HC Deb 29 June 1915 vol 72 cc1663-83

(1) The Commissioners of Customs and Excise may authorise a person to receive spirits without payment of duty for use in the preparation in a public hospital of tinctures and other articles to be used for medical purposes in the hospital in the like manner and subject to the like conditions as they may authorise the receipt of spirits for use in art or manufacture, and Section eight of The Finance Act, 1902, shall have effect accordingly.

(2) The like allowance shall be paid in respect of spirits received for use in a public hospital as aforesaid as is payable under Section one of The Revenue Act, 1906, in respect of spirits received for use in art or manufacture, and the provisions of that Section with respect to the payment of such allowance shall have effect accordingly

(3) If the treasurer or other responsible officer of a public hospital shows, to the satisfaction of the Commissioners of Customs and Excise, that any tinctures or other articles which contain spirits or in the preparation or manufacture of which spirits were used have within the preceding six months been used for medical purposes in the hospital he shall be entitled to obtain from the Commissioners repayment of such amount as he shows to their satisfaction to have been paid by way of duty in respect of the spirits contained in or used in the preparation or manufacture of the said tinctures or other articles.

If any person, for the purpose of obtaining any repayment under the foregoing provision, knowingly makes any false statement or false representation he shall be liable, on summary conviction, to imprisonment for a term not exceeding six months with hard labour.

(4) For the purpose of the foregoing provision the expression "public hospital" means a hospital supported by any public authority, or wholly or partly out of any public or charitable funds or by voluntary subscriptions.

Clause brought up, and read the first time.

Mr. BRIDGEMAN (Lord of the Treasury)

I beg to move, "That the Clause be read a second time."

My right hon. Friend has deputed me to move this Clause, because it is the outcome of a rather long discussion which I had with his predecessor. He has met me very handsomely, and has inserted safeguards which his advisers thought necessary to prevent the Clause from abuse. I hope that if I move it from this side of the House, instead of the other, and if I get the support, not only of the present Chancellor of the Exchequer but of two previous Chancellors of the Exchequer, the Committee will realise that it is a most desirable improvement. Hospitals make use of a large amount of spirit in their various preparations, and the rectified spirit has been found to be the only satisfactory solvent of most preparations. If I give one example of the great hardship of this duty it will be enough. I am informed that last year the London hospitals bought 195 gallons of rectified spirit, for which they have to pay £256. Of that £256 a sum of £229 represented duty, and the other small amount was the cost of the spirit. I think everyone will agree that that is a very heavy impost to place upon a charitable institution. At any time the claims of hospitals for considerate treatment are, I think, justified, and they have certainly an overwhelming claim at a time like this, because everyone knows what a tremendous strain has been put upon our ordinary hospitals as well as our military hospitals by the War, and how splendidly they have met the demands made upon them. I think hon. Members will agree with me when I say that the difficulty that confronts the treasurers of hospitals in keeping up their subscriptions is a very severe one at the present time. I do not know whether I ought to be glad or sorry to say that probably a good deal of the money which now will go to the War Loan might, under other circumstances, have been secured by the treasurers of hospitals to help the finances of those institutions. I reaffirm that the hospitals have an overwhelming claim at this time, and one which I feel sure the Committee will agree is just.

The objects of this Clause are, first of all, to give a supply of duty-free spirits to the hospitals for the preparations which they make themselves under the regulations which prevail under Section 8 of the Finance Act of 1902, and also to give a rebate on tinctures and other things which they buy ready-made, if they can prove that they have been used for the hospital. These exemptions are subject to compliance with such regulations as the Commissioners of Excise may require, and anybody who makes a false return is liable to a fine of £20. I think the Committee will agree in the main with the Clause. I see that there are a considerable number of Amendments down, which I think are not hostile to the intentions of the Clause, so much as they are intended to prevent the possible abuse of the privilege. To my mind, the fact that the regulations and restrictions are considered sufficient by those very careful guardians of the public purse who preside over the Customs and Excise, ought to be a sufficient guarantee for this Committee. However, I know that my right hon. Friend the Chancellor of the Exchequer will be very glad to consider any Amendment, if it is possible to strengthen the provisions against any abuse, and I do hope that those who think there is any danger of that kind, will not oppose the whole Clause. When you come to realise that a concession has been made of duty-free spirit to arts and manufacture, and that some of these manufactures consist in making explosives, I am sure the Committee will feel that the most beneficent use to which spirits can be put, namely, in the treatment of sick and wounded, deserves, at any rate, a similar privilege to that which is granted in regard to the manufacture of munitions of war. I beg to move.

Mr. HEALY

Is there any registration of the persons who are to get this privilege? I suggest that there should be some method of registration, so that everybody should not be allowed to put in a claim. I take it that this will include chloroform?

