NATIONAL HEALTH SERVICE (CHARGES)

HC Deb 02 July 1952 vol 503 cc476-578

5.58 p.m.

Mr. Hector McNeil (Greenock)

I beg to move, That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Dental Treatment) Regulations, 1952 (S.I., 1952, No. 1020), dated 23rd May, 1952, a copy of which was laid before this House on 23rd May, be annulled. I think that the House will not disapprove if I say to the Minister of Health that we are all sorry about the illness at his home and hope that there will be a complete and speedy recovery.

If it is agreeable to you, Mr. Deputy-Speaker, and to the House, we on this side hope that we may proceed on these Prayers as we have done before. There are eight Prayers on the Order Paper in the names of my hon. Friend and myself. There are, for Scotland and England, Prayers dealing with dental charges, charges relating to drugs and appliances, charges relating to hospital accommodation and outpatient departments, and to what we call amenity beds. I hope that by moving the first Prayer we may then have a general debate covering the range of the subject mater embodied in the other Prayers.

Mr. Deputy-Speaker (Mr. Hopkin Morris)

If that meets the convenience of the House, I think that would be a very good thing to do.

Mr. McNeil

Perhaps it will also be for the convenience of the Whips if I say that it is not our intention to divide on the two Motions dealing with amenity beds. We anticipate that we shall get satisfactory information from the Minister upon those two sets of regulations. On this side, as on the Government side, we are anxious to see the best use made of amenity beds. However, unless the right hon. Gentleman is able to offer some evidence that Her Majesty's Government will shortly alter its lamentable policy as reflected in the other Regulations, we shall be obliged at the end of the debate to divide upon them.

It might be convenient if I dealt with the subject matter of the prescription charges as reflected in the Regulations covering England and Scotland.

Miss Margaret Herbison (Lanarkshire, North)

On a point of order, Mr. Deputy-Speaker. Since four of the eight Prayers with which we are dealing refer to Scotland, ought we not to have a Scottish Minister on the Government Front Bench?

Mr. Deputy-Speaker

That is not a point of order.

Mr. McNeil

Be that as it may, would it not be within the normal usage of the House if, when this huge Department with a great Vote has four sets of Regulations before the House for which its Minister is exclusively responsible, the Government Front Bench were adorned by one of the seven Ministers who represent the Scottish Office?

The Minister of Health (Mr. Iain Macleod)

On a point of order. The representative of the Scottish Office is on his way and does not have to be sent for. Anyone who could prophesy to within a minute or so the end of the debate which we have just had—

Mr. Deputy-Speaker

That may be an explanation and a comment, but it is not a point of order.

Mr. McNeil

I am indebted to the right hon. Gentleman, but from time to time we meet this difficulty. If the right hon.

Gentleman and his Parliamentary Secretary, who have huge difficulties, do not find it too much troublie to wait for a debate, let us hope that eventually one of the seven Ministers from the Scottish Office will do the House the courtesy of attending to its business.

I propose to deal mainly with the charges on prescriptions, although if my hon. Friends are fortunate in catching the eye of the Chair they will bring their specialist knowledge to bear—notably my hon. Friend the Member for Tottenham (Mr. Messer) and my hon. Friend the Member for Wolverhampton, North-East (Mr. Baird)—on the other Regulations.

Mr. J. Enoch Powell (Wolverhampton, South-West)

Where is the hon. Member for Wolverhampton, North-East?

Mr. McNeil

My hon. Friend the Member for Wolverhampton, North-East will be here. [Laughter.] Hon. Gentlemen opposite had better contain their laughter. A Minister has an obligation to the House. Hon. Members are in a different position. My hon. Friend will be here in time and will be competent to deal with any interest that hon. Gentlemen opposite display in the subject.

I want first to deal with some aspects of the two sets of Regulations reflecting the 1s. prescription charge. I hope I am not being unreasonable in wanting the Minister to tell us—he was, understandably, a trifle coy at an earlier stage—what he hopes to save by the deterrent effect of these Regulations and what he hopes to gain in respect of the charges for prescriptions by doctors and hospital out-patient departments. The right hon. Gentleman must now have some kind of exact calculation, for he has now had a full month in which to scrutinise the workings of the scheme and, no doubt prodded by the Treasury, he has carefully watched the working of the parsimonious, niggardly and ill-conceived scheme by which he still intends to filch shillings from the purses of the sick and distressed.

I have here some figures which I confess I cannot pretend are typical. They come from a small sector of the population of a town of some 90,000 people, and the calculations are from pharmacists and are necessarily approximate. I do not want to argue that from a statistical point of view they are necessarily significant, but I want the House to agree that even at this stage they must give us cause for concern about the operation of the Regulations.

From this sample I find that in June. 1952, the number of prescriptions is down by just under 5 per cent. compared with June, 1951. The House will note that I am talking about the number of prescriptions and not the value of the prescriptions. Later on I shall quote some figures relating to this point. Many of us must suspect—I do not think the right hon. Gentleman will fail to suspect it—that the general practitioner, who is, by and large, a warm and humane creature, will be concerned to save his patients charges whenever he can, and I have little doubt that in an appreciable number of cases the figures will eventually show that more than one item is put on the prescription form and that quantities prescribed are larger than has been the case previously.

Thus, we may find at the end of the day that there will be no appreciable net saving under these Regulations. At any rate, I am only able at this point to allude to the calculation of the number of prescriptions in June this year compared with June last year in this sector of the population, and I repeat that the figure is down by approximately 5 per cent.

Further—this is even more disturbing—I find that about 2 per cent. of the people in this sector who learn when presenting their prescriptions that there is a charge from which they have no hope or anticipation of escaping, do not return for their drugs. I also find that about 10 per cent. of them are asking for receipts. I do not know what proportion of them go to the National Assistance Board, and perhaps the right hon. Gentleman or the hon. Lady wil be able to give the House some figures on that point later.

My hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross) has been good enough to supply me with some further figures obtained independently. To a surprisingly high degree they corroborate the figures I have taken from the samples available to me. I do not know that I am at liberty to quote the name of the firm. However, my hon. Friend's analysis shows that the number of prescriptions in June, 1952, showed a drop of 10 per cent. compared with June, 1951, and 20 per cent. compared with June, 1950. He says that the requests for receipts are exceeding 5 per cent. He also discusses in some detail the type of patient who is being most affected by these Regulations. He says there is a definite hardship discernible in the case of old age pensioners, those suffering from acute chest complaints, including tuberculosis, diabetics and people suffering from ulcer conditions. These people have to pay 1s. or more practically every week, which is a drain on their already small income.

He goes on to state one case of a man suffering from a duodenal ulcer who required a weekly prescription, and who in one week had both of his children ill. I quite agree that that is not a general condition, but in such a case there would be a great hardship. This pharmacist gives some further figures about appliances, with which my hon. Friend will no doubt deal; but there is corroboration here that the sample I have given may be approximately typical.

It will not only be the concern of the House to try to find out from the Minister whether the figures are showing a general pattern of that type—I must agree that one cannot come to any conclusion with only the experience of one month, but they may indicate a tendency—but it will also be our concern to know whether the Minister has any kind of information on the type of patient—I mean not a reference to his condition but to his disease—who is falling inside these three categories. I doubt very much whether the right hon. Gentleman will yet have that information, but that is really the worry of every Member who has an interest in, and experience of, this subject.

It will be no economy and it will be a great injustice if people who are really ill are part of the 2 per cent. who are not going back for their prescriptions, or part of the 5 per cent. who, compared with June of last year, are no longer going to the pharmacist for their prescriptions. We all want to see the use of unnecessary drugs eliminated, but no one has offered hard, good evidence to the House showing that the abuses exist which some suspect. Lacking such evidence, this drop of 5 and 2 per cent. must be a worry to every hon. Member.

I hope the Minister will give us the figures for which I have asked so far as they are available. I hope that, in making this calculation as to the saving, he will tell us frankly what the additional costs for printing and for personnel are likely to work out at. The cost of printing must be very substantial. I have here a collection of forms and circulars issued by the Government which was to set the people free. I do not pretend that my collection is necessarily complete, but there are 21 circulars and forms which doctors, nurses, dentists and patients are expected to comply with and to employ in consequence of these Regulations. Perhaps the Minister has a final figure, and he might like to tell the House how many circulars and forms he has been obliged to issue so as to secure compliance with these Regulations, which were to be a great saving.

Moreover, apart from the financial cost, the exasperation to sick people and highly trained technicians must be quite substantial. Experienced as we all are in Government jargon, there are some fairly good examples in these circulars. There is one in E.C.N. 97 which refers to the charges for drugs, and if I am not boring the House perhaps I might read this piece of English which relates to what the Leader of the House told us at one time was a simple Regulation: Under the regulations, drugs and appliances will be deemed to be supplied on one occasion, notwithstanding that they are supplied at different times, if they are supplied at or following a visit or attendance and before a succeeding visit or attendance takes place. The best is yet to come: A repeat supply is not deemed to take place on the same occasion as the original supply, notwithstanding there has been no intervening visit or attendance. It must be a great consolation to an over-worked doctor to have his conduct laid down for him so clearly and so completely. The chemists and the patients must be equally grateful.

Mr. J. K. Vaughan-Morgan (Reigate)

Perhaps the right hon. Gentleman would care to read the next paragraph in E.C.N. 97. That is very clear and simple.

Mr. McNeil

It is very clear and simple, but it does not refer to the operation of this new Regulation which we were told was to be simple. The hon. Member asked me to read the next paragraph and in fairness to him I quote it: Doctors are asked not to increase the quantities normally supplied on any one occasion. Had these Regulations not been operated by this Government, there would have been no need to give this warning. This proves what I have already indicated I suspect will happen and what I suspect every hon. Member opposite knows will happen—that a doctor who is concerned for someone who is ill and who is decently and warmly disposed towards that person will, despite this Regulation, try to make it easier for the patient, which professionally he should try to do because he hopes to make him or her well.

But this is by no means the only sample of involved and exasperating English. There is another from one of these circulars which I should like to put to the Minister. Earlier I asked him to tell us how many additional personnel he calculates will be necessary to see that these Regulations are obeyed. Here is a circular issued to hospital authorities, R.H.B. 52/56, which deals with charges for prescriptions to hospital outpatients, and this is an instruction from it: Hospitals should arrange that an officer is available when outpatient clinics are being held to inform the patients claiming exemption whether, in fact, they are exempt or not. It then goes on to say that records should be kept of all exemptions and the patient given a ticket or token at the dispensary to show that he is exempt. Then it goes on to talk about the collection of the charges and says: It is important that, whatever arrangements are adopted in each hospital, they should be as simple and as inexpensive as possible, and should, in particular, be so devised as not to involve any substantial increases of staff or of administrative costs. Is that just the natural caution of the right hon. Gentleman, which we should applaud? Or does it indicate that he expects that, on a busy afternoon at an outpatient department, it will not be possible to advise the patients and, much more difficult, to collect from the patients, unless there is a fairly substantial staff employed?

From time to time hon. Gentlemen opposite have worked themselves into paroxysms of righteous indignation about snoopers, but here is a new line of snoopers. Here is the snooper who has to sit down with the sick and suffering.

and perhaps dying, people in an outpatient department to see that the hospital authorities do not escape from the miserable obligation which the Minister places upon them of charging a shilling. The snooper has to see that no poor person in the outpatient department gets treatment and drugs without paying the charge enforced by these Regulations.

As the House was reminded at an earlier stage in the debate, there may not be a great deal of enthusiasm in outpatient departments for this scheme. I believe that the professional staff will say that their job is to cure and not collect. I believe that my hon. Friend the Member for Tottenham has more information on this subject. Perhaps he will be fortunate enough to catch the eye of the Chair, when he can inform the House about it. I have no evidence, except a speech, but I am told that some outpatient departments are not very zealous already about the collection of the shilling. Perhaps the right hon. Gentleman will tell us how he proposes—I cannot discover it from the circulars—otherwise than by snoopers, to check up on these outpatient departments. No documentary evidence is provided.

My hope is not that they will encourage it but that they will shame the right hon. Gentleman into giving what I know to be his well-disposed reaction to such a situation. It is another proof of how ill-conceived these Regulations are. If an outpatient department is concerned solely with its legitimate task of diagnosing, prescribing, advising and dispensing, there will not be any time for this nonsense, and there will be no enthusiasm for it. There is no means by which the Department of Health will be able to check up, other than by snoopers. Perhaps we might be told how many snoopers against the sick the right hon. Gentleman expects that the authorities will have to employ under the Regulations which he has now been operating for a month.

I have indicated that we shall feel ourselves obliged, unless there is some change of policy or change of heart in the Government, to vote against these Regulations. I hope I have shown that two of them are unjust, administratively clumsy and probably will not yield the revenue which the right hon. Gentleman and his colleagues at one time expected. If the printing costs are taken into account, and if a calculation is made for the time employed of busy professional people like dentists and pharmacists, we suspect that the saving will be very small indeed. Therefore, on administrative grounds as well as on moral and social grounds, we shall divide against these iniquitous and ridiculous Regulations.

6.26 p.m.

Mr. A. Blenkinsop (Newcastle-upon-Tyne, East)

I beg to second the Motion.

We are opposed on principle on this side of the House to the charges brought forward in these Regulations. We have expressed our opposition to the principle many times in this House. It is becoming more and more clear each day that the results of these charges are what we expected they would be. They are not without danger, and they are proving to be a barrier between patients and the professional people concerned.

Today we are emphasising rather more the administrative arrangements which are set out in detail in these Regulations, and I want to turn to certain matters arising from the detailed administrative proposals as well as to some of the consequences that flow from them. There has been a very real amount of administrative muddle and discontent throughout the service, following the introduction of these charges. Nowhere is that more clear than in the hospitals, where there is a general lack of understanding how on earth the Regulations are to be operated without, in very many cases, avoiding collecting the charge altogether. I am glad indeed that that should be the case. The tragedy is that today—

Mr. Richard Fort (Clitheroe)

Is the hon. Gentleman trying to encourage hospitals not to collect the charge and to go against the will of this House? Is that what he is arguing?

Mr. Blenkinsop

Certainly. If hospitals are confronted with the problem, as many of them are, of patients coming into the hospitals and of the hospitals being officially required to secure the collecting of the charge before treatment is given, I certainly would not blame a hospital for saying that they must avoid—

Hon Members

Hear, hear.

Mr. Joseph T. Price (Westhoughton)

Perhaps I can take this issue out of the realm of theory by a personal experience which I had on Monday of this week. I had occasion, on account of a slight disability, to go to one of the great London hospitals. I was received with all the kindness and efficiency by the technical staff that one expects at these institutions. Eventually, after a painful quarter of an hour, the surgeon suggested to me that I might do with a sedative, and that he would prescribe one for me which I would get at the dispensary.

I went to the dispensary, feeling rather shaky—the dentist's chair is not a pleasant experience—and I had not a shilling. They said, "Get a shilling stamp out of the machine," but nobody could change my £1 note. They said, "Go to the office. You will get it there." I went to the office, where the bewildered official in charge said, "I am very sorry. People are coming here all day for shillings. What can I do? You can go to a shop in Horseferry Road." Nobody could change my £1 note. I can imagine people, after a distressing experience, being compelled to travel round the streets—

Mr. Speaker

Order. I must protect the right of the hon. Gentleman who is addressing the House.

Mr. Blenkinsop

I am grateful to my hon. Friend for a most moving example of what we all know is happening in many hospitals. Many constituents of mine are not in the happy position of my hon. Friend of having a £1 note to change, and there have been many calls on Labour Party rooms in my constituency asking for the loan of is, to enable them to get the prescription. I am glad to say that in many cases now hospitals are not insisting on payment.

It is a tragedy, however, that so many professional men today, dentists as well as doctors, particularly dispensing doctors, are having to spend so much more of their time upon the administrative side when they ought to be devoting the whole of their time to the job for which they are qualified. It is an amazing thing that the party opposite, who have always claimed that they have so much objection to red tape and form filling, have through the charges added an appreciable number of forms to be filled in. Much of this would have been quite unnecessary if the advice given on this side of the House had been followed and the proposals rejected at the proper time.

Through these Regulations we are making the professional men into tax gatherers, and there is no section of the community which is less popular in the minds of the general public than the tax gatherers. It is a great pity that this attitude of mind should have been developed in relation to the professional services which we have always regarded as being of great consequence, and we would have hoped for a higher moral standard than is being forced upon them by these Regulations.

Now I want to turn to two aspects of these Regulations that are of special significance. The first point I want to consider is what action the Minister is taking to judge the effects of these Regulations. I think he said himself at one time, perhaps before he took over his present office, that he was most anxious to find out to just what extent the charges imposed were having a deterrent effect upon the general public, and also to just what extent the sums envisaged were being raised by these Regulations. He said he was keeping a careful eye on the matter because he was most anxious to keep closely in touch with the position.

I want to ask him, particularly in relation to the 1s. prescription charge, what method he is proposing to adopt to ensure that he has effective and reliable information about the resulting effects of the charges upon the general public. I know that he can say that we have the information about the number of prescriptions dispensed. I hope that he will be able to give that to the House periodically so that we may judge the effect in that regard, but I think he will be the first to agree that that in itself is not sufficient.

We know that there may be calls upon the doctor which do not need prescriptions. At the moment there are no returns showing how many people are visiting doctors. We want to know, too, what effect these Regulations are having in turning people to more self-medication, which is a matter of great importance and of natural concern to us all.

Mr. Powell

Would the hon. Gentleman elaborate his point that these Regulations might result in an increase of self-medication? I take it that self-medication means the purchase of self-prescribed medicines. In most cases, if not in all cases, the medicines so purchased would cost more than the prescriptions.

Mr. Blenkinsop

Not necessarily. It might well mean, however, that they were not getting the proper prescriptions. I should have thought the hon. Gentleman would have been the first to agree that we should be anxious to avoid any barrier between the patient and the doctor in regard to proper medical advice and proper prescriptions.

Colonel Malcolm Stoddart-Scott (Ripon)

Answer the question.

Mr. Blenkinsop

I was arguing that surely it is the desire of hon. Members opposite, as well as those of us on this side, that we should have more information about the result of this scheme upon patients all over the country and, in particular, its effect upon the frequency of visits to the doctor by different categories of persons. For instance, we have a particular interest in the position with regard to children at one end of the scale and older people at the other end. What is the effect of these prescription charges upon the frequency of visits to the doctor?

Colonel Stoddart-Scott

Answer the question.

Mr. Blenkinsop

If the hon. and gallant Member will show a certain amount of courtesy, I hope the Minister will say that he is as anxious to have this information as anybody. Some of this information used to be available. The Social Survey Department used to provide what is called the "Sickness Survey." I have a copy of the quarterly reports that are made available through the Report of the Registrar-General, which is a comprehensive document. It gives a lot of valuable information about the extent of sickness in the general population, both sickness which is so serious as to warrant calling a doctor and sickness dealt with at home without any call upon the doctor. This is split up into different categories of younger and older people.

It is extraordinary that at this time when we most need this information I understand that it has been stopped. I do not blame the Minister, because I believe that the order for stopping the collection of this information was given by his immediate predecessor, the Leader of the House. Could we have a worse time for stopping the collection of what is vital information if we are to know the facts, and not merely hearsay? We all have the information from our own areas. We have had much discussion with chemists, and others; we all have our own opinions about what is happening; but we need a real attempt to get a scientific answer, as far as that is possible, as to the amount and extent of calls upon doctors in these different categories.

The Minister responsible has allowed this most valuable information to be stopped for the sake of saving £28,000 a year, which was the total cost of running the "Sickness Survey" under the Social Service Department. Hon. Members on all sides have paid tribute to the value of those statistics. The "Economist" and other newspapers have used the information on many occasions and it has been of the utmost value. I want the right hon. Gentleman to say that he proposes to put right this appalling error of judgment on the part of his predecessor by reinstating this service without any delay, by reviewing it, and by seeing whether it should not be extended because of the special need today to have the most accurate and detailed information.

It is a shocking thing that at this time all this information should have dried up. In fact, I do not know whether, even if the right hon. Gentleman gave the order today, it would be possible to collect together the staff quickly enough to reinstate this service. One might, indeed, properly feel that there is some much less satisfactory motive behind the action of his predecessor. Was it that he did not want us to know the effect of these charges or was it just complete incapacity to understand the needs of the service as a whole? I suppose that it would be more charitable to assume that it was due to the general ignorance he displayed so frequently in the passage of the Bill through the House. I ask the right hon. Gentleman's successor, to whom I give credit for having much more serious interest in this matter, to repair the damage that has already been done and to give an order without delay that the whole of this work should be re-started and, if possible, extended.

My right hon. Friend has mentioned to some extent the question of the cost of all this. He rightly mentioned that extra costs have been incurred in the printing of the great mass of circulars and forms that now have to be filled in, in addition to all that we had before. There are all the forms that the dispensing doctor now has to complete, the stamps that have to be cancelled, and all that kind of work. I take a rather more serious view, however, of the effect of these charges upon the demands of the different professional bodies for extra remuneration.

There are Members on the other side who can speak with some responsibility for some of the other professions. In particular, I hope that the hon. Member for Putney (Mr. Linstead) will be able to catch your eye, Mr. Speaker, and to express the feelings of the pharmacists. Their views have been put in writing in their journals with very great vigour, but we have not heard the hon. Member putting their point of view with quite the same vigour and accuracy as we might have expected. No doubt he has been waiting for the occasion of today to do so.

Mr. McNeil

And to vote against the Government.

Mr. Blenkinsop

We shall listen to his views with great interest and we shall welcome his support in the Division Lobby later in the day. We have the clear understanding that the National Pharmaceutical Union have agreed to put in a fresh demand for increased remuneration because of the effect of these charges, they expect, in reducing their total turnover and because of the extra staff they will require to do the work that is necessitated by these Regulations. We must take account of the extra remuneration that is likely to flow from that demand and from the demands of other professional bodies, for which I have no qualification to speak, who will, no doubt, be putting in their demands for the same reason. We must take account of all this in considering what the charges will be on the service.

Also, we ask the right hon. Gentleman to tell us to what extent he estimates that the National Assistance Board will be required to make extra payments in reimbursement of these charges, which must clearly be set off against any saving on the health side. It would be quite ridiculous if we were to look only at one side of the picture. I emphasise once more that we on this side feel, as we have felt right through, that these charges are having a serious effect on the whole status of the professions involved. The whole hope that we had of developing a better standard of health treatment is being endangered by these charges.

We would even at this moment ask the right hon. Gentleman, now that he has come into this unhappy estate, to take this his first opportunity to say how unwelcome this whole estate is to him. I hope he will repudiate even some of his earlier speeches. I hope he will say that, so far from liking the whole concept of charges, as he said before, he regards them as of a purely temporary character and he is prepared to review them. I hope that, if he is not able to say today, as I fear he will not be able to do, that he is going to withdraw them altogether, he will tell us that he is prepared to review them in the light of the information that we all have about their effect, and that he will take the very earliest opportunity of bringing in revised Regulations which will at least exempt many of the categories of persons—old people, children and others—who are most severely hit by these charges.

6.45 p.m.

Mr. Hugh Linstead (Putney)

I must, first, declare an indirect interest that I have in the subject of the debate, because, as the hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) has indicated, I happen to be the secretary of the Pharmaceutical Society, although that society is not engaged in any way in the negotiations in connection with the remuneration of chemists.

