HC Deb 22 February 1929 vol 225 cc1475-93

12 n.

Dr. DRUMMOND SHIELS

I beg to move, in page 44, line 25, at the end, to insert the words (2) The Central Department may, before the beginning of each fixed grant period, make a scheme providing for the payment by county councils and town councils of large burghs specified in the scheme of such amount as may he specified in the scheme to the central council or committee of an approved organisation which provides services in the nature of general publicity, and educational propaganda in furtherance of the prevention and treatment of venereal diseases. This Amendment is to add, to the possible schemes already indicated in the Clause, one in regard to venereal disease. Those who are interested in public health are a little apprehensive as to the effect of this Bill on many of the health services, and many are specially anxious about venereal disease. It is an unpopular subject. We feel, therefore, that it is likely to suffer. This Amendment deals with another aspect of the subject. It deals with the position that those suffering from these diseases may from ignorance have no inclination or desire to seek treatment, a treatment which is important for themselves and important also for the community. We feel—in this connection—that the proposal of the Government implied in the omissions of this Bill, to drop the grants which have been previously given for propaganda is very unwise. From the names attached to this Amendment hon. Members will see that it has the approval of Members representing all parties in the House.

Last year we had a Debate in connection with the Edinburgh Bill, a Bill which sought to give power to Edinburgh Corporation to compel those who were suffering from the disease to undergo treatment. The House decided, under the guidance of the Minister of Health, that the voluntary system was sufficient. My own feeling is that a purely voluntary system will not be effective in stamping out these diseases. That is, however, a matter of opinion; but the one thing on which all who understand anything about the treatment of this disease are agreed, is that the voluntary system cannot succeed unless the public generally understand and realise the seriousness of these conditions. They are not only personally serious, but they are socially serious. A great deal of our work in hospitals is really, in origin, related to this subject, because a great many cases, labelled by other names have their beginnings in one or other of these diseases.

Now, a similar Amendment was put forward in connection with the English Bill and the Minister of Health did not find himself able to accept it. We have, however, made a very important alteration in the present Amendment by substituting the word "may" for the word "shall." The Minister of Health felt that lie should not be compelled to make such a scheme if he thought it was unnecessary, and we have altered the Amendment so that it will now be within his discretion to make such a scheme if the attendance at the clinics or the number of defaulters is such as to make it, in his opinion, desirable. A committee in Scotland has been carrying on this propaganda since 1921. It is a Committee of the British Social Hygiene Council, but it is a purely Scottish Committee. It has a number of distinguished members, whose names I will not read, but one name on it which will prove my statement is that of the hon. Member for St. Rollox (Mr. Stewart). This Committee has been carrying on very important work by giving lectures, advertising, and distributing literature, more particularly in those areas where there has been a lack of interest and where cases were not corning forward to the clinics.

The Scottish Board of Health has been in the habit of giving a grant of £1,000 a year for the work, and in view of the statements that are sometimes made as to the value or otherwise of propaganda, perhaps I may be allowed to quote an extract from the report of the Scottish Board of Health on this subject. The Report for 1927 states this:— Propagandist and Educational work.—The former of these provisions the Board has left in the hands of the Scottish Committee of the British Social Hygiene Council, being well assured that that body could and would do the work as well as it was possible for it to be done, and content, therefore, to stand by approvingly and render the necessary financial aid. That the work of the Scottish Committee has been effective and of high value is certain, but we learn from time to time with some surprise that information regarding these ailments, their nature and treatment, and regarding the existence of clinics where efficient and confidential treatment is available without charge to all, and, at least to the great majority of city and town dwellers, reasonably acceptable—that this information, actively disseminated as it has been for six or seven years, has not as yet by any means found its way to the whole of the population. At the male venereal disease clinics it is no uncommon experience to hear, in answer to the medical officer's question, 'Why did you not come here sooner?' the remarkable reply, 'I did not know that there was such a place.' In the female clinics such an assertion of ignorance is still more frequent; and at the latter, in addition, there is often revealed an almost incredible ignorance with regard to the manifestations of one or other of the maladies in question, or even as to the nature and significance of general indications of ill-health. There is more in the Report, but enough has been quoted to show that the Scottish Board of Health, which is very well qualified to judge in this matter, have stated clearly that this propaganda work of the Scottish Council has been effective. Personally, I feel that such work is national work and that it should be done by a national department. I should prefer if it were done by the Board of Health itself. The Government, however, are not likely to agree to that, and therefore, I suggest that this body, a voluntary body, composed of many very able and well-informed people, which has been doing such effective work, should be allowed to carry on, or else that some similar body should have the task of enlightening the public as to the great importance of these diseases. Those who are in charge of the treatment of these diseases in the various cities and counties of Scotland are satisfied that if things are left as they are in the Bill, local authorities will not voluntarily contribute to the funds of such an association. It has been suggested that local authorities would naturally subscribe to a central association of this kind without anything being in the Bill at all, but it is a matter of experience that unless these things are done uniformly, and unless there is a stimulus centrally applied and equally distributed, the desired general effect will not be produced.

