minister reconcile that fact with his statement a month or two ago that increased respect is being shown for pedestrian crossings and that the accident rate is being reduced? Does not this show that the zebra crossings are an absolute failure?

I do not think the hon. and gallant Gentleman can base that conclusion on this evidence because, in fact, though the number seriously injured increased in 1954 as against 1953, the number killed shows a reduction.

Will the right hon. Gentleman consider publicising the suggestion to the general public that they should not step off the footpath after a car has passed the 15 ft. studs? I think that would tend to reduce these accidents.

In view of the unsatisfactory nature of the reply, I wish to give notice that I shall raise the matter on the Adjournment.

Schemes, Nottingham And Derby

28.

asked the Minister of Transport and Civil Aviation what schemes for road improvements he intends to sanction, or has already recently sanctioned, for the counties of Nottingham and Derby.

With the hon. Member's permission I will circulate in the Official Report a list of schemes in these counties which have been sanctioned or committed since 1st April, 1954. As regards the future I cannot at present add to my statement of 2nd February.

Is the Minister aware that a considerable number of existing roads are in a very bad state of repair and require a good deal of alteration? I am thinking particularly of the A.6 road, which is his responsibility, where an old Bailey bridge takes a single line of traffic over the river.

I shall, of course, look at each of these schemes as it is put forward, but, for the reasons which I gave in my statement on 2nd February, I cannot go further in announcing authorisations at this stage.

Following is the list:

Road improvement schemes sanctioned or committed in the counties of Nottingham and Derby since 1st April, 1954.

Estimated cost.

1. TRUNK ROADS£

Nottinghamshire

West Drayton diversion (part of East Retford byepass)212,144
Reconstruction of Millington Hill Bridge*15,597
Improvement of Pinfold Lane, Stapleford*7,134
One scheme estimated to cost less than £5,0004,156

Derbyshire

Reconstruction of Goose Bridge, Fernilee 14,195
Reconstruction of Etwall Station Bridge 21,768
Three schemes estimated to cost less than £5,000†4.536
2. CLASSIFIED ROADS

Nottinghamshire

Oxton Byepass completion, A.6097 30,000
Widening of Stockwell Gate and Sutton Road, Mansfield, A.61521,000
Improvement of High Road, Chilwell, B.646412,100
Widening of Shireoaks Road, Worksop10,707
Construction of roundabout, Abbey Street/Castle Boulevard, Nottingham, A.45317,424
Eight schemes estimated to cost less than £5,000 each22,346

Derbyshire

Widening of Castleton-Sheffield Road, Chapel-en-le-Frith, A.62513,500
Widening of Belper Bridge, A.5179,088
Improvement of Cross Hill Railway Bridge, Codnor, A.600721,721
Seventeen schemes estimated to cost less than £5,000 each19,805

3. UNCLASSIFIED ROADS

Nottinghamshire

Construction of new bridge over River Trent, Nottingham432,381
Reconstruction of Breck Hill Road, Arnold13,346
Two schemes estimated to cost less than £5,000 each6,580

Derbyshire

Reconstruction of Ascot Drive, Derby8,934
Construction of new road to new bus station, Swadlincote7,561
Six schemes estimated to cost less than £5,000 each14,410

* Committed for land acquisition and preparation of plans only.

† One scheme committed for land acquisition and preparation of plans only.

Linthouse Tunnels

27.

asked the Minister of Transport and Civil Aviation the respective estimates if the Linthouse Tunnel is made complete as one operation and alternatively in two or more stages.

56.

asked the Minister of Transport and Civil Aviation if he will give an estimate of the relative cost of building the two tunnels at Linthouse together, and of building them as separate projects, starting the second immediately on completion of the first.

The estimated cost of the entire twin-tunnel scheme is about £5 million, and it is not expected that, with suitable co-ordination, authorisation of the tunnels in succession will increase the cost.

Can the Minister say whether the scheme includes the gas, electricity and water services which are required to pass under the Clyde? Is it not desirable that there should not be three or four public utilities making tunnels under the Clyde, but that the work on gas, electricity, and water services, as well as on the road, should be embodied in one great operation?

My answer related—as I understood, perhaps wrongly, the right hon. Gentleman's question to relate—to the roads crossing by way of a tunnel. If the right hon. Gentleman had in mind tunnels for other utilities I should be grateful if he would put down another Question, although I doubt whether it would be addressed to me.

The proposition is that one tunnel should be used for all those purposes and that there should not be a number of tunnels. Is the Minister coordinating with his fellow-Ministers to see that there is not a duplication or multiplication of work? The greatest economy is achieved by doing all these things in one operation.

I would rather not answer that question without notice, though I am bound to say that I have a great deal of sympathy with the right hon. Gentleman's point of view.

Is the Minister aware that his figures will have value only if the second tunnel is started immediately the first is completed?

My figures are based on proper co-ordination, which is the expression I used. If the hon. Gentleman thinks that that is proper co-ordination, as he has suggested, I have no doubt that we should not quarrel very much.

By "proper co-ordination" does the Minister mean that the second tunnel will start immediately the first is finished? Otherwise his figures are valueless.

The figures are a result of calculations of what can be done. I certainly do not propose to add to my answer.

Tolls

29.

asked the Minister of Transport and Civil Aviation whether he will give an assurance that the toll schemes which he is considering will be limited to certain costly bridges and tunnels, and will not be applied to stretches of highways or to motorways.

No, Sir. I have nothing to add on this subject to what I said in the course of my statement on 2nd February.

Is not the Minister aware that in any case there is a considerable amount of feeling against the introduction of tolls, but, if he does introduce them, will he keep them within very small limits?

I do not think that there is any need to add to what I said. The hon. Member will recall that I related tolls specifically to certain very large and costly schemes of national importance.

Since more roads and bridges will benefit the whole of the community, would it not be a mistake to make motorists, by means of these tolls, pay more than their fair share?

That is a debatable question, but I do not think that it arises on this one.

May I ask the Minister not to hold up any of these projects because of the argument about tolls? Once the bridges are there we can deal with the question of tolls at any time.

Is my right hon. Friend not aware of the great strength of feeling there is in the country against the whole idea of going back to tolls—[HON. MEMBERS: "No tolls."]—and that our hope is that we shall get rid of some of the existing tolls as soon as possible?

Of course my hon. Friend recognises that this is not an innovation. Tolls have operated in the Mersey Tunnel for a good many years.

From the questions that have been asked, does the Minister realise there is a considerable difference of opinion in this House as to the advisability of introducing tolls? Will it be necessary to introduce legislation in regard to them? If not, will he at least give an assurance that before any tolls are introduced the House will have an opportunity to express its views?

In this respect I think the House reflects opinion outside. There is a good deal of difference of view. So far as particular schemes are concerned, legislation has previously been required to enable tolls to be levied in respect of them, but I would rather not answer a general question on legislation without notice.

39.

asked the Minister of Transport and Civil Aviation how many tolls there are on British roads at the present time.

Since the aim of the new road programme is to speed up traffic, would it not be a retrograde step to have any more tolls on these new roads?

That raises the rather wider question whether it is wiser to concentrate all our money on road construction rather than for the time being on dealing with tolls.

How many of the 103 tolls are owned by private enterprise, and how many of them have more than repaid the cost of the original construction time and time again?

I have no details of those figures. One or two are owned by the British Transport Commission and one or two by local authorities, but if the hon. Gentleman likes to put down a Question, and give me time for necessary research, I will endeavour to give him an answer.

Is my right hon. Friend aware that there are many people who would prefer a toll road to no road at all?

New Roads And Bridges

35.

asked the Minister of Transport and Civil Aviation what public bodies decide or advise on the priority of the construction of new roads and bridges, as now authorised by Her Majesty's Government.

Responsibility for the decision as to the authorisation of trunk road schemes or acceptance for grant of classified road schemes must necessarily rest with me. I give due weight to the views expressed by all interests concerned, particularly those of the highway authorities in respect of classified roads. There is no public body specifically charged with the duty of advising me on these matters, but in fact I get plenty of advice.

When considering all the advice which is given to him, will the right hon. Gentleman bear in mind the advice given by the hon. Members for Lancashire, who impressed upon him the urgency of Barton Bridge?

The particulars published in my statement of 2nd February give to the hon. Gentleman a pretty satisfactory answer to that point.

As the Minister takes responsibility for decision on behalf of the Government, can he tell us why this Government has changed the decision of the two previous Governments to put the Tyne Bridge and the Severn Bridge on the top priorities in any road reconstruction scheme?

If the hon. Gentleman likes to put that Question down, I shall, in view of the fact that I have answered a Question about it last week, be happy to answer it again.

The Minister has never answered the question as to what considerations have led the Government to put the Severn Bridge, which was given No. I priority, in such a place that it does not appear in the programme at all.

If the hon. Gentleman will read the reply which I gave last week to his right hon. Friend the Member for Battersea, North (Mr. Jay), he will see that I gave an answer, whether he likes it or not.

Improvement, Dumbarton

36.

asked the Minister of Transport and Civil Aviation if the plan in connection with the road improvement on A82 at Dumbarton has now been approved; if all the necessary land has yet been acquired; and on what date in 1955–56 he expects work will commence.

The plans for the section of this improvement between Dumbuck and south-east of Barloan Crescent have been agreed, and most of the land has been acquired. I hope that work will begin this summer.

May I have an assurance that the Minister will do all in his power to expedite the work?

37.

asked the Minister of Transport and Civil Aviation why the improvement on A82 does not include the fly-over junction at Barloan, Dumbarton, for which the Dumbarton Town Council have repeatedly asked in the interests of road safety.

The improvement on A.82 at Dumbarton to be authorised in 1955–6 does not include the fly-over junction at Barloan, because preparation of plans and acquisition of land on the length from south-east of Barloan Crescent to east of Bellsmyre, which includes the fly-over junction have still to be undertaken and will take some time to complete.

Could the Minister inform the House whether there is any moral to be drawn from the fact that the road improvement in this case stops at the local cemetery gates, and would he consider the plea of the local council with a view to carrying this improvement past that point?

As I have explained to the hon. Gentleman, the land for the fly-over to which he refers has to be acquired and, as he probably knows, there is a procedure laid down for that which I cannot accelerate beyond a certain point.

Would not the right hon. Gentleman find it possible to accelerate the procedure if he made the owner of the land pay a tax according to its value?

Relief Roads, Newbury

38.

asked the Minister of Transport and Civil Aviation whether he has now reached a decision on the proposals made to him for relief roads to remedy traffic congestion in Newbury.

Yes, Sir. I hope shortly to publish draft Orders under the Trunk Roads Act, 1946, as a preliminary to the construction of two relief roads.

High-Level Bridge, Barton

40.

asked the Minister of Transport and Civil Aviation if, in view of his decision to include a high-level bridge over the Manchester Ship Canal at Barton in his programme of major road works for the years 1956–9, he will now authorise the Lancashire County Council to increase the rate of work on the south approach and to begin work on the north approach.

I will consider any proposal which the Lancashire County Council may care to put to me. My hon. Friend is, no doubt, aware that the line of approach on the north side was the subject matter of objection at a recent public inquiry.

Is my right hon. Friend aware that tipping has already started on the south approach and that it could be considerably increased if the necessary authority was given to the Lancashire County Council? Will the Minister take every step possible to expedite the commencement of work on the north side, because this bridge is necessary to industry and to the workers in Trafford Park?

I agree that this bridge is necessary, and that is why it is in the programme. I believe that tipping on the south side is proceeding fairly satisfactorily and economically.

Fly-Over Crossings

41.

asked the Minister of Transport and Civil Aviation whether the expanded road programme makes provision for fly-over or fly-under crossings at Hammersmith Broadway and at the Elephant and Castle.

In the Cromwell Road Extension scheme there will not be a fly-over at Hammersmith Broadway initially, but provision will be made for constructing one later if necessary. At the Elephant and Castle a fly-over is not considered suitable.

Does my right hon. Friend not think that at a time when we are proposing to make spectacular changes in road development in this country, these important changes should be introduced in the radial roads out of London? Why should we be more backward than the French, who provide these facilities at nearly every radial exit from Paris?

My noble Friend will, I think, appreciate that this stretch of this road is one for which the London County Council is the improvement authority. The London County Council has indicated to me that it does not feel that a fly-over, which would cost £1 million, of which it would have to find 25 per cent., is desirable at this stage, but it has undertaken to protect the line of a future one so that one can be installed later, if necessary.

Pelham Bridge, Lincoln

42.

asked the Minister of Transport and Civil Aviation when he expects the Pelham Bridge, Lincoln, to be completed.

The constructional work should take about two years, but as I indicated in my answer to the hon. Gentleman's Question, on 1st February, the scheme has not yet been submitted for my consideration.

Is it not a fact that the Minister has known about this scheme for many months? It should have been submitted by yesterday, and I am very surprised that the Minister should say what he has said. Could he not say definitely that if the scheme is submitted to him within the next few days it will be possible to make a start this year?

I appreciate the importance of this work there, but I could not give a blank answer with regard to a scheme which I have not yet seen.

Development Plans, London

44.

asked the Minister of Transport and Civil Aviation how many comprehensive plans for the long-term development of London's road system have been produced during the last 20 years; when were they published; and what major schemes of road construction or reconstruction, recommended in these plans, have been undertaken or are scheduled for the next four years.

As the answer is rather long I will, with the hon. Member's permission, circulate it in the Official Report.

Is it not a fact that most of the major improvements scheduled for London stem from a plan which was published about 20 years ago? Does the Minister not think that there is a real need for a new inquiry into the requirements of London road development? Is he not in danger of embarking on a piecemeal programme which will not get to the root of this problem?

I think the hon. Gentleman probably has in mind the Bressey Report, but there have been a number of plans submitted since, and while there is a good deal in what the hon. Gentleman says, now that the time for carrying out road works has started I am anxious not to hold them up while further planning takes place.

Is the right hon. Gentleman aware that there is no need whatever to hold up existing work as planned, but there will be a desperate need for a new look at the situation in the very near future?

I do not exclude that possibility, but at the moment we are getting on with the programme which has been announced.

Following is the answer:

The only plan published in the last 20 years dealing solely with the long-term development of London's road system is the Highway Development Survey, prepared by Sir Charles Bressey in 1937.
Road proposals are also included in six other plans for the general development of the London area; these are the County of London Plan (by J. H. Forshaw and Sir Patrick Abercrombie), 1943, Greater London (by Sir Patrick Abercrombie), 1944, the Report of the London County Council Improvements and Town Planning Committee on Proposals for Post-War Reconstruction in the City, 1944, the City of Westminster Plan (by Mr. J. Rawlins on), Reconstruction in the City of London (by Dr. C. H. Holden and Prof. W. G. Holford). and the London County Council Development Plan, 1951.
The major schemes referred to in the reports which have already been carried out are the reconstruction of Waterloo and Wands worth Bridge, the improvement of Parliament Square and improvements to the southern approaches of Westminster Bridge and Waterloo Bridge. The Cromwell Road Extension, in the current year's programme, and all the schemes for the London area mentioned in my statement of 2nd February, are included in one or more of these Reports.

Albert Bridge (Reconstruction)

48.

asked the Minister of Transport and Civil Aviation the estimated cost of reconstructing the Albert Bridge; and if he will give his reasons for awarding this scheme so high a priority.

About £1,100,000. The present bridge is weak and narrow and its reconstruction is necessary to improve the flow of cross-river traffic.

Is the right hon. Gentleman aware that this bridge does not form part of any main traffic route at all? Does he not agree that there are at least a dozen similar schemes in London which merit a higher priority?

According to the statistics which I have, a very great increase has been shown in traffic over this bridge. Traffic has increased by about 100 per cent. since petrol was derationed. The bridge is weak and unable to take adequate loads. From that point of view the scheme is rather urgent.

Is the Minister aware that this bridge is almost the only piece of Victorian architecture in London, perhaps almost anywhere in the world, which is at all beautiful, and that it would be rather a pity to remove it?

Highway Authorities (Projects)

49.

asked the Minister of Transport and Civil Aviation, in asking all highway authorities for their proposals in respect of classified roads, what time limit he has given for the receipt of such schemes; and what specific projects he has ruled out in making this request.

What does the right hon. Gentleman propose to do about accepting the schemes? Does he intend to wait until he has them all in before making a decision? If so, why does he not set a time limit within which schemes must be submitted?

Clearly, other things being equal, if schemes are submitted earlier they have a chance of earlier approval, but many of these schemes involve a good deal of work for the local highway authorities, and it would be unfair to those with difficult schemes to handle to give them a time limit to which they might not be able to keep.

Tyne Tunnel

52.

asked the Minister of Transport and Civil Aviation when it is now anticipated that work on the Tyne Tunnel will be recommenced.

I have nothing to add to what I said on this subject in reply to the right hon. Member for Battersea, North (Mr. Jay) on 9th February.

Does the right hon. Gentleman realise that that utterly unsatisfactory reply brings no comfort to us in the North-East? Will he assure the House that the Tyne Tunnel retains its priority as next on the list after the White inch Tunnel?

My answer means no more than that it is not in the group of large schemes during the first four years of the plan which I announced on 2nd February.

Highland Programme

54.

asked the Minister of Transport and Civil Aviation to what total figure the two special allocations for Highlands roads of £750,000 in 1950 and £1 million in 1953 have now been reduced.

The £1 million programme will be authorised in full and work costing £601,000 had been authorised under the 1950 programme before it was superseded by the other.

Is the Minister aware that up to July of last year the 1950 programme was still in force, and that since then it appears to have been quietly dropped? Can he say what is now the total amount available by way of special grant for Highland projects, over and above the Crofter Counties Scheme?

My recollection is that I answered that question for the hon. Gentleman last week. In any event, if he wants a further answer, I should be grateful if he would try to put the question down again.

Can the Minister say whether the Crofter Counties Scheme will now be started?

Civil Aviation

Aircraft (Backward-Facing Seats)

8.

asked the Minister of Transport and Civil Aviation whether he is now in a position to make a statement on his policy regarding safety regulations for civil aircraft; and what decision he has reached concerning the system of backward-facing seats.

Is the Minister aware that it is more than two months since he asked me to put down a Question a little later on, and that it is now considerably more than a little later on? Is he also aware that in Australia all civil aircraft are to be fitted with these seats as from January, 1957? Will he tell the House what he means by "a little later on"?

The reply to the second part of the hon. Lady's supplementary question is that I hope to have the opportunity of a talk tomorrow with the Australian Minister for Air, who is in this country. I shall know a little more about the factors which affected Australia's decision when I have done so. It is very difficult to answer the last part of the supplementary question. Perhaps the hon. Lady will put the question down.

Has not this question been put to my right hon. Friend and to his predecessors for a great number of years? If this country has a Civil Air Attaché in Australia, why has not my right hon. Friend's Department been kept informed on these matters?

The Department is kept informed on this matter, but when I have the good fortune of being able to discuss the matter with the Australian Minister concerned, I think I should be, wise to take it.

Operating Licences (Issue)

11.

asked the Minister of Transport and Civil Aviation what steps he is taking to avoid delay in issuing operating licences recommended by the Air Transport Advisory Council.

No avoidable delay has arisen in dealing with recommendations from the Air Transport Advisory Council. But many of the applications are for international services and these involve reference to foreign Governments, whose consent must be obtained.

Is my right hon. Friend aware that there are indications that after these recommendations arrive at his Ministry they remain in the "pending" tray for a number of months, causing great inconvenience and possibly financial loss? Will he do what he can to speed them up?

If my hon. and gallant Friend has any case in mind I will, of course, look into it. I would remind him that since 1st September, 1954, these applications have been coming in at three times the previous rate. Subject to the point I have made about consulting foreign Governments, I do not think there is any delay.

Boldon Airport

51.

asked the Minister of Transport and Civil Aviation what discussions he had with the interests concerned before deciding to withdraw safeguarding restrictions from Boldon Airport site.

I am not sure what the hon. Member means by the interests concerned. I have in fact, had discussions both with the Newcastle-upon-Tyne Corporation and with hon. Members.

Why has not the right hon. Gentleman discussed this with the North-East Airport Committee? Surely he knows that this committee met in December and decided to make inquiries. Without discussing the merits, is it not discourteous of him not to discuss this matter with the committee, which represents all the interests affected by his decision?

I should much regret it if it were thought that I had behaved discourteously to anybody. I was not aware that this body wished to make representations in this matter, but of course if it wishes to do so, I am always at its disposal.

Is my right hon. Friend aware that most people in the North-East are extremely pleased that finally a decision has been taken, and that most of them welcome the decision which has been taken?

In view of the fact that the right hon. Gentleman has now decided to abandon any possibility of an international airport at Boldon, will he urge upon his right hon. Friend at the Treasury the need for giving Customs facilities at Greatham, and thus provide other facilities in the North-East?

That is a matter for my right hon. Friend the Chancellor of the Exchequer but I will not conceal from the hon. Gentleman that I am aware of the facts of this matter.

In view of the fact that the hon. Member for Sunderland, South (Mr. P. Williams) is misinformed, will the Minister get in touch with the North-East Airport Committee to see that discussions take place with the interests mainly affected?

I could not accept that my hon. Friend the Member for Sunderland, South (Mr. P. Williams) was misinformed on any subject, but, as I have said, if this body wishes to talk to me I am always available.

Will the right hon. Gentleman realise that Newcastle does not of necessity speak for the whole of the Tyneside?

Comet Aircraft Accident (Report Of Inquiry)

53.

asked the Minister of Transport and Civil Aviation what action he proposes to take arising from the Report of the Commission of Inquiry into the Comet disasters.

:As the answer to this Question is rather long, I will, with permission, answer it in a statement at the end of Questions.

Railways

Modernisation (Branch Lines And Rural Areas)

18.

asked the Minister of Transport and Civil Aviation whether he will ensure that in any scheme of modernisation and re-equipment of British Railways the requirements of branch lines and rural areas are not overlooked.

Does my right hon. Friend realise that in the proposals so far put forward by the British Transport Commission there is little reference to this subject, and will he draw the attention of the British Transport Commission to this grave error?

If my hon. Friend will look at paragraph 47 of the modernisation Report, he will see that the use of diesel units on these lines is strongly and, I think, wisely recommended.

Is it not a fact that before any branch line is closed the matter is referred to a Transport Users Consultative Committee?

Electrification, Euston—Crewe

46.

asked the Minister of Transport and Civil Aviation how many years the electrification of the London-Midland main line from Euston to Crewe will take to complete; at what stage the Euston-Rugby section will be begun; how long this will take to complete; and when structural work is expected to start.

As I explained during the debate on 8th February, it is not possible at this stage to give dates with respect to particular items of the modernisation plan. The British Transport Commission will, however, as I then indicated, publish annual forecasts.

Will the right hon. Gentleman use all his persuasion to get the maximum priority for this electrification scheme? Will he recall his experience when he visited the Chalk Farm motive power depot, and appreciate that one of the very good reasons for getting on with this work is the health and convenience of my constituents?

I indicated in the debate on the modernisation plan that one of the advantages of electrification is getting rid of smoke from steam locomotives, but the plan must be considered as a whole, and I could not say that this scheme necessarily came ahead of all the others.

Shipping

Cranes, Immingham

26.

asked the Minister of Transport and Civil Aviation when he expects the four portal cranes ordered for the port of Immingham to be completed and in working order.

I understand from the British Transport Commission that the first crane should be ready for operation by April and that they expect all four to be in operation before the end of July.

Is my right hon. Friend aware that on 16th October, 1952, his predecessor promised me that the first crane would be delivered in the next month—November, 1952—and the last one in May, 1953? Does not my right hon. Friend think that two years' delay is too much?

My right hon. Friend neither gave, nor would he be able to give, any such promise. This is a matter between the owners of the port—the British Transport Commission—and the manufacturers of the cranes. What my right hon. Friend did was to pass on the information which the suppliers had given to him, and which turned out to be unduly optimistic.

On a point of order. My right hon. Friend has said, Mr. Speaker, that what I said in my supplementary question is not true, and I have quoted from HANSARD.

There was no accusation of untruthfulness against the hon. Member that I heard. The Minister disagreed with the hon. Member's rendering of the facts, but that is quite usual in this House.

South Goodwin Light Vessel (Report Of Inquiry)

47.

asked the Minister of Transport and Civil Aviation whether he will make available to the relatives or to representatives of the relatives of those who lost their lives in the South Goodwin Light Vessel on 27th November, 1954, a copy of the report of the inquiry by the Elder Brethren of Trinity House into the loss of the vessel, a copy of which he has placed in the Library of the House.

Yes, Sir, I have been in touch with the Elder Brethren, and they inform me that they will gladly make copies of the Report available, on request, to the relatives of those who lost their lives.

Questions To Ministers

45.

asked the Prime Minister if he will arrange that the Minister of Transport and Civil Aviation should answer Questions in his capacity as Minister of Transport on a separate occasion from that on which he answers Questions in his capacity as Minister of Civil Aviation.

I have been asked to reply.

No, Sir. It is admitted that the number of Questions to the Minister of Transport and Civil Aviation has been high for some time but the proposal now made would in any case not result in an even division of the burden because Questions on civil aviation matters are comparatively few.

Does not the Lord Privy Seal agree that Questions on civil aviation have tended to diminish because to some extent the subject has been overwhelmed by the major interest? Does he not agree that the grouping of the Questions concerning the two Departments would lead to a much greater concentration of interest within the House instead of having Questions scattered higgledy-piggledy, as has been the case over a number of weeks?

I do not think one could draw that deduction. For example, there are 56 Questions to the Minister today but only five are about civil aviation. What the hon. Gentleman asks for would, therefore, not be achieved in this way.

Does not the Lord President of the Council remember that he promised to look into this matter again? Will he bear in mind that there is a good deal in what my hon. Friend has said—that because there are 56 Questions on the Order Paper to the Minister of Transport, the possibility of getting a coherent reply about civil aviation is so limited that it is scarcely worth while putting the Question on the Order Paper?

I could not accept any suggestion of the sort about the replies given by my right hon. Friend.

Comet Aircraft Accidents (Report Of Inquiry)

I will, Mr. Speaker, with your permission and that of the House, answer Question No. 53 with the following statement.

I am sure that the House will share the Government's gratitude to the noble and learned Lord, Lord Cohen, and to his assessors, Sir William Farren, Professor Duncan and Air Commodore Wheeler, for their conduct of this memorable Inquiry, and for the clear and masterly Report which they have produced.

The court found that the cause of the accident to the Comet wrecked off Elba was the structural failure of the pressure cabin brought about by fatigue. Owing to the impossibility of salvaging any of the wreckage from the Naples crash, the court could give no positive answer to the cause of this accident but concluded that it was at least possible that the cause was the same as that of the Elba accident.

The court have made a number of recommendations designed to prevent future similar accidents and the Government has no hesitation in accepting all these recommendations. They include suggestions directed to guarding against fatigue, particularly in pressure cabins, the fullest use by aircraft manufacturers and others of the facilities available in Government research establishments, the pursuit of scientific and technical research into the problems of pressure cabin design; and the possibility of more intensive flight testing of future aircraft with novel design features.

I am glad to be able to assure the House that action to implement these recommendations is being taken by my right hon. and learned Friend the Minister of Supply and myself in collaboration with the Air Registration Board. Indeed, as my right hon. and learned Friend the Member for Chertsey (Sir L. Heald), speaking on behalf of the Crown, informed the court, action on some of these matters was decided on some little time ago.

The knowledge gained in this investigation will enable the Comet to be strengthened and made safe for future operation. As the House will be aware, B.O.A.C. have on order 12 Comet Us and five Comet IIIs. They are now discussing with de Havilland's the future composition of their new Comet fleet and, indeed, contemplate increasing their order to 20 aircraft.

In addition, a number of Comet IIs in a modified version are being ordered for delivery to the R.A.F. for Transport Command as early as the work involved allows. Special pressure tank tests will be arranged and the aircraft will be required to obtain a full passenger certificate of airworthiness before they can go into service.

Comet I aircraft cannot be made suitable for further airline use without extensive and costly modifications. Certain of the existing aircraft, which can be usefully employed to further research and development work for which the Ministry of Supply is responsible will be required by that Ministry. The aircraft will, in particular, be used to assist the programme of further testing and research which was recommended by Lord Cohen in his Report.

The work of the court could not have been so thoroughly done without the help given by the Italian and South African Governments. The admirable work both of the Royal Navy in salvaging so large a proportion of the wreckage of the Elba Comet, and of the Royal Aircraft Establishment, Farnborough, made possible the discovery of the cause of these accidents.

While thanking my right hon. Friend for that very comprehensive reply, may I ask whether it may now be assumed that, as a result of these misfortunes and investigations, the Comet will now prove to be the most extensively-tested aircraft that ever left the ground?

I think it is true that the results of these very detailed and careful investigations will have the effect suggested by my hon. Friend.

Does the Minister appreciate what a tremendous effect the very thorough investigation that has been made of the Comet will have on the public travelling by air, and how reassured they will be by the ruthless way in which anything considered to be unfit will never be used again? I am sure it is the view of the whole House that the new Comet will move from success to success.

I am much obliged to the right hon. Member, and I agree with what he has said.

Will my right hon. Friend make quite clear that the tests carried out at the Royal Aircraft Establishment, Farnborough are a lesson to the world in thoroughness? Secondly, may I ask the approximate cost of the Comet I taken over for test purposes and the approximate date when the Comet II is likely to be in service?

The answer to the first point is "Yes, Sir." I would ask that notice of the second part of the supplementary question should be given to my right hon. Friend the Minister of Supply.

How much will be added to the cost of Comet II and Comet III in order to bring them up to the standard required, following the recommendations?

I think that is a question which better be put down on the Order Paper.

Can my right hon. Friend say whether the inquiries made in the course of the investigation have satisfied him as to the security conditions existing along the route travelled by the Comet?

If I recollect rightly, that matter was dealt with by the court of inquiry. I have no reason to doubt the wisdom of the court of inquiry.

Would the right hon. Gentleman say upon whom will fall the cost for the Comet Is which are not now to be put into airline service? Secondly, can any statement be made by any of his colleagues about the transference of public funds to the de Havilland company for the purchase of the Comet IIs, which are already in the course of production, and which, I understand, will also not go into civil airline service?

I think that questions on that subject are rather for the Minister of Supply.

Is it not the case that the original cost of the Comet I was borne by B.O.A.C. which, of course, entered into those commitments with the agreement of the Minister, and that to some extent he is responsible for these contracts? To that extent, therefore, can he not answer the question?

No, Sir. In the first place, this is purely a commercial matter between the builders and the operators. If the builders were the concern of any of my right hon. Friends, I think it would be a matter for the Minister of Supply.

