House Of Commons
Friday, 24th March, 1972
The House met at Eleven o'clock
Prayers
[Mr. SPEAKER in the Chair]
Northern Ireland
11.5 a.m.
With permission, Mr. Speaker, I will now make a statement about Northern Ireland.
This House has debated the affairs of Northern Ireland on many occasions in recent months. All of us in this House deplore the grievous suffering inflicted upon its innocent people by the continuing campaign of lawless terrorism and we admire the steadfastness with which they have attempted to sustain the life of the Province. Throughout this period Her Majesty's Government have maintained close consultation with the Northern Ireland Government. We have made repeated attempts with all concerned to promote discussions to find an agreed solution to the problems of Northern Ireland. At a meeting which my right hon. Friends the Home Secretary, the Lord President, the Defence Secretary and I had with the Prime Minister and the Deputy Prime Minister of Northern Ireland on 22nd March we made it plain that in the British Government's view new and more radical measures were necessary if there was to be any prospect of breaking out of this deadlock. We made three main proposals. First, in the hope of taking the Border out of the day-to-day political scene, and as a reassurance that there would be no change in the Border without the consent of a majority of the people of Northern Ireland, we proposed periodic plebiscites on this issue. Second, we proposed that a start should be made on phasing out internment. Third, we were concerned about the present division of responsibility for law and order between Belfast and Westminster whereby control remains largely with the Northern Ireland Government while operational responsibility rests mainly with the British Army and, therefore, with the United Kingdom Government. This responsibility is not merely domestic; it is a matter of international concern as well. We were also well aware that the control of law and order was a divisive issue in Northern Ireland, and we thought that there would be advantage in seeking to take it out of domestic politics in Northern Ireland, at any rate for a time. We therefore told the Prime Minister and Deputy Prime Minister of Northern Ireland that we had reached the conclusion that responsibility for law and order in Northern Ireland should be transferred to Westminster. The first two of our proposals were in principle acceptable to the Northern Ireland Government. But Mr. Faulkner told us that his Government could not accept proposals for the transfer of responsibility for law and order from Stormont to Westminster. At a further meeting yesterday evening he confirmed, after having consulted his Cabinet, that this was its unanimous view, and that if any such proposal were implemented, it would entail the resignation of the Northern Ireland Government. The United Kingdom Government remain of the view that the transfer of this responsibility to Westminster is an indispensable condition for progress in finding a political solution in Northern Ireland. The Northern Ireland Government's decision therefore leaves them with no alternative to assuming full and direct responsibility for the administration of Northern Ireland until a political solution to the problems of the Province can be worked out in consultation with all those concerned. Parliament will, therefore, be invited to pass before Easter a Measure transferring all legislative and executive powers now vested in the Northern Ireland Parliament and Government to the United Kingdom Parliament and a United Kingdom Minister. This provision will expire after one year unless this Parliament resolves otherwise. The Parliament of Northern Ireland would stand prorogued but would not be dissolved. The present Prime Minister of Northern Ireland has agreed to continue in office until this legislation is passed. The increased burden which this transfer of responsibilities will entail means that it will no longer be possible for my right hon. Friend the Home Secretary to discharge these duties in addition to his many other responsibilities. A new Office of Secretary of State for Northern Ireland is, therefore, being created. My right hon. Friend the Lord President is to be appointed to this office, together with the necessary junior Ministers. He will be empowered by the new legislation to appoint a commission of persons resident in Northern Ireland to advise and assist him in the discharge of his duties. It will be our objective to invite to serve on this commission a body of persons fully representative of opinion in Northern Ireland. Her Majesty's Government, having assumed direct responsibility for law and order in Northern Ireland, will be no less concerned than the Government at Stormont has been to overcome terrorism and bring violence to an end. We shall do all we can to protect life and property in a part of the United Kingdom which is no less our responsibility than any area of Great Britain As long as active terrorism persists and bombings and shootings continue, and until respect for law and a normal situation of order have been restored throughout the Province, we must retain the power to arrest and inter those who there is good reason to believe are actively involved in terrorism and violence. But a reduction of tension is the essential first step in the process of reconciliation. We believe that that requires that we should make a start in the process of bringing internment to an end. We intend within the next few weeks to set free, subject to safeguards where appropriate, those internees whose release is no longer thought likely to involve an unacceptable risk to security. The Secretary of State for Northern Ireland will establish a procedure to review each case personally. If the measures which we have taken lead to a reduction in terrorist activity, it will be possible to consider further releases; but this must depend on a clearly established improvement in the security situation. Thus in the matter of internment, as in the next matter to which I shall refer, we are giving effect to a proposal which we put to the Northern Ireland Government and which in principle they accepted. This Government, and their predecessors, have given solemn and repeated assurances that the position of Northern Ireland as part of the United Kingdom will not be changed without the consent of the people of Northern Ireland. We have decided that it would be appropriate to arrange for the views of the people of Northern Ireland to be made known on this question from time to time. We therefore propose in due course to invite Parliament to provide for a system of regular plebiscites in Northern Ireland about the Border, the first to be held as soon as practicable in the near future and others at intervals of a substantial period of years thereafter. These plebiscites will be in addition to, and not in substitution for, the provisions in the Ireland Act, 1949, which require the consent of the Northern Ireland Parliament to any change in the Border. This position is not prejudiced by the temporary prorogation of that Parliament. We hope that this arrangement, while leaving open the possibility of a change in the status of the Province if the majority so wish, will both confirm that no such change will be made without their consent and provide, in the intervals between plebiscites, a greater measure of stability in the political life of Northern Ireland. These are our immediate proposals. But they do not in themselves constitute a lasting solution for the problems of Northern Ireland. We remain determined to find means of ensuring for the minority as well as the majority community an active permanent and guaranteed rôle in the life and public affairs of the Province. Our immediate proposals are put forward in an endeavour so to change the climate of political opinion in Northern Ireland that discussions can be resumed in an effort to reach agreement on a new way forward to this end. It is our intention, as soon as circumstances permit, to promote the necessary consultations about the future structure of Government in Northern Ireland. Meanwhile, Her Majesty's Government will continue to give high priority to the rehabilitation of the economic life of the Province. I would like to pay tribute to the determination with which the Prime Minister of Northern Ireland and his Government have sought to overcome the difficulties which have beset the Province; and the House will wish to acknowledge the spirit in which he has agreed to remain in office until our legislation has been enacted. We greatly regret that we were unable in the end to reach agreement with him. In the last resort, however, responsibility rests with the United Kingdom Government and Parliament; and Her Majesty's Government would be abdicating that responsibility if in this critical situation we did not take the action which we believed to be right.In the very grave situation that the right hon. Gentleman has described, the Government are entitled to ask for the full support of the House in the course they have rightly—reluctantly, of course—decided upon. On behalf of my right hon. and hon. Friends, the Prime Minister should know that we will give every facility for getting the legislation through.
There are two reasons why I pledge our backing. The first relates to the policy whose acceptance the Government sought in their discussions with the Northern Ireland Government. It is true that on Monday we strongly criticised the long delay during which time resistance was built up, organised and, indeed, armed. We can argue—and history, perhaps, will have a view—whether these proposals earlier might have had a better chance. But, as far as they went, we would have supported them. We would have tried to build on them and develop them, but we would have supported them, because they seem to us to have incorporated the two strategic requirements that we have been pressing on the Government since last autumn; namely, the transfer of security from Stormont to Westminster, and quick action on internment; and this was right. We welcome the proposal for a resident Cabinet Minister. I shall come to that in a moment. But that is, I take it, in the new situation that the right hon. Gentleman has now put forward. This package was well directed in our view, and we would have wished to support it had it been accepted. Secondly, the Bill is now inevitable. Direct rule has always been regarded by both Governments, and by both of us in Opposition, as the very last resort, not an objective to be sought for itself, and we have all of us maintained this. But the fact that that last resort was there and that in the last resort neither of the Governments that have been concerned with this would have flinched from it has, I believe, been a central element in the strength of this House and of Her Majesty's Government in dealing with the problem. I want to raise the question of the Bill. A few weeks ago we gave all facilities for passing the Northern Ireland Bill through all its stages in one day. That was an irregular and highly exceptional procedure. Will the right hon. Gentleman confirm that the House is not being asked to do anything unprecedented or irregular in regard to the Bill that will be laid? As I understand it, the Bill is very short, though of massive constitutional importance. I understand that for technical reasons it cannot be laid today, but perhaps the right hon. Gentleman will confirm that the text of it will be available for all hon. Members to study today. That means that there will be adequate time for a debate next week, for considering, tabling and debating any Amendments which hon. Members in any part of the House regard as needed. We believe that the Government are entitled to support in the aim of getting the Bill on the Statute Book, an essential stabilising force in what looks like being a very difficult and dangerous Easter period. My one doubt about the statement is the reference to plebiscites. Particularly at this time, it would be extremely dangerous to stir up passion on all sides in the political situation, and if there is to be any further restriction of marches or public meetings, it might make it an unsuitable background for a plebiscite. Finally, as I understand it, these are temporary powers, renewable after one year. All of us recognise that this action does not of itself solve any of the problems of Northern Ireland; it merely creates a new stage or setting in which the solution of problems, which are as urgent as ever, has to be sought. It is urgent that the period immediately ahead be used for this purpose. For this, the right hon. Gentleman will not be surprised to know that we would propose that the problems will not be solved purely by contacts between Governments—there will not be a Government in Stormont. This is now the occasion for a set conference and all-party talks between all parties here and all elected parties in Stormont, and the fullest programme of consultation with all the Irish parties in the Dail. On a personal note, may I say to the right hon. Gentleman that some of us will know what he and his colleagues have been up against in the sense of personal strain and anxiety. This has not been an easy decision. We understand that. The same is true of Mr. Faulkner and his colleagues during this difficult period. We shall be sorry to lose the Lord President as Leader of the House. He has served the House well. All of us will wish him well in the new and arduous and tremendous task that he has taken on.I thank the Leader of the Opposition for his remarks. It is because we have all along realised the gravity of such a decision that it has been so carefully and, as the right hon. Gentleman would say, so lengthily considered by my colleagues and myself, and in discussion with the Prime Minister of Northern Ireland.
The right hon. Gentleman is right in saying that the Bill to be placed before Parliament contains temporary provisions for one year, as I have announced; and it is renewable by affirmative order if Parliament so decides. We do not propose to adopt the procedure followed with the short Northern Ireland Act. We shall give notice of the Bill today and present it on Monday. The draft Bill is now available in the Vote Office and in the other place. All Members will have access to it over the weekend and on Monday so that they can give proper consideration to it before the House is asked to discuss it on Tuesday. My right hon. Friend the Patronage Secretary will make an announcement about business for next week. We think that the decision now gives an opportunity for a breakthrough to lower tension and make a fresh start. Of course, it is right that a plebiscite should not be held until that is possible. I said in my statement that it would be held as soon as practicable. What we are trying to do is to reduce tension and not take any action likely to exacerbate feelings. This must be taken into account on the timing of the plebiscite.Is my right hon. Friend aware that if there is a time for rancour, bitterness, recrimination and questioning of the decision he has just announced, responsible people everywhere will realise that that time is not today, because in the weekend and the weeks ahead the people who must be most in our thoughts are the people of Northern Ireland?
Will my right hon. Friend recognise that there are many, probably even in this House, who believe that, rather than the steps which have been announced, it would have been perhaps a better and franker approach to go for complete integration of Northern Ireland into the United Kingdom? Has my right hon. Friend any form of assurance or any indication from those who have so far refused to come forward and help in finding a solution to the problem of Northern Ireland that they will now do so as a result of this so-called initiative? Does my right hon. Friend realise that the decision emphasises something which many of us have recognised for a long time, the very great constitutional difficulties of being a Member of Parliament for Northern Ireland in this House, because of the inter-action between the two Governments? Does he realise that, whatever some of us may think, there will be some who will feel bound to consider very carefully and very seriously whether they have any mandate to support such a decision, or, indeed, a mandate to remain in this Parliament?The whole House appreciates the part my hon. Friend has played in the past in trying to bring about a peaceful solution to the problems of Northern Ireland, and we wish to pay tribute to him for that.
The decision has been taken only in consultation with the Government of Northern Ireland. There have been no consultations about it with others. I hope that, in the light of the decisions which Her Majesty's Government have taken and which they will ask Parliament to implement next week, there will be a response from both communities in Northern Ireland, and from those who are concerned with these affairs south of the Border, which I hope will lead to a reduction in tension and to the seizing of the opportunity to make a fresh start. I well know—many of us have appreciated this over nearly 20 years—the difficulties some of the Members representing constituencies in Northern Ireland have faced, with two Parliaments and two Governments. But I should like to assure my hon. Friend that everyone in the House will value what he has to contribute in the future in this new situation until we can reach a longer-term solution to the problems of the Province.Is the Prime Minister aware that there are in my constituency more people from Northern Ireland than in any other constituency in Great Britain, and that these men and women, both Protestant and Catholic, live and work side by side and in peace? Is he aware that the overwhelming majority of these people hope that all people in Northern Ireland will co-operate with Westminster and thus avoid the possibility of handing over their brothers and sisters in Northern Ireland to the extremists on one side or the other?
I am sure there are a great number of people—indeed the majority—in both communities in Northern Ireland who want to live together. I hope this decision will give the opportunity of reaching an agreement about the future nature of the Government in the Province which will enable them to do just that.
Since all history shows the extreme difficulty, as well as the undesirability, of direct rule in a geographically separated country without the full-hearted and unconscripted consent of the people, will my right hon. Friend the Lord President, whom we all wish well in his endeavours, make a special point of seeking the co-operation of the people of Northern Ireland as a whole, including in particular those elected representatives in Northern Ireland who have conscientiously striven to do their duty according to their lights?
I have two brief questions on the other points. First, will my right hon. Friend confirm that the plebiscites will not supersede the provisions of the 1949 Act and will be consultative only? Second, in phasing out internment, will he assure the House that those internees against whom charges can properly lie will be proceeded against in the courts, so that this is seen to be a deterrent to terrorism and not an encouragement or condonement of it?Yes, Sir. I can assure my right hon. and learned Friend that in all cases where it is possible to bring a case in the courts this will be done. Parliament in Stormont is prorogued. Therefore, the undertaking, the Clause in the 1949 Act, remains fully operative, which is the second assurance for which my right hon. and learned Friend asked. I am sure that my right hon. Friend the Lord President in his new capacity will do everything possible to secure the co-operation of all people in Northern Ireland. Although Northern Ireland may be separated geographically, as my right hon. and learned Friend said, we have always been insistent, and so far the people of Northern Ireland have always been insistent, that they are part of the United Kingdom, equal in every way to the other parts of the United Kingdom. In our view this remains the case until, if it should happen at some future time, a majority decide that they wish the position to be otherwise. What we are doing is to create both an assurance and an opportunity, through the plebiscite, to confirm that that position will be held.
Is the Prime Minister aware that, faced with the unwillingness of Stormont to transfer responsibility for law and order to this House, Her Majesty's Government had no alternative but to follow the course they have taken?
As we move into a very tense situation, particularly in the next few days, does the right hon. Gentleman agree that all sections in Northern Ireland should realise that this new opportunity might also be the last chance? Does he agree that people in this country would not take kindly to any body of opinion in Northern Ireland which sought to boycott the advisory commission his right hon. Friend the Lord President is to empanel, and that we hope that all sections of the community will co-operate to make it work? On a more personal note, is the Prime Minister aware that as the Lord President sets out on the most arduous and dangerous task of his career he will take with him the good wishes, and I believe the prayers, of the whole House?I am sure that is the case. The right hon. Gentleman has emphasised that this is an advisory commission: it is not Government by commission. It is an advisory body assisting the Lord President, who will have the power and be responsible to this House. In this respect it is similar to advisory committees of many kinds which Ministers have in Britain, whether the Secretary of State for Scotland, the Secretary of State for Wales or Ministers at Westminster. I very much hope that a fully representative body can be found to assist the Lord President. I would again like to pay tribute to the Prime Minister of Northern Ireland because, as he and his colleagues know, I fully appreciate their position, which is that they do not believe that as a Government it was possible to arrange for the transfer of these powers and to maintain the support of their party in their House. I fully understand that position, and ultimately the responsibility comes to Westminster and Her Majesty's Government. We have accepted that responsibility. At the same time the Prime Minister of Northern Ireland is giving a splendid example to everyone in the Province of full co-operation in saying that he and his colleagues will remain in office until legislation here is passed so that the changeover can be perfectly smooth and normal.
While I agree with my hon. Friend the Member for Londonderry (Mr. Chichester-Clark) that it is important that we should speak with moderation because human lives are at stake, I must tell this House that we shall be unrealistic if we do not realise that what has happened will be looked upon by the majority in Ulster as a victory for the I.R.A. [Hon. Members: "Nonsense."] We would be unrealistic if we did not realise that was the case, that whatever be the merits or demerits of a local Parliament, whatever be the merits or demerits of direct rule, about which people can argue, the bringing about of a constitutional crisis and the imposition of direct rule against the wishes of the majority can only be described as an act of folly.
I hope that on reflection my hon. and gallant Friend will not continue to hold that view. This is a time to invite all those involved in political life in Northern Ireland to solve this problem by agreement, and to reach a fresh basis on which the life of the Province can be carried on in peace and security. Her Majesty's Government remain convinced that that is what the great majority of the people in Northern Ireland want. The I.R.A. has demanded an amnesty. That is not Her Majesty's Government's proposal. It demanded the withdrawal of all British troops. That is not Her Majesty's Government's proposal. It demanded the abolition of Stormont. That is not Her Majesty's Government's proposal. It cannot therefore be said that we are acceding to the demands of the I.R.A.
Is the Prime Minister aware that many people on this side of the House will appreciate the great courage and vigour which he has shown in this matter because of the difficulties, of which we have just seen an example? We admire him, if only a little bit, for what he has done. May I question him on two points? He will be aware that special powers and internment have been a real bone of contention for the minority. Can he give an assurance that the evidence against the people whom he regards as hard core internees will be produced so that people will in some way or other be able to judge the attitude of the Government and so that no man will be arrested merely on suspicion and no man will be regarded purely and simply as being a hostage there for the good behaviour of people who might be released?
With regard to the special powers, can the right hon. Gentleman elaborate further on how these are to work when we have a Secretary of State for Northern Ireland, because again we want to see how these will work into the domestic law of the United Kingdom and be observed in the United Kingdom?
The hon. Gentleman will see from the Bill, when he studies the draft, that all the powers belonging at the moment either to the Executive or to the Legislature of Stormont will be transferred to and exercised by my right hon. Friend the Lord President. I have also stated that he will ensure that a complete review is carried out. Obviously, on the question of special powers this is part of the legislation of the Parliament of Northern Ireland which is required in this present situation. That also is a matter which can now be examined by my right hon. Friend and considered by Her Majesty's Government.
Would the Prime Minister not agree that the situation in Ulster at present is very tense indeed and as a result of the mounting tension the people of Northern Ireland have the right to demand of his Government now a strong declaration on two specific points? No. 1 is that there will be no let-up in the campaign against the Irish Republican Army, that this is a time for a strong military initiative and that in no way will the I.R.A. be given in to but that there will be a definite drive now, irrespective of protests from Dublin or anywhere else, to deal with the murderers in our community.
