HC Deb 16 December 1927 vol 211 cc2724-31
Mr. CHAMBERLAIN

I beg to move, in page 6, line 1, after the word "Act," to insert the words: the council of every county as respects that county and the council of every county borough as respects that borough shall be. Clause 8 of the Bill deals with the local supervising authority and defines it. There has been a rather chequered history of this Clause. The local supervising authority was, in accordance with the recommendation of the Select Committee, the, council of the borough or of the county, and the Committee upstairs decided also that a district council whose medical officer was not otherwise employed might also act. Since the proceedings in Committee, there have been discussions with representatives of the various classes of local authorities concerned, and they have all come to an agreement upon the Amendment which now stands in my name. I think, therefore, that under these circumstances it is quite unnecessary for me to detain the House with a speech on this subject. We go back to the original county borough or county council as the local supervising authority, but there are powers given to the authority to delegate their powers to the minor authorities, and the minor authorities have the power of appealing to the Minister if their application for such delegation be refused. The present Amendment deals with these points. There are some other Amendments, which are consequential, dealing with the way in which the expenses are to be distributed. I understand that technically, because of the fact that the incidence of rates will be somewhat varied by these Amendments, it is not possible to move them on Report. Therefore, I shall propose, when we come to those Amendments, to move that the Bill be recommitted to a Committee of the Whole House for their consideration. After those Amendments have been made in Committee, we shall resume the Report stage.

Mr. EVERARD

Might I ask the right hon. Gentleman whether this Amendment has been accepted by the County Councils Association?

Mr. WILFRID PALING

My information is that it has not. I should like the right hon. Gentleman to tell us who represented the County Councils Association?

Mr. CHAMBERLAIN

The Chairman.

Mr. PALING

My information is quite the contrary. It is that the Chairman represented himself and not the County Councils Association. In any event, I have a resolution which has been passed by the County Councils Association stating that in the circumstances the Committee are not prepared either to abandon or to pursue their opposition to the Clause. My information is that the County Councils Association have never met from that day to this, and that what is being done is being done on the individual authority of the people concerned. In any event, some of the members of the County Councils Association are still as adamant in their opposition to the Clause as they were on that date. They state that this compromise has been reached without any authority from the County Councils Association, and that only the individuals themselves have taken the responsibility. I do not propose to vote against the Bill or to cause any trouble, but I was asked to bring this matter forward and make a protest and to say that in so far as a compromise had been reached the individuals concerned would have to take the responsibility.

Lieut.-Colonel FREMANTLE

I have been in close touch with the County Councils Association and certain county councils. Although the association ha, not had a full meeting, I understand that their constitution and arrangement such that the chairman has power to act and he was assured that he would gel sanction and approval at the next meeting. I agree with the hon. Member that the whole compromise is questionable I have been very much concerned about it and very doubtful whether we ought to give way. The Bill as originally introduced left the inspection entirely to the county councils and the county borough councils, and I am certain that that would have been the best form of administration; but we were faced with the fact that certain boroughs felt very strongly that they should have responsibility in the matter, and that they were prepared to block the Bill at all costs rather than that it should go through as it was. I am afraid that, as in the last Bill, we are liable to deal with these questions in the interests of certain parties concerned and not of the public.

I was responsible for introducing last year, with the support of the Minister of Health, a Bill which became the Maternity Homes Act, and which is working perfectly well at the present time. That Bill, with the strong support of the Minister of Health, gave the whole power of inspection to the county councils and the councils of the county boroughs. When the present Bill was introduced, it seemed to me only natural to follow the same course. Some opposition was raised last year, and opposition has been raised in connection with this Bill with the result that we have this compromise. I would ask my hon. Friends who feel with me so strongly as regards the desirability of having the larger authority responsible for dealing with this matter, to realise that we are confronted with the alternative of losing the Bill or accepting the compromise. I ask them to accept the compromise. I do so with great hesitation, but in a matter so urgent as the inspection of nursing homes, and the scandals which have been revealed by the Select Committee, I suggest that we accept the compromise. I would ask the Minister to be most careful to see that the bodies to whom the power is delegated shall carry out the powers so delegated, not in the interests simply of themselves and of their credit but in the interests of the public, which are liable to be lost sight of when we are making this kind of bargain.