I do not think it is necessary to labour the point regarding the importance of this subject, but I suggest that, not only because of the very baneful and serious effect of the diseases themselves, but also because of their great social and economic importance, and the great number of innocent people who suffer from them—for even the cases of blindness and of mentally defectives that we have been considering lately, are very largely linked up with these diseases—surely the Government will consent, especially having regard to the optional nature of this Amendment, to consider central propaganda, I trust that they will look again into the matter and ensure a continuance of the system which has secured at least, an effective method of disseminating information regarding these diseases throughout our country.

Mr. SCRYMGEOUR

I wish to support the Amendment which has been so ably moved by my hon. Friend. The Government maintain throughout this Bill that there will be better service rendered in every department of public life by their plan of centralised effort. Unless the Amendment is adopted the Government, in this matter, will be leaving the arrangement as a sectional arrangement, against which they have taken up a strong attitude, for their whole policy hitherto has been in favour of centralised areas and effort. Here is a public body that has been set up specifically for giving publicity to methods for getting down to the depths of this almost indescribable disease. I believe that before long there will be compulsory notification of the disease. Some municipal bodies have disappointed and have not done their duty in the matter in the past. Members of all parties are associated with the Amendment. They say in effect, "At any rate let us have this organisation optionally placed under the control of the Ministry to give it the requisite imprimatur." I hope there will be the desired response on the part of the Government. The Under-Secretary of State has personal knowledge of the situation.

Major ELLIOT

It is true, as the hon. Member has stated, that this is a nonparty subject, and that the Amendment is backed by Members in every part of the House. I have done my best to address myself to it from a non-party point of view, because undoubtedly there is much to be said for the arguments which have been advanced, that the propaganda with regard to this disease is of vital importance, and that in many ways it is better exercised from a central body than from a local body. There are difficulties, and, I think, conclusive difficulties against adopting the course of compelling local authorities to contribute subscriptions towards voluntary associations. To begin with, there is an Amendment down in the name of other hon. Members to omit the whole of this Clause, on the ground that these compulsory schemes put forward by the central department are, so to speak, nibbling at the general grant and to that extent detracting from the responsibility which is the essence of the Government's scheme—the responsibility which the great health authorities are being asked to assume now and for the future.

It is quite true, as the hon. Member for Dundee (Mr. Scrymgeour) says, that we have brought into existence somewhat more centralised machinery than at present exists, but note where that centralised machinery rests. It rests in the burghs and counties of Scotland. It is centralised for the health areas, but we are attempting to decentralise as far as the central administration is concerned. The particular small grants which have been made from time to time to this or that organisation, to induce it to pursue some particular course, are being swept into a general pool and that general pool is distributed to the local authorities who will then it is hoped—and I confidently believe—take upon themselves all the duties and more than all the duties which the central department has previously stimulated them to carry out. The very fact that many local authorities have sympathetically approached myself and other Members with regard to the proposal, shows that there is a feeling of full responsibility among health authorities as to their duties in connection with propaganda work. It is not, therefore, desired in any way to discourage propaganda, but it is desired to give local authorities a feeling of full responsibility for the whole of the health activities in their area including the responsibility which they have in regard to propaganda. There is great danger of specialising one or two activities or a group of activities concerning which the local authorities must make payments. We have to deal with that in the case of the blind and the mentally defective, but payment to voluntary associations,—subscription by a local authority under the compulsion of the department towards a voluntary association,—is an unsatisfactory way of dealing with present difficulties.