Having listened to the speeches of the right hon. Member for Greenock (Mr. McNeil) and his hon. Friend, I am bound to say that there is a note of very considerable exaggeration in the case that they have put to the House. One cannot help getting the impression from what they have said, and the way in which they have said it, that there is in the background an attempt to encourage those responsible not to make these Regulations work. It is unfortunate that in the House of Commons, which has already by legislation decided that charges of this kind shall be the law of the land, responsible Members, both of them ex-Ministers, should publicly have indicated, for example, that hospital officers were not loyally trying to carry out the law of the land—

Mr. A. C. Manuel (Central Ayrshire)

They could not carry it out.

Mr. Linstead

—and by the manner of their speeches, if anything, encouraged those people not to carry it out.

Mr. McNeil

I hope the hon. Member agrees that I tried to show why I thought the Regulations were unworkable, and I gave some experience to show why I thought they were unworkable. My argument was that the Government had no right to embarrass the authorities with unworkable Regulations.

Mr. Linstead

All I can say—it is well within the recollection of the House—is that the general impression which would have been gathered by anyone listening to the remarks of the right hon. Gentleman and his hon. Friend was that if there was anything that could be done to make it difficult for these new Regulations to be brought into operation, they would be very glad to see it done and would, indeed, encourage it.

Mr. Blenkinsop

Would not the hon. Member agree that if a hospital is placed in such a position as in the sort of cases I have described, it would be the essential duty of the hospital, concerned with the health of its patients, to ensure that they did not have to pay the 1s. charge?

Mr. Iain Macleod

This is a most important matter. May I put this to the right hon. Gentleman? A law being on the Statute Book, does he accept that, whether the hospitals and the healing professions like that law or not, they should do everything in their power to make it work?

Mr. McNeil

That is very fair, and I should certainly think it improper if anything I said could be taken as abetting them; but the right hon. Gentleman would be very quick to admit that there might be a conflict in both their duties, and they have professional duties which they cannot escape.

Mr. Linstead

It is obvious to all of us that in a matter of this kind doctors, pharmacists and hospital officers from time to time will be faced with individual cases where they will, naturally, as professional men and as human beings, allow their sense of charity to over-ride statutory obligations; but these cases are rather exceptions, and it ought not to be accepted that it is to be the general rule.

Mr. Manuel

Does the hon. Member really mean what he has said, that the practitioner would allow his sense of charity to override his statutory obligations? Is that the sense he conveyed, that it would be charity?

Mr. Linstead

I will move on to another subject, but the hon. Member must remember that charity has a narrow and a wide connotation, and I was using the word "charity" in the widest possible connotation.

Mr. Frederick Messer (Tottenham)

I do not want to interrupt, but a misleading effect is being created. The doctor has his job to do; the collection of prescriptions is not his job, it is that of someone else.

Mr. Linstead

I may pass on from that by saying that the occasional hard case will be met in the way in which any of us here would meet the occasional hard case. I do not think the occasional hard case should be made the occasion for suggesting that these Regulations are unworkable.

The first point I want to make is that I believe it is a matter of surprise to all of us in this House, and a matter of congratulation to the Minister and to the Ministry, that this quite substantial administrative provision has been brought in with so little friction and so much smoothness. I can speak from experience, first of all as a Member of this House. I may be an exception, but my post-bag has contained one letter only concerning the introduction of this new scheme.

I can speak also as one who has had daily contact with pharmacists in this country. I have been amazed at the smooth way in which they have been able to do their part, not merely in collecting the shilling, but in acting as public relations officers for the Minister in explaining to the public how the scheme works and why it has to work. I hope I may carry the House with me in saying that a word of thanks is due to them for having shouldered that burden.

So far as the hospitals are concerned, it may very well be that there are teething troubles of one kind and another and we must all have been moved by the picture of the hon. Member for Westhoughton (Mr. J. T. Price) walking about Westminster with £1 in his pocket and having no opportunity of changing it. But that is a minor example of a creaking of the machine which experience will surely cure.

The right hon. Member for Greenock produced some figures, which he was fair enough to say were representative of a small sample and might not be generally representative, to show that there was only a 5 per cent. saving to be effected by the new charges.

Mr. McNeil

A 5 per cent. drop in the number of prescriptions.

Mr. Linstead

A 5 per cent. drop in the number of prescriptions only; and he was suggesting that the saving might be even less because of more generous prescribing on each form. For what it is worth—I do not pretend at this moment to be able to draw any worth-while inference from the figures—my information in respect of Scotland is that the average drop at the moment is about 15 per cent. But I believe that after three weeks or a month it is quite impossible to draw any really serious conclusion from statistics of this kind. We are all familiar with the good resolutions which are made when the Tobacco Duty is increased about the smoking of tobacco. There may be a temporary fall, but it is followed by a re-establishment of the old habits.

Dr. Barnett Stross (Stoke-on-Trent, Central)

Can the hon. Member say whether the comparison he made was between this June and June last year?

Mr. Linstead

The comparison of 15 per cent. is not between June of this year and June of last year; it is between June of this year and the average for the whole of last year. From that point of view, it may be challenged on the ground that June is one of the healthiest months of the year. That is another reason for saying that it is far too early yet to start drawing any substantial lessons from statistical returns.

Mr. McNeil

Lest I did not make it plain, my comparison was between June, 1952 and June, 1951.

Mr. Linstead

That can now be on the record. The two substantial facts which have come to my notice are these. Contrary to the right hon. Gentleman's experience, the demand for receipts has been extremely small—very few indeed. It is interesting to notice that the number of medicines made up but not called for is. I would agree, at present round about 2 per cent., but that is not substantially more—

Mr. William Keenan (Liverpool, Kirkdale) rose—

Mr. Linstead

I am taking up the time of the House and other Members wish to speak; I had better continue.

That figure of 2 per cent. must be compared with the general tendency under the National Health Insurance Act for about 0.5 to 1 per cent. of medicine not to be called for because the patient, after a day or two, found he was getting better, or there may have been other reasons. Always there were a certain number of uncollected medicines. It is significant that in the terms of remuneration of chemists the Minister has provided for a 1 per cent. non-collection, a 1 per cent. wastage. So I do not think we can draw any significant conclusion from the fact that in some areas 2 per cent. of the medicines are not being collected.

The other fact which I think can be noted is that on the whole there has been a larger fall in the consumption of medicine in the North than in the South. I do not pretend to know why, but, generally speaking there have been fewer prescriptions presented in the North.

I wish to put four questions to the Minister relating to the content of the Regulations which I think might help the Service if they are answered. The first question relates to the position of resident nurses in hospitals. My information is that the practice of hospitals at present varies. If a resident nurse is seriously ill and is put to bed in the staff sick bay, obviously she is treated as an in-patient and makes no payment. Suppose that she has some quite minor ailment for which some prescription may be necessary, but an ailment which does not prevent her from continuing her duty so that she actually corresponds to an outpatient. I should like to know from the Minister whether or not the hospital should make a charge in those cases where the nurse is in effect an outpatient. The practice varies, and I am sure that my right hon. Friend would be the first to agree that it is desirable that there should be a general practice followed throughout the country.

Secondly, can my right hon. Friend explain the reasons for a divergence between the hospital Regulations and what I may call the shop Regulations? If hon. Members have Statutory Instruments Nos. 1021 and 1023 in their hands, they will notice, near the bottom of the first page of No. 1021, which relates to shops, the words: the sum of one shilling respect of the drugs and appliances. … whereas near the bottom of the first page of No. 1023 the words are: the sum of one shilling in respect of the drugs. … but not appliances. That relates to hospitals.

The effect is that the out-patient at a hospital pays 1s. for his drugs but if he requires only a bandage, or cotton wool or lint, he gets it free whereas the patient who goes to the chemist's shop, has, if he requires a bandage, cotton wool or lint, to pay 1s. for it. I have not been able to understand precisely why there should be that difference in the case of the outpatient as compared with that of the domiciliary patient.

A point which has been brought to my notice has some substance but it may relate to so small a number of cases as not to call for administrative action. It is the case—and this is my third question—which requires prescriptions that run on to more than one form. I had a case from Wales brought to my notice the other day in which the prescription ran on to three forms.

I do not think that such cases are frequent. I have had only one brought to my notice. But when three pieces of paper are presented three separate shillings have to be paid. That was never the intention, I think, of the Minister or the Regulations. I wonder whether it might not be possible to provide for some form of continuation sheet or something of that kind which does not count as a separate form so that what was clearly intended will apply and the patient will have to pay only 1s. in such circumstances.

My fourth question is perhaps a more specialised one. It relates to quite a little group of hospitals, some of them rather important ones. They are the disclaimed hospitals, hospitals which for one reason or another were not taken over by the Minister. Some were hospitals run by religious orders; at least one was connected with the trade union movement; and there are others. In some of those hospitals it has until now been possible for patients to be notionally the patients of the hospital doctor. He has written a prescription for them on a National Health Service form, and it has been dispensed in the hospital dispensary under contract with the executive council, and that executive council has paid the hospital for those medicines.

It has been brought to my attention that one hospital receives about £1,000 a year from the National Health Service in respect of medicines dispensed in that way. If 1s. for each of those prescriptions has to be paid either by the patients or the hospital, it will cost them about £30 a month. Those patients are in-patients. If they were in a State hospital they would not have to pay, there would be no question of a charge. They are being cared for free of charge to the State. They have hitherto, by an arrangement with the State, been able to get their medicines free of charge. I do not think it unreasonable to suggest that the Minister might inquire into the possibility of that arrangement continuing in those cases.

Those are the four questions to which I hope my right hon. Friend may give some reply later. I conclude by saying that I do not believe that we can at the moment assess how these Regulations will affect the future of the Health Service. It is quite clear that the charges are unpopular, and the present Leader of the Opposition, when he first made the announcement in this House that these things would have to be done in the national interest, quite clearly recognised that they would be unpopular. When the right hon. Member for Ebbw Vale (Mr. Bevan) resigned from the Ministry of Health, he quite clearly recognised that they would be unpopular. It has fallen upon the party to which I belong to see that these essential but unpopular things are done.

Nevertheless, my own impression is that the start has been so good, the administrative difficulties have been so small, that we shall find the new arrangements settling down as part of the normal functioning of the Health Service, and that, at any rate so far as the charge on prescriptions is concerned, it may be that even in a few months' time—

Mr. Blenkinsop

I hope the hon. Member will say something about the claim which I understand the profession is to make for payment to cover the extra charges of administering this scheme.

Mr. Linstead

In that case, I shall have to add a postcript to my peroration, if that is permissible. I was about to conclude by saying that in a very short time this will be accepted as a normal part of the functioning of the Health Service.

With regard to the point raised by the hon. Member for Newcastle-upon-Tyne, East, I understand that a claim has been put in by the National Pharmaceutical Union for a possible increase in remuneration if it is found, as a result of experience, that the chemists' overheads are being substantially increased in relation to their remuneration because of these charges. All I can say is that I once heard the secretary of a trade union say, "When you are negotiating with any employers the great thing is always to have a claim in." Some Members opposite may be more experienced in that matter than I am. The chemists at the moment are most loyally accepting and carrying out this obligation.

7.7 p.m.

Mr. William Keenan (Liverpool, Kirkdale)

It is so long since I had an opportunity of addressing the House that I feel almost like asking for the indulgence which is requested for a maiden speech. I wish to follow what the hon. Member for Putney (Mr. Linstead) said, because he made some very useful observations with which many of us would agree. I take exception, however, to what he said about the chemists. He told us that an allowance of 1 per cent. was being made to cover costs which may occur in the making up of a prescription.

The hon. Member said that the position, so far as he knew it professionally, was that 2 per cent. of prescriptions were wasted. Does the hon. Member know that there is no wastage? So far as I can gather from inquiries I made last week, the chemists do not make up the prescription now until the public have paid the charge.

Mr. Linstead

The hon. Member must not quarrel with me. The figure of 2 per cent. was produced by the right hon. Member for Greenock (Mr. McNeil). He stated that his inquiries showed that a possible 2 per cent. of the medicines were not collected. It is with his right hon. Friend that the hon. Member must quarrel, not with me.

Mr. McNeil

The hon. Gentleman agreed that he had a similar figure.

Mr. Keenan

What I have been told by those who have the information is that as a result of early experience the chemists do not now make up the prescription until the charge is paid because some patients do not come back for it. That is an indication to me, though perhaps not to the Minister, who does not take the same point of view, that such patients cannot afford the charge. The Minister would say that they are not in need of the prescription.

I will give the Minister an example. A chemist told me that two days before our conversation a woman who was entitled to insulin had come to his shop. The insulin was there, the chemist showed it to me, but the woman had not 1s. to pay for it. I do not know what happened; it was there waiting for her to collect. There must obviously have been poverty or inability to pay at the time. I do not think that under any circumstances a patient should be put to any delay in receiving insulin required for treatment.

I suppose that the average individual who has means, or who is in employment, will not be distressed by this charge. But I am concerned about the 3½ million older people receiving contributory pensions who are not entitled to supplementary assistance or who do not receive it. There are many who could get such assistance if they made a claim, but they do not claim; and I gather from the number of chemists whom I have visited that there is a large reduction in the number of elderly people who formerly collected medicines.

I continued my inquiries last weekend at the Assistance Board office and saw the area officer. So far as he was concerned, he told me, there had not been a great disturbance. But he admitted that there had not been a great many people who had called to collect 1s. I think that is due, not only to the lack of knowledge on their part, but the lack of assistance and advice from the Ministry of Health or the Ministry of National Insurance.

I cannot worry the Minister about the National Assistance aspect of the matter, because that is not his concern. But I saw no posters or other information displayed in the Assistance Board office which could have been a help to anyone. In the post offices I visited I have seen a small card which I suppose might be considered to be a poster, but I had to look for it to find it.

It has been suggested by the hon. Member for Putney that there has not been the call for receipts which the chemists had anticipated. That may be true. But is the Minister aware that it is difficult to say off-hand, and without making expensive inquiries, what percentage of elderly people there are among the patients of an average medical practitioner? I think it true to say that generally speaking, many elderly people visit their doctor regularly and I think they will not do so if they cannot pay the 1s. for the prescription. If they are dependent on their pensions, and are not entitled to any supplementary assistance, that 1s. would have to come out of their pension; and nearly 80 per cent. of the pensioners in this country are not entitled to National Assistance, or at any rate, they do not claim it.

As one who has been concerned with these matters for the last 30 years, I would say to the Minister that a number of these people, because of their lack of means and the other difficulties which I have already mentioned, will become indifferent and will not bother. The consequence will be that some complaints suffered by elderly people, which might have been dealt with in the early stages, will not be treated. That may lead to serious consequences and even to accellerating their death. When the National Health Service Bill was going through its various stages, the tragic thing to me was how often hon. Members opposite seemed to fail to understand how the average worker lived and died.

It was obvious that the Parliamentary Secretary did not know very much about that. She has not had sufficient experience to prepare her for the important position she occupies today. I do not know the background of the Minister and I am under some misapprehension about his capacity in this field. He has the theoretical knowledge, but does he understand the problem from the point of view of the working class?

One of the greatest boons to parents under the free Health Service was that they had no longer to worry about whether they could afford to take a child to the doctor. Now, a parent with three, or four, or five children will have to face the difficulties created by the increasing cost of food, as well as this additional charge which they will have to pay when they take their children to the doctor. We are in danger of returning to the state when parents will not take their children to a doctor, because they will have to pay, even though the amount demanded is comparatively small.

If that happens it will be a serious matter for the health of the community. It may mean that children will develop complaints which will affect them all their lives, and which, had they received proper attention, could have been prevented. It must be remembered that in a large family the payment of is, for each child becomes a difficult matter even with the assistance provided by the the family allowance. That is something which must be faced.

It is regrettable that we have to debate these Regulations at so early a stage when we are not in possession of the information and experience that we shall have later, when the Regulations have been in operation for a period. But so far as I can gather, there has been a reduction in the number of people who visit the doctor. I will give the Minister the benefit of the information I obtained from doctors whom I interviewed. One doctor told me that he had experience a 30 per cent. to 35 per cent. reduction in the number of his patients; although, of course, it may be argued that this is the time of the year when a reduction may be expected.

Another doctor told me that the reduction in the number of his patients was about 15 per cent. Yet another doctor told me that he was afraid of the consequences which would follow the imposition of this charge. He thought that poor people would stay away from his surgery. But he said that it did give him more time to look after the patients who did come, because he might have only 20 people to treat instead of 30.

The Minister should pay close attention to this problem. The health of the people is his responsibility. I fear that as a result of these charges some children may be seriously neglected. I do not suggest that parents will deliberately neglect their children, but we know that many of them are hard pressed and will hesitate before paying a few shillings. We shall have to make up for that later.

Other hon. Members who wish to speak have more knowledge of the hospital services than I have. I have mentioned the difficulties of the parents and the plight of the elderly. Another consideration is this charge to the outpatient. I do not think that the Minister, his predecessor in office, or the Parliamentary Secretary appreciate the position. Many out-patients at hospitals have been injured or have suffered illness for a lengthy period. As a consequence many of them have ceased to be breadwinners. They have to depend on our social services. During this period of illness many are forced to go on to the National Assistance. They are not in a position to pay the 1s. charge.

I should like to remind the Minister, because he was not the Minister at the time, that we objected to the refusal to exempt T.B. cases. I am convinced that great hardship will result and that many people will be caused serious difficulty. I am afraid that there will be difficulties at the hospitals. I cannot imagine anything worse than that people should be compelled to be outpatients at hospitals because there is no accommodation and that—because they are out-patients—they should be charged when, otherwise, they would not have been.

For these reasons, the Minister should think again about this matter. I hope that he will give serious consideration to what is said during this debate. The reason why these proposed charges were not put into effect by the Socialist Government was that we were convinced that serious difficulties and wrongs would result. For all these reasons I hope that the Minister will realise the gravity of the problems involved and that he will give further consideration to the matter.

7.24 p.m.

Mr. Richard Fort (Clitheroe)

The hon. Member for Kirkdale (Mr. Keenan), who speaks with great feeling and knowledge of the difficulties of our old folks, must always be listened to with attention. But, as one who has some knowledge of an industrial constituency, I suggest that he exaggerates the old folks' ignorance and lack of understanding of how they can be helped by the National Assistance Board. I certainly have not found that among my constituents.

It has been my experience that the dentists, doctors and pharmacists have done admirable work in making known to those who might be entitled to help from the National Assistance Board the fact that they have that right. It has also been my experience that the National Assistance Board has found that the Regulations are working fairly easily, though, like the hon. Gentleman, I have had the experience of being told that they have not been called upon very often.

It is a strange comment on this debate that the two principal speakers who opened it could not find much to do but talk about such matters as the English of some of the circulars. The hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop), who, I am sorry to see, is not here now, talked about doctors having to spend more time on administration than on healing. We have heard that complaint from doctors under the régime of Socialist Ministers of Health. It is a fair comment on the adequacy of these Regulations that none of the principal speakers opposite has been able to find much to criticise in detail in the Regulations themselves or in the explanatory notes sent out with them.

There are one or two points which I wish to ask the Minister to explain. I wish to draw attention to the pamphlet entitled, "General Dental Services" E.C.N. 99. On the last page, in Appendix III, there is a heading, "Application by Patients for National Assistance." I should like to ask why, in paragraph 2, the instruction is: The patient should not be invited to sign Part 12 of Form E.C.17 (revised) or Part 1 of Form E.C.60 at this stage."? I hope that that is in no way an effort to discourage the dentists from making known to those who may have to take advantage of National Assistance their rights in this connection.

There is another point in the same Appendix, in paragraph 3, which says: The National Assistance Board has agreed that, where a patient is entitled to a grant of National Assistance, payment will be made on the dentist's notification that he now requires payment, whether that is before he undertakes the work or after he completes it. Again, I hope that the arrangements between my right hon. Friend's Department and the National Assistance Board are such that there will be no question of work being held up on someone who is having to receive help from the National Assistance Board and that this Regulation, which, on the face of it, is humane and sensible, will allow prompt payment to be made to the dentist and, therefore, prompt work to be done on the patient.

Although we have to make these economies and carry through the intention of the Act, I am sure that we all wish to see that it is run in as humane a way as the Regulations set out to achieve. When hon. Gentlemen opposite attacked the Act, as they did for days on end—and they are now going through the argument again—they were always asking for us to forget, and perhaps they themselves genuinely forgot, that they were the originators of this scheme. It was they who said in the first place that charges had to be imposed in order to put a ceiling on the National Health Act.

With a few honourable exceptions—and we have seen them in the House this afternoon—hon. Members opposite adopted a very different tone in the debate last year, when their party were introducing charges, from that which we have heard from them day after day this year. The hon. Lady the Member for the Liverpool, Exchange (Mrs. Braddock) is an honourable exception. I know that last year she opposed her own Government with almost the same vigour that she shows now, though she did not carry it to the extent of voting against them.

Mr. Speaker

I do not like interrupting the debate or constraining it within unduly restricted limits, but perhaps I ought to say that we must not fight the battle of the Bill again. That has been passed by the House, and it is not in order for the House to impugn one of its own decisions, except on a Motion for a repeal. I wish it to be a useful debate, but I would ask hon. Members if they would, on this occasion, confine themselves as much as possible to the administration of the scheme as set out in these Regulations, which would be of more value than fighting the old battle again, besides being in order.

Mr. Fort

I am very grateful to you, Mr. Speaker, for reminding us all of what is in order, and particularly for placing emphasis on the fact that this is the law, and that it is our duty now to do what we can to make sure that these Regulations carry out what is the present wish of the House.

7.31 p.m.

Miss Margaret Herbison (Lanarkshire, North)

I want, first of all, to draw attention to the Ministers on the Front Bench opposite. We have here four Regulations for England and Wales, and four for Scotland. Since the beginning of the debate, we have had the Minister of Health and the Parliamentary Secretary listening to the points put forward both from this side of the House and their own, and, as the debate went on, one of the three Joint Under-Secretaries from the Scottish Office took his place on the Front Bench.

We have always understood that, since there was such a great addition of strength to the Scottish Office, we would get more of the time of the Secretary of State. The matters we are now discussing are of first importance to the Scottish people, and I am sure that my hon. Friends on this side would like me, in case they are not called, to enter a protest that the Secretary of State for Scotland did not think it worth while to take his place along with the Joint Under-Secretary and the Minister of Health during our discussion of these Regulations.

My right hon. Friend and my hon. Friend who preceded me have dealt mainly with administration under these Regulations, but I should like to point out that the administration of these Regulations has an effect on thousands of people. If we wish to pray against these Regulations, indeed, if we wish—even if we do not win in the Division Lobbies tonight—to make a case that will cause the Minister of Health and the Secretary of State for Scotland to think again, then we have to deal, not merely with administration, but with the effect of that administration on certain categories of patients. I therefore hope that what I intend to say will be in order.

When my hon. Friend the Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) was speaking, he suggested that there was a danger of people reverting to self- medication, and there were sneers about that on the other side of the House. An hon. Member opposite, who, I understand, is also a doctor, wanted my hon. Friend to be forthright and tell him what he meant by self-medication. This is just another instance of how divorced hon. Members opposite are from the way in which the ordinary people of this country live. Before we had the National Health Service, many mothers would use an old cough mixture bottle which somebody else had got when a child developed a cough, which might be the very worst thing to do. That is self-medication.