Miss WILKINSON

I wish to add my protest against the compromise which has been arrived at, not as the result of the decision of the County Councils Association but through the action of the chairman and secretary. I think it is a thoroughly retrograde step and it may do a great deal towards limiting the good that might otherwise have been done by this Bill. We all know what happens. If you allow inspection by these small authorities, especially in the rural dis- tricts and the smaller urban areas, there is always the possibility of intrigue and influence and the fear of people losing their jobs, and it is only by entrusting the inspection to the wider authority, where the inspector is free from any economic difficulty and the fear of losing his job, that you can really get adequate inspection.

The public have a real grievance in this matter. The question of the registration of nursing homes was not taken up until it had become a public scandal. Everybody knows the intolerable conditions that exist in many nursing homes; homes which are charging very high fees. It is not simply a question of homes which have not good financial backing, but homes charging 20 guineas a week have been responsible for some of the worst scandals, and homes which have had medical practitioners at the head of them. After so much public indignation and after the Report of the Select Committee, surely it was the duty of the Minister to see that the Bill was carried through with the fullest possible protection for the public. I submit that the Clause making the inspection the duty of the larger authorities was the only safeguard that the public had that inspection would be properly carried out. I have had a series of resolutions from the National Council of Nurses and from local bodies in my constituency against the idea of inspection being carried out by these smaller bodies.

I suppose we have to accept the compromise or lose the Bill but I, nevertheless, feel that the Minister has been lamentably weak in the matter and that he ought to have forced the Bill through. The Minister smiles, but I would suggest that the Government of which he is so shining an ornament has forced through much more contentious matters. If he was genuinely concerned in protecting the public he would have seen that this Measure, which everybody on the Select Committee agreed was much the best, would have got through rather than accept a compromise which may destroy a certain part of the value of the Bill. I wanted to make my protest and to say that we regret that this compromise has been made, although we cannot vote against it.

Colonel APPLIN

I wish to make my protest. I feel very doubtful about this Measure, largely because it will bring the midwife under two authorities. If the Minister will give us an assurance that the midwife will not be under two authorities with regard to inspection when the minor people are doing it, I should be completely satisfied. That is a very important matter and I hope the right hon. Gentleman will give us some assurance on the point.

Mr. VIANT

We are apt when discussing a question of this kind to overlook the fact that there are exceedingly large urban areas. I am speaking now as one who has had a request from the Middlesex County Council and from the Willesden District Council, who differ on the question. The county council has appealed to me to support the Bill as it stood, and the urban district council, representing a population of 170,000 people, claim that on a matter of such importance, and being responsible for such a large population, they should have the right to have a say in the administration of the Act. I have no doubt that there are other areas equally as large nd equally as important. I hope the House will support the compromise. When I received information from the County Councils Association that a conference had taken place and a compromise had been arrived at, I hoped that the House would be prepared to accept it almost without discussion. If this compromise is not accepted the Bill will be lost, but if it is accepted the Bill will be able to go through, I hope, unopposed. We must not overlook the fact that there are quite a number of urban districts which have their own medical officers, and in that case the administration will be far more up to date and efficient than if it was left to the county council, which has to cover such a large area.