Mr. BRIDGEMAN

I think that that would be one of the regulations which would be made by the Commissioners of Customs. The definition Clause in Subsection (4) practically restricts it to people who are responsible for the working of the hospitals.

Mr. HEALY

I do not think so, although I have looked at it from that point of view. You begin by authorising the person to receive the spirits, and then you define public hospitals. Does not the person get this indemnity, or modification, provided he satisfies the Government that he is going to supply public hospitals? The definition of public hospitals would not cover the word "person." The person will be any person. Any person could get it, provided that person is going to supply a public hospital. I am heartily glad that the hon. Gentleman has brought in this Clause—and I congratulate him on his new position—but at the same time I desire that by some means, by registration or otherwise, that in regard to the persons who engage in the supply of these things, such as chloroform, ether, etc., we should know who they are, so that we should have some means of effective check in later years.

Mr. GLYN-JONES

Appreciating, as I do, and as I think, in all probability, every Member of this House will appreciate the desire of the hon. Member (Mr. Bridgeman) to do something to assist the hospitals, I am sorry to say that I am bound to oppose the Clause. I may say at once that I am doing it because I have been asked to do it by the organisation which represents the medical profession of this country, namely, the British Medical Association, and also by the Pharmaceutical Society, which represents the pharmacists of the country. The fact that this Clause appears on the Paper is not due to any new burden which has been placed upon hospitals as a result of this Finance Act or of any financial measure this year. The Committee knows that there was a good deal of discussion over the increased duties on alcohol. First of all, the Government proposed to double the duty, and then to add 1s. 6d. per gallon duty on immature spirit, but the Bill to which this Clause is proposed to be added excludes from the operations of this new duty—which is the only new duty imposed, namely, the 1s. 6d. duty on immature spirits—all medicines, so that there is no additional burden placed on hospitals in that respect.

The hon. Member for Oswestry, as he has told us, has taken very great interest in this question, and he has put on one or two occasions questions to the former Chancellor of the Exchequer. On the last occasion the Chancellor of the Exchequer said he would deal with the matter in the Finance Bill. It did not occur to anyone—at least it did not occur to me, and it certainly did not occur to the medical profession—that that meant that there would be any attempt in the Finance Bill to remove the whole duty on alcohol used in hospitals. Obviously the medical profession would desire anything that would assist the hospitals. It is the last thing that they would want to do, to place any difficulty in the way of the hospitals, but I would point out this danger to the House: that there are many ways of assisting hospitals other than by making a rebate on certain taxes which they pay, if by assisting them in that way you do perhaps more mischief than good. The first difficulty is the difficulty of defining what is a hospital. The Clause defines it in this way—

(4) "For the purpose of the foregoing provision the expression 'public hospitals' means a hospital supported by any public authority, or wholly or partly out of any public or charitable funds or by voluntary subscriptions."

It is quite clear that any institution of any kind that could, in law, bring itself within that definition, is entitled to claim from the Commissioners such privileges as they give to hospitals under this Clause. That will not be a matter of interpretation for the Commissioners; the law defines what is the institution that is to get this privilege, and it is defined in this wide way: Under the Clause as it stands any place where the sick are surgically or medically treated, whether by qualified or unqualified people, would come within that definition. There are, as is well known, institutions run by unqualified people, by quacks, and so long as that person running that institution gets some charitable funds, or voluntary subscriptions, the institution becomes a hospital within the meaning of this Clause. It is also well known that there are a large number of nursing homes run for profit. I do not want to say anything which may be misunderstood, but there are numbers of these nursing homes run for profit by private individuals, and it would be quite easy for these nursing homes to comply with this definition and come within its scope. Then there is the other class which is to come into this Clause, namely, any institution of a public authority. Does that mean workhouse infirmaries, fever hospitals, and so on? What this Clause would do would be to relieve the local rates of the cost of their local institutions at the expense of the national Exchequer. If the House thinks that it ought to do that, then let it do it, but we have here raised the whole question of the relief of the local rates of this country, and surely this is not the proper way to do that. If you want to relieve the boards of guardians from the taxes which they pay upon the alcohol which they use in their institutions, why not also equally relieve them from the taxes which they pay on their buildings? If you are going to relieve them of their taxes upon alcohol you make a grant out of the Exchequer amounting to an indefinite sum, and it seems to me that if you are going to do that there is no reason why you should tax a local authority ort its infirmary, or its fever hospital, or its sanatorium, or that you should not relieve them of any other contribution which they make on these buildings to the national Exchequer.