Whilst, when the Comet II and III again come into service, they will probably be far and away the safest aircraft flying, that is obviously going to take some time. Will the right hon. Gentleman tell us what is likely to happen in the meantime to that small but expert team of B.O.A.C. engaged on Comet development? What are they to do in the meantime?

I think that in the first place that is a matter for the B.O.A.C. commercial management, but if I can get the information for the hon. Member from them I shall be glad to do so.

Can the right hon. Gentleman tell us what is happening to that part of the fleet of Comet Is which will no longer be used commercially? Is that going to the R.A.F.? If so, are those machines going to be in a state of airworthiness?

I did deal with that matter in the penultimate paragraph of my statement. When the hon. Member has read it, he may put down a further Question, if he cares to do so, and I will do my best to answer it. I think the statement deals fully with the matter.

Are we to understand that it will now be a requirement for future certificates of airworthiness that pressurised aircraft must be tested in a tank similar to that at Farnborough? If that is the case, what will be the policy of the right hon. Gentleman towards the purchase of aircraft of a similar type from other countries which have not had the same type of testing to which British aircraft will, in future, be subjected?

I should not like to answer the first part of the supplementary question completely dogmatically without notice, but generally speaking the answer is "Yes." The general question of aircraft supplied from foreign countries is, of course, a different one. If the hon. Member wants an answer to that I suggest that he put a Question down.

National Coal Board (Reorganisation)

With your permission, Mr. Speaker, and that of the House, I will make a statement about the National Coal Board.

I have recently received from the National Coal Board a Report on its organisation, presented to it by a Committee which, at the Board's invitation, has been engaged for more than a year in a searching investigation of the whole structure and functioning of the Board. Dr. Fleck, the chairman of I.C.I., was the chairman of this Committee and its membership included Sir William Lawther, the late President of the National Union of Mineworkers, and men with wide experience of industrial organisation outside as well as inside the coal industry. The House will remember that the appointment of the Committee was warmly welcomed within the industry and in all quarters of the House.

One recommendation in the Committee's Report is of a different character from the others. It is addressed to the Minister of Fuel and Power, and action upon it must precede consideration of the Report by the Board. The crucial words in the recommendation are as follow:
"That the National Coal Board should consist of 12 members, namely. a chairman and a deputy-chairman, six other members giving the whole of their time to the Board's work and four part-time members: …that the Board should now be reorganised in the way we have proposed and that the reorganisation should be carried out as a matter of urgency."
The Government have decided to accept this recommendation and to act upon it at once.

The chairman, the two deputy-chairmen and all other members of the existing Board expressed their willingness, in order to facilitate this reorganisation, to resign their offices if I asked them to do so. In some cases I have made this request and I am able to tell the House that a new Board will take office next Monday, 21st February.

Sir Hubert Houldsworth will remain chairman. There will be one deputy-chairman, Mr. James Bowman, and six full-time members, each of whom will share fully in responsibility for the Board's general policy while having a special concern with one aspect of the Board's activities. Five of these eight full-time offices I have filled with new appointments, chosen from those whose abilities have been proved by work within the industry. In addition to the chairman and deputy-chairman the following will be full-time members of the new Board: Sir Andrew Bryan, Mr. J. Latham, Dr. W. Reid, Mr. W. H. Sales, Mr. R. E. Thomas and Mr. A. H. A. Wynn. Four part-time members will bring the membership of the Board to 12.

I would take this opportunity of paying tribute to the notable services rendered to the coal industry by Sir Eric Coates and Sir Walter Drummond, who are retiring from their positions as Deputy-Chairmen, and by Sir Charles Ellis, who has been a member of the Board since its inception, and to their public spirit in facilitating, as they have done, the immediate reorganisation of the Board. I am sure that the House would also wish me to express appreciation of the great service which Dr. Fleck and his colleagues have rendered in devoting so much time and effort to their important work.

The Board has decided that the Report of the Committee should be published today, and copies are now available in the Vote Office. It will be among the first tasks of the new Board to consider the Report as a whole and its many important recommendations. I hope I may speak for the whole House in wishing the Board good fortune as it takes up its responsibility for the leadership of this great industry.

The House will be obliged to the right hon. Gentleman for his statement. This is, of course, a matter which, by its nature, is not a party political question. I join with the Minister in thanking the Committee of investigation, and I should like to join with him also in expressing my appreciation of the public spirit of the members of the existing Board for placing their offices at his disposal.

I am glad that the Minister has retained the principle of part-time membership on the part of a limited number of members of the Board. The only point about which I am a little doubtful—I admit that it is subject to argument and controversy, and I would not like to bind my hon. Friends on this point—is whether the full-time members of the Board should be depart-mentalised, and whether that is good for the corporate supervision of the Board's activities, making the executive officers responsible to the collective judgment of the Board. It is, no doubt, a point that we shall be able to consider.

We are obliged to the Minister for what he has said. It will not be the full statement of what is to be found in the White Paper, and therefore, after reading the White Paper, it may be that the Opposition will ask the Government to provide facilities for a debate.

I know the right hon. Gentleman's interest in the important point which he has mentioned about the duties of the members of the Board. On that, I would simply say that the Report emphasises that the primary duty of the members of the Board is to act as a team and to take their full share in the collective responsibility for the Board's work. The departmental heads are not themselves to be members of the Board.

Is my right hon. Friend aware that there will be great satisfaction at the prompt action he has taken in implementing the proposal which was made by the Committee to appoint a new Board, and that the new Board will have the fullest good will of all sides?

I am grateful to my right hon. Friend for what he has said. There is a certain broad connection between the statement I made yesterday on the future policy regarding atomic energy and the Committee's Report, which I think the House will be very interested to read. The Report shows that there is real need for a technical and managerial renaissance in the coal industry to fit it to take its part in the atomic age.

Does not the Minister consider that a matter of considerable principle is at stake when one of the national boards sets up a committee to reorganise itself and the report is so quickly adopted without Parliament having a proper understanding of the position?

The particular recommendation with which my statement was concerned was transmitted to me by the Board. After considering it, the Govern- ment felt that the best thing they could do would be to give a constructive lead in the way I have announced this afternoon.

What is the present position occupied by Mr. Bowman, whose name my right hon. Friend has mentioned?

Mr. Bowman, the new Deputy-Chairman, is at present the Chairman of the Northern—Northumberland and Cumberland—Division of the Board. Because of the duty of the Minister of Fuel and Power to make these appointments to the Board it is also his duty to keep in touch with the achievements of the leading men in the coalfields, and I have for some time been impressed with the administrative ability of Mr. Bowman.

After their return from their tour of the coalfields, Dr. Fleck and some of his colleagues indicated to me that they considered Mr. Bowman to be the outstanding administrator in the coalfields. That is the reason I have appointed him. The fact that he started his life at the coalface is in a way irrelevant to my decision, but it is very satisfactory that these qualities have been found in such a man and it is a great pleasure to me to make this appointment.

Is the right hon. Gentleman aware that we view the position with perhaps some apprehension and do not at the moment welcome the statement which he has made? We know that some of the appointments may be highly satisfactory and gratifying, but the Minister will agree that we must await eventualities before judging the result of these appointments. We must wish the members well in their administration, and anything that can be done, on both sides of the House and in the industry, to make the Board a success, ought to be done.

In view of the importance of his statement, may I ask my right hon. Friend whether he is in favour of an early debate on the Report and its implications?

Will the Minister convey to the newly-appointed Board the feeling of those of us from the Scottish coalfield that we want as our new chairman someone of the calibre of the man whom we have lost to the National Coal Board?

Can the Minister tell the House whether any suggestion is made in the White Paper that a little greater initiative and wider scope might be left to the regional boards in Scotland, England and Wales rather than that important decisions on development schemes should wait upon the decision of a rather remote Board sitting in London?

Is it not a matter for regret that the Government did not adopt the same judicial approach to the transport industry before setting up the railway boards?

Order. Hon. Members ought to read the Report before we debate this matter.

Bill Presented

Public Works Loans

Bill to grant money for the purpose of certain local loans out of the Local Loans Fund, presented by Mr. H. Brooke; read the First time; to be read a Second time upon Monday next and to be printed. [Bill 44.]

Justices Of The Peace Act, 1361 (Amendment)

3.50 p.m.

I beg to move.

That leave be given to bring in a Bill to amend the Justices of the Peace Act, 1361.
I am asking the House today to allow me to introduce a small Bill which is concerned with technicalities into which I would not normally venture. I hope that it is also a non-controversial Bill. May I say, at the outset, that I have been fortunate in having had the help and support of a number of distinguished lawyers on both sides of the House, and also of quite a number of magistrates who have been specifically concerned in the kind of cases with which the Bill deals.

The one and only Clause of the Bill simply says that nothing in the 1361 Act should prevent a person who is bound over for a breach of the peace from appealing to quarter sessions. No more than that. It has arisen because there have been half a dozen cases in recent years, one of which actually took place in my constituency. In that case my constituent was alleged to have been sending out anonymous letters, and was brought before the bench and bound over. In the eyes of the law, binding a person over is not equivalent to a conviction. Therefore, the law as its stands says, "As there is no conviction there is nothing to appeal against, so you cannot appeal."

Unhappily, in these times, when these things make great headlines in the newspapers, an impression is made on the public mind that a person has been declared guilty, and there have been cases, perhaps, and certainly in the one with which I am more directly concerned, in which persons strenuously deny guilt but feel that a stain has been put on their characters and on their honour which will last the rest of their days. Yet the law denies them any possibility of appealing for a second hearing.

In the particular case I have in mind several of the magistrates themselves told me that they were most unhappy, and it does seem to me that in this democratic age the least one can do is to make a very minor adjustment of the law which, I am advised by magistrates and lawyers, will not have any repercussions anywhere else but which will give a person who finds himself in this most unfortunate position a right of appeal to quarter sessions for a second hearing, to make quite clear his innocence in the case.

It seems to me fundamentally wrong that we should place this terrible slur on a person's character and then deny him any opportunity at all to appeal to a higher court to get another trial. That is all that this Bill seeks to do, and I hope the House will allow me to bring it in, and will possibly give it a quiet and peaceful, indeed a silent, passage to the Statute Book.

Question put and agreed to.

Bill ordered to be brought in by Mr. Leather, Sir L. Heald, Mr. Simon, Mr. W. T. Williams, Mr. Royle, and Mr. Gilbert Longden.

Justices Of The Peace Act, 1361 (Amendment)

Bill to amend the Justices of the Peace Act, 1361, presented accordingly and read the First time; to be read a Second time upon Friday, 11th March, and to be printed. [Bill 45.]

Orders Of The Day

Supply

[1st ALLOTTED DAY]

Considered in Committee.

[Sir CHARLES MACANDREW IN THE CHAIR]

Civil Estimates And Estimates For Revenue Departments, Supplementary Estimate, 1954–55

Class V Vote 5

National Health Service, England And Wales

Motion made, and Question proposed,

That a Supplementary sum, not exceeding £4,848,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1955, for the provision of a comprehensive health service for England and Wales and other services connected therewith, including medical services for pensioners, etc., disabled as a result of war, or of service in the Armed Forces after the 2nd day of September, 1939, the treatment abroad of respiratory tuberculosis, certain training arrangements, the purchase of appliances, equipment, stores, etc., necessary for the services, and certain expenses in connection with civil defence.

3.55 p.m.

The Parliamentary Secretary to the Ministry of Health
(Miss Patricia Hornsby-Smith)

When introducing the National Health Service Estimates last year my right hon. Friend drew attention to the fact that we had endeavoured to make these as exactly accurate as possible in accordance with the recommendations of the Public Accounts Committee, which had suggested that amounts for possible additional contingencies like wage increases, for example, were really speculative and should not be included, but, if the need for such additional sums arose, they should be the subject of a Supplementary Estimate. I think that the Committee generally accepts in principle this more realistic method of estimating.

Notwithstanding, however, this stricter interpretation of the main Estimates, the Estimates last year for the National Health Service have proved to be more accurate than in most previous years of that service. The net additional amount to be provided in the Supplementary Estimate now submitted to Parliament is £4,848,000, slightly over 1 per cent. of the sum provided in the original Estimates. Covering, as the National Health Service does, nearly 3,000 hospitals, 20,000 doctors, 10,000 dentists, 8,000 ophthalmic medical practitioners and opticians, and 15,000 chemists and suppliers of appliances the smallness of this margin, in the circumstances, is, I hope the Committee will agree, a very creditable one, because the demands on the general practitioner services can never be truly predictable, nor, indeed, can wage increases be entirely foreseen or accurately estimated.

It will probably be for the convenience of the Committee if I deal briefly with some of the main items which, I think, will arouse the most interest in the Supplementary Estimate, and my right hon. Friend will deal with any additional points specifically raised by hon. Members in the debate.

While I understand that it is not in order to discuss savings in this debate, perhaps you will allow me to explain, Sir Charles, how the net figure of the Supplementary Estimate was arrived at. The sum now asked for is made up of various increases, totalling £8,562,000; but that sum is offset by savings on other subheads of £3,009,000, and by increased appropriations in aid which are likely to bring in £705,000. That leaves us with a net Supplementary Estimate of £4,848,000.

Let me deal with the most important and, in the main, the largest items in the Supplementary Estimate. The first is hospital maintenance. The main increase for hospital maintenance accounts for the sum of £2,608,000, and that is divided up under three main heads. There are increases in pay over and above the £1 million included in the original Estimates which require us to provide an additional £1,200,000; increases in costs which account for £900,000; and cash required to meet expenditure which it had been originally estimated would be met by running down stocks, and this sum is £500,000. That gives a round figure of £2,600,000 as an additional estimate for hospital maintenance.

4.0 p.m.

Before leaving the question of the hospital services, I should like to pay tribute to the hospital authorities who, generally, have shown every willingness to cooperate and who have efficiently considered costs. That they are using the money made available to them to very good purpose is shown by the continuously increasing services which have been given. Last year, for example, the figures showed an increase of 8,000 in the daily average of occupied beds, an increase of 125,000 in the number of new out-patients and of 277,000 in casualty attendances.

The next major increase for which the Supplementary Estimate provides is for an additional £2,133,000 for the pharmaceutical service. This is due mainly to an increase in the average cost per prescription above that originally estimated and, secondly, to an increase in the number of prescriptions dispensed. This is offset by a saving due to a change in the arrangements for paying the chemists. That has resulted from the completion of the task of overtaking the pricing arrears, which I am sure the Committee will welcome. We have had much discussion and many Questions on this subject in the past and I should like to pay tribute particularly to the staffs of the pricing bureaux for having completed this task earlier in the past year than we had estimated.

When the original Estimates were framed, the average cost per prescription appeared to be showing a tendency to fall. On that basis it was assumed that this trend would continue and would result in an average cost per prescription of 3s. 11¾d. whereas, in fact, the average cost for 1953–54 worked out at 4s. 1d. The trend was reversed shortly after the Estimates were framed and we now expect the average cost to be 4s. 2¾d., an increase of l¾d. compared with last year. In the main, this is due to a wider use of the newer and, in many cases, much more expensive drugs and preparations.

The Committee, however, will be aware of the various measures which have been taken by my right hon. Friend to keep the cost of drugs within reasonable limits. Doctors are continuously being kept cost-conscious in several ways. It is done through the activities of the Cohen Committee, by letters from the Ministry's Chief Medical Officer, through "Prescribers' Notes" issued to general practitioners and, most recently, through the introduction of arrangements whereby a doctor can compare the cost of his own prescribing with that of his colleagues.

The Committee will also be aware of the energy with which my right hon. Friend has initiated discussions between the Department and manufacturers on price investigations, a policy which, I believe, has the support of the whole House. At the same time, we are not unmindful of the valuable research work which is done by many of the larger firms. As a result of these investigations, price reductions have been made in a number of cases. The combined effect of all the measures has been to keep the average cost of a prescription reasonably stable over the past three years, notwithstanding the almost continuous introduction of new drugs which, certainly in the early stages, are very expensive.

Whereas the average cost in 1952–53 and in 1953–54 was 4s.1d. and we anticipate this year's final figure to be about 4s. 2¾d., in contrast the average cost in the early years of the Service jumped from 2s. 9d. in 1948–49 to 3s. 10d. in 1951–52. The increase in the number of prescriptions is now expected to be about 4½million more than was anticipated originally, but it is always impossible to predict exactly the number of prescriptions which are likely to be issued in any year. The bad summer last year produced a higher incidence of prescriptions than is normally the case, and the July figure was the highest ever for that month.

I turn now to the Supplementary Estimate for the general dental services. If any Supplementary Estimate ever finds favour in the House of Commons, I think that the reason for the increase of £1,701,000 on the general dental services should find favour in all parts of the Committee. It is entirely due to the facts that the number of patients treated exceeded the number assumed in the original Estimates and that there was an all-time record for conservative dental treatment. Whilst one may regret the dental decay that created the need, it is heartening to see that the nation is beoming more dental conscious and, in particular, that there has been a very substantial increase in the demand for treatment from children and young people.

Two very important figures are that last year conservative treatment generally rose from the 1953–54 figure of 5,400,000 to 6 million, and of that figure the number of those treated who were under 21 years of age rose from 2,600,000 in 1953–54 to 3 million last year. This was in spite of the fact that the number of school dentists increased from 717 in 1950 to 979 in 1954, which, in turn, means that more children are being treated under the school service than ever before.

The increased demand for adult treatment is particularly encouraging. Though it does not show such a dramatic rise as the 16 per cent. for the priority classes of young children and expectant mothers, nevertheless there has been a 7 per cent. increase in the adult classes who, of course, pay the initial £1 charge.

The estimated increase in expenditure on the supplementary ophthalmic services is £824,000, which is again due to the increased demand. There has been an increase in the number of sight tests, which is to a large extent attributable to the time coming round for a second test for those who came earlier into the Service. Also included in that figure are the increased numbers of people who have been supplied with glasses. That, to an extent, reflects the increasing age of the population and of the number of people who are reaching the age or condition in which they require spectacles.

There is an increase of £600,000 on superannuation. Here, we originally under-estimated the amount which would fall to be paid out for death benefits, short service gratuities, and for the return of contributions to those leaving the Service. These items are never easy to forecast and can vary very much from year to year. This sum is offset by increased receipts of £345,000, so that the estimated net increased cost of the superannuation scheme this year, compared with the earlier Estimate, is £269,000.

There are still, of course, uncertainties. One cannot make a final estimate of the demands upon the different services, particularly for the general practitioner service. Even the weather can make a vast difference. Nevertheless, these Estimates are based upon our most recent experience and on the best projection forward that it is possible to make on the present evidence.

It is a little difficult to follow the Parliamentary Secretary into all the details which she has mentioned, though I must thank her for having given a clear explanation of the various increases for which she and her right hon. Friend are asking. No doubt other hon. Members who may have a little more time than I have had to reflect upon what the hon. Lady has said may raise more detailed points than I shall attempt to do.

The hon. Lady began by reminding us that the total Supplementary Estimate now requested represented only about 1 per cent. of the total cost of the National Health Service. That, of course, is perfectly true, but although that is so there is now a total sum of £4,848,000 more than the Committee approved last May. That undoubtedly calls for a careful examination of the question whether some of the increases which the hon. Lady mentioned need to be as large as they have turned out to be.

It is true, of course, that she partially excused having to bring forward these Estimates on the ground that the Public Accounts Committee suggested that in the past some of the estimating for contingencies was a little too generous. I accept that, but I would remind the Committee that the right hon. Gentleman said, in May, in reply to the question whether the amount made available was enough, and that in his judgment it was. In May, he thought he had got very close indeed to an accurate estimate of what was required, and he thought that what he was providing was what the service needed. After all, there had been under spending in the previous year, and he explained in some detail how he arrived at his proposal to increase that sum by about £11 million.

We need a little more explanation than we have had up to now of how it comes about that underestimating of nearly £5 million should have taken place. I do not wish to talk about some of the Estimates in front of us. I have no complaint—and I doubt whether anyone will have—about increased expenditure on home nursing and domestic help. These things help mothers, old people and all sorts who are in difficulties. The very small increase in the ambulance costs no doubt ties up very closely with the welcomed increase which the Parliamentary Secretary told us about in the number of outpatients and the number of other patients receiving treatment in the hospitals.

I do not want to discuss these matters this afternoon, nor do I want to talk about the increase for superannuation and various miscellaneous expenses like the cost of cleaning or keeping in good order the limb fitting centres. I am glad that the limb fitting centres are evidently well looked after. I used to have a close interest in them when I was Minister of Pensions, and it is good to know that they are receiving careful attention under the new management.

We need to go into some detail about the services of the hospitals and executive councils. The biggest increases asked for are in the hospital boards, but the increases which are asked for in the services provided by the executive councils, though they are not absolutely the largest, are, in proportion, by far the largest and represent the biggest increases in demand and costs. All of these services provided by the executive councils, which include pharmaceutical, dental and ophthalmic services, which are now costing more than last May, are subject to charges on the public imposed by various Acts. As there have not been any unusual epidemics or anything of the kind since last May it looks as if the charges are less of a deterrent in their effect than they were.

It seems to suggest that the fall in the value of money, which is going on steadily under the present Government's administration, has effected, on the one hand, an increase in the cost of drugs and other services, which we will talk about in a moment, and yet has lowered the value of the shilling or other charges which people have had to pay for their prescriptions. To the latter extent and to that only it will be welcomed. If the charges are less a deterrent we on this side of the Committee are pleased.

What the hon. Lady told us about the dental service was good news. She said that there was a heartening increase in demand for treatment, and, in particular, that there was an increased demand for treatment of young persons less than 21 years of age. That was very good news indeed, and we on this side are very glad that we pressed as hard as we did when the Bill imposing these charges was before the House for the exemption of people under 21. We need have no regret about what we did in that instance.

4.15 p.m.

It also seems that more people in need of glasses are getting them. They are finding the charge there less onerous than it was, or that, having put up for a time with some hardship, they have now decided to go ahead and get what they need. I am glad that this is so, and I hope there will not be any temptation on the part of Her Majesty's Government, now that the charges actually mean less, to propose an increase. The right hon. Gentleman himself has already made welcome remarks about getting away from the ceiling, and I trust that there is no temptation to say that now that the charges are less onerous than they were and people are going ahead and increasing their demand for spectacles, dental treatment, and so on, the charges ought to be increased. I know that this is not a subject which we can debate this afternoon, but I just mention it in passing.

A fortunate part about the increases for dental and ophthalmic treatment is that there is no suggestion of any increase in cost. It is only because there is an increase in demand and, therefore, I think the Committee will have no objection whatsoever to voting the increased sums for that purpose. We are glad that that is happening. We see no difficulties arising from it.

When we come to the pharmaceutical service, however, we find there is an increase both in demand and in costs, and this deserves more scrutiny. The expenditure upon drugs has been the most criticised part of the whole Health Service. It is one on which most criticism has been levelled from outside both by lay men and professional people. It has probably caused successive Ministers of Health more troubles and worry than any other part of the Service.

We have been told many times by professional people that some of the expenditure on drugs covers a good deal of supplies of doubtful value. A great deal has been written and said about this in the medical journals and elsewhere. We know that there has been a tendency to prescribe excessive quantities and that the prices charged by the manufacturers for many of these drugs has been excessive. So, when requested to vote more money, we have to ask ourselves how far this kind of thing is still con- tinuing; how far is medicine of doubtful value still being prescribed, because that is a way out of a difficult situation; how far there may be a tendency to prescribe excessive quantities to save oneself trouble or to please some patient; or how far the prices, where the Minister has taken some welcome action, are still too high?

I will not dwell too much upon what the right hon. Gentleman said last year, but he did expect then that the pharmaceutical service cost would remain more or less where it was. Is he surprised by this increase which has, in fact, become necessary? The average cost of prescription had fallen from the peak of 49d. per prescription to 47¾d., but now the figure has risen again to over 51d. per prescription. Why?

If the right hon. Gentleman speaks later, I should like him to go into a little more detail about this. I thought the Parliamentary Secretary slipped very lightly over the subject. After all, as the Parliamentary Secretary reminded us, there are now coming to the Minister many fruits of action taken by my right hon. Friend the Member for Ebbw Vale (Mr. Bevan) in the setting up of the Cohen Committee, and in setting on foot the cost investigations and the issue by myself of prescribers' notes, all of which were referred to this afternoon. It is rather disappointing to find that, while all these things which were set on foot some time ago are now bearing fruit in a reduction in cost, the total cost is, in fact, going up. Why is it still going up?

I will certainly deal with the point later if I catch your eye, Sir Charles. There is an important point that I can mention now. When Estimates are prepared, they are done on the basis of the knowledge available to the Minister at the time. Since we prepared these Estimates it has been decided to make two most expensive drugs, aureomycin and terramycin, freely prescribable. The fact that they are now prescribable on forms E.C.10 will be a major factor in the increased amount for which we are now asking the House.

I have no objection to raise to that. Very often some of the more expensive drugs are very much better value for money than the less expensive ones. Perhaps, if he speaks later, the right hon. Gentleman will give an even closer estimate of the amount involved.

We should like a little more information now about the result of the attack which the right hon. Gentleman launched upon the prices of certain proprietary articles. He told us of 91 articles whose cost was to be investigated, and he said that their sale accounted for 18 per cent. of the total drug bill. He stated that if he could not obtain the reductions which he thought necessary he might have to advise general practitioners not to prescribe the drugs. We are all in favour of that, and the right hon. Gentleman's statement was greeted with loud applause. Perhaps he could bring the story up to date this afternoon and assure the Committee that no part of the increase is due to unnecessary or excessive charges for proprietary drugs which continue to be prescribed.

The right hon. Gentleman has recently received, and, I believe, will shortly publish, a very valuable Report from the Central Health Services Council dealing with the work of a sub-committee, over which the hon. Member for Putney (Sir H. Linstead) presided, on the hospital pharmaceutical service. The Report, as already summarised in the Report of the Central Health Services Council, shows many ways of effecting economies in the hospital section of the provision of pharmaceuticals. I appreciate that this is a separate service under the National Health Service, but it is so closely related to the other work that it seems convenient to mention it at this point.

It would appear from the Report that there is a source of possible economy in the prescribing of drugs in hospitals, which costs a lot of money and in which a lot of drugs are used. We are assured by many people with experience who have written to us that the Report will not be carried out fully and effectively unless the pharmaceutical staffs in hospitals can be strengthened to enable them to do their job properly and to enable us to get away from the present situation in which much of the making up of medicines prescribed by hospitals is done by outside pharmacists. If that is the position, would it not be a great economy, since the cost of outside prescribing is evidently rising, to increase hospital pharmaceutical staffs in order to take pharmacists back from the trade outside and build up on the modern lines recommended in the Report a good hospital pharmaceutical service which will be an example to the whole of the pharmaceutical profession?

It seems that salary adjustment alone will do this. In a way one is suggesting extra expenditure to save money, but would it not be a real economy to get more full-time pharmacists in the hospital service and let them do what their training and professional skill entitles them to do, which is to spend their whole time on pharmacy, instead of their being outside spending part of their time on pharmacy and the rest of their time as shop assistants?

I should also like to know whether the right hon. Gentleman is now satisfied—I gathered from what the Parliamentary Secretary said that he is, but I should like him to confirm it—that the number of cases of over-prescribing by doctors is diminishing. We know that there have been such cases; action has been taken by executive committees in some notorious cases. Is the number of those necessary actions diminishing, and do the reports coming from executive councils show that that sort of thing is declining?

The Parliamentary Secretary said that the Minister was getting good co-operation from the medical profession in this respect. I know that he has had a great deal of co-operation from the profession. The immense amount of voluntary labour that Sir Henry Cohen has put into all this has been mentioned several times, but I should like to say once again how much my hon. Friends and I appreciate it. It is co-operation, indeed; it is devoted and selfless service for the public good.

However, when my right hon. Friend the Member for Greenock (Mr. McNeil) and I had our long discussions with the representatives of the medical profession in 1951 about the remuneration of general practitioners, we were assured again and again—I am not disclosing any secrets—that if the question of the remuneration was put to an independent adjudicator, we could be confident that the medical profession would make a renewed effort to secure the co-operation of all general practitioners in bringing down the cost of the drug bill by reducing over-prescribing or, as far as it could be done, the prescribing of less valuable medicines.

That was a solemn promise on the part of the profession, and I think I have a right to refer to it this afternoon. I am not saying that the profession is not doing what it said. I am only asking whether it is doing so, and whether any part of the increased demand for drugs comes from the persistence of a certain element of insufficient care on part of the general practitioners in their prescribing.

4.30 p.m.

I pass now to the hospital services, where, the Parliamentary Secretary rightly said, the greater part of the Supplementary Estimate arises. The hon. Lady reminded us that the amount normally put into previous Estimates for the contingency of rises in staff pay had been reduced. I accept that, and in view of it I suppose the increase in pay of £1,200,000 above what was then estimated is nothing serious, spread as it must be over many tens of thousands of employees.

But how much of that is accounted for by increases in the number of staff beyond what the right hon. Gentleman expected? Some of it must be accounted for by higher wage awards than he expected, but some may be accounted for by increased numbers drawing those new payments. In May, the right hon. Gentleman referred to the possibility of getting as many as 2,000 more nurses for the Mental Health Service, and if he has them, we shall be delighted.

I thought the hon. Lady passed very lightly over the increase in costs of £900,000. To what has this increase been due? Is not this failure to estimate the increase in costs simply an example of a Minister believing the propaganda of his colleagues? Have not the costs risen more than he expected because of the action of his colleagues in the Government? Is it not the Minister of Food or the President of the Board of Trade or the Chancellor of the Exchequer, each of whom have influence upon the cost of living, who are responsible for this increase?

During our debate last May my right hon. Friend the Member for Greenock asked, "What about butter?," but he did not get an answer. Today, we are bound to ask again: what about it? What about butter and tea and bread and bacon and all the other things whose prices have risen in the meantime?

My hon. Friend says that the patients do not get butter. Is that true? We hear on all sides that hospitals who used to be able to supply butter to their patients are no longer able to do so.

I can tell my right hon. Friend that the Liverpool teaching hospitals have refused point-blank for the last six months to supply any of their patients with butter.

That is an example of what we hear. Is that now general? Has there been any directive about this matter? Does the right hon. Gentleman intend to get up and say that margarine is as good as butter for feeding patients in teaching hospitals or in any other kind of hospitals?

The Minister may quote to me my right hon. Friend the Member for Fulham, West (Dr. Summerskill), but I hope we shall not get into that kind of debate. Exchange of the chit-chat of quotations from light-hearted speeches made outside the House is not the kind of debate that I want to get into. I am serious about this. How much of this increase is due to an unanticipated increase of costs and, therefore, solely due to the failure of the Government to keep down the cost of living?

