PUBLIC HEALTH (SCOTLAND) AMENDMENT BILL. (Hansard, 22 July 1924)

§ Mr. SPEAKER
The Amendment on the Order Paper to Clause 1, in the name of the hon. and gallant Member for Blackpool (Lieut.-Colonel Meyler)—at the end of Sub-section (1) to insert the words Provided that nothing in this Section shall empower the Board to enforce any particular form of treatment upon any person"— is out of order, as it has no relevance to the subject of the Clause.

§ Captain WEDGWOOD BENN
I want to take this opportunity to ask the Secretary for Scotland whether he has made up his mind on what is really the vital point in this Bill. The Bill, as the House knows, is to permit the Secretary for Scotland, by Order, to schedule certain other diseases, and have them treated by local authorities in the same way that diabetes has been treated recently. It is perfectly obvious that local authorities cannot carry out this work unless assisted in some way from central funds. There is ample precedent for it. It has been done in the case of tuberculosis and other diseases. The Under-Secretary, in his speech in Committee, was very helpful on this point, and he did suggest something of this kind would be done. I would ask the Secretary for Scotland whether he could not say, in order to make this Bill a success, which is highly to be wished, that more extensive public assistance could be given to treat these diseases. But that can only be done if the Secretary for Scotland is able to say that the Government will come in and bear its proper share of the burden.

§ Mr. BUCHANAN
I regret that this Bill was altered in Committee. I think it is to be regretted that the Secretary for Scotland is going to be prevented in the future, if science finds some new method of dealing with disease, in not having that remedy carried to the poor people at the earliest possible moment. I regret that Liberals and Conservatives 1271 joined in a new coalition on that occasion to defeat the Secretary for Scotland. I do not exactly share the views of the hon. and gallant Member for Leith (Captain W. Benn). I think if the question of expense is to be raised at all it should not be raised on a Bill of this kind, but on the question that the whole health services of Scotland are out of date and not in keeping with modern requirements. The question should not be raised here of how much or how little the Secretary for Scotland should give to the local authorities, but the whole question should be raised as to how far the health services of Scotland can be guaranteed and helped in a more generous fashion. I regret that this has been made an excuse for weakening what I regard as a very small and meagre step in trying to help comparatively poor people in Scotland. I accept the Bill, but I speak for a large number of people of progressive ideas in Scotland, in regretting the limitation which has been made in the Bill. I hope in a short time the Secretary for Scotland will go into the whole question of co-ordinating health services and helping local authorities in a more generous fashion.

§ Lieut.-Colonel Sir JOHN GILMOUR
I should not have said anything on this subject had it not been for the remarks of the hon. Member for Gorbals (Mr. Buchanan). As hon. Members from Scotland know, this matter has been fully debated in Grand Committee upstairs. I associate myself with what the hon. and gallant Member for Leith (Captain Benn) said in regard to the question of assistance from a central fund, but any alterations or amendments which have been made in Committee, have been made at the instance and in the interest of the local authorities in Scotland who are mainly concerned in the question.
All we have done is to place control in the hands of Parliament, and it is an exaggeration to claim that anything done in that respect will either lessen the chances of any future disease being dealt with, or will in any measure delay the putting into operation of any new discovery which may be made for the effective cure of any of these diseases. I think it right that Parliament should know of any fresh departure which is made, particularly in these grave medical questions, and they should know from the Minister 1272 concerned, the head of the Department for the time being, the reason why Orders are sought to be made. Parliament should understand to what the authorities are being committed. If any fresh discovery is made in the possible cure of such a fell disease as cancer in this country the House of Commons, however it may be composed, will give its consent to any Measure if they are satisfied it is a correct one and can be approved by the medical fraternity. On the other hand, the House of Commons has a right to know and the local authorities have a right to know to what such a Measure will commit them. No one looking ahead can say what cost it may not mean to the local authorities, and I think it should be fully considered by Parliament. It was for that reason the Amendment was moved, and I am glad the Government have accepted it.