Rectified spirits of wine paying duty will cost 4s. a pint; duty free it will cost as many pence. Imagine what the state of things will be! In a public institution, however well managed, hundreds of people will have access in one way or another, at some time or other, to the tinctures which are medicines and which come within this Clause, because, as the hon. Member for Oswestry pointed out, there are two things to be done under this Clause. The hospital is to get its rectified spirit, for anything in which it makes in the way of medicine, subject to certain conditions, free of duty, but it is also to be able to get a rebate on all the tinctures used in medicines which it purchases. Take, for example, tincture of orange. It is there because there are certain drugs which, as some of us know, perhaps from experience, are not very pleasant to take, and this is a flavouring tincture, a medicine with a distinct value as a medicine, but it is added in order to make the article more palatable. That tincture conies within this Clause. It is about double the alcoholic strength of brandy. A pint of it would cost 6d. Dilute that pint with an equal quantity of water and you have got a quart of what some people would call a nice, palatable cordial at a cost of 6d. a quart. Is it certain that that is the state of things which it is wise to bring about?

May I call attention to the fact that the British Medical Association, which represents not only general practitioners but very largely surgeons and others who hold hospital appointments, have thought it necessary to send a representation to the Chancellor pointing out these difficulties? Associated with that representation is the Pharmaceutical Society. What they say is:— There are many disadvantages to the practice of medicine in general which might follow if alcohol were permitted to be used in hospitals under conditions which differ from those obtaining outside. There is no doubt that if alcohol in hospitals were duty free the present economic restrictions on its use would entirely disappear, and preparations largely consisting of alcohol would be used more frequently than they are now. This would be unfortunate, because the tendency of recent years has been to limit the use of alcohol in the use of medical preparations so far as is consistent with efficiency, and many new preparations have been brought into general use because they have been found to be quite efficient, though containing little or no alcohol, and are therefore cheaper than the older preparations. Then I would point out another consideration, which I do not think would appeal at first blush to the layman. They say:— It would be unfortunate, too, if students who after they have qualified would have to prescribe or use preparations containing duty paid alcohol"— that is £1 on rectified spirits, or about a guinea a gallon— were trained under conditions in which the cost of alcohol had not to be considered. This would lead either to an extravagant use of alcohol in prescriptions, for which the public would have to pay, or to their haying largely to unlearn the habits of prescribing what they had been taught in the hospital. Then they point out that the possible effect of such prescriptions of preparations containing alcohol as a drug on the National Health Insurance should not be overlooked. The Drug Fund is overdrawn. There is not sufficient money now to meet the demands made on the Drug Fund. Members of the House have no doubt been approached by insurance committees and by pharmacists pointing out that pharmacists have been discounted—that committees have not been able to pay them their full bills. What is the effect of training medical students under a system where the cost of alcohol does not matter and then turning them out to order the same thing which cost a few pence in the hospitals and will cost many shillings outside? What is the effect going to be on the Drug Fund of the Insurance Act?

It is well known that some of these large institutions have in the course of the year scores of thousands of out-patients. The out-patients are within this provision, as to duty free alcohol, of which, because of its dearness, the Revenue have allowed certain common liniments to be made. You have got to make them with spirit. They are made with methylated spirit and not rectified spirit. Once this concession is given the hospital would have to make the liniment with rectified spirit rather than methylated spirit, as methylated spirit would cost the hospital rather more than rectified spirit. The result is that all these liniments would be made of rectified spirit. In the case of a number of these people who go to the hospitals it often happens that the physician in prescribing does not specify the amount. The patient takes the prescription downstairs, the dispenser looks out through the pigeon-hole, takes the prescription and says, "Where do you want to use this liniment?" They are so fond of it that they say, "All over me." This is a most common practice amongst poor persons, who leave the hospital now with methylated spirits, but who in future will leave with a pint of rectified spirit which will have cost the hospital 3d. or 4d., but is worth outside many shillings. That is not a thing which ought to be overlooked. Then as to the hon. Member's safeguard, how is the provision as to allowing the duty-free alcohol, the raw alcohol, to make preparations to be safeguarded? The Clause says that it is under the provisions of the 1902 Act, under which the manufacturers are able to obtain duty-free spirit, but if Members will look at that Section of the 1902 Act they will see how almost impossible it is, if any good at all is to come out of this concession, to apply it to the hospitals. The Clause says:—

"Where, in case of any art or manufacture carried on by any person in which the use of spirits is required, it shall be proved to the satisfaction of the Commissioners of Inland Revenue that the use of methylated spirits is unsuitable or detrimental they may, if they think fit, authorise that person to receive spirits without the payment of duty for use in such art or manufacture upon giving security to their satisfaction that they will use the spirits in the art or manufacture and for no other purpose, and the spirits so used shall be exempt from duty: provided that foreign spirits may not be so received or used until the difference between the duty of Customs chargeable thereon and the duty of Excise chargeable on British spirits has been paid,"

and then we have

"(2) The authority shall only be granted subject to compliance with such regulations as the Commissioners may require the applicant to observe for the security of the Revenue and upon condition that he will to the satisfaction of the Commissioners, if so required by them, render the spirits unpotable before and during use and will from time to time pay any expenses that may be incurred in placing an officer in charge of his premises."