The hon. Lady said that the reduction in stocks, about which we were told last May, had not taken place to the full extent of what was then anticipated. On the whole, I am glad to hear that because I am not certain about the reduction of stocks as a sound measure of economy. If prices continue to rise, it may not be sensible to reduce the stocks which could be bought in a cheaper period.

That leads me to ask about supplies. How much of this £900,000 is due to the increase in prices of food or to increases in the prices of other kinds of supplies? In particular, what measures are being taken to reduce the price which the hospitals have to pay for their supplies of food and other necessities without reducing the quantity or the quality of what they buy? There are ways of doing that, and on this side of the Committee, whilst we deplore the astonishing and disgraceful rise in prices that has taken place, we have never stood for waste or extravagance. Even though prices are rising, if it is possible to continue to supply reasonable and sensible quantities of supplies and of food by methods of centralised purchase, then we are all for it.

Has the right hon. Gentleman read the account in the February number of a magazine called "The Hospital" of what has been achieved by the Tees-side Hospital Management Committee through the adoption of bulk buying and central storage? The article shows that it was possible for this committee, having an extraordinarily able officer in charge, to effect a 10 per cent. saving on coal and coke over the last three years, a 20 per cent. to 30 per cent. saving on foodstuffs, 16 per cent. on tea, 8 per cent. on meat, 4 per cent. on bread, 28 per cent. on standard pharmaceutical requirements and other similar savings, though, obviously, it is not so easy to state savings on medical and surgical equipment in the form of percentages. That committee adopted the practice of centralised storage of the necessary supplies as far as that is possible, thereby reducing stocks without in any way reducing the quickness of transmission to the separate hospitals, and of buying in bulk and from wholesalers instead of from local retailers.

That is a way of avoiding an extra expenditure of £900,000 without sacrificing the interests of the patients, without giving them margarine instead of butter, or giving them smaller pieces of meat. This Government boast that they got rid of rationing. Have they got rid of rationing inside the hospitals or is a new kind of rationing being imposed upon patients in hospitals, who need good food for their proper care and attention, as the result of this increase in prices and the failure to keep pace with it?

We will vote money gladly enough if it means better food for patients, and we do not intend to vote against this Supplementary Estimate this afternoon. However, we want to be sure that proved methods of economy in providing these necessary steps are really being applied, not only in Tees-side but everywhere else throughout the country.

I have listened with considerable interest to the speech of the right hon. Gentleman the Member for Middlesbrough, East (Mr. Marquand). He made many points which I would like to follow, but, as I was hoping this afternoon to concentrate my remarks mainly on the pharmaceutical service, I will not do that. However, I want to refer to the very moderate terms in which his speech was couched and to contrast it with some other debates on the National Health Service to which I have listened in Committee or in the whole House. I hope that as the Service gets bedded down and established, and finds its roots, it will tend to move away from the political arena. If it does that, I am sure that it will be an extremely healthy thing, because basically the Health Service is something which all of us want to see flourishing and serving the public.

If I had any slight criticism of what the right hon. Member for Middles rough, East had to say, it would be when he rather twitted my hon. Friend the Parliamentary Secretary for having claimed that the Estimates were as substantially accurate as any Estimates could hope to be. We must always remember that here we have an unlimited liability. It is quite impossible for anybody who is looking twelve months ahead to guess what use is to be made of the Service, when the Service is freely at the disposal of the public. It seems to me that there can be no possible complaint on the ground that there was lack of foresight, because of this unlimited liability which can never be hoped to be matched from a fixed sum of money.

Before I deal specifically with the pharmaceutical services, I should like to refer to two remarks made by the Parliamentary Secretary. I join with her in congratulating those responsible for having overtaken arrears in the pricing of prescriptions. It is not merely that there was a very substantial outstanding debt at one time which the Ministry owed to the chemists. What is more important is that, until the arrears in pricing were caught up, it was not possible for the Ministry to keep a check on the not inconsequential number of doctors who, often through carelessness, were over-prescribing. Now that pricing has caught up with the current demand, the Ministry is in a position to make quite certain that, if there is over-prescribing, it can be at once investigated and I join with the Parliamentary Secretary in congratulating the staffs of the pricing bureau in having caught up.

I should imagine that the Committee, on reflection, must be appalled at the vast number of bottles of medicine which are still, in spite of all the checks put on them, being supplied to the British public. When we look at the increased costs in the pharmaceutical service and translate them into terms of 210 million or 220 million prescriptions a year, we really have cause to pause and to hope that we shall slowly educate the public away from the magic that is attached to the bottle of medicine.

Frequently the bottle of medicine is necessary, but frequently it is no more than a palliative given to the patient to satisfy him in a rather vague psychological way. I hope that general practitioners, who are in the most advantageous position to undertake this education, and the Ministry and the schools, will undertake this work. Attempts must perpetually be made to educate the public to realise that the answer to health is very often not in the bottle of medicine.

The right hon. Member for Middles-borough, East referred to the large increase in the cost of the pharmaceutical service and used a phrase about the cost of some medicines with which I want to quarrel. He said that when the prices charged by manufacturers had been investigated, they had often been found to be excessive. It is that word "often" on which he slipped, if he will allow me to say so. Certainly, on investigation, some, but relatively few, prices have been found to be excessive.

It is significant that on the one occasion that medicines have gone to the Monopolies Commission for investigation—and that was the insulin investigation—manufacturers came out with one of the rare medals which the Commission has ever pinned on anyone's breast. The Commission declared itself completely satisfied that the manufacturers in that case had steadily brought down the price of that vital drug.

4.45 p.m.

The points I should like to bring to the notice of the Committee about the increased cost of the pharmaceutical services are these. Basically, the increased cost is due to the fact that medicine is advancing with extreme rapidity and that new and inevitably more expensive drugs are very rapidly replacing the old and traditional and cheaper drugs. All of us who have the future of the Service and the well-being of its patients at heart would not want to see the Minister backward in adopting and encouraging the use of the new drugs as fast as they come out.

These new drugs generally reach the market and the medical profession in the form of proprietary medicines. That is largely due to the fact that a good deal of the research in the medical and pharmacological field is being undertaken in the research laboratories of manufacturing houses. Some is done in teaching hospitals and universities, but at an early stage their researches have to be turned over to manufacturing houses for private development. Consequently, there is a heavy development and research bill attached to most new drugs before they come on to the market and it is not unreasonable, indeed it is essential, that these costs should find their way into the final cost of the medicine.

The percentage of prescriptions for proprietary drugs as distinct from the old simple drugs is steadily increasing. According to my information, 18 per cent. of the prescriptions in 1950 were proprietary; 27 per cent. in 1953;and 29 per cent. in 1954. That does not mean that the manufacturers are getting an increasing grip on prescribing. It means simply that newer and better drugs are coming out, and that is reflected by these figures. It is interesting to note that in France, the United States and Italy the percentages of proprietary medicines is enormously higher, and in France probably about 80 per cent. So we really have no cause to complain that the manufacturers are, in fact, exploiting the situation here.

It is also important to realise that these new drugs are facilitating the speed of cures. There is no doubt at all that the more rapid turnover of hospital beds is due to the increasing use of, for example, antibiotics. All of us who have looked back over our lifetime will recognise that pneumonia has now ceased to be the terrifying illness that it was twenty years ago. So, today, a bed need not be kept for three weeks, or a month, but be released in a week or ten days. Diphtheria has practically disappeared, again owing to the use of more expensive prophylactic methods. The same thing is happening with tuberculosis, although we are moving much more slowly in our fight against that disease.

I do not want to run away from briefly examining the very proper criticism which the right hon. Member for Middles-borough, East made and which, I think, is very much in my right hon. Friend's mind. The question is whether proprietary preparations are more expensive than is necessary to finance the research which the manufacturers undertake and to provide them with a reasonable profit. It is very interesting and encouraging that an investigation team which has been set up by the Ministry of Health and the manufacturers jointly is now settling down to what seems to be a much more rational and hopeful approach to that problem.

I think there was a natural tendency for them to start their work at arms' length, with the officials—sometimes encouraged by our Public Accounts Committee and by the Comptroller and Auditor General's Reports—looking for "niggers in woodpiles," and the industry tending to pull back in consequence. My information is that now, more and more, that team is beginning to discover that there is much to be said on the manufacturers' side as well as on the financial side. I am hoping that as a result of these investigations we shall get an outcome fair to the manufacturers as well as to the Ministry.

I know that the hon. Member is well informed on these matters, and I should like the benefit of his knowledge and experience regarding a question which has caused me concern for some time. I find myself in complete agreement with what he has been saying, and having myself benefited, I am all the more in agreement. I have heard allegations that firms from other countries—and one country in particular—which have subsidiaries in this country, are charging too much for the products being sold here. I should like to have the opinion of the hon. Member on that.

I think it would be extremely dangerous for anyone to throw off a generalisation on a matter of that complication. It may be that certain foreign firms are charging extremely high prices for the proprietary medicines which they offer. If that be so, we have two instruments by which their prices may be investigated. One is the heavy instrument of the Monopolies Commission. The other is this working party between the Ministry and the industry which is now functioning. I am sure that each one of these examples must be investigated as an individual case and that we should not be wise to try to dispose of charges of this kind by generalisations.

The exports of our own home-manufactured proprietary preparations are substantial. They are accepted in foreign countries because of their known quality, and it would be an extremely unwise policy on our part so to pare down the profits from the home market that the effect was not merely to damage the pharmaceutical industry, but also to cut down the amount of research work which those manufacturing firms are doing. It is not a matter of pulling at two ends of a tug-of-war rope. It is much more a question of the Government and industry getting together, with the background of a common interest, in order to make certain that our research is not damaged; our exports are not damaged, and that the Ministry of Health is not required to spend more than is reasonably necessary on purchases from industry.

Would the hon. Member enlighten the Committee a little more on this point about exports? Does he mean that British manufacturers of proprietaries are exporting their products at a lower price for foreign markets than they are charging at home?

No, I would not necessarily say that. But in this field, probably more than in any other, quality and being in the forefront of research are the things that matter. A new proprietary or drug which does not represent any significant advance in the pharmaceutical field will not easily break into the export market, because a great many countries impose barriers to make certain that such things shall not come in. All I am saying is that this is a field where we must be completely in the lead. That can be done only at the expense of large research departments which inevitably have to bear a substantial share of the cost. It is along those lines, rather than on the narrower lines just mentioned by the right hon. Member for Middlesbrough, East, that I was advancing my argument.

I wish to pick up one or two further points made by the right hon. Member. He was kind enough to refer to the report of a working party, of which I was the chairman, dealing with the pharmaceutical service in hospitals, and that is very relevant to this question of the increased cost of the pharmaceutical service generally. I am sure that the right hon. Gentleman has not seen the full report, which has yet to be published, and I think that he was somewhat misinformed from the brief summary which has appeared.

In the report, we did not encourage the dispensing of medicines for out-patients outside hospitals in order to effect an economy. In fact, that would not be brought about, and is not the criterion by which to decide. One has to decide whether a patient should get his medicine in or out of hospital and the criterion by which that is decided is whether it is good for the patient to continue to come to the out-patient department to see the doctor at the hospital, or whether it is better that at as early a stage as possible the patient should be returned to the care of his general practitioner.

On the whole, I favour the second course. I believe it to be the duty of the hospital to diagnose, to prescribe the necessary treatment and then to send the patient back to his general practitioner, his family doctor—and, we hope, his personal friend—with advice from the hospital which the general practitioner will apply in the treatment of the patient. Therefore, whether we dispense medicine in the hospital or the chemist's shop is purely a secondary matter which should be determined in the interests of the patient, and in answer to the question whether the patient should stay as an outpatient of the hospital or be returned to his general practitioner.

I am sure that there are very substantial economies still to be secured in the pharmaceutical costs in hospitals. Such economies will be secured only in as far as the chief pharmaceutist in each hospital is a person of substantial scientific knowledge, who is respected and whose advice is listened to by the consultant and the hospital medical staff. They will not be secured in any other way.

The right hon. Member for Middlesbrough, East was right when he emphasised that one of the tasks confronting my right hon. Friend is to make the hospital pharmaceutical service sufficiently attractive to ensure that the present drift out of the service does not continue. That will be done by giving it a career value. We do not need a large number of well-paid appointments, but we need at the top, at national level, at least in the big teaching hospitals, it may be a couple of dozen really first-class appointments which will encourage the intelligent young graduate to stay in hospital pharmacy and not go into manufacturing or industrial pharmacy.

Those men in key positions could influence the teaching in the teaching hospitals, so that young medical students would be taught sane prescribing, and they could remind consultants of better and more economical ways of treating their patients in hospitals. I hope that my right hon. Friend will give attention to this problem because I am certain that there is money to be saved by increasing the quality of the key men in this service. At present, they are drifting away.

I very much hope that the small sum of money for which my right hon. Friend is asking will be granted by the Committee.

5.0 p.m.

I want to refer to a figure which was mentioned by my right hon. Friend the Member for Middlesbrough, East (Mr. Marquand). He asked about the sum of £900,000, which the Parliamentary Secretary told us was needed mainly for increased wages costs in hospitals. I should like some further details about mental hospital staffs and the present general situation in that respect. My right hon. Friend said that when the Minister introduced the Estimates on 10th May last he mentioned in passing—I appreciate that he did not intend it as a very meaningful figure—a figure of 2,000 more recruits to the mental nursing staffs. I want to know how much of these increased wages costs is in fact the result of getting more people into mental nursing.

The Minister also said that there had been an increase of about 900 in the first nine months of 1953. How has the position developed, especially as between male and female staffs—because I have some very disturbing figures in relation to my own area of Birmingham, and I want to put them to the Minister in the hope that he may say something encouraging and explain what his ideas are for improving the position? The figure of an extra 2,000 a year in recruitment to mental nursing will not get us very far. He knows that I have been pursuing him about the position in the West Midlands, and he told me, in reply to a Parliamentary Question, that we are 1,300 short in the West Midlands alone; so that the 2,000 extra will not do very much by the time it is spread over the country.

I should like to mention one hospital which I know something about, because I make it my duty to keep in close touch with it. In the Hollymoor and Rubery Hospital, the situation is quite appalling. An hon. Friend of mine has just remarked that it is the same everywhere. That may be so, but we have to keep saying that it is appalling and keep pressing the Minister to put out further ideas, particularly for recruitment, in order to alleviate the position. I have here the report of the Board of Control which visited the hospital a few days ago. The figures and comments contained therein are most alarming. It refers to gross overcrowding, inadequate staff, the fact that the hospital is having to cut down parts of the service, and so on.

In one part of the hospital there are about 400 women, who need 90 nurses. That is about 4½patients to a nurse. The hospital has in fact 40 nurses and some part-time workers who are equivalent to about 20 more full time. These part-time people do not always turn up, and in parts of a big industrial city it is very difficult to keep them for very long because of the alternative attractions in well-paid employment. In this case, the hospital has a maximum of 60 nurses where 90 are needed. In another part there are 335 men, needing about 75 nurses, but all the hospital has is 50. A further point to remember is that recruitment on the male side is getting worse and worse. Far from achieving any increase, the figures sup- plied to me show a continued depletion of the male nursing staff. Does this apply nationally? I should like the Minister to tell us what is the general position.

The situation is made much worse by gross overcrowding. Wards intended for 35 women now contain 66. The beds are placed in the normal sitting and eating parts of wards, and the Commissioners found that the day before they visited the hospital one male nurse was available for a tuberculosis unit of about 20 men. If this situation continues the unit may have to close down.

What is the Minister doing about recruitment? He has told me that he is carrying forward further publicity, but I have not seen a great deal of it, and I should like to know what it consists of. He mentioned the cadet service. Is that getting anywhere? Does it hold out any hope of increasing the staffs in mental hospitals?

The hospital which I have mentioned has, as the Minister knows, one of the biggest problems to face in connection with the increased ratio of the aged and chronic sick who are entering hospital. I believe that its figures are much worse than those for the rest of the country—that is, in the case of admissions of people of over 65 years of age; and this aggravates the nursing staff problem, because these people need so much more attention than those who may be treated for mental illness at an earlier age.

Compared with 20 per year in the years 1939 to 1947, the figure of admissions of the over-65s to this hospital has risen in recent years to 170 per year. That is a rise from 7 per cent. to 24 per cent. of all the hospital admissions. The national figure is below 20 per cent., so the situation at this hospital is much worse, and the staff problem is going from crisis to crisis, partly as a result of the increased attention which is needed by these old people.

I now turn to the question of capital expenditure. The Estimates show a £60,000 Supplementary. Estimate for capital expenditure in Wales. That contrasts very forcibly with the reduced expenditure of approximately £500,000 in England. What is the meaning of this? What is happening, especially in regard to mental health? Why is Wales doing so well as compared with England? Not so long ago the Minister told us that only about two-thirds of the much-publicised "mental million" pounds is likely to be spent in the current year. In my area it is months before we can hope to receive approval for the expansion of buildings. The Minister has now come forward with ideas for new hospitals, but we have been pressing for permission to expand existing hospitals, where the central services are already available.

Why is it that Wales is forging ahead and asking for a Supplementary Estimate while we cannot get permission from him except under considerable pressure? He has now given us permission to put up another 80 beds at the hospital which I have mentioned. We need and can take about 360. The central services are already available and we have plenty of land to build upon. We are entitled to some explanation why it is that Wales is going ahead and England is not even managing to spend the whole of its Estimates on capital expenditure.

In reply to a Parliamentary Question on 15th November, the Minister told me:
"… I have made very special and careful provision for the needs of the mental health services in the last year or two."—[OFFICIAL REPORT, 15th November, 1954; Vol. 532, c. 28.]
I think that is probably true, and I do not grudge the right hon. Gentleman a word of praise. All I would say is that, in my part of Birmingham—and not only there, but in other parts as well—we do not see much result from this increased provision in regard to buildings, getting on with the job of providing better facilities and increasing the number of staff. I know that it is not only the Minister's official responsibility, and that he cannot conjure people out of thin air, especially from jobs which are more highly paid; but we in Birmingham have not felt the increased attention which he claims.

In this hospital, it is really a case of a devoted staff, and of a very enthusiastic management committee, for whom no praise is too high, because it is really getting on with the job. But the talk is always of crises over staff and buildings, and I therefore ask the Minister to give us some hope of a better outlook and some ideas for alleviating the very bad conditions I have been describing.

I hope that the Committee will forgive me if I leave the large city area of Birmingham and go into the wider spaces of East Anglia, because this is one of the opportunities for hon. Members to make points of great interest to their own constituencies. I therefore hope that other hon. Members will not think that too insular an outlook.

Of all the health services operating in a constituency such as mine, I think that home nursing, district nursing, health visiting and that type of work is probably as important as anything. What I find a little surprising in this Supplementary Estimate is that the items for health visitors, midwifery and the care of mothers and young children all show a considerable reduction below the estimate originally made for the year. That is true even of the prevention of illness, which comes under the heading of "Grants to Local Health Authorities."

Yet, when we look at the grants made to local health authorities, as set out on the first page of the Estimates, we find that the amount required for home nursing has increased by £154,000 and for domestic help by £234,000. I find something a little inconsistent in these figures, because I have thought that, to some extent, home nursing would have involved a certain amount of post-natal or even pre-natal care. Yet we see that the amount for midwifery is down by £87,000. I shall be grateful if the Minister will tell us how the increased costs of home nursing have been produced.

According to the explanation given, it is
"because of the revision by local health authorities of their estimates of expenditure as a result of expansion of services and increased costs."
I should like to know the measure of the expansion of the services and of the increased costs, because I know that in my own constituency we have had some difficulty in replacing district nurses.

One of the troubles there is the somewhat unsatisfactory situation in regard to the salaries of district nurses, and the disparity between those salaries and those of other nurses. I believe that, at the present moment, some negotiations are proceeding on this subject, and I will not therefore pursue the matter in detail. It seems to me that we need to be assured, when voting another £154,000 for the purpose of home nursing, that we are, in fact, getting full value, that the money voted is being wisely spent, and that we are really increasing the service.

I am quite certain that, in rural areas in particular, these services can prevent a very great deal of the overburdening which is taking place in the hospitals, and I should have thought that home nursing was the greatest single factor in the health services in diverting people away from the hospitals. When one sees the increased cost of the regional hospital boards and of the teaching hospitals, amounting to over £2 million, one is obviously only too anxious to try to find some way of improving the services provided through the National Health Service and the local authorities which would tend to restrict the pressure on hospital beds. Therefore, I hope that the Minister will give us fairly full information on this subject.

I wish to refer to one matter of considerable concern in the area of the Eastern Regional Hospital Board, and that is the question of a teaching hospital. As far as I am aware, there is no teaching hospital in the whole of that area, and we are naturally very interested in ensuring that the hospitals' in our area are provided with skilled staffs who realise the somewhat special needs of the region. I know that one must not debate this matter in detail, but I must say that when the Minister announced his plans for the future, the greatest disapointment was caused in East Anglia by the fact that, apart from Harlow, no other new hospital was to be built in the area.

The hon. Gentleman asks me whether there is not one at Cambridge, but the hospital at Cambridge cannot be regarded as a teaching hospital. I think that a certain amount of teaching does go on there, but it is not organised on the basis of a teaching hospital, for which there is a very great need. I hope that my right hon. Friend will, perhaps, be able to give more encouragement to that in the future. I am grateful to the hon. Gentleman for his interruption, because it has helped me to emphasise a point which I wanted to make.

5.15 p.m.

I apologise to the hon. Member for Newcastle-under-Lyme (Mr. Swingler) who, I think, wishes to raise the question of a report which appeared the other day of an experiment with antibiotics on infants. It seems to me to be utterly outrageous—and I use this phrase deliberately—that experiments should be carried out with drugs, no matter how safe they are known to be, without the parents being consulted. I should have thought that it was the obvious duty of hon. Members of this House to try to provide all patients in the National Health Service with the finest service they can have, including the latest drugs and so forth. It seems to me that, where there is a question of choice between two forms of treatment, or of choosing between two different types of drugs, both of which are known to be excellent in their own way, the parent should certainly be considered.

I wish to make this protest, because I think there is a tendency today, about which we have to be very careful, for parents' choice to be overlooked, and towards the attitude that the management committee or the man in County Hall knows best, and for these people to take these decisions without allowing another point of view to be considered. I am quite certain that the treatment that is given in our hospitals is always given in good faith and with the intention of providing the most rapid cure, but I am not at all satisfied that it should always be the only consideration to be taken into account. It seems to me that the principle of liberty of choice is a very important one to safeguard, and I am not at all satisfied that it is always regarded with the care that it should be.

I see a reduction in the amount spent by local authorities upon prevention, and am glad to note that it is not more below its original estimate than I expected. Nevertheless, it is £42,000 below that estimate. I should have thought that one of the aims of the service, if it is not to be simply a hospital service, was the prevention of disease. I find it surprising, knowing the pressure that there is on all our hospitals, that a local authority should not find it possible to spend all that it spent originally on prevention of illness.

On a point of order. I am most anxious to answer all the points in this debate, but I imagine that practically every point that is being raised by my hon. and gallant Friend the Member for the Isle of Ely (Major Legge-Bourke) is related to the item concerned with savings. If that is so, I shall not be able to reply to those points. May I ask whether my hon. and gallant Friend is in order?

Before you give your Ruling, Mr. Williams, may I point out that we are considering the increased cost of the hospital service, and that my argument is that before we vote increases for the hospital service we ought to make sure that every possible avenue is explored to prevent that increase from taking place.

We are not dealing with savings in this debate, and it would be just as well to confine ourselves to the relevant aspects of the matter. The hon. and gallant Member was rather drifting.

This point is of importance. If the hon. and gallant Member was putting the point forward that local authority health services are now spending more money than they did initially, it is clear that if that money had not been spent there would be less need for a Supplementary Estimate. This is a point which might be in order.

That is an ingenious argument, but we had better leave the situation as it is.

I am grateful, Mr. Williams, for your Ruling, and I will bow to it without any question whatever. I am sorry if I have strayed from the strict path of order, but I have now reached the conclusion of my speech.

I welcome this Vote, in so far as it represents an extension of the National Health Service. If it is a result of rising prices, it simply reveals the Government's failure to keep down the cost of living. I do not rise for the purpose of entering into any general controversy about the voting of this money, but the hon. and gallant Member for the Isle of Ely (Major Legge-Bourke) has given me a lead. He must have been already aware that I had notified the Minister of Health that I wished to raise a special point which I believe to be of importance to all of us.

The Vote is partly concerned with the extra money needed for hospital services. Part of the work of that service is properly devoted to medical research and experiment. On the subject of clinical experiments in hospitals, I have recently had some communication with the Minister. I am entirely in favour of voting money for medical research in the hospital service. British medical scientists have made an outstanding contribution to discovery in this century, and we would all wish to give them the best possible facilities for enlarging the scope of medical knowledge.

There must be a combination of work in the laboratory and experimentation in the hospital. Experiments on human beings are necessary and desirable to increase medical knowledge. While the community should give to medical scientists and doctors the best possible facilities and conditions for medical research, medical scientists and doctors should be extremely careful not to use their privileged position to treat human beings merely as laboratory specimens. I agree with what the Minister of Health recently said, that difficult problems of ethics are raised by clinical experiments on patients in hospitals. With all diffidence, and speaking merely as a layman, I think two principles are clear. Medical experiments on patients should not be conducted unless there is a chance of patients benefiting.

Clinical experiments in hospitals should not be conducted unless the consent of the patients has been freely given in the knowledge of the nature of the experiments. The doctor should explain to a patient that experimental treatment is necessary, the nature of the experiment, the risks involved, and the benefits that might be obtained or the injury that might result, in order that the patient might understand as much as possible so as to give or withhold consent. I should have thought that the giving of consent was an important matter in experiments conducted by doctors in hospitals.

This principle is not being universally observed. I recently drew the Minister's attention to a case where penicillin had been administered to newly-born babies for the purely scientific purpose of observing their reaction to penicillin, and to establish the properties of that preparation.

5.30 p.m.

It was quite clear in this case that the penicillin was not required by the baby. There was no question of its having any beneficial effect on the babies. It was also established by the Minister on inquiry that the consent of the parents was not sought. The mothers or fathers of the children were not informed that the experiment was being conducted in the hospital concerned, and they were not given an opportunity either to give or to withhold their consent. In my opinion, even if consent had been given in these cases, the experiment was ethically dubious.

I wonder how far the consent of a parent to permitting experiments on children should be taken. We would not agree that the parents' consent to allowing an assault to take place on a child could be valid. The parents' consent could not morally justify anything like that being done to a baby. It is obviously impossible to consult babies about the conduct of experiments conducted upon them, but, in the opinion of those who conducted this experiment, and in the opinion of the Minister of Health, there was no possibility of harm being done.

That, I think, is considered to be a vital point. All that I would say on that is that in the same issue of the "British Medical Journal" in which this experiment and its results were reported, there appeared a report of a speech by a distinguished doctor to a meeting of the Royal Society of Medicine, in which he gave a warning about the uses and abuses of antibiotics. One of the things which he was reported to have said in his speech was that a doctor should think twice before prescribing the first-ever dose of penicillin to any patient.

It would seem, therefore, that when a very distinguished member of the medical profession has warned doctors and the Royal Society of Medicine about prescribing the first-ever dose of penicillin, unless it is absolutely necessary, there is some risk involved in allowing members of the profession to experiment for purely scientific purposes in the administering of penicillin to new-born babies without informing or obtaining the consent of the parents.

This is not an isolated case. I do not pretend in any way to be an expert on this matter, but, since my attention was drawn to this case, which I passed on to the Minister, I have searched through the medical Press of the last two or three years, and I can tell the Minister that if his advisers search through it for those years they will find at least half a dozen cases reported of clinical experiments on children in hospitals, not designed to benefit the children in any way, experiments which may, like the one I have mentioned, have been conducted without the parents' consent, but which are reported to have been carried out merely to test the reaction of children to the administration of certain drugs.

That is treating children as guinea pigs. Let us be perfectly plain about it. It is treating children in these cases as laboratory specimens. The Minister says that judgment on this sort of question could be left to the clinician in charge of these cases, but I would point out to him that some clinicians allow their enthusiasm for science to override all moral considerations.

I should have thought that it was the responsibility of the Minister of Health, in conjunction with the Ethics Committee of the British Medical Association and the Medical Research Council, to lay down some guiding principles for all such cases. It is because I feel that this kind of thing is liable to continue, and that there will be general agreement on the two principles which I have previously stated—that consent should be previously given by people before they are experimented upon, and that the nature of the experiment should be designed to benefit patients—that I would urge the Minister to consult with his advisers, and with the B.M.A. and the Medical Research Council, to see if some kind of directive or code could be sent to hospitals in order to prevent and prohibit experiments, especially on children, which are for purely scientific purposes and which are not designed in any way for the promotion of health.

I understand that my hon. Friend is dealing with children in hospital, but is he aware that these experiments are being carried out on children who are not in hospital and that an experiment of that nature has been going on at the Bridge of Weir Orphans Home?

I am aware of that, but you, Sir Rhys, would rule me out of order if I attempted to discuss something which would clearly be outside the Supplementary Estimate with which we are dealing.

I am simply dealing with the aspect of clinical experiments in hospitals. I do not want to exaggerate it at all, or to suggest that it is a widespread practice, or that these things have arisen from anything except enthusiasm for science. But there are other things besides enthusiasm for science which should govern the conduct of clinical experiments in hospitals. That is why I am urging the Minister, or whoever is responsible in this matter, to consult the scientists and doctors about the ethical aspects, so that some ethical guidance may be given which will act as a necessary and desirable curb on the enthusiasm for enlarging scientific knowledge.

I find myself largely in agreement with the general purport of the remarks of the hon. Member for Newcastle-under-Lyme (Mr. Swingler). What worries me is that all consideration of the parents appears to have been overlooked. I wish to echo what was said by my hon. and gallant Friend the Member for the Isle of Ely (Major Legge-Bourke) on that subject.

It seems to me intolerable that children should be used for any experiment, however innocuous it may be, of things to do with new drugs, such as penicillin, which are bound to have a slight element of danger. It seems to me intolerable that children should be used for that experiment without even the parents being asked if they are willing to allow it. We should look at this matter from a personal point of view, because children are very precious. We have been considering newly-born children. There are always dangers connected with a new-born child. Is it right that a hospital should take a risk, however slight, without informing the parents that this risk is to be taken?

I do not want to overstate the case, and I think that the hon. Member for Newcastle-under-Lyme was careful to steer clear of any such error. I am, however, prompted to go ahead by a statement which I read in the Press that my right hon. Friend the Minister of Health, when questioned on this case, was reported to have said that, in his opinion, it would have been better if consent had been sought.