Secondly, will the Prime Minister give a firm undertaking to the people of Northern Ireland, now that their democratically-elected Parliament is prorogued, that they will be consulted about anything that would in any way attempt to change their destiny as part and parcel of the United Kingdom? Will he tell us why this Government, having accepted that the citizens of Northern Ireland are part and parcel of the United Kingdom, will not completely integrate Northern Ireland into the United Kingdom? Is the Prime Minister not aware that if there are not strong assurances on these two vital points there could be a very serious situation from which no one in Northern Ireland will profit? With regard to the commission that he proposes to set up, will the Prime Minister give an assurance to the House that this commission has no legislative powers, that this Parliament of the United Kingdom has full legislative power and that there will be no legislative power dele- gated to any commission that he has in mind to assemble? As the Parliament of Northern Ireland is now prorogued, can he guarantee that that Parliament will have a say in the future destiny of Northern Ireland? Will he see that as soon as possible the people of Northern Ireland, irrespective of what might be said by the Opposition there, have the right to declare where they stand on the Union? Does he not believe this would help to take considerable tension out of the situation? Can he also assure the House that there will be no consultation with Dublin with regard to the future of citizens of this Kingdom?When the hon. Gentleman has time to study my statement he will see that I gave a categoric assurance about the security situation in Northern Ireland right at the beginning.
On the question of any change in status, not only did my statement contain the very clear undertakings given by all Governments in the past—and I made it clear that the 1949 Act remains operative because Stormont is only prorogued—but I referred to the further reinforcement of this position which we believe can be achieved by means of the arrangements, which would be statutory arrangements, for the plebisecites. As for the duties of my right hon. Friend the Lord President, again when the hon. Gentleman studies the draft Bill he will see that a duty is placed upon my right hon. Friend, wherever practicable, to discuss any proposed legislation with the advisory committee. That committee has no powers whatever to legislate. Its advice having been considered, the legislation must then be dealt with here by the Westminster Parliament. On the question of integration, this is a matter which I know has been discussed by various hon. Gentlemen. What will happen at this moment is that the departmental structure in Belfast will remain the same. This is much the best way of dealing with the situation, so that the Departments in Belfast will be responsible to my right hon. Friend the new Secretary of State for Northern Ireland. The whole of those arrangements will remain unchanged but the responsibility will be handled through the Secretary of State for Northern Ireland in this House. The future allows all these matters to be discussed and an attempt to be made to reach agreement on them by those concerned in the public life of Northern Ireland.Needless to say, this could be a very emotional occasion for any representative from Northern Ireland. Viewed from that aspect, one can readily understand the feelings of anxiety which must exist among people throughout Northern Ireland. The proposals put forward by the Prime Minister this morning certainly merit very serious consideration by any person holding any office of responsibility in Northern Ireland.
For my part, I wish to indicate to the Prime Minister that this is not the time for instant comment in view of the dangers which may arise in Northern Ireland over the weekend, but I can promise him that my party, in association with other representatives of the community, will give very serious consideration to all the proposals which have been put forward, not with a view to any personal or political gain but in the interests of the whole community in Northern Ireland.Accepting the inevitability of what my right hon. Friend has put to the House, but bearing in mind what he said about the Border, lest there be any misunderstanding on either side of the Irish Channel, does he agree that, however much we may hope for the best, we may yet face a task of the grimmest kind and perhaps a protracted one? Is it not well to say that we may yet find ourselves no less severely tested than have been Mr. Faulkner and his Government?
I think that Governments of both parties ever since 1969 have recognised that that test might come and that we would have to be prepared for it. But what we are now doing as a deliberate act of policy is setting out to lower the tension and to reduce the violence and counter-violence in an attempt to achieve a lasting settlement.
Has the Prime Minister given consideration to the proposition that, as a way of controlling the violence, there should be a combined police force drawn from the Irish Republic and from the Royal Ulster Constabulary for patrolling the Border?
No, we have not considered that. The R.U.C. will remain as a police body, in exactly the same way as we have other police bodies in different parts of Britain. It is not correct to say, as I saw reported in one account today, that this body will just become merged with other police forces. It is natural that the police authority which has been established should remain, but in so far as a Minister in Northern Ireland has had responsibility for it, that responsibility will now rest with the new Secretary of State.
rose—
Order. The House should now hear the Business Statement.
Later—
On a point of order, Mr. Speaker. Is it not possible for other Members from Northern Ireland to have the opportunity of putting questions to the Prime Minister?
In my view, it would be better for the House to debate this matter on Tuesday.
Business Of The House
Mr. Speaker, following the statement made by my right hon. Friend the Prime Minister, I should like to announce a change of business for next week.
Consideration of the Sound Broadcasting Bill will be deferred from Tuesday, when the House will be invited to consider the Northern Ireland (Temporary Powers) Bill.The right hon. Gentleman the Leader of the House has already heard the attitude of most of us on this side of the House. We will do our best to facilitate the Bill, after the proper consideration which I think the right hon. Gentleman is giving the House time to give to it.
I thank the right hon. Gentleman for his remarks.
I am not clear about the arrangements for next week. Shall we have a full day's Second Reading debate on Tuesday? If so, when is it proposed that we should take the Committee and further stages?
I should like an opportunity to discuss this matter through the usual channels, but the intention would be to have a Second Reading debate on Tuesday. I should like to discuss the matter when the House has had a chance to study the Bill. Wednesday can be used for continuing the discussion.
For the Committee stage?
Yes.
On a point of order, Mr. Speaker. Being deeply shocked and ashamed by the Prime Minister's statement, I had intended to seek to move the Adjournment of the House under Standing Order No. 9; but it is a Friday—
Order. That cannot be done. Will the hon. Gentleman make his point of order?
Yes, Mr. Speaker. I wish seriously to put to the House the view that before proceeding to the legislation next week it would be well for us to have a general debate on the situation while Mr. Faulkner is still in office and while, I would hope, other counsels might yet prevail not requiring the legislation which the Government have in mind.
I do not think that is a matter of order.
Orders Of The Day
National Health Service (Family Planning) Amendment Bill
As Amended ( in the Standing Committee), considered.
11.49 a.m.
I have selected new Clause No. 3.
I wish to raise a point of order, Mr. Speaker, concerning the selection of Amendments and the time given to Members to consider the Amendments which have been selected. I realise that I can say nothing to you about the selection of the Amendments, but I am saddened that so few of the carefully drafted Amendments have been selected. Only one new Clause out of four or five has been chosen, together with only two groups of Amendments.
The matter which I wish to draw to your attention, Mr. Speaker—and I know full well that the House is in this difficulty on many Fridays—concerns the question of when Members are able to know, on a Friday or Thursday evening, the Amendments which are likely to be selected. Is it not possible to make an arangement to enable Members to know at, say, 10 o'clock or 10.15 on a Friday morning the likely selection of Amendments? I realise the difficulty that Amendments could have been tabled last night—although in this case no Amendments were then tabled—which therefore could not have been considered by you until this morning. But if in a case like this, which I imagine is normal, no Amendments are tabled the night before, surely it is not impossible to publish a provisional selection of Amendments the night before or at 10 o'clock on Friday morning. That would facilitate Members enormously in the very difficult job of considering the Amendments.I am obliged to the hon. Gentleman for raising that point of order. I will carefully take into account what he has said. I now ask him to move the new Clause.
Further to that point of order—
Order. The Chair must occasionally take a decision that it will have no more points of order on a particular matter. The hon. Member for Yarmouth (Mr. Fell) has made his point of order and I have said that I will take it into account. I am not prepared to accept any other point of order on this matter.
I am grateful to you, Mr. Speaker, for your help.
New Clause 3
Ministerial Circulars
Any circular issued by the Secretary of State with regard to services to be provided by local health auhorities under this Act shall be the subject of regulations made in the form of a statutory instrument, a draft of which shall be laid before Parliament.—[ Mr. Fell.]
Brought up, and read the First time.
I beg to move, That the Clause be read a Second time.
Basically the reason for the new Clause is to make sure that Parliament has a fairly tight rein on the whole Bill when it becomes an Act, which I pray it will not. The difficulties of the Bill are manifold. When this poor creature was considered in Committee, far from being improved it was emasculated and all the safeguards were taken out of it. I understand the reasons for that, but unfortunately it has not been possible to put down Amendments on Report which would have the effect of putting back the two major safeguards. I know that I cannot talk about them because they were disposed of in Committee and I can discuss them only in passing. The Bill is that much worse now since it does not include the very safeguards which the hon. Member for Derby, North (Mr. Whitehead), the sponsor of the Bill, saw fit to include. In Committee, by what we thought was almost a mistake, an Amendment was agreed to which left out of the Bill what had been proposed by the hon. Member for Derby, North, I think much to his grief. Therefore, this poor thing which is before us this morning does not contain the necessary safeguards for those who might come under the knife. The new Clause is designed to give protection. The country is undecided on the question of vasectomy; it has had no chance to be anything else. The grave issues that led to the Prime Minister's statement this morning have had the effect that no newspaper during this last week has contained any letters or articles on the subject of vasectomy—There was a very full article on the subject in yesterday's Daily Mirror which included an item by a man who had submitted to a vasectomy operation.
I am grateful to the hon. Gentleman for drawing my attention to that article, which I am sorry not to have seen. I imagine that the article only gave one side of the case, the case for the introduction of vasectomy under the National Health Service.
Not altogether.
One thing which is certain is that it did not mention the other side of the case.
The public do not know very much about this subject and must be protected from following advice to have a vasectomy without having had the opportunity of being fully informed about the effect of it. We have had no experience of the result of vasectomy operations. The Simon Trust produced a great document but it is not medically acceptable. All those who were interviewed had had the vasectomy operation only a short time before being interviewed, but the effects of the operation should be considered over 10 or 15 years. Meanwhile, the House must be vigilant about passing such a far-reaching Bill. The operation which the Bill seeks to provide free under the National Health Service is accepted by the proponents of the Bill as being irreversible. Even without the operation being provided under the National Health Service, the number of operations will increase. Once the operation has the blessing of the National Health Service, with the Minister sending out circulars about it, the numbers will rocket. The hon. Member for Derby, North has been frank throughout the proceedings and he has told us of the waiting lists for this operation. We have no assurance that the people who are advised to have the operation will know exactly what they are doing. The new Clause is essential because of the consideration which will be brought into this whole subject following the effects of any further research, and particularly the effect upon people's minds. Let us take the case of a man who has the operation at the age of 30 or 25, or even at the age of 21 since it must be remembered that there is no age limit. If a husband and wife are having marital difficulties, it may well happen that a busy family doctor may not spend a great deal of time on the case personally but will send the couple to a local family planning clinic for advice. What will happen when the young man goes to that clinic for advice?12 noon.
What has this to do with the new Clause?
This argument is essential to the new Clause, because I want to avoid the possibility of this provision being misused and things going wrong.
To come back to the case of the young man, if his marriage is in difficulties he may well be easily persuaded by a stronger personality than his own to follow a certain course of action. The counsellor may well say to the wife "It seems to me that the main cause of your marital troubles has to do with your sexual relationships. There is a way in which you can get out of those difficulties. You will not have to worry about becoming pregnant because of your husband's attentions." I agree that this would have to be carried out on a doctor's advice, but the doctor concerned might be thoroughly in favour of a vasectomy operation. Let us follow up the case of the young man who has this irreversible operation. Let us suppose that his wife is involved in a terrible tragedy and is killed in a motor crash on the M1. If the young man later meets another girl and wishes to marry her, he will have to tell her "You must remember that you will not be able to have a child by me." This is one of the serious considerations which enter into discussion of the Bill, namely, the whole subject of safeguards. The hon. Member for Pont pool (Mr. Abse) made many discourses in Committee on the need for careful advice to people who attend clinics, but I query at once the whole basis in which all responsibilities for an individual's actions are taken over by the State. The State involves itself in everything, and nothing will be left to the individual. Is it too much of an exaggeration to say that if things go on as they are, with everything coming under the State umbrella, there will come a time when people will be in capable of accepting any responsibility for themselves? Will not the National Health Service be butting in and sending circulars to local authorities telling them what to do and issuing plans for birth control throughout the country: "Vasectomise the nation"? A Liberal member of the Standing Committee made a serious contribution to our debates. I will not go in detail into what he said, but it shows the danger of not having full parliamentary control in a matter such as this. I am sure that my hon. Friend the Under-Secretary of State will say that we do not have to worry because the National Health Service will be reorganised in 1974. So what? What assurance does that give us that when this Bill becomes an Act it will not simply be taken under the wing of the National Health Service and then be pushed by the whole panoply of that service as a way to exercise national birth control?The whole force of the hon. Gentleman's argument is directed to the fact that he does not want the National Health Service to have anything to do with this operation, or to have only a limited capacity to deal with it. Does he not appreciate that at present anybody who is prepared to spend £30, £40 or £50 may have the operation?
The hon. Gentleman is right. There was a ruling about 10 years ago—I do not know the exact date—by Lord Denning on this matter. The hon. Gentleman is right to say that for £30 or so one can have the operation. I believe that Lord Denning still regards the operation as illegal, except for medical reasons.
My hon. Friend wished to know the date of that judgment. It was in 1954.
I am grateful to my hon. Friend for supplying the date, 1954, which was quite a long time ago. I was about to give another illustration of how serious this whole matter can become and how important it is that this new Clause should be accepted to limit the disasters which might accrue from the Bill's provisions and to provide that the matter shall be examined every year.
I should like to draw to the attention of hon. Members some remarks that were made in Committee by the hon. Member for Cornwall, North (Mr. Pardoe). I am sorry he is not present because I am sure he would soon be interrupting me with a cry of "Rubbish", but I will put to the House the burden of his argument. It was an argument that made the hair of several hon. Members—not only opponents of the Bill—stand on end. In a way, the hon. Member's argument was quite fun. He said:What the hon. Gentleman was doing was quantifying the amounts that would be saved for every man who was vasectomised and for every child prevented from being born. If that is taken to its logical conclusion, it will be seen that it might be possible to do away with the National Health Service within a few years, since no one would be born—"I was trying not to take up more time of the Committee than was absolutely necessary. May I slow down for the sake of the calculations to come, merely taking three items which are fairly easily quantifiable and which I have, in fact, already quantified."—[OFFICIAL REPORT, Standing Committee C. 23rd February, 1972; c. 174.]
Order. I have given the hon. Gentleman a great deal of latitude in making what is really a Second Reading speech. I ask him now to come a little closer to the new Clause.
I am most grateful to you, Mr. Speaker, for bringing me more to the point at issue, and of course I shall respect what you say. Nevertheless, I am sure you will not be too angry with me if from time to time I use illustrations to show how dangerous it would be for the nation—
Order. I am never angry with the hon. Gentleman, whatever he may say.
I am even more grateful for that, Mr. Speaker. That assures my future at least. Though I may be told to sit down, I shall be told with a smile, which is always nice—[HON. MEMBERS: "Sit down."] There was a time when I was about to be interrupted by the most senior Member of the House. I did not permit him to do so, and Mr. Speaker made him sit down. Now, four or five hon. Members opposite are trying to usurp your position, Mr. Speaker, by telling me to sit down. They cannot do it. With the exception of myself, by the application of a certain amount of self-restraint, the only person in the Chamber who can tell me to sit down is you, Mr. Speaker—
Order. There is nothing in the new Clause about the hon. Gentleman sitting down.
I stand corrected, Mr. Speaker. You are absolutely right.
Perhaps I might complete my illustration. This must be germane to the subject. The importance of the Bill is enormous. It should never have been a Private Member's Bill, though it was brave of the hon. Member for Derby, North to introduce it and try to get it through. Its importance is enormous because we are discussing the lives of tens of thousands if not millions, of yet unborn children. Depending on how tough a future Government become with their birth control policy, we are talking about the future of tens of thousands, perhaps millions, of young men who may be advised to be vasectomised by Government-sponsored busybodies. That is the importance of the Bill if it should become an Act. I shall complete the quotation from the speech of the hon. Member for Cornwall, North. He was showing how much money could be saved by the State. It would be unfair to the hon. Gentleman to quote only part of his speech and not to quote the actual figures that he used. He said:These are the savings that he forecast."First family allowances."
because most vasectomies would not be advised, I hope, until someone had had more than one child and probably more than two—"Taking the figure of 10,000 on the waiting list and assuming that each vasectomy means one less child, though in fact each vasectomy will mean rather more than that, that is 10,000 fewer children. Let us assume that those children are not the first children, that being the likely event—most vasectomies will be after a certain number of children have already arrived"—
That is in respect of those 10,000 children who will not be born because of vasectomy operations. 12.15 p.m. The hon. Member for Cornwall, North went on to say:"that works out roughly at £10,000 per week or £500,000 a year."
it is different since the Budget—"Next, the savings in tax allowances. The tax allowance for a child under 11 works out to the parent at about £50"—
The hon. Member for Cornwall, North was saying that for £200,000 we can make sure that 10,000 children are not born, which would save the State at least £2 million on three items that those children would later have cost the nation. If you say to me, Mr. Speaker, that I have taken up enough of the time of the House on my humble contribution, I shall not dispute it—"so that would save £500,000 a year. The cost of a primary school place is about £100. It was £102 last year. So that is £1 million. There is a cool £2 million on three items alone saved for a cost of £200,000, and, as a taxpayer, I rate that a very good bargain."—[OFFICIAL REPORT, Standing Committee C, 23rd February, 1972; c. 174.]
Order. The hon. Gentleman has issued an invitation. I accept it. Will he now bring his remarks to a conclusion?
I am grateful for your prompt attention to my wish, Mr Speaker. It is with the greatest pleasure and confidence that I shall have the support of other hon. Members that I commend the new Clause to the House.
12.15 p.m.
I rise, I hope not causing any offence to any hon. Member in any part of the House, to make an early intervention on what is an important new Clause. I hope that in so doing I shall not in any way evade my opportunity or responsibility for listening carefully to any further speeches. I thought that it might be to the advantage of the House if I commented in detail at an early stage on the point which has been made about circulars of guidance—
Is my hon. Friend about to give us the Government's advice on circulars generally, and then allow other hon. Members to comment on what he has said? If that is the case, will my hon. Friend feel precluded from commenting on anything said in subsequent speeches? This is one danger of a Minister intervening so early in a debate on what is quite an important new Clause.
I must play this one by both ear and eye. I think that the major responsibility for commenting will rest upon the hon. Member for Derby, North (Mr. Whitehead). But I shall remain at the disposal of the House, and I shall intervene if hon. Members should ask specific questions.
I must begin by addressing myself to the precise terms of the ingenious but unsatisfactory new Clause. It is ingenious because it seeks to effect a peculiar hybrid marriage. But it is unsatisfactory because such marriages often fail to realise the full benefits of more orthodox conjunctions. What my hon. Friend the Member for Yarmouth (Mr. Fell) has sought to do is to impart to a circular issued by the central Department to local authorities the full status of law. I am afraid that I must advise the House that this would be an unsatisfactory imposition for the Government to accept in terms of this Clause. The House will be aware that the Bill, which was given a Second Reading without a Division, made provision to empower local authorities to perform certain functions. In that case, if it is the wish of the House that local authorities should so be empowered any guidance which is proper in this context must be guidance which cannot be held to be legally binding. If the new Clause is accepted it will impose upon the central Government the peculiar task of making circulars to local authorities, which are semi-independent bodies, have the full force of law. If the House wishes to legislate in respect of local authorities, the specific powers which they may or may not have and the specific duties which they may or may not perform by law, then it must produce the law. It must either produce firm proposals or give delegated powers to make regulations which the House can in turn consider under the normal Statutory Instruments procedure. If the House has decided to empower local authorities to perform certain functions, it is not acceptable in the same breath to seek to inhibit, restrict and limit those powers by circulars. Normally, circulars, as understood in local authority matters, cannot have the power of law; they are for guidance. I must on those grounds suggest that this is an improper constitutional and legislative development which the House should reject. At the same time, I am grateful to my hon. Friend the Member for Yarmouth for bringing forward this ingenious new Clause and giving me the opportunity to go over some of the ground which I promised in Committee to go over concerning guidance. I refer specifically to the accepted kind of guidance which does not have the force of legally binding obligations upon local authorities, but is the kind of guidance which local authorities are accustomed to receiving and for which they normally look.Although I fully appreciate the Minister's point about the legal enforceability of the circulars, may I ask whether I am right in saying that under the parent Act it is open to the Government or the Minister to approve or not approve any schemes into which local authorities may enter? Am I not equally right in presuming that if the guidance is being disregarded it is open to the Minister not to approve grants or assistance to any such local authority?