I think the matter would be much more readily met by the method which I am about to propose to the Committee. It is that, in the first place, the present grant from the central authority to this voluntary society should be continued. That runs up to May 1930. I am prepared to recommend that a substantial additional sum should also be obtained from the Treasury, and I do not doubt I shall be able to obtain it, towards the expenses of this voluntary society. That gives a considerable time for those concerned to look round. I am also prepared to say that I will call a meeting of the local authorities who are particularly concerned in this matter and to discuss the subject frankly with them, and I have no doubt that we shall be able to come to an agreement with the local authorities as to the health and propaganda work which they desire to carry on. I do not desire to take upon the central department further powers to compel local authorities by fiat to expend sums out of monies which they rightly regard as their own money and their own responsibility.

The provision that the central department may make a scheme, means that in case the Government decided against making a scheme this provision should be a dead letter. I think it is much more satisfactory to say that we shall call the local authorities together to consider it and that we shall be more than ready, if they so desire, to act as banker for any sums which they may wish to spend on health propaganda including health propaganda of this kind. That will give us the advantages of the centralised control and centralised expenditure which the hon. Member for Dundee has suggested. The only difference is that the local authorities will have themselves contributed freely, and not under the compulsion of the central department. I am pleading here for freedom for the local authorities, as against the very accusations which have been made in the past about compulsion on local authorities, and I am proposing, in addition, a substantial sum to enable the society in question to reconsider its position and to bridge over the transition period. It may be that, in future, local authorities will desire to undertake this work themselves—they are undertaking a considerable proportion of it already—but that is in the future. The position of the society will be safeguarded for this year. It will be safeguarded for a period, and during that time the local authorities will have considered, not so much the position of this society—which, though important, is not the main point—but the position of health propaganda and publicity which it is the desire of all to see continued and extended.

Dr. SHIELS

Is it not the duty of the Government to give a lead and guidance to the local authorities in this matter, as much as in the matter of the blind and mentally defective, and to give a constant stimulus?

Major ELLIOT

We think that the point is covered by the general provisions of Clause 50 which provides in the widest possible words that the Secretary of State shall be satisfied that a council have carried out their obligations; that he shall be satisfied that they have not failed to achieve a reasonable standard of efficiency in the discharge of their public health functions arid that the health of the inhabitants, or some of them, has not been or is likely to be endangered. The power of the central authority to call the local authorities together and to ask them what they are doing, and, if the central authority is not satisfied, to intimate to the local authorities that they are not doing enough, meets the point. The matter is completely covered, I suggest, by the general power in Clause 50.

Sir PATRICK FORD

If Clause 48 were to stand as it is, it seems to me that there would be a certain amount of contusion. Certain things are to be done—quite rightly—by voluntary associations. They are to help in tending the blind and the mentally defective, but, as we know, only too many cases of blindness and mental deficiency arise from this very source which we are considering. Why cannot we amplify this provision? Instead of being tagged on to the end of the Clause a provision dealing with this matter ought to be the first Sub-section of the Clause. Why cannot we go to the root of the matter. If it is desirable to draw the attention of local authorities to the means of dealing with the blind and the mentally defective, is it not even more incumbent on the Government to see that attention is drawn and that activities are directed to the cure of a disease which causes so much of the other two diseases that we are tinkering with in this Clause?

Sir R. HUTCHISON

Everyone who has had experience of dealing with the dreadful scourge of venereal disease realises that it is necessary to have a central organisation dealing with propaganda and education in this matter. It is obvious that, under the Bill, the funds available for this propaganda will be at the discretion of the local authorities. Are there any funds, outside those which would be provided by voluntary contributions, available for such health propaganda.

Major ELLIOT

The Department of Health in Scotland has no special appropriation for health propaganda or for preventive publicity work. To deal with the point put by my hon. Friend the Member for North Edinburgh (Sir P. Ford), I quite agree with him that if it was being left out, it should be inserted as indeed the first of all these paragraphs; but my point is that the differ- ence between this and the blind and mental defectives is that this is so clearly a health activity that it does not require to be specified in the list of things to which the local authorities have to pay attention, whereas the mental defectives and the blind are border-line cases, and it is much more welfare work in these cases than health work. Propaganda against venereal disease is so clearly and distinctly one of the health duties and functions of the local authorities that we claim, first of all, that it is covered by the general activities of the authorities and, secondly, that the very wide words of Clause 50 would give the Secretary of State full power to call the attention of the local authorities to any case of default, if it arose, which I have every hope it will not.