When I saw in "The Times" today that the hon. Member for Newcastle-under-Lyme was to raise this point, and that the information was available in detail in the "British Medical Journal," I hastened to provide myself with a copy. Very shortly, and in order to put the case in its perspective, I should like to read out the facts. The article was entitled "Penicillin by Mouth in Infancy"—that is certainly less alarming than by injection. It was written by the Tutor of the Department of Child Health, University of Bristol. This is the description:
"…the present trial was begun in order to compare the efficiency of oral benzathine penicillin and oral crystaline sodium penicillin when given to infants and to determine (1) What practical minimum dose of penicillin is required to give adequate blood levels and how long an adequate blood level is maintained after one dose, and (2) What is the optimum interval between doses and what should be the dosage."
That is a perfectly fair experiment, and I have no criticism of its being carried out, but I do think that the parents of the child should first have been asked—and I am not sure that all of us in this Committee today would have been agreeable to our children being experimented on. The article continues:
"This study was carried out on babies born at the Bristol Maternity Hospital. In this hospital there are two nurseries, each administered by a sister and nursing staff. A total of 20 babies under 12 days of age were selected at random …"
that is, selected at random without their parents' consent.

I have no doubt that the experiment was quite harmless. The infants merely took teaspoonfuls of these two preparations; some took one and some took the other. I am happy to say that, according to the information given, none of the children is any the worse, though one can never tell whether an experiment will prejudice the effect of a particular drug on children when they grow a little older. The conclusions were not spectacular. Apparently one sort of preparation tastes rather better than the other, while the other works rather more quickly. A whole series of doses of one cost 12s. 7d. and of the other 7s. 8d. None of us, I think, is in opposition to these facts being elicited.

It comes down purely to the guinea pig aspect mentioned by the hon. Member for Newcastle-under-Lyme, but that must certainly not be over-emphasised because, as I know my right hon. Friend would agree, nothing is more important than public confidence. This is like justice; it should not only be done but it should appear to be done; but here I am not satisfied.

There is a note at the foot of the article in which such a lot of people are thanked. The consultant obstetricians and the consultant paediatrician were thanked. Thirdly, the professor was thanked for guidance; fourthly, the doctor was thanked for laboratory facilities; fifthly, the lecturer in statistics was thanked; sixthly, the resident medical officers; seventhly, the nursing staff; eighthly, the technician was thanked for help with the blood samples, and ninthly the firm which produced the penicillin was thanked. But were the parents or the children thanked? No. The children were too young, but the parents were not only not thanked but were not even consulted. I hope that my right hon. Friend will deal with that when he replies.

This has been an interesting and rather exceptionally wide debate so far, and I hope that none of the previous speakers will object if I direct my attention more specifically to the particular expenditure provided by the Supplementary Estimate. At a later date I hope to have an opportunity to deal with many matters concerning hospitals. I want to see more money rather than less being spent, and I should find it very difficult to carry out an examination of a Supplementary Estimate which, in the case of hospitals, proposes a relatively modest increase in expenditure which we all welcome. We only wish that it was a great deal larger than it is.

I want to make a further inquiry into the pharmaceutical bill, about which my right hon. Friend the Member for Middlesbrough, East (Mr. Marquand) asked some pertinent questions and on which, earlier in the debate, the hon. Member for Putney (Sir H. Linstead) made some very useful and helpful comments. The actual increase in the expenditure on the pharmaceutical service is not really exceptionally large—an increase of about 5 per cent. On the other hand, it is perhaps a little disappointing—I am sure to the Minister as well as to everyoneelse—in view of the great interest there has been in this subject, and the Minister's own active campaign to reduce costs.

5.45 p.m.

Quite naturally, many hon. Members who have already spoken on the subject, and many of those who have written articles in the Press, have concentrated on the proprietary medicines, which, as the hon. Member for Putney rightly said, are taking an ever larger share of our drug bill. With the hon. Member for Putney, I am not surprised at that. Like him, I rather feel that, on the whole, it should be expected in view of the development of new types of modern drugs such as we are getting today. I quite agree that in relation to the experience of other countries, such as America, we are still using proportionately a good deal less of the proprietary brands. I should, however, like to know a good deal more about the action the Minister is taking.

We understand from the Parliamentary Secretary that negotiations with the industry are going on at present. The hon. Member for Putney referred to the progress so far made in those negotiations. We all wish them well and hope that a satisfactory conclusion can be reached. It is a matter of concern that, in spite of what is said by the Comptroller and Auditor General in his last Report on the Civil Appropriation Accounts about voluntary reductions in prices by some firms producing proprietary brands—there are quite considerable savings there—nevertheless, in one or two particular cases the bill is still going up rather considerably.

In the Report of the Comptroller and Auditor General on the 1953–54 Accounts this appears:
"These firms had already, since the accountants' reports, made price reductions estimated to save the Exchequer about £850,000 per annum. Further price reductions were expected in response to the recent approach."
Has the Minister any report to make of any further voluntary price reductions?

There are some quite startling figures given in the Report. Some firms, on a calculation of profits obtained on the various preparations, gave figures ranging up to 60 per cent. on selling prices. We should all look at that with some care. Unless there is a very special reason in an individual case we should certainly not accept that as desirable in the general public interest.

The proprietaries are by no means the only problem. It is fair to say that, perhaps increasingly, the prices of proprietary brands may be coming down in relation to those of other drugs. I would be glad to know what the position is there. I should like to know rather more, also, about what is happening about other drugs and the related problem of dressings, and so on.

In the case of selective basic drugs, including anti-biotics, vitamins, hormones and insulin, which, I understand, the Ministry has been investigating and which costs about £10 million a year, a great deal is being done. There have been some announcements about savings which have been made, but I should be glad to hear from the Minister about any further report which he may have to make and whether he is proposing to recommend that doctors should not prescribe any further items among those that he has been investigating. There is also the general question of non-proprietary drugs, about which I am not satisfied that we have done enough.

Some hon. Members have referred to the importance of the export market. I think we all recognise its importance. We recognise that there is a considerable pharmaceutical export trade. I am rather disturbed to find, looking at the recent figures in the Trade and Navigation returns for last year, that the increase over the year in the value of pharmaceutical exports is very modest, to put it mildly, while the increase in the imports of pharmaceutical products is considerable.

I agree that the imports of pharmaceutical products are still very much below the value of the exports, but, nevertheless, it must be of some concern that we seem to be importing today quite a large amount in value of proprietaries and in vitamins and matters of that kind, all of which contribute to our drug bill. I should like to know from the Minister whether he can say anything about that aspect of the problem and whether he is satisfied that those drugs which are being imported are being satisfactorily costed by his Department with those which are being produced in this country.

Last autumn, I had the opportunity of going to Switzerland, where I discussed with the authorities there the control that they exercise over drugs, and I was rather impressed by the independent investigations that they make. It may well be that the team that is now being built up by the Ministry to deal with cost investigation may eventually cover adequately the whole field, but the Swiss have had a long experience of control of drugs, both new drugs brought on to the market and drugs of the widest character, including medical preparations of all kinds, with regard to quality, advertisement and price, and it would be well worth considering whether their ideas are of any value to us.

I should also like to know from the Minister whether there has been any further development in the discussions with the pharmacists on the question of their remuneration. I presume that the Minister cannot be including in this Supplementary Estimate any provision for any increased pay for pharmacists. I notice that there has, indeed, been some alteration in the terms of payment which has brought some relief to the Exchequer, and I welcome that.

If I may turn to the ophthalmic service, in the note that the Ministry of Health sent to the Public Accounts Committee in May last year they commented on the fact that prices for lenses, metal frames and cases had been increased after a full investigation, but that increase which was estimated then to cost £170,000 a year was a good deal less than what had been originally claimed by the opticians themselves. Could the Minister tell us how that figure has, in fact, turned out? Has £170,000 been the sum required to meet that extra cost, and is that included in the Supplementary Estimate which we are now considering?

Has the Minister considered at all the question of the relative fees paid for sight testing as against fees paid for prescription of glasses? Sometimes the question is raised whether glasses which are prescribed are always necessary. I know it can be argued that everybody needs glasses, and that, excluding political myopia, there are forms of shortsightedness which afflict everyone to some degree. If we paid slightly more for sight testing and included in that fee the cost of the provision of glasses as well, would we, on balance, find, as is sometimes suggested, some reduction in the number of glasses prescribed? I should like to have the Minister's views on that.

On the question of dentists, again we know that discussions are going on with the dental profession about the restoration of the last 10 per cent. cut in their fees. I suppose I am right in assuming that no provision for that restoration has been made in these Supplementary Estimates, but, again, that is a matter on which we should like to have some further information. As I say, on the whole, we on this side of the Committee wish that the Minister were spending a good deal more than he is. That is a matter that I hope we can develop on some other occasion.

A point which was raised by my right hon. Friend on which I would like to comment related to the use of hospital pharmacists. The hon. Member for Putney made some very useful comments on that matter—and surely there is no one more knowledgeable on that subject than he is. I would remind the Minister that it is suggested that the total number of hospital pharmacists needed throughout the country to provide adequate staffing is something like 1,500. I support what my right hon. Friend said earlier in this connection, that if we could have the hospital pharmaceutical service built up we might make some very useful financial savings. I do not suggest that we should do it purely with that object in view. I think it would be of great value to the hospital services as a whole if we could build up the pharmaceutical service in the hospitals, but I think that we could, at the same time, make a useful economy.

I welcome the fact that this debate is taking place in a much quieter and more moderate atmosphere than when I had the opportunity of introducing some modest Supplementary Estimates for this very Service a few years ago. I hope that the intemperate criticism that we received as a Government from hon. Members opposite in those days taught everyone that we should not follow their example. The way in which many hon. Members opposite are today having to adopt a very different attitude towards the Service which they assailed so bitterly in the past shows how right we were in much of what we then said and how right we all are today in concentrating on the positive value of helping to build what is and can be a very wonderful Service.

6.0 p.m.

I see in the Supplementary Estimate that provision is made for an additional sum of £234,000 to cover domestic help and services.

I know that it would be wrong for me in this debate to raise the lack of adequate provision of special schools in my own County of Worcestershire, for spastic children and handicapped children generally, and it would be wrong, too, in this debate, for me to stress the need for the home teaching of these children.

Nevertheless, I want to ask the Minister very seriously to consider that when these grants are made to the local authorities, he should impress upon the authorities, and particularly the county authorities, the need to give domestic help, especially to working-class parents of spastic children and of handicapped children in special cases. The Minister is aware of that need. There are certain cases in which expert domestic help is necessary to assist the parents in doing their best for these handicapped children.

I want to stress that point in connection with my constituency which, of course, falls within the County of Worcestershire.

I suppose I have to be very brief, Sir Rhys, although you have been kind enough to call me to speak in a debate on a subject about which one could speak for four or five hours. This has been a most interesting debate. Hon. Members who have the least knowledge of the subject have developed arguments which can be cast to the ground with a puff of wind and have pretended that they know a great deal about the subject when, in fact, they know nothing.

I am one of those who have done medical research. My research was as a result of a scholarship which I won at my university. I had the experience of working under one of the best research professors in Glasgow for a time. Apparently, I am causing some perturbation on the Front Bench. I do not know what it is about.

I hope that the hon. Member will not carry this too far.

He was a very distinguished medical professor, formerly of Glasgow University, and I am sure that the Committee would like to know his name.

If other hon. Members had been called to order when apparently as irrelevant as I have been, I am sure that the punishment would have been more justified.

These researches are done for definite medical reasons. They are done because research into pharmacological products has to be undertaken separately in independent and impartial laboratories, even although research work on them has been done previously in private laboratories; because, with the best intentions, these firms have to sell their products which, therefore, have to be vetted by the independent research worker.

You are watching me very carefully, Sir Rhys. I do not know whether I am in order. These drugs have to be vetted officially by the official bodies when they are produced in private laboratories, who announce them in the medical Press. We have, therefore, to distinguish between private research and the impartial research laboratory. A whole batch of new drugs has been put on the market over the last ten years. Everything is done to prevent a proper trial of these drugs. I know because of experience in hospitals which are run privately—not Government hospitals. These drugs are put into private hands, their sales are through private shops. The whole thing is absolutely absurd.

One hon. Member has spoken about tuberculosis and has suggested that tuberculosis ought to be treated experimentally with some of the new drugs. Great work is being done on tuberculosis even now in the ordinary hospitals and sometimes in the Poor Law hospitals. One of my hon. Friends reminds me that they are to be Government hospitals. The fact remains that research into treatment can be done not only in the voluntary hospitals, but also in hospitals under Government bodies run by electors who have sent their representatives to run them.

Not only do we produce drugs of the Continental type in our laboratories, but we are doing a great deal of research work by private individuals. It is the duty of hospitals not only to treat well, but also to diagnose well. There are many constituencies in the country in which the out-patient department does not exist. It is only in some of the teaching schools and exceptional hospitals that these out-patient departments exist. From the point of view of obtaining experience with new drugs, these facilities should be available to almost any hospital. Many economies can be made in hospitals when making prescriptions. Each hospital makes up a list of prescriptions and sticks to it for five or seven years without change. Yet they say that all the modern medicines, all the new drugs, are available when they are not.

There is no co-ordination between the different public bodies which run these hospitals and there is no Government supervision except for particular purposes. Even the staff at the Ministry of Health seems to know very little about the chronological reactions of certain drugs which are being used.

I have no desire at all to interrupt the hon. Member, but I hope he will keep somewhere near the Supplementary Estimate.

I hope I shall, Sir Rhys. I am trying my very best, but I really must refer to these drugs, where they have come from, how they are recognised and what laboratories are investigating them. Surely that comes within the purview of this debate—how these drugs come to the market and are used? I am entirely in your hands and I realise that I am not a very good follower of instructions, but I am doing by very best to keep within the terms and the ambit of your Ruling.

I want to try to crack open the private control of drugs which, in my opinion, are being put on the market too soon before a proper investigation. Patients are treated with drugs about which there has been comparatively little and superficial investigation. I do not know how they do it, but staffs get into Government Departments and give their approval of where drugs should be used in certain institutions. It is extraordinary. Sometimes those drugs are not cheap. The voluntary hospitals can take them and no one asks questions, but the Government hospitals have to ask questions. The recruitment and remuneration of the medical officers who have to give their consent is extraordinary.

I do not think that the recruitment of medical officers comes within these Estimates.

If you rule that, Sir Rhys, I shall have to accept it, but surely consent and reports on these new treatments have to be made by some officials in Government Departments? For example, the Ministry of Health must usually take the advice of Government officers before approving of certain people to go into institutions. I know that is the custom of various Departments, but, if you rule that it does not come within the purview of this discussion, I bow to your Ruling. It is very difficult to talk on a matter like this when one is hemmed in and does not know when one is in order or not.

Take, for example, the remarks about parents and the treatment of children ——

I would remind the hon. Member that there is no difficulty about keeping in order. All he has to do is to keep within the limits of the Estimate.

Thank you, Sir Rhys. All I can say is that I have sat very patiently all through this debate today and have not even indulged in my usual rude interruptions.

All right, twice. Having done that and heard other hon. Members indulging in remarks, I thought I might be able to take a little off the fringe of what some of them have been saying.

If you will allow me to proceed, Sir Rhys, I would mention the choice of treatment. This, of course, could be left to the medical practitioner, whether he is a consultant or a general practitioner. Sometimes parents get advice from all sorts of people—including Members of Parliament—as to the treatment which should be given to their baby. Tears have been shed about the baby being treated in a certain way.

6.15 p.m.

As a medical practitioner I went into many homes. I saw how the ordinary civilian, of whatever profession—especially if he is a Member of Parliament—pretends to know something about medicine, although he knows absolutely nothing at all about it. Sometimes the treatment is dangerous for the child. I presume that dangerous treatment is within the purview of this Vote.

Sometimes it is very difficult to decide what type of treatment to undertake. That is why the fools who go into the medical profession and try to learn something from the physiology of the diseased human body try to know how to treat a case and to choose drugs which are either new, or as old as the hills. I suppose that if any medical man started to treat malarial fever in the tropics or anywhere else with something not touched with quinine radical he would be in trouble——

I must draw the attention of the hon. Member to the fact that he is very wide of the Estimate.

I am grateful to you, Sir Rhys. It is rather difficult for an ordinary layman who knows something about medicine to keep within the actual terms circumscribed by the Vote; at least, I find it so. I have often found it so in this Parliament. I hope you will pardon my transgressions, because this is a subject on which I want to get the interest of the Committee. I find medicine important and especially of public interest at the moment.

The point may be very important; I am not disputing that, but this is not the proper occasion to deal with that subject. There are other occasions. This is an occasion to deal with the specific Estimate.

There is a sum mentioned in this Estimate. We have to satisfy the Committee and ourselves that the matter comes within the fringe of the amount mentioned in this Vote. I am doing my very best to do that and I want to do it honestly. Suppose, for example, that I talked about treatment and said that one expensive treatment is not particularly necessary, although I realise that these things have to be used in their proper places from the point of view of experiment——

Thank you, I am glad to know that on one point at any rate I am in order. We train the physician so that—whether he has been in practice for long or is on his first trial—he shall know whether a particular drug should be used in certain conditions from which a patient is suffering. That may be useful for treatment in subsequent cases.

Human derangements are very difficult matters, and sometimes it is difficult to treat a patient who has not only physical symptoms, but mental symptoms. Some people who are not ill have mental symptoms, but some who are ill have mental derangements at the same time, and they have to be treated both with sedative treatment as well as for their physical derangements. I urge that in cases of this kind, the drugs that are used should be of a certain quality—I wish their result could be guaranteed—and should be put in the hands of men who are qualified by long years of training and experience to deal with illness and to provide the proper treatment.

I beg of you, Sir Rhys, to allow the Committee to have free discussion in dealing with medicine, treatment and diagnosis. I ask you to allow latitude to a man like myself, who, although he has been in Parliament for some years, is not a brilliant absorber of Parliamentary rules. Outside the House, I like to say what I think, and in the House of Commons I sometimes think that I should be able to do the same thing here, but that is not always the case. I ask you, Sir Rhys, to allow as free discussion as possible on this Vote, not only to me but to the whole Committee.

That is precisely what I am trying to do. There are occasions for doing what the hon. Member desires to be done, but we are now dealing with the Supplementary Estimate.

On a point of order. My hon. Friend and I are no longer responsible for one another in any sense——

—but I see, in page 79 of the Supplementary Estimate, an additional sum of £8,562,000, which is then sub-divided, and I see an item which is called

"K.6—Prevention of Illness &c.—£42,000."
Would not my hon. Friend be in order—[HON. MEMBERS: "That is a saving."]—I beg pardon. That is a saving, certainly, but, nevertheless, it comes into the accounting which has led to the Supplementary Estimate.

Where do I come in in all this? I wanted to make my preliminary remarks in order to come to certain conclusions. I want to try to reply to certain of the illustrations which have been put forward, some of which were really extraordinary. It has been said that an infant should not be given treatment by an ordinary outside doctor. Many of the remarks which have been made reflect upon the whole medical training of the general practitioner.

Some men do not pass their examination at the end of five years. Some of us are lucky enough to do it, but sometimes it takes seven, eight or nine years for men to pass their examinations. These men, after working hard and treating patients according to their judgment, are being told in the House of Commons, where every word spoken is recorded, that they are not doing the right thing by way of treatment and should not be allowed to treat young patients in a dangerous state of health with the drugs which they select for use. Why should they not be allowed to do so? If they have done anything wrong, they can be punished for it. Even Members of Parliament make mistakes.

The medical men have to treat their cases, but some people who get into Parliament have no knowledge whatever of medicine, of the difficulties of medical diagnosis or of the difference between a young baby and a supposed adult, and yet they blame the doctor for the way he treats his patients.

I have not said half of what I wanted to say. I have not been allowed by the rules of order, apparently, to deal with the arguments which were allowed from one side and which, I thought, would be allowed to be answered from the other side. I can only say that some most stupid, indifferent and ignorant remarks have been made in the House of Commons, as they are usually made, about medicine. They are allowed to pass by, while somebody who wants to prove them wrong is prevented by the rules from giving the appropriate answer. I am very sorry. One of these days we must ask for a special non-Parliamentary debate, outside the Chamber. We will ask you, Sir Rhys, to be chairman and then we will see what a free hand we have in the debate.

I regret very much that this debate is not wide enough to allow me to deal with all the criticisms, both of particular cases and regarding the medical profession, which handles a very difficult job in the finest way possible. I know all the difficulties, because I have gone through every phase of medical practice—general practice, research, specialist practice, and consulting practice. I have done all that and I have escaped, so far, the clutches of the law.

I was hoping that tonight I should be allowed an opportunity of making some appropriate remarks with a view to putting medicine in its right place in the debate. I hope that when I have learnt more about procedure to be able to take part in debate and to prove that what the medical profession has been doing is fine. We all make mistakes, but most of the mistakes are made by the lawyers. I hope that on a future occasion I will be able to speak more fully on this subject, which touches my heart strings and about which the ordinary layman knows nothing at all.

6.30 p.m.

We have had a wide and very interesting debate, which has turned out to be a half day's debate, on the National Health Service, and now I shall do my best, fairly shortly because I know there are other matters which interest hon. Members and to which they would like to proceed, to answer the points which have been made. The three main matters raised have been costs and wages in the hospital service; the experimental, clinical research in hospitals with particular reference to one case that has been mentioned on both sides of the Committee; and the question of the pharmaceutical service. There are other most important matters such as those about mental nurses to which I shall try to refer.

Perhaps I may be allowed to start by repeating to the Committee the last words of my speech on 10th May, 1954, when I put forward the Estimates to which this Supplementary Estimate is a postscript. I said this:
"Although it will be difficult for hospitals to manage this year, I think that we shall be able to meet the main needs and to go forward a little. The capital position points the way to a much brighter future, and I invite the Committee to approve the Estimate and to say that these are the right sort of figures for the National Health Service."—[OFFICIAL REPORT, 10th May, 1954; Vol. 527, c. 893.]
I am quite ready to stand by those words today. We cannot debate it now, but it has proved true that the capital position has pointed the way to a much brighter future, which we are all glad to see, and beyond doubt it is true that the year has proved a difficult one for the hospitals.

I would take three general points before I come to the particular ones which I mentioned. First of all, I do not think we always give in our debates and Questions in this Chamber a very accurate picture of what is happening in this great Service. Inevitably, we concentrate—and quite rightly so—on what is wrong. An hon. Member will put Questions down to say that something is going wrong in his constituency, and others draw the attention of the Minister to any difficulty there may be and urge certain action upon him. Therefore, the public gets an idea that there are more things wrong with the National Health Service than is, in fact, the case.

As I said in my speech on the main Estimates last year, I am very proud to be the Minister of this Service. It is, perhaps, worth mentioning that since 1948 the number of beds available has gone up every year; that the number of beds staffed has gone up every year; that the number of beds occupied has gone up every year; and, turning from the in to the out-patients, the number of outpatients treated has gone up every year. There is a very great deal of progress against the background of which we must look at the difficulties that have been put forward.

The second general point I should like to make is this. I explained in my speech on the main Estimates that we were embarking, largely on the advice of the Public Accounts Committee, on a rather more realistic method of estimating, in which we took no advance provision for wages beyond a token amount of £1 million last year, and no amount at all for increased costs. The right hon. Gentleman the Member for Middlesbrough, East (Mr. Marquand) made some reference to this. I should be very happy to debate the cost of living with him. He trailed his coat once or twice, but I do not particularly want to tread on it at the moment, so I will say that if, as has been the experience of all of us since the end of the war, we are to have increases in wages which we must accept from year to year, and if, at the same time, the general trend of prices is to be upwards, then it will follow that, if the estimating is accurate, we must look forward to a series of Supplementary Estimates such as this. I do not think that this is necessarily something to be deplored, because if we take into the Estimates amounts to cover possible Whitley awards and possible increases in food and other costs, we do to that extent mask the true figure for which we ask Parliament. I think the argument on both sides of the Committee is that we are right to follow the procedure which is being followed at present.

There is one important footnote to something which the right hon. Gentleman said. It is quite true that a good deal of this Supplementary Estimate, and of the main Estimates, of course, is outside my control because it depends entirely on the amount of demand that there may be. A fair amount of the hospital service is within my control, in that if it appears to me, as it did some time ago, because we have monthly figures of how the expenditure is going, that a Supplementary Estimate will be needed, one can then face the necessity for the Supplementary Estimate or one can order the boards to cut services or close certain departments. We did not take that course, and we have come to the Committee with a Supplementary Estimate.

The right hon. Gentleman asked some questions about the amount of money that is involved, as mentioned by the Parliamentary Secretary. The £12 million for increased wages is over and above the £1 million which we took as a token reserve in the Estimate. The right hon. Gentleman asked, "Is this due to more nurses or to increased pay rates?" The answer is that it is due entirely to increased pay rates. We did allow, in our estimating in the original Estimates, for an expansion of between 3,000 and 4,000 over the whole of the country. As far as we know, that figure will turn out right. Therefore, the amount we are asking for is applicable not to more staff than we thought of in our Estimate, although there are more staff, but to increased wages.

The right hon. Gentleman asked about the £900,000 which reflects additional costs that have had to be met by the hospital authorities. That reflects all sorts of rises, mainly, no doubt, in food, and also, of course, a number of minor decreases that there have been in household goods and some other things of which hospitals are very substantial consumers indeed. I should be very ready indeed, if this were the occasion to do so, to deal with how much would have been needed to have covered comparable costs in the last year of the Labor Government, but, if the Committee will forgive me, I think that on the whole I should avoid that comparison.

The right hon. Gentleman will agree, will he not, however comparative the figures are, that the savings in this case are in respect of those commodities for which the Government have no responsibility and that the increases are in respect of the commodities for which the Government have responsibility.

No. That is a good deal too wide a proposition, but the right hon. Gentleman and I can debate that on another occasion.

I should make this clear, that no directives go out from me, from the Ministry, about the amount or the quantity or the quality of food—apart from general advice on catering matters—that should be given to the patients in the different hospitals. A number of questions have been asked about this. It is true that from time to time regional boards, to keep more closely to their estimates, may lay down certain wide instructions to the hospital management committees, but they do not come from me.

If it prove that such costs increase, and if we are satisfied that the regional boards and the hospital authorities cannot face those amounts from other sources, and while we expect them to explore every avenue, as the phrase goes, before we can be so satisfied, we should be prepared to meet those amounts, just as, indeed, we have included this amount of £900,000 in the Supplementary Estimate.

I want to turn from that point to a matter which has aroused great interest. It was raised originally by my hon. and gallant Friend the Member for the Isle of Ely (Major Legge-Bourke), but the main speech on it was made by the hon. Member for Newcastle-under-Lyme (Mr. Swingler). It is the question of experimental clinical research in hospitals. Particular reference was made to a case which was quoted in learned papers and particularly in the "British Medical Journal."

Let us be quite clear what we are discussing. We are not discussing at all whether, in that particular instance, the consent of the parents should have been asked for. It is admitted that it should have been asked for. The people responsible, who are people of the very greatest authority and competence, regret very much, as I do, that that was not done. What we are really discussing is whether such experiments are proper and whether any action should be taken by the Minister of Health in these matters.

The hon. Member for Newcastle-under-Lyme raised this matter in a very reasonable way, of which I have no complaint. He put forward two propositions and I am not certain whether I agree with one of them. In fact I am sure that I disagree with his proposal that it would be wrong and unethical for any clinical investigation—I prefer that to "experiment"—to be carried out which would not immediately benefit the person on whom it was carried out. If it is to add to our knowledge for the future I do not see how that could be so. For instance, the reward that will come to those who try to catch the common cold at the research unit which is in operation at Salisbury is not that they will derive direct benefit to themselves, but that the general pool of knowledge may be increased and that others may be helped in the future.

It is true, therefore, that when the hon. Member for Newcastle-under-Lyme asks who benefits from this, the answer is that all the babies yet unborn may well benefit from this continued thrusting forward to new frontiers. I make that one reservation about what has been said. It seems to me that there are two propositions with which most of the Committee would agree. First, there is bound to be clinical investigation and experiment. Indeed, if that was not so, our knowledge of surgery and medicine would not have changed over the centuries. Secondly, only the clinician in charge can say what is right and proper and what safeguards are needed in the actions which he takes.

In the Parliamentary Question which he put to me, the hon. Member for Newcastle-under-Lyme suggested that
"… before further clinical experiments on children are undertaken, the nature of such experiments …"
be reported to my Department, so that my medical staff
"can ensure that there are adequate safeguards against harmful effects; …"—[OFFICIAL REPORT, 14th February, 1955; Vol. 537, c. 4.]
He also asked that I should issue a directive to hospital management committees on the ethical principles involved.

In my view, that is a wrong conception of the duty of the Minister of Health. I do not think that it is my duty, indeed, I think that it would be wholly improper for me, to try to lay down what ethical and medical principles should govern the conduct of professional men in the work which they undertake in the hospitals. In this instance, there was undertaken an experiment which all those concerned—who are of the highest capability—were quite certain was completely harmless. I have regretted, and I say it again, that the parents were not informed and their consent was not sought.

As far as I am concerned, if a small child of mine, or a child of any age, was in hospital and I was told by people of the standing, for example, of a professor of medicine and child health at the university concerned, "We are interested to know the effects of a perfectly safe clinical investigation. It may very well be that we can learn from what is done and as a result can drive still lower the infant mortality rate in this country," I should be more than ready to give my consent. I should be delighted.

I do not want to use legal words because I am not a lawyer, or to use medical words because I am not a doctor but, if I may borrow the phrase used by the hon. Member for Newcastle-under-Lyme and speak "with due diffidence because I am a layman," the common sense of the matter is that where a clinician intends to undertake an investigation which is so novel as to amount to an experiment, he would be wise to seek consent from the patient or parent, as the case may be, for what is proposed. That seems to me the common sense of the matter, but I am absolutely convinced that it would be quite wrong for a Minister of Health to issue directives on a matter which is one essentially of medical ethics to those concerned.

May we take it from what my right hon. Friend has said that he will send directives to hospitals in the sense in which he has spoken?

6.45 p.m.

No, Sir. I am sure that it is entirely unnecessary and wrong. The "British Medical Journal" and other learned papers have already reported the Questions asked and the answer given to the hon. Member for Newcastle-under-Lyme, and what I have said and he has said will no doubt be reported in the professional papers. I am sure that it is best to leave the matter to the profession and not to have a lay Minister of Health interfering in a matter that is very precious to those professionally concerned.