There the Revenue—it was so difficult to manage that—had to provide for an official being placed on the premises and the expense of that was cast upon the manufacturer. In 1906 that was modified to this extent, that the manufacturer had not got to bear the cost of this Revenue official being on his premises, save in exceptional circumstances. I wonder if the hon. Member has really discussed the matter with any hospital authorities, and has he discussed with them what kind of supervision they would expect and what kind of supervision is in fact exercised on the provisions which are made to apply to them.

First of all, they have got to have an officer to see that the conditions are complied with, and then when they came to deal with manufacturers the great safeguard was that the Commissioners could require them to make the spirit unpotable. Of course that did not matter at all when dealing with manufacturers, but here you are dealing with medicines, which are used for internal purposes, all of which are potable. It is very difficult to define "potable." If you look up the dictionary you will see that it says "fit or suitable for drinking." All medicines are fit or suitable for drinking, or else they would not be ordered, except liniments for external purposes. Then if it is to be a question of palatable, I should be sorry to have to define that, because that is all a matter of taste. There are people who think that methylated spirits are palatable. If it really does mean that the Commissioners, if they granted this, are going to compel the hospital to make drugs, which are not in themselves unpleasant, unpleasant by using a spirit which is to be made unpalatable, then I think that the effect of that on the art of medicine is extremely serious.

Everybody knows the great difficulty which doctors have got in getting patients to take medicine because the patients say that the medicine is nasty, and doctors do everything they can to make it pleasant, especially when dealing with children. But not only are you not trying to make drugs more pleasant to consume, but you are making drugs, which are not in themselves unpleasant, unpleasant if you use alcohol as solvent, in order to get free alcohol. That seems to me to be obviously undesirable. When you come to deal with the question of rebate, you find that they are entitled to get the rebate upon all these tinctures, subject to certain restrictions which the Board of Inland Revenue may make, and neither the House nor the hospital, nor the profession, knows what that means. I think that I have said enough to show that this thing is not as easy as at first appears, and that there are difficulties. That is very strongly borne out by what happened some months ago, and I think that the House will be interested to learn what has taken place meantime. The hon. Member for Oswestry on 10th March asked the Chancellor of the Exchequer— If he will consider the desirability of providing in the Finance Bill for the supply of duty-free rectified spirit to hospitals for the making of tinctures under similar restrictions to those which regulate the supply of absolute alcohol, free of duty, for the purpose of research in clinical laboratories and colleges? Mr. Lloyd George said:— The general question of the use of spirit is under consideration, but I am afraid that it would not be possible to grant this particular exemption. The hon. Member then asked:— Is the right hon. Gentleman aware that the Loudon Hospital alone has spent £256 on tinctures of this kind, of which £229 is duty, and could he not at any rate make an exemption in favour of tinctures and solutions of iodine; I think it will be easier to do that? The Chancellor replied:— I could supply the hon. Gentleman with the reasons given to me by the Customs as to the difficulty in making a discrimination. I will hand the paper over to him. That was the official position in this House in March. Since that time, the hon. Member for Oswestry has been appointed to a position on the Treasury Bench, and it may be that he has been able to convert the Commissioner of Customs to the view of the feasibility of doing this; but I frankly say that those who know the difficulties do not see at present how it is to be done. What they ask for is this. They say in their circular:— Representations have been made by our association to the Chancellor of the Exchequer that the Clause may be dropped, and that the whole question of duty-free alcohol in medicine be referred to a special committee for consideration and report. We earnestly ask your support in the House in support of this recommendation, as under the Finance Act the position of hospitals is not in any way worsened in regard to the use of spirits. Our associations are of opinion that the suggestion of delay is reasonable. That is signed by Mr. Alfred Cox, Medical Secretary to the British Medical Association. If this Clause is proposed in consequence of some promise made to the hon. Member for Oswestry, it certainly was not a Parliamentary pledge, but if it was a Parliamentary pledge, does it amount to one for dealing with this matter in the Finance Bill. There is another pledge which the Government have given, and which I think ought to be borne in mind, namely, that they will introduce nothing in this House which is not necessary for the conduct of this War, and which is controversial. They have given that pledge, which I think is an excellent one, and in a case like this, where there are serious objections from the whole recognised body of the medical profession, and from the recognised body of pharmacists—and I have taken the responsibility of saying so—I do appeal to the right hon. Gentleman that it is not fair, that it is not right, that he should at this moment proceed with this Clause.