A mother might provide a gargle which, if a doctor were called, might be proved to be a very good thing, but there might be all sorts of cases in which an ordinary salt gargle would not be the right thing. That is self-medication, and it has very dangerous results indeed. I should have thought that no one would have questioned my hon. Friend about what was meant about self- medication. If I had more time, I could give the hon. Member many more examples of what working-class mothers did before the National Health Service Bill was passed.

The hon. Member for Putney (Mr. Linstead) said that he understood that, in the north, the number of prescriptions had decreased to a much greater extent than in the south, and he was not able to obtain any reason for this. I think that we on this side can give him a reason. In the north, we have over 100,000 unem- ployed at the present time, and the 1s.

for the prescription for such people will be difficult indeed to find. In the north, we have far more lower wage earners than in the south, and, again, they will think a few times before they ask for a prescription for which they have to pay 1s.

There are a number of other points on administration with which I should have liked to deal, but, in spite of what the hon. Gentleman opposite said, I feel that, concerning the difficulties of administration, even including the extra clerical work placed on professional men who ought to be giving their energies to the prevention and curing of disease, my right hon. and hon. Friends have made that point clear without further elaboration from me.

I wish to devote most of my time to the position of the industrially disabled under these Regulations. The industrially disabled are being treated differently from, the war disabled. To get their appliances, they first have to fill in a number of forms, and the form filling which has to be done—and I have here a wallet with copies of all the forms—under a Government which derided form filling for six and a half years, is incredible. These forms ought to be posted all over the country. The war disabled, after filling in their forms, may get their drugs or appliances free of charge, provided that the drug or appliance is needed because of the war disability. If their illness is due to any other cause, even the war disabled have to pay their 1s. under these Regulations.

Since 1948, we have tried to treat the war disabled and the industrially disabled in the same way. Wherever there has been a change in the money that was paid to the war disabled as a pension, or to the industrially disabled under the industrial injuries scheme, everything possible has been done to ensure that they go side by side and that the money received each week would be exactly the same.

We have a change under these Regulations. Under them, the war disabled have been treated meanly, and the industrially disabled have been treated in a far worse way. I know quite a lot about the industrially disabled, and these men are being asked to pay for all their drugs by the 1s. prescription, and they are also being asked to pay for their appliances.

I have a letter here that came from one of my industrially disabled constituents, who says he is sending me a copy of a letter which he has sent to the Ministry of National Insurance after he had found out what was happening to him under these Regulations. I wish to deal with this specific case because it is typical of what is happening to hundreds, perhaps thousands, of industrially disabled people all over Britain.

I do not think that the man who sent me the letter is quite 40 years of age. In 1949, he had a serious accident in the pit and, among other injuries, he had his back broken. He is going to spend most of the rest of his life in bed, or on fine days, when he feels a little bit better, he will be able to go out in his motor propelled invalid chair.

Under a Labour administration that man, and hundreds like him, were given some hope and some comfort. They had the feeling that the Ministers in the Labour Administration really cared for them. They have already lost that feeling, and I will give one instance to demonstrate how they have lost it. I will try to bring home to hon. Members opposite what their administration lacks. It lacks all the finer feelings of humanity which are so important.

I have many mining villages in my constituency. There was one miner who, when he heard that the man of whom I am talking had an invalid chair, went in his chair to have a look at it. He admired it, and said, "If I had that chair, my first stop would be Blackpool." My miner replied, "And if I were fit enough, my first stop would be London to say 'Thank you' to Clem Attlee and Jim Griffiths." The hon. and gallant Member for Ripon (Colonel Stoddart-Scott), who is a doctor, may laugh but that is the feeling of such men who have suffered so badly from accidents in the pits, in the steelworks, and in the heavy industries of this country.

But what has happened to this man? Here is his letter in which he says: You will understand that I receive prescriptions every week, sometimes on three occasions, for the undermentioned articles: methylated spirit, cotton wool, medicated lint, cod liver oil, Dettol, Elastoplast bandages, dressings, codeine tablets, laxatives and sulphur tablets. These are all the things which that one man needs to make life at all liveable.

I went to see him at the week-end, and he told me that when he was first given these prescriptions, for which he had to pay 1s., his wife went to see the area officer of the National Assistance Board. This man gets no National Assistance, All the usual inquiries were made—the inquiries which hon. Members opposite used to call "snooping "—and his wife was told that he would have to pay for all the prescriptions because he was above the scale. But all that man is receiving is his industrial injuries benefit, his sickness benefit and the family allowances. He has no other source of income at all.

He has to have his wounds dressed every day, and these Regulations will add to the unavoidable suffering which he and hundreds like him have to bear every day of their lives. They will add shocking, avoidable suffering, because he and the others like him will not be able to pay for these prescriptions. It may be that many of the things that he needs could be put on one prescription and that he could be saved a certain amount of expense if his doctor were allowed to give him more tablets, or whatever it may be, on one prescription than he originally received. But when my hon. and right hon. Friends suggested that, hon. Members opposite were shocked and said that we on this side were asking the doctors and other people not to carry out the legislation passed by the House.

I have here form E.C.N. 97. One hon. Member said that there was at least one sentence in it which was clear and simple. How clear and simple that one sentence is. It reads: Doctors are asked not to increase the quantities normally supplied on any one occasion. If my doctor, who is also this man's doctor and a very good fellow, decides to increase what he usually gives, will he be hauled up for it? Will he be told by hon. Members opposite that he is breaking the law? That is one of the questions which I would like whoever is to reply to the debate to answer. But the difficulty does not end with this man personally. He has a wife and three children of school age. How he is to find the money for the prescriptions which he needs and, at the same time, if necessary, for prescriptions for medi- cine for his wife or any of his children should they be ill, I just do not know.

I know another miner who needs five appliances before he can even go out in his invalid chair. What is to happen to him? I have spoken mostly about miners who have been disabled in the industry, but there are other workers in steel works and in all the heavy industries of this country who have also been disabled.

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

The hon. Lady raised the point of a miner with five appliances before. Would she tell us what five appliances would incur a charge?

Miss Herbison

Certainly, I will send the hon. Lady the letter I received from that miner.

Miss Hornsby-Smith

Will the hon. Lady tell us what five appliances could possibly involve a charge under these Regulations?

Miss Herbison

I will send the hon. Lady the letter and she can find out from that what these appliances are.

Miss Hornsby-Smith

The hon. Lady made this point with great emotion before. She complained about the plight of this miner, with whom I had great sympathy, and said that it was necessary for him to use spinal and other appliances. She must know that there is no charge on such appliances, so I think we are entitled to know what charge she thinks applies to them.

Miss Herbison

I accept the challenge of the hon. Lady. It may be that some of these appliances do not bear a charge, but I am drawing the attention of the House to this miner—and he is only one of many—who needs these five appliances. Added to that, he will have to pay all these other charges. It may be that I do speak with emotion. If the hon. Lady represented the same type of people that I do and saw broken bodies every week in her constituency, perhaps, she might speak with similar emotion, because these people are very near and dear to me.

But it is not only miners who have broken bodies through accidents about whom I want to speak. I also want to mention the miners and the steel workers who are suffering from pneumoconiosis. These men also need prescriptions for cod liver oil and other things, and because they are industrially disabled they have to pay for the prescriptions they receive.

I want to plead with the Minister that he will at least treat the industrially disabled in the same way as he is treating the war disabled. That is the only plea I make to him on this point, because if he does give them the same treatment then much suffering will be avoided by these people.

Mr. L. M. Lever (Manchester, Ardwick)

Much better treatment than for the war disabled.

Miss Herbison

I have dealt with that point already, and I have said that even they were treated meanly. There is another point which I should like to make, though I may be accused by the Parliamentary Secretary of having made it before. I wish I could find words to bring home to the hon. Lady and hon. Members opposite what it must be like to live on the old-age pension and the supplementary pension. When I read the instructions sent out by the Ministry I begin to despair of ever finding words to bring this home to hon. Members opposite.

Mr. Ellis Smith (Stoke-on-Trent, South)

Will my hon. Friend allow me to intervene for one moment? I have great respect for her, because of her very fine record. We are all listening to her with great attention and what she is saying is rousing the deepest emotions in me. But I want to make it known that what she has been saying applied always and that it should be a lesson to every one of us.

Miss Herbison

Form E.C.N. 96 issued by the Ministry states: A person who wishes to make such a claim"— that is, to have the 1s. refunded— should be given a receipt on Form E.C. 57, which explains how a refund can very simply be obtained at the same office (usually the post office) and at the same time as the regular weekly payment from the National Assistance Board. The word that sticks in my throat, and makes me despair of hon. Members opposite ever realising how these people live is that word "simply," because in another part of the form we are told that they will receive their 1s. at the same office and on the same day as they collect their pensions.

I want to say again that when the old-age pensioner has paid her rent and has paid for her light, her coal, the little food that she can afford to buy and anything extra for clothing, and that is very little, a few days after she has received the pension and supplementary pension she does not have 1s. left for a prescription. Will the chemist be allowed to give her medicine and to give her a form to come back with the 1s. when she receives it at the post office, or will that be frowned upon by hon. Members opposite? If it is frowned upon, then, if they have any feeling at all for these old people, they will change these Regulations so as to exempt these old people from paying anything at all.

Finally, it is not only the old-age pensioners who will suffer. The lowest wage earners, and particularly those who have families, will suffer very much indeed. The hon. Member for Clitheroe (Mr. Fort) said that we on this side of the House first introduced these charges. It is true that we had on the Statute Book an Act which would have made it possible to charge 1s. on prescriptions, but it was on the Statute Book long before we came into office. We did not put it into effect because of the existence of the very people of whom I have spoken today, and because of the administrative difficulty of carrying it out fairly and justly.

Mr. Fort

How does the hon. Lady square what she has said, with great sincerity, with the remarks of the right hon. Member for Ebbw Vale (Mr. Bevan), who said he needed to manoeuvre in order to avoid these charges?

Miss Herbison

That is not a question which the hon. Member ought to put to me.

Mr. Deputy-Speaker (Mr. Hopkin Morris)

Neither do I believe that discussion of that is in order in a debate on these Regulations.

7.56 p.m.

Mr. J. K. Vaughan-Morgan (Reigate)

Before the hon. Lady the Member for Lanarkshire, North (Miss Herbison) rose, it was remarkable how few had been the fireworks in this debate compared with what one might have expected from the impassioned speeches on Second Reading of the Bill. The right hon. Gentleman the Member for Greenock (Mr. McNeil) and those who succeeded him were very restrained and seemed, on the whole, to have singularly little to criticise; and what criticism they made was very thin.

Then the hon. Lady the Member for Lanarkshire, North entered the debate and made a speech which was charged with emotion. No one objects to emotion and no one wishes to minimise in any way suffering in any quarter. Everyone wishes to alleviate that suffering wherever it is possible. But when an hon. Member is making an emotional speech he or she ought to be particularly careful to get the facts right. When the hon. Lady was challenged she could not answer, and I think my right hon. Friend the Minister of Health will have no difficulty in dealing with all the points she raised.

Miss Herbison

Most of my speech dealt with the charge for drugs. On that there is no contention whatever. The other point I made was to show the added misery which these same men have to suffer without having further misery imposed upon them.

Mr. Vaughan-Morgan

I do not think that that alters in any way what I said. We are all speaking from our experience of these Regulations, which have been in being for a very short time. We shall have to wait very much longer before we know how they are actually working and we can only give our experience of the Regulations as we have found them so far.

In company with my hon. Friend the Member for Putney (Mr. Linstead) and other hon. Members, I am surprised at how few complaints and criticisms we have received so far. I think that some hon. Members opposite will agree when I say that we have had some rather wild statements about administrative chaos, with very little evidence; though we had an account of one harrowing incident from the hon. Member for Westhoughton (Mr. J. T. Price), who interrupted the speech of his hon. Friend the Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) at considerable length.

The right hon. Gentleman the Member for Greenock waxed very humorous, just as the hon. Lady the Member for Lanarkshire, North waxed very emotional, on the subject of the bad English and the jargon used in some of the circulars issued by the Ministry of Health. In some ways I agree with them about the bad English. I wish that my right hon. Friend, like every other Minister, could for a time get Sir Ernest Gowers on to his staff to try to simplify the phraseology which seems necessary to convey even the simplest meaning. But that did not begin with my right hon. Friend. It seems to be a vice that goes through every Government Department.

The right hon. Gentleman the Member for Greenock did what is the easiest trick in the world. He took one phrase out of the form and asked what it meant. I pointed out that it should be read in conjunction not only with the sentence following, which was perfectly clear, but with everything else in the form. The right hon. Gentleman failed to draw the obvious conclusion from his remarks, namely, that the very fact that there have been so many, perhaps too many, of these forms was the real reason why there has been no administrative chaos in the launching of this system. I think that we ought to give credit to the Ministry of Health, instead of just laughing at them, for having been able to launch this difficult scheme without causing more upset throughout the country than they have done.

I want to raise one or two small points of administration, to which I should like to draw the attention of my right hon. Friend.

Mr. A. Woodburn (Clackmannan and East Stirlingshire)

I gather from what the hon. Member has said that he gives complete absolution to the Government, and says that nobody seems to have had any trouble under this scheme. Does he consider that old-age pensioners, whose ages range from, say, 65 to 85, in having to go to chemists, getting a form, and having to draw the 1s. later, do not have all sorts of trouble? They may lose the form, they may not be clear about what they ought to do, and many of them may not be able to recover the 1s. because of their own mistakes. Does the hon. Gentleman think that the scheme could possibly work simply when old people are supposed to read instructions of the type that have just been read out?

Mr. Vaughan-Morgan

I was referring to the speech of the right hon. Member for Greenock who spoke of administra- tive chaos, and I was referring in particular to the circulars of the Ministry. I shall have a few remarks to make on the subject later. This is a very difficult scheme to put into practice. Hon. Members opposite have said that it would break down completely, yet, at the same time, they are complaining that it has not broken down completely.

There are one or two further points to which I wish to refer. The first is the question of the chronic sick. I want to ask my right hon. Friend—I think it was the hon. Member for Kirkdale (Mr. Keenan) who referred to it—whether he will keep a very close watch on what is happening to certain categories of the chronic sick, and whether under the Regulations as they stand he will be in a position completely to exempt certain drugs if necessary. I have in mind medinal for epileptics and insulin for diabetics. It may be that he will find in due course that he can easily exempt those particular drugs which can only be used for a limited purpose, as I understand it. I believe that he can, and I should like him to bear that point in mind.

The other point to which I wish to draw attention relates to what I might call the borderline National Assistance Board cases. I hope that I have the sympathy of the hon. Member for Liverpool, Exchange (Mrs. Braddock), because I know that she is concerned with this matter. There are certain classes of people in this country who are not N.A.B. cases; they are not receiving assistance. It may well be that they ought to.

It may be—I think I would be out of order if I enlarged on this too much—that they ought to have been brought into touch with the N.A.B. a long time ago, and this could be one way of doing it. When such a person goes to the chemist he is told on the receipt form what to do if he is receiving assistance, but he is not told anywhere what to do if he wants assistance. I think that ought to be made clear on the receipt form.

I know that my right hon. Friend has taken a great deal of trouble to see that the information where to go for assistance has been widely distributed. I want him to go further. I want him to do two things. I have a Question down to him on this subject. First, I want him to send the necessary posters and information to the town halls and citizens' advice bureaux throughout the country, and it should be their task to send the posters and information out to all the voluntary bodies, including the old peoples' clubs, and so on, where the information may be necessary.

I want my right hon. Friend to consider one other suggestion. The prepaid form for claiming assistance is at present obtained at the post office. I suggest that it might be possible for those forms to be made available in the chemist shops as well, so that when someone is in a chemist shop and makes a complaint about the charge, and possibly about the iniquity of my right hon. Friend, the chemist will be in a position to show him or her there and then the card which he or she can fill up to get assistance. That might help in a good many cases to provide assistance for such people sooner than might otherwise be the case if they had to go to the post office to get the form. I should like my right hon. Friend to consider those two points that I have mentioned.

Mr. William Ross (Kilmarnock)

The hon. Gentleman is suggesting that there should be extra publicity to enable old people who have not been in touch with the National Assistance Board to get assistance. Is it not obvious that many of these people will discover for the first time that they have a right to draw 1s., and many will discover, for the first time, that they are entitled to National Assistance? Would it not be easier and cheaper to leave these old people on pension out of the scheme altogether?

Mr. Vaughan-Morgan

If the hon. Gentleman would listen to my speech he would realise that he has been repeating the point that I have made. The hon. Member for Batley and Morley (Dr. Broughton) is in his place; I am very glad because I was looking forward to making a quotation from one of his speeches. It reminds us of the background against which these Regulations are being discussed. The hon. Member for Batley and Morley made a very able speech on 24th April, 1951. He said: The National Health Service is to cost more this year than it has cost before. That is still true.

So we cannot say that re-armament is causing less expenditure than formally. A figure of approximately £400 million has been decided upon as the limit of expenditure for this year and I think this huge amount should be regarded as reasonable in present circumstances."—[OFFICIAL REPORT, 24th April, 1951; Vol. 487, c. 294.] There is not a fact in that quotation which has changed in the year. That is why we are discussing these Regulations, and it is no good hon. Members coming forward with their remarks about administrative chaos and iniquities. What we have to bear in mind is that that sum of money is limited. We want it to be spent not on cough mixtures which are not necessary, but on the things which are really necessary for creating health.

8.8 p.m.

Mr. Tom Brown (Ince)

In the first place, I ought to reply to the statement made by the hon. Member for Putney (Mr. Linstead). In view of his reputation in this House for being a fair-minded man, I was amazed when he made a mild accusation against this side of the House and said that we were doing all that we could to make it impossible for these Regulations to be carried out. Let me assure the hon. Gentleman that such is not the case, and I hope that whatever may be our views on legislative matters or Regulations, we shall never advise our people not to work the Regulations or disobey legislation.

I am one of those who believe that all of us, on whatever side of the House we sit, are citizens of this country before we are politicians, and we want to honour the legislation that is passed in this House. But at the same time it is our job to try to improve the Regulations, whether they come from this side or the opposite side of the House. If we see anything that is not helping our people it is our job to speak out and tell the Minister or the Government Department concerned where they are wrong. That is what we are trying to do tonight.

On the Committee stage of the National Health Service Bill the hon. Member for Putney said: …we are in danger, in the Health Service in particular, of forgetting one very fundamental thing. That is, that no State can take away from an individual the responsibility of his own health."—[OFFICIAL REPORT, 3rd April, 1952; Vol. 498, c. 1979.] But what we can do and what we should do is to make it possible for the individual to enjoy good health by assisting him in every way possible. That should be our objective.

I want to deal with the Regulations as they affect appliances. I hope that I shall not be accused of speaking emotionally about the miners because I happen to come from the mining fraternity. I speak emotionally, as did my hon. Friend the Member for Lanarkshire, North (Miss Herbison) because these cases are with us every day of our lives. It is because of what we see in the mining villages that we speak with emotion and profound feelings.

I want clarification from the Minister on three points—abdominal supports, knee caps and surgical boots. On the third page of the Schedule there appear the words "surgical abdominal supports each," and then the information is conveyed that applicants will have to pay £1 whatever the cost of the surgical appliance. I would remind the Minister and the Parliamentary Secretary that the men in the pits have to buy three supports. Will they have to pay £1 for each support individually or £1 for the three together?

I will give an illustration. I can understand the right hon. Gentleman and the Parliamentary Secretary not understanding our point of view because they do not know the industry, but I hope they will take some notice of those who speak from experience. A miner who sustains a rupture or a hernia cannot always get into hospital immediately, because of the shortage of beds, unless he has a strangulated hernia, in which case he is admitted at once. If the man continues at work he has to have an abdominal support. He has to buy one belt in which to work, one to wear at home, and one has to be available to meet the need for repairs. Hon. Members with practical knowledge of mining know full well that a miner cannot wear at home the abdominal belt he wears in the pits. I want to know from the Minister whether these men will have to pay £3 or £1 for their appliances.

Dr. Stross

Is my hon. Friend aware that the Regulations state that the payment for a truss is 1s. on a form and that these abdominal belts are actually trusses for hernia of the abdomen or the umbilicus?

Mr. T. Brown

Far be it from me to pit my brains against those of my hon. Friend. I am trying to argue on the basis of what the Regulations say and that is that £1 will have to be paid for an abdominal support.

Men in the mining industry suffer from what medical people call subcutaneous cellulitis of the patella of the knee. That is beat-knee or, in plain language, housemaid's knee. A man suffering from that complaint has to wear a knee-cap immediately while he waits for an operation for the removal of the fluid and he has also to wear a knee-cap after the operation. Will such a man pay three times or only once? It is an important point these days because we have a tremendous number of these cases owing to the lowness of our mines. Practically all the tall mines, particularly in the North, have been worked and our men now frequently work the seams 2 feet 6 inches or 3 feet high, and they are on their knees seven and a half to eight hours out of the 24 hours.

Mr. Ivor Owen Thomas (The Wrekin)

Would it not be helpful to the House if the Minister would indicate the actual position, in reply to the two points which my hon. Friend has raised? The schedule specifically says "surgical abdominal supports each £1."

Mr. Brown

That is what I have said.

Mr. Thomas

The schedule says "each" in regard to elastic hosiery and other things.

Mr. Deputy-Speaker

Order. The hon. Member for Ince (Mr. T. Brown) is in possession of the House.

Mr. Brown

I can understand my hon. Friend's enthusiasm but I am prepared to wait until the right hon. Gentleman or the Parliamentary Secretary replies. I am trying to put my points very humbly as an ex-miner and in a way which will help the mining fraternity and the Minister.

I also want some clarification of the position concerning surgical boots. The Parliamentary Secretary tried to trip up my hon. Friend the Member for Lanarkshire, North on the question of the five appliances. It may surprise the Parliamentary Secretary to know that we have men in the mining industry who have to have three trusses, and also knee-caps and surgical boots, and that makes five appliances that they have to buy. Some men are in an even worse position than that.

Mr. Manuel

Does the Parliamentary Secretary give in?

Miss Hornsby-Smith

The hon. Lady the Member for Lanarkshire, North (Miss Herbison) mentioned five spinal supports in her speech but did not name them and I challenged her. No. Sir, I do not give in.

Mr. Brown

I do not want to get at cross purposes with the hon. Lady.

Mr. Manuel

Why not? That is what we are here for.

Mr. Brown

What I am seeking to do in my very humble way is to educate them in the direction in which they ought to go. They do not understand. I am not blaming them because they do not understand; what I am trying to point out is that we who have had experience in the minefields know what we are talking about, and I hope the Minister and his Parliamentary Secretary will take some notice of the suggestions which we are making and the questions which we are putting to them.

Take the question of surgical boots. The same thing applies here. A man has to have a pair of boots for work at the pit and a pair to wear at home. No man, by any stretch of imagination, would wear the same boots at home as he wears in the pits. Will they have to pay the extra for the additional pair of boots? There are three direct questions which I am pleading that the Minister or his Department should answer. First, there is abdominal supports; secondly, kneecaps; and thirdly, surgical boots.