That is true. Any provisions made under the parent Act, which the House has therefore agreed to accept, are binding upon any matter if it should arise under this extension of the Act. I am making the narrow point that it would be improper to seek to treat the kind of circular which I am about to discuss as having the full force of law.
I warned the Committee, and I must now warn the House, that it would be impossible for me to give a specific advance view or trailer of the precise terms of any local government circular which we may issue in future in the context of the Bill. We must see whether the Bill is finally passed. It will be against the background of the debates which we have had, not only in Committee, but in the House, that we shall wish to consider the precise terms of the guidance. For the convenience of the House I will now summarise the main headings which in general terms we would seek to cover in the circulars which we shall issue in connection with the Bill. I refer back to the commitments and views which I expressed when we debated this subject in Committee. I expressed the view in Committee—this will be reflected in the circular—first, that vasectomy should normally be regarded as an operation only for married men or, by way of variation on that, men who enjoy a stable union and have completed their families. This will be the main framework of guidance, the main guiding rule, which we shall seek to set forth in the circular. It will be the guiding rule against which any exceptions should be placed in their proper perspective.My hon. Friend has already got himself into the most hopeless trouble. He has just said that the main guiding rule will have it in a reference to the person—it has to be a male; we all know that—and that he has to have completed his family. What kind of suggestion is that? Who knows when a man or woman has completed his or her family? There are thousands of cases in which a man and wife think that they have completed their family and then have another child, probably by accident, five or 10 years later. And who is to say that that is not the best and happiest child of the lot?
I shall hope to cover my hon. Friend's misgivings as I develop the broad framework of guidance which we hope to give. Since he drew particular attention to the word "rule", which I perhaps inadvisedly used—I carefully put it in inverted commas in my notes because I said that the circular cannot have the force of law—I repeat that, within the main framework and guidance which we shall seek to give, we hope to draw to the attention of local authorities our belief that the law should be the limitation of sponsorship for this operation to married men or those enjoying a stable union and that such men should have completed their families. I assure my hon. Friend that I shall hope to deal with the term of art which he suggests is involved in that phrase.
Secondly, I indicated in Committee, and I undertake that it will be given expression in the circular to local authorities, that we would expect them to give particularly careful consideration to any proposal to carry out the operation on men who were younger than the general rule of patients for whom such an operation might be indicated. Thirdly, I said in Committee—and I repeat that this will find reflection in the circular—that the consent of the wife should normally be obtained in every case. Those three main points form the outline bulk of the general import of the guidance which we shall seek to elaborate to local authorities. I turn now to counselling, an aspect of the whole question of vasectomy which perhaps engaged to the greatest extent the concern and interest of the Committee when debating the Bill. The Government have given a good deal of careful thought to the question of counselling as a result of both the points made by the hon. Member for Pontypool (Mr. Abse) and others in Committee and points which have been made since. This is an area in which the Government are bound to steer a careful course. If we want to give positive advice about counselling we must remember the realities of the Government's position. The Bill explicitly seeks to confer powers on local authorities which are answerable to their own electorates. They enjoy a real measure of independence; they are not simply the agents of Whitehall. Indeed, the whole purpose of the Local Government Bill would be frustrated if in this context we sought to narrow rather than to develop the area of discretion and responsibility which local authorities already enjoy. The House will appreciate that the danger of being grandmotherly towards local authorities is real. It is probably true that the best way to induce responsible behaviour in local authorities is to assume in them the responsibility and trustworthiness which already exist and not to treat them as needing to be bossed, badgered and prompted at every turn. At the same time, in the matter of counselling we are straying into the area of professional training and knowledge where the judgment of an individual doctor, for example, is a real factor. A reference to the importance of counselling in general terms is a perfectly proper and valuable provision for the Government to make, but a detailed specification of the precise form that counselling should take would probably be counter-productive because there is such an infinite variety of individual cases which we would have to seek to specify. For these reasons, we believe that it is not practicable to give, in the administrative circular, the sort of range and degree of advice which some hon. Members in Committee have been hoping for.12.30 p.m.
My hon. Friend is showing the same courtesy and kindness which he showed throughout the earlier stages of the Bill, and I thank him for giving way again. He has said that of course he does not want to go too much in the way of direction to local authorities, but that they have to have guidance and help and so on, which is the purpose of circulars. Do I understand him to say also that these powers will remain with the local authorities after the reorganisation of the National Health Service?
No. There is no question of that. What we are discussing here is the circular of guidance which arises under the Act and not the Bill, which lapses upon the loss by local authorities of their health functions following the introduction of the Bill to reorganise the National Health Service, which, whenever the Bill is introduced, will take place in 1974. We are thus talking here about a circular which will have effect only so long as the local authorities remain local health authorities. A terminal date is set upon it. I hope that puts my hon. Friend's mind at rest.
Against this background of having to tread delicately and not only registering confidence in local authorities, which I believe is fitting, but of having to recognise also that professional matters arise in the question of counselling, the Government have decided that an administrative circular would not be the proper vehicle for going into details on counselling. I am happy, therefore, to announce that the Chief Medical Officer in my Department is to set up a group of persons with special interest and knowledge of this subject which will help him prepare advice, for transmitting on what I might call the professional network, to medical officers of health about counselling. This advice will be transmitted on the professional network to medical officers of health at the same time as the administrative circular is sent out, and the circular itself will make allusion to it. But it will be distinct and definitely directed, because of the professional implications of counselling, to the professional people involved in local health authorities. Through the courtesy of the hon. Member for Pontypool, I have had sight of an expression of views presented to him by the British Medical Association and the Medical Defence Union bearing upon the local authority implications of the extension that the Bill implies. The B.M.A. in particular feels, I believe, that it is essential that the operation should be carried out under full sterile conditions in an operating theatre of a hospital, nursing home or group or health centre. The M.D.U. is particularly concerned at some of the failures which have occurred in the operation, viewed in the aftermath, and I understand that these failures may have been due to faulty follow-up. First, I will deal with the M.D.U. case. We believe that the range of counselling which the Chief Medical Officer's committee will consider and transmit to the professional bodies concerned will lay some special stress upon the vital importance of follow-up, which is really the key to avoiding the failures about which the M.D.U. has had some misgivings. On the case put by the B.M.A., I remind the House that the Family Planning Association already requires the following facilities before opening vasectomy clinics—an operating theatre, facilities for sterilising equipment, a consulting room for the surgeon and the Association doctor, changing cubicles and toilets, a re- covery room for beds, and a room for the reception clerk and health workers. Many local authorities will wish to make use of the Association as agent, in any case, and I find it inconceivable that any local authority which does not do so would seek to provide the facilities needed for this work on a scale less demanding or less exactly than the standards imposed by the Association. The administrative circular should, first of all, lay stress upon the need for the local authorities to limit the sponsorship of this operation to married men or those with a stable union and those who have completed their families; secondly, it should quite explicitly state that the consent of the wife should normally be obtained; thirdly, particularly careful consideration should be given to any proposal to carry out the operation on men who are younger than the general rule of those for whom the operation might be indicated. I add, further to that, that there should be, alongside the administrative circular, advice on the professional network, and I hope I have made clear that the B.M.A. and M.D.U. sensitivities and concern will be fully borne in mind. I believe that the view of my hon. Friend the Member for Yarmouth as to exactly when it might be held that a family has been completed is exactly the sort of thing where sensitive counselling alone can provide proper safeguards. It is impossible, as it is already impossible in the provisions of the National Health Service, to lay down hard and fast rules, and it is in this area that we look to counselling to provide proper safeguards.I understood my hon. Friend to say that account would be taken of the general age, but I did not quite catch the point. Could he elaborate? What does he mean? If the average age turns out to be 50, will the operation tend to be done at that sort of age? What is the point of the reference to average age?
We have sought deliberately to avoid any reference to a particular age, because otherwise there would certainly be anomalies. By making a broad rule, I have sought to set down one in which the operation should be considered as suitable only for married men who have completed their families, and in this way we are already narrowing the range or normal applications for the operation to a certain age group. It is by reference to this age group that those who are younger than that will be subject to consideration and counselling.
My hon. Friend, in referring to the point I had raised, said that the sort of thing such as deciding whether a family is completed or not depends upon sensitive counselling. Have we really got to such an idea that we can tell a man and woman who have got a family better than they can tell themselves whether their family is completed? This is the whole nonsense of the case.
That is not the case. There is already within the law of the land and in the operation of the National Health Service complete freedom for individuals to decide for themselves whether to have this operation. All I am saying is that establishing also whether or not in a particular case it really is in the best interests of the individual concerned to have this operation is best left to sensitive counselling and is certainly not a matter for statutory limitation or law.
I came to the House today because I feel so deeply about the dangers of the Bill. I was therefore sorry to hear my hon. Friend—for the first time, to my knowledge—give the Government's wholehearted and complete support for the Bill so early. That is a change in their original attitude. Everything that the Minister has said so far has strengthened my determination to resist this wholly unwarranted interference by the State in what is essentially a private matter. This is not an area in which the State should interfere at all. The idea of State counselling terrifies me. It is wrong that public money should be expended on these matters. Where will it all end? Eventually, it will end up like Russia.
I must try to adjust my hon. Friend's perspective slightly. He must try to understand that the Government have faced the fact that the House gave a Second Reading to this Bill without compulsion or constraint by the official Whips. That is the perspective in which we have to work. The Govern- ment's interest is to secure that, for the very short period for which the Bill will apply, all the proper safeguards and provisions which may be necessary and reasonable will apply for the health of individuals who will henceforth be able to secure this operation under the National Health Service, in addition to already being able to secure it privately. So when it comes in under local government we want to ensure that the same reasonable and humane conditions apply.
My hon. Friend talked about counselling. He will appreciate that there is already State counselling, although the term is odious and misleading. In so far as the general medical service provided under the National Health Service, in the shape of the work of the general practitioner, is State-subsidised and fully State-supported, it is an integral and essential part of the work of a general practitioner that at every stage in his professional relationship with a patient he should be counselling him or her on personal issues affecting the patient's health. We seek now to do no more than ensure that counselling which is right and proper for operations with profound medical implications should be as effective when it is provided under local government auspices.rose—
Perhaps it would be more appropriate if I did not give way any more now but listened to my hon. Friends' speeches and any comments which they have to make.
I am grateful for the clear and concise way in which my hon. Friend the Member for Yarmouth (Mr. Fell) moved the Second Reading of the new Clause. I apologise to the House for having been absent for a few moments as a result of the very serious statement which my right hon. Friend the Prime Minister made before the debate.
The Under-Secretary at least paid a tribute to the new Clause when he described it as ingenious. My hon. Friend and I are grateful for that much. After that faint praise, he proceeded to damn the new Clause by saying that it was unsatisfactory and that it was not appropriate to give the status of law to a circular of the kind in question. I should have thought that, in this very important and far-reaching matter, a circular might have been designed in the same way as the code of conduct which accompanies the Industrial Relations Act. It seems to us that control not only by the Secretary of State but also by this House is important. That is why we ask in the new Clause that any such circular should be laid before Parliament. Normally we are not acquainted with the terms of circulars issued by the Secretary of State on these matters. The Under-Secretary said that he could not give the precise terms of the circular which he had in mind, but he was good enough to suggest certain conditions which he thought should be imposed upon vasectomies under the Bill. We are grateful for this. He said that this operation should be only for men but also only for married men, for those who enjoyed a stable union and who had completed their families. There was some discussion about this. This is one of the vaguenesses which require consideration. My hon. Friend the Member for Yarmouth waxed eloquent about it. 12.45 p.m. I can contribute something from my personal experience. In my own family there is a gap of seven years between our last child and our last but one. It was not our intention that our youngest daughter should be born. My wife and I do not approve of artificial means of contraception. Let us suppose, however, that we had taken a different view and that after the birth of our fifth child—we have six—we had seriously considered whether or not we had completed our family and had resorted to counselling, the sensitive counselling which my hon. Friend is concerned should exist. I am sure that, even without sensitive counselling, we should have concluded at that stage that we had completed our family. But we are now fully aware that that would have been a wrong decision. This is very difficult. It is not enough to say that, after a bit of serious thought and after seeing a good counsellor, one can come to the right conclusion. In many cases I do not believe that one will come to the right conclusion. One way out of this was to raise the age limit from 30 in the original Bill to 60. This was the purpose of the Amendment in the name of my hon. Friend and myself. In the end, however, no age limit was written into the Bill. This is one of the serious reasons why we are concerned about the form and content of any circular issued by the Secretary of State to the local health authorities. The new Clause reaches to the whole question of parliamentary control. After all, the hon. Member for Derby, North (Mr. Whitehead) seemed to sympathise with our point of view because he said when moving the Second Reading:We cannot take this matter as lightly as some hon. Members would wish. At least the hon. Member has been frank with the House, as has my hon. Friend the Member for Norwich, South (Dr. Stuttaford), who was the only medical Member on the Standing Committee—'"The Bill is a short one…but I would not seek to disguise from the House the fact that it touches upon great issues—issues of human relationships, parenthood and family life."—[OFFICIAL REPORT, 21st January, 1972; Vol. 829, c. 826.]
And the hon. Member for Halifax (Dr. Summerskill).
At least, my hon. Friend was one of only two medical Members on the Standing Committee. He was very blunt about it and said we must assume that the operation is irreversible. That also is the position of the hon. Member for Derby, North. The new Clause would ensure that so drastic and irrevocable an operation should not be carried out without strict control—and much stricter control than is provided for as the Bill has come from the Standing Committee.
The Standing Committee was of the view that the Secretary of State should be kept fully informed. An Amendment was unanimously supported to enable the right hon. Gentleman to receive annual reports from all local health authorities. We are here concerned to see that Parliament is kept fully informed and has some control in the matter. The Minister spoke of the sort of criteria that his right hon. Friend will wish to lay down. Alas, he will not always be in office. We do not know what regulations will be introduced and we want a degree of certainty by ensuring that they are laid before Parliament. The hon. Member for Pontypool (Mr. Abse) laid great stress on the need for counselling. On Second Reading he said that there could never be a completely watertight system of counselling. He tabled an Amendment in Committee to require psychiatric advice to would-be vasectomees and asked that, alternatively, advice should be given by a counselling service. Unfortunately the Standing Committee rejected that Amendment. Despite what the Minister said, we are left in considerable doubt that adequate counselling will be given. Perhaps the hon. Member for Pontypool was satisfied with the Minister's remarks, and we look forward to hearing his point of view because he rightly laid stress in Committee on the importance of adequate counselling. When the Bill was originally presented to Parliament it stated that vasectomy should not be performed on a man aged less than 30. Indeed, the hon. Member for Derby, North said on Second Reading:I am glad that the hon. Gentleman believes in that—"For the couple who present themselves, calmly and rationally, for vasectomy but with no medical indication that it is needed, the only additional check required would be a lower age limit for the man, which the Bill fixes at 30. By that time society can say it has protected for a long period a man's right to have a family"—
He continued:"even though he wishes to abdicate that right."
That is doubtless the case. Nevertheless, such is the pressure from what I call anti-life propaganda and the pessimism in some leading circles about the future of the human race that I am not sure that it would always be the case that a man presenting himself for vasectomy would already be 30 or considerably more. There are impressionable people, and all the propaganda nowadays is towards every form of contraception and abortion. There are the masochists, to whom the hon. Member for Pontypool referred eloquently. If there were no statutory age limit the situation would be extremely serious because men under that age—immature and irresponsible men; this would be the case despite what might be in the general principles laid down by the Minister—would find some, if not many, medical men who would be willing to perform this irreversible operation, as we are informed we must regard it."In the vast majority of vasectomies done outside cases of extreme medical need the man is already 30 or considerably more".—[Official Report, 21st January, 1972; Vol. 829, c. 837.]
Would not my hon. Friend agree that the younger a person is, the greater will be the pressure on him to ask for an operation which later, when he becomes more responsible, he may deeply regret?
I am obliged to my hon. Friend for putting the point so succinctly.
I referred to this matter in Committee when I said that younger people were today less susceptible to the advice of their elders and established society while being more susceptible to fashion, and fashion today is all on the side of this sort of thing. This is the trend. We must, therefore, protect younger people from decisions which they may subsequently regret. We are dealing not with normal contraception or abortion, because a woman can bear children after an abortion.Not always.
That is correct. This is an irrevocable and irreversible operation and we want to be sure that younger people are protected.
In Committee the right hon. Member for Sowerby (Mr. Houghton) often descended upon our deliberations at about noonday—I do not see him among us today—and then, rather like a non-vasectomised bull in a china shop, upset the apple-cart. I say this with deep respect to such a senior Member. On one occasion, to the horror of the sponsor of the Bill, the right hon. Gentleman succeeded in deleting the age limit of 30 from the Bill.He vasectomised the Bill.
For once we had the sponsor voting with us. It was clear from the remarks of the hon. Member for Pontypool that that action changed the complexion of the Measure.
We owe it to the House at this stage, and particularly to some of our colleagues who have entered the debate for the first time, to point out that this is not the Bill which received a Second Reading without a Division. This Measure provides for vasectomy on the rates at any age, subject to what local authorities, doctors and the Department may want to happen. That is one reason for the new Clause. We do not desire simply the general aspirations of the Department to be made known. We want put down in black and white what are the restrictions under which this operation may be carried out within the family planning system. We ought to hear a little more from my hon. Friend the Under-Secretary about this. It is not enough for him to say "Here are the sort of conditions I should like to see." We must have laid before us the sort of circular that will go out. We must know what is in it and be satisfied, so far as we can be—those of us who are opposed to it in principle cannot be satisfied, but the House as a whole ought to be satisfied—that if there is to be this extension of vasectomy at public expense through local health authorities, the circumstances in which the operation may be carried out are known and properly circumscribed.1.0 p.m.
First, speaking from a neutral Front Bench, I give my personal views on the Under-Secretary's statement. I can agree with his general reflections on the new Clause and would oppose it. It seems a contradiction in terms to have statutory guidance. By its very nature, guidance cannot be statutory and cannot be imposed on local authorities.
We heard in Committee and today once more the vitally important guidance which will be given to local authorities. We now have the guidance that older men rather than younger men will be receiving this operation; that they will be married rather than single men and that they will have families rather than no families. All these are important and necessary assurances. It would be wrong to lay down in a Statute guidance for what is, after all, a surgical operation. In this operation, many factors will be taken into account, and not only the age of the person, which in itself is vitally important. But it would be difficult to lay down a magic age above which the operation can be performed and below which it cannot and to say that it should be 30 rather than 40 or rather than 35. That would make the operation extremely difficult to carry out. Not only age but the social and economic background of both the man and his wife would be considered. The reasons why they want the operation are very important. The general health of not only the man but, more important, the woman, the number of children, whether they are alive and their ages, and the emotional stability of the couple and the marriage must be taken into account by the family doctor, the surgeon who is undertaking the operation and the counsellors. This is, therefore, a very complex subject. It is the carrying out of what has been regarded by the Committee and the House as an irreversible operation. Therefore, all these factors have to be considered carefully, and we must have some trust in the doctors, the G.P. and the surgeon, and those who will be counselling the man involved. It would make their job extremely difficult if not impossible to lay down in a Statute certain conditions for the operation. Every case will be different and will have different factors. There will always be some cases where regrets will be felt afterwards. That is inevitable. It is possibly inevitable in any operation but more so in this one. I welcome the statement about the setting up of the chief medical officer's special committee, which will serve to give guidance to the counsellors. Therefore, they in their turn will feel that they have a body to which they can go for advice. We have heard a great deal from the supporters of the new Clause about State intervention. They have been opposing State intervention, yet by the Clause they are advocating more State intervention concerning this operation. On the one hand they are saying that the individual should be free to make decisions for himself—which we fully support—but on the other hand they are saying that the State can intervene. The Bill has a completely voluntary aspect all the way through. No one is being forced to have this operation. As I pointed out on Second Reading, the Family Planning Association is very careful to counsel man and wife and to give them an interim thinking and deciding period before the operation to make quite sure that they really want it. The voluntary aspect is further emphasised by the fact that rigid stipulations will not be laid down. Each case will be considered separately and there is freedom for the individual to consider this method of family planning. After all, if we deprive individuals of this method—which is a legal operation already being carried out in the private sector of medicine for people who want it and are able and willing to pay for it—we are therefore limiting the available methods of family planning for those who cannot perhaps afford to pay for this in the private sector. We are simply adding a last-resort method of family planning to the methods already available.Does not the right hon. Lady agree that there is an extraordinary difference between being able to pay for the operation and having the operation with the whole panoply of the State?