There are plenty of ways of dealing with it in the meantime. If it is desired to give relief to hospitals, let it be done quite apart from spirit altogether, and if the right hon. Gentleman consents to do this I can assure him the medical profession and the pharmacists' profession would want to help him in improving the position of hospitals, and, if it can be done in that manner, they would place no difficulties in the way. Is that an unreasonable thing to ask when we are at war? We have this proposal in the Bill, and the secretaries of associations have been calling their members together from all parts of the country to consider it, and this at a time when they have a good deal else to engage their attention. The country do not understand this sort of thing. I am very sorry to detain the House at this stage in trying to bring this about. There is a string of Amendments on the Paper, and in normal times I am bound to say that I should have felt it absolutely my duty—unless the Government dropped the Clause and agreed to go into the whole subject systematically, in order to apply it to medicine generally—to use every form of this House in order to defeat the proposal. That is not possible at this time. The medical profession and the Pharmaceutical Society, having made these representations, and there being no evidence of an organised representation from the hospitals in regard to it, I do think that the Chancellor of the Exchequer would be justified in taking into consideration the representations of these bodies, and in not proceeding with the Clause to-day.

Sir HENRY CRAIK

The hon. Member who has just sat down will not doubt that I recognise the great authority with which he speaks, an authority that I myself cannot rival. I attach very great importance to the arguments which he brought forward, and I also attach great weight to the representations which have been made. I suppose that there are many representatives who have members of the British Medical Association in their constituencies. I am bound to say, however, that although I have received this communication from the British Medical Association, I cannot find that it has been supported by any general communication from other members of the medical profession, some five thousand of whom are constituents of my own. That gives me some reason to doubt whether the arguments, weighty as they are, which the hon. Member has adduced are sufficient to lead me to oppose the Clause. I think the matter has been fully discussed. I am not quite sure that the medical profession is so universally against it as the hon. Member assumes, for I think I should have heard from outside representations in that sense. I have not received any, and while I attach great weight to some of the hon. Gentleman's arguments, yet I should like to urge some other considerations which lead me, on the whole, to give my support to the Clause. In some respects I think the hon. Member's arguments had the weakness of being a little too strong, and now and then perhaps a little far-fetched. We were told by the hon. Member in the earlier part of his speech that this Clause would have the effect of transferring the burden on the rates to the National Exchequer. Is not that a little far-fetched? There are a great many hospitals in this country, perhaps the bulk of hospitals in this country, which do not draw anything from the rates, and which are supported by voluntary contributions, and surely you should not deprive these voluntary institutions of an advantage in doing their benevolent work because of the incident that some trivial small expenditure might be transferred from the rates to the National Exchequer.

Mr. GLYN-JONES

In this Clause the hospital is defined as a place supported by any public authority, and it is to the institutions supported by public authority that I applied that argument.

Sir H. CRAIK

I have no doubt there would be a very slight relief to the rates. One must remember that these institutions, supported by the rates, are not institutions which require the most of our benevolence, and the institutions which do require our benevolence are at this time placed under great difficulty owing to the pressure which has fallen on private benevolence of every sort in consequence of the War. I am not inclined at all to think that all the dangers which the hon. Member foresees would, in fact, be realised. I do not think that hospital attendants would find in these medicines something which might have a lowering effect upon them and cause them to drink. I do not think that in any ordinary, well-regulated hospital—and I know something of hospitals, and as a governor I ought to be attending a meeting of the governing body of a hospital near here if I were not detained by the Debate on this Bill—any disorderly conduct of the kind suggested would occur. I am quite prepared to support any sort of safeguard which the hon. Member may think necessary, and which the Minister in charge of the Bill may think proper to adopt. I think possibly it might be well to confine the Clause to medicines for the use of any patient, and that would solve one difficulty which the hon. Member thinks is likely to occur. I think, also, that it is right and proper to restrict the benefit to those hospitals which are not run for private profit. There are certain classes of homes, certain institutions, which are really carried on for commercial purposes, and I do not think that they deserve this special consideration. If the Chancellor of the Exchequer or the hon. Member in charge of the Bill thinks it proper to confine the Clause to those institutions that are not carried on for private profit, I should be very glad to agree to that, and to know that one, at all events, of the difficulties which the hon. Member has raised was guarded against.

But I am not quite sure that I see great weight in some of the arguments he adduced on the part of the British Medical Association. I know the authority of that association, and I should be the last to derogate from it, knowing how many of my own Constituents are members of it. But I do not think their arguments carry complete conviction. They allow that this is a gift, and they admit that their communication appears like looking a gift-horse in the mouth. I go further: I think it does. This is a gift by the Chancellor of the Exchequer, and I think we may take it that it is a very considerable gift, and an advantage so far as it goes. I do not want to raise difficulties on the very inception of this proposal. The British Medical Association in their circular do not apparently think that this is an advantage which should not be obtained; all they say is that if it were delayed the hospitals would not be put in a worse position than they are at present, and that the matter might be referred to a Special Committee for consideration and report. The British Medical Association do not say that there is no grievance, nor that this grievance ought not to be cured; yet it seems rather ungracious to propose that the Clause which is to be embodied in the Bill should be thrown overboard, and that we should be asked to postpone the gift until the Greek Kalends—until a Committee has been appointed and reported. It is not likely that a Special Committee can be appointed now, or that it could turn its attention to the subject.