Mr. J. STEWART

The Under-Secretary said just now that the mental defectives and the blind were borderline cases, and that is true, but it is also true that they are the results in a great degree of venereal disease, and that that disease has arisen mainly out of ignorance. Like the ostrich, we have buried our head in the sand and declined to speak about or to mention venereal disease, and up to the last ten years or so nowhere in decent society were the words "venereal disease" mentioned, and we allowed our young people to move about in ignorance and acquire this disease because of it. Then came the Association for the Prevention of Venereal Disease, now the British Social Hygiene Council, which went to work with the assistance of the Government, with the unlimited monetary aid of the Government, arising out of the revelations made with regard to venereal disease in the Army during the war and the results that accrued therefrom, causing many of our men who ought to have been effective units to be absolutely useless and rather a burden and a hindrance than anything else in the carrying on of that war. So there came this Council, with the support of the Government of that day, and practically unlimited money. They went here and there, and they travelled abroad and throughout this country, setting up local organisations for the purpose of combating this disease; and I believe that one of the most effective ways to prevent this disease is by letting the people know what it means. It means disaster in every direction.

Those of us whose painful duty it has been to visit our asylums know that in every section of them, in every ward, are to be found the results of this disease, the results of ignorance and of the desire to hide the shame of it. Here we are asking that this Council should, in a little way, gain support, for the purpose not of aggrandisement or glorification of any individual, but for the purpose of carrying on this good work. I am glad to say that, so far as my own city is concerned, we have recognised the value of education and have entered into contracts with the education authority dealing with this matter, not caring so much about the expense as about preventing the development of the disease and the continuance of the ignorance that leads to it. We should give the Government credit for the fact that they are going to give an increased grant, though an unstated increase. I would rather the Under-Secretary had indicated what the amount was to be, but it is only to last until 1930, and that is not good enough. That is not giving us very much, and we ask the central authority to take power unto itself to deal with any local authority that is not continuing this work.

The Under-Secretary says they already have this power. Then why refuse to accept this little word "may," that the central authority may in its wisdom do this thing? If they may do this thing, they will be doing what is right, and there may be a local health authority that will refuse to do this work. In fact, I may say that some very considerable health authorities are showing no great enthusiasm in dealing with the disease; and consequently, while I consider that the grant is something, I wish the Under-Secretary would still further consider it and make a better offer that would enable the real preventive work of education to be carried out even more fully than it has been carried out in the past.

Sir R. HAMILTON

All who are concerned over this matter realise that propaganda, properly directed, is absolutely essential to the combating of venereal disease, and, that being the case, we should do nothing to interfere at all with the carrying on of the propaganda which has been started and has been and is being efficiently carried on. I realise the difficulties which the Under-Secretary sees in attempting, as he says, to coerce or interfere with the liberty of local authorities to take such line of action as they may think fit, but I think he relies too much on the power reserved to the Secretary of State in Clause 50, which he would find very considerable difficulty in giving effect to. He admits that there is no fund outside the contributions which might be given by local authorities for the carrying on of this propaganda work. Personally, I should much prefer to see a national fund, controlled by the Board of Health, and that the Board of Health should have the control of this propaganda work, and if we could have some assurance from the Government that that line of action would be taken, and that we should not be in danger of losing the advantages of the propaganda being carried on, I would agree with him that this Amendment should not be inserted, but that the whole of the propaganda work should be left under the control of the Board of Health.

