HC Deb 21 July 1913 vol 55 cc1816-21

Resolution reported, That it is expedient to make provision for improving Medical Service in the Highlands and Islands of Scotland, and for other purposes connected therewith, and to authorise for those purposes the payment out of moneys to be provided by Parliament of—

  1. (a) a Special Grant to be called the Highlands and Islands (Medical Service) Grant; and
  2. (b) the salaries or remuneration of the secretary and of the officers and servants of a Board, to be called the Highlands and Islands (Medical Service) Board, and of any expenses incurred by the Board in the execution of their duties."

Motion made, and Question proposed, "That this House doth agree with the Committee in the said Resolution."— [Mr. McKinnon Wood. ]


My hon. Friend the Member for West Aberdeenshire (Mr. J. M. Henderson) has a point which he wishes to raise upon this Resolution, and while he is getting his references ready he has given way to me in order that I may put a point with regard to a question of order. The Secretary for Scotland pointed out that the words "medical service" were fairly broad and would entitle the Committee in apportioning this money to apportion it us they thought fit, subject only to this limitation. I do not challenge that, but my right hon. Friend went further and said that the Committee would have power to define "Highlands and Islands." The suggestion was made in Committee that a district remote from the Highlands could be included if the Committee so wished. I do not take that view. My own view is quite clear, that if any town remote from the Highlands were included it would need another Financial Resolution. I understand the difficulty to be that there is no statutory boundary for the Highlands and Islands, but there is a common interpretation of that term which would be accepted as a rule by most of the inhabitants of Scotland. I am only concerned in the question from the point of view of order. If it were interpreted by the Committee to include a distant town merely at the whim of the Committee, that would besetting a precedent. I only say that in order to protect our rights. Dealing with this idea in a special way to my mind is one proof of the wisdom of this House in appointing separate National Commissioners. If there had not been a separate Commissioner appointed for Scotland, I do not think this idea would have been brought into vogue. It was because local men were dealing with local problems that they saw that the distribution of medical service in the Highlands and Islands needed special treatment.


The difficulty here is the definition of what are Highlands and Islands. I have looked in vain for any statutory definition of that term. There has been an idea that it applied to the crofter counties, but that hardly obtains in this case, because the Commissioners have gone beyond the crofter counties and included the Highlands of Perth. I represent one of the most Highland places in the whole of Great Britain, and I want to know that I shall not be precluded in Committee from asking that these other Highland places may be included. The Education Trust for the Highlands and Islands under the Education Endowment Act of 1882 includes not only the crofter counties, but the districts which I propose should also be included. In passing this Resolution, I should like to stipulate that I am not debarred from seeking to add the other Highland districts, which can be shown to be as necessitous for this additional assistance as those which are enumerated in the Dewar Report. If I am assured that I am not debarred by a technicality from moving this, I have no objection to the Resolution.

The SECRETARY for SCOTLAND (Mr. McKinnon Wood)

The position is this. Tile Treasury, finding a considerable difficulty in the medical service for the Highlands and Islands in connection with the Insurance Act appointed a Committee which decided on suggesting the inclusion of certain districts in Scotland in the term Highlands and Islands. There is no statutory definition of Highlands and Islands, but there is a definition of crofters' counties and, of course, it is a question whether this might not have been confined to the crofter counties. However, the Committee decided to include the Highlands of Perthshire and some other districts of Perthshire in their recommendations and, of course, it will be open to them in my judgment either to exclude some of the places which are suggested or to include other places which were not suggested by the Committee. I think it will be convenient probably to take as the basis of our discussion the districts which were recommended by the Committee, but I do not think my hon. Friend need have any fear that it would be impossible for him to ask that certain districts ought not to be excluded in the term, or even that certain other districts ought not to be included.


I join with the hon. Member (Mr. J. M. Henderson) in protesting against the inclusion of the Highlands of Perthshire in this Resolution. His constituency, like others in Scotland, has as much difficulty in securing medical attendance and a share of this money as Perthshire. There is a definition of Highlands and Islands which has been well known in Scotland for some twenty years. The Committee recommended that Perthshire should be added for this purpose. the characteristics of parts of my hon. Friend's constituency are quite the same in inaccessibility as Perthshire and why his constituents should be excluded from a share of this money one is unable to understand. I hope the Secretary for Scotland will not exclude that district when he comes to consider the matter in Committee. If you take in Perthshire there are other districts in Scotland which should get a share of the money.


I remember in the discussions on the Scottish Small Landholders Bill it was frequently pointed out that the Highlands and Islands were not confined to the Northern districts, and that there were Highlands in the South of Scotland in which the conditions were very similar to those in the North. Are we to understand that the Secretary for Scotland, with regard to the area to which this Grant is to apply has so far an open mind on the subject and that when we come to it in Committee he will not resist., on the matter of form, the inclusion of districts in the South, say, the South of Lanarkshire or Dumfriesshire, or Kirkcudbrightshire, or Galloway, where you have real Highland districts as isolated and as remote from medical aid as any portion of the Highlands. Are we to understand that the Secretary for Scotland will not resist these on the question of form, but that he will be willing to consider the inclusion of each of these particular places on their merits?