I have no quick reaction to this matter but I agree that my hon. Friend the Member for Newcastle-under-Lyme (Mr. Swingler) has presented it with great care. Should I understand the Minister—and perhaps I should not—to say that a patient in a hospital shall only be consulted if the methods of investigation or experiment to which he is part are novel? I think that those were the words which the Minister used. It seems to me that a patient primarily goes to hospital for therapeutic measures directed towards his condition. It may be true that, thereafter, he offers to take part in an experiment, but surely the Minister was going a little wide.

I do not think so. If the right hon. Gentleman studies my words he will see that the point which he was making is not excluded in any way. I said that the man who must be concerned in this is the clinician in charge of the case, but the one person who cannot be concerned is a medical or lay officer of the Ministry.

This is very important. I am sure that the right hon. Gentleman would not attempt to sustain the plea that only the clinician is responsible, for no court in the country would hold that view. Indeed, more and more frequently actions are taken, I suppose properly, against the administration.

Is this in order, Sir Leonard? When I tried to speak on a subject which was just as foreign to the debate I was ruled out of order.

I understand that the Minister is replying to a statement made earlier, and to that extent he is perfectly in order.

It is kind of my right hon. Friend to give way. The only point that I am making is the very narrow one that in the case of small children the consent of the parents should be obtained. That is all. I do not need to be a medical practitioner to think that a parent has a right to be consulted where his child's health is concerned.

I do not know whether my hon. and gallant Friend was in the Committee, but I started my remarks by saying just exactly that. I have said it in terms over and over again. A mistake has been made and it has been——

I appreciate completely why the Minister should resist the idea that he himself should go into this matter and send a directive, but in view of the complexity of the situation does he not think that it is the duty and responsibility of the heads of the medical profession to give some ethical guidance? As it has been brought to his attention that there are cases where, for example, consent has not been obtained and where experiments are being conducted which have nothing to do with the actual treatment, will he not use his good offices to ask the heads of the medical profession to give some guidance on that?

That is a very different matter and one with which I am in some sympathy. Of course, if I have the slightest reason to believe that the position today is not fully understood then I will informally—and it can only be informally in a matter like this—draw the attention of those responsible to what has been said. As the hon. Member knows—I think I sent him a copy of it—the Medical Research Council sent out a confidential memorandum rather on those lines. If I have any reason to believe that the position is not completely clear and that it is desirable for these things to be drawn to the attention of those responsible then, of course, I would not object at all to what I may perhaps call an informal notification from myself. Of one thing I am clear, no directive must come from the Ministry of Health on a matter of this delicacy.

I should like to pass from that to the third of the main matters that were raised, which was the question of the pharmaceutical service. I was asked to report on what is happening about cost investigation, and to say whether the Estimate included any reflection of the progress made as well as reply to a number of other minor matters that were raised by the hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop).

If I may briefly report on the three main heads, we have completed our general investigation into the question of the secondary manufacture and compounding of drugs, and we have stated a preliminary view that we have no evidence before us to show that excessive profits are being made. On the question of basic drugs, we are still considering the accountants' report.

The question of proprietaries is the one that interests the public most. I announced to the House some time ago that I intended to make an investigation into all these matters, but particularly into proprietary medicines. Some information has been given to the House about reductions made by three firms, estimated to save £850,000 a year, and a number of other reductions have been made which are estimated to save some £350,000.

But I should add that there has been a general downward tendency in price, and I have no reason to suppose that the investigations that have been carried out are the only, if, indeed, they are even the main, reason for the reductions. I would invite the Committee to consider for a moment the very genuine dilemma that this position involves. After I started my investigation I was asked by the Association of British Pharmaceutical Industry if I would consider proposals that they wanted to put to me which would alter the basis of the investigation, and one which they considered fairer and more realistic. I agreed to do so, and that, in part, accounts for some of the delay.

We all know there are preparations which are unworthy of being sold under our National Health Service, but we must also remember that this industry has made a wonderful advance in recent years. It has an export trade of very great importance indeed and research is absolutely vital to it. Also, an infinite amount of research may be necessary before one single product proves worth putting on the market. All these matters are apt to be reflected in the price.

The dilemma is how to reconcile the preservation of these features with the fact—recognised by the industry itself—that the duty I have to the House and to the taxpayers is to see that no undue strain is put upon the National Health Service. That being so, I think we are right to proceed slowly, although possibly the pace is a little slower than I should like to see, but I am very grateful for the co-operation I have had from the industry. I am sure I can rely upon it in the future and I am sure it means what it said some little time ago—that it did not seek in any way to defend the indefensible.

A number of references have been made to what we may call the Linstead Report, which I have agreed to publish and which will be issued in a few weeks' time. I do not want to go into that in detail tonight except to say that I am very interested in the quality of hospital pharmacists. Perhaps the best thing is to see how the Report is received in the country and, for a short time, to let opinion crystalise around it after it has been produced.

The hon. Member for Newcastle-upon-Tyne, East asked some questions about this and allied matters to which perhaps I can give very short answers. It is not a very good comparison to look at the import figures into this country because, of course, they may and do cover drugs and preparations which are not necessarily applicable to the National Health Service. It remains true that we have to import many drugs because they are not made in this country and they are of the first importance, although, on the whole, we are finding that many of the important firms are beginning to contribute to their manufacture.

Is not the Minister aware that the Pharmaceutical Society, through its journal, is calling attention to this matter and is rather anxious about the rapid extent of the increase?

I have not seen that particular reference, but now that it has been drawn to my attention I will certainly look at it.

Perhaps the next main point which I should take up was that made by the hon. Member for Northfield (Mr. Chapman), about capital expenditure, which he managed to bring within the rules of order by referring to overspending in Wales as against saving in other parts of the country. With one exception, there has been very substantial under spending of capital almost every year since the Health Service started and the reason, I think, is that we have underestimated the time that it takes to get big new work going. That is why I deliberately announced a three-year programme. We can then see farther ahead and get these matters clear.

But when it became apparent in the summer of last year that there was to be under spending I deliberately over-allocated to those regions which I felt could take a considerable extra amount. That is why Wales is overspending, but if we divide the English saving up into its regional compartments there would be one or two regions—Newcastle is a case in point—which might also find themselves in a similar position. The fact is Birmingham has under-spent considerably—I am not making any criticism of the region—but, on the other hand, it is unfair to suggest that this is due to delays in my Ministry.

7.0 p.m.

The hon. Gentleman asked me questions about the nursing staff which concern us all. When I referred to the figure of 2,000 a year ago, I was taking that not as a practical proposition—as a glance at HANSARD will show—but as a wildly optimistic estimate, so that we could be certain that even if such a figure were reached the amount of money available would enable us to enrol the nurses. Here again, although it is small and not satisfactory, there has been a steady increase in the three quarters of 1954 for which I have figures. There is an increase of full-time nurses of 166 and of part-time nurses of 130. Those figures can be added to the trends which I showed in my earlier speech.

Probably, although they cover only three quarters of the year, but they are better than the years previous to 1953 though there is an immense amount to be done in this respect which I must try to do with the assistance of the Minister of Labour. It may well be that there are special difficulties in Birmingham because of the competing demands for labour.

On the question of what we are doing, I do not know whether the hon Gentleman has seen the pamphlets and circulars we have issued. I can summarise quickly what we are trying to do. First, by better selection we are trying to check the wastage which has been particularly bad in mental nursing; secondly, we are trying to increase the use of the nursing assistant; thirdly, we are trying better and more imaginative methods of training the nursing assistant; fourthly, although it is difficult to do by circular, we are trying to do something in the most vital section, staff relations. If the hon. Gentleman has not seen those circulars, I shall be glad to send him copies.

My hon. Friend the Member for St. Pancras, North (Mr. Robinson) mentioned at one time the shortage of money for recruiting campaigns. Is it not the case that any idea of a film would be ruled out because, although one hospital board has made a film for attracting recruitment, the Ministry would not put up the money?

If I may digress, it was also an extremely good film—but I do not propose to follow the hon. Gentleman down that path.

My hon. and gallant Friend the Member for the Isle of Ely raised some points, one of which was also taken up by the hon. Gentleman the Member for Oldbury and Halesowen (Mr. Moyle). I cannot say much to my hon. and gallant Friend on the question of development capital for the teaching hospital in the East Anglian area. Also, on the interesting question he raised about savings in the midwifery and other fields, it would be out of order for me to attempt any detailed reply. However, his speech is on record and I will write my hon. and gallant Friend a detailed reply to his points, whether they were in or out of order.

A point which was in order referred to the increases for services under the local health authorities for which I am asking. I am sure that there is no increase which the House of Commons grudges less than that, because all such increases mean more work by home helps, home nurses, and so on, and to that extent do a great deal to take the strain off the hospitals.

The hon. Gentleman the Member for Newcastle-upon-Tyne, East referred to dentists' pay. I am aware that this has taken a long time, but it is being discussed now between the Chancellor and myself, and I hope that it will be only a short time before an announcement is made. There is no provision in the Supplementary Estimate now before the Committee for this.

The investigation of chemists' earnings is still proceeding. The method by which it was agreed we must proceed in face of the Public Accounts Committee was by questionnaires, and these are still coming in. On the question of the opticians, the full amount of £170,000 is not included, but there is a certain amount in the Supplementary Estimate for the increased costs. Owing to increased demand, it is likely that the amount of £170,000 will be exceeded. There, again, the pay claim is under investigation.

I have tried to answer the immense variety of points put before me, but I will write to any hon. Members who feel that I have not covered their points satisfactorily. In conclusion, may I say that this is an amount which it is wholly right the Committee should examine searchingly because, although it is only 1 per cent. of the Estimate, it represents nearly £5 mil- lion. But I cannot help observing to the hon. Member for Newcastle-upon-Tyne, East, who contrasted the temper of the debate with that on the last Supplementary Estimate he introduced, that there is a difference between £4·8 million and £89·4 million, which was the amount for which he was asking.

But under different circumstances. Also, it must be remembered, in the previous two years there was no Supplementary Estimate.

The circumstances are always different when they do not suit us, but I merely make the point in passing.

This Supplementary Estimate is an amount of reasonably close estimating. The possibility—perhaps even the probability—of a Supplementary Estimate is contained in the new methods we have adopted, and I hope that the explanations I have been able to give the Committee will enable it to feel that it can pass this Estimate.

Question put and agreed to.

Resolved,

That a Supplementary sum, not exceeding £4,848,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1955, for the provision of a comprehensive health service for England and Wales and other services connected therewith, including medical services for pensioners, &c, disabled as a result of war, or of service in the Armed Forces after the 2nd day of September 1939, the treatment abroad of respiratory tuberculosis, certain training arrangements, the purchase of appliances, equipment, stores, &c, necessary for the services, and certain expenses in connection with civil defence.

Vote 11

National Health Service, Scotland

Motion made, and Question proposed,

That a Supplementary sum, not exceeding £1,233,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1955, for the provision of a comprehensive health service for Scotland and other services connected therewith, including medical services for pensioners, &c, disabled as a result of war, or of service in the Armed Forces after the 2nd day of September, 1939, the treatment abroad of respiratory tuberculosis, certain training arrangements, the purchase of appliances, equipment, stores, &c, necessary for the services, certain expenses in connection with civil defence, and sundry other services.

7.9 p.m.

This Supplementary Estimate seeks additional provision under four heads only. These are the running costs of hospital and specialist services, for which almost £1 million extra is sought; the general dental service, requiring an extra £200,000; the pharmaceutical service, with £250,000 more; and the supplementary ophthalmic service—sight-testing and the supply of spectacles—with a smaller item of £45,000. Relatively small savings under two other heads, and an increase in certain items of income appropriated in aid of the Vote, offset these additional costs by £249,000 in all, leaving the additional sum asked for at just under £1¼ million.

For the dental and optical services, the extra expenditure simply reflects the fact that the public are making more use of these services than was expected when the Estimates were framed.

The extra cost of the pharmaceutical service is due to the fact that more prescriptions are being dispensed, and at a higher average cost, than was expected when the Estimate was prepared. The increase in average cost represents an increased proportion of proprietaries and other expensive drugs, rather than an increase in the prices of individual drugs. The increased number of prescriptions reflects a rather high level of sickness at the beginning of 1954, and also the recent influenza epidemic.

I can give that to the right hon. Gentleman when I reply to questions, if that satisfies him.

The largest item in the Estimate is the additional £987,000 for hospital running costs. This sum is needed for a variety of reasons. To begin with, when the final accounts for 1953–4 became available, we found that assumptions made this time last year relating to the course of expenditure in 1953–54 had resulted in under-provision to the extent of some £175,000 in the 1954–55 Estimate. At the same time hospital authorities had run down their stocks in 1953–54 to a level of £160,000 below the target we had set them, and thus we have to reduce the further call on stocks to be made in the present year. Then, during 1954–55, it happens that weekly paid wages and salaries have to be met on 53 occasions, there being 53 pay-days in this particular financial year. That means an extra £160,000.

Events which could not have been foreseen in framing the original Estimate were further wage and salary awards made by Whitley Councils, which are costing nearly £100,000 more than the sum provided in the Estimate, and also rises in prices—especially prices of fuel, of surgical dressings and of provisions—which we now expect to absorb £230,000 in the current year. These items do not quite account for the whole of the Supplementary Estimate, the balance reflecting the fact that hospital authorities are unlikely to achieve economies—by that I mean savings without detriment to the treatment of patients—quite on the scale we had hoped.

I should like to make it clear to the Committee that if we provide hospital authorities with the additional sum now sought, they will be able to maintain their programme of expansions and improvements in the service at the level authorised at the beginning of the present financial year.

I would remind hon. Members that, as I explained when the Estimates were considered by the Scottish Standing Committee last summer, the sum allowed for additional running costs arising in this way was designed to enable boards to bring into operation in 1954–55 improvements and expansions that would cost £700,000 to run in a full year. This the Supplementary Estimate will still leave hospital authorities in a position to do, despite the increased expenditure resulting from Whitley awards and higher prices over which the authorities have no control.

With this brief explanation, I hope the Committee will see fit to authorise the provision now sought. I will naturally endeavour to answer any questions which may be put to me in the debate.

7.15 p.m.

I will try to emulate the right hon. and gallant Gentleman in his brevity. I am sure the Committee will acknowledge their indebtedness to him for his frankness, some of which perhaps was a little impolitic, if I understood him.

I will try to keep my remarks to the two main points of sub-heads H and B.

I hope the right hon. and gallant Gentleman will try to explain to us how it came about that the Scottish Estimates were proportionately wider from the original than the English Estimates. Without elaborating the point, it will be obvious that if the comparative figure is £1·25 million against £4·8 million, there is an unusual disproportion.

The misestimates are surprising. In B, for example, the figure is at least 3 per cent. out, and in H it is nearly 5 per cent. out. It may be that in B, in addition to the explanations which the right hon. and gallant Gentleman offered, they were caught on one leg by the advice of the Public Accounts Committee. I will not attempt here to discuss that, but if it is true, as the Minister of Health told us, that in future Estimates are to be based without any allowance being made for what might reasonably be anticipated in the movements of wages, of prices, of foods, drugs and supplies, as a Committee we shall be left in a very curious position year after year.

The right hon. and gallant Gentleman explained that some of these increases which he has had to meet this year were unpredictable. With great respect, I scarcely think that that is wholly true. The right hon. and gallant Gentleman might plead that with such a wonderful Government, backed up by such wonderful pledges as have been given, there should have been a degree of control in the movement of prices which events subsequently did not display, but, even if that were so, he knew last May that awards would be made. He might not have been able to predict the exact amount but he could not escape from anticipating those awards, nor could he completely escape from anticipating a continued increase in the price of certain drugs, supplies and food.

If my hon. Friend wants some help in keeping in order, perhaps he would have a private word with me afterwards.

The right hon. and gallant Gentleman explained, I must say I thought somewhat naively, that these changes were unpredictable, but it is straining the credulity of the Committee to ask us to believe that the fact that there were to be 53 pay days in the year was unpredictable. The right hon. and gallant Gentleman said that.

If the right hon. and gallant Gentleman did not overlook that calculation, then in presenting his original Estimates he misled the Committee. There is no point in shrugging this off.

The right hon. Gentleman did not hear what I said. I said I never put that in the unpredictable class.

Then let me make my point laboriously. If that were indeed predictable and if the right hon. and gallant Gentleman did not include it in his Estimates, then he has misled the Committee. I think the right hon. and gallant Gentleman's Department was caught out in what is a relatively minor matter, but he had better accept it with a little grace and say, "We missed the fact that there were 53 pay days."

I want very quickly to make one or two points about pharmaceutical costs. The right hon. and gallant Gentleman knows that this subject is almost a phobia with me, but I will not attempt to pursue it as emphatically as did my my right hon. Friend the Member for Middlesbrough, East (Mr. Marquand) and other hon. Members concerned with the disturbing costs of proprietary drugs, despite the steps the Government have most properly taken.

I was a little unwilling to accept the explanation offered about the increased prices of the new anti-biotics which are now being used. The Minister of Health said that the increase in the average price was not due so much to a marked increase in the more usual drugs as to the higher prices of the anti-biotics.

The hon. Member for Putney (Sir H. Linstead), who always leaves the Committee in his debt because of his knowledge of these things, quoted figures which I imagine must have been right. They were very disturbing and in conflict with the apparent explanation which the Minister of Health offered. The hon. Member for Putney said that the proportion of proprietary drugs was apparently steadily increasing and that in the last three years it had risen by 9 per cent., from 18 per cent. to 27 per cent. I am not sure that the amounts of the two new drugs, aureomycin and terramycin, would account for 9 per cent. in value in three years. There must be another large factor.

The probability is that if the Scottish figures have followed the English figures, we have had, I am sure to the distress of the whole Committee, another substantial rise in the number of prescriptions which the Minister of Health so cheerfully said was a reflection of the weather. I would not think that we could blame Scottish weather for much and my constituency is frequently blamed more than any other in the community for its weather. I do not think that the increase can be due to Scottish weather conditions.

I believe that the right hon. and gallant Gentleman will later tell the Committee that, despite the intentions of the Government and the claims the Government made for their imposition of the 1s. charge, there has been an increase in the number of prescriptions. I fear that we shall be confronted with Supplementary Estimates for our pharmaceutical services almost annually unless there is a concerted effort to address ourselves, at university level, perhaps at school level, certainly at the Ministry of Health and the Department of Health, to trying to persuade people that their health does not lie in these almost endless prescriptions, some of which are not worthy of the service.

That takes me to my second point, which is to hope that the extension of the hospital pharmacy service will continue. If the hospital pharmacy service had been developed with vigour, we would not have had an estimate of this size for the pharmaceutical service. The hon. Member for Putney was a little cool in saying that he was in favour of the hospital service, but was not at all sure that a patient should be kept at a hospital, instead of being sent out to general practice. But, in constituencies the size of mine, a man could go back to his general practice and have the staffs and facilities available for his dispensing at the hospital and it would be done at a much cheaper rate.

I suspect, although this is a very delicate question, that the dispenser in a hospital is always able to give a little of that positive education which the dispenser at a commercial drug store could not possibly risk. If we continue to be as short as we now are of good men in the Service, then one of the other ways of tackling that problem is to see that more and more qualified pharmacists are provided with whole-time employment, which a hospital affords, rather than continuing to be employed in a shop where much of their time is misspent.

I do not use that argument on a party basis. The right hon. and gallant Gentleman would be the first to admit that all over the country that practice has been adopted by the best of the commercial drug stores. The big drug stores do not have qualified men selling scented soap. That only happens in the little shops, and it is there that there is an extravagant misuse of the qualified pharmacists, and the health of the country cannot afford that kind of extravagance.

I hope that the right hon. and gallant Gentleman will give a few more details about Item B. He explained to us that several hospital authorities had run down stores beyond the anticipation of the Government at the time of the presentation of the Estimates. We ought to know a little more about that. I cannot imagine that any hospital authority took to throwing stuff out of the window or overfeeding its patients. I presume that the real explanation was that the Department under-budgeted for normal consumption over this nine months and that the hospitals were therefore forced in the treatment and feeding of patients to raid those stores and run them down further than was prudent.

I am sure that the right hon. and gallant Gentleman did not want to escape blame for that, that it was an accident of presentation and that he will admit it was a fault of the Government that they forced the hospital authorities to go to those stores and that the hospital authorities were forced so to do by the misestimation of the Government last May. Perhaps he will give us these details so that we can fully value this additional Item B.

What was the value of the run-down in the hospital stores? He might give us a breakdown, even in percentages, and tell us what the increased hospital supplies cost in terms of drugs, medical appliances, food and other commodities. I have no doubt that the other commodities, including bed linen, blankets and so forth will probably show a drop. That is the whole case of the Government about the cost of living. I have no doubt that the other three categories will slightly alarm the Committee and give no promise that next year's Estimates are likely to be correct, unless, of course, there is a change of Government in that period.

7.30 p.m.

I wish to comment on the pharmaceutical service in hospitals. No one would object to the manner in which the right hon. and gallant Gentleman introduced the Estimate, but I must say that it was rather in contrast with the way that he used to speak when in Opposition during the period of office of the Labour Government. He seemed to be much more forthright and to speak in a much louder voice then. I am pleased to see that he has his right hon. and learned Friend the Lord Advocate to support him tonight. Possibly the right hon. and learned Gentleman has sat on the sidelines for too long. I am very pleased that he decided that he would win quicker advancement if he left Ayrshire and that he would do better in Edinburgh; but that is as may be.

Some useful information could be given by the Joint Under-Secretary about the pharmaceutical services within hospitals or groups of hospitals. Perhaps he can tell us to what extent the various regional boards employ pharmacists in hospitals. From my experience as a past convener of Ayr County Public Health Committee, I would say that when we had a pharmaceutical service within a hospital, employing its own pharmacists, we effected large savings. When I was a member of the Western Regional Hospital Board I tried in a limited way to advance arguments why we should extend the service. I should like the right hon. and gallant Gentleman to tell us what is the position in Scotland.

This service has not had the help and extension which its importance deserves. It may be that the Health Service as such may not have settled down sufficiently to enable us to have come to definite conclusions about the pharmaceutical service in hospitals. It may be that we have not yet decided what would be the best plan. I myself am thoroughly convinced that real economies should be made if such a service were general.

It may be that since I was a member of the Western Regional Hospital Board there has been an extension in the pharmaceutical service. I should like the Minister to tell us how many hospitals under the direction of regional hospital boards in Scotland have not the benefit of staff pharmacists. I am not unmindful of the fact that there are small hospitals in some groups and that there may be based on the larger hospitals a group of pharmacists who dispense medicines for supply to the orders of the small hospitals. Can the right hon. and gallant Gentleman ascertain whether there are any hospitals which have not the advantage of such a system?

I suggest that perhaps the Estimate is augmented because some hospitals have to depend on purchases from chemists' shops or have to deal with a store in Glasgow, Edinburgh or Inverness. Does that happen? If it does, would the right hon. and gallant Gentleman have some regard to the undoubted saving which results from the employment of pharmacists in hospitals?

This work can be divided into two parts. This is the dispensing work done by pharmacists within a hospital or group of hospitals and, apart from that, there is the question of the supply to the pharmaceutical hospital service of the ingredients used in dispensing. Although hon. Members opposite may not be aware of it, we are doing a fair amount of bulk purchase in this connection already. The regional hospital boards have a central supply system. Obviously this achieves a big saving, but is full advantage being taken of this method of bulk purchase? Some hospitals are not yet tied to a group for the supply of medicines and are still buying from shops.

In the old days, purchases were made from local chemists. That is a most extravagant and wasteful method of using public money. The local pharmacists may have their uses, but they lie in another part of the Health Service and they ought not to be used at all in connection with regional hospital board work.

The word "supply" covers a wider range than I have indicated. As the right hon. and gallant Gentleman will readily acknowledge, hospital supply covers a very wide range, including fabrics and furnishings of all kinds. A vast amount of money is involved in the supply of hospital requirements. Has the Estimate on page 88 been augmented in any way because we are not acquiring many necessary articles by bulk purchase? These articles represent a terrific figure. The expenditure on hospital furnishings, curtain materials, chairs and so on, is very large.

If we are not covering the whole country in an adequate way, giving the rural hospital the advantage of just as good and expensive furnishings as those supplied in the more populated areas, we should examine the position. We could do the job much more cheaply if we dealt by way of bulk purchase. The regional hospital boards, or a central agency for the whole of the boards, should study the various hospitals and consider their needs over the whole range of supply.

I want to pinpoint the subject with which I started my remarks—the question of the hospital pharmaceutical service and just how far we are dealing with the position by employing pharmacists in hospitals. I know that there is a shortage of trained people. I hope that the boards and the Government will encourage the proper grading of people employed in the pharmaceutical service and provide proper salary scales to attract and to keep them. The employees should be provided with good working conditions. The hospital service could provide places of work which are preferable to some of the outside places. I am not saying that in a derogatory way, but if we are doing this we should provide the best possible conditions for these pharmacists.

On page 89 of the Supplementary Estimates, under "Advances to regional hospital boards," reference is made to
"additional provision required, owing to increases in remuneration and other costs."
I can understand that there have been increases in remuneration, although I was not greatly attracted to the idea of the right hon. and gallant Gentleman that there were 53 pay-days in this year. That was predictable, and I cannot understand why he should mention it. But what comes under the heading of "other Costs"? Can the right hon. and gallant Gentleman give us the supplementary figure for the actual food cost for the hospital service in Scotland? Can we be told why the costs have gone over the figure provided? Are the Government allowing food prices to run away?

We have over £800,000 indicated in this Vote, and a considerable proportion of that may be attributable to added food costs. It will be even worse in the latter part of the year. For example, how much extra will tea cost? I hope that the right hon. and gallant Gentleman will give us a figure, and I hope that he will be able to discover something in connection with my earlier remarks about the numbers of hospitals in Scotland which have not the benefit of a pharmaceutical service either individually or in their group.

All hon. Members, certainly all hon. Members on this side of the Committee, are concerned to ensure that the hospital service and the Health Service as a whole is run as efficiently as possible. We are all concerned to see that better and better results are achieved for less and less social effort. I do not propose to suggest many ways of improving the Service, but I wish to refer to the sum of nearly £1 million which is required for the general running of the hospitals.

A regional hospital board arrives at its estimate by inviting the various management committees in its region to submit estimates. My own experience is that estimates so submitted are the result of very careful consideration, but it would seem almost as if regional boards operate on the principle of thinking of a number and then halving it. No matter how modest, or how carefully calculated, any figure submitted is certain to be drastically reduced. I can understand that regional hospital boards receive similar treatment from the Department of Health. Naturally, the management committees and the regional board start the year on an estimated basis which they know to be quite inadequate to provide the necessary services.

7.45 p.m.

I believe that to be an accurate statement, although I anticipate that as more experience is gained in the hospital service, and comparisons are made with the working of previous years, the estimating may not be so blind. But there may still persist a great deal of this blind method of slashing whatever figure is put forward. I suggest that hospital boards are operating——

I do not think that the hon. Member is correct. Sums are allotted to the regional hospital boards by the Department.

Yes, the Department allocates a sum presumably on the basis of the estimates from the regional hospital boards and those estimates are, in turn, derived from the figures of the management committees within the region. So we get down to the management committees which are seeking to discover what it costs to run a group of hospitals over a given period. My experience is that no matter how carefully the figure is estimated it is always drastically reduced, and it would seem as if the method is that the figure should be slashed, no matter what it proved to be. I expect an improvement as the hospital service progresses and comparisons are made with the figures of previous years.

I wish to refer to a feature of the accounting system which seems to be wasteful, and it is the question of waste that we are discussing. Estimates having gone out, eventually a hospital group is given an agreed figure within which it is expected to work. That figure will cover many items, and it may be that quite a number of them are difficult to obtain. As the end of the financial year approaches there may be a substantial sum in hand. That is not due to overestimating, but because of difficulty in spending money on essential items.

Those concerned find themselves in the position of having money which, if not spent by the end of the financial year, will, in effect, be taken from them; and they fall over themselves to get rid of it before the end of the financial year. That seems a most wasteful method of expenditure. Often these people feel themselves obliged to spend money unnecessarily, because if they do not spend it they will be so much short in the next financial year.

We must recognise that spending is a continuous process and does not end at a time convenient to someone's accounts. The allocation of this money should not be subjected to such a break. It causes dislocation, waste and sometimes almost a feeling of guilt in the minds of honest men who feel that they are obliged to do something which they would not otherwise do because of this recurring break and the necessity to render an account in order not to lose an essential part of the next allocation. That is a point which should be considered. Surely we can find ways and means of allowing for this continuity of spending and not compel hospitals to operate upon the present basis.

My next point concerns the employment by hospital management committees of technicians, such as architects and engineers, to do certain jobs, often at very high fees. It is normal for a regional hospital board to have its own engineer or architect, but it is often found that the board cannot make him available for jobs which a management committee expect to have to do, and the management committee has to bring in an outside technician. This has caused a duplication of expenditure in respect of work which could well have been carried out by a staff of technicians employed by the regional hospital board, servicing all the hospital management committees in its area. If those two points were considered substantial improvements might be made.

My last point is that to show a saving in the running of a hospital strange demands are sometimes made of management committees. At the beginning of this financial year the board of management with which I was concerned was instructed to dispose of valuable stock which it had built up over a period—because, by disposing of it, it was possible to show a certain income which, upon the basis of the present system, would indicate a saving in the running of the hospital. Valuable stock, including clothing material, was disposed of almost for a song to show a certain seeming saving that was, in fact, a scandalous waste. This was something that the people running the hospitals were very much against, but they had to do it.

Who gave these instructions? It must have been the regional hospital board.

These instructions came via the regional hospital board, pre- sumably from the Department of Health. It was said that stocks held had to be go rid of, that no matter what loss was made upon the disposal of stocks the business was to be done, in an effort to show savings which were really substantial losses. If we scrutinise these items carefully we can do very much to improve the Health Service without drastically increasing the cost of running it.

We must all deprecate a thing like that. Is it quite certain that these instructions came from the Department—that valuable stock could be sold at a loss to show a paper saving? It seems incredible.

What I am saying is that the board found itself obliged to dispose of stocks which it held. It was not said that the stocks must be disposed of at a loss, but that they must be disposed of.

This is something of which I have never heard. What I understand from the hon. Member's remarks is that the board actually disposed, by sale, of stock.

I am sure that the right hon. and gallant Gentleman will have some regard to the experience of my hon. Friend the Member for Motherwell (Mr. Lawson), who has served upon some of the boards in Scotland. I want to be brief and shall therefore make only two short points, more by way of seeking information than anything else. In regard to Subhead B—Hospital, Specialist and Ancillary Services—I wonder if the right hon. and gallant Gentleman can say whether the sum asked for includes a sum in respect of any increase in the number of chest surgeons or specialists? He will know that in Scotland some perturbation has arisen over this matter. The right hon. and gallant Gentleman knows that surgery, especially in the case of tuberculosis, is playing an increasing part in effecting cures and rehabilitating people. The increase in the incidence of lung cancer is also causing some trouble, and surgeons are rather perturbed about the future.