Order. The hon. Gentleman is now going to the principle of the Bill.
I apologise, Mr. Deputy Speaker. I was asking the right hon. Lady what I thought was a question directly related to what she had been saying.
The hon. Gentleman must not follow the hon. Lady in the direction in which she was going—unfortunately, not pulled up by the Chair.
Surely that is something we always do to Eve.
The hon. Lady will not stray from the path any longer; anyway, she was about to conclude her remarks.
The proposals put to the House by the Under-Secretary seem a more acceptable way of looking at the Bill than the rigid rules which would be imposed if there were statutory guidelines—not that it is possible in practice to have guidelines which are, at the same time, statutory.
I support the new Clause which my hon. Friend the Member for Yarmouth (Mr. Fell) moved very clearly and in a way that was helpful to those of us who did not have the opportunity to serve on the Committee.
It seems to me that the purpose of the Clause is that the Secretary of State should not circularise local authorities in secret but that the circulars should be the subject of regulations laid before Parliament. This may seem an unusual thing to do, but, after all, it is rather an unusual operation. Such a procedure would fulfil two useful functions. First, it would enable those of us with doubts or worries about the developments to air them. That is one of the most important functions of Parliament. It is a forum where we can do that. Second, and very important, as a result of the debate here the public may be made aware of the various doubts of some of their representatives and the dangers they see. Therefore, it would be helpful to have an assurance from the hon. Member for Derby, North (Mr. Whitehead), whose Bill it is. I refer to him because my hon. Friend the Minister has withdrawn and has had nothing to do with the matter, though I believe the opposition to the Clause comes from him on rather purist, constitutional lines. I have been in the same sort of position as my hon. Friend, though not in the English sense but in the Scottish sense, and the Scots take a very strict constitutional view of things. I do not know that that is necessarily right. My hon. Friend was saying that we must either leave things to the local authorities or do them ourselves. Both sides of the House have a kind of love-hate relationship with local authorities. When local authorities are doing what the party in power agrees with, they must have every freedom. When they wish to do something the party in power does not agree with, they should not have any freedom at all. At this moment a Bill is going through the House to restrict the freedom of local authorities in relation to house rents. I do not know that my hon. Friend failed to support the Government on that. Therefore, I regret the rather purist line that he is taking. I conditions in the circulars to be tabled believe that it would be possible for the and either approved or not approved by the House. The Minister's remarks were very interesting. He made them with great clarity, but, like my hon. Friend the Member for Oldbury and Halesowen (Mr. Stokes) I was rather startled by some of the things he said. Perhaps if he had not been such a good Minister and had not been so clear I should have gone for my lunch instead of having my stomach rumbling just now. But I felt I had to say one or two things because I was concerned by his statement, particularly in connection with the advice that the operation should be carried out only on married men. I understand that it is purely advice, and that there is no compulsion about it. The local authorities can ignore the circular altogether. We know how, when people have a bit between their teeth, they pay little or no attention to advice. I thought my hon. Friend's statement that the operation should be carried out only on married men was a good point, but he qualified it by saying, "when they have completed their family". I do not see how one can tell when they have completed their family. We have the evidence of my hon. Friend the Member for Chigwell (Mr. Biggs-Davison) that people get married very young nowadays. We all know that. They are getting married younger and younger. The tendency is to have one or two children. 1.15 p.m. A man of 28, who could easily be the father of four children, urged perhaps by his wife, his social conscience or all the trendy things we read about in the newspapers these days, and encouraged by the fact that the operation is easily available under the National Health Service, may go along to the sensitive counsellors. Incidentally, I do not see how anyone could be a counsellor unless he or she was sensitive. When he explains that he wants the operation, that he has four children and is aged 28, they say, "Why not?" Then a year or two passes and a disaster happens. His wife may be killed and there may be a breakdown in the marriage. Plenty of people do not event start having a family until they are over 40.I speak from personal experience. I did not get married until I was 39. Suppose I had been roving around the world as a sailor, which indeed I had, and had had the operation—though I admit that one could not if one's local authority followed my hon. Friends advice. But I think the conception of having completed the family is nonsensical. I do not see at what age it is possible to say that one has completed one's family. That is one reason why I am very worried about what will happen. I do not think my hon. Friend said what would happen after the reorganisation of the National Health Service, but if he could say a few words on that, it would be helpful to the House. I must refer next to the hon. Lady who led us astray, the hon. Member for Halifax (Dr. Summerskill). I understood completely why my hon. Friend the Member for Yarmouth referred to her as "the right hon. Lady". It was the most natural mistake. I had only to shut my eyes for a moment and to me it was her noble mother who was speaking.I must plead guilty to describing the hon. Lady incorrectly not once but four or five times. I am extremely glad she corrected me in the end.
I remember that in the old days—and when I speak about the old days my children, who are very young, ask what I mean, and I say "Fourteen or fifteen years ago", when they were not alive—the hon. Lady's noble mother was sitting on the bench that she herself has been sitting on today and I was sitting on the bench that my hon. Friend the Minister is now occupying. I had only to close my eyes for a moment and I had the feeling I was listening to her noble mother again.
The hon. Lady spoke very effectively. I am sorry she has gone, because I wished to ask her whether in the course of her professional life she had had any experience of the effects of the operation. I thought she was perhaps just a little unkind when she said to my hon. Friends and myself that we were asking for extra State intervention. Is not this always the trouble? Once the devil—in this case the State—is let in, we do not get a little devil. There is a natural tendency to see more: "Quis custodiet custodes ipsos?". I hope that is understandable to the House, even in these days when the classical languages are not as well known as they used to be. I hope that for the few reasons I have given it may be possible for the hon. Member for Derby, North to see that there are some matters concerning us and to indicate that he does not necessarily take the view of the Government Front Bench.My approach to this new Clause is to ask myself whether it is likely, if accepted, to assist the stabilisation of family life. We are all exceedingly grateful to the hon. Member for Yarmouth (Mr. Fell) and the hon. Member for Chigwell (Mr. Biggs-Davison) for having tabled the new Clause. It has given the Under-Secretary the opportunity of making his statement and has given us the opportunity of discussing whether we are likely to make a contribution to the proper use of family planning and, hence, the enchancement of family happiness.
The appoach of the hon. Members for Chigwell and Yarmouth and my approach are quite different because, as they have frankly indicated, they are opposed to all forms of contraceptives and, impliedly, to these forms of family planning. There is a great difference between us, and, therefore, there will be a difference in our approach. Although I have valued, in Committee and on the Floor of the House, the contributions made by the hon. Members, I regard it as my duty to point out that we live in a plural society in which if we hold particular views, however tenaciously, with whatever regard and respect, there comes a time when, having contributed those views, it is time to accept the consensus. My second approach to the new Clause is as to assessment—whether it is likely to contain the proliferation of vasectomy so that its use will be generally a proper one or whether it is more likely that there will be abuse. Clearly, whether or not the hon. Members who framed the new Clause like it, vasectomy is here and it will be part of the family planning armoury. It is legal and available cheaply. It can either be done under proper circumstances, with sensitive advice and guidance, or it can be done merely by the payment of fees to any irresponsible or psychopathic doctor. I would have thought that both hon. Members would have been concerned, particularly since they share with me a hostility towards the abortion Act and are aware of what has flowed from it, to ensure that we have sufficient checks and guidance to make sure that vasectomy does not go into an irresponsible private sector but is contained within the State sector so that it is unlikely or improbable that it will do harm to those who submit to the operation.Surely this is the whole purpose of the new Clause, to provide that if this happens it happens in the best possible way with the best possible safeguards.
I am making it clear that I do not think that is the purpose of the new Clause. Although the hon. Member is pressing me to be more explicit, I believe that neither hon. Member wants this Bill, and since they do not want it I am bound to assess the new Clause in terms of whether it is genuinely intended to bring about the result they claim or whether it is a filibustering, negative exercise.
The hon. Gentleman is the soul of courtesy as always. He will be remembered by all of us in Committee, but it was not very kind of him to suggest that this Clause is simply filibustering. Had it been thought to be so it would never have been accepted. It is true, and we have said so openly from the very beginning, that we are opposed to the Bill, but there is nothing to stop us trying to improve it. Surely the hon. Member agrees with that?
I will accept what the hon. Gentleman says. I am bound to test whether it is a genuine attempt to improve the Bill or whether it is an attempt to sabotage it. The hon. Member is too frank and too honest not to enable me to make that comment without his excessively demurring. I have to consider whether the important statement made by the Under-Secretary sufficiently assuages my doubts about supporting the course he suggests or whether I should turn to the alternative of the new Clause.
I am grateful to the Under-Secretary for the manner in which he has made it abundantly clear that there is intended to be certain aid for local authorities in an administrative and medical circular. I am certain that this would not have come about with the precision and clarity that we now have if it had not been for the hon. Members for Yarmouth and Chigwell being so persistent in Committee. We must accept that the cautionary words we have used have brought about what is an unusual course for a Minister to take, to give in advance in such terms a clear account of what type and nature of circular will flow from the passing of this Measure. I am particularly grateful, and I think that the hon. Members will be grateful because it comes from their work, that we now have a statement making it clear that the caveatswe entered in Committee against the nature and character of counselling—if it was not of a wholly sensitive and insightful kind—have brought a response from the Under-Secretary. The fact that he is prepared to set up an advisory committee gives me some assurance. I hope that committee will contain those representing urologists who have a special knowledge of the matter, and I hope that the committee will look for guidance to people such as psycho analysts, within their Institute of Psycho-Analysis in particular. Both urologists and psycho-analysis have already made clear from their contributions on the subject that they fall into a special category in the character of the counselling that can be given. What can flow from the work of this committee is an improvement in the advice now given by the Family Planning Association and other institutions, and I, therefore, welcome it. I am sure I am representing the view of those who came to me from the British Medical Association and the Medical Defence Union when I say that they are bound to express thanks to the Minister for having quite clearly given careful and considered thought to the representations which have been made through me. What he said about the concern regarding failed vasectomies will allay most of the anxieties of the Medical Defence Union, which would be the first to recognise that the setting up of the committee on advice and counselling will be a contribution to making it unlikely that there will be failed vasectomies, because there is a necessity for post-vasectomy as well as pre-vasectomy counselling and advice. I believe that we can move forward without this Clause with a sense of assurance that the Bill will make a genuine contribution to family happiness and good family planning and that it is not likely only to yield to morbid masochism in the community.rose—
Mr. Fell.
1.30 p.m.
I apologise if the hon. Member for Derby, North (Mr. Whitehead) wished to speak. I should have loved to have heard him before I made a second speech.
I cannot be happy about the situation which has arisen over the new Clause. It would be wrong of me to weary the House with tedious repetition, but I must admit that I am very disappointed about what has happened. I wish to say a few words about the characteristically helpful speech of the hon. Member for Pontypool (Mr. Abse). I cannot understand why he is happy about the Under-Secretary's answer concerning sensitive counselling. I do not propose to read extracts from the hon. Gentleman's speech on counselling into which he put so much work, but the Minister has not said anything which makes me happy about the kind of counselling which will be available. The hon. Member for Pontypool talked about failed vasectomies. The Under-secretary also referred to that. I believe he was able to refer to it only because the hon. Member for Pontypool was kind enough to let him have a copy of the document which had been sent to him by the medical authority concerned. I am sorry to say that I have not seen the document. The B.M.A., bless its heart, did not have the courtesy to send a copy of it to my hon. Friend the Member for Chigwell (Mr. Biggs-Davison) or myself, who were at that stage the only opponents of the Bill. I am pleased that the hon. Member for Pontypool is satisfied that what the Under-Secretary said about failed vasectomies was all right. However, I beg leave to have some doubts about it. It would, however, be wrong for me to discuss, in the presence of the hon. Lady the Member for Halifax (Dr. Summerskill), with all her experience, the question of failed vasectomies. I do not know the figures concerned because I have not been given the relevant information. I have some major bones to pick with my hon. Friend the Under-Secretary of State, who could not have shown more kindness and courtesy in Committee. He said, as though it were an excuse for supporting it, that the Bill will run only to 1974 and that therefore we need not worry. But he gave the game away because he said that the Bill had had a Second Reading and that therefore the will of the House had been demonstrated. I should not have thought that the Second Reading of a Private Member's Bill on a highly controversial but general subject like this which took place on a Friday when very few Members were present could by the wildest stretch of the imagination be regarded as giving a blessing to the Bill. What worries me enormously is that my hon. Friend the Under-Secretary has said that the Bill, when it is an Act, will come to an end in 1974 and I do not know whether, when that happens, a new Bill will have to be presented or the matter can be dealt with by the Department issuing regulations. By 1974 matters will be well under way and vasectomies may be running at the rate of 20,000 a year. Can my hon. Friend tell me whether a new Bill will have to be introduced if the Department wishes to do that? Suppose, however, that a Private Member wished to introduce a new Bill—perhaps the hon. Member for Derby, North, who has taken so much trouble over the Bill. If he wished to introduce a Bill at the end of 1974 or in 1975, it would be said that a similar Bill had been passed by the House with acclamation once and therefore it could be tackled without any trouble. That would be a most extraordinary way of proceeding in a democracy. We have surprises every five minutes in the House. This is perhaps the second this morning. We did not divide against the committal of the Bill to a Committee upstairs. We always try to facilitate the wishes of the hon. Member for Derby, North, and therefore I shall not keep the House for more than another minute or two. But without being accused of tedious repetition I should like to know what my hon. Friend the Under-Secretary of State means when he talks, presumably with the advice of his Department, about "a completed family". I simply do not know what that term means. I know that in practice a family is completed is when either the father or mother is not able to conceive. But the vasectomy method of completing the family may apply even to a young married couple. My hon. Friend has been kind and helpful, as he always is. He is a Christian man with the greatest morals and principles, but suppose we have someone sitting in his chair in 10 years' time who has different ideas about principles and morals. Suppose there is a Minister sit ting there who sees that the birth figures have gone up; suppose we have a crank sitting on that bench—Order. I tried a little while ago to get the hon. Member to talk about the circular. I know he is a man of his word, and he has just said that he will be speaking for only a moment or two.
I am getting carried away with the subject, Mr. Speaker. A vasectomised Bill has been sent down to us and it is so much the worse for that. I just wish to say something on the question of the completed family to which the Minister referred.
We have heard quite a lot from the Minister and from the hon. Member.
I want to know what safeguard there will be. How long will it be before there is a statutory "completed family"? How long will it be before a completed family is a family with two children or three children? I have tried to express the fears which my hon. Friend the Member for Chigwell and I have at the back of our minds about the moral outlook towards society Let me not be a moraliser, because I cannot ever aspire to that. The hon. Member for Pontypool is right when he says that I am against the Bill. The Minister has turned down the new Clause without making any suggestions about what might replace it, but I hope he may be able to give us later assurances of help on other parts of the Bill.
After a full debate which has ranged far, from the fears of the hon. Member for Yarmouth (Mr. Fell) and his hon. Friends through brief excursions into the classics, autobiography, memoir and history from the hon. Member for Glasgow, Hillhead (Mr. Galbraith), it might help if I attempted to sum up the impression left on me by the valuable contribution made by the Minister. We all have a debt of gratitude to the Minister for the way in which he and his advisers have sympathetically followed the course of the Bill throughout and have attempted to meet the wishes of the Committee.
My understanding, as a comparatively new Member of Parliament, is that the whole purpose of the Report stage is to build upon the creative conflicts in Committee, and that is what we have done. In that context I pay tribute to my hon. Friend the Member for Pontypool (Mr. Abse) and others who have shown some of the problems which might arise if vasectomy, as the hon. Member for Yarmouth might say, were to get out of hand. We have always made it clear that vasectomy would never be the primary method of birth control and that we never intended it to be more than an operation which should be available, regardless of cost, on their own free judgment—there is no question of Moscow-like decisions—to people who, as the hon. Member for Oldbury and Halesowen (Mr. Stokes) said, had decided that their families were complete. If the hon. Member for Yarmouth disagrees and thinks that people are not in a position to say this, that is for him, but those of us who feel that free men can make this decision—after all, the Bill refers to voluntary vasectomy—have been heartened by what the Minister has said. As I understand, the parent Act contains in Section 1 (1) the words:There is, therefore, no doubt that any clinic, advisory service or hospital service provided under the Bill by the local authority would have to meet the full approval of the Secretary of State before it could stay in the business of performing these functions. 1.45 p.m. I accept what the Minister has said about the delicate relationship between local authorities and the Secretary of State. I am glad that the administrative circular will draw attention to the fact that this is normally an operation for married men or those in stable unions—I hope the words "those in stable unions" added in parenthesis by the Minister will find their way into the circular—and to people of mature years who have completed their families. I am glad also that local authorities will be recommended to look carefully at the motives of younger men who come forward for the operation. I accept that consent is of the essence of the Bill and that the consent of both partners should be given before the operation is undertaken. I welcome the setting up of an advisory group to prepare expert advice on counselling for the medical officers of health. I hope that it will contain amongst the parameters within which it can give advice the question of the processes which are to be entered into in the counselling procedure—the fact that referral, for example, should normally be by the general practitioner since he will know the family situation better than anyone else, and that discussions will be entered into. I suggest that the processes recommended by the advisory group should include particular stress on the follow-up procedure, counselling and advice where necessary afterwards as well as before, and, of course, the full and proper procedure for ensuring that the operation is successful. The majority of the cases referred to in the letters which were sent to my hon. Friend by the Medical Defence Union were adjudged failures only in so far as the people concerned had not been told that the vasectomy operation was not successful unless two successive negative sperm counts had been obtained. That procedure is more likely to take place outside the aegis of the local authority health services and the National Health Service, and the procedures to be followed if we consider the advice given by the Family Planning Association and the Simon Population Trust on what the patient must be told and what procedures he must follow are laid down already. Those procedures should be followed by the local authorities when the Bill becomes law. I believe that the vasectomy clinics will have the minimum demanded by the B.M.A. and in some matters will probably have greater standards of care than is the case now in private practice. I also hope that the point will be well taken about bringing all these services within the aegis of the National Health Service and providing proper back-up facilities, including hospital beds, where needed, for all patients. In considering the new Clause we must take into account what was said by my hon. Friend the Member for Pontypool Does the hon. Member for Yarmouth wish to strengthen the Bill or not? On the one hand he appears to be asking for no State intervention, and on the other hand he seems to be saying that State intervention should be strengthened. He also appears to be giving his advice on correct procedures for this operation which would facilitate the proper undertaking of the operation when, as we heard in Committee, he is entirely opposed to the whole notion of the operation and even questions its legality."with the approval of the Minister of Health".