I have gone on rather longer than I intended, but I want to put a final plea to the Minister. If he cannot help us in the many directions which we desire, can he help us to erase the 1s. charge for prescriptions for old age pensioners? If he could do that—and I know he will find it difficult; I know there has been behind-the-scenes working—

Mr. Ellis Smith

What does that mean?

Mr. Brown

I will tell my hon. Friend what it means. Behind all this—and I say it with all the emphasis that I can command—there is the parsimonious, niggardly policy of the Treasury; they are the people behind this, and we have to suffer and our people have to suffer because of it. If he does nothing else, will the Minister endeavour to erase the Regulation which makes it compulsory for our old folk to pay the 1s. prescription charge? I could draw some very weird pictures of what I see in my village because of this charge. If any man can show me, whether he be right hon. or hon. Gentleman, or whether he be an expert or not, that the old age pensioner who is in receipt of the miserable pittance of basic pension, can pay 1s. for a prescription, I will hand out a laurel leaf to him.

Be it understood that the economic conditions of our old folk, who have to have perhaps two or three or four prescriptions a week, because of the complaints from which they are suffering, are such that they cannot afford to pay the 1s. prescription charge for the medicine which they must take to help them along the pathway of life. I plead with the Minister, if he cannot concede what we ask in so many other directions, will he please, above all, concede the elimination of the charge for the 1s. prescription to old age pensioners?

8.25 p.m.

Mr. Spencer Summers (Aylesbury)

I do not know whether it was a slip of the tongue, but when the hon. Member for Ince (Mr. T. Brown) drew attention to the position of the old age pensioners, and in the plea which he made on their behalf, he gave the case of the old age pensioner who was drawing National Assistance, suggesting that in those circumstances it would be impossible for such a person to afford to pay the 1s. required under these Regulations. Of course, the hon. Gentleman must know that such a person would not have to pay. [HON. MEMBERS: "Of course he will."] It is completely misleading to illustrate a plea for old age pensioners by a case in which the pensioner is so lacking in resources that he has a right to draw National Assistance.

Mr. Percy Shumer (Birmingham, Sparkbrook)

Certainly he would have to pay.

Mr. Summers

If the instance is a recurring one, I agree that there may be one case in the series; there has to be one to start the chain.

Mr. Shurmer rose—

Mr. Summers

I would prefer to deal with the hon. Member for Ince.

Mr. M. Turner-Samuels (Gloucester) rose—

Mr. Summers

I cannot give way to the hon. and learned Gentleman, although I will give way to the hon. Member for Ince.

Mr. T. Brown

I am much obliged to the hon. Gentleman. I know his interest in the welfare of old folk and I have heard him speak on the subject from time to time. I am fully aware that the old age pensioner in receipt of supplementary assistance is exempt from paying the 1s. prescription charge. My reference was to the large number of old age pensioners who are not in receipt of supplementary assistance and who will have to pay this shilling when they go to the doctor or chemist.

Mr. Summers

I will deal with that section. I will deal with the largest section of the old age pensioners in the later references I want to make.

I want to register my protest at some of the completely extravagant language of the right hon. Member for Greenock (Mr. McNeil), who moved the Motion. It is a shocking thing so to distort the position we have reached as to say that where a charge is to be made of one-quarter of the value of the goods, that is tantamount to filching money out of the pockets of the poor and sick. It is not rendering a service to the House or to the understanding of this system to distort matters to that extent.

The right hon. Gentleman went on to speak of this "nonsense" when he referred to the collection of charges in out-patient departments. The hon. Gentleman who seconded the Motion strayed from the facts so far as to describe the effect of the Regulations as setting up a source of fresh tax gatherers. I want later to make the broad point about the principle of charging. But it is quite misleading to suggest that to charge a quarter of the value—which is the effect of these Regulations—is setting up a tax gathering service.

In my view, it is regrettable that hon. Members should bring forward a series of very hard cases, admittedly hard, and should claim that, because of the effect of these Regulations on a very small proportion of the population, therefore the Regulations ought not to be approved by the House. It may well be that there are individuals who are denied the right of recovery under the administration as it is now arranged, and I for my part would be only too ready to study individual ways of bringing within the scope of relief those genuine cases, small in number, which bring with them substantial hardship. To be willing to see that individual cases of hardship are helped by administrative methods, while permitting a broad system of charging to go on, is quite a different matter from saying that the whole scheme should be abandoned because of its effect upon a small number of people.

There is great merit in these Regulations. It is right and proper that the system which prevails in this country should work so that the individual should look to his own resources for the running repairs that he needs. [HON. MEMBERS: "Oh."] If there is any doubt about what I mean by "running repairs," let me explain that I mean the smaller charges which arise from time to time. I want to make quite sure that funds are available to deal with those who are sick, whether chronically or through accident, first in hospitals, and secondly for severe cases where, if the victims had to rely upon their own resources, they would be denied the benefits of science.

Because of the increased ability to have the severe charges upon an individual covered by the general scheme, I welcome the principle of the smaller charges being left to the individual to find out of his own resources. With that thought in mind, as a background, of enabling more money to be available to hospitals by keeping a ceiling on this section of the Health Service, I welcome this system which has been introduced, and I hope that—

Mr. Deputy-Speaker (Mr. Hopkin Morris)

The principle of the general charge is not in order in this discussion. Whether it is justified or not, it has already been authorised. We are now considering special charge.

Mr. Summers

I am coming to the end of my remarks, Sir. I hope, for the reasons that I have given, that this prayer will not be upheld.

8.32 p.m.

Mrs. E. M. Braddock (Liverpool, Exchange)

The hon. Member for Aylesbury (Mr. Summers) commenced his speech by saying that he was surprised at the extravagant language used by the mover of the Prayer. I might inform him and the Minister of Health that if I used some of the language that my constituents have used to me about their feelings, it would be completely unparliamentary and that I should probably find myself outside, as I did on a previous occasion. The comments that have been made by people who have found themselves compelled to pay a shilling when they went to an out-patient department or the chemist's shop were in the sort of language that working-class folk use about people they do not like.

I want, first of all, to dispel the idea which seems to be prevalent that a state of chaos exists in relation to these regulations. I have always found that, however difficult, however mixed up and hard to work a Regulation may be that comes from a Government Department, the poor officials who are paid to do the job make it their business to see that it is as easy as possible and to make it work as easily as possible. Mixed up, bad and difficult though these Regulations are, I have found that the officials who have to work them are doing so to the best of their ability.

On a public platform not long ago I made a statement, and I want to make it again here. It was to the effect that I hoped that everybody in the country living on low wages or unemployment pay who felt entitled to the return of the 1s. they had had to pay would make it their business to go to the Assistance Board, or to send for a visitor from the Assistance Board, to get their claim examined for a return of the 1s. I believe that by that process this scheme would be completely broken up, because the administration would not be able to stand the claims and the additional stamps and forms that would be necessary.

I wanted to say that here because I had an idea that the Minister was going to make reference to the speech I made and to suggest that I was not prepared to advocate the carrying out of the legislation. I am advocating the complete carrying out of the legislation. If people who are so entitled take advantage of the legislation, the scheme will completely fall to pieces, because the administration will be incapable of doing the work. Many people will be entitled to the 1s. refund and they should apply for it, and find out whether the Assistance Board will make the necessary inquiries to discover whether they are so entitled.

The second thing I want to refer to is this. Reference has also been made to the fact that certain medical or administrative staffs in the hospitals will not charge the 1s. I do not think they will do so because they are in a difficult position. If the doctor in an out-patient department of a hospital issues a prescription which he considers to be necessary, and the patient has not 1s. with which to pay for the prescription, it would be outside the ethics of the medical profession if the hospital service refused to give that necessary medicine to the person in question. I know that the hospital service will not under any circumstances refuse to hand out the medicine that is prescribed by a specialist or a medical man in a hospital to a person who has not got the 1s. to pay for it. What arrangements are made about that?

Whether hon. Gentlemen opposite know it or not, there are thousands of people who cannot take 1s. out of their pockets without wondering what they will have to do without if they give that 1s. for a prescription. What will happen about the person who goes into the chemist's shop? Already two sets of requests have been issued. The first one asked the chemists to get the 1s. when they make up the prescription. However, so many prescriptions have not been claimed because the person concerned has not got 1s., and the medicine has gone down the drain since it could not be given to anyone else, that an instruction has now been issued that the chemists must not make up the medicine until the 1s. has been produced.

What a position to put a patient in? I say definitely and bluntly, so that it is on record, that if anything happens to one of my constituents because he or she has not got 1s. to pay for a bottle of medicine prescribed by the doctor, I shall make it my business to take legal action against whatever Department is responsible and bring it as far into the high courts as possible, because, if the person dies, it will be murder or manslaughter on the part of some- body. I am warning the Minister that that is the stand I shall take if any of my constituents suffer because they have not got the 1s.

Dr. Stross

Is it quite correct to say that a new Regulation has gone out stating that the medicine must not be handed over without the 1s. being produced? Is it not rather that they cannot be legally compelled to give it without the 1s. and that, as a result, chemists have a variation in conduct? Those with the best social consciences risk the loss of the money, and those who have not got such a social conscience can please themselves.

Mrs. Braddock

It is a question of interpretation. That is the difficulty with all these Regulations. Everyone interprets them in any way they wish.

Mr. Turner-Samuels

Will the hon. Lady allow me—

Mr. Deputy-Speaker

Order. A large number of hon. Members wish to take part in this debate, and it is much better if hon. Members will reserve their remarks until they have an opportunity of making their own speeches.

Mrs. Braddock

I am not concerned with what the chemist does, provided he gives the medicine to the person who has not got 1s. Someone may go to a doctor, take up a quarter of an hour of his time, the doctor issues a prescription for the medicine he considers necessary, and then the patient may not have 1s. when he goes to the chemist. That is a waste of the time of the medical service. Working people do not go to a doctor and ask for a prescription for fun. They go because they need it, and they see the doctor because they need to do so. I can imagine what the doctors would say if a stream of people went to their surgeries simply to get notes for prescriptions that they did not need.

These Regulations, the charges, and the way in which the matter has been dealt with, are causing, and will cause, in spite of the fact that there is very little evidence of it at the moment, great upset and difficulty later in the year, from October to March, when practically every aged person suffers from bronchitis and has to have medicine perhaps once or twice a week. They just will not have the money, and all the work that has been done in getting people to live longer will be undone by the fact that they cannot get the services that the previous Government gave them in relation to medicine.

Let me say a word about the various methods of collecting the shillings. I have discovered some queer methods. In one of the hospitals in my constituency, a machine has been installed for the purpose of issuing receipts. That machine takes only shillings—no other coins can be used. I found an old lady running around outside the hospital looking for a shilling. I asked what was the matter. She said, "I have to get some medicine. I had two sixpences and put them in the machine, but nothing happened." I investigated and found that what had happened was that the next person to go to the machine had had a shilling and had inserted it, with the result that she had got her receipt and the sixpences had come back to her. Unless someone is standing by these machines to explain how they are to be used, all sorts of difficulties can be created.

In addition, there is a shortage of shillings generally. Almost every slot machine in my area, for gas, electricity, and so on, is a shilling meter. There are not enough shillings in circulation for people to carry them permanently in their pockets in order to be able to present one at every chemist's shop or wherever it is necessary to obtain a prescription.

I notice that in the Regulations a slight alteration has been made. According to Statutory Instrument No. 1023, relating to outpatient departments of hospitals, anybody who is in receipt of National Assistance has only to show his or her book at the dispensing department of the hospital and does not have to pay the 1s. But people who go to a chemist's shop to get their prescriptions must show their book or give their names and state whether they are in receipt of National Assistance.

There has begun a whispering campaign in chemists' shops. People wait until somebody else whom they do not wish to know that they are receiving National Assistance has left the shop. People go up to the chemist and whisper, "I am in receipt of National Assistance. May I have a receipt to get my shilling back?" All the personal, open contact with the people who are connected with the Service has gone completely. People do not want everybody to know that they are in receipt of supplementation.

Even when people get the necessary form, it is divided into two. On one side, the chemist has to put the name of the person and his own staff. Then he hands the form to the person, who has to go home, fill in his or her name or state whoever is to draw the 1s., and state his C.P. number—I do not know whether that stands for "Communist Party" or "Conservative Party."

Like other hon. Members who represent industrial areas, I have many old people who do not understand form-filling and who get into all sorts of difficulties, who put the queerest things on ballot papers, never mind forms to fill in to get their shillings back. Think of the difficulty, the worry, the upset and the unnecessary administration that is being caused, not only to old people and to those who need to make a claim, but to the Departments concerned. Could it not be arranged that where a person is in receipt of National Assistance, the same procedure applies in the chemist's shop as is now being arranged for out-patient departments; whereby people who show their National Assistance books can get their medicine free?

Then there will be all the extra administration for the chemists, who have to say how many prescriptions they have given free and how many have been paid for. Looking through the various forms, I do not know what the chemists and doctors are going to become. There are so many forms that I could lay them on the Floor of the House and they would extend from one end to the other. One person must fill in one form, while another person has to fill another form. I believe the whole thing is unnecessary. I believe it is a piece of administration which we could easily do without. People have plenty of other things to do, particularly paid officials, without filling in forms, giving advice and helping people who ought to be assisted by the State and not put to the difficulty of filling forms and meeting all these charges.

I hope sincerely that the advice I am giving at every meeting I address that everyone who is able to do so and believes he is entitled to claim the shilling should make it his business to see that the officials are there in order to see that they get it. I believe that by that method the scheme can be put out of operation completely and we can go back to the method we employed previously.

8.46 p.m.

Mr. Baker White (Canterbury)

A large number of hon. Members opposite wish to speak and I shall be very brief. For fairly obvious reasons, I shall not follow the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock) in her arguments—[An HON. MEMBER: "You could not."] Perhaps not.

I wish to correct a point which I thought was put wholly unpleasantly by the hon. Member for Lanarkshire, North (Miss Herbison) and wholly pleasantly put by the hon. Member for Ince (Mr. T. Brown), that no hon. Members on this side of the House had any experience of human relations in industry, particularly in the mining industry. I have lived for many years in close proximity with the mining industry and the second boring for coal in Kent was on my father's land. I have several thousand constituents who are miners and my relations with them are wholly cordial. So I think I know a little about their problems and difficulties.

The point I wish to raise with my right hon. Friend concerns those persons who have to go to the National Assistance Board office to get the 1s. back. I want to know, because they are not clear about it, whether, if they have to travel an appreciable distance to do that, they get their bus fares paid or not? I was proved wrong over this the other day. I read a letter in the "Manchester Guardian" in which the writer made the point that in East London it might require a 4d. bus fare or more, to get 1s. back.

I looked up the National Insurance offices in the telephone directory and thought this was wrong, but the writer was perfectly right. No one has raised this question with me as a complaint, but merely as a question. I made inquiries in my constituency and found that it may cost up to 1s. or 1s. 6d. in bus fares to go to the National Assistance Board. I should like to see that point cleared up and I should like to see it arranged that if people have to spend bus fares they shall be reimbursed.

So far as old-age pensioners are concerned, from the little experience we have had I say, quite frankly, that I would like them to be excluded from the charge. I believe that I have been consistent about this. When the decision was first announced I put down a Question asking whether they could be exempt. Again, I have had no complaints at all from old-age pensioners, but I think it would be worth while the little additional expense to relieve them from the anxiety and worry, even if they are to get their 1s. back from one channel or another.

I want to put only one general point. I think it is accepted that the post-bag of a Member of Parliament is a mirror of public opinion, and certainly a mirror of public indignation. If there were the alleged public indignation, maladministration and chaos that some hon. Members opposite have depicted in the working of this scheme, surely we should have had very many letters about it. I have here more than 200 letters which I have had from constituents about the question of passenger fares. I have a large batch of letters about the Pensions (Increase) Bill, but from 62,000 constituents I have had but one complaint about the working of these Regulations.

Mr. John Baird (Wolverhampton, North-East)

This is a rather important point, which has been made by a number of Members opposite. It is quite true that not many complaints have come to Members of Parliament but if the hon. Member would ask any professional man, dentists or pharmacists, in his division, he will find that the public are now complaining and that bad feeling is being created which has not yet percolated to Members of Parliament.

Mr. Baker White

I can only say that the rate of percolation must be unusually slow compared with other matters which cause letters to be written, because there was no such delay about the rate of percolation of representations about the new Pensions (Increase) Bill. The rate of percolation there has been exactly 24 hours.

I wanted to know whether my constituency was unique in this respect, so I asked 20 of my hon. Friends last night, and I chose constituencies with some care—industrial ones, including one in which there is acute unemployment, dormitory ones, and rural ones like my own. Those 20 constituencies have a total electorate of 1,138,000. The total number of verbal or written complaints which those Members have received so far about the working of these Regulations is 10—from 1,138,000 people.

8.52 p.m.

Mr. Somerville Hastings (Barking)

In the short time I wish to detain the House I want to deal solely with the impact of these charges on the hospital services. I took the trouble to make inquiries at several hospitals with which I am associated and what I want to say tonight is concerned with what I have found as a result of those inquiries.

There has certainly been some reduction in out-patient attendances, but I should not like to say very much about that because people's general health may have been better and certainly more people are on holiday in June than in May. To my surprise, to some extent, I learned that the people who raised most objections to these charges in the hospitals were the doctors and nurses. A little thought on my part made it clear why this was the case. Doctors belong to the most socialistic of all professions. It is our tradition to treat our colleagues and nurses without any payment. Those of us who are working in hospitals also treat in the same way all other hospital workers.

When a doctor has seen a colleague or nurse or perhaps another hospital worker, and, that person takes the prescription to the dispensary and is asked to pay 1s., there is a very strong feeling of resentment. All those who have worked in hospitals must realise what is the traditional attitude of the hospitals—that we work together as a team and that we thoroughly agree with that Scriptural injunction which says that it is, wrong "to muzzle the ox that treadeth out the corn."

We who work in hospitals were delighted when in 1948 the almoners of the hospitals, instead of being mainly collectors of money, became what they really ought always to have been, almoners in the true sense; people who made known the possibilities of the social services available to the patients. And we have tried, as has been suggested, to withdraw from the almoners the need for collecting funds, by the use of stamp machines, with more or less success. But in any case, the organisation of this collection has to be carried out by the almoners. When the patient has not 1s. the almoner lends 1s. to the patient and hopes that it may be returned. Sometimes the almoner gets it, and sometimes he or she does not. I know perfectly well that in these Regulations there is a paragraph which says: Any sum payable under these regulations to a hospital authority or any other person shall be recoverable summarily as a civil debt. But I would ask the Minister whether he thinks that will be carried out, and whether the habit of people borrowing a 1s. and failing to return it may not grow?

There is another point in these Regulations to which I would like to refer. It is in Statutory Instrument No. 1023, which deals with charges for hospital services, and I read in Schedule 7 (1, b), that a person who receives the drug or appliance for the treatment of a disability which has been accepted for an award by the Minister of Pensions, being a disability for the treatment of which that Minister may defray any necessary medical or surgical expenses shall not be charged any fee. That is in the Regulation.

But there are one or two points I should like to raise about this. First of all, we do not treat a disability, we treat a patient. We do not treat a wooden leg, but the individual who carries it. I would point out how difficult it is to say whether symptoms for which treatment is required, are the result of a disability which has been accepted for an award by the Minister of Pensions or not. A man may perhaps have lost his leg, and he cannot sleep at night. Is that due to the loss of his leg, or to something else? Or a man may be receiving a pension for a head injury, and he gets a headache. How can a doctor possibly say whether the headache is due to the injury, or to one of the many hundreds of other causes of a headache?

But my chief objection to these Regulations is that they affect most severely the poorest and most defenceless of our people. I know that provision is made for those in receipt of National Assistance. But I want to refer to the class who are not in receipt of National Assistance; decent, honest people who have been successful in paying their way all their life, and yet when sickness comes upon them, must ask for help.

Take a man who needs a surgical boot. What is he to do? I will read from Circular R.H.B.52/57, which has been issued by the Ministry. This deals with people not in receipt of National Assistance. It will take me some time to read it. Perhaps the Minister will explain it when I have read it. It reads: If, however, when the patient is asked to sign the undertaking to pay the charge … This is for, say, a surgical boot— … the claim is made that he requires assistance before he can meet it, the person concerned should be advised to apply to the Board's office nearest to his home. That is the National Assistance Board's office nearest to his home— The hospital should complete Form A.P.4 and arrange for the hospital's stamp and the date to be entered on the form. (The person should not be asked to sign the form at this stage.) The form should be given to the person to send with his application to the National Assistance Board and he should be asked to return it as soon as a decision has been given. If the Board decide they can help him, they will provide him with a note (Form F.3) indicating the amount of the assistance they are prepared to give, assuming there is no change in the person's circumstances by the time payment is due. This amount may or may not be the full amount of the charge. The person should give Form F.3 to the hospital when he returns Form A.P.4, which he should then be invited to sign. The hospital can then proceed, if necessary, to order the appliance. If the appliance is to hand, or, if ordered, when it is ready to be fitted, the person should be notified in writing and at the same time told that he should send the notification to the same National Assistance Board office who will, if still satisfied that the person could not meet the charge without hardship, make out a crossed cheque in favour of the hospital authority and hand or send it to the person. The person will present this cheque to the hospital authority when collecting the appliance.

Mr. Iain Macleod

I am distressed that the hon. Gentleman finds that incomprehensible, because, with the exception of about three words, it is identical with the provisions made by the Socialist Government for charges for dentures.

Mr. Hastings

I have been through this rather carefully more than once. I think that I have at last managed to comprehend it. As I understand, it will take about a month to carry out all the different operations. Meanwhile, my poor friend who needs a surgical boot, or needs his surgical boot repairing, will be in real difficulty.

What about people with less education than the Minister? Will they not find this provision most difficult to understand? Some of us hoped that in 1948 we had made the deterrent Poor Law a thing of the past, and that we should hear no more about it; but are not Regulations such as this just as much a deterrent? Will they not keep poor people who need these services from applying for them? What uneducated person is likely to understand such Regulations as these? Cannot the Government try to put out something more simple if they must make these charges?

When the Minister comes to this House and tells us how much these charges have saved the nation, will he also explain that the reason for this saving is not that there is less need but that people have been "choked off" when they need these services. Indeed, those who have been "choked off" may be in the greatest need.

9.5 p.m.

Mr. C. J. M. Alport (Colchester)

I have no doubt that my memory is at fault, but I do not recollect either having read of or heard the hon. Member for Barking (Mr. Hastings), who has just spoken, making the same remarks on the occasion when the debate took place on the Regulations introduced by the Government of which he was a supporter and relating to dental charges, in which precisely the same terminology was used.

However, it is not with the hon. Member's speech that I wish to deal, but with a point made by the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock). The hon. Lady has offered, as far as I can make out, to her constituents—or, indeed I imagine, to anybody—that, in certain events, she will take action on their behalf in the High Court. We realise that the hon. Lady has experience of the High Court, and, therefore, presumably, she is as good as her word, although I still recollect that, on a previous occasion, when she made a somewhat similar threat in the days of the last Parliament about the way in which she would oppose by every means in her power the provisions of the National Health Service Bill, within a few hours she was in the Division Lobby in its support. That, perhaps, may be a warning to those who take her too seriously.