My second point relates to the increased amounts asked for under the general dental, pharmaceutical and ophthalmic services. The sums under those three Subheads amount to about £500,000. What are the sums which have come in byway of income in charges for dental services, for spectacles and for shilling prescriptions? If we could be told that, we should be able to have a better idea of these matters and view them in their proper perspective. For example, the income from dental charges in 1953 was about £600,000, and ophthalmic charges amounted to £431,000—a total of £1 million for those two items alone. Yet the increased sum asked for here is about £250,000.

I suggest that, balancing these charges against the increase for which he is asking, the right hon. Gentleman should reconsider his whole attitude to these charges and in future take a little more advantage of the discussion of Estimates in the Scottish Grand Committee. If he asks for an extra £2 million to cover these charges, I am sure that the Committee will not refuse it.

I shall not delay the Committee more than two or three minutes, but the hon. Member for Motherwell (Mr. Lawson) made what seemed to me to bean unsubstantiated statement which, if true, should be probed by the Committee. If I understood him correctly, a certain regional hospital board had instructions—which he inferred came from the Department of Health—to dispose of valuable stocks at a loss in order to show a certain paper income which would help its finances to look better than they were. Perhaps I was wrong.

It was said that the stocks they were carrying were too large and required to be reduced.

That seems to be quite a different matter. Naturally, if the stocks were too large, it might be prudent of the Department to suggest that a reduction should be made. I thought the hon. Gentleman was saying that they were forced, rather against their wish, to dispose of valuable stocks imprudently and not prudently; and there is a difference between the two versions.

I rose to suggest that if the hon. Member has a specific instance in mind, I hope he will let my right hon. and gallant Friend know so that the Committee may be told what is the truth of the matter, because, as he presented the case to the Committee originally, it seemed to be something into which the Committee ought to probe.

8.0 p.m.

I want to reinforce the point made by my hon. Friend the Member for Motherwell (Mr. Lawson) about this ruthless cutting of the hospital boards' estimates. It all derives from the right hon. and gallant Gentleman's own Department. His is the Department which does the cutting, and the regional hospital boards have to accept the cuts. Can the right hon. and gallant Gentleman tell us to what extent the additional £987,000 which is required under Subhead B bears a relation to the cuts which were made by the Department when it examined the regional hospital boards' estimates? I am convinced that there is much in what my hon. Friend says—that the management committee of a hospital has a pretty shrewd idea of what it will spend.

From the facts given by the right hon. and gallant Gentleman when he introduced the Supplementary Estimate, it seems that the reduction in the stocks held by hospitals are very substantial. What was the reason for that reduction? Is it intended now to increase these stocks? If so, is it intended to revert to the level of stocks held two years ago or is it intended to revert to another level? We would like some information about that.

The third point I wish to make concerns the pharmaceutical services and the average cost of prescriptions. I support the plea of my hon. Friend the Member for Central Ayrshire (Mr. Manuel) for the extension of these services in the hospitals, and also, I should have thought, along the lines of the service which has been established at the Sighthill Centre. A dispensary has been established with a trained staff of pharmacists. I understand that the work done there is increasing enormously, and it seems to me that if the work at the Sighthill Centre pharmacy is increasing to such a large extent, similar provisions ought to be made wherever possible in the Health Service. It seems to me that by the provision of facilities similar to those at Sighthill it ought to be possible to effect a considerable reduction in the cost of these pharmaceutical services.

This Estimate, which originally was for £1,482,000, has been reduced by certain savings and by appropriations-in-aid, amongst which is included the receipt by the regional boards of £75,000. I ask this question simply in an exploratory manner: to what extent do the payments for fee-paying beds in hospitals enter into this calculation? Has there been an increase in the amounts being received in respect of fee-paying in hospitals? Hon. Members on this side of the Committee would like some information about that.

I apologise to the right hon. and gallant Gentleman for the fact that I missed his speech.

It is amazing; never has £1¼ million been asked for and expected with so few words. It shows the temper of the Committee today. The Government are asking for nearly £39 million extra today. I have a very good memory and I remember the speeches which used to be made on the subject of Supplementary Estimates by hon. Members opposite. As a member of the Estimates Committee it is part of my duty to look at this question of Estimates. I recall the Prime Minister, when he was Leader of the Opposition, talking about a spendthrift Labour Government spending our substance. I have been making some calculations and I find that if we vote this extra money, then the Government will have spent, every single day of last year, over £1½ million more than was ever spent by the Labour Government.

On a point of order. Are we able to discuss the Estimates as a whole? Are we not discussing only Class V, Vote 11, National Health Service, Scotland, where the Supplementary Estimate asked for is under £1¼ million?

That is the figure—£1¼million—which the hon. Member for Kilmarnock (Mr. Ross) gave.

Yes. This £1,253,000 is part of the sum which is the subject of our discussions in Committee. I can well understand the hon. Member for North Angus and Mearns (Mr. Thornton-Kemsley), who was famed for his wonderful "spendthrift" speeches at Conservative garden fetes, being a little rankled by being reminded of the failure to live up to promises.

Here we have something which can be explained by only one of two things—or by a combination of the two: a request from the Secretary of State for this extra £1¼million, which is due either to an increase in cost or to bad estimating. I am surprised that there should be this bad estimating.

I am surprised in the light of what hon. Members opposite said. I will prove my case by quotations. One cannot accuse them of anything other than small increases in remuneration and other costs with reference to the £987,000, which is the biggest item. There is no suggestion that there has been an extension of the services.

I think I ought to correct the hon. Member for Kilmarnock (Mr. Ross). He was not in the Committee when I spoke, but I believe that the hon. Member for Edinburgh, East (Mr. Willis) was present. I pointed out that the improvement in certain services was running at the rate of £700,000 in the full year.

We were told that £100,000, in round figures, was for additional wages, because the Government forgot that there was an extra pay day. We were told that there was another £100,000 because of wage increases. Then we were told that there was another £200,000 because of the increased cost of provisions. That is £400,000 at least. I am not including all the other items which the right hon. and gallant Gentleman mentioned. Arising from that, would the right hon. and gallant Gentleman explain where he gets the figure of £700,000 for additional services?

I am sure my hon. Friend has made that speech in a far more concise form than that in which it was made originally by the right hon. and gallant Gentleman, and I am very grateful to him.

If the right hon. and gallant Gentleman has any explanation of his Estimates to make, we have prescribed a form for estimating in this way. The bulk Estimate is given first and then it is broken up into headings and "Details of the foregoing "is the title. All that is here is:
"Additional provision required, owing to increases in remuneration and other costs."
There is no reference to any suggestion of increased services or expansion of services. Can the right hon. and gallant Gentleman tell us of any single new service that has been introduced which accounts for any of this £987,000? If he could it was his duty to have it properly put into the Estimates, to guide those whose business it is to go through the Estimates.

I ask why the right hon. and gallant Gentleman made such a mistake in this estimating when we consider what has been the trend on the hospital side in the past two or three years since his Government took over? If the right hon. and gallant Gentleman turns to page 59 of the Reports of the Department of Health for Scotland and the Scottish Health Services Council, he will see that
"the average cost of maintaining a patient in hospital"
in Scotland during the year ended 31st March, 1953, was 22s. 8d. per day.

That was an increase of 5·5 per cent. over the year before when the average cost was 21s. 5d. per day. The right hon. and gallant Gentleman knows what the trend has been. It has been very much controlled by the financial policy of the Government which has increased the cost of food since then. I want to know why these increases of costs which were known to the Government, and were the direct result of Government policy, were not adequately covered by their budgeting.

Will the right hon. and gallant Gentleman tell us what is the average cost of keeping a patient in hospital today, so that we can compare this with the efforts of the Government to keep down the cost in 1952–53–54? Is it yet another increase of 5₷5per cent., or very much more? The same applies to the treatment of outpatients. That went up from 16s. 4d. per patient to 17s. 2d. in the years 1952–53–54. That was due to increased cost of materials and other matters.

I turn to the pharmaceutical services. There no new service was provided, but the services were used much more than had been anticipated. I want to know exactly how that has happened and whether the Government have been controlling it properly—[Interruption.] I am not concerned with the mutterings of the hon. Member for North Angus and Mearns. If he wants to make an interruption, let him get on his feet. I hope he will be a little more effective than he was last time.

I was saying that if the hon. Member wanted to know these things he should have done my right hon. and gallant Friend the courtesy of being here to listen to his speech and not put these questions, all of which have been given a satisfactory answer.

There are only four of the 35 Tory Scottish Members present.

8.15 p.m.

It is nice to know that the hon. Member for North Angus and Mearns is the only back bench Conservative Scottish Member, apart from those on official duties, here today. I was very busy in the Library and as soon as I saw the name of the right hon. and gallant Gentleman go up on the annunciator, I rushed to my place. When I got there the right hon. and gallant Gentleman was just sitting down. That was why, at the beginning of my speech, I made reference to the fact that this large sum of money was being proposed with so few words.

What is happening in the pharmaceutical service? The right hon. and gallant Gentleman will remember that this has been causing a certain amount of concern to the Government. They took the opportunity to draw up a full prescription list form which they sent to doctors. In 1953, they thought that was having the effect of reducing the number of prescriptions and the average cost of prescriptions. Now we see that they have gone up, not only in numbers, but in average cost.

I want to know whether the same vigilance is exercised with regard to prescrib- ing by doctors as was suggested as necessary in the Report for 1953, on pages 37 and 38. If that is happening the estimating should have been very much better. The Report said:
"The production of these figures will assist doctors to watch their prescribing in the light of their own and their colleagues' costs and will also indicate to local medical committees the doctors whose prescribing might merit investigation under the regulations."
In the past, it has been necessary to investigate the prescribing of doctors and in 1953
"13 doctors had sums varying from 5s. to £50 withheld from their remuneration and 16 other doctors were warned."
Can the right hon. and gallant Gentleman tell us whether account was taken of this? The answers to Questions we have asked show quite clearly that in the poorer part of Glasgow the average cost of prescriptions was very much lower than the cost in the more residential part of the city. Has that been properly investigated in order to bring down the cost of prescribing by some doctors?.

These are questions which must be answered. I hope that the right hon. and gallant Gentleman has all the relevant data and that in his winding-up speech he will be a little less sparing of time devoted to this extra £1¼ million.

I listened to the speech of the Minister more in sorrow than in anger, because he lives in my constituency. Unlike my hon. Friend the Member for Kilmarnock (Mr. Ross), I always come into the House to listen to my constituent, because I may have many questions to answer about his conduct when the General Election comes.

The right hon. and gallant Gentleman and I both have to pay rates to the county council of Ayrshire. I wonder what the right hon. and gallant Gentleman would say if that county council estimated in this slipshod, reckless and extravagant manner. I am quite sure he would say that this was Socialist squandermania. I had to listen to his extremely inadequate, concentrated, on-explanatory statement, and I really do not know what I am to say when I have to defend the Minister in my part of Ayrshire.

What would we say to the county council if it had forgotten a week's wages? It is his duty as Minister to supervise the estimates of local authorities. He should set an example to them. Like Caesar's wife, he should be above reproach. I hope next time he speaks he will improve on this inadequate explanation and these extremely careless Estimates. I am sure that next time he writes to Ayrshire County Council telling it to be more careful about finance it will have a reply to which he will have no adequate rejoinder.

I have certainly been given plenty to answer and I will endeavour to do so to the best of my ability, although the Committee will realise that there are some things which obviously could not possibly be answered "off the cuff."

I was rather pleased with a remark made by the right hon. Member for Greenock (Mr. McNeil) at the start of his speech. He chided me with being, perhaps, too frank and not too politic. I feel that when one comes before this Committee to ask for money one should say as honestly as possible why the money is needed. I stand on that, and I do not feel that I have really been chided by the right hon. Gentleman.

I was not chiding the right hon. and gallant Gentleman; I was feeling a little sympathetic. I should like him to come up and admit that he had missed one of the Saturdays.

It was not a Saturday that was missed. I will tell the right hon. Gentleman later what it was.

The right hon. Gentleman evidently did not hear what I said, because he suggested that I had indicated that the weather in Scotland had something to do with the additional number of prescriptions or cost. I said nothing whatever about the weather. What I said was this: "The increased number of prescriptions reflected a rather high level of sickness in the early part of 1954, and also the recent influenza epidemic." Those are my actual words.

The right hon. Gentleman then put to me a number of questions, the first of which was in connection with the increased number of prescriptions and how many there were. I can give the figures for the 11 months from January to November, 1953, and for the same months in 1954. The number of prescriptions in that period in 1953 was 18,700,000, and in 1954 19,060,000, or an increase of approximately 360,000.

The right hon. Gentleman proceeded to refer to what he considered to be the difference proportionately in this Supplementary Estimate and that for England and Wales.

The Minister was kind enough to give those figures. Can he state the average cost per prescription, which was given by his hon. Friend the Parliamentary Secretary in respect of England and Wales?

The average estimated cost of prescriptions has risen from 5s. 4d. to 5s. 5₷7d.

I did not catch the number of prescriptions. Will the right hon. and gallant Gentleman repeat it?

In the first 11 months of 1953, 18,700,000, and in the first 11 months of 1954, 19,060,000.

I am giving the period of 11 months. The hon. Member must have got something wrong somewhere.

Was the number really 18 million? That would be 50 per head of population. It must surely be a different figure from that.

—and I believe it to be correct. This is the number of prescriptions for Scotland in the 11 months.

That is an increase of 16 million. Perhaps the right hon. and gallant Gentleman will listen carefully while I read from the account of the pharmaceutical service:

"The estimated number of prescriptions dispensed in 1953 was 2,049,500."
That represents a difference of about 16 million.

I have had the figure given to me, and at the moment it must stand.

I was speaking of the difference in cost and the size of the Estimates for Scotland and for England and Wales. The main difference is in the hospitals. The average cost per bed in Scotland is lower than in England, and it seems that savings are possible only on a smaller scale.

I was then asked why we had not estimated for the Whitley awards. As a matter of fact, we endeavoured to estimate to the best of our ability. The estimated amount that we allowed for the increase was £804,000 and the sum actually needed was £893,000; so we did not make a bad shot at it. In connection with the extra week's payment, of which such fun has been made, the mistake came about in a very simple way; it was the kind of mistake that could easily be made. There happened to be 53 Thursdays in the year and it was not realised that the money was drawn on a Thursday, although it was paid on a Friday. That is how the error crept in.

The question that has disturbed the Committee most of all has been that of hospital stocks. We set out deliberately to reduce the stocks during last year. The reason was that we thought the stock being carried was too high, and the items which we proposed to run down were drugs and dressings, bedding and linen, and hardware. We proposed that we should continue the run-down during the present year, because the stocks held were obviously too heavy and, as the Committee will realise, it is no good keeping money bound up in stocks which are not required and are not being turned over. What happened was that the hospital stocks ran down much more than we had anticipated and we have now to reduce the further call on stocks to enable the expansion of which I spoke to take place.

The hon. Members for Central Ayrshire (Mr. Manuel) and Edinburgh, East (Mr. Willis) pressed the point regarding the pharmaceutical services. They both thought that it would be advisable if pharmacists were employed to a greater degree and that supplies should be bought in bulk. Surely, both hon. Members know that practically all the Scottish hospitals draw their main supplies under contracts placed centrally for the whole of Scotland. It is, therefore, unlikely that better buying prices could be secured, but the possibility of economies resulting from more skilled local handling will certainly be borne in mind. I will endeavour to discover the statistics about the hospital pharmacists and will send them to both hon. Gentlemen.

8.30 p.m.

I wanted to ask the right hon. and gallant Gentleman about the pharmaceutical service at the Sighthill Health Centre, and whether he has any information about its cost, in comparison with pharmaceutical costs generally. Perhaps he will let me have that information later on?

I think if the right hon. and gallant Gentleman looks at Appendix X he will be able to correct the error about the prescriptions.

The hon. Gentleman the Member for Kilmarnock(Mr. Ross) referred to a figure of 2 million. I am told that it should be 20 million. There was a misprint, and it was explained, I understand, at the time that the Estimates were discussed in Committee. That misprint evidently accounts for the difficulty in which we have found ourselves.

The hon. Gentleman the Member for Maryhill (Mr. Hannan) asked me about the dental charge. He does not seem to be in his place, but I will give him the figure all the same. The dental charge has amounted to between £700,000 and £750,000. He also asked me about the optical charge. It has been running at about £460,000.

The hon. Gentleman the Member for Kilmarnock asked me about the cost of drugs. While the estimated cost of the pharmaceutical service this year has risen the latest figures of costs are encouraging. They suggest that the information about drug costs which we are now supplying to each doctor three times a year has helped doctors to observe economy in their prescribing without any detriment to their patients. This information, which is being sent out in response to requests from the medical profession, shows each doctor his own costs both per patient and per prescription, and gives him the corresponding average figures for the doctors in the area and for doctors in the whole of Scotland.

The right hon. Gentleman asked me if I would be good enough to break down some of the figures. I will give him figures in respect to increases in the general figure for the hospital service. The increase in the cost of provisions was £160,000. The increase in the cost of dressings was £40,000. The increase in the cost of boiler fuel was £72,000. The increase in the cost of laundry was £36,000, and of electricity and gas £17,000.

I think I have covered most of the questions that were put to me.

I am sorry, but I have not that figure, and cannot make it available to the Committee at the moment.

I am not blaming anybody, and I remember this misprint, and I remember drawing attention to it last year, but the right hon. and gallant Gentleman has left the Committee in the most baffled condition. If the figures he has given us are right, and there is an increase in prescriptions of 360,000, and if the cost of a prescription is about 5s., then we get a figure of £95,000, but the figure asked for the pharmaceutical service is £1,250,000.

Plainly, in this difference the right hon. and gallant Gentleman has given us there must be something wrong. He told me there were 360,000 more prescriptions, and he told me the cost was 5s. 4d., an increase of l·7d.—inconsiderable this time. However, if the increase is 360,000 prescriptions, and if each costs 5s., the total the right hon. and gallant Gentleman should be asking for is £95,000 or thereabouts, whereas he is asking the Committee for£1,250,000. Therefore, although I do not like to hold up our proceedings, I feel we must have a little more information on that point.

The right hon. Gentleman's accounting is a little out. Let us get it square first of all that the number of prescriptions is approximately the number which I gave. The right hon. Gentleman has only applied the cost to the increase and not the increased cost per prescription to the other 19 million odd prescriptions. If he does that mathematical exercise he will find that that figure is correct. I hope that that is a good enough picture.

I am indebted to the right hon. and gallant Gentleman, but if he is out by 19,700,000 in his statement to us he might be a little more generous to a poor Member like myself.

I was not out at all. The hon. Member for Kilmarnock, quoting from last year's Reports, said that the number was 2 million. It was nothing of the kind.

I quoted the actual words from the Reports. It is not the right hon. and gallant Gentleman who is out, but the Secretary of State, who is responsible for the Reports.

The hon. Member has a very long memory, sufficiently long to remember that that mistake was corrected seven or eight months ago, if not more, and brought to the notice of the Scottish Grand Committee at that time.

I have dealt with the questions raised to the best of my ability in the time available to me. I now ask the Committee to grant the Supplementary Estimate for which I have asked.

Question put and agreed to.

Resolved,

That a Supplementary sum, not exceeding £1,233,000, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1955, for the provision of a comprehensive health service for Scotland and other services connected therewith, including medical services for pensioners, &c, disabled as a result of war, or of service in the Armed Forces after the 2nd day of September, 1939, the treatment abroad of respiratory tuberculosis, certain training arrangements, the purchase of appliances, equipment, stores, &c, necessary for the services, certain expenses in connection with civil defence, and sundry other services.

Class Vi

Vote I

Board Of Trade

Resolved,

That a Supplementary sum, not exceeding £23,700, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1955, for the salaries and expenses of the office of the Committee of Privy Council for Trade and subordinate departments, including assistance and subsidies to certain industries; certain grants in aid; and other services.—[Mr. Low.]

Class Ii

Vote 9

Kenya

Motion made, and Question proposed,

That a Supplementary sum, not exceeding £3,973,550, be granted to Her Majesty, to defray the charge which will come in course of payment during the year ending on the 31st day of March, 1955, for sundry colonial services, including grants in aid; and certain expenditure in connection with the liabilities of the former Government of Palestine.—[Mr. Lennox-Boyd.]

8.39 p.m.

This Supplementary Estimate covers additional expenditure in respect of Kenya, and I regret that we have such little time to discuss the subject. It is fair comment to say that the Opposition have provided time for debate of the Parliamentary delegation's report on another Supply Day. I should like to thank the Colonial Secretary for the comprehensive list of answers to Questions which I have put to him, which appear in today's HANSARD. Those replies will avoid a good deal of questioning at this stage. They show that a great deal of good work has been done, but, at the same time, there is a good deal to be criticised.

What I am troubled about—and I have said this before—is that there have been successive statements from Ministers that things are improving in Kenya. There is no doubt that some of the Ministers in the administration are really able men, doing a good job, but there is a good deal of confusion and ineptitude in the Kenya Government.

There is no doubt about the division of views between those in authority. There is ambiguity in the statements made by Government members, to say nothing of the rifts between Europeans on the question of what the situation requires. There has been the resignation of at least one quite important official and Mau Mau terrorism still continues. This means that heavier burdens are going to be carried, and the reforms upon which all are agreed are being delayed.

I would suggest to the Secretary of State that it is not a very dignified position with which we are confronted and with which we must face the world. We in this Committee send our sympathies to those who are suffering. The emergency which has gone on for two and a half years is a terrific strain on all. I have said before, and I repeat, that it is unfortunate that many of the benefits in Kenya which have been provided by the skill and enterprise of the Europeans are not being acknowledged, and it is unfortunate that at a time when more progress has been made we have this disaster.

I have stated before that the Government themselves hear a major responsibility. I think they were wrong to ban the Kenya-Africa Union. By banning that Union they left a free field to the Mau Mau terrorists and gangsters. Rounding up those whom they thought were Mau Mau sympathisers and putting them into detention camps has meant that there is no effective African leadership, and that is what is required. I go so far as to say that in the whole of Kenya today there are few African sympathisers with Her Majesty's Government. The bulk of them are passive and the others are either Mau Mau or sympathetic to it. That is the situation we have to face.

There are 60,000 people in detention camps who are feeling bitter and the repercussions throughout their families are also causing anxieties, worries, troubles and difficulties. I believe we are building up for the future a much more vicious task than confronts us today. There are many responsible people who say that there are thousands in detention camps who are innocent, and others have stated that Mau Mau sympathisers have contaminated the internees, making them into anything but reasonable citizens. Indeed, this has been supported by prison officers.

As the Secretary of State must know, higher officials have been saying that Africans will not be released unless they are actively opposed to Mau Mau. I suggest the Government should do something about changing that situation. As far as I know in the first nine months about 400 have been released, but 2,000 more were added. Recently, at the time of the proposed amnesty, 1,000 more were detained in Nanyuki. So here we have this situation of increasing the numbers in detention and if only for economic reasons—I will not quote what a noble Lord said in another place recently, when he referred to the fact that he could not get labour—these people should be released because the economy will fail if the workers are not available.

If I had the time I should like at length to congratulate the Church Missionary Society for a good deal of the work it is doing and for the way in which it is stimulating thought. When I was with the Parliamentary mission I suggested that O'Dede, the acting President of the Kenya-Africa Union, should be released and that people like Mathu and Awori, members of the Legislative Council, should be used to appeal to Africans not to follow the Mau Mau terrorists, but to work for progress and good order.

8.45 p.m.

That suggestion was not accepted, yet some time later "General China," one of the thugs, one of the gangsters, was given the opportunity of making an appeal to those in the forest. I also suggested in this House that there should be an amnesty for the detainees. That was turned down, but later the Kenya Government made a proposition that the men in the forest, those really responsible for all this terrorism, should be granted an amnesty. We are doing these things in the wrong proportions and far too late, whereas if the chances had been taken in the way I suggested for the Opposition, things might have been a little easier.

To refer to the possibility that those people might have talked subversively, what does the Minister intend to do about the important Member of the Legislative Council, Mr. Slade, who is quoted in the "East African Standard" as saying to the Security Forces that they should not serve a Government which had repeatedly let them down so badly? What would happen if an African, an Asian or an Arab made a similar appeal? This is frightfully bad. It is sedition. The Minister ought to consider carefully what he is going to do about members of the community in Kenya who behave in this way.

We in this Committee have a responsibility. We are asked to provide money for the Kenya Government, so we are entitled, without insisting on too much detail, to lay down the broad principles within which it shall be used. It is important, therefore, when considering this Supplementary Estimate, to state clearly the general aims we have in view and for which we consider the money should be used. The money will be used, of course, for the emergency in Kenya and it ought to bring that emergency to an end. If it is to be brought to an end, it must be brought to a peaceful end, and we must watch carefully the methods used and the situation at which we are aiming.

It is time that the people of Kenya, and particularly of its European community, recognised that Britain has no intention of subsidising the establishment of a system based upon apartheid. The members of the Kenya community should be left in no doubt about this. Racial separation or segregation can have no part in the new Kenya, which is the only Kenya we are prepared to subsidise. The philosophy of segregation is diametrically opposed to the basic values of Western civilisation, and we can be no party to such a betrayal of human values in any of our Colonial Territories.

I have said that we have responsibilities and we here as well as those in Kenya can be condemned for the present crisis. Equally, we condemn Mau Mau, but we have to think of the state of mind which made it possible. The Kikuyu were essentially friendly people. Thirty years ago Norman Leys wrote that certain policies and attitudes which we were following would lead to this kind of trouble. Well, we did little about it, and we are now facing the trouble. We must change these attitudes and policies if we are to overcome the emergency. Therefore, I want to make one or two suggestions.

I know that the Royal Commission on Land is due to report. Perhaps the Minister will tell us when we are likely to get its report? I do not want to anticipate it, but the entire land position in Kenya must be radically changed. The preservation of the White Highlands is certainly a basic cause, both psychologically and practically, for a great deal of the African discontent. In a genuine multi-racial society the only test for a land holding should be that of good husbandry, not the colour of one's skin. I was disappointed to see that one European Minister advocated the reservation of the White Highlands for Europeans for ever. That is not the way to help this situation.

On education, in a genuine multi-racial society there can be no separate educational organisation. In time all the educational systems must be integrated, and we should not fall behind the United States of America, which has set an example in this direction. We welcome the principle of a multi-racial Government. I have previously congratulated the Secretary of State upon that.

I also said that I thought it would be wise on his part to ensure that there were two African Ministers in the Administration. Surely the present position cannot be allowed to continue. If we are really to succeed in making a multi-racial Government work, the Africans themselves must have representatives who know the feelings and desires of their people. This can only be done by building up African political organisation, which we ought not only to allow but should encourage.

I do not believe that we can think in terms merely of separate political representation. The political organisation should be responsible to all the races in Kenya. What we should aim at is preparing the ground for the gradual introduction of a common electoral roll and preparing the ground for a Government which is truly Kenya in its representation and responsibility instead of, as now, being divided into separate groups.

We in this House of Commons should state these views clearly and lay them down as policy. I also believe that we ought to give further consideration to the question of a general amnesty for all detained in the camps. These ought not to be just platitudes or pious hopes; something really bold and dramatic is called for if we are to end the emergency.

I believe I was right earlier in suggesting that a resident Minister should go to Kenya. I still believe that that should be done, and I should like the Secretary of State to consider it. If he does not consider that to be a proposition, I throw out another suggestion which has been made in another place, that there might be another visit to Kenya by the Parliamentary Mission.

A third suggestion, the one I favour, is that there should be a conference in London, with the Secretary of State presiding, to which I would bring Europeans, Asians, Arabs and Africans, and among the Africans would be Odedi, the acting chairman of the Kenya African Union. I would have the Secretary of State saying to them that all the things which I have narrated shall be the basis of discussion. I believe that if that can be done we shall be able to give a lead which will do much to ease the emergency, and perhaps end it.

If we fail to do that, gone will be all the influences for good, law and justice, culture, economic progress and commercial development, the proper use of technological and scientific knowledge—all the things which can lead to a fuller and richer life for all in Kenya. I put the proposition to the Secretary of State in as reasonable way as I can, because I genuinely believe that this is the only way to tackle the very important question of ending the emergency in Kenya.

First, I must ask you, Sir Rhys, and the Committee for the indulgence it is customary to give an hon. Member who is facing the ordeal of his first speech in the House.

I venture into the debate because it happens that, until a few months ago, I was farming in the troubled areas of Kenya. Most of my workers were originally Kikuyu, and I still have many of them. As far as I am concerned, they have been helpful, friendly and courageous, and I am very grateful to them. I suggest to the Committee that the news from Kenya which sometimes tends to imply that we have made no progress in changing the minds of the Kikuyu is false and misleading.

Perhaps I may try to make my point by giving a personal experience. I remember early in the emergency being asked to patrol a piece of road at night by jeep. I asked some of my own Kikuyu whether they would like to go with me. The answer I got was, "Yes, we would like to go, but we do not think we had better go because if we were seen to be helping we might get into trouble and our families might be molested."

For about the last six months, or longer, before I left Kenya we were almost every night having patrols and ambushes and so on. After that first experience, I never again asked anyone to go with me. I let it be known that I was going and always there was a party of volunteers to go with me. At first it was only the Kikuyu, but later there were men from other tribes.

There was another peculiarity about the patrols. We had been told by the police, by the C.I.D., that all the Kikuyus in our area had taken what was known as the platoon oath, one of the rather more murderous oaths. So one had this situation—it was in no way peculiar to me but was happening to Europeans all over the country—of going on patrol with people supposed to have taken these murderous oaths who were armed with spears, bows and arrows and pangas and the European being the only man armed with a rifle.

It would of course have been the easiest thing in the world to put a spear through the European and be in the mountains or forests with his rifle in the morning. But I never felt the faintest flicker of doubt about my Kikuyu, and if the idea occurred to them, I believe that they put it out of their minds.

I should like to try to suggest to the Committee what in fact has been going on in the minds of the Kikuyu. I do not agree with the right hon. Member for Rochester and Chatham (Mr. Bottomley) that the great bulk of the Kikuyu are still our enemies and still favour the Mau Mau. I have spent most of my life away from this country in Asia and Africa and, on the whole, I have been surprised not how different varying colours and races are but how alike they are.