I tried to spell out this matter to the hon. Member for Pontypool (Mr. Abse). Surely it must be clear that even though the new Clause may be badly drafted and even unworkable, it nevertheless attempts to do a job. If the
Division No. 102.]
| AYES
| [1.55 p.m.
|
| Galbraith, Hn. T. G. | TELLERS FOR THE AYES:: | |
| Hornsby-Smith,Rt.Hn.Dame Patricia | Mr. Anthony Fell and | |
| Stokes, John | Mr. John Biggs-Davison |
NOES
| ||
| Abse, Leo | Hattersley, Roy | Rees-Davies, W. R. |
| Albu, Austen | Houghton, Rt. Hn. Douglas | Roper, John |
| Alison, Michael (Barkston Ash) | Huckfield, Leslie | Rost, Peter |
| Allen, Scholefield | Jenkins, Hugh (Putney) | Sandelson, Neville |
| Atkins, Humphrey | Jessel, Toby | Short, Mrs. Renée (W'hampton,N.E.) |
| Atkinson, Norman | Johnson, James (K'ston-on-Hull, W.) | Silkin, Hn. S. C. (Dulwich) |
| Baker, Kenneth (St. Marylebone) | Johnson, Walter (Derby, S.) | Silverman, Julius |
| Barnett, Guy (Greenwich) | Judd, Frank | Sinclair, Sir George |
| Blenkinsop, Arthur | Kaufman, Gerald | Spearing, Nigel |
| Brown, Ronald (Shoreditch & F'b | Kelley, Richard | Spence, John |
| Clark, David (Colne Valley) | Lane, David | Stewart, Donald (Western Isles) |
| Clegg, Walter | Leonard, Dick | Stewart, Rt. Hn. Michael (Fulham) |
| Cormack, Patrick | Lestor, Miss Joan | Stuttaford, Dr. Tom |
| Cunningham, G. (Islington, S.W.) | Lipton, Marcus | Summerskill, Hn. Dr. Shirley |
| Davies, Denzil (Llanelly) | Mackenzie, Gregor | Taverne, Dick |
| Davis, Terry (Bromsgrove) | Mackle, John | Tomney, Frank |
| Deakins, Eric | Mendelson, John | Trafford, Dr. Anthony |
| de Freitas, Rt. Hn. Sir Geoffrey | Meyer, Sir Anthony | Urwin, T. W. |
| Edwards, Robert (Bilston) | Mikardo, Ian | Vaughan, Dr. Gerard |
| English, Michael | Miscampbell, Norman | Walker-Smith, Rt. Hn. Sir Derek |
| Eyre, Reginald | Moate, Roger | Weitzman, David |
| Fletcher, Raymond (Ilkeston) | Molloy, William | Wellbeloved, James |
| Gilbert, Dr. John | Neave, Airey | Whitehead, Phillip |
| Golding, John | Ogden, Eric | Williams, Alan (Swansea, W.) |
| Grant, Anthony (Harrow, C.) | Parker, John (Dagenham) | |
| Grant, John D. (Islington, E.) | Peel, John | TELLERS FOR THE NOES:
|
| Gummer, Selwyn | Pendry, Tom | Mr. William Hamling and |
| Hamilton, William (Fife, W.) | Rankin, John | Dr. David Owen. |
Question accordingly negatived.
Under-Secretary or the hon. Gentleman wanted to exchange it for something else, they could have suggested an alternative at any time. It is not worthy of the hon. Member for Derby, North (Mr. Whitehead), who has been most helpful throughout the Bill, to suggest that the new Clause has been tabled for fun and games, because there is no fun and games about this matter where I am concerned.
I share the hon. Gentleman's serious approach to these matters, and it is obvious that there is a difference of opinion between us on his new Clause. If we had wanted such a provision, we would have sought to write it into the Statute.
I am happy with the undertaking given by the Under-Secretary. Because of the hon. Gentleman's sympathetic outlook I know he will take seriously into account what has been said this morning, and, therefore, I have no hesitation in advising the House to reject new Clause 3.Question put, That the Clause be read a Second time: —
The House divided: Ayes 3, Noes 80.
Clause 1
Provision Of Voluntary Vasectomy Services
2.0 p.m.
I beg to move Amendment No. 2, in page 1, line 6 after 'may', insert:
'on payment of a fee except in cases of medical necessity'.
With this Amendment we are also considering Amendment No. 9, in line 19, at end insert:
'and at the end of that subsection there shall be added the words—
"Provided that such a charge shall always be recovered in respect of vasectomy services unless such services are provided for reasons of medical necessity" '
I shall be brief in introducing the Amendment. I am very sensitive of what was said by the hon. Member for Pontypool (Mr. Abse), who indicated that there might be an element of filibuster in the debates on some of the Amendments that the Chair thought fit to admit to the Report stage. I wish to remove any such misapprehension. After all, I am the hon. Member who closured his own speech in Standing Committee and thus, I believe, made parliamentary history. So I do not think there can be any element of filibuster in our proceedings. If the hon. Gentleman cares to examine the Official Report of the proceedings in Committee he will see that I did not take up much time.
I am anxious also to remove the curious impression that because an hon. Member is opposed to the principle of a Bill he should not be concerned to improve it. If an hon. Member dislikes a Bill in principle and is concerned to circumscribe some of the effects of it and to make others of them less obnoxious, it is his duty as a Member of this House to try to do so. This Amendment is concerned with payment for vesectomy operations for the purposes of contraception. I think that that is quite a reasonable proposition. I accept the view that those of us who do not like a law are expected to obey it and that very often citizens have to pay through their rates or taxes for services of which they do not approve. That is understood, and it is normal. Pacifists help to pay for the Armed Forces, and people who hold my view of this matter very often have to subscribe to services of which they do not approve. But I do not see that there can be any objection to this Amendment. At the moment payments are made for vasectomies. There was an interesting article in yesterday's Daily Mirror by "Mirror Man Steve Turner" on vasectomy. I think that the intention was to prepare the House and the public for this debate. One of the questions that he asked and answered in his article was:The answer that he gave was as follows:"How much does a vasectomy cost?"
I suppose that the implication is that if there is a queue and someone is in a hurry he may be expected to pay a doctor who requires a larger fee. I do not believe that the payment of fees is objectionable whether the operations be done in the private sector or otherwise. After all, the sums of money being paid at present are not formidable when one considers that it is a once-for-all operation. Indeed, one of the complaints that we have about it is that it is a once-for-all operation. I do not think that anyone could reasonably object to fees being charged under the provisions of this Act, if the Bill is enacted, and it would also help remove some of the objections of those who say that they do not wish to see this service provided purely at the ratepayers' expense. I accept the proposition that ratepayers and taxpayers may have to pay for services of which they disapprove thoroughly, but on the whole this Amendment seems reasonable and helpful to those ratepayers who do not approve of this at all and who take the view of the Bill that my hon. Friend the Member for Yarmouth (Mr. Fell) and I do. If it is said that there are people who will not be able to pay a modest fee such as that mentioned in the Daily Mirror article for an operation which is once-for-all and a matter which should give pause to the person contemplating it, it is a good idea that some pause should be given, and this would be one of the results if the Amendment were accepted. I hope that the hon. Member for Derby, North (Mr. Whitehead) will see his way to accepting the Amendment. It is wholly reasonable. It can do no harm to anyone, even to the most enthusiastic supporter of the Bill."There is no standard fee. Family Planning Association vasectomy clinics (there are seventeen now, with more planned) have been charging £15·50 for counselling and surgery From 1st April, the cost via F.P.A. goes up to £21. Some doctors do vasectomies for £25–£30. One man is known to have paid £125 for his operation. The average waiting-time for a vasectomy at an F.P.A. clinic is now four months."
I support my hon. Friend the Member for Chigwell (Mr. Biggs-Davison). I can see no reason why a fee should not be exacted except in cases of medical necessity. The hon. Member for Brixton (Mr. Lipton) made a very interesting speech earlier when he told the House the costs of this operation, which he said ran at between £30 and £40. That sounds a lot of money, but we are all very old-fashioned. It is not a lot of money at all. It represents about one week's wages.
Most people could well afford that sort of money for an operation which is not necessary. After all, the Amendment saysWhere it is not necessary on medical grounds, why should the man having the operation not make this small contribution? It is no good hon. Members opposite saying that the proposed fee is not small. It is small, and they know it. This proposal questions the whole purpose of the National Health Service and what it is meant to do. Is it for health only? Is it to help people who are in medical need, who need medical help not only from a medical point of view but from a financial point of view? Or is it for other ancillary purposes? Is it for improving the look of one's face, for example, or, if my hon. Friend the Member for Chigwell will forgive me, for things like toupees—he and I are beginning to get into the same state—tattooing, and so on? I believe that the National Health Service should be reserved for health matters, not for other things. What I have said applies to my hon. Friend the Member for Oldbury and Halesowen (Mr. Stokes) —I hope he will forgive me—and, indeed, from my vantage point, to the Minister himself. His hair is not as thick as it used to be. There may be something to be said for the 18th century—perhaps I am going rather wide. At any rate, the National Health Service should be not for people's convenience or vanity but for matters which are necessary from a medical point of view. The proposer of the Bill, who unfortunately is not here—"except in cases of medical necessity."
I am taking note.
I am delighted that the hon. Member for Pontypool (Mr. Abse) is at this moment taking charge of the Bill.
I am merely taking note.
Is the hon. Gentleman going to reply for his hon. Friend? Are we to have no reply from the other side of the House? This is rather a serious matter.
My hon. Friend the Member for Derby, North (Mr. Whitehead) told me that he would be returning any minute.
Unfortunately, he did not make arrangements about his sandwich. Perhaps he is munching it in the Lobby. I sympathise with him. Meanwhile he is missing the point.
I wanted to ask the promoter of the Bill: what are the sums involved? If the Amendment were accepted, how much would it save the public purse? I have looked at the effect of this matter on the ordinary individual. I believe that £30 to £40 is not beyond the capacity of somebody who wants this operation not on grounds of medical necessity but because he would like it. This is not what the National Health Service exists for. I realise that there is a basic conflict in philosophical approach between the two sides of the House on what the National Health Service should be for. I believe that it should be for medical necessity. I go even further—I do not necessarily expect to carry my hon. Friends—and say that where a person can pay, even incases of medical necessity, there is a strong argument for saying that he should. I support the Amendment. I very much hope that some hon. Gentlemen opposite who support the Bill will be able to deal with the small points which have been raised. If it is to be the hon. Member for Pontypool, nobody could be more grateful than I because I recognise that he is an authority on these matters and speaks with a wealth of knowledge for which the House is greatly indebted.I well understand the motivation behind the genuineness of the Amendment. Nobody should have the idea that in any matter where there could be self-help there should be a subsidy. That is the view behind the Amendment, and it is one which I share.
Through my association with the parent Act, the National Health Service (Family Planning) Act, 1967, there is no question but that the decision whether payments are made, in what circumstances they are made, whether there is a means test or whether people are financially screened, is entirely for the local authority concerned. Under the National Health Service (Family Planning) Act, 1967 practices vary in different parts of the country whether payment is made, whether advice is given free and whether contraceptives are charged for. Therefore, we are not taking away the discretion from local authorities which will be deciding about the circumstances in which payment may have to be made. I think that most local authorities will take the view—there may be some which will not—that they will assess each case in turn to decide whether payment should be made. The misunderstanding which has prompted the Amendment is that we could do a great deal of harm if we did not save the community a great deal of money by allowing this operation to be carried out free in what I hope are special and particular circumstances. 2.15 p.m. One of the main objects of the parent Act—it will apply here, to—is that for the first time the opportunity for domiciliary visits was given. It provided the opportunity for social workers and medical officers to seek out the problem families and, in seeking them out, to advise and counsel them. I do not imagine that it would be the wish of the House, if vasectomy is to be available, to exclude it from the problem family with six or seven children, which is a grave charge and burden to the State. For example, it may be that the wife is regularly asking for an abortion because she cannot face the prospect of bringing another child into slum conditions, or bringing into being an extra burden, or because her husband may be indifferent or feckless. It is precisely in those circumstances where we would want to make certain that vasectomy could take place without debarring the man, who may otherwise accept it, by insisting upon payment of a sum of money. I expect that, knowing their natural shrewdness, local authorities will take decisions which will mean that contributions towards the cost will be taken in certain cases. However, I am particularly concerned about families which are a heavy burden to the community. Often a woman who has had a large number of children now demands an abortion. It is precisely in that area that there must be discretion to allow a free vasectomy. I hope that that view will not conflict with the reasonable presentation of the case which the hon. Member for Chigwell (Mr. Biggs-Davison), in his succinct, not filibustering, speech, brought to the question. I think that we would be operating against the very people we want to help with the possibility of vasectomy if we accepted the Amendment.The hon. Member for Pontypool (Mr. Abse) has missed out the care which the State has for the very poor and needy. If ever a Government have tried to show that they will help the poor and needy, it is this Government.
The hon. Gentleman always puts his argument so immaculately and with such thought and care that it is difficult to fault them in any respect. But I wonder whether he really meant what he said about the problem family where the wife was being given a child every year and the husband was a feckless so-and-so Surely he did not think that we should make a great charge—he did not say "great"—on such families for this kind of operation. They are the very families where the husbands will be advised to have a vasectomy. I do not want to lake a party point, but it would be ridiculous to suggest that no Government have not made charges for medical reasons of one kind or another. One can remember cases where charges for prescriptions were imposed, and not only by the Conservative Party. It has been accepted that there should be charges in certain circumstances for health services of one sort and another. I agree that where a family really needed help in this way and where, after consultation in the manner suggested by the hon. Gentleman, it was thought that a vasectomy was the right thing to do, rather than having something done to the wife, which is a horrible thought, it would be monstrous to charge. Surely no one can suggest that the State would not be able to find a means of helping that poor family. Under the present Government, such a family is unlikely to be really a bread-line case if it has so large a number of children, and it is quite unthinkable that there would be a charge of £20 or whatever it might be for the operation. I disagree with the hon. Member when he attempts to suggest that my hon. Friend the Member for Chigwell (Mr. Biggs-Davison)—perhaps the most humane man on this side of the House—and even myself have such diabolical minds that we would advocate that someone for whom it was necessary but who could not really afford it should nevertheless have to pay. The Amendments have not been read out to the House. Amendment No. 2 simply states: in page 1, line 6, after 'may', insert:It seems to be harmless enough.on payment of a fee except in cases of medical necessity'.
It is not.
The hon. Gentleman says that it is not. But he is trying to get the Bill through. Is every Amendment that we try to argue to be considered so irrational and impossible that it must be turned down out of hand? There has been no attempt by the hon. Member for Derby, North (Mr. Whitehead) to alter the Bill back to where it was on Second Reading. If there had been, we might have been happier. Does he expect us, if he turns everything down out of hand, and if my hon. Friend the Under-Secretary of State does not move towards us, to sit down and watch the Bill simply trundle through the House? Will the hon. Gentleman support these Amendments?
Amendment No. 9 has not been read out to the House either. It says: in page 1, line 19, at end insert:'and at the end of that subsection there shall be added the words—
It shows the reasonableness of my hon. Friend the Member for Chigwell and, I hope, of myself. I fail to understand why, throughout the proceedings on the Bill, after all that has been said, no move of any sort has been made towards those who represent not vast numbers but a substantial opinion in the country, and who represent what we believe to be the right thought."Provided that such a charge shall always be recovered in respect of vasectomy services unless such services are provided for reasons of medical necessity"'.
Is it not notice able that the hon. Member for Pontypool (Mr. Abse), who voted with us against the removal of the 30-year age stipulation, is taking no steps to reinstate that age limit although he considered it essential to the Bill and said that the hon. Member for Derby, North (Mr. Whitehead) had practically lost the Bill because of it? Is this not extraordinary obduracy and a failure to respond to the wishes of the Standing Committee and to fulfil his own wishes? This is an extraordinary attitude.
What is more it shows the enormous faith of the hon. Member for Derby, North, which is not normally apparent, in the Government, because his proposition—
I would be out of order in answering the hon. Member for Chigwell (Mr. Biggs-Davison) because Amendment No. 8 has not been selected. It stands in the names of the hon. Member for Chigwell and the hon. Member for Yarmouth (Mr. Fell).
I am talking about Amendments Nos. 2 and 9. I am sorry if the hon. Gentleman looked at the wrong one. It is a mistake any of us can make. In trying to gain support for these two Amendments, I was remarking on the in credible fact of the amount of trust which the hon. Gentleman places in the Minister. It has never been seen in him before. But we have also seen it in the hon. Member for Pontypool. Perhaps the hon. Member for Pontypool is more in the habit of putting his trust in Government Ministers, but I have not particularly noticed it.
However, I do not want to delay the Committee. Time rushes by. One can hardly stop the minutes going by and it would be churlish of me in any way to attempt to filibuster. What I am trying to draw out of the hon. Member for Derby, North or out of my hon. Friend the Under-Secretary of State, or both, is some recognition that my hon. Friend the Member for Chigwell and I have got a point. We have not had a single recognition since the beginning of the Bill that those who oppose it have any point on which to stand. I am sure it is right—Order. The hon. Gentleman must confine himself to the Amendment. The Chair is not allowed to hold any view of any Bill, but I am beginning to wonder whether a glossectomy Bill might not be a good idea.
With respect, Mr. Speaker, we had considerable trouble in Committee, which you know about only from reading the Official Report, because we were only two. Today our vote showed that we are three strong, at least in the Lobby. We had enormous trouble in Committee in trying to get our view across. It is a minority view but it is none the less important for the fact that it is a minority view.
Figures can be made to prove anything. It is well known that when a Division takes place in the middle of the lunch hour hon. Members, being human, see one of their friends and, with out thinking too much about it, go through the Lobby—
Order. Even interventions must be in order. I was not seeking to curtail the hon. Member for Yarmouth (Mr. Fell) but was warning him to address his speech to the Amendment.
While hastening with alacrity to comply with your ruling, Mr. Speaker, I point out that I have at least done the House the courtesy of reading out the Amendments so that we might know what we are talking about in full. I also remind the House that I am using extraneous speech only because I cannot go on saying "Please, I want this Amendment," since you would then immediately call me to order for tedious repetition, and rightly so. Surely I am at least to be allowed to put a case when I see those whom I am trying to impress looking so dumb and stupid. [Laughter.] Well, at least I have got a laugh. The hon. Member looks a little more helpful.
I shall be glad of any sign of assistance from the hon. Member for Derby, North or the kind Minister, who has been helpful throughout. Is it not something to be kind in all one's dealings with one's fellow Members? It is quite another thing to be kind in practice. All I want is some kindness in practice, some gesture to show that the Minister will not let the worst happen. He could start by saying that he will find a way of making charges for these operations in the National Health Service or wherever they are done, except, of course, in those cases where there is real hardship, which neither my hon. Friend nor I would dream of doing.2.30 p.m.
I am faced with the onerous task of both keeping in order and attempting to recover the normative smile upon the face of my hon. Friend the Member for Yarmouth (Mr. Fell).That is a difficult task to perform.
I listened with sympathy to my hon. Friend's view that he had a frustrating task in Committee in seeking to bend the general direction of the Bill more in the sense that he and his hon. Friend would wish it, but I ask him to ponder carefully the words of the hon. Member for Pontypool (Mr. Abse) when he rehearsed the extent of the Government's obligations in communicating with local authorities. The assurances which we have found it necessary to give are a full and explicit recognition of the sensitivity which we have felt towards the arguments of my hon. Friends. We have recognised—they have often spoken in harmony with the hon. Member for Pontypool—that their points are important. My earlier undertakings reflect this.Order. It seems to the Chair that the Minister is now doing what Mr. Speaker asked him not to do.
Of course I accept that ruling, Mr. Deputy Speaker, and I hope that what I have said so far will recover my hon. Friend's sense of well-being.
