§ Motion made, and Question proposed, "That a Supplementary sum, not exceeding £27,000, be granted to His Majesty, to defray the Charge which will come in course of payment during the year ending on the 31st day of March, 1917, for the payment of Grants towards the Cost of the Extension of Sanatorium Benefit to the Dependants of Insured Persons under the National Insurance Act, 1911, and of the Treatment of Tuberculosis generally."
§ Mr. BOOTH
I regret to have to move the reduction of the Vote by £100, but I do so in order to call attention to one of the most cruel-hearted swindles ever perpetrated by Government officials upon the citizens of the country. I think that hon. Members, in passing the Insurance Act, were in agreement as to the treatment of tuberculosis, but I regret to say 1017 that the interpretation of their intentions, at any rate by the late Government and officials, in administering the tuberculosis branch of insurance, have not fulfilled those intentions. The argument is used by Government Departments that all these persons who have paid their premiums for years under a definite contract are, legally, entitled to no benefit at all. If there happens to be a little money to spare, an applicant can have a bed in a sanatorium. It is monstrous that the approved societies should be held to their bargain to pay sickness benefit and disability benefit, if the State, whether it is doing well or badly, whether the funds are mounting or decreasing, docs not, itself, in retaining the right to administer sanatorium benefit, perform its contract. It is well known that all approved societies are responsible to the insured persons, and the Insurance Commissioners themselves are the first to take up the case of any insured person and to compel the approved society to honour its contract. What do we find now? We have here a paltry sum of £27,000 in the Supplementary Estimate, though it is well-known that all over the country there has been a lamentable deficiency, notwithstanding that there has been no reluctance on the part of this House to vote the necessary money. I do not know any quarter of the House where there, has been any reluctance on the part of any group or party to fulfil the intentions of the House in this matter of the treatment of tuberculosis. I ventured, when the late Government was in office, to point out that there was great dissatisfaction in the country in regard to this subject. I am not a London Member, but I went on to the London Insurance Committee dealing with sanatorium benefit. I thought it was a convenient method of finding out at first hand about poor persons suffering from this dreadful disease, and who were waiting in vain to obtain sanatorium treatment. I brought the matter before the Government time after time, but it was minimised, and the House were given misleading statements. I can give an instance of the kind of statement the Government was making upon this question. In the autumn of 1915, and again in the autumn of 1916, I put a question just to test this manufacture of evasive answers. They stated to the House that the numbers on the waiting list were diminishing, and that 1018 the problem was lessening, though they knew quite well, these officials who supplied the hon. Member for Lincoln with this statement, to mislead the House——
I do not think that the hon. Member is in order in raising the question on this Supplementary Vote, for if he looks at the details of the Estimate he will see that the £27,000 is to be allocated to the Local Government Board for Scotland, owing to the expenditure of local authorities being greater than that anticipated.
§ Mr. CHARLES ROBERTS
On the point of Order, Sir. I would point out that the hon. Member (Mr. Booth) has already accused me of being party to a swindle under the Act, and I wish to have the opportunity to reply, for I should be very glad indeed of the chance to meet him, either on this or on any other occasion. I repeat that the hon. Member has made an accusation to which I should like the chance to reply.
§ 4.0 p.m.
§ Mr. BOOTH
May I submit that if I can prove that the deficiency in England is even more insistent and more terrible than the deficiency in Scotland, then I have a right to ask on this Vote for £27,000 that it should not be granted to put Scotland right without something being done for England in the same direction. That is my argument. I am moving a reduction of £100, and my contention is that this House ought not to make up an admitted deficiency in relation to Scotland without dealing with the still greater deficiency in this country.
This Vote deals with the Scottish case and no other, and the hon. Member must confine himself to that. I did not quite catch the remarks of the hon. Member for Ponte-fract with reference to the hon. Member for Lincoln, but the hon. Member for Lincoln, I understand, emphatically denies the allegation, whatever it was. We cannot go into that here, however, because this Vote applies to Scotland only.
The hon. Member must confine himself to the Vote, which applies to Scotland only.