I think my hon. Friend's appeal should have received a more favourable response than the derision with which it was treated by the Secretary for Scotland. Those who know something of Scotland know that there are districts in the South which are very similar to those which are receiving consideration under the Resolution which we are now discussing. There are districts of an isolated character remote from railways where the conditions with reference to medical attendance are as difficult as in parts of the Highlands and Islands which are included in the reference to the Committee of the hon. Baronet the Member for Inverness-shire (Sir J. Dewar). My hon. Friend the Member for South Lanarkshire (Sir W. Menzies) has told me—and my own knowledge of that part of the county enables me to bear out what he says—that in the part of Lanarkshire which he represents there are many districts where the difficulties in regard to medical treatment deserve as much consideration as has been given in the case of the districts dealt with in the Report of the Committee. But these conditions are not confined to Lanarkshire. There are, for example, districts on the borders of East Lothian and Berwickshire, the district of the Lammermoor Hills, where there is no railway communication. We must consider the matter very largely in relation to railway communication, because where there is railway communication, there need be no difficulty in administering medical benefit under the Act. I only rose, because apparently when my hon. Friend the Member for the Bridgeton Division mentioned the necessity in other parts of Scotland, it was only a subject for derision. I hope, however, other Members representing Scottish constituencies, even although they happen to be Members of the Government, will, when the Bill comes before the Committee, consider the matter on its merits. I hope they will consider the conditions of all those districts, not simply in relation to the amount of pressure which Members have been able to bring upon the Committee, but in relation to the necessities of the constituencies. The Debate on Friday last gave us some indication of the method by which these areas have been chosen, and after what was revealed then, a strong effort will be made by Members from Scotland to see that the considerations which have affected the Committee are not the considerations which will determine the action of Parliament in dealing with the districts on their merits.


There is one point I wish to be quite clear upon before the House agrees to the Resolution, namely, whether it is to be entirely the question of inaccessibility which is to determine the districts dealt with under the Grant. If Members will refer to the Report pub. lished on this matter, they will discover that over and above the question of inaccessibility, the question of the economic conditions of the people has largely governed the relief to be afforded. For instance, in some of the Western Islands, according to the evidence in the Report, milk, which under ordinary circumstances would be available for children, has been of necessity devoted to the rearing of calves. That one fact alone illustrates the economic conditions in some of the Islands, where through hard, economic necessity the crofters in those parts have had to give up to the rearing of stock the milk which otherwise would have gone to the rearing of the children. If, therefore, the question is to be determined by the economic conditions of the people, the question of inaccessibility will largely govern the relief to be given to districts that others would desire to be brought within the four quarters of the Grant. If economic conditions are to govern the Grant, then there are a great number of other districts where this or even a larger Grant might be spent, but if inaccessibility is to be the dominating factor, I think a clear case is made out for confining the Grant to the Highlands and Islands, which are understood by all Scotland to mean the crofter counties. There was no evidence about that. If hon. Members will read Sir John Dewar's Report, they will see that a large part of it deals with the conditions in the Highlands, and particularly the outer islands of the Hebrides. If we allow Perthshire to be brought in on the ground of inaccessibility, I would suggest to my right hon. Friend that he will find there are quite as strong claims for other parts of Scotland. If he is prepared to confine this Grant to the Northern counties on the ground of inaccessibility, we will give every facility for the Bill becoming law in the immediate future. My hon. Friend the Member for North West Lanarkshire (Mr. Pringle) reminds me that a point ought to be made as between the inaccessibility of the districts and the accessibility of the Secretary for Scotland to certain Members of this House. It is perfectly obvious that certain Members find the right hon. Gentleman more accessible than certain other Members. If we had communicated to us the secret whereby this inaccessibility on our part could be bridged, we might hope to include a great many other districts. Speaking seriously, I hope that my right hon. Friend will adhere to the question of inaccessibility, because if other questions, particularly the question of the economic conditions of the people are raised, he will find himself in an exceedingly difficult position.


I gave my assent to this Resolution on Friday on the ground that it was going to be limited to the Highlands and Islands, a more or less well-defined area. Now I find it is proposed to extend it to other parts of Scotland, and as an English ratepayer, I am to pay in order to give medical benefit to any part of Scotland. I hope the right hon. Gentleman will resist this proposal. If not, Cumberland, Northumberland, and the Mountains of Wales, as regards their inaccessible parts, should also get the benefit of a Grant. Really it is a great mistake to be too kind and indulgent in this House, because the moment you give an inch an ell is at once demanded. I hope the right hon. Gentlemen will stand firm to the Resolution.

Bill ordered to be brought in upon the said Resolution, by Mr. McKinnon Wood. Presented accordingly, and read the first time; to be read a second time to-morrow (Tuesday), and to be printed. [Bill 273.]