I am grateful to my hon. Friend for taking such trouble with me. After all, why should he? That is not an assurance. All he has done is tell me that the hon. Member for Pontypool (Mr. Abse) is happy. That does not reassure me, bless his heart. I think he has been marvellous on the Bill, but I am not reassured to know that the hon. Member for Pontypool is happy.
I am afraid that I must now press on and address myself to the Amendments.
The sum of them is that a charge should be the normative thing for social as distinct from medical cases and that fees will always be charged, so that remissions cannot be made on grounds of hardship. This is the effect of Amendment No. 9. The vasectomy operation is already available under the National Health Service on medical grounds. If it is proposed, as the Bill proposes, that vasectomy should be available now under local authority sponsorship, it is certainly likely that the applicants whom local authorities will most actively and conscientiously want to consider will be those who want to come forward on social grounds—very large and very poor families. It is against this background that I must ask the House to reject any Amendment that would exclude social cases—that is, almost by definition, large, poor families—from a subsidised service. The resources available for this operation, particularly in terms of medical manpower and facilities for the operation, will of necessity limit the number of cases for which a local authority can provide. I would therefore expect that only those with a very strong social need would be provided for in this way—again the large families and pre-eminently the very poor ones. The effect of counselling and selection which, as I have suggested, we shall ask local authorities to do will also be to limit the availability of the operation to those in greatest need in social and, therefore, in financial terms. It would be totally unreasonable to expect that sort of man to pay for the operation. My right hon. Friend the Secretary of of State has not yet reached a decision on charges but, subject to consideration of any view expressed by the local authority associations, he is seriously considering whether he should approve charges at all for this operation because of the undesirability of introducing a financial distinction between hospital-and local authority-sponsored operations under the National Health Service. If the Bill is to give effective powers to local authorities in this matter, it is almost certain that those whom they will wish to help will be large, poor families whose need arises primarily on social grounds. We must have provision to be able to subsidise and remit charges to them. I must therefore ask the House to reject both these Amendments.My hon. Friend says that because it would be wrong to make a charge to a problem family, and this would mean that such a charge was made, everybody else must go free as well. That is putting it the other way round. Is it really beyond the wit of the Government to find a way of paying for a vasectomy for the type of family my hon. Friend is talking about?
I must ask my hon. Friend once again to bear in mind the terms of his own Amendment. It is explicit that a charge shall invariably be made and then recovered—this means from the person undergoing the operation. For this reason the poor, needy family would necessarily be charged.
The Minister and my hon. Friend the Member for Pontypool (Mr. Abse) have put very clearly the problem which would arise if one had to charge poor families who lived in bad housing conditions and had a large number of children or else had to ask local authorities to impose yet another means test. There are already 49; this would be the fiftieth means test.
One of the most persuasive arguments of the Minister was that under the National Health Service any hospital vasectomy, whether on medical grounds or, less frequently, on social grounds, is free at the time it is done. Therefore, it would discriminate against those who have this operation on the National Health Service under local authority auspices if they were charged while other people who may have the luck to get into a hospital in their area and have the same operation done for the same reason—either medical or social—did not have to pay. This would seem to be unfair discrimination against those who have the operation under local authority auspices. Large families are nearly always less well off with poor social and housing conditions. Considering that they would either have to pay or have a means test to avoid paying, the fairest way to finance this operation would seem to be through the rates, under the direction and control of the local authority.This Measure would have no purpose unless it enabled the provisions of the National Health Service to be extended in this way for the poor and the very poor. It is to that end that the sponsors of the Bill originally introduced the Measure.
I remind the hon. Member for Chigwell (Mr. Biggs-Davison) that the parent Act is specific in allowing a local authority to make charges for this operation if to do so seems desirable. I need do no more than tell the hon. Gentleman and those who support the Amendment that they must consider its effect on Section 1(2) of the National Health Service (Family Planning) Act, 1967, which says:That is eminently clear, particularly when taken with what the Minister said about the way in which the local authority must look at the problems of the very poor who come forward for this operation and who should not in those circumstances be charged. The Amendment would simply add another barrier between those people and their having proper access to the operation. That would be bound to occur if we began trying to write into the Bill distinctions between medical and social grounds in the way that some hon. Members suggest. I trust that the hon. Member for Chigwell appreciates our concern in this matter. After very careful checking among some of the family planning clinics where vasectomies are carried out, I discovered that the question of follow-up procedures is a matter causing some concern. I was told that the only time that concern is felt is when a person who has had the operation has not made himself available for the subsequent tests, because he either did not want to pay or could not afford to pay. It would be ridiculous if, having brought this operation within the provisions of local health authority services, it were made harder for people to make themselves available to clinics and hospitals for the necessary follow-up procedures—sperm tests and so on—after the operation but before it has been pronounced a success. I therefore join with the Minister in urging the House to reject the Amendment."A local authority may, with the approval of the Minister of Health, recover from persons to whom advice is given under this section or substances or appliances supplied there under or from such persons of any class or description such charges (if any) as the authority consider reasonable, having regard to the means of those persons."
2.45 p.m.
The hon. Member for Derby, North (Mr. Whitehead)was so persuasive and courteous in the presentation of his case that I almost felt like begging leave to withdraw the Amendment. Unfortunately, however, he concluded his admirable comments by showing crusading zeal for vasectomy and issuing a proselytising call for yet more vasectomies. How terrible it would be, he said, in effect, if someone who might want to be vasectomised were discouraged from having the operation. I shall, therefore, resist the temptation to withdraw the Amendment.
I did not say that. I said that I was concerned that the operation should be as available to the very poor as to the well-off. That is a concern for social equality.
Although I oppose the Bill, I appreciate and sympathise with those remarks.
The hon. Member for Pontypool (Mr. Abse) thought it should be a matter for the local authority, and in this connection the hon. Member for Derby, North quoted Section 1(2) of the parent Act. The hon. Member for Pontypool spoke of the shrewdness of local authorities. In other words, he is prepared to leave it to them to decide whether to recover charges from persons having this operation. We think that local authorities should make recovery. We do not in the Amendment specify a scale of charges or even ask for one to be laid down in regulations or elsewhere. The Minister said that if the Amendment were accepted charges would always have to be recovered. Perhaps so, but there are ways of giving assistance, and in cases where people could not afford the charges ways could be found to provide the money. The arguments against the Amendment are not convincing, and I must, therefore, ask the House to divide on this issue.The Question is—
On a point of order. Will you be granting separate Divisions for the two Amendments, Mr. Deputy Speaker?
Division No 103]
| AYES
| [2.50 p.m.
|
| Biggs-Davison, John | TELLERS FOR THE AYES:
| |
| Galbraith, Hn. T.G. | Mr. John Stokes and | |
| Hornsby-Smith,Rt.Hn.Dame Patricia | Mr. Anthony Fell. |
NOES
| ||
| Abse, Leo | Hornby, Richard | Sandelson, Neville |
| Albu, Austen | Houghton, Rt. Hn. Douglas | Short, Mrs. Renée (W'hampton, N.E.) |
| Alison, Michael (Barkston Ash) | Huckfield, Leslie | Silkin, Hn. S. C. (Dulwich) |
| Allen, Scholefield | Jenkins, Hugh (Putney) | Sinclair, Sir George |
| Atkinson, Norman | Johnson, James (K'ston-on-Hull, W.) | Spearing, Nigel |
| Barnett, Guy (Greenwich) | Johnson, Walter (Derby. S.) | Stewart, Donald (Western Isles) |
| Blenkinsop, Arthur | Kaufman, Gerald | Stewart, Rt. Hn. Michael (Fulham) |
| Booth, Albert | Kelley, Richard | Stuttaford, Dr. Tom |
| Braine, Bernard | Kerr, Russell | Summerskill, Hn. Dr. Shirley |
| Brown, Ronald (Shoreditch & F'bury) | Lane, David | Taverne, Dick |
| Clark, David (Colne Valley) | Leonard, Dick | Tomney, Frank |
| Clegg, Walter | Lestor, Miss Joan | Trafford, Dr. Anthony |
| Cormack, Patrick | Lipton, Marcus | Tuck, Raphael |
| Cunningham, G. (Islington, S.W.) | Mackie, John | Tugendhat, Christopher |
| Davis, Terry (Bromsgrove) | Meyer, Sir Anthony | Urwin, T. W. |
| Deakins, Eric | Molloy, William | Vaughan, Dr. Gerard |
| de Freitas, Rt. Hn. Sir Geoffrey | Neave, Airey | Walker-Smith, Rt. Hn. Sir Derek |
| Driberg, Tom | Normanton, Tom | Wellbeloved, James |
| Edwards, Robert (Bilston) | Ogden, Eric | Whitehead, Phillip |
| English, Michael | Parker, John (Dagenham) | Williams, Alan (Swansea, W.) |
| Farr, John | Peel, John | |
| Fletcher, Raymond (Ilkeston) | Pendry, Tom | TELLERS FOR THE NOES:
|
| Golding, John | Roberts, Rt.Hn.Goronwy(Caernarvon) | Mr. William Hamling and |
| Gummer, Selwyn | Roper, John | Mr. William Hamilton. |
Question accordingly negatived.
Clause 2
Reports To Be Made And Records To Be Kept By Local Health Authorities
I beg to move, Amendment No. 10, in page 2, line 4, at end insert:
'and showing the expenditure of public money incurred by that authority in fulfilling their functions under this Act'.
With this Amendment it would be convenient to discuss Amendment No. 11, in line 4, at end insert:
No. Mr. Speaker has already ruled that there may be only one Division.
Why?
Order.
Further to my point of order, Mr. Deputy Speaker. May I seek—
Order. It is not in order for the hon. Member to seek to pursue the matter further at this stage.
Question put, That the Amendment be made: —
The House divided: Ayes 3, Noes 68.
'and copies of these reports shall, within one month of being received by the Secretary of State, be published and made available for sale to the general public'.
Amendment No. 12, in line 8, at end insert:
'and how many of these patients subsequently applied again for treatment'.
and Amendment No. 13, in line 8, at end insert:
(3) Every local health authority shall be under an obligation to make a report to the Secretary of State every year on any significant effects on the circumstances or social relationships of persons who have received treatment in accordance with the provisions of this Act.
I imagine that the Amendments will be acceptable to the promoter of the Bill. If it should happen that they are not acceptable to the promoter, I presume that it would be in order to have a Division upon each, because they are all about separate points. They are not related. We could easily have discussed just the one Amendment. The Amendments do not follow each other. May I have your advice about that, Mr. Deputy Speaker?
I should be prepared to give some advice later, when we see how things go.
Thank you, Mr. Deputy Speaker. It is always helpful to know not where one is but where one is not.
The purpose of the Amendments is to provide more information and to make it more widely available than it would be under the Bill in its present form. This is an attempt to improve the Bill. At present, the reform for which the Clause calls deals with the number of people to be dealt with and their age. Clearly, these are two very important matters, mainly of a medical kind and, to a certain extent, of a social kind. But in the Bill we are dealing with a service which is being provided free. It is a relatively expensive service compared with more normal forms of birth control. Though not very expensive itself, it is more expensive than the normal forms of either simply restraining oneself, which I suppose could be called birth control, or mechanical or chemical methods more normally used. When a service such as this is being provided, it is right that the public should be aware of its cost. No one could complain about that. Presumably the figures will be available somewhere. But it is often rather a job to sort out the figures. We are all aware of how difficult it is to get help on such matters. Perhaps that is one reason why our secretarial allowance has been increased—so that we could have the benefit of people to do this sort of thing for us. When we are to have a report in any event, it would not be a bad thing for it to be rather fuller, embodying what I believe will be interesting and valuable financial information, readily available without Members having to hunt all over the place for it or get their new research assistants to do it for them. I do not think there is anything unreasonable in this modest extension. I therefore hope that it will be acceptable to the promoters of the Bill and the Government, though I see that my hon. Friend the Minister has left the Chamber. I do not know whether that means he has lost interest in the Bill.My hon. Friend has gone only for a moment.
3.0 p.m.
I am glad to hear that from my hon. Friend's Parliamentary Private Secretary. I imagine that as it will cost a little Government money, the Government will also have a view on that. When I said that he had perhaps lost interest, I did not mean anything disrespectful to my hon. Friend but I wondered whether in an official capacity he no longer felt that it mattered one way or the other.
Amendment No. 11 deals with rather a different point. Reports are always being sent to Secretaries of State on all sorts of subjects. Many of them do not seethe light of day, which may or may not be a bad thing. We tend in the House to be deluged with too much paper of one kind or another, and Members may quail at the thought of more bumf to read, but the public are interested in the matter. The hon. Member for Brixton (Mr. Lipton) told us about a recent article in the Daily Mirror. If there is one thing the Daily Mirrorknows, it is what the public are interested in, and that article would not have appeared if they were not interested. We should take a leaf out of the Daily Mirrorand see that the report which is to be received by the Secretary of State is published and made available to the public so that they can not only be interested but be informed of what is happening and be given the facts. We hear a great deal these days about the need for public participation in government. We even hear calls for a referendum and plebiscites, revolutionary things in our constitution. By comparison with such suggestions from Opposition Members, my request is very minor; that the Secretary of State should be under an obligation not only to receive the reports but to make them available to the public. It would be very interesting to see whether there is any difference in the incidence of the operation between one part of the country and another, between one occupation and another. That is the sort of information which I hope the report would contain and which would be made available to the public. That is all I wish to say on Amendment No. 11. It is quite difficult for me to dart from one subject to another like this, Mr. Deputy Speaker, but if that is how you wish the matter to be dealt with, I am happy to comply with your wishes.I am so impressed by the cogency of the hon. Gentleman's argument so far that I would be willing to accept the two Amendments he has already spoken about and the other two that he has yet to speak about.
That was what I was very much hoping. There is inevitably a tendency on Private Members' Bills for promoters to feel, particularly at this stage on a Friday afternoon, that anyone who rises to speak is rising to waste time and not to improve the Bill. I know that anyone who has gone to the trouble of preparing a Bill feels very much about it as a mother feels for her child and does not like anyone to touch it.
Does my hon. Friend realise that this conversion and readiness to accept a couple of Amendments by one who has been voting against us is magnificent? We now have the first conversion, and it may be that by his influence the hon. Gentleman will be able to help fill our Lobby when these Amendments come to a Division.
We all know how promoters feel about their Bills. They do not want them altered in any way; they look upon them as their children.
indicated dissent.
I am glad to see one of the promoters disagreeing. I see the hon. Member for Derby, North (Mr. Whitehead) shaking his head one minute and nodding it the next. I feel that these gesticulations, if that is the right word, coupled with the verbal support of the hon. Member for Brixton, may help us to get an Amendment accepted.
The next two Amendments are of greater substance and perhaps more important in a medical sense than the purely participatory Amendments with which I have dealt. Dealing with Amendment No. 12, as I understand the Bill a patient may be refused treatment if he is under the age of 30. I see my hon. Friend the Member for Yarmouth (Mr. Fell) looking at me suspiciously. This is what the Bill seems to say in Clause 2(2).I feel that my hon. Friend in his first-rate speech is a little out of date. I think he has an unamended copy of the Bill.
No, I have got a Bill as amended by Standing Committee C. There seems to be some qualification about the age of 30. I understood from what the Under-Secretary said that although there was no absolute bar, there would be the hope the people under 30 would be turned away.
I apologise to my hon. Friend. He is quite right and I was wrong. I was thinking of Clause 1(2).
These Clauses divided into subsections are confusing. Some of these people may be refused if they are under 30. Some may leave it at that and never return. They may say "I am glad I was saved from that." On the other hand others may come back, and it would be valuable to know how many make an attempt to have this operation. I do not see how this provision can be objected to.
indicated assent.
I am glad that the hon. Member agrees. It would be very helpful if it could be accepted.
I come to the last of the quartet of Amendments—Amendment No. 13. I admit that it is a little vague, and the promoter may not like it for that reason, but I believe that it is possibly the most important of the Amendments. If a report is to be made, we may as well make it satisfactory and worth while. I understand from the movements of the head of the hon. Member for Derby, North that he is in favour of three out of four Amendments. Therefore, having got over three hurdles, I hope that I shall be abe to go right round the steeplechase and that we shall finish going down the straight together. I did not have the good fortune of serving on the Committee, but I have read its proceedings, and I have been very impressed by some of the observations of the hon. Member for Pontypool (Mr. Abse), who, we all recognise, is a great authority on this and kindred subjects. From what was said by him and by other members of the Committee, it seems to me that in making this operation generally and cheaply available for the first time we are, to a certain extent, venturing on to unknown ground which some of us feel may be dangerous. It is not a matter of simple birth control of a temporary nature. I am not a doctor; I am a layman, but I understand that once the operation has been done it is difficult, if not impossible, to reverse it.That was the advice given to us in Committee by the sponsor of the Bill and by my hon. Friend the Member for Norwich, South (Dr. Stuttaford), who is a keen supporter of the Bill.
We try to make it plain in each case that the operation is probably irreversible, although we know that in some parts of the world they are achieving a 50 per cent, rate of reversibility. It would not be fair to tell a patient that there was a 50 per cent, chance of reversibility. We must tell him that he should accept that it is irreversible, even though we know that that may not be so.
This is news to me, and I am grateful for that information. I do not know whether the chance of reversibility depends on the patient, his age, the cost, or anything else. However, we must accept that in general it is not possible to reverse it.
It is difficult to say what will happen in the future and to decide whether to have an operation which would so fundamentally affect one's life not just temporarily, but permanently. Therefore, because of the peculiar nature of this operation it would be of great benefit to the public if the report to the Secretary of State dealt with the personal and social circumstances of the patients treated, the extent to which the man takes the initiative, the extent to which his wife wishes him to undergo the operation, and the question whether or not the man is married. I know that my hon. Friend will advise that the operation should not be performed at public expense on a man who is not married, but he is a great believer in leaving things to local authorities and they may pay no attention to his advice. 3.15 p.m. When we think of all the psychological and practical reasons against vasectomy, it is strange that people should still want it. I should like to see stated in the report the reasons why conventional methods are not acceptable. It would also be interesting to know the social and occupational groups from which the patients come and whether they come from a particular area of the country. All this will be most useful in building up a picture of all the circumstances surrounding a request for this unusual operation. I realise that all this information will make the report more cumbersome, but we are venturing on to uncharted seas and it would be as well if the records of our journey on them were as full as possible so that if in future there should be a move towards a change we shall have adequate information easily available in these annual reports to enable us to make a wise choice. With these few remarks by way of explanation, I hope that my Amendments will commend themselves to the House and to the promoter of the Bill.It is a great pleasure to follow the hon. Member for Glasgow, Hillhead (Mr. Galbraith), who has done a service to the House by bringing forward these Amendments. From the careful way in which he spoke to them, it is clear that he has followed the proceedings of the five weeks during which the Bill has been in Committee. If the hon. Gentleman was following the movements of my head and was concerned whether they were affirmative or negative, he would be right to discern both movements at one time or another. I have slightly mixed feelings about some of the Amendments. I see some merit in the Amendments and will go a certain way in a proper spirit of co-operation.
I have no objection to Amendment No. 10 and do not wish to divide the House against it. I agree with most of the arguments put forward by the hon. Member for Glasgow, Hillhead on Amendment 10. The Government could perhaps indicate—if not here, then in another place—whether they feel that Amendment No. 11 would put an intolerable strain upon those who would have to prepare the reports for publication in the time scale suggested by the Amendment. I see no particular arguments against Amendment No. 12. The new Clause tabled in Committee by the hon. Member for Hampstead (Mr. Geoffrey Finsberg), which was accepted by the sponsors of the Bill, made clear that we should have a report each year by every local health authority on the work of the Bill. It is right and proper that we should have such a report and also that, in view of the original phraseology of the Bill, we should have annually details of those who have been given treatment and those who have not. Therefore, a small but useful service will be fulfilled by the terms of Amendment No. 12. I have slightly more reservations about Amendment No. 13, under whose terms a quite different burden will be placed on local health authorities. They will be asked to provide a massive follow-up, not merely according to the needs of the patient but according to the statistical necessity which will be incumbent upon the authority to provide a detailed study of each patient who has undergone the vasectomy operation. This is not something a local health authority is required to do in any other operation under its auspices, and, of course, there are many more serious operations than vasectomy.I am grateful for the pleasant way in which the hon. Gentleman is replying to the Amendments, and I am sure he would agree that there is no other operation like vasectomy; it is a quite different kind of operation. Surely he would agree that it is not like an operation for appendicitis or something like that?