Captain FANSHAWE

I support the Amendment, or the intention of the Amendment, and I should like to see in a separate Clause the same Amendment put in the place of paragraph (a), for the reason that many hon. Members of this Committee have drawn attention to the fact that venereal disease is very generally the root and source of both the other diseases, of blindness and mental deficiency. I think it would be advisable, and I would ask my hon. and gallant Friend the Under-Secretary of State for Scotland if he would consent, though perhaps not accepting the actual words of the Amendment, at any rate to enter the new Sub-section before paragraphs (a) and (b), drawing attention to this terrible scourge of venereal disease, which, after all, brings these other two diseases in its train and also brings misery into countless homes up and down the country. The Under-Secretary said that Clause 50 will give the Secretary of State full powers of supervision, but I want more. I want the words put into the Bill, so as to spur people on to get right down to the root of the matter. A very earnest desire has been expressed on all sides of the Committee, and I very much hope that the Under-Secretary will accept the sense of the Amendment.

Mr. ROSSLYN MITCHELL

I do hope that the Government will take this power which, I am sure, the Committee is willing to give them. The Under-Secretary spoke of a sort of power he might have under Clause 50, but what does that mean? It means that if one county or large burgh is not taking part in the fight against venereal disease, all that he can do is to say: "Very well, we penalise you by taking a certain amount of money which you are already using for other health services." That does not seem to me to be at all a good weapon for a department of State to use. May I remind him—and I do so with great deference, because I know he is so well aware of these things—that this form of compulsory uniform action to combat disease is really one of the stages that are common to all fights against diseases. It begins, as this began, by some individual, who feels very deeply on the matter, starting to talk about it, and those who have hitherto been ignorant of the existence of such a thing hold up their hands in holy horror. But this gallant soul goes on, and talks, and awakens people's conscience to the existence of the disease and the evils which flow from it. A few gather round, and then become a little society but, first, it is looked at askance, not only by local authorities but by people generally. Then gradually it makes its way, and people become familiar with it. Then the local authority comes in with a donation to the little organisation, the voluntary workers, and then, once it has become interested, the next stage is that the health department says: "We must know the source of this disease; we must find out who has it." Then they ask for compulsory notification, and a great many people in the name of liberty oppose it. Then you have a sort of uniform system of contributions from all the authorities, and eventually you have notification and the elimination of the disease.

Speaking from my own personal experience, I remember precisely the same sort of opposition being offered to steps which were proposed to be taken to eliminate another disease in Glasgow. It was called ophthalmia neonotorum. It was a disease which brought to Glasgow about 150 or 200 blind children every year. It was a constant source of recruitment to the blind population of Glasgow. One or two folk became interested, and then began to talk about it. The public authority, during my own time, became interested in it. They promoted schemes to deal with it, and then they obtained, in face of the opposition of a lot of folk, powers to compel notification of the disease. From the expiry of the first year of compulsory notification and public treatment, there has not been lost in the city of Glasgow one eye through that disease. From having 150 to 200 totally blind children, we reached the stage, in about 15 months, of a complete cessation of the loss even of one eye. I can speak from my own experience of precisely the same development of ideas in the question of dental treatment of children, for I myself proposed in the Town Council of Glasgow that the health department should have regard to the treatment of teeth, and I received no support whatever. But some people began to take an interest in it. Private groups grew up, until it was taken up by the school board and is now compulsory. I hope that the Committee will excuse my being personal, but I do not like to speak on anything unless I have personal experience. It is in the time of my own public experience that the question of phthisis has become a matter for public authorities to deal with. I can remember very well being present at the opening of the first children's clinic in the City of Glasgow by a little group of women who were concerned about child welfare. It has all developed very quickly, and it has all developed along the same lines.

I regard this proposal as another definite stage in the fight against this terrible scourge, because unless you can compel every county and every large area to take, not merely an active bu a financial interest, you may have half of your areas, or even nine-tenths of your areas, doing it, and the tenth of the area not doing it may become a new source of contamination. In political ideas there is a stage when the idea of adherence to personal, individual liberty on the part of an individual or of a county becomes a challenge to social freedom, and the stage does arise, in the development of people's consciousness of the existence of an evil, when they say: "Not merely have we the power, but it is right that we, representing the whole community, shall insist upon all local authorities taking their part in the challenge to, and the conflict with, this disease." Therefore, I hope that the Government will not rest upon this penalising provision of Clause 50 to deprive a local authority of money which is intended for other purposes because it does not do its work, but that they will accept the power which we are willing to give them. Whether they utilise it or not will depend upon circumstances, but, at any rate, they would have that urge upon local authorities by the fact that they had this power in their hands. I hope, therefore, the Government will accept the Amendment.