The SECRETARY for SCOTLAND (Mr. William Adamson)
I have nothing to add to what was said on the Committee stage of this Bill. The last speaker is right in saying that this matter was fully considered in Committee. Even the point that has been raised by the hon. and gallant Member for Leith (Captain W. Benn) was raised in Committee, and I then said all that I could say on that point. I cannot understand his concern on the point now, in view of the particular provision contained in this Bill. It is quite true that a local authority can schedule a disease. It is also provided that the local authorities have the power to say whether or not they will supply the necessary medicines. In addition to that, as has been said, the House has to give sanction to the scheduling of any new disease. That introduces a limitation that was not in the Bill as it was originally presented. It may not lessen the chances, as the hon. and gallant Member for Pollok (Sir Gilmour) said, of treatment being given for the disease that may be scheduled, but I think he is wrong in saying that it will not only not delay the chances, but it will not delay the provision for treating the diseases that may be scheduled.

§ Mr. STURROCK
Before the Bill goes from the House I think we are entitled to express our great regret that the Secretary for Scotland has not been able to give us some sort of assurance with regard to the financial aspect of the Bill. In Committee he certainly did declare 1273 that this point would be carefully considered by him and his colleagues.

Mr. ADAMSON
I do not want my hon. Friend to put into my mouth words that I did not use. What I said in Committee was that, after we had had experience of the financial liability involved in this Bill, I would be quite willing to look closely into the point raised by the hon. and gallant Member for Leith.

§ Mr. STURROCK
I do not wish to put into my right hon. Friend's mouth words that he did not utter, but, I submit, with all respect to him, that we did have an understanding that the question of finance was to be considered by him and his colleagues, and that we should hear something further about it. Now he tells us that he wishes to wait for experience of the working of the Bill before he makes any further statement. In any case, it seems to me that on the whole the Bill passes front our consideration not exactly in such a way as we would have wished. Undoubtedly, the Bill is going to turn on this question of finance. It is true that in Committee we did discuss it briefly, but my right hon. Friend was perfectly adamant upon all the Amendments and suggestions that were put forward, until finally an Amendment was carried against the Government. Even now the hon. Member for Gorbals (Mr. Buchanan) says that this is going to some extent to damage the Bill. I suggest, however, that he will find that the argument of the Secretary for Scotland that this is going to delay the application of the Measure is a very doubtful point. I hope that there is to be no more talk about an unholy coalition between the parties on this question.

§ Mr. SCRYMGEOUR
I think it is just as well to emphasise the point that, from the very beginning, it has been the attitude of the Opposition to cut out other diseases entirely from this Bill, and it was only after very emphatic opposition that the Secretary for Scotland found it necessary to accept this particular Amendment, which has weakened the Measure.

§ Mr. FALCONER
The hon. Member for Gorbals (Mr. Buchanan) is under a complete misapprehension with regard to the spirit in which this Bill was considered Upstairs. It may be that he took one 1274 view and that we took another, but he and his friends are not in the least more anxious to do everything that could be done in order to deal effectively with other diseases than we are. What the Secretary for Scotland proposed was to give power for the Board of Health to prescribe any other diseases, and we thought—and I am still of opinion that we rightly thought—and the majority of the Committee thought, that it was not right to introduce a new principle, imposing new responsibilities of that kind, in the Bill without making some provision under which the local authorities would have the right to know what were the conditions as regards the financial obligations imposed upon them. L could not understand the attitude of the Secretary for Scotland, because his argument on the Bill was that it was permissive to the local authorities that they should supply those other medicines. I have not been able to understand, and I do not understand from what he has said to-night, why he should object to the desire we have to make it clear that what he said was the real effect of the Bill. All that we asked was that he should lay on the Table of the House the Order which he proposed to issue bringing in these other diseases, which would necessarily set forth the conditions under which the local authorities would require to provide the medicines. It is not at all the ease, as represented by the Senior Member for Dundee (Mr. Scrymgeour), that we opposed the inclusion of other diseases. We are perfectly willing that the Bill should apply to other diseases, provided the conditions under which the local authorities were to supply were set out clearly, and I do not agree that there will be any delay caused by the acceptance of the Amendment.