It is not like an appendectomy, but it is a sterilisation operation. Female sterilisation is carried out quite extensively, and we in this largely masculine assembly do not show much concern for female sterilisation, which is an internal operation requiring general an aesthesia, and, indeed, is a much more serious operation. About 20,000 or 30,000 women are sterilised each year under the National Health Service. Sterilisation is a by-product of the hysterectomy operation which is performed on 50,000 or 60,000 women each year. I do not think Parliament has ever called for follow-up services to be carried out on every woman who has had a sterilisation operation or a hysterectomy to see what psychological effects it may have had. If there are psychological side-effects to the vasectomy operation, the careful counselling procedures to be carried out in the advice given to local authorities by the special committee and in the circular will be sufficient to identify them.
The hon. Gentleman has just said a most extraordinary thing. It may be that I shall be corrected by my rt. hon. Friend the Member for Chislehurst (Dame Patricia Hornsby-Smith) or by my hon. Friend the Member for Norwich, South (Dr. Stuttaford), but I do not regard it as apposite to bring in the question of hysterectomy as though it is an operation which is performed for other than medical reasons.
We have already gone into these matters very fully in Committee, and I should be out of order if I were to refer to them again. It is right and proper that if comparisons are to be made of operations like against like, which is what the hon. Member for Glasgow, Hillhead was inviting the House to do, one should suggest that a similar operation is that of female sterilisation. The operation of hysterectomy renders the woman concerned sterile.
I do not see that vasectomy is so different in kind from the other matters I have been discussing that we should demand, as Amendment No. 13 would require, local health authorities to make a follow-up report on what significant facts, if any, arise from the social relationships of all persons who have had treatment. It is my understanding that the only Amendment to have been moved so far is Amendment No. 10. I have no objection to that and am prepared to accept it. Subject to what maybe said in another place about Amendments Nos. 11 and 12, I find those relatively acceptable as well. However, I have reservations about Amendment No. 13, since it would give rise to a serious problem for local health authorities if they were required to carry out this kind of search.We are grateful to the hon. Member for Derby, North (Mr. Whitehead) for responding so sympathetically to the case presented to the House by my hon. Friend the Member for Glasgow, Hillhead (Mr. Galbraith). However, I must ask the hon. Gentleman to acquit hon. Members on this side of the House of any lack of concern for those women who may undergo operations involving sterilisation. I thought that the hon. Gentleman was making a false comparison. He was really discussing operations which are for therapeutic purposes and not for birth control purposes. As the hon. Gentleman knows probably better than anyone, we are concerned with a Bill designed to provide through local health authorities vasectomy operations for purposes of contraception.
I am sorry to see that the hon. Member for Derby, North is leaving us. I do not know whether my hon. Friend the Undersecretary intends to intervene, because we have now reached a position where we may perhaps hope to come to a conclusion on this group of Amendments. It is difficult for me to continue in the absence of the hon. Member for Derby, North. As I understand it, he said that he was disposed to accept Amendments Nos. 10, 11 and 12. Perhaps my hon. Friend the Member for Hillhead can enlighten me.I understood the hon. Gentleman to say that he accepted Amendments Nos. 10 and 11, although he would like to know the Government's view on the practicality of them. He also said that he accepted Amendment No. 12. He had doubts about Amendment No. 13, but I did not get the impression that he was totally hostile to it.
I am obliged to my hon. Friend for assisting the hon. Member for Derby, North in this matter. I see that the hon. Member is with us again. We require clarification about his considered attitude to Amendment No. 13. Apparently he has reservations about it. In the interests of expediting his Bill, does he accept all the Amendments, or will he accept certain of them and not No. 13—in which case I shall suppose that we shall have to proceed to separate Divisions? In any event, I gather that his reservations about Amendment No. 13 are subject to the view of my hon. Friend the Under-Secretary. The hon. Gentleman would like to know the extent to which the Department thinks that the implementation of the Amendment is practicable. I think it would be proper for us to hear from my hon. Friend the Under-Secretary, and I will gladly give way to him shortly.
I must say in general how warmly I welcome, as to some extent did the hon. Member for Derby, North, the Amendments proposed by my hon. Friend the Member for Hillhead. As my hon. Friend said, this is an uncharted sea. We do not know the psychological effects upon individuals who undergo this operation, and it is desirable that the fullest possible information should be available to the Secretary of State, to Parliament and to the public at large. I hope we shall hear from my hon. Friend the Under-secretary in reply to the doubts voiced by the hon. Member for Derby, North, especially on Amendment No. 13.3.30 p.m.
We are certainly grateful to the hon. Member for Glasgow, Hillhead (Mr. Galbraith) for the way that he moved this set of Amendments. No one could reasonably object to Amendments Nos. 10 and 12. They certainly indicate a way to obtain the information which we require and which will be of enormous service when the local health authorities become integrated in the new form a few years hence. It is important to use this period as a pilot experiment, as it were, so that when decisions are finally made on the whole question of the integration of the family planning service within the National Health Service we have all the information which we can possibly get.
I ask the Minister not to respond at this stage on matters concerning Amendment No. 11. I think that he may over-commit himself against it. I should be surprised if what is obviously an onerous task being placed on the bureaucracy by having it as expeditiously as is suggested in the Amendment did not cause trouble. I ask my hon. Friend the Member for Derby, North (Mr. Whitehead) to accept Amendment No. 11 on the understanding that he would need to have discussions with the Government at a later stage if in some way it required to be reshaped.indicated assent—
I am pleased to see the Minister indicate his assent. I think that is the way we should move forward. The Under-Secretary, with his experience, will appreciate that we do not want to provoke the Minister into giving us a firm negative when a little elasticity on our part may get what I am sure is his as well as my objective.
Therefore, we are left with Amendment No. 13. My personal sympathies, as the hon. Member for Glasgow, Hillhead would anticipate from his obviously generous and evident reading of the proceedings, are bound to be directed towards the proposition implicit within the Amendment, because it attempts to grapple with the possibility that mistakes may arise as a result of insufficient counselling, care and probing. We are right to be exceedingly sensitive on this issue. However, the hon. Gentleman was honest and frank enough to say that the sponsor of the Bill may regard it as vague. Although I agree with the intention, I believe that it is not very satisfactory, adept as the draftmanship is, to get at what he is striving to do. Despite what my hon. Friend the Member for Derby, North has said so far, I think, sensing the opinion of the House, that he would be well advised to give an undertaking that if it is possible—I put it no higher—to interpret in a Clause what is a very subtle concept, he will, between now and the time that the Bill goes to another place, discuss with those who have the good or bad fortune to be steering it through the other place a way of meeting what is hoped will be there in some form. If he would do that, I think that we may see in another place something which, in a more refined way, grasps the elusive subtleties which he has attempted, but not wholly succeeded, to put forward. I hope that in that spirit he will accept this group of Amendments in this form.I shall not make a speech about these Amendments. I merely express the hope that we can have guidance of the sort asked for. Unless we have an answer from the hon. Member for Derby, North (Mr. Whitehead) and from my hon. Friend the Under-Secretary of State, we shall get into a terrible muddle because we do not know which Amendments are blessed by the Department.
Indeed we are already in a great muddle because we do not yet know whether the Amendments are to be taken separately. They have been argued separately. I imagine, therefore, that we shall be allowed to vote on each one separately. I wonder whether we can have any guidance as to whether we are to vote on the Amendments separately.It might be convenient, since time is getting on and as the House has approached this group of Amendments in a co-operative and constructive way, if I follow the invitation of my hon. Friend the Member for Pontypool (Mr. Abse) by saying to the hon. Member for Glasgow, Hillhead (Mr. Galbraith) that of course I accept on reflection that there might be merits in Amendment No. 11, as in Amendments Nos. 10 and 12. I would like to hear from the hon. Member whether he accepts the serious reservation, which was not a rejection, about Amendment No. 13 as drafted. I would be prepared, subject to that, not to stand in the way of his group of Amendments at this stage, and I would hope to come together with the hon. Gentleman to see whether we could not agree to a mutually satisfactory series of Amendments on the lines of this group of Amendments before the Bill is considered in another place.
I am not quite certain what the hon. Member for Derby, North (Mr. Whitehead) is suggesting. Can I prevail upon my hon. Friend the Under-secretary of State to say something before I go on? He sat very still at one stage and then I saw him nodding his head at hon. Members opposite. Can he say a few words about Amendment No. 11 and the extent to which it is possible? There is complete agreement on both sides about this. It really all depends on what my hon. Friend says. Does he think it no good or that it might be possible? Although I welcome the offer of the hon. Member for Derby, North that he and I should get our heads together, I do not think we should achieve anything that way because I believe it is almost impossible to put down in the Bill what the hon. Member for Pontypool (Mr. Abse) and I want to achieve by Amendment No. 13. I think one can only give the most general indication of what one wants included in the report, and this is where the Minister's circular comes into the picture. Can we get into the Bill something on the lines of questions such as whether the initiative is by the man or the wife, whether the man is married, whether reasonable birth control would not suffice and the circumstances of the area in which those concerned live. These simple matters would be of infinite value to anyone interested in this matter. As the Minister will issue circulars, I do not see why we cannot embody these questions in them.
It is a great mistake to be too specific in a Bill; one should simply say that the report should include this sort of subject. The Minister might want to add to or subtract from my list. It is sometimes inconvenient to be pressed as a Minister, but that is what Ministers are for. If my hon. Friend wants time to consider the matter, we shall understand. Amendments Nos. 10 and 12 are agreed, and there is no objection to Amendment No. 11 except for possible minor administrative difficulties. The only real problem arises with Amendment No. 13, which it is impossible to draft any better. I hope that the Minister will ask for reports under the several headings that I have mentioned.I made a practice in Committee of expressing the wish always to weigh carefully what hon. Members on both sides said. As my hon. Friend the Member for Glasgow, Hillhead (Mr. Galbraith) said, he is a newcomer to these matters. I have remained silent because I wanted to hear the views of the whole House. I am inclined to support the suggestion of the hon. Member for Derby, North (Mr. Whitehead) that the House should not divide against these Amendments. However, I must follow my hon. Friend's invitation to weigh his words and assess the implications of the options of either Clauses in the Bill or insertions in the circular so as to choose the most practicable and effective way of giving expression to the wishes of the House. There are further opportunities for carrying this forward. I would wish to consider all these exchanges and see what we can do to help the House. Mean while, I would follow the hon. Member's proposal and let the Amendments go through as they stand.
Is my hon. Friend suggesting that these Amendments should be accepted?
indicated assent.
I am delighted.
Amendment agreed to.
Further Amendments made: No. 11, in page 2, line 4, at end insert:
'and copies of these reports shall, within one month of being received by the Secretary of State, be published and made available for sale to the general public'.
No. 12, in line 8, at end insert:
'and how many of these patients subsequently applied again for treatment'.
No. 13, in line 8, at end insert:
(3) Every local health authority shall be under an obligation to make a report to the Secretary of State every year on any significant effects on the circumstances or social relationships of persons who have received treatment in accordance with the provisions of this Act.—[Mr. Galbraith.]
Motion made, and Question proposed, That the Bill be now read the Third time.
3.45 p.m.
We have had a long series of debates today and in Committee, and I do not propose now to speak for more than two or three minutes. I reiterate the considered view of its opponents that the Bill is no better than it was when we discussed it in Committee. Indeed, it is a far worse Measure because of the acceptance of the Amendment tabled by the right hon. Gentleman the Member for Sowerby (Mr. Houghton), who denuded it of the two real safeguards that it had. It has become a shadow of itself or, as I have described it before, a vasectomised Bill.
The Bill has been slightly improved by Amendments Nos. 10, 11, 12 and 13, and my hon. Friend the Member for Glasgow, Hillhead (Mr. Galbraith) is to be congratulated on being the first Member who has spoken in any way against the Measure to have got any Amendments accepted. Indeed, he is the first hon. Member to have any Amendment even looked at kindly either by the Ministry or by the hon. Member for Derby, North (Mr. Whitehead). I hope that the Bill will never reach the Statute Book—I am quite recalcitrant about that—but I congratulate the hon. Member for Derby, North and my hon. Friend the Under-Secretary on being most civil throughout the various stages of the Bill so far.3.47 p.m.
I oppose the Bill on principle on a number of grounds, and I feel that I have the support of a very large number of people not only in my constituency but in the country at large whose views may not yet have been heard here.
I oppose the Bill, first, because by it the State takes a further hand in what I believe to be an essentially private matter. It represents an extension of State interference which I believe to be dangerous and quite unwarranted. Second, I deplore an attempt to control the population of the United Kingdom when immigrants are still entering the country in large numbers. Third, I fear that the Measure will encourage licentiousness. Fourth, I believe that we still know too little of the psychological and other effects of male sterilisation to give it a welcome even on medical grounds. The Bill is typical of so many Bills today. We have too many laws. I had hoped that this Government at least, which believe in individual liberty and personal responsibility, would have drastically reduced the number of such Bills and would not have encouraged a Private Member's Bill of this nature. The Bill, although presented in a very civilised way, is the dream of cranks, busybodies, do-gooders and intellectuals who presume to tell us what is good for us, often on completely unknown or false premises. For those reasons, I sincerely hoped that the Government would have steered well clear of this Measure. The Government have already, in my view, disgraced themselves by giving public money to the so-called experiments of family planning associations in Runcorn and Coalville; experiments which are to saturate—the official word—those two towns with family planning devices and propaganda. I suppose that added to that we shall have the surgeons waiting, sharpening their knives for the sacrificial victims of this Bill. I also object to the title of the Bill. The very phrase "Family Planning" in this case is a nonsense. "Planning" is a vogue word today, beloved of industrialists and businessmen. "Family planning" suggests that human life can be dealt with as a businesslike operation, and that is what some social engineers would like to see. Thank goodness our lives are not yet wholly planned. The Bill should be entitled "Birth Control and Family Limitation Amendment Bill", but that was probably too forthright for the promoters. Why this panic to control British births? Why do we doubt our rôle in our own country and in the world? If we have too many births here, there are many countries—Australia, Canada, South Africa, New Zealand, Rhodesia, to name a few—which would be glad to receive more people of British stock. One does not find this fanaticism to control the population in France and other great Common Market countries. Of course we all want the best to breed more and the others to breed less, but who is to decide that? Not the State, I hope. When I hear the Minister talk of a family coming to an end I am, frankly, terrified. Who is he to say that? We all know of cases where later children have been great blessings to families. I believe that in these permissive days the Bill will encourage licentiousness. Just as we now have abortion on demand, so I fear that as a result of the Bill we may in time have male sterilisation on demand. I object to hon. Members—ladies and gentlemen here—propounding on what in my view should be private and sacred matters as if we were discussing the Budget. Human life and freedom to live it in one's own way will be put at risk by the Bill—if not now, then soon. Who knows what the personal circumstances of individuals will be if they have to have what still is, after all, an unnatural operation? Who knows the consequences and side effects? I believe that if the House were to pass this legislation it would be interfering in human lives in a way that no despot in the past would have dared to have done, and in the end I prefer the common sense of every man to the self-styled experts promoting this Measure.3.53 p.m.
On Second Reading I had an open mind on the issue with which the Bill is primarily concerned. I now feel that as a result of the age limit having been removed in Committee a tragedy has occurred. That is now my view, despite the fair words of my hon. Friend the Minister.
The Under-Secretary used a torrent of well-chosen phases, but they did not convince me one bit that there are sufficient safeguards and that local authorities will not be able to widen the channels which the Bill opens, so that we shall not at some time have a complete parallel here with what has occurred under the abortion legislation. My fear is that it will be reproduced in this sphere, with easily available vasectomies. It is all very well for the Minister to say that local authorities will be advised of certain matters, that this is primarily for married men and that the age limit should be about 30. We have already seen a highly qualified minority of doctors abusing the powers we gave them to do abortions. Equally, we can imagine young men, influenced—a young boy, perhaps, having got a young girl into trouble—with recriminations on one side and pressure on the other side, saying to themselves" I will put an end to any possibility of this happening again." There are not sufficient safeguards in the Bill. I regret deeply that the Committee stage removed what I should have thought was acceptable—an age limit of 30 years.3.55 p.m.
I did not address the House on Second Reading, so perhaps I can say something on Third Reading. I agree very much with what was said by my right hon. Friend the Member for Chislehurst (Dame Patricia Hornsby-Smith), that unacceptable though the Bill was to some of us in its original form, it has become so much the more intolerable because of the wanton manner in which the Amendment put forward by the right hon. Member for Sowerby (Mr. Houghton) was put to the Committee. Against the wishes of the Bill's sponsor—who has said nothing about it today—by that Amendment the age limit of 30 years has been removed. Therefore, the House would be very ill-advised to give a Third Reading to the Bill this afternoon.
My hon. Friend the Member for Old-bury and Halesowen (Mr. Stokes) made a very powerful and persuasive speech. He referred to the question of population policy. I have referred earlier to what I consider to be a bias against human life in certain sections of our society today. This recalls what Aldous Huxley wrote before the war. In "Antic Hay" we find this Malthusian attitude to human life:This is the attitude of some supporters of the Bill. We have had a very traumatic experience from the Abortion Act. In most cases that Act has not prevented women subjected to abortion from having another child. There are artificial forms of contraception which make it possible for children to be born later on. But vasectomy is irreversible. For that reason and the very serious aspects of the Bill as it has emerged from Committee, I feel very strongly that it should not go further forward at this stage. It is the sort of Bill which is more suitable to Government legislation, especially as the Government, within a short period, are proposing entirely to reorganise these services."And the way they breed, like maggots, sir, like maggots. Millions of them, creeping about the face of the country, spreading blight and dirt wherever they go; ruining everything. It's the people I object to."
3.58 p.m.
Perhaps I should explain why I, as a Scottish Member, have taken part in a debate on a Bill which is limited to England. I always welcome English Members when they partake in Scottish legislation, though I realise that the threat of being put on the Scottish Committee is rather like the threat of being sent to Van Diemen's Land 150 years ago.
But the reason why, as a Scottish Member, I have intervened in the debate on this legislation, which is primarily English, is that I have noticed that when a Bill is passed and becomes an English Act of a sort of permissive kind, in a very short time people in Scotland who until that moment had made no demands for the sort of legislation requested in England immediately raise a demand in Scotland. It is rather a case—rose in his place and claimed to move, That the Question be now put; but Mr. DEPUTY SPEAKER withheld his assent and declined then to put that Question.
It being Four o'clock, Mr. DEPUTY SPEAKER proceeded to interrupt the business.
Debate to be resumed—what day?
rose in his place and claimed to move, That the Question be now put.
I am not accepting the closure Motion now.
Debate stood adjourned.
Debate to be resumed upon Friday, 14th April.
Trade Descriptions Bill
Order for Committee read.
Object.
Committee deferred till Friday, 14th April.
Carriage By Railway Bill
Considered in Committee; reported, without Amendment.
Order for Third Reading read.—[ Queen's consent, on behalf of the Crown, signified]
Motion made, and Question, That the Bill be now read the Third time, put forthwith pursuant to Standing Order No. 56 ( Third Reading), and agreed to.
Bill accordingly read the Third time and passed.
Sunday Cinema Bill Lords
Considered in Committee.