The point to which I wish to draw the attention of the House is that it is quite clear that these Regulations, and the explanation of them which has been issued by the Ministry, have been drawn up as simply as possible and with as great an understanding of the difficulties with which people may find themselves faced in meeting them.

I should like to draw the attention of the hon. Lady to a particular paragraph in a circular, to which I think she referred, which is known as E.C.L. 41/52, dated 23rd May. In this circular, it is perfectly true that it is laid down that chemist contractors shall be under no obligation to supply drugs and appliances except upon payment of the appropriate charge, but the hon. Lady will also note that in paragraph 10 of that circular it is stated that, when the return of the 1s. which has been taken in respect of the prescription is made, only 11¾d. will, in fact, be required from the chemist.

The other ¼d. per form will be allowed to be retained by the chemist to cover cases in which the contractor may be unable to collect the 1s. charge, because the patient does not return for the item ordered, or because the item seems to be urgently needed, but the person collecting it appears to be genuinely without money.

It seems to me quite clear that, not only does that apply in the case of a chemist, but that it must also apply to the dispensing departments in the hospitals. The Minister, and indeed, everyone who regards these Regulations from a practical point of view, will realise that there will be occasions in which the person tendering the prescription is unable to provide the 1s.

In the case of the chemist—who, after all, is almost a family institution, just as much as the doctor or the grocer or any of those others who serve the family, and who knows very well, perhaps better than most, the circumstances of each family, and whether the claim to be unable to pay the 1s. is likely to be genuine or not—he is given a very proper discretion in the matter. Therefore, I am quite clear that those fears which the hon. Lady tried to raise on this matter are quite unfounded.

In very large schemes of this description there are bound to be considerable difficulties, but as far as possible the approach made by the Minister in framing these Regulations and in inviting interpretation of them is as humane, and, as applied to the practical every day problems of those concerned with carrying them out, as simple as possible.

Therefore, I believe that this last effort by the party opposite to gain political advantage from a misrepresentation of the purpose of this policy will fail. Indeed, it has quite clearly failed from the fact that hon. Members opposite as well as hon. Members on this side of the House know quite well that the initial stages of this scheme are working with a smoothness which was, perhaps, a matter of some surprise to hon. Members on both sides of the House.

9.11 p.m.

Mr. John Baird (Wolverhampton, North-East)

First of all, I want to refer to the rather impertinent interjection by the hon. Member for Wolverhampton, South-West (Mr. Powell) in the first few minutes of the speech of one of my hon. Friends, when he drew the attention of the House to the fact that I was not present. I was here within five minutes, and I would say to the hon. Member for Wolverhampton, South-West that if he is as vocal in his division concerning his attitude towards these charges as he is in this House, I am quite certain he will lose the next Election.

Many hon. Members opposite have made the point that these charges have not caused the amount of ill feeling among the ordinary people of the country that we expected, and that therefore we can assume that they are being received quite well. As I said earlier in an interjection, it is quite true that we Members have not heard a terrible lot about the suffering of these people, but the reason for that is that it is the professional man who is receiving the complaints just now.

We in the professions know that there is a large amount of ill-feeling being caused between the patient and the practitioner because of the imposition of these charges. Another reason we have not heard a lot of complaints about them is that the civil servants are very vocal people and know how to compose a letter whereas a large number of people suffering from these charges do not know how to express themselves in a letter.

Mr. Powell rose—

Mr. Baird

No, I do not propose to give way to the hon. Gentleman. In the last speech that he made in the House on this subject, he refused to give way to me, and I have no intention of giving way to him tonight.

I want to deal with the question of the dental charges as imposed under the dental Regulations. The debate so far tonight has been confined to prescription charges. It is quite true that, according to the Minister's estimates, the prescription charges are going to bring in £13 million while the dental charges may bring in only £7 million. But I make the forecast tonight that at the end of the financial year the right hon. Gentleman will find that the money received from the prescription charges will be less than the estimate, whereas the money received from the dental charges will be much higher than the estimate. The reason for that is that the dental charges are causing great hardship and because of them people are not receiving treatment.

I am glad this debate has taken place and I particularly welcome it because it gives us an opportunity to take stock of the position. While it is true, as some hon. Members have said, that we have as yet not much proof of what is happening, we have a certain amount of proof. I think I can say without exaggeration that, as far as dental charges are concerned—and here I declare my interest as a practising dental surgeon—they are already causing great hardship in the country. The dental health of the general public is suffering already as a result of these charges.

Mr. Powell

On a point of order. Could you give the House guidance on this point, Mr. Speaker? The hon. Member for Wolverhampton, North-East (Mr. Baird) is now referring to Regulation No. 1020 (Charges for Dental Treatment). Those Regulations deal only with certain administrative matters and neither with the fact of the imposition of charges nor with the amount of the charges. I ask whether it is in order in this debate to refer to the effects of the imposition of the charges or indeed to any matter not included in the Regulations?

Mr. Speaker

I have given a Ruling to the effect that the House must not in discussion of these Regulations seek to impugn the decision arrived at by the House when it passed the Bill and that speeches should be confined to matters of administration covered by the Regulations. That is the strict rule of order with regard to this debate.

Mr. Baird

I have been directly referring to the effect of this Statutory Instrument. [An HON. MEMBER: "No."] The hon. Member for Wolverhampton, South-West is completely muzzled in his own division and is trying to muzzle me as well. I want to submit to the Minister facts which I believe will prove that these charges are already imposing great hardship. The Secretary of the British Dental Association sent me today some figures which he tells me come from one of the most responsible dental practitioners for whom he is willing to vouch.

Mr. Fort

On a point of order, Mr. Speaker. Will it be possible to reply to the rather wide way in which the hon. Member for Wolverhampton, North-East is speaking?

Mr. Speaker

One breach of order does not excuse another, but I will ask the hon. Member for Wolverhampton, North-East to have regard to what I said and to confine himself to what is in this Statutory Instrument. The general question of charges for dental treatment was settled in the Act.

Mr. Manuel

Further to that point of order. The hon. Member for Clitheroe (Mr. Fort) went very much wider when he was speaking than has my hon. Friend the Member for Wolverhampton, North-East without in any way being pulled up. With great respect, Mr. Speaker, I do not think my hon. Friend was out of order in replying to assertions made from the benches opposite. I hope he will be allowed to reply.

Mr. Powell

Further to that point of order. My hon. Friend the Member for Clitheroe was referring to the charges for prescriptions which are in fact actually imposed by the Statutory Instrument. The hon. Member for Wolverhampton, North-East is referring to dental charges not imposed by the Regulations.

Mr. Speaker

The relative Regulation in the Statutory Instrument is Regulation 3, which says: Any charge authorised by section 2 of the Act to be made in respect of services provided as part of the general dental services under Part IV of the National Health Service Act, 1946, may be made and recovered by the dental practitioner providing those services as a simple contract debt. The hon. Member is entitled to refer in passing to the general effect, but he must confine himself on this dental business to what is in the Statutory Instrument.

Mr. Powell

With the greatest respect, Mr. Speaker, the Regulation in the Statutory Instrument which you have cited states that the charge may be made and recovered as a simple contract debt. I therefore submit that what the hon. Member for Wolverhampton, North-East is entitled to discuss in relation to the Regulations is whether or not these charges should be so recovered, namely, as a contract debt, or not.

Mr. Speaker

Perhaps the hon. Member will let me look after these points, but I ask the hon. Member for Wolverhampton, North-East to confine himself to what is in the Regulations and not to stray too wide. This is not an occasion, I would point out again, on which we can re-fight the battle on the National Health Service Act; but the hon. Member should keep himself in order by attending to what I said.

Mr. Baird

I was trying to keep to the narrow point of the debate. I am trying to prove that these Regulations are creating so much trouble that there is a great deterioration in the dental health of the people of this country already. The facts that I was going to give are facts which have been presented to me by the British Dental Association. They relate to a responsible leading dentist in an industrial area who, working with a partner, interviewed and examined this year up to 1st June an average of 250 to 300 new patients per month. Last month he interviewed 35 new patients as a result of this Regulation.

It is quite true that it could be argued that the charges imposed by the Labour Government stopped abuses, but no one can argue that the charges imposed by the present Minister will stop abuses. Therefore, I say that it is causing considerable hardship to a large element of the population. I know that hon. Members opposite do not like hard facts, and these are hard facts.

Mr. Alport

On a point of order, Mr. Speaker. You gave a very clear Ruling, which I think all hon. Members in this House understood, that the line of argument which the hon. Member for Wolverhampton, North-East was following was not in order. May we have a Ruling whether the arguments which are now being put forward by the hon. Member are in order?

Mr. Speaker

I was listening to the hon. Member and I was of the opinion that he was about to pass on from that to the Regulations themselves. I hope he will pass.

Mr. Baird

Mr. Speaker, I have sat through almost the whole of the debate, and I have listened to hon. Members opposite and on this side of the House. The debate has gone fairly wide the whole evening, and I feel that I have the right to put my case in my own way as long as I do not go out of order.

Mr. Speaker

It is true the debate has gone fairly wide, but the hon. Member will see if he refers to the Statutory Instrument, that there is a difference between the dental charges and the other ones. The charges for prescriptions and so on are set out in the Instruments themselves which we are discussing. All the Instrument says about dental treatment is to refer us to the Act. The Act is passed and cannot now be discussed.

Mr. Turner-Samuels

With great respect, Mr. Speaker, do not these Regulations deal with charges and with services, and with the administration in each respect? All that my hon. Friend is doing is to refer to those matters. He is referring to the effect that the administrative result from these Regulations is having. Surely, with great respect, that must be in order, quite apart from the fact that the debate has been proceeding on those lines all the time.

Mr. Speaker

The debate has been a general debate, and perhaps that is where the confusion has arisen. Many of these Statutory Instruments do include the charges which are now to be imposed, but in the case of the dental Regulations, which are in No. 1020, the charges to be imposed are laid down in the Act and not in the Regulations. The Regulations prescribe the machinery by which the charges shall be collected. The hon. Member is entitled to refer to that machinery, but he is not entitled to go back and impugn the decision of the House in passing Section 2 of the Act.

Mr. Baird

Perhaps I may refer to the very complicated forms which have been issued as a result of these Regulations. I know quite well that hon. Members opposite are trying to muzzle me altogether. Might I, in a very narrow way, refer to the question of the forms which are necessary as a result of these Regulations?

Mr. Speaker

It is in order to refer to the forms.

Mr. Baird

I remember when Prayers were moved in this House during the last seven years, before many of the vocal hon. Members opposite were ever in the House—and I may be here long after they are out. When the Labour Government were in power, hon. Members opposite were saying that the Labour Party meant bureaucracy and that we were imposing all kinds of forms and Regulations on the poor doctors and dentists. On many occasions in this House I have attacked the dentists, but tonight, if Mr. Speaker had allowed me, I should have liked to say something in their favour.

As a result of the charges and the forms, dentists in industrial areas are suffering very severe hardship. I am sure the Minister understands that, and I hope he will investigate their financial position. The income of many dentists in industrial areas is lower now than it was before the war as a result of the charges. As a result of our Act and the intervention of myself and some of my hon. Friends, we were able, when the National Health Service Act was introduced—

Mr. F. A. Burden (Gillingham)

On a point of order, Mr. Speaker. Are we now dealing with these Regulations or with Acts?

Mr. Speaker

The hon. Member for Gillingham (Mr. Burden) is quicker than I am. I had not come to the end of the sentence being uttered by the hon. Member for Wolverhampton, North-East and had been unable to gather what it was he was speaking about.

Mr. Baird

The form introduced by the Labour Government was a very simple one and contained 12 entries altogether. We have now had introduced a complicated form which means that, for a simple operation, the dentist has to make about 46 entries. There is no justification for this complicated, unworkable machinery, and I hope the Minister will simplify it.

I hope I am in order in saying that, as a result of the Regulations, the amount of new estimates being submitted to the Dental Estimates Board has been considerably reduced. The new patients of one dentist have fallen from an average of 250 per month to 45, and that is happening all over the country as a result not only of the charges but also of the complicated machinery. The work of the Dental Estimates Board must have been considerably diminished, and I wonder if anything has been done to cut down the staff of that bureaucratic institution. As a working dentist, I have found that they have not as much form filling to do and the result is that dentists are getting many more needless and pin-pricking letters from them on all sorts of trivial and silly matters. The Minister could save money by cutting out waste in connection with the Dental Estimates Board.

I shall be out of order if I say much more. [HON. MEMBERS: "Hear, hear."] I hope hon. Members will listen for a minute. I have been trying to make a serious and fairly constructive speech. Perhaps hon. Members opposite do not know very much about it, but I am sure the Minister does. I am very glad to see the Minister in that office. I entirely disagree with many of his views, but I think that, unlike his predecessor, he knows something about the job. While I shall do my best to get him out as soon as possible, at least I know he is a competent Minister in health questions.

There are many patients today who cannot afford to receive dental treatment because of these charges. Every dentist in the country must know of patients telephoning and cancelling appointments because they now have to pay. It is happening all over the country. The consequences of the charges are more serious than we ever thought would be the case. The Minister, therefore, will save much more money than he thought he would.

Finally, I want to say a word on behalf of the dental profession itself. There is considerable hardship in industrial areas among dentists, who are working part-time. It may be that what the Minister said earlier, about these charges forcing dentists into the school dental service, will come true, because many dentists will be bankrupt as a result of the charges. But I assure the right hon. Gentleman that it still will not solve the school dental problem. The dental profession in these areas is very hard hit indeed, and I should like the Minister to look into the matter. If he does not, the dental health of the great mass of the people of this country, and especially that of the poorer people in industrial areas, will suffer considerably.

Mr. Ross

Before my hon. Friend sits down, would he, as a working dentist, give me information on the effect of this form in which the person who is receiving dental treatment must sign to this effect: I understand that the dentist may require me to pay the whole or part of this sum before proceeding with treatment. What effect is that having?

Mr. Baird

Of course, this is one of the points with which I did not deal earlier because I might have been ruled out of order. The reason for this form is as follows. If the dentist does not get the money beforehand, very many patients are too poor to pay him afterwards. Again, I am not speaking for myself, but dentists all over the country carry out treatment and, after the treatment has been finished, they find that the patient did not realise that he would have to pay. As a consequence the dentist suffers. The Regulation has been introduced for that purpose; it gives the dentist the sanction to charge before the treatment, and it is necessary because of the poverty of a large number of the patients attending dentists.

9.33 p.m.

Mr. Thomas Hubbard (Kirkcaldy Burghs)

I thought that tonight we were dealing on this Prayer with an issue which would be a cause neither of great controversy nor of the hilarity such as we heard during the speech of my hon. Friend the Member for Wolverhampton, North-East (Mr. Baird). The section of the community with which these Regulations deal consists of people who, because of the very nature of their illness, are the poorest and the least likely to be able to afford not merely the 1s. prescription but the multiple of the 1s. prescription. The more prescriptions they require, the more likely it is that they are unable to work in gainful occupation and the more difficulties they have to meet.

I should have thought that, in dealing with such Regulations, everyone would have been anxious to do something to improve them. I am not surprised to find the difference in the experiences which have been related by hon. Members on this side and hon. Members opposite. It has been said on many occasions by hon. Members opposite that they have not had many complaints about the charges made under the Regulations. That may be true; these are early days in which to receive complaints. When people are sick and require repeated prescriptions, two or three or more, sometimes in the same week, even the 2½d. stamp which is necessary to put a complaint to a Member of Parliament is a matter for vital consideration.

I want to call the attention of the Minister to the way in which the Regulations affect people. I have had experience in the administration of health matters on a town council and since I have been in this House. Probably my greatest experience is from a patient's-eye view, because I must myself have repetitive prescriptions. I know what it means, although I do not complain about it. A few weeks ago I asked a Question about the number of patients who were awaiting admission to a hospital in my constituency. I got the information that the number was only two short of 1,600 for a hospital that had 75 beds.

What does that mean in terms of prescriptions? It means that those people require remedial treatment in a hospital, but meanwhile they have to take medicines to hold the complaint in check, or to give them relief from pain, and in many cases to enable them to continue at their ordinary employment. The longer those people have to wait for hospitalisation the longer they have to go on paying 1s. for prescriptions.

It may well mean that because they have not been able to get hospitalisation they require appliances to keep their illness in check. Some require to work and some are anxious to work, but they must have appliances. Nobody who understands these things imagines that appliances have to be used every day and all day. Many of the people who are awaiting hospitalisation, requiring repeated prescriptions and appliances, work in industries where appliances cannot be used at all times of the day. They may have to change their clothing completely, especially in heavy industries or in the mines. Such people may have to have more than one appliance.

One trouble very often leads to another. Again, I speak with some little knowledge of that matter. In trying by means of appliances to save one part of their bodies these people may strain another part. It is like a snowball that keeps on growing. A miner may require a particular appliance while he is at work and another appliance while he is at home, if he wishes to go out. The same can be said of an engineer and of any worker who sweats profusely while at work.

These are all added difficulties for the sick section of our community. Many people can go for a whole year without requiring a prescription, and to those who are in that happy position 1s. for a prescription does not appear to be very much or anything to raise emotional speeches about. The only people affected by Regulations are those who require prescriptions so many times, and are in difficult circumstances, that the charge becomes a new burden upon them.

I do not want to go into the question of old-age pensioners, but I happen to be the President of the Scottish Old Age Pensioners' Association. Because of that I receive many complaints. They are complaints not merely on behalf of individuals. In Scotland alone there is an organisation with 80,000 members, the Old-Age Pensioners' Association. At their weekly and monthly conferences they complain bitterly of the hardships they are experiencing as a result of these charges. It is true that if they go to a hospital there is not so much lack of dignity about it, but if they go to a chemist's shop there is still a lack of dignity.

It is wrong that those people should be put in a different category simply because they are the poorest section of our community and, because of their age and infirmity, are more likely to need prescriptions frequently. While it would be wrong to go back to the original Act, it would be very wrong if we did not remind the Minister that what is happening now is what we saw so clearly would happen the moment charges were imposed which rested only on a section of the community instead of on the community as a whole.

This is the sort of legislation from which the Minister and the Government should take a lesson. I hope that they will realise that no matter what money a Government may wish to save, it is wrong to impose charges on one section of the community, particularly that which is the worst off, that do not apply to the larger and better-off section. I am satisfied that the Minister, the Chancellor and the Government will not get any satisfaction out of a saving of £30 million more or less. It must worry them that a section of our people must hesitate before getting medicine in order to keep themselves fit.

It must be realised that when we speak in terms of 1s. for a prescription we are not dealing with a sole charge on an individual. It affects people with a number of children who normally go through the processes of children's troubles such as measles, fevers, stomach complaints from taking too much ice cream, and other little upsets.

Mr. Manuel

Too much red meat.

Mr. Hubbard

I do not think that anyone is suffering from that complaint today.

I suggest seriously to the Minister and to the Government that if they really have an interest in the health of the people of the country, not only now but in the generation to come, the ability to keep healthy must not be tied to the ability to pay. If we are to overcome our economic difficulties we can only do so if we have a healthy nation. It is a lesson that we shall learn dearly.

We have read the reports from year to year of the general improvement in the standard of health of our people, of the reduction in infant mortality figures, of the wiping out of many diseases. We read daily of the results of medical research, of the different remedies that are becoming available. Surely these things must be given in equal measure to everyone. Therefore, these Regulations ought to be annulled. They serve no purpose, they are impractical and they attack the poorest section of the community. They give satisfaction to no one and the quicker they are removed the better for all.

9.45 p.m.

The Minister of Health (Mr. Iain Macleod)

In the course of the discussion on these Regulations I have been asked a great number of varied questions, and perhaps it would be for the convenience of the House if I indicated the order in which I should like to try to deal with the problems that are in front of us.

I should like to say a word—only a sentence or two, but it should be recorded—about amenity beds; to take, second, the dental Regulations, on which it is extremely difficult to keep in order; then to discuss the charges, both at hospitals and at the chemists; then, to take together some of the matters like emergency treatment and the rural areas, which have hardly been mentioned; and finally, and much more important, to give the House all the information I can about the working of the charges in the last month. That seems to me to be infinitely the most important part of the discussion as to whether the charges are or are not a suitable vehicle for carrying out the intention of the Government.

The amenity bed Regulation—Statutory Instrument No. 1022—is perfectly simple in that it doubles the charges from 6s. to 12s. for single rooms and from 3s. to 6s. for small wards. The only two things that should be said are, first, that we retain, as the previous Regulation, which we are amending, retained, the proviso that if the normal cost of treatment and maintenance is less than 24s. a day, the proposed charges will be proportionately reduced.

The only other matter that perhaps should be recorded is something about the scope of these beds. There are just under 6,000 of them, 2,700 in mental, including mental deficiency, institutions and 3,200 in the remainder. If all those were occupied on the present charges, there would be an income of about £400,000 a year; but because, first, a great number of them are required for patients who have urgent medical reasons for the added privacy, and second, because, wherever the fault may lie, there has been inadequate publicity given to these amenity beds, the charges at present are bringing in rather less than half that amount.

In the same sort of way with the double charges, in theory £800,000 should come in. In practice, and owing to the two factors I have mentioned, although we are trying to increase the knowledge about these beds, because it is our experience, certainly in England and Wales, that where their existence is known there is a considerable demand for them, it may be that the amount that will be brought in will be not much more than half of the £800,000.

Let me come to Statutory Instrument No. 1020, relating to charges for dental treatment. It is true that it is essentially a machinery Regulation and that it does not raise directly or indirectly the merits either of the £1 or the full cost charge for dental treatment. Perhaps the only points that I need take up at the moment from the hon. Member for Wolverhampton, North-East (Mr. Baird) are his observations about the forms. Later, when I give the results of the last month, perhaps I might comment on one or two of the figures and comments that he made as to the effect of a dental charge during June.

The hon. Member was rather scathing about the dental form—I confess, not being a dentist, that I find it formidable—that dentists have to complete. He said that my predecessor introduced the new form—E.C.17 revised—but the reason that it had to be introduced and the form had to be revised was to cope with the additional work put upon dentists by the dental charges made a year ago.

Mr. Baird indicated dissent.

Mr. Macleod

Certainly. The position is that a year ago dentists had to use two forms, E.C.55 and E.C.17 and that the two were later amalgamated. For exactly the same reasons they must again use two forms at the moment—E.C.60 and E.C.17 revised. As soon as we possibly can do it—we could not beat the gun on this matter before the House passed the Act—we will have available a new, and I concede at this point, an even more complicated form, which will be E.C.17 re-revised.

Mr. Baird

I am sure that the Minister would like to help the profession if he can. The reason why the much more complicated form was introduced was, first, to amalgamate the other two forms, but chiefly to meet the needs of the Dental Estimates Board who wanted to alter the filing system in which they had patients names duplicated. It derives from the bureaucracy at Eastbourne and has nothing to do with the dentists at all.

Mr. Macleod

It is common ground that just as we must amalgamate two forms now, under the legislation of a year ago two forms had to be amalgamated. I welcome suggestions as to the way in which these forms can be simplified.

I come to the great number of questions that were raised about the prescription charge, first in its application to the hospitals. I shall, of course, be dealing later, as I said at the beginning, with the results which my Ministry have gathered from hospitals in England, Wales and Scotland. We shall also give the House the results and estimates as best we can in regard to all the matters raised on prescribing at the chemist's shop. Those figures will show how ludicrously exaggerated were the stories of difficulty which we have heard this afternoon. I am sure that the House will agree that what matters is not flam-buoyant prophecies about what ought to be happening, but the factual reports from the chemists' shops and hospitals on what is happening as a result of these charges.