Mr. CHAMBERLAIN

I can only speak again by leave of the House, and I would have said more in moving the Amendment if I had supposed there was likely to be any considerable discussion upon it. The hon. Member for East Middlesbrough (Miss Wilkinson) considers that I have displayed a lack of interest; that is perhaps due to the fact that I have not had my lunch. I would certainly not put my name to a compromise of this kind, even to secure the passage of this Bill, unless I was satisfied that it was a good one and would work out in practice. I would ask the hon. and gallant Member for Enfield (Colonel Applin) to look closely at what this delegation covers. It says: The council of a county may, on the application of the council of any county district within the county, delegate to the district council, either with or without any restrictions or conditions as the county council thinks fit, any of the powers or duties of the county council under this Act. I call his special attention to these words, and I feel certain they will avoid any possibility of the duplication of inspection. What would happen would be this. In some cases the county council will refuse to delegate at all. It may be on the ground that these maternity homes have been inspected by them and that they see no reason for making any alteration in the practice. The municipal authority will have the right to appeal to the Minister, but I do not imagine he would make any change in a case like that. In another case the county council will agree to delegate to a body which is a capable one and which has a competent staff already undertaking some of the work in connection with pre-natal conditions. It would be quite easy in that case to make arrangements between the two authorities which will avoid any duplication of inspection. The county council may delegate the inspection of these homes to them, and may say: will you, therefore, take from us the inspection of the midwives, and act as our agents. It will be quite possible to make arrangements of that kind. I am quite sure there will be no friction or inefficiency in the administration.

Miss WILKINSON

Might not that lead us to this position? The Minister said on the Maternity Homes Act that he wanted the larger authority, now he leaves a loophole that the county council may delegate their authority—

Mr. DEPUTY-SPEAKER

The hon. Member has exhausted her right to speak. She can ask a question if she desires.

Miss WILKINSON

I am not making a speech; I was only asking a question.

Mr. DEPUTY-SPEAKER

If the hon. Member wants to ask a question will she put her question?

Miss WILKINSON

I am endeavouring to do so to the best of my poor ability. Is not the effect of what the Minister has said to make it possible for the county council to hand over to the smaller authorities the supervision of midwives, which they could not do under the terms of the Maternity Homes Act?

Mr. CHAMBERLAIN

They cannot delegate responsibility. They may make arrangements for the inspection to be carried out by the officers of another authority, if that authority cares to lend them for the purpose. It is not a question of the delegation of responsibility, but merely a question of the particular individual who will make the inspection.

Mr. PALING

Is it not the case that in reference to the Midwives and Maternity Homes Act the evidence of his own Department was to the effect that it was working badly?

Amendment agreed to.

Further Amendment made: In page 6, leave out from the word "authority," in line 2, to the end of line 13, and insert the words: (2) The council of a county may, on the application of the council of any county district within the county, delegate to the district council, either with or without any restrictions or conditions as the county council thinks fit, any of the powers or duties of the county council under this Act. (3) If any district council by which an application is made under Sub-section (2) of this Section is aggrieved by the refusal of the county council to delegate any of its powers or duties under this Act or to delegate any such powers or duties otherwise than subject to conditions or restrictions the district council may make a representation to the Minister with respect to the matter, and the Minister, after consultation with the county council may direct the county council to delegate to the district council either with or without restrictions or conditions such of its powers and duties under this Act as the Minister thinks proper, and the county council shall comply with any direction so given."—[Mr. Chamberlain.]

Mr. DEPUTY-SPEAKER

The next four Amendments to Sub-sections (2) and (3) of Clause 8 involve a charge and cannot be taken on consideration.

CLAUSE 11.—(Short title, extent, repeal and commencement.)

Mr. CHAMBERLAIN

I beg to move, in Clause 11, page 9, line 22, to leave out the word "January" and to insert instead thereof the word "July."

Obviously, there is not enough time to get this organisation by next January, and it is proposed to postpone it until next July.

Amendment agreed to.

Motion made, and Question, That the Bill be recommitted to a Committee of the whole House in respect of the Amendments to Clause 8, Sub-sections (2) and (3), standing upon the Notice Paper in the name of the right hon. Member for the Ladywood Division of Birmingham.—[Mr. Chamberlain.] put, and agreed to.

Bill accordingly considered in Committee.

[Captain FITZROY in the Chair.]