Brigadier-General CHARTERIS

I hope that the Committee will feel that those hon. Members who may not desire that this Amendment should be accepted are in no way actuated by any hostility to the efforts made by the voluntary associations in the treatment of venereal disease or also in regard to the treatment of the blind and mentally defective. There is 'another point of view from that which was so eloquently expounded by the hon. Member for Paisley (Mr. R. Mitchell). If the Amendment were accepted there would be a real risk from the central authority laying down not only the policy and principles, but from it also specifying the actual amount of the contributions that are to be made. It might act as a sort of chloroform to the local authorities themselves. The tendency and desire of the local authorities to assist might well be reduced by the feeling that the responsibility in the matter is no longer theirs and that it rests with the central authority. That will be particularly the case if they get the feeling that the central authority will in due course order them to take the subscriptions that are necessary.

There is another difficulty and that is the grave objection to this proposal which was stated by the Under-Secretary of State. It would be in contradiction to the whole principle of the Bill if while you were adopting the general policy of giving Government grants to the local authorities to use and administer at their discretion, you do not give to them the full responsibility for the public health. By this Clause and this further Amendment, when you are professing to give discretion and responsibility to local authorities. At the same time you say to them "Out of this sum you shall pay so much, whether you think it right or wrong, for this or that institution, whether you think it is badly run or not." If you do that you will be making a very severe attack on the whole principle which lies at the root of this Bill. I heard with much pleasure the intention of the Under-Secretary that there should be an increased grant during this year and next year. I am sorry that the Under-Secretary did not give the figure of the grant. It is a. good thing to give this increased grant and far more good also will be done by assembling the representatives and the local authorities and explaining to them their duties and obtaining from them assistance in the effort which the Bill seeks to make toward the prevention of disease. That is more practical and more in accordance with the spirit of the Bill and more likely in the long run to be successful. I therefore hope that the Government will not be swayed in their decision and diverted from their judgment by the speech of the hon. Member for Paisley who so eloquently put the case for the Amendment and the need which we all acknowledge of dealing with this disease the existence of which we all deplore.

Dr. SHIELS

While I am glad to hear what the Under-Secretary of State proposes to do in connection with this organisation, I am sorry that I cannot regard it as a satisfactory substitute for the Amendment. I think it is quite obvious that the Secretary of State's Conference with local authorities will be much more likely to be effective if he has behind him the power to make such a scheme in the event of nothing satisfactory coming out of the conference. I therefore ask the Under-Secretary if he will consider this matter before the Report stage. If he agrees to do that, I will withdraw the Amendment; otherwise, I am afraid it is a matter upon which I and my hon. Friend and many hon. Members in the Committee feel so deeply that we must press it to a Division.

Mr. MACQUISTEN

This Amendment appears to me to be an improvement, on the Clause. This is an educational Amendment, and it is therefore a thing about which any central authority must be more concerned; it goes to the beginning of the matter. Paragraphs (a) and (b) in the Clause deal with events which follow subsequently, but it is important to get at this business from the start, and you can do that by educational measures more than by subsequent action. It is a very difficult proposition to establish that the central authority is to say that the county councils and the town councils of the large burghs, who, after all, are the local bodies, are to make provision for the other associations mentioned in the paragraphs. One would assume that those bodies would naturally do that on their own account. It is really strongly subversive of the democratic principle that a central body, established far from the local areas in question, should have the right to overrule those associations. This Amendment is on the lines of our general educational principles, namely, that the distribution of information of this kind, which is not localised and does not deal purely with local matters but applies to the whole country, should come from the central bureau or office. When, however, you come to deal with individual cases specified in the various areas, it appears to me to be more a matter for the local people themselves than for the central bodies. I suggest that it is a sounder principle that this Amendment should take the place of Clause 48, and should constitute the whole of that Clause; then, the two paragraphs in Clause 48, which obviously are appropriate to local administration, and the duties of which can be carried out by local people in their own particular areas, should be left to the local people to deal with.

