HL Deb 23 October 1946 vol 143 cc640-5

Constitution of Central Council.

1. The number of members of the Central Council shall be forty-one of whom six shall be persons for the time being holding the offices of the President of the Royal College of Physicians of London, the President of the Royal College of Surgeons of England, the President of the Royal College of Obstetricians and Gynaecologists, the Chairman of the Council of the British Medical Association, the President of the General Medical Council and the Chairman of the Council of the Society of Medical Officers of Health, respectively; and of the remaining thirty-five members, who shall be appointed by the Minister,—

5.52 p.m.

LORD ADDINGTON moved, in paragraph 1, to leave out "forty-one of whom six shall be the persons for the time being holding the offices of the" and insert "forty-two, of whom seven shall be persons for the time being holding the offices of the Chairman of the Council of the Association of Municipal Corporations, the". The noble Lord said: This is an attempt to provide that there should be direct representation of the local health authorities on the Central Council. These authorities have a place and a responsibility in the affairs of the Council which seem to justify my submission for ex officio representation no less than that which has been given to some of the other bodies mentioned in the paragraph. While the Society of Medical Officers of Health have ex officio representation it is some what anomalous that the bodies whom there serve, and to whom they are responsible for carrying out their duties, have not been accorded the same privilege. If there is a case for giving ex officio representation to the societies mentioned in the paragraph, there is no less a case for the inclusion of the local health authorities. I have referred only to the municipal corporations in this Amendment, but if it would be acceptable I should be quite ready, after consultation, to add county councils and other bodies concerned.

Amendment moved— Page 63, line 5, leave out from ("be") to ("President") in line 7, and insert the said new words.—(Lord Addington.)

THE EARL OF LISTOWEL

I am sure the noble Lord will agree that the local health authorities are going to be directly represented on the Minister's Central Council. In the First Schedule, to which he moves this Amendment, subsection (c) of paragraph 1 reads: five shall be persons not being medical practitioners with experience in local government. What the noble Lord is proposing in his Amendment is to include among the ex officio members of the Central Health Service Council the Chairman of the Council of the Association of Municipal Corporations.

LORD ADDINGTON

That is the point of my Amendment.

THE EARL OF LISTOWEL

Let me, if I may, put this point in reply. No doubt the Chairman of the Council of the Association of Municipal Corporations would be an eminently appropriate member of the Council. There is no question of that at all, and of course he would attend as representative of those whose experience is based on local government mentioned in paragraph 1 (a) of the Schedule but surely he should be included among the five members to whom I have already alluded, and not as an additional ex officio member. I really think there are strong objections to adding to the representation of the local authorities in this way. In the first place, your Lordships will have noticed the Central Council is to be regarded primarily as an expert professional group of advisers representative of doctors, dentists, nurses, etc. In the second place, I think your Lordships will agree that any alteration in the composition of the Central Council will upset a very carefully balanced body in which all the different elements have been designed in relation to the bodies they represent. Finally, it seems perfectly clear, and in deed the noble Lord in his speech suggested it, that alterations in one direction can only lead to a demand for alterations in another. That, of course, would still further upset the balance and increase the size of a body which I think is about right at the moment. I very much hope that the presence of this eminent gentleman in local government may be secured in the way that I have suggested.

LORD ADDINGTON

I understand there is a possibility that this gentleman and the most responsible people in local authorities will be among those chosen. I am willing to withdraw the amendment.

Amendment, by leave, withdrawn.

5.58 p.m.

LORD WOLVERTON moved, in paragraph 1, to substitute "forty-two" for "forty-one" The noble Lord said: On behalf of my noble friend Lord Teviot who cannot be here, I beg to move this Amendment. If I may, I would like to move his Amendments as one because if this is not accepted it does not mean we do not need the others. The object of the Amendment is to secure representation of the dental profession on the Central Council of the Minister. We think it is very necessary that the Chairman of the Dental Board should be a member of that Central Council. The noble and learned Lord Chancellor in an admirable speech in the Second Reading debate pointed out that Clause 1 states: It shall be the duty of the Minister of Health … to promote the establishment in England and Wales of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales and the prevention, diagnosis and treatment of illness, and for that purpose to provide or secure the effective provision of services in accordance with the following provisions of this Act.