When I hear people talking about the Asians or the Africans or the Kikuyu as though they were people whose responses and reactions were quite different from our own, I am always extremely suspicious. It is, I think, a fair parallel to compare the Kikuyu in Kenya under the influence of Jomo Kenyatta the Mau Mau with the ordinary rank and file of the Germans in Germany under Hitler and the Nazis. There was the same prestige of success in the early stages and the same national conceit, the same lure of self-interest but stronger than all those the fear of what might happen if one protested or showed opposition on any count at all. Now in Kenya there is no longer the prestige of success, there is no longer the lure of self-interest and, most important of all, there is no longer the fear of showing oneself in opposition to Mau Mau.

9.0 p.m.

Time is short and I will not try to say all that I had thought of saying. [Hon. Members: "Go on."] There is one point which I wish to make on which there are misconceptions in this country. There is a belief that, even in the restricted areas where Mau Mau has been active, this is a struggle of black against white.

The last night I spent in Kenya during the Christmas Recess I spent in the Athi River rehabilitation camp, of which many hon. Members know. There, they are trying to rehabilitate the Kikuyu by Christian principles. The African perhaps primarily responsible for the work in the camp is David Waruihu, whose name I have heard mentioned here by, I think, the hon. Member for Shettleston (Mr. McGovern). David Waruihu's father was a senior Kikuyu chief who was murdered early in the emergency.

Putting aside ideas of revenge, the son has devoted himself in this camp to helping his countrymen, or his fellow tribesmen, who to his mind have lost their way. He told me that that morning one of the men detained in the camp had said that he wanted to talk to him. What he had to tell him was that, having seen that in the camp there were no ideas of revenge, he wanted to inform him that he had been the messenger who had carried the money to his father's murderers.

In that camp I talked to quite a big group of Mau Mau detainees who had been rehabilitated. Some of them had been leaders of the Mau Mau in their own districts, where they were well known. They said that they were anxious and willing to go back to the districts where they were known and had been leaders, and there openly to denounce the Mau Mau. The message that these people asked me to take away from that camp was that, to their minds, this was no longer a struggle of black against white; to their minds, it was a struggle of right against wrong.

I have never had to follow a maiden speaker before, and I count myself fortunate to be able to follow the hon. Member for Armagh (Mr. Armstrong) on this occasion. Normally, we listen with typical sportsmanship and attention to a maiden speaker. Tonight, we listened more attentively than ever before, I think, because of the obvious sincerity and the deeply informed knowledge of the hon. Member. I have been to Kenya and sometimes I speak about it, but as I listened to my hon. Friend—I think I can call him that—I felt humble to think that I go on public platforms and attempt to tell people what the position is out there. I hope that we shall hear him often in future.

The civil war in Kenya is not, and never has been, a war of black against white. It is a civil war among the Kikuyu people, black against black. I have said that before in this House and I repeat it, reinforced as I am by the hon. Member for Armagh, who has amore intimate knowledge than I of the present scene in this beautiful but most unhappy land.

I wish to support the suggestion of my right hon. Friend the Member for Rochester and Chatham (Mr. Bottomley) about a delegation coming to this country, an idea originally sponsored by the right hon. Member for Kelvingrove (Mr. Elliot). But when they come let the delegation do some work as a conference. I have found that the news of a delegation being invited to this country has been taken by some Europeans as an invitation for them to come over here and be told what they should do. That is the last thing that should be allowed to happen. Both white and coloured people should be asked to come here and put forward their ideas about the future of the Colony.

Twelve months ago I went to Kenya with five of my Parliamentary colleagues; and tonight I think that we might do a little stocktaking because there is a great deal of anxiety about this emergency, which is referred to in the C.M.S. pamphlet on Kenya entitled, "Time for Action." Hon. Members may or may not agree with the editorial in the "Daily Herald "which said:
"The dirty business of Kenya's Mau Mau war will be debated tomorrow in Parliament. Drastic proposals are overdue to end a situation which is smirching Britain's reputation in Africa. Lets have new ideas."
I hope that we shall have some new ideas. I hope that the Secretary of State will tell us some of the ideas which I am sure that he has in mind, and which he hopes to carry out in the future.

A few day ago there was a debate in another place in which Lord Milverton made what was, I believe, a bitter and moody speech, castigating the Government of Kenya and, by implication, Her Majesty's Government. I take the opposite view. If we are to spend money in the Colony I want it to be spent on upholding law and justice in ways which I hope to suggest. I hope that the Minister will tell us a little more about the resignation of Colonel Young. I hold the view that this problem of Mau Mau is essentially an African question and can be settled only by Africans and with the cooperation of Africans. We must gain the loyalty and goodwill of the African or we shall never settle this beastly business.

What are we doing to gain the loyalty of the African? In these indiscriminant sweeps which have taken place we are pulling in far too many loyal Kikuyu. On 2nd February the "East African Standard" stated:
"They find themselves bracketed with the suspects when there is any incident or screening operation. They have very little sense of real security, and in some the spirit of bitterness is developing."
One hears of reputable Africans like Tom M'boya, the Secretary of the Kenya African T.U.C., talking about their anxiety regarding screening in the camps and I hope that the Minister will give the figures. I understand that about 50,000 are now in the camps. So far, only about 6,000 have got out to work in the rehabilitation camps, and only 450 have been screened and are back at their lawful vocations.

I think it unfortunate that we should speak about white and black in screening operations. We might use happier terms than whites who are clean, and blacks who are not quite so pure in this conspiracy. I do not think that we have heard all that we should or might. I do not think that Colonel Young and the police under his administration have had a square deal. If, in the conspiracy in Malaya, Colonel Young could have been on the War Council in Kuala Lumpur, why could not he have had the same status in Kenya, with an equally important job to do? If he was good enough for General Templer, I say that he is good enough for General Erskine. I can put it no higher than that.

The régime in Kenya must be based upon justice and not upon fear. The most important development in the last twelve months is the African feeling of good will towards the police. The success of the police since our Parliamentary Mission went there can be measured in the number of cases exposed by the C.I.D. and in the number of Africans coming forward to help the police. There is now more faith in the police than in many parts of the Administration, which is a rather sad thing.

I want to touch upon some of the abuses and misdemeanours that have occurred. It is quite obvious that the Administration wished for a quid pro quo—an amnesty for the Mau Mau together with an amnesty for the Kikuyu Home Guard. I am informed upon good authority that at least 25 prima facie cases of murder in the Home Guard were pending, but those cases have now been dropped because of the amnesty consequent upon the offer of 18th January. Perhaps the Minister will comment upon that matter, because these things are doing us no good either in the Colony or outside.

I hope that first-class law officers, such as Mr. Whyatt and Mr. Griffith-Jones, are getting all the official backing they should get. They are having a very difficult time in this colonial society, and sometimes have to face social ostracism. It is very difficult for them to steer a path of objective justice between black and white, when they do not always have the backing they deserve.

I hope that Mr. Hartwell will continue in the office of chief secretary. He is a man of the utmost integrity. We should do our utmost to back up the men who are fighting this difficult battle against an emotional, ill-inspired and often vicious campaign, not merely against these officers but against Mr. Blundell and Mr. Havelock.

I should like to say a word about Mr. Slade. I have the "Kenya Weekly News" here and am staggered to read what Mr. Slade is reported to have said. He is a very skilful lawyer, but what he has said verges upon sedition. He has apparently been telling the police that they might think twice about helping the Government and the War Council in this emergency. I should not like to think what may happen to Mr. Patel or Mr. Eliud Mathu if they talk upon a communal platform in this fashion.

The Lyttelton Settlement was a bold and imaginative concept, and we are encouraged by the fact that for the first time we have a black Cabinet Minister in Central Africa. The course is set, and we have to go ahead. But the utterances of many Europeans in Kenya do not help this project. If the Lyttelton constitution is upset or capsized, the government of the colony comes back to this House, which is paradoxically what the Europeans do not want.

9.15 p.m.

There are three points upon which the communities differ, and if we can settle these the money which we are now voting will be well spent and we shall move towards a harmonious and co-operative society out there. The three points upon which the communities seem to be split, and on which they are pushing and shoving, are land, education and political representation.

I have not much time to talk about the land question. We all await the Land Commission's findings—and we wait in hope. In the Report of the Parliamentary Commission we gave quite a clear hint. It was unanimous from both sides of the House. I am glad to see the hon. Member for Colchester (Mr. Alport) in his place, because I assure him, if he needs assurance, that his letter in "The Times "and his comments in the House have caused quite a furore in the Colony. This bears out what we all think should be the policy—an honest, open access to any land in the Colony. The test of farming should be that of competent husbandry and not the pigmentation of a man's skin. Let us hope we shall see that recommendation in the Land Commission's Report.

No one in the House or outside thinks that if we give the Africans all the White Highlands, the 16,000 square miles, it would solve all their difficulties. It would not. There is land congestion and land hunger on an enormous scale, and also bad African farming. But the important point is that if we were to allow some of them into the area, it would pay enormous dividends and have an enormous psychological effect in obtaining the good will of the Africans. If we allowed some of them to farm these territories instead of being squatters, as they have been in the past, it would create good will.

The Asian and African races want some kind of multi-racial education. Let us spend some of this money in this Vote upon one good multi-racial secondary school, and give the different colours a chance to live together. As I have always said, we might get a more closely-knit adult society if we attempted something of a closely-knit adolescent or school society. If they meet at school, there is a chance that later, having played games together at school, they will work together in business or commerce, for instance. I hope the Minister will comment on that. I am worried to see that the Europeans in Kenya are talking in terms of a separate European education board. This is a move towards a communal——

I do not think that education arises under the Vote. It deals with expenditure for the emergency and for agricultural purposes, but education does not enter into it.

Charging my memory, I think that the emergency Vote is a comprehensive Vote which includes not only the operations in the emergency but also funds for the future. When this was announced, I think by Lord Chandos, I think part of it was to be spent on social services, including education.

I thought that some of the money was going towards teacher-training colleges, for example, which would be social service expenditure, quite apart from other money spent on sending the Lancashire Fusiliers and other troops to the Colony.

Looking at the terms of the Vote, I see nothing in it about education. There is a reference to agriculture and administration but nothing about education.

I bow to your ruling, Sir Rhys.

In view of the time, may I turn to the last point—popular elections? We are delighted that the Coutts Commission is there, and, of course, we hope soon to have some good news about the franchise for Africans. It would also help enormously if we had an experiment of a common electorate as opposed to a communal electorate. I heartily agree with Mr. A. P. Patel's suggestion of having 10 cross-benchers in the Assembly, elected by a common vote on a common roll.

I end by appealing, if I may, to the European leaders in the Colonies, many of whom I know personally, in the coming months to put the common weal before their own communal and personal interests. In my closing sentences I find it sad to have to tell the Minister that in tonight's evening paper, the "Star," I read that the surrender offer is to be withdrawn. This newspaper stated:
"The Kenya Government are to withdraw the surrender offer to the Mau Mau, Mr. Michael Blundell, Minister without Portfolio, told a hostile meeting of European electors today.
He said, according to A.P., that the Government would make a statement in the Legislative Council tomorrow giving the date of the withdrawal."
I deprecate the whole tone of this announcement, but, even more, I deprecate that it should be announced to a hostile European audience and not made to the Legislative Assembly in Nairobi or by the Minister here in this House.

I have spoken longer than I intended. I hope the Minister will answer some of the questions I have asked him most sincerely because as he knows no one desires more than I to see a happy ending to this business in Kenya.

I should like to join with the hon. Member for Rugby (Mr. J. Johnson) in congratulating my hon. Friend the Member for Armagh (Mr. Armstrong) on his maiden speech, to which we all listened with very great interest. My hon. Friend speaks with considerable personal knowledge. Last September, in Gilgil, I had my only car accident in 20 years. The person I nearly killed was the hon. Member for Armagh. I would certainly have been terribly disturbed to feel that I had deprived this House of the speech he has delivered tonight.

The right hon. Member for Rochester and Chatham (Mr. Bottomley) sought to put a certain amount of blame for our troubles in Kenya on this Government, but far too little is said of the blame which attached to the Socialist Government in the six years prior to our coming into office. [Hon. Members: "Oh."] There is no time to challenge that point now——

—but far too little has been said about it.

I wish to refer briefly to the surrender terms about which the hon. Member for Rugby has spoken. I am sincerely hoping that what is reported in the Press statement is not exactly accurate. We must be very practical. We in this country expect parents to agree to their sons going to serve in Kenya, fighting there and risking their lives. We also expect people in this country to vote this money to help everyone in Kenya. We cannot expect this support if there is no real endeavour to end the emergency quickly. To do so, we must either root out the hard core of Mau Mau or persuade them to surrender.

On the question of trying to root out the hard core of Mau Mau, anyone with practical knowledge of the Aberdares will immediately realise the tremendous difficulties facing our forces there. On the second suggestion, we cannot expect the criminals, however bad they are, to come forward and give themselves up if they are to fear the death penalty as soon as they have done so. Therefore, I personally fully support the endeavours that have been made by the Kenya Government and Her Majesty's Government in order to obtain the maximum amount of surrenders they can. I only have some doubts as to the timing, but we must assume that there was good advice from the people on the spot who must have been satisfied that the timing was right.

My real worry, and I am sure that of many hon. Members, is that the surrender offer may not be as successful as we all wish it to be. I think most of us would also agree that we should at the same time endeavour to press home the military operations as hard as we can.

There have, unfortunately, been misunderstandings about the surrender offer. There was a general belief, certainly when I was in Kenya—my hon. Friend the Member for Armagh (Mr. Armstrong) will, I think, bear me out—that miscreants who surrendered would get off scot free. That, of course, was absurd, but nevertheless that misunderstanding existed, and someone was to blame when there was a lack of appreciation of what the real offer was.

People who criticise an offer of this kind should put forward their own alternative. The real trouble is that people will not put forward alternatives because they cannot suggest them. Therefore, I am deeply concerned in case the voices of the settlers and those in Kenya who disagree with the offer—the hon. Member for Rugby correctly referred to Humphrey Slade; and many of us must deprecate what we have heard he said if the Report was true—should have any deterrent effect and should convey the impression to the wrongdoers that even if they give themselves up, the Government will not keep its word. If this should lessen the chance of success of the surrender offer, the responsibility lays clearly on the shoulders of those who are prepared to make these statements.

I should like to see a stepping up of the rehabilitation of the Kikuyu under controlled villagisation schemes, which are most effective. We do not want unnecessary detention in screening camps for long periods. In my opinion, Kikuyus are being kept too long in these screening camps. Officialdom is moving far too slowly in Kenya, and I hope that my right hon. Friend the Colonial Secretary will be able to give instructions to speed up this work.

I consider that such rehabilitation will make the Kikuyus realise the wisdom of being good citizens for the future and will in itself lead to better conditions. It might even be wise to endeavour to establish clean areas in parts of Kenya. Every sensible person who has the future of Kenya at heart must obviously wish to bring this unfortunate emergency to an end quickly and would fully support the actions of both the Kenya Government and Her Majesty's Government.

It is extremely easy to criticise, and many people here and in Kenya do so only too frequently. It is a different matter, however, when one asks for practical alternative suggestions. In the absence of such alternatives being put forward, we should all do our utmost in this House of Commons to support the Kenya and Her Majesty's Government in endeavouring to bring this very troublesome emergency in Kenya to an end.

I will be brief, because time is short, but I should like first to say how, like other Members of the Committee, I listened with great interest to the speech of the hon. Member for Armagh (Mr. Armstrong), because I know the kind of thing he has been through. I know the country where he has been living, and I, too, was there last autumn. I was to have gone to a farm—and nearly did—if it had not been for another programme that I had to carry out. When I got back to Nairobi, I heard that the owner of the farm had been carried off to the forests—he has since been buried alive—and his wife strangled. So I know the kind of circumstances under which the hon. Member was living.

I quite understand that there are those among the settlers who feel bitter, but all the same, bitterness is no substitute for statesmanship. It is statesmanship we want now. Therefore, I am glad that the surrender offer has been made, and I hope that it will be successful.

9.30 p.m.

I visited detention camps, and my impression is that the right thing is being done there in trying to screen those who have taken the Mau Mau oaths. I was given to understand that it was only those who had taken various grades of the Mau Mau oaths who were put into those camps, and that those who had taken the final oaths were thought impossible to be got right again, and they are likely to be detained in the emergency. All the others, however, are in various stages of rehabilitation, and while I was there a number were being released. I think that that is the right policy.

No doubt there have been mistakes, and a long delay, which should be avoided at all costs, but, as one of the district officers said to me when I was visiting these camps, "What we have to struggle for is the soul of the Africans." We have to get them to understand that we are out to try to help them to help themselves.

The Kikuyu country has been so much overcrowded, owing to a number of circumstances which I shall not now go into, but if the land is properly farmed, it can, I believe, support the whole of that population there, and many more besides. I was much heartened to see the great progress achieved by those wonderful men of the agricultural advisory service. The work they are doing there is excellent. I spent very interesting and valuable hours with them. They are teaching the Kikuyu tribesmen how to prevent soil erosion and how to grow coffee. Coffee is a valuable crop. I saw several coffee plantations belonging to Kikuyu farmers. The agricultural advisory service men are teaching them how they can earn a good living from the land.

Abuses have gone on, undoubtedly, among members of the Home Guard, Kikuyu bullying Kikuyu, and making a shambles of British justice. That has happened, and I am a little disturbed that those Africans who have been guilty of those kinds of crimes against other Africans are apparently to get off. There may be a reason for it, but I should like the Secretary of State, when he replies to the debate, to say something about that. Is it really necessary? Will it not be a grave danger to the sense of justice which we have to instill into the people of Kenya if that kind of thing is allowed? Of course, it has something to do with the resignation of Colonel Young.

Since the resignation of Colonel Young I have had letters from people in Kenya. My impression is that one must be careful in this matter. In a country like this, in a European country or in America, the police must be quite separate from the Executive and from the political side of the system, but in a country like parts of Kenya where there is a civil war going on among Africans, in a country which is still primitive and with a tribal system, things are different.

The African looks to the" provincial commissioner, to the provincial and district officer, as a man who will be his father and mother. We must be very careful not to appear to divide authority. A simple-minded African will not understand the niceties of a constitution and, therefore, there is a good deal to be said for making the police act within the policy laid down by the Governor, the Executive in Nairobi and the provincial and district commissioners. I do not see how we can do anything other than that. Only in that way will we secure the confidence of the African tribesman, who will look to the district officer as his friend and ally.

I am very grateful to hon. Members on both sides of the Committee who have cut short their remarks, and particularly to the hon. Member for Gloucestershire, West (Mr. Philips Price), who recently travelled with me to Kenya and whose keen interest in and knowledge of agriculture and forestry, two of the foundations of Kenya's wealth, I know from first-hand experience with him.

Six colonial Votes could be debated tonight, but I think that we all recognise that Kenya represents to both sides of the Committee and to all our people our most anxious colonial preoccupation. I should like to join with those hon. Members on both sides of the Committee who have congratulated my hon. Friend the Member for Armagh (Mr. Armstrong) on a really memorable maiden speech. In my long time in the House of Commons I do not remember any maiden speech which has evoked from an hon. Member on the other side who immediately followed the description of the speaker as "my hon. Friend." I hope that my hon. Friend will recognise that his moving and encouraging speech has been of the very greatest possible service to this country, and, indeed, to the Commonwealth.

When some of us who know about my hon. Friend's work in Kenya heard that he had been persuaded by his fellow countrymen in Ireland to represent them in the House of Commons, it might have appeared to us at first sight as if it were a loss to Kenya, but it is not so. It is a gain to Kenya that one who possesses such first-hand knowledge and such a broad and humane approach should be here to give us his views on this most urgent problem. I should like to assure my hon. Friend and his constituents that we know that this is not by any means the first, and I am sure that it is not the last, of the contributions of Ulster to the British Commonwealth.

This has been a very interesting, but, unhappily, a short debate. We have had something nearer the atmosphere of the Council of State during the debate than we have had on many occasions. I should like to thank the right hon. Member for Rochester and Chatham (Mr. Bottomley) and the hon. Member for Rugby (Mr. J. Johnson) for the way in which they couched their observations. They both know from first-hand visits a good deal about the problem of Kenya. The right hon. Gentleman will know that the advice given by the Parliamentary mission that selective steps should be taken to deal with Mau Mau and the violent crime in Nairobi—although I believe that it is one which will prove to be one of the turning points in the troubles in Kenya—has created one of the great problems of detention with which we now have to grapple.

I hope that release ultimately will make it selective.

The Committee will be most interested in the new surrender terms and I am very glad to make a few comments upon them. Had the House of Commons been sitting at the times when the surrender terms were announced, I should have taken an early opportunity to talk about them in Parliament. There were two previous surrender offers. There was the "Green branch" offer, as it was called, which was made in August, 1953, and which is still in force. Under it there will be no execution of those who surrender if their offences were the carrying of arms or ammunition or consorting with terrorists.

Then there was, in April, 1954, what was called the "China terms"—ad hoc terms. It was hoped that there would be a mass surrender under which even those guilty of murder would not have been executed. That offer may have failed, and very likely did fail through a tragic accident. The War Council of Kenya has been considering for some time the need for new surrender terms and it was generally accepted between it and myself as representing Her Majesty's Government here that when it was satisfied that the time had come for such an offer to be made it should put it forward. That was done in the middle of January and, of course, it had the full support of Her Majesty's Government here.

It will be remembered that the offer was that all who surrendered from 18th January would not be prosecuted by the Government for any offences connected with the emergency committed before 18th January. That they would be detained and that the period of their detention would depend on each individual case was, of course, clearly understood. I think it is self-evident that it would be quite impossible to put forward a new surrender offer and continue at the same time the Criminal Investigation Department investigations and prosecutions of loyalists who, in the same period, had been guilty of malpractices.

The results of the surrender offer so far show that 127 people have surrendered since 18th January and I am advised that 25 per cent. are what might be called hard core, raising the weekly rate of surrenders from 11 to 31 a week. It is not a spectacular result but a definite improvement. Here, let me say straight away to the hon. Member for Rugby that there is no question whatever of any statement being made tomorrow in Kenya or anywhere else that this offer is being withdrawn. It has always been clearly understood that it would not be an indefinite offer, and I can assure the Committee that it would not be withdrawn on the morrow of a Parliamentary debate here without my telling Parliament all about it.

I know some hon. Members have been disturbed by what they regard as the immunity granted to those who, while loyalists, have broken the code which we all try to follow. But I think it is necessary to get this matter in perspective. The Mau Mau movement reveals that the terrorism has been mainly directed against the African people themselves. No fewer than 465 members of the African security forces have been killed and 1,308 African civilians have been murdered. This is indeed a formidable total. The first job is to try to stop it. It was our duty, and that of the Government of Kenya, to muster all our forces to stop it, including, naturally, the African people who have borne the brunt of the savagery.

It is true that some of these people, embittered by this savagery, have dealt with Mau Mau in their own coin. We cannot all act in the way that David Waruihu has acted and show generosity and far-sightedness. What is the task of the Government when confronted with such a situation? It is to issue clear orders and track down offenders. What have the Government done? They have done exactly that. While they have not covered up anything, they have brought offenders to public trial and in certain quarters there is an outcry by some forms of public opinion.

9.45 p.m.

The substance of the outcry is that these things should not have happened, but they have happened, and they would not have been brought to light were it not for the action of the Government. The Government brought the offenders to trial, the Government have issued the warning and, they have brought these things into the light of day. I think the Government of Kenya are entitled to praise for the courage they have shown under desperately difficult circumstances.

As I have said, the Government of Kenya have had an extraordinarily difficult task. As I shall show, they have had to deal with no fewer than 250,000 interrogations in Kenya. I do not altogether quarrel with the pamphlet issued by the Church Missionary Society. It is entirely sound in much of what it says, but it is written by people who are immersed and torn by the cares of the Kenya situation, just as I, as Secretary of State for the Colonies am immersed and torn—though I recognise that I am not on the spot, but often wish I could be.

In the words of the Bishop of Mombasa, this pamphlet was one-sided and its issue has caused him bewilderment and embarrassment. And all who know Bishop Beecher know of his standing in Africa and elsewhere. I hope that people who take too easily some of the things in this pamphlet will remember that this responsible bishop has said it has caused him bewilderment and embarrassment. It concentrates on one aspect of the tragic situation and deals with the positive achievements of the Government of Kenya in a sentence or two. It has been widely distributed to thousands of people who do not understand the Kenya situation in any detail, and it has given a very exaggerated picture.

I believe it was absolutely essential that the new surrender offer should be coupled with an offer of immunity to loyalists who had committed offences prior to the same date. Indeed, in the light of the information that is now coming in, it is clear what the effect on morale would have been had there been no such gesture at a time when the working of "Opera- tion Hammer," a military operation, has made it more than ever essential for us to be able to rely on the loyalty of the Kikuyu guard to stop terrorists bolting at the forest edge.

The gangsters and thugs and murderers in Mau Mau are coming in, or will come in. We will not let them out, but will keep them in a detention camp for a long period of years. Why cannot we also take under guard in detention camps thugs and murderers who are members of the Kikuyu Home Guard?

I think that that would give a distorted picture. We must not forget the strain to which these people have been subjected, many of whom knew perfectly well, in the early days of the emergency, that it was impossible for their own wives and families to be protected, which families have frequently been subjected to the cruellest atrocities. How can one treat these people, who have thrown in their lot with us and with the future of Kenya, in precisely the same legalistic manner as we are obliged to treat with those who are convinced Mau Mau?

As the Committee knows, there has been continuation of the charges against those where charges had already been instituted. I must confess that this aspect of the problem gave me considerable anxiety. There was, for example, the case of Chief Mundia, whom many of us know. It appeared to me and to the Government of Kenya to be quite clear that, where a case had already been started, it was essential that the case should continue; otherwise, the impression would have got around—to give only one reason—that some information had come to light which the Government of Kenya were anxious should not be disclosed.

In the case of Chief Mundla. I am glad that the judgment declared that the evidence showed that his handwork, his energy and his courage in the discharge of his duties had been of the first order. It is quite obvious that such a man would excite the animosity of Mau Mau.

On the question of timing, I was asked whether it was the right moment to make the offer. I believe it was. I share the views of my hon. Friend the Member for Armagh that there is the beginning of a break in terrorist morale. It appeared to the Government of Kenya and to ourselves to be the right moment. It was a gesture made out of strength at a time when nine battalions were involved in "Operation Hammer" and when there was every indication that the strain of Mau Mau terrorism was beginning to make some real change in the hearts of many of the Mau Mau themselves. It is a time, also, when the farm guards are helping to combat the gangs foraging in the central areas and when the situation in the reserves is so much better that the troops have largely been withdrawn, leaving law and order to the Administration and to the police.

African and Asian opinion has accepted the surrender terms willingly. I understand the difficulties in which many of our European friends find themselves today, but I hope they will take to heart the statements that have been made at different times by hon. Members on both sides of the House. It will be a very heavy responsibility indeed on the conscience of any individual if, in the future, the surrender offer in any particular locality should be largely nullified by rather wild statements made by him.

I must confess that there are indications that in certain areas the surrender offer is looked on as a trick, and it may well be that some of the statements made have led to this reaction. I am very conscious that those who regard this as a breach of principle would be less likely to do so if it were successful, and all I can ask is that the same generous approach should be given to the offer at the start as will no doubt be given to it historically if it is successful.

One or two comments have rightly been made about the resignation of Colonel Young, the Commissioner of Police. I must apologise for the speed with which I am obliged to deal with these most important matters. I am very grateful to the Court of Common Council of the City of London, which released Colonel Young, and to Colonel Young himself for the work that he did in Kenya. No Colonial Secretary who knew also of his work in both the Gold Coast and Malaya could fail to realise what splendid qualities he brought to our aid in Kenya.

The hon. Member for Rugby asked why Colonel Young was not put on the War Council, as he was in Malaya. In Kenya, we have a Ministerial system, a wholly different situation from that which existed in Malaya. The representative of law and order in the Ministerial ranks, Mr. Michael Blundell, is, of course, represented on the War Council. I believe it would be a great mistake if we tried to see the two problems as precisely similar.

Colonel Young and I and the Government of Kenya have agreed on a statement about the causes of his resignation. I believe that, as the statement was freely entered into, it is best to leave it as it stands, but I think I can, in fairness to Colonel Young and to the Administration of Kenya, and to myself as Secretary of State, make a very brief addition to it along the lines of what the hon. Member for Gloucestershire, West said.

The administration of the African areas is based on a policy of developing African constitution and working through African tribal authorities. The Provincial Commissioner is the principal executive officer of the Government, and under him are the district commissioners, the chiefs and the headmen and the tribal police. They have statutory powers under the Native Authority Ordinance. The Provincial Commissioner is responsible for the peace and good order of the province, and any organisation not subject to him as the principal executive officer of the Government would lead to confusion, endanger the structure of African administration, and be absolutely disastrous at the height of an emergency.

I have followed with great care the improvements of the Kenya police, as shown in the Kenya Sessional Paper No. 24 of 1954, and I look with confidence to the highest degree of co-ordination between police, military and Administration. The Government of Kenya are also taking steps to reorganise the Kikuyu Guard on a more regular basis. Nine hundred have been recruited in the tribal police of the Central Province and over 6,000 are forming a tribal police reserve. As the Committee will know, there has also been an inquiry by Sir Vincent Glenday into screening.

A revised system for reception, examination and custody of suspected persons, terrorists and potential detainees is now being worked out. In his provisional report, made on 14th February, Sir Vincent expressed himself as satisfied that the scheme now under way should allay public anxiety. I recognise that there has been a good deal of public anxiety at the slow rate of releases and I am all the time anxious, as are the Government of Kenya, that this should be speeded up, but the magnitude of the problem should be borne in mind. The Government of Kenya were not equipped to deal with this type of emergency and have had to interrogate 274,000 people.

Fifty-five thousand of the detainees were released after preliminary questioning and 108,000 after screening. Of those detained under "Operation Anvil," about 33,000, 10,500 were released almost immediately and another 5,300 after screening. Of the balance, apart from those already classified as hard core, there are still 6,300 awaiting classification. They have to be sent to work camps for final screening locally and the delay, which we all regret and nobody more than the Government of Kenya, is due to the building of those camps and the long and tragic quarantine periods for typhoid in some of the camps.

I recognise that remedial measures to bring back happiness to Kenya must take an imaginative form and apart from dealing with those who have fallen by the wayside in the present terrible period. I am very conscious of my duties as Secretary of State—and the Government are conscious of their duty—for reconstruction and the rehabilitation of detainees and for the building up of a more prosperous and happier Kenya in the future.