My hon. Friend the Member for Putney (Mr. Linstead) invited my attention to a question which arises on Regulation 3 of Statutory Instrument No. 1023 about drugs and appliances. He is perfectly right when he points out that it is possible, owing to the difference in wording between the two Regulations—which was quite deliberate—for the anomaly he indicated to arise. The reason that decision was taken by my predecessor was purely one of administrative convenience and I have no doubt that he is overwhelmingly justified because, otherwise, we would have to ask hospitals to distinguish between those appliances for which 1s. would be payable under the general practitioner service and all the other infinitely wider range of articles which are likely to be supplied from a hospital outpatients' department. Although my hon. Friend was right in the point he raised, I am certain—I have looked at the matter—that the administrative complications make the method we have adopted very much preferable.

My hon. Friend also raised a matter which, I must confess, was new to me until today and certainly new in the very elaborate debates we have had. He asked me to look into it. This was the question of the disclaimed hospitals and the procedure at present used at such places as the Putney Home for Incurables. I will certainly give the undertaking that I shall go into the matters raised; but in regard to the arrangement which he indicated, which I am sure it is clear to the House is entirely an unofficial one—if a patient is being treated in the way he indicated and is thus using the benefits of the National Health Service, I must say that at first sight I can see no reason why, when the terms of the Health Service are changed, the conditions applicable to all other patients of general practitioners should not equally apply to him. But my hon. Friend asked me to look carefully into the point, and I will certainly do so.

Dr. Stross

Do not patients of this kind fall into a category concerned in a problem which I brought before the Parliamentary Secretary by letter? I refer to bulk prescribing; that is to say, permission is given by local executives to the doctors who attend to prescribe in bulk and, therefore, there is only 1s. for a bulk prescription for the whole home.

Mr. Linstead

May I suggest that the principle applicable in these cases is that which was enunciated at the very beginning of the scheme, namely, that every patient had a right to choose to come into a section of the scheme and remain out of another section of it? It is rather on that principle that the point which I ask my right hon. Friend to consider is founded?

Mr. Macleod

There are a good many exceptions to the principle which my hon. Friend has now enunciated. In so far as it is valid the bulk prescription arrangement normally does not apply to this sort of patient. No alteration has been made in the arrangements normally carried out for bulk prescribing.

Again, on the question of the appliances and drugs that are dispensed at hospitals, my hon. Friend the Member for Putney also asked me about the position of resident staff. It is quite clear that if they are not being treated in the ward they are in these matters regarded in the same way as the rest of the citizens of this country—I quite agree that there may be exceptions because hospitals have their own methods of dealing with these matters—and would normally be expected to pay the charge.

The next point which comes conveniently here was that raised by the hon. Member for Ince (Mr. T. Brown). He always puts his points very persuasively, and I should like to help him. As one of his hon. Friends indicated, however, I think he knows what the answer is and that the Regulation in these cases means what it says. In the example he quoted the charge would be made for each appliance, as the Schedule has stated, and indeed as we have understood since the Act was presented.

I should like to add that the picture which the hon. Member was painting seemed in large measure to indicate a much wider range of appliances than are, in fact, being charged for. It is not the case that there is a charge for spinal supports or for ileostomy or colostomy belts. From the way he was speaking I gathered that he might have thought that there was.

Mr. T. Brown

I hope that the right hon. Gentleman will appreciate the point of view which I expressed about the abdominal belts of men suffering from hernia who have to buy three due to the fact that they work in very high temperatures and consequently perspire very freely. The Minister ought to appreciate that some of our men in the minefields are working in temperatures of 120 degrees—and we have been grumbling about 90 degrees. That excessive perspiration tends to rot the belts that they wear. Consequently, they are called upon to buy belts much more frequently than ordinary persons who suffer from hernia.

Mr. Macleod

I appreciate this point, although as the hon. Member very fairly said, I have not the personal knowledge which he has. But I am afraid that does not, and cannot, alter the answer which I gave, and which I think he expected.

Still on hospital matters, there was one point which I was invited to answer by the hon. Member for Barking (Mr. Hastings), who talked about Regulation 7 and about the accepted disabilities. The answer there is that the definition of the accepted disabilities is not a matter for my Department, but for the Minister of Pensions.

I want to come to the biggest single problem that confronts us, the question of the ordinary drugs, the 1s. on the prescription given at the chemist's shop. I want to say a word about two matters raised from both sides of the House. They refer, not to the patient who is receiving his National Assistance grant, for whom, by and large, I think everyone would agree that the provision is adequate, but to those borderline cases as they have been described, who are either on the border of extreme poverty, even as judged on National Assistance standards, or who, for one reason or another, are too proud—if that be the right word—to make use of a service which, to some people, still retains the old taint of Poor Law.

I feel that there may be some validity in the point that arrangements for such a person are not so clearly laid out as they should be. It may be that by added publicity we can help to meet some of the points which have been made. The poster available to everybody makes it quite clear that these people, not only the people taking grants, but all people, can—subject, of course, to a means test—obtain such remission. The words are: The National Assistance Board is authorised to assist anyone who can show that his resources are insufficient to meet these charges. That, of course, does not apply, from the wording, only to those who are receiving National Assistance grants.

Miss Irene Ward (Tynemouth)

That raises a very important point, because people who, in normal circumstances, have not had recourse to the National Assistance Board would not connect their case with that poster in the chemist's shop. That is the problem which we are most anxious that my right hon. Friend should overcome.

Mr. Macleod

I think I am seized of the point. Of course, we must remember that when the National Assistance Act came in it was provided that health requirements—because an Act was in contemplation—were not to rank for National Assistance grants. The breaches in that were made a year ago by the 1951 Act, and the position, apart from those having grants, is exactly the same in all fields, on the 1s., 5s. and 10s. charges; although for obvious reasons it is unlikely that the 1s. would tip a person over this knife-edge about which we are talking.

The requirements of such a person are now on all fours with the requirements of everybody who for any reason feels his resources are inadequate to meet this or any other charge. Therefore, as an answer given by my right hon. Friend the Minister of National Insurance two days ago to the House indicated, the arrangements available for the ordinary cases apply equally to the borderline cases we are discussing.

Miss Ward

May I remind my right hon. Friend that when I asked the Minister of National Insurance—

Mrs. Braddock

When I asked him.

Miss Ward

I do not think the hon. Lady asked this question. When I asked my right hon. Friend whether he could indicate the number of cases that had been dealt with by the Assistance Board under that procedure, he said that the information was not available. That indicated to me that there could not have been a very large number of people, otherwise the information must have been available.

Mr. C. W. Gibson (Clapham)

I understand that the right hon. Gentleman has said that in suitable cases the charge can be paid by the National Assistance Board, whether the person concerned is already receiving National Assistance or not. Will the right hon. Gentleman make sure that his staff and the National Assistance staff know that? Only this week I had a complaint from a man who badly needs assistance who was told that he could not claim from the Assistance Board for health charges because he was not already in receipt of National Assistance. This is a most important point.

Mr. Macleod

I had not heard that there was any difficulty. If necessary, I will get in touch with my right hon. Friend. On the question of information being available, later I shall be giving some figures which have come in in the last day or two.

Mr. Manuel

On this question of assistance for authorised medicines or appliances, is the decision made on the weekly budget for one week, taking into account clothing, and other necessities? Is it on that assumption that the supplementary assistance will be given?

Mr. Macleod

I am sure that the hon. Member knows that that is a matter for determination by the National Assistance Board. Apart from any question of Ministerial responsibility, it would be highly improper for me to intervene in that matter.

I want to comment also on the point about the arrangements in rural areas, although that question has only just been touched on today. There are, in rural areas, both for chemist contractors and for dispensing doctors, special arrangements which have been agreed upon with the professions concerned. I emphasise again that this is only in rural areas and only in those areas where a considerable proportion of drugs change hands without the supplier and the patient meeting. The arrangement we have made involves the use of postage stamps which may be accepted, and which are to be cancelled by the dispensing doctor or the chemist contractor concerned and rendered in that form to the Executive Council, and so to the Treasury.

There has been—not in this House but in the national Press—a good deal of comment by doctors and others about this arrangement, but it has been worked out very closely with the General Medical Services Committee. This comment has been made by doctors in the "British Medical Journal" and by others.

During the course of our debates on the Act there have been—and it has been hinted again today—comments on the different habits of prescribing in various areas of the country. The allegation is normally made that in what are looked on as the rich, wealthy residential areas the cost of prescribing, and perhaps the number of prescriptions also, is very much higher than it is in the industrial areas. It is a very important point. As far as I can, I have made the closest study of the returns of all the Executive Councils, and I must confess that I can draw no valid conclusion whatever from them. Anyone who likes to study them can make whatever case he likes.

Perhaps I may give two examples. I do not want to start a private war in this matter, but it seems to me an astonishing thing that at Blackburn the cost per person per year—which is the best guide—is £1 4s. 1½d., whereas in Bolton it is 16s. 2d. The second illustration shows how impossible it is to make any conclusion, because it is said—and, indeed, it is understandable—that because of the patients—the rich, wealthy Tory patients, as they are imagined to be—[Interruption.] Well, if it is not, perhaps the hon. Member can answer this point. If the cost in Bath is £1 2s. 8½d., why is it £1 4s. 10½d. in that other well-known Tory spa of Wigan?

Mr. William Hamilton (Fife, West)

Will the Parliamentary Secretary, assuming that she is to speak in this debate, and I hope she is, also give the figures for places like Inverness and Elgin, compared with Hamilton and Kilmarnock, and say why residential areas are at least 50 per cent. up on working-class areas?

Mr. Macleod

We will certainly have a look at the Scottish figures, but when we talk of the highest areas in England let us remember that these figures cover industrial cities like Manchester, Wakefield and Blackburn, residential areas like Blackpool, Southport and Bournemouth, and rural areas like Cornwall and Westmorland. If anyone can draw any conclusion whatever from the facts that I have given, he is a better man than I am.

Mr. Ellis Smith

The Minister has the advantage of us, because he will have seen the figures for days and will have had an opportunity of making an analysis of the returns. Has he himself come to any conclusion as a result of that examination?

Mr. Macleod

Yes, Sir; I have just said that the close study that I made led me to the conclusion that there is no conclusion to be drawn.

The next matter that was raised in relation to the charge in the chemist's shop, which is the last matter that I want to take up in this particular field, because I want to go on to the question of results, in which most people are interested—was that mentioned by my hon. Friend the Member for Colchester (Mr. Alport) about allowances made to the chemists. It is quite true—and we recognise it and have said so in the Regulations and in all the documents that have been issued—that cases are going to arise in which somebody will not call back for a bottle of medicine. It is quite true that cases may arise in which not only a person genuinely has no money, but in which—and this is also essential—the need for that particular medicine is extremely urgent.

We have arranged with the representatives of the chemists that an allowance which works out at one prescription in every 48 will be made to cover these contingencies. How that works out will be in this way. The chemist will receive 1s. for each prescription form paid for, but only 11¾d. will be deducted eventually from his remuneration by the executive council. The arrangements in relation to rural areas are slightly different.

Mr. Linstead

Before my right hon. Friend goes on to his general survey, could he help me over the question I raised of the prescription which extends to more than one form, and say whether it is going to be necessary for a patient to pay 1s., 2s., or 3s. according to whether the prescription runs to one, two or three pieces of paper?

Mr. Macleod

I have looked carefully at that point, but I do not propose to pontificate on it tonight, because I was asked a Question on this matter last week in this House. I said I did not intend to make this a matter of caligraphy, but there are many reasons against what is called the "continuation form." I do not want to go into them in great detail, but I am told that such a form may be an encouragement to what has previously been called "medical shopping." I think that is a valid point.

Secondly, it may be that there would be a danger of adults' and children's prescriptions being dealt with together, and the possibility, so I am informed by those who advise me, that the dosage might be confused. But I have said in this House before that this is one of the matters which I am going to watch carefully as the scheme develops, and I do not intend in any way to give a final answer to that tonight.

Mr. Frederick Messer (Tottenham)

The form could be made bigger.

Mr. Macleod

The form could be made as big as this table, but there would still be immense difficulties. However, I will look into all those matters.

There is one most important matter to which no reference has been made tonight. I think the reason for that is that most people know that it is a matter which has been settled. At the same time, it is one which I think should be on the record. It is that satisfactory arrangements have been made to enable what are called the "five shilling pensioners," those occupying residential accommodation under Part III of the National Assistance Act, to get a refund, and that certain arrangements have been agreed between the local authorities and the representatives of my Department on which I do not need comment further. I know the House will be glad to know that, as indeed was always the intention of my predecessor, these people have been brought within the scheme of exemption from these charges.

Mr. R. Ewart (Sunderland, South)

May I ask the right hon. Gentleman one question in connection with that? It is a matter I intended to raise if I had been called. Will that provision apply to similar persons in residences outside the local authority institutions, such as those run by, say, religious denominations and the kind of institution run by the Salvation Army?

Mr. Macleod

Arrangements have also been made to cover this sort of case. There is a segment of this field where the people looked after by voluntary organisations are the responsibility of local authorities under Section 26 of the National Assistance Act, and that covers the point raised by the hon. Member.

I come now to the most interesting point which has been raised, and that is to see exactly what has been happening as a result of these charges in the shops and hospitals. I have asked for returns, and they have been coming in up to this afternoon and this evening, and have added to the figures I have in my possession. I have had replies from 14 regional hospital boards, from eight provincial boards of governors, and from 24 London boards of governors. I think that the sample they have been able to offer the House has been of hospitals within their own immediate experience, constituency, or whatever it may be, though the sample has inevitably been small.

I must make a number of reservations before I give these figures and these conclusions. First of all, we must remember—and everybody of course appreciates this—that any conclusions drawn from the first month of a scheme are, or may well be, very faulty. Secondly, we have to bear in mind that this scheme started in the middle of the Whitsun holiday and that complicates some of the reckoning, not only for the first few days but for some time after that. Thirdly, we have to remember that the month of June—and I hope this goes on—has been exceptionally fine, and that of course has a considerable effect in these matters.

Five general conclusions are reached by my senior officials, which they have put before me, as a result of the investigation we have made into hospital charges for drugs and appliances. I think the House will be interested in them. First, there has been no noticeable decline in the number of prescriptions dispensed during June which cannot be accounted for by the Whitsun period and holidays. Second, there has been no evidence of any variation in practice as a result of the charges, for example, the ordering of larger quantities on prescriptions, or repeat prescriptions. Third, there has been no falling off in the number of out-patients. Fourth, there is no noticeable increase in queueing in out-patient departments, but some congestion and delay is occasioned by patients needing advice, explanation, or change of money. Fifth, there are no difficulties consequent upon the introduction of charges for either drugs or appliances.

Really, in view of that evidence, collected as carefully as we have been able to collect it from as wide a sample as we can get, first of all what nonsense is made of some of the speeches we have heard in this House and in Committee. Secondly, it is extremely hard to understand how in the passage of the Bill, now an Act, we managed to spend a day a line going through it.

Mr. Frederick Willey (Sunderland, North)

The right hon. Gentleman has given the conclusions reached. Would he give the evidence? What is the percentage fall in the number of prescriptions as compared with last year?

Mr. Macleod

If the hon. Member would only wait a moment; I should have thought that it was clear, at least to the rest of the House, that that would be given in about the next sentence or so.

Mrs. Braddock

With reference to the supply of drugs to hospitals, will not the right hon. Gentleman say that hospitals have been informed that they must not raise their drug account or drug purchases at all? Would not that be an indication that no increases were made in the drugs necessary to supply hospitals?

Mr. Macleod

I do not know whether the hon. Lady would like to quote the authority she uses for saying that no hospital must increase its drug bill. I have not heard of it.

Mrs. Braddock

The right hon. Gentleman should make inquiries.

Mr. Macleod

We might well ask for the evidence on that too.

Before we come to the prescription charge, I should like to take up the point made about the effect on dental treatment by the hon. Member for Wolverhampton, North-East, subject to what reservations I have made. There has been a substantial fall in the demand for dental treatment during the past month. It is also unquestionably true that a substantial proportion of the estimates submitted have been for those who can claim exemption.

It follows, therefore, that the policy of Her Majesty's Government that where we have not enough resources and enough dentists those most in need shall not go without is being implemented. That figure has to be taken also together with the increase in the number of dentists in the school dental service, which on the full-time basis has gone up in the last six months from 716 to 793. That trend is continuing. Therefore, the teeth of these priority classes will in the future be better looked after than they ever have been.

Mr. Baird

Let us give the right hon. Gentleman that point. Let us assume that, as a result of the charges, the children are going to be treated a little better than they were before. He himself admitted that between 2,000 and 3,000 school dentists were required to get an efficient school dental service. He has not got anything near that number and he is not likely to do so with these charges. Does he not admit that, as a result of these charges, a very large section of the population will allow their teeth to rot because they cannot afford to pay for dental treatment?

Mr. Macleod

That is quite untrue and the hon. Gentleman, as a professional man, must know that that observation is a very silly one. The short answer is that, whatever the ideal number we need, 793 is better than 716.

I want to give the position, as we estimate it this month, in relation to the prescription charges. The general conclusion is that there has been something like a 15 per cent. drop in all. That is again subject, I must say, to all the reservations that have been made about June. I am comparing, as the right hon. Member for Greenock (Mr. McNeil) did, June with June.

Dr. Stross

In estimating the fall of 15 per cent., has the Minister got any evidence of what is happening to individual prescriptions? Perhaps I may give an example. It appears from evidence that we have got that the tendency is that they are more costly on a percentage basis than they were before. Has the right hon. Gentleman got any evidence yet?

Mr. Macleod

Not on the actual cost. The hon. Gentleman knows the position of pricing in this country. It is impossible to give that information.

On the point which was raised about quantities—and again we have had all this talk about what the doctors would do, how they would pile it on to every form and there would be no saving—I have here 10 replies from the regions on this point. The replies are as follows: Newcastle, no substantial change, tendency to order more for chronics; Leeds, no substantial change; Nottingham, most report increase in tablets but little in liquids, increases usually for chronics; Cambridge, no substantial change; Reading, no evidence of increase; Bristol, no information; Tunbridge Wells, little general change; Wales, little change; Birmingham, no evidence of change; Manchester, little evidence of change.

Mr. McNeil

The right hon. Gentleman presumably has obtained these reports from pricing bureaux, and if he has them from pricing bureaux presumably he is able to give some kind of answer to the point raised by my hon. Friend?

Mr. Macleod

No, they come from much wider sources than the pricing bureaux. They come from my own regions, executive councils and a great variety of sources. As the right hon. Gentleman knows, the pricing is a good deal behind.

On the question of appliances, the National Assistance Board have not yet available full information, but they have made a spot check in two areas, Leicester and St. Pancras, and the results are as follows in this month. Number of applications for relief from the charges: appliances—Leicester, four, of whom three were already in receipt of assistance; St. Pancras, no applications. For prescriptions—Leicester, 10 applications, eight of whom were in receipt of assistance; St. Pancras, 10 applications, 10 of which were in receipt of assistance. It is fair to add that those figures exclude people who have made use of the automatic method of refund through the General Post Office; but that merely strengthens the point that that part of the scheme is working extremely well.

Since we have been asked questions about Scotland, perhaps I might give the National Assistance Board figures for Scotland, subject to the comments that I have made. From 1st to 24th June, on prescriptions by family doctors, the number of applications to the National Assistance Board was 272 out of one million—that is all—and out of that number 176 persons were already in receipt of National Assistance. The figures that I have given prove that there is extremely little dissatisfaction with the scheme. Unless the hospitals and the regions are making false returns that is unquestionably true.

The right hon. Gentleman asked about the cost of the posters—

Mr. Manuel

On a point of order, Mr. Deputy-Speaker. The Prayers we are considering cover Scotland and a Scottish Minister is sitting on the Government Front Bench. Can we have an assurance that a Scottish Minister will deal with the position in Scotland, or is it to be dismissed in two lines by an English Minister?

Mr. Deputy-Speaker (Sir Charles MacAndrew)

I cannot call either an Englishman or a Scotsman unless he rises to his feet.

Mr. Macleod

The right hon. Gentleman asked about the cost of the posters and the cost of the additional forms in a full year. He seemed to imply that the figures were astronomical. I have given them in the House in reply to a Question. In a full year the posters for England and Wales cost £203, and the estimated cost in a full year of the forms that have been brandished round the House today is £4,862.

The real question lying behind the debate is whether or not the Regulations and, in particular, the "bob" on the prescription will work. The Leader of the Opposition said at Nottingham 10 days ago: The prescription charges plan was put up to us We found it would not work. They have no ideas of their own"— "They" are the Tories— so they picked it up like a boy picking up a banana skin and, naturally, slipped on it. I do not know how one manages to pick up a banana skin and slip on it, but it just shows the dangers that attend these colourful ventures into speech.

But what is of the first importance—because we have heard that said again tonight—is when the Socialist Party came to the conclusion that these Regulations, which they are going to oppose in the Lobby, would not work. Presumably it was not when the Leader of the Opposition made his announcement as Prime Minister that there would be such a charge. Presumably it was not a few months later when the right hon. Gentleman the Member for Ebbw Vale (Mr. Bevan) piloted this provision through the House. Presumably it was not in 1950, when the Chancellor of the Exchequer, Sir Stafford Cripps, said, The power to charge will, of course, remain so that it can be used later if it is needed."—[OFFICIAL REPORT, 18th April, 1950; Vol. 474, c. 60.] Finally, to come a little closer to the twins sitting opposite, the right hon. Member for Greenock and the right hon. Member for Middlesbrough, East (Mr. Marquand), a year ago they introduced the 1951 Act and they took power in Section 2 to make the requirements of the National Assistance Act applicable to Section 16 of the National Health Service Act; and presumably they thought even a year ago, within a few weeks of their going out of office, that this scheme would work.

Mr. Marquand

I am sorry to interrupt the right hon. Gentleman since I hope to address the House very soon, if I catch your eye, Mr. Deputy-Speaker; but the right hon. Gentleman has said all this before, and he knows perfectly well that in my Second Reading speech on the Bill, as it then was, I said definitely and in some detail why we rejected a prescription charge.

Mr. Macleod

If the right hon. Gentleman rejected a prescription charge, it seems a most extraordinary thing to do to waste the time of the House in taking provision to send these people to the National Assistance Board. We were used to the right hon. Gentleman filibustering on our Health Service Bill, but I did not realise that he was filibustering also on his own Bill. It seems to me that it is not this Government which slipped on this banana skin.

Mr. Blenkinsop

Before the right hon. Gentleman leaves the point, I asked him a serious point about the Social Survey, which I think he will agree gives very important information for the purpose of trying to estimate what the effect of these charges will be.

Mr. Macleod

The answer has been given in the economic debates previously by representatives of the Treasury, and the answer is that in the circumstances of the country at the time we simply did not think the money spent on that part of the Social Survey worth the information we were getting from it.