5.0 P.M.

This is an urgent matter. We know the difficulties; we know that at this moment hospitals are reduced in their resources from private benevolence. We know that the necessary charges for this kind of rectified spirit required for the purposes of the hospitals were tremendously heavy, as the hon. Member has pointed out. We know that out of the sum of £260 no less than £220 in a fever hospital was paid for spirits. It is now proposed, I am very glad to know, to relieve them of that burden. I chink we might also trust to the regulations which have been laid down by the Commissioners. In Section 8 of the Finance Act of 1902 we have a distinct settlement of the conditions under which regulations are to be issued by the Commissioners in the case of the use of spirits in any arts or manufactures. In the case of arts or manufactures it was really a far more difficult thing to stop the abuse of such a relief than it is in the case of hospitals. "Arts and manufactures" is a very widely-expressed definition. All sorts of institutions for carrying on arts and manufactures might be relieved from the duty on spirit, and it might in the case of such a very large class of arts and manufactures be a real danger. This danger was considered to be sufficiently guarded against by the regulations laid down in Section 8 of the Act. Similar regulations will be laid down under the present Clause, because it embodies Clause 8 of the Act of 1902. Will they not be sufficient for carefully managed institutions like hospitals if they are sufficient for the very wide range of art and manufacturing institutions using spirits, and which were given exemption under the Act of 1902? Representing as I do a very large section of the medical profession, I cannot, even after the arguments brought forward by the hon. Member, take the responsibility of rejecting this Clause and of refusing to accept what I think is the very handsome concession made by the Chancellor of the Exchequer. By all means introduce safeguards, if they are necessary, and restrict your exemption, if you like, to those hospitals which are not run for private profit, and restrict it, if it should be considered necessary, to in-patients. You can lay down the rule that those medicines, which it is said may prove to be so palatable, should be under the regulations laid down under Clause 8 of the Act of 1902. I cannot, of course, speak for the Chancellor of the Exchequer, and I do not know whether he contemplates those restrictions. I think there is a great deal to be said for them, and that it might be well to guard against some of the fears which the hon. Member has expressed by consideration of those Amendments, but I cannot join in the responsibility of rejecting the Clause, which confers a very considerable benefit upon very deserving institutions.

Mr. LYNCH

It seemed to me at first that this Clause was a fairly simple matter. The first serious objection to that view was the receipt of this circular from the British Medical Association. I was, of course, greatly impressed by the weight of authority, but as I read the arguments which they adduced in that circular I must say their authority began to dwindle, as none of their arguments were very convincing. I had somewhat the same experience to-day in listening to the hon. Member for Stepney (Mr. Glyn-Jones). He himself enjoys an exceptional reputation in this House for his extraordinary and enviable knowledge of drugs, but as he developed his arguments I began to find that none of them would hold water. He has a highly analytical mind and I am inclined to think he has given to chemistry what was intended for metaphysics. His research enables him to find reasons and excuses and arguments which would never occur to any mind of common sense. Take, for instance, his argument that these drugs would become so useful that they would be freely prescribed. That seems to me to be equivalent to a remark I once heard in the case of a surgeon who said that the knives were too blunt, but the authority seemed to think they would do harm if they were sharp. The hon. Member for Stepney seemed to think that if the medical officers of hospitals had too free a range they would be likely to run riot in prescribing drugs which were not useful in particular cases which they had. Then, again, there was the argument of students learning expensive prescribing in hospitals, and afterwards mulcting their poor patients outside. From what I have seen of medical men outside I am inclined to think they forget a good many things they learned in hospitals. One of those things most sharply brought to the imagination afterwards is the art of not prescribing expensive and unattainable drugs. I think that argument also vanishes.