The works of irrigation, road work, agricultural clearing and cultivation are being pushed ahead and I am glad to say that I am now getting the most encouraging reports about the work of child welfare in Nairobi and the Central Province. I should like to give a message of good will from the whole Committee to Ministers like Mr. Blundell and Mr. Havelock and others who are carrying on this splendid work in the face of difficulties far greater than those with which any Minister of this Government has had to contend.

I recognise, also, my duties in the distribution of Colonial Development and Welfare Fund money in the building up of a more prosperous Kenya. I am glad to see that the Kenya agricultural plan provides for dramatic increases in the growing of tea, coffee, cotton and pyrethrum, naming only a few crops bringing a better balanced economy and a better distributed wealth to the people of Kenya as a whole.

I am glad that this debate has taken the form of understanding of the great problems in which Kenya is now engaged, of the responsibilities of the Committee for playing a proper part in discharging them and of gratitude to those Europeans, Asians, Africans and Arabs who are cooperating so loyally and bravely in this most difficult, but vital task.

I do not think we ought to pass this Vote tonight, if we can keep it open from now until March so that we can discuss it further at any time. I am not quite sure that I agree with the Colonial Secretary that this debate has been like a Council of State debate, in which everybody agrees with everybody else.

It being Ten o'clock, The CHAIRMAN left the Chair to report Progress and ask leave to sit again.

Report of Resolutions to be received Tomorrow; Committee also report Progress; to sit again Tomorrow.

Central Land Board Payments Regulations

Order read for resuming Adjourned Debate on Question [15th February]:

That an humble Address be presented to Her Majesty, praying that the Central Land Board Payments Regulations, 1954 (S.I. 1954, No. 1599), dated 1st December, 1954, a copy of which was laid before this House on 6th December, be annulled.—[Mr. A. J. Irvine.]

Question again proposed.

10.1 p.m.

The Parliamentary Secretary to the Ministry of Housing and Local Government
(Mr. W. F. Deedes)

When I was interrupted by the clock last night, I was in the course of replying to questions from the hon. Member for Edge Hill (Mr. A. J. Irvine) and the hon. and learned Member for Leicester, North-East (Sir L. Ungoed-Thomas).

They raised three points. Two were minor ones, and the other was of some substance. It will be convenient to deal with the minor points first. The hon. Member for Edge Hill mentioned Regulation 6 (3) of Statutory Instrument No. 1599. He referred to our proceedings in Committee on the Town and Country Planning Bill and complained that nothing had been done to remove doubt then expressed about which the appropriate body was to decide when a person was a person:
"… entitled to an interest in land which is substantially affected by that apportionment. …"
I think that his doubts are resolved by Regulation 6 (1) which says:
"Subject to the provisions of paragraph (2) of this regulation, if the applicant wishes to dispute the Board's findings, or if any other person, to whom particulars of an apportionment have been given or who claims that he is entitled to an interest in land which is substantially affected by an apportionment, wishes to dispute that apportionment, he may within 30 days of the issue of the Board's findings, give notice in writing to the Lands Tribunal that he disputes the findings, or as the case may be, the apportionment, and thereupon the dispute shall be referred to that Tribunal…"
In those circumstances, it is for the Tribunal to settle the question, as a preliminary point of jurisdiction, whether that person should be heard or not. There are arrangements for that to be done.

It is fair to add that the Board can inform those whom they believe have an interest, but, of course, they cannot divine who has an interest. They cannot guess who it may be. Therefore, the onus of discovering what is going on rests with the person who is interested and who wishes to intervene. It can hardly be otherwise. I think that it would be accepted by the hon. Member that the Board cannot take the initiative. If there is a party who feels that he has a part to play or a claim to make, he must take the initiative, and I think it will be agreed that under Regulation 6 (1) he has an opportunity to make his point.

The second point the hon. Member made was on the difference between Statutory Instruments 1599 and 1600. No. 1599 requires an application for payment to be made:
"… on a form issued by and obtainable from the Board. …"
No. 1600 says:
"A claim …shall be made in the form, or substantially in the form, prescribed by the schedule. …"
There is nothing sinister about this. It is a simple administrative point. The explanation is that it was just not possible to put the printing of the forms relating to Statutory Instrument 1600 in hand until rather late.

And so the Regulations were framed to enable claims for compensation to be made even though the forms were not obtainable. If they can get them, of course everyone would prefer to have a printed form, particularly if they can get one free. In fact, the Central Land Board sent out 30,000 forms to people whom it believed to be entitled to a payment. The hon. Member can check the accuracy of what I say if he looks at the date of the respective forms, because he will see that the form to which I refer was printed in December, 1954.

What happens in the case of the Regulation where the application has to be in the prescribed form and, because they are out of print or have been destroyed by fire, the forms are not available? Why is precisely the same form of words used in that case as in the other Regulation?

If the applicant can make it clear that the required form was unobtainable, I have no doubt that his claim would be accepted.

I think that is a point which might be left to the discretion of those who have to judge the claims.

That is exactly the kind of thing which is so intolerable. Either these Regulations have a meaning and should be followed and should be binding on absolutely everyone, including civil servants, the Lands Tribunal, the Central Land Board and everyone else, or they should not be binding on everyone. It is utterly unjustifiable for the Minister to say that these Regulations are binding on the citizen but only binding upon civil servants and the Tribunal and the Board at their discretion. His explanation is rather extraordinary. Will not the hon. Gentleman reconsider this Regulation in the light of his own argument?

I think that the hon. and learned Gentleman has misunderstood what I said. He asked what would happen to someone unable to obtain the prescribed form who made his application on another sort of form. The implication of what he said was that the claim would be rejected. All I was saying was that clearly it would not be. Of course it is binding on the authorities to provide the proper form, and that is understood. As the hon. and learned Gentleman knows, this is repeated in legislation introduced by his own Administration, and is more or less uniform throughout town and country planning.

Order. The hon. and learned Gentleman has already spoken twice on this Motion. He is only allowed one speech.

With respect, Mr. Speaker, I am not making another speech. I am only asking for elucidation of what the Minister has said. I hope that is in order.

If it is a short point, but we cannot allow the debate to degenerate into a conversation.

May I leave it like this: I will ascertain what will be the situation if these forms are not available and if an applicant failed to get a form, and I will undertake to satisfy the hon. and learned Member on that point.

We come now to the major point raised last night. The hon. and learned Member for Leicester, North-East (Sir L. Ungoed-Thomas), in particular, was concerned with the wording of Regulation 5. He described it, as did his hon. Friend, as bureaucracy at its worst, and so on. I should like to go through Regulation 5 (1) rather critically, and I think that it would be for the convenience of the House if that were done sentence by sentence.
"The Board shall consider any particulars supplied pursuant to the last preceding regulation"—
there is nothing wrong about that—
"and cause such investigations to be made and such steps to be taken as they may deem requisite for a proper determination of the application …"
I think that is fair enough, because there are things to be verified and values to be checked and so on. Some of these payments relate to transactions in land where the purchaser may have his story to tell as well as the vendor. Finally, when the Board has done everything necessary for the proper determination of the application it shall,
"thereafter determine the amount of the payment …"
That is what they are there for.

We now come to the proviso about which the hon. Gentleman is concerned, and I appreciate the point he made. First, it must be remembered that the form of application which is issued has been deliberately kept as simple as possible. In the more complicated type of case—for example, the analagous cases dealt with under Section 10—additional information may be required. Sometimes the applicant may not fill in the whole form. In such a case the Board will have to seek additional information before it is in a position to determine the application, and it is given the necessary powers to do so under Regulation 4 (1) and (2).

What is to happen if the particulars or evidence required by the Board are not forthcoming? If it is a case where the information already supplied is inadequate, the Board is likely to defer the determination of the application until the evidence is available. That is the most likely course. On the other hand, information may reach the Board from another source. It may be able to fill in the gaps through its own knowledge, and may then feel that it is best to settle the claim.

But there is another possibility. What is to happen if the information is forthcoming but is not accurate? I use the words "not accurate" with some care, because it may be accidentally wrong or—and this must be admitted—deliberately falsified. Let us assume the more innocent of those possibilities—that misinformation has been quite innocently provided. How does the Board know that it is wrong? Again, it may have to obtain its information from more than one source. That will be so in many cases. Secondly, there may be inconsistencies in the one application which make it quite clear that one part of the information is not correct.

In those circumstances, the Board is in duty bound to ignore the information which appears to it to be false. What is the alternative? If it takes the informa- tion into account and determines the amount payable at a higher figure than it would otherwise do, that is a misuse of public funds. It may be said that the decision whether the application should be taken at its face value has to be taken at the Board's discretion. I think that the right hon. and learned Gentleman would agree that the Board is bound to check and cross-check the information.

But this is not the last check. As my hon. Friend the Member for Oldham, East (Sir I. Horobin) pointed out yesterday, the applicant has a remedy if his information is wrongly interpreted. If, as a result of the Board's action, an amount is determined at a lower figure than the applicant thinks right, under Regulation 6 (1) he can take the matter to the Lands Tribunal. It may be asked why the Board is so anxious to determine an application in these circumstances and why it should not defer the decision until the applicant takes some different action. The answer is that the amount payable to some other person may depend upon that which is payable to the first applicant.

There is a queue in this matter, and a certain order of priority. For example, a vendor who sold land at a price somewhere between the restricted and full value may be entitled to a payment under Section 5, and the person who bought it from him may be entitled to a payment under Section 11, or under Part II or Part III of the Act. The amount payable to the purchaser depends upon what is left of the claim upon the fund after the claim has been paid; and so the application of the first person cannot be left undetermined indefinitely. As long as it is left indefinitely undetermined, someone else is waiting. That is therefore a reason for some element of time to be taken into consideration and for establishing priorities.

I have gone through the Regulation in some detail, and I am bound to say that I regard what I have said as a more reasonable explanation than the interpretation which the hon. and learned Member put on it last night. I hope he will now see it in that light.

10.15 p.m.

I rise to make only one very small point on a matter which is of some practical importance in the adjudication of these claims. My hon. Friend the Parliamentary Secretary has referred to Regulation 6(1), which governs the determination of disputes and under which the jurisdiction of disputes is given to the Lands Tribunal, which is an admirable body for these purposes; but the difficulty about that provision, as I see it, is that the notification of disputes has to be made within 30 days of the issue of the board's findings.

In connection with the time limit for lodging claims, 30thApril, to which some exception has been taken, there is a proviso in Regulation 3 allowing the board to make an extension of time. There is no such proviso in regard to the time limit of 30 days for the notification of dispute, and, in my submission, it is all the more important to have some provision for the extension of time in that notifications may be made not only by people who are claimants but also by people who, not having themselves made a claim, then take the point that they are entitled to an interest in land in respect of which somebody else has made a claim.

Those are people who, of course, are not apprised of the matter at all, or not necessarily apprised, at the time that the initial claim is put in, and 30 days without any provision for extension, one would have thought, is, therefore, an unduly short time for the limiting of the notification of dispute with the Board.

Under Regulation 7 (2), if the notice of dispute is not made within those 30 days, then the finding becomes conclusive for the purposes of Section 14 of the Act. As the House is aware, most time limits of this sort, for example in the rules of the Supreme Court, are subject to a provision for extension of time, and I am very apprehensive that injustice may result if some provision for the extension of this 30 days' limit is not written into these Regulations. I hope my hon. Friend will bear that in mind and, in due course, will be able to amend the Regulations.

10.18 p.m.

Dealing with the points which have been raised by my hon. and learned Friend the Member for Leicester, North-East (Sir L. Ungoed-Thomas), I was a little surprised at the line which the Parliamentary Secretary took on the question of that prescribed form.

After all, if the Regulations require the claims to be made in the prescribed form, I should have thought there was no answer to my hon. and learned Friend's contention that that binds everybody, both the person who makes the claim and the person who receives it and has to adjudicate upon it.

I understand that "the form "means the form of words and that it need not necessarily be the exact piece of paper as printed by the Stationery Office and handed out. If a person who is studying the italic form of handwriting thinks that his claim would look better in that form of handwriting, then if he gets the exact words and fills in the blanks properly, as I understand it his application is in the prescribed form.

But what my hon. and learned Friend was assuming was that the supply of forms had run out, there were none available and the person concerned was unable to get somebody else's form from which to copy.

I understand that as between these two Regulations provision is made in the other for such a contingency, but in these Regulations it is not made. One, therefore, must hope that there will always be a sufficient supply of forms, either to be handed over the appropriate counter, or available to be copied if that is the only way in which the thing can be done when the last form on the pile has been reached. I imagine there would be no difficulty about that.

There is no doubt that as the proviso to paragraph 5 of these Regulations is worded there is a very wide discretion left which on the explanation of the Parliamentary Secretary is not needed. The words in the last line but one of the proviso are:
"in so doing may disregard any particulars already supplied…."
What I understand the Parliamentary Secretary to mean is that that should be limited to incorrect particulars. If the particulars supplied are correct clearly they have to be given judicial consideration by anyone who is to adjudicate on the claim. If that is the interpretation I think that the Regulations would have been improved if the word "incorrect," or a word of similar meaning, had been put in before the word "particulars" to make it clear that if accurate information is supplied it will not be ignored.

10.22 p.m.

I am grateful to the Parliamentary Secretary for the care he has given to the points raised by us on this Regulation. But one matter emerges which, on analysis, I think can only be described as laughable. We had thought that Statutory Instrument No. 1600 and also the Regulations governing the procedure for reference to the Lands Tribunal were more flexible and satisfactory than this Regulation because they gave greater consideration to the public and persons concerned in not requiring the use of the prescribed form. We are now told that that is simply due to the fact that there was a danger that an insufficient number of printed forms would be available. This is bureaucracy reduced almost to the ultimate farce.

Here was a provision contained in Statutory Instrument No. 1600 and also in the Regulations governing reference to the Lands Tribunal which affects estate agents and persons with an interest in property and was regarded as being helpful in character. We now learn that the sole explanation of that helpfulness is the danger that the forms may run out. Whilst thanking the hon. Gentleman for the kind attention given to the points raised, I must remark that that explanation cannot be regarded as satisfactory.

As to the point I raised on Regulation 6 (3), it could not have been clearer from what the hon. Gentleman said that the question of whether a person is entitled to an interest which is substantially affected so that he may refer to the Lands Tribunal is to be treated as a preliminary point by the Tribunal. Those were the words of the hon. Gentleman and they were perfectly clear. But why not say it like that in the Regulation? It is nowhere expressed there. The lawyer and the layman alike will have difficulty in determining from the Regulation as it is worded how this question is to be dealt with. We hear from the Parliamentary Secretary, and it will be contained in the Official Report, that it is a preliminary point for the Tribunal, but that, alas, will not receive the circulation and atten- tion that this Statutory Instrument will receive among the people affected.

With regard to the Regulation 5 proviso, I entirely agree with my right hon. Friend the Member for South Shields (Mr. Ede) that there would be no objection if the Board was empowered to disregard incorrect or inaccurate particulars. The proviso would not have been criticised in this debate had that precaution been taken; but as my right hon. Friend pointed out, what is inequitable and open to objection is that the Board is given explicit power—it is invited, as it were—to disregard particulars submitted without any reference to their correctness or incorrectness, their accuracy or inaccuracy. I should have thought that this would be generally agreed to be most unsatisfactory.

Nor is it any additional answer to say, as the Parliamentary Secretary has said and as the hon. Member for Oldham, East (Sir I. Horobin) said yesterday, that this was nothing to worry about because one could go to appeal. That is not at first sight a satisfactory answer. Even on analysis, I do not think it is satisfactory. What kind of prospect of success would an appellant have if he took this issue to the Lands Tribunal and that Tribunal was made aware that the Central Land Board had arrived at its determination having disregarded certain particulars which it had been empowered by Parliament to disregard? The prospect of success in a appeal, in the context which I have invited the House to consider, would be negligible.

I cannot help feeling that the whole problem of the delegation of powers, and far too often arbitrary powers, to administrative tribunals is still an unsolved problem and one of the most important problems of our time. I believe that it is the duty of Ministers when considering Regulations emanating from their Departments to check Regulations with that overriding consideration in mind. In this instance, the Minister has failed in that duty and he has perpetrated in these Regulations one of the worst examples of the dangers of which I speak.

Question put and negatived.

Hospital Service, South Wales

Motion made, and Question proposed, That this House do now adjourn.—[ Mr. R. Thompson.]

10.29 p.m.

I propose to draw the attention of the House to the National Health Service, with particular reference to the hospital service in South Wales. We heard from the Minister this afternoon of the improvements that have taken place in the Health Service since the hospitals were nationalised. Many of our problems have been solved, but it is my task to draw attention to some of the problems which still remain for us in the Principality.

Since the hospitals were taken over there has been an increase of nearly 40,000 a year in the number of in-patients in Wales. There has been an increase in the number of out-patients of over 160,000 a year, but there still remains a waiting list of 36,000 people who are anxious to get into hospitals for treatment. In the City of Cardiff alone there are no fewer than 10,000 people awaiting admission to hospitals. Some of them have been waiting for years. This is nearly a third of the waiting list for the whole of Wales, and of the beds that are available in the Cardiff hospitals, 60 per cent. are in buildings which were established before the First World War, and some of them as long ago as the last century.

In view of our problem, many hopes were raised by the Minister's statement in the House last week. They were false hopes. We have had the principle of the establishment of a new teaching hospital in Cardiff approved for the past five years. This Government and the previous one held up the establishment of that hospital for various reasons. The statement made by the Minister last week was misleading in the case of Wales at least, for people believed that he would not have made a statement to the House about the provision of this new teaching hospital in Wales unless the Government really proposed to do something about it or provide more hospital bed accommodation in the City of Cardiff.

The Minister's statement, on examination, makes it perfectly clear that neither this Government nor the succeeding Government will have to pay for the provision of a teaching hospital in Cardiff. We shall be very lucky if the Government after the next one will be dealing with this question of a new hospital. What is clear is that we shall be more than fortunate if, during the next decade, we have a new teaching hospital established within the boundaries of the city.

The Board of Governors of the United Cardiff Hospitals have, understandably, gone on record in favour of the new teaching hospital as opposed to the extension of the Llandough Hospital, but I am hoping that, in view of the waiting list of 10,000 in the City of Cardiff and 36,000 in the Principality of Wales, the Minister will now communicate to the Board of Governors that he will sanction the immediate development and extension of the Llandough Hospital.

This is not propaganda, but something practical that the Minister can do to relieve our problems in Wales. The Llandough Hospital has all the facilities for a hospital of 900 beds. It has about 350 beds. It has the administrative block, the kitchen and the laundry and all the equipment necessary for the 900 beds. Llandough Hospital is itself a teaching hospital, and at a minimum cost we could provide nearly 550more beds within the year. Also, we could provide new medical teaching in the Principality.

We have a right to ask for urgency and priority in this matter. There is in Wales an overall shortage of 3,000 beds, compared with the facilities here in England. According to the information that I have been able to glean, Wales has about 1,000 more beds for tuberculous patients than exist in England, and we are better off for accommodation in mental hospitals, as distinct from hospitals dealing with mental deficiency, than our English brethren. We are better placed for maternity beds, but, for general beds, Wales is 1,000 down and is also 1,000 short in accommodation for the chronically sick. In mental deficiency we are 1,500 beds short, compared with England.

It is not fair merely to recite problems to the Parliamentary Secretary; I want to put one or two constructive suggestions which, I hope, will help her examination of the problems. The problem of the chronically sick disturbs anyone in public life. They would be far better off if treated in their own homes, if adequate nursing and other facilities could be provided. Will the Ministry consider the establishment of a wider domiciliary nursing service for the chronically sick? They will feel better in their own homes, and the hospital beds can be given to acute and urgent cases, thus helping to relieve the waiting lists.

The Minister is faced with an urgent need for more nurses. In South Wales, we have by agreement to transfer nurses from general hospitals to tuberculosis sanatoria. Could the Minister ask the General Nursing Council to include in the qualifying experience of nurses that they shall serve a period in tuberculosis sanatoria or mental hospitals? I make those suggestions with the best intentions, and I hope they will be looked at.

Last week, the Parliamentary Secretary created the impression that a lot of new building is to go on in Wales. How many hospital management committees in Wales have, during the current year, been prevented from spending what they thought was necessary for the ordinary amenities of their hospital service?

I am indebted to my hon. Friend, who is well-informed on this subject. I am told that the Talgarth Sanatorium was prevented by the Minister this year from providing 50 lockers for the patients to have alongside their beds. Mean and squalid economies have been made during the past year. I earnestly hope that the Minister will be able to give hospital management committees in Wales a message of hope by her reply tonight.

10.39 p.m.

I support generally the case put forward by the hon. Member for Cardiff, West (Mr. G. Thomas). He put it extremely fairly. As he said, Wales is better off in provision for tuberculosis and certain cases of mental illness, and even for maternity cases, but is decidedly and dangerously worse off than most of the country for beds for general cases and mental deficiency. At this very moment the Department are considering three or four cases which I have sent of persons who have been waiting for a very long time to enter a hospital for treatment which their doctors say has been necessary for a long time.

As I think my hon. Friend will appreciate, that is not the whole picture, because I do not trouble her Department unnecessarily with these cases. I generally take them up, first of all, with the local health division so that they may, if possible, be dealt with locally. I can assure her that, in addition to the cases which are being considered by her Department, there are certain other cases which I have had referred to me by constituents.

I should also like to stress that we have heard with great interest in Wales, as in the rest of the country, of the new plan for hospital building which has been announced. I have a Question to put on that topic shortly. I hope—I am sure that the hon. Member for Cardiff, West does, too—that Wales will have a fair crack of the whip in respect of the new development.

10.41 p.m.

The hon. Member for Cardiff, West (Mr. G. Thomas) has tonight ridden at least one of his pet schemes on which he knows there is certainly not majority agreement in the Principality of Wales.

I will first deal with the very controversial comments that he has made about the new Cardiff teaching hospital. I think it is fair that we should get the matter in proper perspective. This is quite the largest single hospital building scheme that has been projected since the war. In fact, a teaching hospital has not been built since the 'thirties, when the Middlesex Hospital was completed.

The need was accepted by the then authorities in Cardiff and was confirmed after the appointed day by the board of governors, and the Ministry accepted the governors' proposals and conceded high priority for the scheme. As the hon. Member was fair enough to say, no hospitals, small or large, were started during the six years of the previous Administration, and it was not until last year that we were able to start, when the first new hospital under the National Health Service began building, and that was a mental hospital.

The three-year programme announced by my right hon. Friend takes nothing away from the priority given to the Cardiff hospital scheme. The first problem in connection with the Cardiff scheme—I think it is fair to give the time-table of the negotiations—was to find a site. That was agreed in March, 1950, when 53 acres were obtained from the city council.

The hon. Member for Cardiff, West knows very well his countrymen's desire to run their own show in these matters. He also knows the enormous amount of planning involved and the many technical changes in hospital construction which have taken place since the last hospital was built in the 'thirties. The four parties concerned—the University of Wales, the Cardiff Medical School, the Board of Governors and the Welsh Regional Hospital Board—formed a working party, and its report giving detailed schedules of the requirements desired in respect of the hospital was not ready until April, 1953, when it was presented to the Department. With an estimated cost of £5 million for the hospital and £1 million for the school, the total expenditure came to more than half the whole of the capital expenditure for England and Wales in any year since the Health Service came into operation.

This Government are, at least, projecting doing it.

The document was then submitted to the Ministry of Health and the University Grants Committee. In a very great and what will be a lasting project of this kind, which involves the expenditure of £6 million, it is obvious that a very detailed and critical examination is called for. In view of the building programme with which it is now possible to go ahead, I can assure the hon. Member that the matter is being treated with urgency. However, he has to consider the decision agreed by the Welsh authorities. It is a great project, being the first of its kind in the country and the first of such magnitude in Wales.

To get the benefit of the best possible design for this most important development it has been agreed by the authorities in Wales to put this out to architectural competition. That, I frankly admit, makes the job longer, although I think that it must be agreed that, for a project of this great importance, it is the right decision to take. It has been necessary to go very deeply into this project, and there has been the precaution taken in respect of the rules of the Royal Institute of British Architects whereby the winning architect automatically becomes entitled to his fees from the time that the plan is accepted; and, had that run through the time of the past and the present Government, it would have gone into several thousands of pounds of money which could be better used elsewhere in the National Health Service.

But the Treasury has accepted the principle of a competition and it will be possible to launch the scheme as soon as the schedules of accommodation are agreed with the authorities in Wales. Since this method of competition has been agreed and accepted by all parties, it would be wholly misleading to talk of an early start for building. There is no delay on the part of the Ministry, and it would be, as I have said, wholly misleading to try to think of a date within the next two years.

The experts on this subject give their opinion that an interval of two years—for research by entrants, for completion of designs, for the adjudication, for the final detailed drawings, and for quantities and tenders—would be unavoidable. That is a purely technical problem which is, to some extent, the result of there being an open competition. I would, however, reaffirm the statement made last Wednesday by my right hon. Friend the Minister of Health, that this project has top priority, both in England and Wales. I reaffirm that we approve the project and want to see it fulfilled and that there will be no unavoidable delay on our side.

But we have given it the "go ahead."

This project is planned to provide 1,000 beds, and although I know that it has been a proposal raised more than once in this House by the hon. Member for Cardiff, West, neither the Welsh Board of Health, nor the Board of Governors, has accepted the Llandough Hospital scheme. It is all very well for the hon. Gentleman to think that this is a temporary measure, but it would, in fact, entail a considerable building project which would take resources from other projects required permanently; whereas, when the new Cardiff hospital is provided, the thousand beds to which I have already referred, will be adequate for that particular locality.

Llandough Hospital is three miles outside the city—it is not in Cardiff—and it has not the accommodation available for the residence of students who would be required; and it is not readily accessible to meet the demand which he makes for out-patients from outside Cardiff. All the Welsh authorities have turned down the scheme, and, had I taken a contrary view, the hon. Gentleman would have been the first to have told me to leave the matter to the authorities on the spot.

I should say something about capital developments. Since July, 1948, the Welsh Regional Hospital Board has spent about £3½ million on capital works. The hon. Gentleman knows of the new maternity home at Cardiff Royal Infirmary—that was £400,000—and the new X-ray department for Llanelly Hospital; the new pneumoconiosis department at the Llandough Hospital, and the new orthopaedic centre which has so dramatically reduced the waiting list in what is a very grave problem in his area. When one looks at the whole thing, there are no fewer than 23 items of capital work. Few regions in the country can show such an impressive list of capital schemes authorised, and either completed in the last 12 months, or nearing completion, as South Wales. This is surely ample testimony of the very fair slice of the capital expenditure which this area has had.

On the question of the hospital management committees and the necessity for keeping under the regional allocation, and, in turn, the national allocation, the committees were not coerced into a reduction. Many committees, in submitting their estimates, put in figures which in the aggregate came to more than the regional hospital boards were obtaining; and we at the Ministry do not keep back a nest egg that we can dole out in bits.

We give the maintenance allocation to the 12 regional boards. If, during the year, there is under-spending—as sometimes occurs if hospitals have estimated to open a wing and it is not opened in time with the result that there is a saving on staff and on food, and so on—then we deliberately give the additional allocation, where we can, to another region.

In point of fact, the Welsh Regional Hospital Board is being allowed £13 million for running costs, and the Cardiff Board of Governors is being allowed £860,000. I want to make it plain that when the Regional Board asked for the co-operation of the hospital management committees in trying to prune their estimates, to keep within the overall budget, we have had the greatest co-operation from 21 out of 22 hospital management committees. Even though they did make certain economies, there was quite a considerable over-spending, some of which will be met by the Supplementary Estimate, the acceptance of which I moved in Committee earlier today. Certainly, Wales has not been treated more unfairly than any other region; it has had a very fair share of capital and of maintenance money.

I cannot accept the hon. Member's high figure of a shortage of 3,000 beds. He very fairly said that in tuberculosis, and mental health as distinct from mental deficiency, and in maternity beds, Wales is much better off than England. It is expecting a lot that the hon. Member should want to be better off than England in everything, although I do not deny that we should like to remedy the deficiencies in every area. In general hospital, mental deficiency and chronically sick beds they are less well placed.

The Cardiff Teaching Hospital will provide 1,000 more beds. On the mental side, expansions already under way will provide for some 440 beds, and further plans are being considered for providing between 400 and 500 more. So, progress is being made. Taking the questions as they come, the beds are being provided for orthopædic cases, extensions are being provided on the mental deficiency side, and the main general hospital—the vast project of the teaching hospital—is also approved.

I agree with the hon. Member on the question of the chronically sick. Their problem in beds is 0·9 per 1,000 as against 1·1 in London. Admittedly, there is a real problem. I agree with the hon. Gentleman that a great deal could be done by the local authorities. Indeed, my right hon. Friend has pressed for increased facilities for the local authorities not only to prevent people who could be nursed at home from going into hospital, thus to leave beds available for those who must be admitted for treatment, but also to enable people who can be rehabilitated to go home again if they can get some domestic help. One of the problems, particularly in industrial areas, is obtaining staff and many local authorities would increase the numbers if they could obtain the additional staff. This is a matter on which we are very ready to see the services expanded to meet the needs of the people.

There has been a real improvement in the tuberculosis figures all over the country, particularly in Wales, where the problem was graver than in most areas and where the number of beds per 1,000 of the population is substantially higher than in England—1·2 per 1,000 against 0·74. There are now 2,900 beds available, including 324 made available from other services not now required. Of these,170 are unoccupied through lack of staff. I agree with the hon. Member about the urgent need for staff for nursing tuberculosis patients. It is difficult, because there is still prejudice which seems to be very apparent in South Wales. The Welsh Board of Health and the regional boards are co-operating with the hospital authorities and doing all in their power to concentrate recruiting on this and mental nursing. Various methods of recruiting nurses are being pursued, and I hope that there will be some response from the local population.

The hon. Member will be aware that the General Nursing Council sets the curriculum and standards of nursing. While not making it compulsory, it has encouraged teaching hospitals to second nurses to take special tuberculosis training. We have had much help from that source in the London area. It is a voluntary measure which has proved successful over the country. It is considered that compulsion would not achieve better results and might deter some people from taking up nursing altogether. The voluntary appeal has been very successful where it had the full support of the matrons who were losing nurses, which is a very important factor.

Results in Wales have not been as good as we could wish, and there are empty beds which we should like to see opened if the necessary staff could be obtained. The general figures are dramatically better, in the incidence, in the deaths, and, indeed, in the admissions of tuberculosis patients. I am sure that the hon. Member knows that two thoracic consultants have been appointed and that this has done much to reduce the waiting list of thoracic surgery.

The picture is one or great improvement in many specialities over the past three years, and I believe that before three Governments hence the hon. Member will be able to attend the opening of his Cardiff hospital.

Question put and agreed to.

Adjourned accordingly at one minute to Eleven o'clock