These Regulations and, in particular, the shilling on the prescription charge rest on three pillars. They implement, first of all, the undertaking given to the House by the right hon. Gentleman the Leader of the Opposition. They rely for their statutory authority on Section 16 of the 1949 Act piloted through the House by the right hon. Member for Ebbw Vale. They rely for their National Assistance provisions, finally, on the arrangements so conveniently made by the right hon. Member for Middlesbrough, East. My right hon. Friend the Leader of the House, who piloted the Bill, and I myself, who present these Regulations, have been no more than the doctor and midwife to the child they have conceived.

10.39 p.m.

Mr. H. A. Marquand (Middlesbrough, East)

It is a little hard to determine whether the loud applause which greeted the right hon. Gentleman when he resumed his seat is a tribute to the political matter which he introduced at the end or to the fact that at last we have a Minister of Health who at least has been able to give the House of Commons some explanation of what his Measures are all about. [Laughter.] It is welcome indeed. I think hon. Members opposite know perfectly well what my reference was. [Interruption.] We know that there are conspicuous examples of some hon. Members whose form of debating during the last Parliament was to giggle and laugh on all occasions, and who have succeeded thereby in getting into the Government. But it is not likely that any vacancies will be provided for them in the future, so they had better get jobs in the Conservative Central Office and see whether they can get in that way.

We are grateful for such factual information as the right hon. Gentleman has been able to give us tonight about what has happened as a result of the working of these charges. If, in addition to being a skilful and not unsuccessful politician, he also wishes to be a good Minister of Health, he will, in spite of the usual political interchanges, take careful note of what many of my hon. Friends have said in this debate. He will not brush aside too lightly the evidence and information that they have brought forward from their practical knowledge of the conditions in which our people live, and the way the National Health Service works.

He will not too easily persuade himself that all is going well, and I hope he will, in particular, pay attention to the suggestions of my hon. Friend the Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop), namely that, although there may be some arguments on the grounds of economy for the dropping of the sickness survey before these charges came into operation, the sort of evidence that has been produced tonight and the doubts that genuinely exist in the minds of many people engaged in the Health Service, do make it most reasonable that the sickness survey should be re-instituted.

Let us watch carefully and be sure we get the sample information from all over the country as to what is really happening so that next time we come to debate these charges—perhaps when the Ministry of Health Estimates are presented—we may have some opportunity of really knowing what the effect has been in detail.

The right hon. Gentleman gave us some views about the effect of the prescription charge in the out-patients' departments of hospitals, and he said that no very great change seemed to have taken place. In particular there was no general evidence of the prescribing of larger quantities of drugs. I do not think any reasonable person would have expected that result in out-patient departments of hospitals which, after all, are run under the regional hospital boards, under the close direction and control of his own Department. It was not there we feared there might be increased prescribing.

It is a pity he could not have given us fuller information than he was able to do about what has been the main topic of the debate today—very naturally—that is the prescription charge in relation to the general practitioner service. It was very naturally the main topic of the debate. Much was said during the debate on the Bill quite recently about charges in out-patient departments, charges for dental treatment and surgical appliances. The general practitioner charge for prescriptions came under the 1949 Act, and though some references were made to it, there was no other discussion.

Naturally, then, tonight most of the discussion turned upon that. I shall confine my remarks, which I will endeavour to make as brief as possible, to that part of the Service. As the right hon. Gentleman said, we have had only five weeks at most in which to watch the working of this charge. During that five weeks we have had a holiday, we have had fine weather, and it is a period of the year anyway in which illness and disease are not normally heavily prevalent, certainly nothing like they are in the winter. But it is remarkable, in view of that fact, in view of the short period in which the charges have been in operation, and in view of the unusually favourable circumstances in regard to the prevalence of illness and weather, that there has been brought forward tonight so much evidence as has in fact come forward.

I thought that a 15 per cent. drop in prescriptions was a substantial change, comparing one June with another, in so for as we can form judgments on so short a period of experience. The right hon. Gentleman seemed to be complacent about this side of the matter as well as about the hospital side, and there was almost a rubbing of the hands with glee by his hon. Friends behind him which seemed to me to be entirely mistaken.

The hon. Members for Putney (Mr. Linstead) and Reigate (Mr. Vaughan-Morgan) said that they had had very few complaints. The hon. Member for Colchester (Mr. Alport) actually said that the schemes were working with surprising smoothness—a hasty generalisation to make on so short a period of experience, and a hasty generalisation to make in view of the evidence that had been supplied by some of my hon. Friends behind me.

I suggest there are two explanations of the difference that exists between us on this matter, apart from any party differences and any prejudices with which people may approach the topic. One is the explanation to which I have already alluded: that it is summer time. The other is the explanation of geography. Hon. Members opposite who spoke with such complacency represented Putney, Reigate, Colchester—

Mr. Fort

And Clitheroe.

Mr. Marquand

The hon. Member for Clitheroe (Mr. Fort) may have spoken too, but if so his observations escaped my attention. If he wants to be included in being called complacent, by all means let him be so and let it go on record. If I understood the hon. Member for Putney aright, he said he did not understand why a greater fall in prescriptions had taken place in the North rather than in the South. If he would only come north with me some time to Middlesbrough, I could explain to him the difference on the spot.

I could point out to him the difference between the North of England, where, on the whole, a far greater proportion of the national wealth of this country is made, and the South of England where a far greater proportion of the national wealth of this country is consumed. That is the difference. The hon. Gentleman would not speak of occasional hard cases if he could come with me into certain parts of my constituency. We are bound to speak from our own experience of this matter; it is the only really reliable evidence that any of us can have at this moment. If he had come with me into the poorer parts of my constituency the week-end before last, when I talked to the chemists, he would have found that these cases are not occasional hard cases in such areas. These are areas in which people have hard times all their lives and to whom the extra imposition comes as a heavy burden.

Mr. Linstead

As the right hon. Gentleman has referred to me, my constituency is a typical suburban London constituency with a substantial industrial element in it, of whom nearly 25,000 voted for my opponent. From that constituency I have had one letter of protest only.

Mr. Marquand

I get comparatively few letters from my political opponents, too. I suppose because they have no faith in me and they have the hon. and learned Member for Middlesbrough, West (Mr. Simon) to look after them. In exactly the same way the hon. Member for Putney has remarkably few letters from opponents because there are plenty of good Labour Members in London to whom they can write if they want guidance. But I will come to that point in a moment because I have some evidence to give to the House about it. I want to say, first, that we all agreed with the hon. Member for Putney when he paid tribute to the zealous care and attention with which the chemists are trying to do their best for their customers at this time.

I was very much impressed by the attitude adopted by the men to whom I spoke in my constituency, who have now become, not so much public relations officers for the Ministry of Health, but welfare officers for their own customers and relieving officers at the same time in some cases. The chemist today, knowing his customers in these districts, where the labourers in the great steel works live, recognises such people when they come into the shop and proceeds to indicate to them what is available in the way of relief from payment for prescriptions. They told me that people come frequently into their shops in such districts and look anxiously around them to be sure no one else is there before they say in a whisper that they are on national assistance; what must they do about it?

This, of course, is not confined to the industrial areas of the north because, as the hon. Member for Putney readily says, even in the most prosperous districts there are areas of poverty and hardship. I have in front of me a letter which was sent by a responsible person in a seaside resort who had been asked among others to return to the Minister answers to the questions which the right hon. Gentleman told us about tonight. I shall not weary the House with the whole letter; I just want to make this quotation from it: The general impression was that there was no difference being experienced in the number of prescriptions dispensed except by chemists with pharmacists in the poorest working class areas. So what is true of an area like Middlesbrough, in which there are huge working class areas, is also true in areas like seaside resorts and pleasant and agreeable places like Putney. This blow has been felt severely.

It has never been claimed from this side of the House that the imposition of a prescription charge of 1s. would cause hardship to everybody. Far from it. We based our case on the claim that the hardship would be caused to the poor. They, fortunately, after six years of Labour rule, are not as numerous as they used to be. We have admitted that the numbers involved may be comparatively small. They may be equal to the three or four million, for example, who draw the retirement pension. Some of the retirement pensioners can meet the charge, but we must include other classes who cannot. Most serious and significant of all to my mind was the statement made to me by one of a chemist—I hope the House will accept my assurance that I did not ask tendentious questions at all; I asked the questions objectively in the presence of another person, who was not a member of any political party, so that the whole thing could be above board and not suspect in any way of bias.

He said to me, "The most serious effect that we see so far "—and I have admitted that the experience is brief—"is not so much upon the old-age pensioners or even upon the adults whom we know to be living on National Assistance. It is on the children. It is those who we know to be the mothers of large families whom we have found not to be coming to the shop so often as they used to do." And the doctors confirm that tendency.

There is a tendency—there is bound to be—among the mothers of large families, living upon a labourer's wage, in those difficult conditions, to hold back from going to the doctor. As I have said before, one of the greatest benefits of our National Health Service—indeed, the greatest benefit of all—was the way in which it relieved such a mother of anxiety about her children's health. It enabled her to feel that she could freely go to the doctor when her children needed attention, that she could place her difficulties, anxieties and doubts in front of the doctor and get him to deal with them. The onset and the spread of illness have been checked by those means, and the danger is that that will cease.

I said on the Second Reading of the Bill which imposed the charges on the out-patient departments and all the rest, that I thought that this business would end in mess and muddle. I have heard nothing tonight to make me wish to change that forecast. I still believe that it will do so. I believe that evidence is growing of a growing complaint. The volume of complaint has not yet anywhere nearly reached its maximum dimensions. As the weather changes, as we pass into winter, as the onset of disease increases, the number of complaints that even the hon. Member for Putney will get will exceed all his expectations, and he will be very sorry that he was so complacent tonight in the House of Commons.

We have had an exploratory debate in the interests of our constituents. It is unfortunate, perhaps, that our rules about the number of days within which Prayers can be tabled have made it necessary to bring the Prayers on as early as this date. It is a pity that more time could not have been taken to study in some detail the effects of the charges, but such evidence as we have had tonight makes us believe that we were right in the stand that we took against the imposition of these charges.

It has been suggested that some of those who spoke earlier from this side of the House might have been inciting their constituents to break the law. That is certainly not true. That has been denied already, and I think the denial has been accepted. Nothing would be further from our thoughts and intentions than to incite people to break the law. I must, however, warn the right hon. Gentleman and his right hon. Friends that it is extremely difficult to enforce any law which has no moral sanction behind it, and he will find it increasingly difficult as the days pass.

Mr. Edward Heath (Lord Commissioner of the Treasury)

rose in his place, and claimed to move, "That the Question be now put."

Question, That are humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Dental Treatment) Regulations, 1952 (S.I., 1952, No. 1020), dated 23rd May, 1952, a copy of which was laid before this House on 23rd May, be annulled,

put accordingly, and negatived.

Motion made, and Question put, That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Drugs and Appliances) Regulations, 1952 (S.I., 1952, No. 1021), dated 23rd May, 1952, a copy of which was laid before this House on 23rd May, be annulled.—[Mr. Marquand.]

The House divided: Ayes. 235; Noes, 254.

Division No. 188.]	AYES	[11.0 p.m.
Acland, Sir Richard	Corbet, Mrs. Freda	Hall, Rt. Hon. Glenvil (Colne Valley)
Adams, Richard	Craddock, George (Bradford, S.)	Hall, John (Gateshead, W.)
Allen, Sholefield (Crewe)	Crossman, R. H. S.	Hamilton, W. W.
Anderson, Alexander (Motherwell)	Cullen, Mrs. A.	Hannan, W.
Anderson, Frank (Whitehaven)	Daines, P.	Hargreaves, A.
Attlee, Rt. Hon. C. R.	Dalton, Rt. Hon. H.	Hastings, S
Awbery, S. S.	Darling, George (Hillsborough)	Hayman, F H.
Bacon, Miss Alice	Davies, A. Edward (Stoke, N.)	Healey, Denis (Leeds, S. E.)
Baird, J.	Davies, Ernest (Enfield, E.)	'Henderson, Rt. Hon. A. (Rowley Regis)
Balfour, A.	Davies, Harold (Leek)	Herbison, Miss M.
Barnes, Rt. Hon. A. J.	Davies, Stephen (Merthyr)	Hobson, C. R
Bellenger, Rt. Hon. F. J.	de Freitas, Geoffrey	Holman, P
Bence, C. R.	Deer, G.	Holt, A. F.
Benson, G	Delargy, H. J	Houghton, Douglas
Beswick, F.	Dodds, N. N.	Hoy, J. H.
Bevan, Rt. Hon. A (Ebbw Vale)	Donnelly, D. L.	Hubbard, T. F.
Bing, G. H. C.	Driberg, T. E. N	Hudson, James (Ealing, N.)
Blackburn, F.	Dugdale, Rt Hon. John (W. Bromwich)	Hughes, Cledwyn (Anglesey)
Blenkinsop, A.	Ede, Rt. Hon. J. C.	Hughes, Emrys (S. Ayrshire)
Blyton, W. R.	Edwards, Rt. Hon. Ness (Caerphilly)	Hughes, Hector (Aberdeen, N.)
Boardman, H.	Edwards, W. J. (Stepney)	Hynd, H. (Accrington)
Bottomley, Rt. Hon A. G.	Evans, Albert (Islington, S.W.)	Hynd, J. B. (Attercliffe)
Bowen, E. R.	Evans, Edward (Lowestoft)	Irvine, A. J. (Edge Hill)
Bowles, F. G.	Evans. Stanley (Wednesbury)	Irving, W J. (Wood Green)
Braddook, Mrs. Elizabeth	Ewart, R.	Isaacs, Rt. Hon. G A
Brockway, A. F.	Fernyhough, E.	Janner, B
Brook, Dryden (Halifax)	Field, W J.	Jay, Rt. Hon D P T.
Broughton, Dr. A. D. D.	Fienburgh, W.	Jeger, Dr. Santo (St Paneras, S.)
Brawn, Rt. Hon. George (Belper)	Finch, H. J.	Jenkins, R. H. (Stechford)
Brown, Thomas (Ince)	Fletcher, Eric (Islington, E.)	Johnson, James (Rugby)
Burke, W. A.	Follick, M.	Johnston, Douglas (Paisley)
Burton, Miss F. E	Foot, M M	Jones, David (Hartlepool)
Butler, Herbert (Hackney, S.)	Freeman, John (Watford)	Jones, Frederick Elwyn (West Ham, S.)
Callaghan, L. J.	Gaitskell, Rt. Hon. H. T. N.	Jones, Jack (Rotherham)
Carmichael, J.	Gibson, C. W.	Jones, T. W. (Merioneth)
Castle, Mrs. B. A	Gordon Walker, Rt. Hon. P. C	Keenan, W.
Champion, A. J	Grenfell Rt. Hon. D. R.	Kenyon, C
Chapman, W. D.	Grey, C. F.	King, Dr. H. M.
Chetwynd, G. R.	Griffiths, David (Rother Valley)	Lee, Frederick (Newton)
Clunie, J.	Griffiths, Rt. Hon. James (Llanehy)	Lever, Leslie (Ardwick)
Cocks, F. S.	Griffiths, William (Exchange)	Lewis, Arthur
Coldrick, W.	Grimond, J.	Lindgren, G. S.
Collick, P. H.	Hale, Leslie (Oldham, W.)	Logan, D. G.
McGhee, H. G.	Pearson, A.	Taylor, Bernard (Mansfield)
McInnes, J.	Plummer, Sir Leslie	Taylor, John (West Lothian)
McKay, John (Wallsend)	Porter, G.	Taylor, Rt. Hon. Robert (Morpeth)
McLeavy, F.	Price, Joseph T. (Westhoughton)	Thomas, David (Aberdare)
MacMillan, M. K. (Western Isles)	Proctor, W. T.	Thomas, George (Cardiff)
McNeil, Rt. Hon. H.	Pryde, D. J.	Thomas, Iorwerth (Rhondda, W.)
MacPherson, Malcolm (Stirling)	Pursey, Cmdr. H	Thomas, Ivor Owen (Wrekin)
Mainwaring, W. H.	Rankin, John	Turner-Samuels, M
Mann, Mrs. Jean	Reeves, J.	Ungoed-Thomas, Sir Lynn
Manuel, A. C.	Reid, Thomas (Swindon)	Wade, D. W.
Marquand, Rt. Hon. H. A.	Reid, William (Camlachie)	Watkins, T. E.
Mayhew, C. P.	Rhodes, H.	Webb, Rt. Hon. M. (Bradford, C.)
Mellish, R. J.	Roberts, Rt. Hon. A.	Weitzman, D.
Messer, F.	Roberts, Albert (Normanton)	Wells, Percy (Faversham)
Mitchison, G. R.	Roberts, Goronwy (Caernarvonshire)	Wells, William (Walsall)
Monslow, W.	Robinson, Kenneth (St. Pancras, N.)	West, D. G.
Moody, A. S.	Ross, William	White, Mrs. Eirene (E. Flint)
Morgan, Dr. H. B. W.	Royle, C.	White, Henry (Derbyshire, N. E.)
Morley, R.	Schofield, S. (Barnsley)	Whiteley, Rt. Hon. W.
Morris, Percy (Swansea, W.)	Shackleton, E. A. A.	Wigg, George Wilkins, W. A.
Morrison, Rt. Hon. H. (Lewisham, S)	Short, E. W.	Wilkens, W. A.
Mort, D. L.	Shurmer, P. L. E.	Willey, Frederick (Sunderland, N)
Moyle, A.	Silverman, Julius (Erdington)	Willey, Octavius (Cleveland)
Nally, W.	Silverman, Sydney (Nelson)	Williams, Ronald (Wigan)
Neal, Harold (Bolsover)	Simmons, C. J. (Brierley Hill)	Williams, W. R. (Droylsden)
Noel-Baker, Rt. Hon. P. J.	Slater, J.	Williams, W. T. (Hammersmith, S.)
Oldfield, W. H.	Smith, Ellis (Stoke, S.)	Wilson, Rt. Hon. Harold (Huyton)
Oliver, G. H.	Snow, J. W.	Winterbottom, Richard (Brightside)
Orbach, M.	Sorensen, R. W.	Woodburn, Rt. Hon. A
Oswald, T.	Soskice, Rt. Hon. Sir Frank	Wyatt, W. L.
Padley, W. E.	Sparks, J. A.	Yates, V. F.
Paling, Rt. Hon. W (Dearne Valley)	Steele, T	Younger, Rt. Hon. K.
Paling, Will T. (Dewsbury)	Stewart, Michael (Fulham, E)
Pannell, Charles	Strachey, Rt. Hon. J.	TELLERS FOR THE AYES:
Pargiter, G. A.	Stross, Dr. Barnett	Mr. Popplewell and
Parker, J.	Swingler, S. T.	Mr. Horace Holmes.
Paton, J.	Sylvester, G. O.
NOES
Aitken, W. T.	Cole, Norman	Harden, J. R. E.
Allan, R. A. (Paddington, S.)	Colegate, W. A.	Hare, Hon. J. H.
Alport, C J. M.	Conant, Maj. R. J. E.	Harris, Frederic (Croydon, N.)
Amery, Julian (Preston, N.)	Cooper, Sqn. Ldr Albert	Harris, Reader (Heston)
Anstruther-Gray, Major W. J.	Cooper-Key, E. M.	Harrison, Col. J. H. (Eye)
Arbuthnot, John	Craddock, Beresford (Spelthorne)	Harvey, Air Cdre. A. V. (Macclesfield)
Ashton, H. (Chelmsford)	Cranborne, Viscount	Harvey, Ian (Harrow, E.)
Assheton, Rt. Hon. R. (Blackburn, W.)	Crookshank, Capt. Rt. Hon. H F. C.	Harvie-Watt, Sir George
Aster, Hon. W. W. (Bucks, Wycombe)	Crosthwaite-Eyre, Col. O. E.	Heaid, Sir Lionel
Baker, P. A. D.	Crouch, R. F.	Hill, Dr. Charles (Luton)
Baldock, Lt.-Cmdr, J. M.	Crowder, Sir John (Finchlay)	Hill, Mrs. E. (Wythenshawe)
Baldwin, A. E.	Darling, Sir William (Edinburgh, S.)	Hinchingbrooke, Viscount
Banks, Col C.	Davidson, Viscountess	Hirst, Geoffrey
Barber, A. P. L.	De la Bère, Sir Rupert	Holland-Martin, C. J.
Barlow, Sir John	Deedes, W. F.	Hollis, M. C.
Beach, Maj Hicks	Digby, S. Wingfield	Holmes, Sir Stanley (Harwich)
Beamish, Maj. Tufton	Dodds-Parker, A. D.	Hopkhison, Rt. Hon. Henry
Ball, Philip (Bolton, E.)	Donaldson, Cmdr. C. E. McA.	Hornsby-Smith, Miss M. P.
Bennett, F. M. (Reading, N.)	Dormer, P. W.	Horobin, I. M.
Bennett, Sir Peter (Edgbaslon)	Doughty, C. J. A.	Howard, Gerald (Cambridgeshire)
Bennett, William (Woodside)	Drayton, G. B.	Howard, Greville (St. Ives)
Bevins, J. R. (Toxteth)	Duncan, Capt. J. A. L	Hudson, Sir Austin (Lewisham, N.)
Birch, Nigel	Duthie, W. S.	Hudson, W. R. A. (Hull, N.)
Bishop, F. P.	Eccles, Rt. Hon. D. M.	Hulbert, Wing Cmdr. N. J.
Black, C. W.	Elliot, Rt. Hon. W. E	Hutchinson, Sir Geoffrey (Ilford, N.)
Boyd-Carpenter, J. A	Fall, A.	Hutchison, Lt.-Com, Clark (E'b'rgh W.)
Boyle, Sir Edward	Finlay Graeme	Hutchison, James (Scotstoun)
Braine, B. R.	Fisher, Nigel	Hyde, Lt.-Col. H. M.
Braithwaite, Lt.-Cdr. G. (Bristol, N. W.)	Fleetwood-Hesketh, R. F.	Hylton-Foster, H. B. H.
Bromley-Davenport, Lt.-Col. W. H.	Fort, R	Jenkins, Robert (Dulwich)
Brooke, Henry (Hampstead)	Fraser, Sir Ian (Morecambe & Lonsdale)	Jennings, R.
Brooman-White, R. C.	Galbraith, Cmdr. T. D. (Pollok)	Johnson, Eric (Blackley)
Browne, Jack (Govan)	Galbraith, T. G. D. (Hillhead)	Johnson, Howard (Kemptown)
Buchan-Hepburn, Rt. Hon. P. G. T.	Gammans, L. D.	Jones, A. (Hall Green)
Bullard, D. G.	Garner-Evans, E. H.	Joynson-Hicks, Hon. L. W.
Bullus, Wing Commander, E. E.	George, Rt. Hon. Maj. G. Lloyd	Kaberry, D
Burden, F. F. A.	Glyn. Sir Ralph	Keeling, Sir Edward
Carr, Robert (Mitcham)	Godber, J. B.	Kerr, H. W. (Cambridge)
Carson, Hon. E.	Gomme-Dunoan, Col. A.	Lambton, Viscount
Cary, Sir Robert	Gough, C F. H.	Lancaster, Col. C. G.
Channon, H.	Gower, H. R.	Law, Rt. Hon. R. K.
Churchill, Rt. Hon. W. S.	Graham, Sir Fergus	Legge-Bourke, Maj. E. A. H
Clarice, Col. Ralph (East Grinstead)	Grimston, Hon. John (St. Albans)	Legh, P. R. (Petersfield)
Clarke, Brig. Terence (Portsmouth, W.)	Grimston, Sir Robert (Wastbury)	Lennox-Boyd, Rt. Hon. A. T.