§ Mr. BOOTH
I have taken pains to make myself acquainted with the position in Scotland. I have been on a tour of examination with the hon. Member for Leith Burghs (Mr. Currie), and we had sittings both in Glasgow and in Edinburgh in order to find out the position in regard to tuberculosis, and I would like to deal with some of the evidence we had in Scotland on this point. The City of Glasgow authorities claimed to be dealing with the tuberculosis problem, and the clerk of the committee (Mr. Jones) gave evidence before us. We were obliged to admit that they were dealing with the subject in a complete way. But I am bound to point this out: It was simply because the Glasgow City Council was doing its duty. The Insurance Commissioners themselves could not possibly cope with tuberculosis. Here we have a contribution—it is nothing more than that—of £27,000. It is a mere Grant-in-Aid, and the fact is that the City Corporation of Glasgow, which has the rates at its back, has itself taken up this question of tuberculosis and made provision for dealing with it. Although I am not allowed to mention English cases, I have no doubt hon. Members will draw the inference as to what might be done in this country in a similar direction. I pointed out to Mr. Jones in one of my questions that he was proving that the insured persons were being compelled to pay twice over. There are one or two places in this country, among them Bolton and Brighton, where the authorities are acting in a way similar to that at Glasgow. They are attempting thus to solve the problem, but I submit it is a great hardship to the insured persons, because they are taxpayers and ratepayers, and at the same this House, with an iron 1020 hand, has compulsorily deprived them of part of their weekly wages, telling them it can spend the money better than they can. That was a very strong step on the part of this House, and it was objected to by two or three hon. Members, as well as by myself, very strongly; still, apart from them, the House unanimously voted for compulsion. Rates and taxes are taken by compulsion. The weekly contribution is taken from the insured worker by compulsion in order that tuberculosis may be dealt with. I would ask the hon. Member who is to reply on behalf of the Government, whose services on the London County Council we all acknowledge, how he can justify an insured person being compelled to pay twice for sanatorium treatment, whereas the non-insured persons pays only once?
§ Mr. BOOTH
Yes, I am dealing with the case of Glasgow now. There are other counties and towns in Scotland where, instead of conferring the boon on the insured worker, they are really being taxed and are getting no benefit. I want to ask why, when an enlightened community like Glasgow, deals with this problem and meets the expenses out of the rates, this House does not fulfil its promise in the matter? Why should we go on with these grants unless the Government recognises its obligations? Why should not the city of Glasgow do more and save this country this £27,000? If you are going to push the burden on the ratepayers, why not let them shoulder it altogether? How is it possible to defend the position that, in an enlightened community only, the insured person pays twice, while in the backward community he only pays once? I do not know what excuse will be given by the Government for this small Supplementary Vote. It will not meet the ease. There will still be numbers of insured persons in Scotland who will consider that they have been swindled in the same way as scores of thousands of people in England feel. I admit they have not the same waiting list in Scotland as here. It is a matter of considerable regret to mc that I am compelled to confine my observations solely to the Scottish aspect. I wish we could deal with England as well as 1021 with Scotland. I could submit some really terrible cases, but under your ruling I am not entitled to do so; cases in regard to which I was going to suggest that the bon. Member for Lincoln and the Government officials would have some difficulty in escaping from a moral charge of manslaughter.
The Hon. Member 13 again going beyond the Vote, and I must ask him to confine his observations to it.
The hon. Member, whether deliberately or not, I will not say, is transgressing my ruling.
§ Mr. PRINGLE
I understand that this is a Supplementary Vote. The original Estimate, according to the Paper, was £455,000. I assumed that that sum was voted for the purpose of the tuberculosis benefit for the whole of the United Kingdom. I hope the hon. Member who is to speak for the Department will tell us what proportion of the original Estimate was designed for Scotland, and then we can see to what extent the original Estimate has been exceeded so far as Scotland is concerned. The Vote as it stands looks as if it were intended to mislead the reader, because it is only at the bottom of the page we find, in extremely small type, a statement to the effect that the amount allocated to the Local Government Board for Scotland proved to be insufficient owing to the expenditure of the local authorities being greater than was anticipated. We therefore want to know how much of the original Estimate was intended to apply to Scotland. I also think that the Committee is entitled to something more than a bold statement. We ought to be told clearly the reasons why the Estimate was exceeded.
§ Mr. CURRIE
As the hon. Member for Pontefract (Mr. Booth) has stated, I was engaged with him in making investigations in Scotland into this matter. I did not know anything in the nature of a general discussion was to be embarked on 1022 this afternoon, and, as the Report of the Commission to which he referred is not yet in the hands of hon. Members, I would prefer for the present to defer any remarks I have to make on the general subject. It is quite true I share my hon. Friend's view that the administration of the tuberculosis benefit is not satisfactory, and that in that regard there is a good deal of room for improvement. I have no difficulty in associating myself with what my Friend said on that point, but I am bound to add, in fairness to the hon. Member for Lincoln, that I cannot go so far as my hon. Friend the Member for Pontefract. I would not like to be regarded for a moment as charging him with personal and intentional misrepresentation. I admit some of his answers were unsatisfactory, but that is quite another thing.
§ Mr. ROBERTS
I need hardly say I shall be most careful to observe the ruling we have had from the Chairman, although it has put me in a very embarassing position seeing that I have been exposed to general charges by the hon. Member for Pontefract, and have no opportunity of replying to them.
§ Mr. ROBERTS
The hon. Member has had many opportunities in the last week or so to raise this whole question, and I hope he will take an early opportunity of doing so, because I shall be glad to have a chance of discussing statements he has made, both in this House and out of it. I give him notice that I shall take care to ask him to justify certain statements he has made.