There was the argument from the case of out-patients. The hon. Member drew an imaginative picture of an out-patient coming to a hospital for some liniment and desiring to be painted all over his body like an ancient Pict or Scot. From what I have seen, an out-patient goes to a hospital because he has serious need of some relief. It is not exactly a matter of enjoyment to wait in an out-patient's department of a hospital for a long time to receive often what the hon. Member thinks is very summary attention and inadequate treatment, and then to apply the medicine he receives for the benefit of his case. I think very few out-patients go to a hospital unless they feel that they are somewhat seriously ill, and that they require really serious treatment. I think even if they require liniment that they would never use it over the whole of their bodies simply on the ground that it was inexpensive. I think the Clause is not quite wide enough in scope, and I would like to see another Clause introduced which would give relief not only to hospitals but in the case of drugs used in research. I do not know whether the Chancellor of the Exchequer intends making any concession to men engaged in scientific research with regard to the cheapening of drugs. Recently Sir William Ramsay, who is not a man to waste words, wrote a rather urgent letter pointing out the great expense that is imposed on men of science in the purchase of materials for research. I think it would be a very good thing if relief could be given in cases of proper research. Finally, with regard to the possibilities of abuse of this privilege in institutions which were not public institutions of a wholly charitable type, I have myself suggested an Amendment, and I have some hopes of having it accepted, which would clear the ground in that respect. I believe, in spite of the circular of the British Medical Association, that nine-tenths of the members of the profession would thank the Chancellor of Exchequer for having introduced this Clause, which is a very serviceable Clause to great hospitals, especially at this time, because it really does arise out of the conditions of the War. The objections to it, urged so ingeniously, are really somewhat far-fetched and almost metaphysical.

Mr. BOOTH

I rise to protest against the Committee of the House of Commons at this time being asked to spend hour after hour upon this matter when we are engaged in a life-and-death struggle with a foreign enemy. It is with the utmost difficulty that I sit here listening to this discussion, and, to be quite candid, I do not feel able to do it. Looking at the newspapers to-day, I am distressed beyond measure. I warned the last Government when it kept on bringing in things like this that it had nothing to do with such matters, and that its only duty was the vigorous prosecution of the War. Month after month they continued to do so despite what I told them, and finally came the great change. I do say it is an exceedingly bad start for this Government, which has been put in power to beat the enemy, to ask us to deal with things which have been called metaphysical, and in which we are told about the British Medical Association or the Pharmaceutical Association, or which have to do with the intricacies of the manufacture of drugs. I am not equal to it, and I protest against it with all my mind and all my soul. I do say it is bringing us to a straining point that we should have Government Whips coming here to-day—

Sir GODFREY BARING

Is the hon. Member in order on this Clause, which deals with a specific point, in referring to what should be discussed?

The CHAIRMAN

I think on the question of whether or not the Clause should be read a second time the hon. Member is entitled to make a protest against the further consideration of it, but I should not allow him to argue the matter.

Mr. BOOTH

I do not want to argue it. It needs no argument; it only needs to be stated. If I am asked to sit here hour after hour for discussions of this kind, I shall decline to obey the Government Whips. I can use my time better. I have been spending nearly the whole of the day in inducing people to subscribe to the War Loan, and rather than remain here for such discussions I would sooner go back to that work.

Mr. McKENNA

I think my hon. Friend is under a complete misapprehension. The Clause proposes nothing more than to give certain relief to hospitals.

Mr. JONATHAN SAMUEL

made a remark which was inaudible in the Reporters' Gallery.

Mr. McKENNA

If my hon. Friend does not want the Clause, and if it is seriously contested, then, of course, a pledge having been given, we shall have to consider the matter. But that is not the point of my reply. I was referring to what was said by the hon. Member for Pontefract (Mr. Booth). This is evidently a Clause which ought to be discussed. We must remember it is a Clause which proposes to give relief to hospitals, and hospitals are now being used in a manner in which they have never been used before. And to speak of this as a waste of time, and of the discussion as one that ought not to be undertaken is, according to my humble understanding of the matter, a complete misreading of the argument.

Mr. BOOTH

I am sure the right hon. Gentleman does not want to do me an injustice. What I am protesting against is the controversy. I have not stated whether I am in favour of the Clause or not. If it is agreed to, well and good; but what I am against is the House of Commons being plunged into controversies.

Mr. McKENNA

My hon. Friend says that he complained against the late Government bringing up matters of controversy which did not relate to the War. How are we ever to know if such a simple matter as this is going to be the subject of controversy or not?

Mr. EDGAR JONES

We had a long discussion before on Second Heading.

Mr. McKENNA

This is a new Clause. How are we to know whether it is to be treated as a matter of controversy or not? If it is to be treated as a matter of controversy, under the pledge the Government will not proceed with it; but we never could know whether it was going to be a matter of controversy or not, and we should be rendering discussion absolutely futile if no Member were ever to be allowed to express an opinion for or against a proposal without being told that he was wasting time. I really think my hon. Friend has not done justice to the merits of the Amendment or the opposition to it.

Mr. BOOTH

During the War.