I remember in the course of my professional practice a case where a voluntary institution was concerned, and where very conclusive evidence was put before me that a large part of the money expended had not gone to the beneficiaries. In that case, it was held that the matter was outside the jurisdiction of the Courts, and that these particular concerns could only be dealt with at an annual meeting. I remember being struck at the time by the fact that that particular voluntary association was not functioning exactly in the way we wished it to function. Such an association might not like to be criticised by a central authority situated far from the particular institution. The association might be more easily persuaded by those in the county or the burgh who know the institution and its particular need. Therefore, I think, we may safely leave the dealing with the provisions of paragraphs (a) and (b) to our enlightened county councils and town councils. I am perfectly certain they will do their duty by these particular institutions in their own areas, and do it without being pressed or interfered with by the central authority. It is a very strong proposition to say to the local authorities that another body, not responsible directly to the people of the area or elected by them, should overrule the ratepayers of the particular area, and should go down and say: "You have a local fund collected, but you shall spend it in a particular way which we desire." That will be giving too much power to the central authority. I hope that this Amendment and also the next Amendment on the Paper in the name of the hon. and gallant Member for Dumfries (Brigadier-General Charteris), to omit the Clause, will be dealt with together, and that the Amendment of the hon. Member for East Edinburgh (Dr. Shiels) will be accepted in substitution for the Clause.

Major ELLIOT

I think we can scarcely be expected to accept the remarkable proposition which has just been made by the hon. Member for Argyllshire (Mr. Macquisten) that we should take out altogether the Clause proposed by the Government. The Committee are asking the Government to consider whether certain services do not require the rather close hand of the central department. We say that all these matters must hang together. Therefore, I will leave over the question as to whether or not the other two paragraphs should be omitted. The Committee this morning have shown a great interest in this matter, and it has been brought to our attention by reasoned speeches from all quarters of the House. We are, unfortuneately, deprived of the presence of the Secretary of State, on whom the official responsibility would have to rest; but it would be unfair that the Committee should be deprived by that reason of the advantage of bringing their views to the notice of the Secretary of State. Therefore, I will undertake to bring this Debate to his notice, and to go over the matter with him, but of course I can give no pledge. But I could not go over it on the somewhat narrow lines suggested by this Amendment, which provides, (a) that payment should be made only to an approved organization, and (b)), that it should be made only in respect to funds to combat venereal disease proper.

I should say that we should consider the question of health and health propaganda not merely in relation to this disease but on a somewhat wider ambit, and, secondly, that we could not in any way guarantee or suggest that these funds should be expended by means of these or any other organisations. It may be that some entirely different method can be found. I will undertake to consider this matter myelf, and, secondly, to bring it to the personal notice of the right hon. Gentleman, the Secretary of State, it being clearly understood that we are not considering or suggesting that any payment or guarantee of payment should be made to any single voluntary organisation or in respect to any disease, barring the additional sum I have already suggested, namely, the sum in consideration of the change in the operation of the grant which is now taking place.

Dr. SHIELS

The Under-Secretary of State has hedged his proposition around with a great deal of Scottish caution, which probably is quite natural in the circumstances; but I think one can see in his remarks a sympathy at any rate with the objects of the Amendment. I think, therefore, it would be the feeling of the Committee that we should suspend our further activities until we see the result of the conference between the hon. Gentleman and the right hon. Gentleman the Secretary of State. I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Question proposed, "That the Clause stand part of the Bill."

1.0 p.m.

Brigadier-General CHARTER'S

The arguments against this Clause have been put by the hon. and learned Member for Argyllshire (Mr. Macquisten), and I can only say that I hope consideration will be given to the proposed Amendment, and that the Government will consider whether the terms of Clause 48 should not be in some way altered, so that we should not have a ruling that the central department are to specify not only the institutions but the amounts to be given by the local authorities.

Mr. MACQUISTEN

I would add my plea to that. It is a very strong power that is proposed to be given to the Central Department.

Major ELLIOT

I cannot, of course, give any such undertaking as has been suggested, though I have no doubt the right hon. Gentleman the Secretary of State will give his attention to this question. This Clause has been very carefully considered, and has its present form although various points have been brought up with regard to it by representative deputations of local authorities. This morning, the Committee have pressed that the central department should be empowered to specify further organisation rather than to sweep away the safeguards inserted by the Government. No doubt this matter will be reconsidered when the Clause comes up again, but I must not be taken as giving any guarantee whatever.

Question, "That the Clause stand part of the Bill," put, and agreed to.