Linstead, H. N.	Nugent, G. R. H.	Stevens, G. P.
Lloyd, Rt. Hon. G. (King's Norton)	Oakshott, H. D	Steward, W. A. (Woolwich, W.)
Lloyd, Maj Guy (Renfrew, E.)	Odey, G. W.	Stewart, Henderson (Fife, E.)
Lloyd, Rt. Hon. Selwyn (Wirral)	O'Neill, Rt. Hon. Sir H. (Antrim, N.)	Stoddart-Scott, Col. M.
Lockwood, Lt.-Col. J. C.	Ormsby-Gore, Hon. W. D.	Storey, S
Longden, Gilbert (Herts, S. W.)	Orr, Capt. L. P. S.	Strauss, Henry (Norwich, S.)
Low, A. R. W.	Orr-Ewing, Charles Ian (Hendon, N.)	Stuart, Rt Hon. James (Moray)
Lucas, Sir Jocelyn (Portsmouth, S.)	Osborne, C.	Summers, G. S.
Lucas, P. B. (Brentford)	Partridge, E.	Sutcliffe, H.
Lucas-Tooth, Sir Hugh	Peake, Rt. Hon. O.	Taylor, William (Bradford, N.)
McAdden, S. J.	Perkins, W. R. D.	Teeling, W
Macdonald, Sir Peter (I. of Wight)	Peyton, J W. W.	Thomas, Rt. Hon J. P. L. (Hereford)
Mackeson, Brig. H. R.	Pickthorn, K. W. M.	Thompson, Kenneth (Walton)
McKibbin, A. J.	Pilkington, Capt. R. A	Thompson, Lt.-Cdr. R. (Croydon, W.)
McKie, J. H. (Galloway)	Pitman, I. J.	Thorneycroft, Rt. Hn. Peter (Monmouth)
Maclay, Rt. Hon. John	Powell, J. Enoch	Thomton-Kemsley, Col. C. N
MacLeod, Rt. Hon. Iain (Enfield, W.)	Price, Henry (Lewisham, W.)	Tilney, John
MacLeod, John (Ross and Cromarty)	Prior-Palmer, Brig. O. L.	Touche, Sir Gordon
Macmillan, Rt. Hon. Harold (Bromley)	Profumo, J. D.	Turner, H. F. L.
Macpherson, Maj. Niall (Dumfries)	Raikes, H, V.	Turton, R. H.
Maitland, Patrick (Lanark)	Redmayne, M.	Tweedsmuir, Lady
Manningham-Buller, Sir R. E	Ronton, D. L. M.	Vane, W. M. F.
Markham, Major S. F.	Roberts, Peter (Heeley)	Vaughan-Morgan, J. K
Marlowe, A. A. H.	Robinson, Roland (Blackpool, S.)	Vosper, D. F.
Marples, A. E.	Robson-Brown, W.	Wakefield, Edward (Derbyshire, W.)
Marshall, Douglas (Bodmin)	Rodgers, John (Sevenoaks)	Walker-Smith, D. C.
Marshall, Sir Sidney (Sutton)	Roper, Sir Harold	Ward, Hon George (Worcester)
Maude, Angus	Russell, R. S.	Ward, Miss I. (Tynemouth)
Maudiing, R.	Ryder, Capt. R. E. D.	Waterhouse, Capt. Rt. Hon. C.
Maydon, Lt.-Cmdr S. L. C	Salter, Rt. Hon. Sir Arthur	Webbe, Sir H. (London & Westminster)
Medlicott, Brig. F.	Schofield, Lt.-Col. W. (Rochdale)	Wellwood, W.
Mellor, Sir John	Scott-Miller, Cmdr. R.	White, Baker (Canterbury)
Molson, A. H. E.	Shepherd, William	Williams, Rt. Hon. Charles (Torquay)
Monckton, Rt. Hon. Sir Walter	Simon, J. E. S. (Middlesbrough, W.)	Williams, Gerald (Tonbridge)
Morrison, John (Salisbury)	Smiles, Lt.-Col. Sir Walter	Williams, R. Dudley (Exeter)
Molt-Radclyffe, C E.	Smithers, Peter (Winchester)	Wills, G.
Nabarro, G. D. N.	Smithers, Sir Waldron (Orpington)	Wilson, Geoffrey (Truro)
Nicholls, Harmar	Snadden, W McN	Wood, Hon. R.
Nicholson, Godfrey (Farnham)	Soames, Capt. C.
Nicolson, Nigel (Bournemouth, E.)	Spearman, A. C M	TELLERS FOR THE NOES:
Nield, Basil (Chester)	Speir, R M.	Mr. Butcher and
Noble, Cmdr. A. H. P	Spence, H. R. (Aberdeenshire, W.)	Mr. Edward Heath.

Question, "That the Question be now put," put, and agreed to.

Motion made, and Question put, That an humble Address be presented to Her Majesty, praying that the National Health Service (Hospital Charges for Drugs and Appliances) (Scotland) Regulations, 1952 (S.I.,

1952, No. 1025), dated 23rd May, 1952, a copy of which was laid before this House on 23rd May, be annulled.—[Mr. Marquatud.]

The House divided: Ayes, 233; Noes, 251.

Division No. 189.]	AYES	[11.10 p.m.
Acland, Sir Richard	Burton, Miss F. E.	Edwards, W. J. (Stepney)
Adams, Richard	Butler, Herbert (Hackney, S.)	Evans, Albert (Islington, S. W.)
Allen, Scholefield (Crewe)	Callaghan, L. J.	Evans, Edward (Lowestoft)
Anderson, Alexander (Motherwell)	Carmichael, J.	Evans, Stanley (Wednesbury)
Anderson, Frank (Whitehaven)	Castle, Mrs. B. A.	Ewart, R.
Attlee, Rt. Hon. C. R.	Champion, A J.	Fernyhough, E.
Awbery, S. S.	Chapman, W. D.	Field, W. J.
Bacon, Miss Alice	Chetwynd, G. R	Fienburgh, W.
Baird, J.	Clunie, J.	Finch, H. J.
Balfour, A.	Cocks, F. S	Fletcher, Eric (Islington, E.)
Barnes, Rt. Hon A. J.	Coldrick, W.	Follick, M.
Bellenger, Rt. Hon. F. J.	Collick, P. H.	Foot, M. M.
Bence, C. R.	Corbet, Mrs. Freda	Freeman, John (Watford)
Benson, G.	Craddock, George (Bradford, S.)	Gaitskell, Rt. Hon H. T. N.
Beswick, F.	Crossman, R. H S.	Gibson, C. W.
Bevan, Rt. Hon. A. (Ebbw Vale)	Daines, P.	Gordon Walker, Rt. Hon. P. C
Bing, G. H. G.	Dalton, Rt. Hon. H.	Grenfell, Rt. Hon. D. R.
Blackburn, F.	Darling, George (Hillsborough)	Grey, C. F.
Blenkinsop, A.	Davies, A. Edward (Stoke, N.)	Griffiths, David (Rother Valley)
Blyton, W. R.	Davies, Ernest (Enfield, E.)	Griffiths, Rt. Hon. James (Llanelly)
Boardman, H.	Davies, Harold (Leek)	Griffiths, William (Exchange)
Bottomley, Rt. Hon. A. G.	Davies, Stephen (Merthyr)	Grimond, J.
Bowen, E. R.	de Freitas, Geoffrey	Hale, Leslie (Oldham, W.)
Bowles, F. G.	Deer, G.	Hall, Rt. Hon. Glenvil (Colne Valley)
Braddock, Mrs. Elizabeth	Delargy, H. J	Hall, John (Gateshead, W.)
Brockway, A. F.	Dodds, N. N.	Hamilton, W. W.
Brook, Dryden (Halifax)	Donnelly, D. L.	Hannan, W.
Broughton, Dr. A. D. D.	Driberg, T. E. N.	Hargreaves, A.
Brown, Rt. Hon. George (Belper)	Dugdale, Rt. Hon. John (W. Bromwich)	Hastings, S.
Brown, Thomas (Ince)	Ede, Rt. Hon. J. C.	Hayman, F. H.
Burke, W. A.	Edwards, Rt. Hon. Ness (Caerphilly)	Healey, Denis (Leeds, S.E.)
Henderson, Rt. Hon. A. (Rowley Regis)	Mitchison, G. R	Slater, J.
Herbison, Miss M.	Monslow, W.	Smith, Ellis (Stoke, S.)
Hobson, C. R.	Moody, A S.	Snow, J. W.
Holman, P.	Morgan, Dr. H. B. W	Sorensen, R. W.
Holt, A. F.	Morley, R	Soskice, Rt. Hon. Sir Frank
Houghton, Douglas	Morris, Percy (Swansea, W.)	Sparks, J. A.
Hoy, J. H.	Morrison, Rt. Hon. H. (Lewisham, S.)	Steele, T.
Hubbard, T. F.	Mort, D. L	Stewart, Michael (Fulham, E.)
Hudson, James (Ealing, N.)	Moyle, A.	Strachey, Rt. Hon. J.
Hughes, Cledwyn (Anglesey)	Nally, W.	Stross, Dr. Barnett
Hughes, Emrys (S. Ayrshire)	Neal, Harold (Bolsover)	Swingler, S, T.
Hughes. Hector (Aberdeen, N.)	Noel-Baker, Rt. Hon. P. J	Sylvester, G. O.
Hynd, H. (Accrington)	Oldfield, W. H.	Taylor, Bernard (Mansfield)
Hynd, J. B. (Attercliffe)	Oliver, G. H.	Taylor, John (West Lothian)
Irvine, A. J. (Edge Hill)	Orbach, M.	Taylor, Rt. Hon. Robert (Morpeth)
Irving, W J. (Wood Green)	Oswald, T.	Thomas, David (Aberdare)
Isaacs, Rt. Hon. G. A.	Padley, W. E.	Thomas, George (Cardiff)
Janner, B.	Paling, Rt. Hon. W. (Dearne Valley)	Thomas, Iorwerth (Rhondda, W.)
Jay, Rt. Hon. D. P. T.	Paling, Will T. (Dewsbury)	Thomas, Ivor Owen (Wrekin)
Jeger, Dr. Santo (St. Pancras, S.)	Pannell, Charles	Turner-Samuels, M.
Jenkins, R. H. (Stechford)	Pargiter, G. A.	Ungoed-Thomas, Sir Lynn
Johnson, James (Rugby)	Parker, J.	Wade, D. W.
Johnston, Douglas (Paisley)	Paton, J.	Watkins, T. E.
Jones, David (Hartlepool)	Pearson, A.	Webb, Rt. Hon. M (Bradford, C)
Jones, Frederick Elwyn (West Ham, S.)	Plummer, Sir Leslie	Weitzman, D.
Jones, Jack (Rolherham)	Porter, G.	Wells, Percy (Faversham)
Jones, T. W. (Merioneth)	Price, Joseph T. (Westhoughton)	Wells, William (Walsall)
Keenan, W.	Proctor, W. T.	West, D. G.
Kenyon, C.	Pryde, D. J.	White, Mrs. Eirene (E. Flint)
King, Dr. H. M.	Pursey, Cmdr. H.	White, Henry (Derbyshire, N. E.)
Lee, Frederick (Newton)	Rankin, John	Whiteley, Rt. Hon. W.
Lever, Leslie (Ardwick)	Reeves, J.	Wigg, George
Lewis, Arthur	Reid, Thomas (Swindon)	Wilkins, W. A.
Lindgren, G. S.	Reid, William (Camlachie)	Willey, Frederick (Sunderland, N)
Logan, D. G.	Rhodes, H.	Willey, Octavius (Cleveland)
McGhee, H. G.	Robens, Rt. Hon. A.	Williams, Ronald (Wigan)
McInnes, J.	Roberts, Albert (Normanton)	Williams, W. R. (Droylsden)
McKay, John (Wallsend)	Roberts, Goronwy (Caernarvonshire)	Williams, W. T. (Hammersmith, S.)
McLeavy, F.	Robinson, Kenneth (St. Pancras, N.)	Wilson, Rt. Hon. Harold (Huyton)
McNeil, Rt. Hon. H.	Ross, William	Winterbottom, Richard (Brightside)
MacPherson, Malcolm (Stirling)	Royle, C.	Woodburn, Rt. Hon. A
Mainwaring, W. H.	Schofield, S. (Barnsley)	Wyatt W. L.
Mann, Mrs Jean	Shackleton, E. A. A	Yates, V F.
Manuel, A. C.	Short, E. W	Younger, Rt. Hon K.
Marquand, Rt. Hon. H. A.	Shurmer, P. L. E.
Mayhew, C. P.	Silverman, Julius (Erdington)	TELLERS FOR THE AYES:
Mellish, R. J.	Silverman, Sydney (Nelson)	Mr. Popplewell and
Messer, F.	Simmons, C. J. (Brierley Hill)	Mr. Horace Holmes.
NOES
Aitken, W. T.	Buchan-Hepburn, Rt. Hon. P. G T.	Duthie, W. S.
Allan, R. A. (Paddington, S.)	Bullard, D. G.	Eccles, Rt. Hon. D. M.
Alport, C. J. M.	Bullus, Wing Commander E. E.	Elliot, Rt. Hon. W. E
Amery, Julian (Preston, N.)	Burden, F. F. A.	Fell, A.
Anstruther-Gray, Major W. J.	Butcher, H. W.	Finlay, Graeme
Arbuthnot, John	Carr, Robert (Mitcham)	Fisher, Nigel
Ashton, H. (Chelmsford)	Carson, Hon. E.	Fleetwood-Hesketh, R. F
Assheton, Rt. Hon. R. (Blackburn, W.)	Cary, Sir Robert	Fort, R.
Astor, Hon. W. W. (Bucks, Wycombe)	Channon, H.	Fraser, Sir Ian (Morecambe & Lonsdale)
Baker, P. A. D.	Churchill, Rt. Hon. W. S.	Galbraith, Cmdr. T D. (Pollok)
Baldock, Lt.-Cmdr. J. M.	Clarke, Col, Ralph (East Grinstead)	Galbraith, T. G. D. (Hillhead)
Baldwin, A. E.	Clarke, Brig. Terence (Portsmouth, W.)	Gammans, L. D.
Banks, Col. C.	Cole, Norman	Garner-Evans, E H
Barber, Anthony	Colegate, W. A.	George, Rt. Hon. Maj G. Lloyd
Barlow, Sir John	Cooper, Sqn. Ldr. Albert	Glyn, Sir Ralph
Beach, Maj. Hicks	Cooper-Key, E. M.	Godber, J. B.
Beamish, Maj. Tufton	Craddock, Beresford (Spelthorne)	Gomme-Duncan, Col. A
Bell, Philip (Bolton, E.)	Cranborne, Viscount	Gough. C F. H.
Bennett, F. M. (Reading, N.)	Crookshank, Capt. Rt. Hon H. F. C	Gower, H. R.
Bennett, Sir Peter (Edgbaston)	Crosthwaite-Eyre, Col. O. E.	Graham, Sir Fergus
Bennett, William (Woodside)	Crouch, R. F.	Grimston, Hon. John (St. Albans)
Bevins, J. R. (Toxteth)	Crowder, Sir John (Finchley)	Grimston, Sir Robert (Westbury)
Birch, Nigel	Darling, Sir William (Edinburgh, S.)	Harden, J. R. E.
Bishop, F. P.	Davidson, Viscountess	Hare, Hon. J. H.
Black, C. W.	Do la Bère, Sir Rupert	Harris, Frederic (Croydon, N.)
Boyd-Carpenter, J. A	Deedes, W. F.	Harris, Reader (Heston)
Boyle, Sir Edward	Digby, S. Wingfield	Harrison, Col. J. H. (Eye)
Braine, B. R.	Dodds-Parker, A. D.	Harvey, Air Cdre. A. V. (Macclesfield)
Braithwaite, Lt.-Cdr. G. (Bristol, N.W.)	Donaldson, Cmdr. C. E. McA	Harvey, Ian (Harrow, E.)
Bromley-Davenport, Lt.-Col. W. H.	Donner, P. W.	Harvie-Watt, Sir George
Brooke, Henry (Hampstead)	Doughty, C. J. A	Heald, Sir Lionel
Brooman-White, R. C.	Drayson, G. B.	Heath, Edward
Browne, Jack (Govan)	Duncan, Capt. J. A. L.	Hill, Dr. Charles (Luton)

Hill, Mrs. E. (Wythenshawe)	Macpherson, Maj. Niall (Dumfries)	Schofield, Lt.-Col W. (Rochdale)
Hinchingbrooke, Viscount	Maitland, Patrick (Lanark)	Scott-Miller, Cmdr. R
Hirst, Geoffrey	Manningham-Buller, Sir R. E	Shepherd, William
Holland-Martin, C. J.	Markham, Major S. F.	Simon, J. E. S. (Middlesbrough, W)
Hollis, M. C.	Marlowe, A. A H.	Smiles, Lt.-Col. Sir Walter
Holmes, Sir Stanley (Harwich)	Marples, A. E.	Smithers, Peter (Winchester)
Hopkinson, Rt. Hon. Henry	Marshall, Douglas (Bodmin)	Smithers, Sir Waldron (Orpington)
Hornsby-Smith, Miss M. P.	Marshall, Sir Sidney (Sutton)	Snadden, W. McN.
Horobin, I. M.	Maude, Angus	Soames, Capt. C.
Howard, Gerald (Cambridgeshire)	Maudling, R.	Spearman, A C. M.
Howard, Greville (St. Ives)	Maydon, Lt.-Comdr. S. L. C.	Speir, R. M.
Hudson, Sir Austin (Lewisham, N.)	Medlicott, Brig. F.	Spence, H. R. (Aberdeenshire, W.)
Hudson, W. R. A. (Hull, N.)	Mellor, Sir John	Stevens, G. P
Hulbert, Wing Cmdr. N. J.	Molson, A. H. E.	Steward, W. A. (Woolwich, W.)
Hutchinson, Sir Geoffrey (Ilford, N.)	Monckton, Rt. Hon. Sir Waller	Stewart, Henderson (Fife, E.)
Hutchison, Lt.-Com. Clark (E'b'rgh W.)	Morrison, John (Salisbury)	Stoddart-Scott, Col, M
Hutchison, James (Scotstoun)	Mott-Radclyffe, C. E.	Storey, S.
Hyde, Lt.-Col, H. M.	Nabarro, G. D. N.	Strauss, Henry (Norwich, S.)
Hylton-Foster, H. B. H.	Nicholls, Harmar	Stuart, Rt. Hon. James (Moray)
Jenkins, Robert (Dulwich)	Nicholson, Godfrey (Farnham)	Summers, G. S.
Johnson, Eric (Blackley)	Nicolson, Nigel (Bournemouth, E)	Sutcliffe, H.
Johnson, Howard (Kemptown)	Nield, Basil (Chester)	Taylor, William (Bradford, N.)
Jones, A. (Hall Green)	Noble, Cmdr. A. H. P.	Thomas, Rt. Hon. J. P. L. (Hereford)
Joynson-Hicks, Hon. L. W.	Nugent, G. R. H.	Thompson, Kenneth (Walton)
Kaberry, D.	Oakshott, H. D.	Thompson, Lf.-Cdr. R. (Croydon, W.)
Keeling, Sir Edward	Odey, G. W.	Thorneycroft, Rt. Hn. Peter (Monmouth)
Kerr, H. W. (Cambridge)	O'Neill, Rt. Hon. Sir H. (Antrim, N.)	Thornton-Kemsley, Col. C. N.
Lambton, Viscount	Ormsby-Gore, Hon. W. D.	Tilney, John
Lancaster, Col. C. G.	Orr, Capt. L. P. S.	Touche, Sir Gordon
Law, Rt. Hon. R. K.	Orr-Ewing, Charles Ian (Hendon, N.)	Turner, H. F. L.
Legge-Bourke, Maj. E. A. H	Osborne, C.	Turton, R. H.
Legh, P. R. (Petersfield)	Partridge, E.	Tweedsmuir, Lady
Lennox-Boyd, Rt. Hon. A. T.	Peake, Rt. Hon. O.	Vane, W. M. F,
Linslead, H. N.	Perkins, W. R. D.	Vaughan-Morgan, J. K.
Lloyd, Rt. Hon. G. (King's Norton)	Peyton, J. W. W.	Wakefield, Edward (Derbyshire, W.)
Lloyd, Maj. Guy (Renfrew, E.)	Pickthorn, K. W. M.	Walker-Smith, D. C.
Lloyd, Rt. Hon. Selwyn (Wirral)	Pilkington, Capt. R. A.	Ward, Hon. George (Worcester)
Lockwood, Lt.-Col. J. C.	Pitman, I. J.	Ward, Miss I. (Tynemouth)
Longden, Gilbert (Herts, S. W.)	Powell, J. Enoch	Waterhouse, Capt Rt. Hon. C.
Low, A. R. W.	Price, Henry (Lewisham, W.)	Webbe, Sir H. (London & Westminster)
Lucas, Sir Jocelyn (Portsmouth, S.)	Prior-Palmer, Brig O. L.	Weliwood, W.
Lucas, P. B. (Brentford)	Profumo, J. D.	White, Baker (Canterbury)
Lucas-Tooth, Sir Hugh	Raikes, H. V.	Williams, Rt, Hon. Charles (Torquay)
McAdden, S. J.	Redmayne, M.	Williams, Gerald (Tonbridge)
Macdonald, Sir Peter (I. of Wight)	Renton, D. L. M.	Williams, R. Dudley (Exeter)
Mackeson, Brig. H. R.	Roberts, Peter (Heeley)	Wills, G.
McKibbin, A. J.	Robinson, Roland (Blackpool, S.)	Wilson, Geoffrey (Truro)
McKie, J. H. (Galloway)	Robson-Brown, W.	Wood, Hon. R
Maclay, Rt. Hon. John	Rodgers, John (Sevenoaks)
Macleod, Rt. Hon. Iain (Enfield, W.)	Roper, Sir Harold	TELLERS FOR THE NOES:
MacLeod, John (Ross and Cromarty)	Russell, R. S.	Major Conant and Mr. Vosper.
Macmillan, Rt. Hon. Harold (Bromley)	Salter, Rt. Hon. Sir Arthur

Motion made, and Question, That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Drugs and Appliances) (Scotland) Regulations, 1952 (S.I., 1952, No. 1026), dated 23rd May, 1952, a copy of which was laid before this House on 23rd May, be annulled.—[Mr. McNeil.]

put, and negatived.

Motion made, and Question, That an humble Address be presented to Her Majesty, praying that the National Health Service (General Dental Services Charges) (Scotland) Regulations, 1952 (S.I., 1952, No. 1027), dated 23rd May, 1952, a copy of which was laid before this House on 23rd May, be annulled.—[Mr. McNeil.]

put, and negatived.

Motion made, and Question, That an humble Address be presented to Her Majesty, praying that the National Health Service (Charges for Hospital Accommodation) (Scotland) Regulations, 1952 (S.I., 1952, No. 1028), dated 23rd May, 1952, a copy of which was laid before this House on 23rd May, be annulled.—[Mr. McNeil.]

put, and negatived.