[Captain WALTER ELLIOT in the Chair]
Clauses 1–5 ordered to stand part of the Bill.
Clause 6
Short Title, Commencement And Extent
Amendment made: In page 2, line 40, leave out subsection (4).—[ Mr. Deedes.]
Clause, as amended, agreed to.
Schedule agreed to.
Bill reported, with an Amendment; as amended, considered.
Motion made, and Question, That the Bill be read the Third time, put forthwith pursuant to Standing Order No. 56 ( Third Reading), and agreed to.
Bill accordingly read the Third time and passed, with an Amendment.
Imports (Marking Of Origin) Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday, 14th April.
Historic Churches Preservation Bill
Read a Second time.
Bill committed to a Standing Committee pursuant to Standing Order No. 40 ( Committal of Bills).
Exclusion Clauses (Services) Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday, 14th April.
Domicile And Matrimonial Proceedings Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday, 16th June.
Power-Boats (Regulation) Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday, 14th April.
Social Work (Scotland) Bill Lords
Read a Second time.
Bill committed to a Standing Committee pursuant to Standing Order No. 40 ( Committal of Bills).
Inland Waterways (Improvement Of Navigation) Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday, 14th April.
Student Unions (Registration) Bill
Order read for resuming adjourned debate on Second Reading [ 25th February].
Object.
Debate further adjourned till Friday, 14th April.
Abolition Of Gazumping And Kindred Practices Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday, 14th April.
Medical Services (Referral) Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday. 14th April.
Transplants Of Human Organs Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday, 14th April.
Anti-Discrimination Bill
Order read for resuming adjourned debate on Second Reading [ 28th January].
Object.
Debate further adjourned till Friday. 14th April.
Cigarettes (Prohibition Of Advertising) Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday. 14th April.
Protection Of Otters (No 2) Bill
Order for Second Reading read.
Object.
Second Reading deferred till Friday. 14th April.
Adjournment
Motion made, and Question proposed, That this House do now adjourn.—[ Mr. Fortescue.]
Butterwick House, Hammersmith
4.8 p.m.
I am glad to have the opportunity of raising this afternoon the problems posed to my constituents and many others in and around London by the threatened closure of Butterwick House in Hammersmith. This raises questions of particular importance to Hammersmith and also questions of more general import. I am grateful that a Minister from the Department of the Environment rather than from the Department of Health and Social Security is to reply. It is important to accept the urgency of this problem. I can say that it will become increasingly urgent as time goes on, particularly in the next few months.
I should like to say a word by way of introduction. It is heartening that I have received on this issue, perhaps not the most popular of issues—namely, what is to happen to 750 single men living in a Rowton House in Hammersmith—an astonishing number of letters. All have expressed great concern; all have been somewhat critical about the way in which various Departments and local authorities concerned have approached the problem. Butterwick House is at 221, Hammersmith Road, in my constituency. It is a Rowton House with 750 beds for single men. They live there at a low rent in accommodation which is not elaborate but is clean and simple. It is noteworthy that no less than 38 per cent. of the 750 men have lived in the Borough of Hammersmith for more than five years. A large number of them suffer from some form of mental or physical handicap. The immediate problem is very simple to state but very difficult to deal with. There is a general redevelopment scheme for the centre of Hammersmith, which I support. It is high time that this part of Hammersmith was redeveloped. Whether one has reservations about the type of redevelopment to take place is another matter, but the principle that it should be redeveloped is unexceptionable. As part of the redevelopment scheme, Butterwick House is to be closed. Two points arise on the proposed redevelopment and the closure of Butterwick House. The first is what is to happen to the men who live there. The second—a more general proposition—is what is the general background of a shrinking pool of housing accommodation for single people, particularly in and around London? I raised this matter originally with the Department of Health and Social Security as long ago as July, 1971. I received a letter from the Under-Secretary of State dated 19th July, 1971, merely saying that Butterwick House was to be closed. The policy at that time appeared to be to continue to take men for short-term slays but not to accept any more long-term residents. The reply ended by saying:I should read another sentence since it is a fact which may assist. The Under-secretary said in his letter:"Officials of the London Borough of Hammersmith are fully alive to the problems likely to arise from the closure of this hostel and discussions have already been held with Rowton Houses Ltd. Further discussions are planned in the near future between the local authority officials and officials of my Department. I am at present considering with other statutory and voluntary bodies what can be done to alleviate the problem created by this closure."
Discussions took place between the Ministry and the local authority and various other interested groups in the area. Those discussions continued until the last few weeks. Surveys of residents of Butterwick House were conducted in September, 1971, and January, 1972. On both occasions only 50 per cent. of the forms were filled in and returned, but they revealed that at least 139 of the men, by reason of age or infirmity, would be unable to arrange alternative accommodation. Christian Action, from which I have received some of my information and statistics, concluded that on those statistics, which it believed to be an inadequate basis for planning, insufficient accommodation for these people would be provided. Christian Action is convinced that many of these single men—perhaps up to 200—will remain homeless after the closure. It is perhaps not realised that the closure is taking place at an eviction rate of 65 per week. Christian Action concluded that perhaps 200 single men might remain homeless after the closure. Rowton Houses guaranteed last autumn that 250 alternative beds would be provided in the Camden or Whitechapel areas, but that figure has been successively reduced. The last working party which considered this quoted 120, but since then the vacancies in other Rowton Houses have fluctuated between a low of 20 and a high of 90. Therefore, it is impossible to be optimistic that as the closure continues enough places will be provided. A letter was recently written by the Private Secretary of the Secretary of State for Social Services to Christian Action. I must categorise that letter as somewhat bland. It does not display the sense of urgency which the problem demands. We are told:"Some of the residents at present in Butterwick House may have special problems—physical disabilities, mental illness, alcoholism and so forth which will mean they are in need of a specially supportive environment is may be run or provided through local authority social services departments."
Since the Department is well aware of the need, I hope the Minister will tell us what plans the Government have for satisfying the need which by that sentence the Department concedes to exist. The Department goes on to say that it has been:"This Department is well aware of the need for more suitable long-term supportive accommodation…and is in close touch with both local authorities and certain voluntary organisations about the respective parts each can play."
The main fact upon which it seems the Secretary of State came to that conclusion was that the number of men under the age of 65 and of pensionable age who were unlikely to be able to arrange alternative accommodation was 83 under 65 and 56 of pensionable age. Since Hammersmith has made arrangements as a result of which 80 men may be accommodated, the Department in that letter seems to take the view that the problem has basically been solved. Enough concern has been expressed, first, about the facts of the situation and, secondly, about the proposals which Hammersmith Council and the Department have devised for solving the problem to make at least a prima facie case for an inquiry either within the Department or in the form of a public inquiry. I have a great deal of sympathy with Hammersmith Borough Council. Rowton House has been in Hammersmith for a long time. It is not purely a Hammersmith problem. It will be quite impossible for a borough of the size of the London Borough of Hammersmith suddenly to rehouse 750 men who require single accommodation. It could not be done. No one who approached the problem objectively and reasonably could expect an in-individual local authority to do that. It is incumbent upon the Government, faced with the shrinking pool of this type of accommodation available in London, to co-ordinate action with other London boroughs viathe G.L.C. so as to ensure that those residents of Butter-wick House who will be displaced in the next 12 months are found some reasonable accommodation if they cannot obtain alternative accommodation for themselves. What is the general situation with regard to this type of housing accommodation? Merely to close one Rowton House in one part of London does not solve the problem. All it does is to move the trouble somewhere else. The 750 men living in Butterwick House will have to find somewhere else to live and it will have to be something of the same type of accommodation. If we consider the removal of Butter wick House as an amenity, which basically is what it is, in terms of the social scene it forms part of a drastic national decline in lodging house accommodation. If we look at the figures for the various major cities in Britain it can be seen that they give a common picture. In London the number of common lodging house beds has gone down from 6,405 in 1962 to 4,708 in 1972. In Manchester the figures are 1,535 in 1960 and 1,325 in 1972; in Birmingham 807 in 1960 and 485 in 1972. If we consider the number of Rowton House beds available in London, since Rowton Houses have to a large extent fulfilled the need for those who require lodging house accommodation, we can see that the decline is even more dramatic. In 1960 the number of Rowton House beds in London was 4,536, and in 1972—this would be the estimated figure for June, 1972—it went down to 2,180. This is an urgent problem and is also a human one. It is a problem which is being caused by the inevitable redevelopment of parts of our cities. The people who live in Butterwick House, Hammersmith, have a right to expect either the public authorities in the area or the Government to give them some hope for the future and some indication of where they will be able to live after the redevelopment has taken place. This is not a new problem. It was raised by my hon. Friend the Member for Eton and Slough (Miss Lestor) in an Adjournment debate on 29th June, 1971. The Under-Secretary of State for Health and Social Security then said:"in close contact with Hammersmith about this situation and their handling of it, and the Secretary of State is satisfied that they appreciate to the full their Social Service responsibilities. Both the Council and this Department are keeping the situation under constant review. Many of the general issues…are being considered by the Working Party with the London Boroughs Association…The Secretary of State does not, therefore, think that any special inquiry into closure of Butter-wick House is necessary."
I know that that exchange did not involve the Under-Secretary of State for the Environment, who is to reply to this debate, but at some stage I would welcome information as to what will happen to that survey. I should like to know what has been examined and what, if anything, has been the result. This now calls for urgent central action by the Government, even if only in a co-ordinating capacity. It may be that the G.L.C. is the proper authority to solve this problem. But of one thing I am certain, and that is that this is a problem that will get worse, in relation not only to Butterwick House but to the provision of this type of accommodation for single persons in all our major cities. I hope the Minister will bring a greater sense of urgency to the consideration of the problems than the Government have shown to date."What are the Government doing to assess the problem and to give greater help? The Supplementary Benefits Commission has asked for an inquiry into the extent and quality of lodging house and hostel accommodation and wants to obtain as much information as possible. We are making plans for a survey, and the leading voluntary organisations in this work will be invited to co-operate."—[OFFICIAL REPORT, 29th June, 1971; Vol. 820, c. 361–2.]
4.23 p.m.
The whole House will be indebted to the hon. and learned Member for Barons Court (Mr. Richard) for raising this issue, which rightly gives a great deal of concern to anybody who is interested in this problem. What he has shown in the wholly admirable interest he has taken in this matter is that the matter of homelessness is not confined to families with children. He has rightly reminded us that single persons also can fall prey to homelessness and that they deserve sympathy and concern in this House.
The House will agree that homelessness, whether on the part of families or of single persons, is a ghastly problem. Nobody with a shred of compassion in a civilised society would tolerate the situation for a moment longer than is necessary—although the problems are more difficult to solve than words can achieve. The case that the hon. and learned Gentleman has raised involves two Departments, the Department of Health and Social Security, which is concerned with those inhabitants of Butterwick House who are in need of care and attention, and my own Department, whose interest is in those whose only need is a roof over their heads. I am therefore speaking on behalf of my right hon. Friend the Secretary of State for Social Services as well as dealing with my own Department's responsibility. Before I come to the question of re-housing from Butterwick House, I think I should first of all explain why the building is coming down. Butterwick House is in a part of Hammersmith centred on the Broadway which has many serious planning defects—poor layout, worn out and obsolescent buildings and, as many motorists who have driven past will testify, bad traffic congestion. Several years ago, the planning authority came to the conclusion that positive action should be taken to remedy these defects. In 1964 the London County Council formally resolved that an area of 38 acres should be dealt with as an area of comprehensive development. This resolution was accepted by the new G.L.C, which proposed to designate the area as an action area for the purposes of the Greater London Development Plan. Hon. Members will know that this plan is now being examined by the Greater London Development Plan Inquiry Panel. Acting on these development plan policies, the borough council has been seeking to provide a co-ordinated scheme of redevelopment to halt the progressive decline in commercial development and to revitalise the area as a shopping and employment centre. As part of its plan the council bought the freehold of Butterwick House and the freeholds of a number of surrounding properties. These and other properties were included by the council in a compulsory purchase order submitted to the then Minister of Housing in 1970. The order was confirmed in August last year by my right hon. Friend the Secretary of State for the Environment following a public inquiry. At the inquiry the council pointed out that two major developments were already proceeding on the order lands and adjoining lands—an office building and an air terminal and hotel. The council considered that redevelopment of the whole site in such an important central position was clearly necessary and that only if it were treated as a whole would a co-ordinated development of suitable size and character be achieved. These arguments were accepted by my right hon. Friend in deciding to confirm the order. I should point out that Rowtons (Hammersmith) Limited, the occupiers of Butterwick House, objected to the order in the initial stages, but withdrew its objection before the inquiry. That, then, is the background to the demolition of Butterwick House, and I am sure that hon. Members will agree that the closure is not the result of a hasty judgment but the result of carefully-considered planning over a long period of years. However, I accept that it is very unfortunate that the hostel is in an area requiring redevelopment. The loss of Butterwick House will exacerbate the problem caused by the decline in lodging house accommodation in London. As one who is concerned about the housing problem of London, naturally I regret any such incident.As the hon. Gentleman will know, my own constituency adjoins this area, and these are facilities which my area uses. Does the hon. Gentleman agree that where redevelopment of this sort is wanted we should look at the social problems arising from the squeezing out of such facilities as these, which are of great signifi- cance in these areas and help partially to solve a national problem as well as one concerning London?
Certainly I accept what has been said about the housing situation and about the reducing number of lodging houses. I shall deal with that problem in a moment.
I had considerable sympathy with what the hon. and learned Gentleman said about the problems facing the Hammersmith Borough Council. It is not just Hammersmith's problem. The people who live in Butterwick House live in Hammersmith, but they are drawn not only from the Hammersmith area. Yet it is Hammersmith which is faced with this situation at the present time. No one in this House has criticised Hammersmith Council, but it has been criticised strongly outside for failing to provide adequate alternative arrangements. In view of the situation, the council has been concerned all along to alleviate the harmful effects of the closure and has taken all positive steps open to it to do so. In July last year, a month before the compulsory purchase order for Butterwick House was confirmed, the council called a meeting of all interested parties. Representatives from 11 voluntary organisations were present as well as representatives from Rowton Hotels, the Camberwell Reception Centre, the British Association of Social Workers, the probation service and the Department of Health and Social Security. Two working parties were set up—one to carry out a survey to identify residents who might need help, and one to consider the long-term problem of providing accommodation for homeless men of this kind. The survey was carried out in September last year by Hammersmith Social Services Department and has been followed by a further survey. It identified about 140 men as being in need of long-term supportive care, all of whom were expected to remain in Butterwick until it closed at the beginning of June. Most of the remainder of the men surveyed appeared to be able-bodied, in full-time employment and—I would stress this—fairly certain that they would be able to find their own accommodation. Some had already made plans to stay with relations or intended to move into other Rowton Houses. Indeed, Rowton Hotels informed my right hon. Friend the Secretary of State for the Social Services that it was confident it would be able to rehouse any of the men from Butterwick who wished to stay in Rowton Houses. As a result of the working parties' efforts the council is making arrangements with two voluntary organisations, the Cyrenians and St. Mungo's, to set up six small homes which will accommodate about 80 men. The council is providing the houses and giving financial support. One home is already occupied, and it is hoped that the others will open in a few weeks. In addition, the council will be making accommodation available, for example, in old people's homes, and altogether suitable accommodation has been found for well over 100 men in need of supportive care. With the help of volunteers and advertising, the council is also looking for landladies in the area who are willing to accept ex-residents of Butterwick who need a sympathetic environment. The gradual closure of Butterwick started at the beginning of this month—I confirm what the hon. and learned Gentleman told the House—and places are being closed at the rate of 62 a week. All the men who had to leave Butterwick House were given priority tickets for admission to the three other Rowton Houses in London—in Camden Town, Whitechapel and Vauxhall. Transport to other houses for any men who want to move is being provided by the council. On the first Saturday 62 priority tickets were issued, but only four were used. In the second week there was no need to turn anyone away, and there were still 80 vacant places. In the third week there were 60 vacancies. This is in line with information given by Rowton Hotels that during spring and summer a large proportion of the men in its houses leave London to take up jobs on the coast. There is no reason to believe that during the closure any men will be left walking the streets or sleeping rough. It is always open to people in this situation to seek accommodation at the Supplementary Benefits Commission's Camberwell Reception Centre, but I understand that the impending closure of Butterwick House has not had any repercussions on the centre. The men are, in fact, leaving faster than the building is being closed, to summer jobs, to other Rowton Houses or to accommodation they have arranged themselves. During the first three weeks of the rundown period at Butterwick there have been vacancies every night at the totality of Rowton Houses. The lowest number was 29 on 8th March; the number reached a peak of 136 on 18th March. I entirely agree that the residents of Butterwick House should have as much information as possible about alternative accommodation, and I am very pleased that Hammersmith, together with workers from voluntary organisations, is planning to use a small empty shop close to Butterwick House as an advice centre for residents who are still worried about their future. Both the council and the Department of Health and Social Security are keeping the situation under constant review. I am pleased to learn that the council, following the advice given by my right hon. Friend the Minister for Housing and Construction, will be opening a permanent housing aid centre later this year. The council as a social services authority has a duty, for which my right hon. Friend the Secretary of State for Social Services is answerable under Section 21(1)(a) of the National Assistance Act, 1948, to provide residential accommodation for people who, because of their age or infirmity, or some other reason, require care and attention not otherwise available to them. However, it can be shown that the council has taken a very responsible view of its duties under this provision. The council is also not neglecting the needs of those whose requirement is a roof over their heads rather than a supportive environment. Positive steps have been taken to assist men to find those places. A number of men have already made their own arrangements without direct help from the authority. If—from the information I have been given this is very unlikely—some men cannot find accommodation, the council will look sympathetically at their housing needs against the many other pressing claims with which it has to contend. No one will know better than the hon. and learned Gentleman that Hammersmith has a severe housing problem. with a large waiting list and a shortage of housing land. The hon. and learned Gentleman will be pleased to know that the Government have just been able to make a small contribution towards the relief of this shortage by releasing a 4½-acre site in the borough, at present in the ownership of the Ministry of Defence, to be used for housing purposes. I am sure that the council will continue to use every effort to ensure that by the time Butterwick House is closed no one will be left without a roof over his head. Finally, I would like to turn to the more general issue which the hon. and learned Gentleman raised and which is very crucial—the question of homeless single people in London and the action needed to provide accommodation for them. There is little concrete evidence of the numbers of homeless single people in London. The Supplementary Benefits Commission in 1965 found that some 300 were sleeping rough in London but the number is now believed to be considerably higher. For example, about 8,000 pass through the Camberwell Reception Centre each year, of whom well over half have special personality and other problems as well as a need for accommodation. There is increasing pressure for more provision to be made for accommodation for single persons of all kinds. The Working Party on Homelessness in London, set up by my right hon. Friend the Secretary of State for the Environment, will be making recommendations on these problems in the very near future. We hope to deal with this expeditiously. The hon. and learned Gentleman also drew attention to the Survey of Lodging Houses now in preparation by the Department of Health and Social Security, and I hope that we shall have further information about that very soon. I assure the House that the Government will deal expeditiously with these surveys as soon as they are available. The problems raised by the hon. and learned Gentleman are being taken very seriously indeed by both the Department of the Environment and the Department of Health and Social Security, both in and out of London. The number of lodging houses in the country is dwindling in our big cities. By drawing attention to this problem the hon. and learned Gentleman has done considerable service not only to the people in Butterwick House but to all people in this situation. The Government will consider the problem very carefully as soon as the reports of the Working Party on Homelessness in London and the Survey of Lodging Houses are received. No doubt other surveys are being conducted by the London boroughs. We shall deal expeditiously with this very important matter and with the problems which could arise if such accommodation were to dwindle still further than it has done.Question put and agreed to.
Adjourned accordingly at twenty-three minutes to Five o'clock.