Mr. McKENNA

That is entirely another point. The only question now is how far this Clause is a proper Clause to bring before the Committee. This is not the final stage of this Clause. Very serious arguments have been raised against it. Those arguments will have to be considered, and may lead to amendments of the Clause. What I suggest to my hon. Friends is that, if they will give the Clause a Second Reading now, we will do our best to come to terms with the opponents of the Clause, and if satisfactory terms are not arrived at, we shall always remain bound by your original pledge not to carry through business to which there is serious opposition. Such an arrangement will give everybody time for further consideration. It is obvious that we are all agreed in wishing to give relief to hospitals. The question is as to the method by which it should be given. If the Committee will allow the Clause to be read a second time now, on Report either we will withdraw the Clause, or, if we come to terms with the general sense of the Committee, we will be able to go forward with it.

Mr. CHAPLIN

I rise to support most heartily the proposal made by the right hon. Gentleman, rather than delay these proceedings any longer. My sympathies are very greatly with the hon. Member who protested against the length at which the Clause has been discussed. Those who have listened to the Debate from the commencement must feel that this is not a controversial subject, and cannot justly be so called, because my hon. Friend (Mr. Bridgeman) began his speech by saying that it was the subject of an agreement between himself and the late Chancellor of the Exchequer.

The CHAIRMAN

Perhaps I ought to intervene on the question of procedure. I understood the Chancellor of the Exchequer to suggest that the Clause might be added to the Bill now, and, in a certain event, withdrawn at the Report stage. I am afraid that that would not be permissible under our procedure, because it would be, in a sense, imposing taxation by withdrawing a relief which had been granted in Committee. The reverse procedure would be possible—to withdraw the Clause now, and bring it up again on the Report stage.

Mr. J. SAMUEL

I think that the Chancellor of the Exchequer in a matter of this kind ought to take into consideration, not so much the views of the medical profession, as the views of the ratepayers and those who manage public institutions. I can assure him, from a very long experience in the management of one very large institution, that we have year after year reduced the consumption of spirits to a minimum.

Sir G. BARING

On a point of Order. Is the Chancellor of the Exchequer prepared now to withdraw this Clause?

Mr. McKENNA

We must listen to objections.

Mr. SAMUEL

I am very strongly opposed to the cheapening of alcohol or spirits in our public institutions. For a long time I have been connected with a large institution containing 1,700 or 1,800 patients, and we have reduced the consumption of spirits there to a minimum. In years gone by, when the consumption of liquor was considered to be popular and essential, I have seen doctors in that institution who themselves became victims to the practice and were discharged from their office in consequence. There is really nothing more dangerous than to give this relief to hospitals. It is not essential. If the right hon. Gentleman is anxious to give relief in a practical way to the ratepayers and the subscribers, I will tell him how to do it. There is a large consumption of sugar in these public institutions.

The CHAIRMAN

That would carry us a long way.

Mr. SAMUEL

I am giving an illustration of how to give relief to these public institutions.

The CHAIRMAN

I have no doubt that other Members might give other illustrations.

Mr. SAMUEL

If we were not at the present time under a truce this Clause would be fought most bitterly from this side of the House. I am certain that it will give umbrage to a large number of public men who are trying to manage these institutions economically and well and to the best interests of the patients. If the right hon. Gentleman proceeds with this Clause, he will cause great discontent to public men in the provinces at any rate. I agree with the hon. Member for Pontefract (Mr. Booth) that the Clause should not be introduced because it is controversial, and I beg my right hon. Friend to withdraw it.

Mr. BRIDGEMAN

I am entirely in the hands of my right hon. Friend in regard to what should be done with this Clause. But as to its being controversial, let there be no mistake about this: I could not know that it was controversial. I proposed it from the other side of the House, and it was accepted by the late Chancellor of the Exchequer. Nothing could be better evidence for me that it is not controversial than the right hon. Gentleman's acceptance of my proposal when I was on that side of the House and he was on this. As an hon. Member seems to doubt whether I had any acceptance of the proposal from the Minister of Munitions, I should like to say that on 20th May I received from the right hon. Gentleman's private secretary a letter which I can show the hon. Member. I do not see that it makes any difference whether I got a pledge in writing from the Treasury or a pledge across the floor of the House. I can only say that so far as I was aware it was an uncontroversial proposal, and I disclaim any sort of idea of introducing a proposal which would be hotly opposed. I still think it might be possible to come to some arrangement by which the abuses feared by hon. Members can be met. I think they will be taking a great responsibility if they prevent the granting of this great boon to hospitals at a time like the present. I will withdraw the Clause now and bring it up again on Report, when I hope we shall be able to come to some agreement.

Motion and Clause, by leave, withdrawn.

Mr. KING

Mr. Whitley, I rose while you were putting the Question, and I called you by name. Have I not a right to speak because the Clause is withdrawn?

The CHAIRMAN

The hon. Member has no right to get up to make a speech when the Mover of a Motion has asked leave to withdraw. It is for the Committee to say first of all whether it gives leave to withdraw. If it gives leave, the Motion is withdrawn.