We all agree with that. When it was discussed in another place the Minister, in Standing Committee on the nineteenth day of proceedings, said: "I earnestly hope in this Committee there will be no auctioning of seats in this Council." We do not think on this side of the House that it is asking for the auctioning of seats if you have got the President of the College of Physicians, the President of the Royal College of Surgeons of England, and the Chairman of the Council of the British Medical Association, and we do think it is a very important thing that the President of the Dental Board who, after all, is a very important man, should be on this Council. The teeth of this nation are not nearly as good as they should be. I think it is admitted they are not as good as in the United States. If we want to improve them it is important the Dental Board should be allowed to have direct representation on this Central Council of the Minister. I beg to move.

Amendment moved— Page 63, line 5, leave out ("forty-one") and insert ("forty-two").—(Lord Wolver ton.)

THE EARL OF LISTOWEL

I think it is perfectly simple to satisfy the desire of the noble Lord opposite that the Chairman of the Dental Board should be one of the representatives of the dental profession on the Central Council. The noble Lord will have observed that among those who will be appointed to sit by the people whom they represent on the Central Council will be three dental practitioners. That is sub-paragraph (d) of paragraph 1 of the First Schedule. It will be quite open to the Chairman of the Dental Board to be included in that way if he and his colleagues so desire. What the noble Lord wants in his Amendment is to add three more dental representatives to the Central Council. However, as I have already said, the constitution of the Council has been carefully worked out so as to provide adequate representation of all the interests that should sit there, and also so as to give a majority of medical members.

LORD WOLVERTON

I would like to say one thing. There is a misprint in the paper. It says: "Page 63, line 5, leave out 'forty-one,' and insert 'forty-four'." That should be "insert 'forty-two')." Has that been rectified?

THE EARL OF LISTOWEL

I have not got it.

LORD WOLVERTON

It is a misprint. That should be "forty-two." We want to add one more.

THE EARL OF LISTOWEL

I see what the noble Lord wants. He only wants to increase the representation of the dentists by one and not three.

LORD WOLVERTON

Yes.

THE EARL OF LISTOWEL

I will gladly discuss it on that basis. If, as the noble Lord desires, the Chairman of the Dental Board were added in addition to the representation already provided for in the Schedule the medical proportion would certainly expect to have an additional member to swell their representation. I am afraid it is quite impossible, as has already been shown by the terms of the noble Lord, Lord Addington's Amendment, to satisfy everyone's desire for what they consider to be adequate representation without making the Council much too unwieldy a body. However, I hope this may be some consolation to the noble Lord, and to the noble Lord, Lord Teviot. It is the Minister's intention to have a standing advisory committee on dentistry to be constituted under Clause 2, subsection (3) of the Bill. On this Committee, of course, dentists will be fully represented, and the Chairman of the Dental Board could also be a member of the committee if he and his colleagues so desire. I can assure the noble Lord—and I think this was a point which the noble Lord, Lord Teviot, had in mind, although it was not mentioned by the noble Lord opposite—that of the three dental practitioners to be appointed to the Central Council under the Schedule one will be a dentist of the 1921 class, if that is in accordance with the views of his professional colleagues. The noble Lord has put these Amendments together—I am very glad he did so—and he will have noticed that one of the objects of the noble Lord, Lord Teviot, was to get a dentist of this class included in the representation.

LORD WOLVERTON

I understand that.

THE EARL OF MUNSTER

I fully agree with the noble Earl that the Central Council should be a very carefully balanced body, but when all is said and done the dentists are a very important element in the whole of the medical life of this country. I should have thought myself that after having included the president and the chairman of the six principal associations in this country, in view of the work that dentists are going to be called upon to undertake under this Act, it might have been possible for the Minister in the first place to include the Chairman of the Dental Board. I think it is a great pity that the dentists should be in a small minority on the central Council. There is a great demand for more dentists, as the noble and learned Lord, the Lord Chancellor, has pointed out on previous occasions during our discussions on this Bill, and I think it is a mistake to exclude the Chairman of the Dental Board from this central council.

THE EARL OF LISTOWEL

He will not be excluded.

THE EARL OF MUNSTER

He is not on it.

LORD WOLVERTON

I must say I am not at all satisfied. I am moving this Amendment on behalf of the noble Lord, Lord Teviot, and I do not know what he would have done in the circumstances. I do not know whether the Minister can give me any assurance that he will look into it between now and the next stage, but if not I beg leave to withdraw.

Amendment, by leave, withdrawn.

First Schedule agreed to.

Second Schedule agreed to.

Third Schedule:

REGIONAL HOSPITAL BOARDS, HOSPITAL MANAGEMENT COMMITTEES AND BOARDS OF GOVERNORS OF TEACHING HOSPITALS.

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