§ Mr. ROBERTS
I now come to this particular Vote. As a matter of fact, I do not think the Scottish people have any reason to think that they have been treated any worse or any better than the English people, or than any other part of the United Kingdom. The Committee knows, I think, that there are circumstances which have reduced the general amount of money available for the treatment of tuberculosis throughout the country. I regret that, and I should be very glad if the deficit could be made up, but this particular Vote has nothing to do with that. It refers only to a particular arrangement for the treatment of dependants of insured persons under Section 17 of the Insurance Act, 1911. Therefore, the whole 1023 question of the general reduction is absolutely out of order. As the Committee will perhaps remember, the dependants, the non-insured population, can either be dealt with by joint agreements made between the local authorities and the insurance committees by means of what is known as the Hobhouse grant, or under Section 17 of this particular Act it is possible for a county borough of a county to make arrangements, if they please, for giving sanatorium benefit to the dependants of insured persons, and then any excess moneys which this arrangement throws upon them are divided between the Treasury and the county authorities. It is that arrangement only which is the issue at the present time. Some of the counties in Scotland have made a more extensive use of this arrangement under Section 17 than was anticipated, and consequently an extra amount falls, I imagine, upon the Treasury to defray, and therefore the Treasury comes for a Supplementary Estimate. It is not a Vote for the Scottish insurance at all. It is a Treasury Vote put down for the Treasury, and therefore all these extraneous questions which it is attempted to bring in, and which once more I shall be very glad indeed to have a chance of dealing with in this House later on, simply do not arise on this Vote.
§ Mr. BALDWIN (Lord of the Treasury)
The hon. Member for Lincoln has explained to the Committee what the origin of the Vote is, and I think I can give a little more explanation of the details on the point raised by the hon. Member for Lanark. The original Vote in the 1916–17 Estimates was for £425,000, and of that £75,000 was the estimate for the Vote for Scotland. When the amount has been sanctioned the control of expenditure passes, for all practical purposes, out of the hands of the Treasury, and is controlled by the three Local Government Boards for England. Scotland, and Ireland, and by the Welsh Commissioners for Wales. All, therefore, that remains for the Treasury to do is to pay up 50 per cent, of the net cost when the accounts are sent in. Now this Scottish Vote has been exceeded, and the amount that is duo to be provided for to meet the deficiency owed by the Treasury comes to £27,000, the sum for which we are asking powers in this Supplementary Vote. We felt, in asking the Committee to assent to this Vote, that it would not be right for us to 1024 keep the local authorities out of their money, but at the same time we felt that, as the Estimate has been exceeded, and especially as it has been exceeded only in the case of one of the countries concerned, we have a right to ask them how it comes that in a year when we think that extraordinary precautions should be taken, the Estimate has been exceeded, and we are told that the increased expenditure has arisen partly from the increased cost of treatment—and, of course, that is common really to all the countries concerned—but mainly owing to an increase in the number of cases they have had to assist, and in the early and unexpected completion of certain sanatoria in Scotland which has led to an increase in the standing charges of those establishments. We have not yet completed our investigations into the causes, as they have been reported to us, but we feel satisfied that we are doing right in asking the Committee to agree to this Vote, that we may hand over to the local authorities in Scotland the balance of the money due to them. I hope that with this explanation the Committee will allow this Vote to pass.
§ Mr. PRINGLE
I will put one further question. Can the hon. Gentleman say whether this acceleration on the part of the local authorities in Scotland has been due to a desire to meet the needs of the military authorities? It is suggested that in one case at least the completion of a sanatorium was accelerated for that purpose, so as to provide a hospital for wounded men, and possibly this may account for the increase in the grant.
§ The SECRETARY for SCOTLAND (Mr. Munro)
I am sorry I cannot definitely answer the point raised by my hon. Friend. My information is that in any case where sanatoria have been completed the reason why the work was proceeded with was because it had gone so far that it would have been wasteful to stop it.
§ Mr. BOOTH
After that courteous explanation from the two representatives of the Government, the House will not expect me to move a reduction, which I should have done if it had applied to the whole of the United Kingdom, but I must express my regret that the explanatory note was not put in a clearer form. There is nothing in if to indicate that no part of the Vote went to England. I would like to draw the attention of the - Committee to this, that one of the great 1025 merits claimed for the Insurance Act when it was passed has evidently been fulfilled as shown by the Vote. It was meant to encourage local authorities to spend their own money in grappling with this disease, and where they did, they were entitled, as has been stated on the Front Bench, to certain grants. This is a case where evidently the authorities In Scotland have been acting up to their duties, and therefore they are entitled to this Grant, so that in addition to the direct benefit of the Insurance Act, although it has its faults, there was also the indirect benefit that it has been the means, in Scotland, at any rate, and I think to some extent in England, of inducing local authorities to do a little more in grappling with this disease than they would have done if the Act had not been passed. I think that result should be 'claimed as a merit for the original passing of the Act.
§ Question put, and agreed to.