§ Again considered in Committee.
§ [Major Sir ARCHIBALD SINCLAIR in the Chair.]
§ Question again proposed, "That a sum, not exceeding £12,943,493, be granted for the said Service."482
§ Mr. HARRIS
When our proceedings were interrupted, I was calling attention to the fact that many local authorities are justifying their inaction in the great London area by the revival of the building of houses by private enterprise. I am one of those who like to see every possible agency at work, but I think it would be most unfortunate for anyone to run away with the idea that the kind of houses being built by private enterprise are really doing much to solve the housing problem. At the present time almost every house built by private enterprise is built for sale, and not for letting, and, therefore, comes right outside the means of the ordinary working man; and, while before the War some 75 per cent. of these houses were occupied by people coming within the definition of the working class, now, to use the words of the Report presented to the London County Council only yesterday, considerably less than one-half, instead of the estimated required proportion of three-fourths, are houses suitable for the working classes. When we come down to the bed-rock of the work done by the London County Council and private enterprise and various agencies, it is pointed out by the county council that there is still a shortage of 52,000 houses to be met. That means that overcrowding is still rampant and that in spite of all our efforts things are not very much improved. It is pointed out by the county council that the number of families has had to be met by closer occupation of houses by more than one family.
We have to recognise facts and to continue our activities. A great promise was held out by the Government 18 months ago that the housing problem could be dealt with by alternative methods of construction. We have had experience of these alternative methods of construction, and perhaps the Minister can give us some guidance. We have made a great attempt to experiment in steel houses. We in London placed orders for almost every kind of steel house. We have been broad-minded; we have had no prejudice and have not been influenced by any desire except that of providing houses to meet the shortage. We have ordered Atholl houses and every other kind of steel house. I have to admit that these houses have not been forthcoming. I believe I am right in saving that up to a few weeks ago not 483 a single Atholl house had been delivered. Every steel house that we have put up, in almost every case, has been a disappointment. We have experimented with every kind of wooden house—Norwegian, Swedish, English, Canadian, but they have proved to be more expensive and far less satisfactory than the ordinary house. Experiments have been made with all sorts of concrete houses, but after every kind of experiment has been tried we have been compelled to recognise in London that the best house to build is the brick house and the brick and plaster house.
Unfortunately, the agencies for building the brick and the brick and plaster house have been held up through the shortage of skilled labour. It is no use trying to run away from facts; we have to face them. If we are to meet the shortage in all the agencies that are required for the building of houses, we must get the necessary skilled labour. The shortage of bricklayers is not so serious as it was, although we could do with a great many more; but when we come to plasterers the famine is rampant. Even if more brick houses could be built, the difficulty of getting the necessary skilled plasterers remains a living fact. That is a question which, sooner or later, will have to be faced by some Government or some Department. I have said on many occasions that I do not believe we shall get the necessary skilled labour until the Government have a policy which they are determined to carry out over a period of years. I have suggested 15 years. Whatever the period fixed, it must be fixed, and it must have Government backing. Once we fix the period the Government will have a right to go to the trade unions concerned and demand that the necessary skilled labour shall be trained. The skilled labour is not forthcoming.
§ Mr. HARRIS
The hon. Member says that the trade unions are not making the difficulty. I do not believe they will if they can be certain that they will have permanent employment for a period of years. If we had a programme for 15 years the uncertainty would be removed. It is that uncertainty and the constant fluctuation in policy which have prevented 484 the necessary skilled labour being provided to make up the shortage. It is admitted that a shortage exists. In many cases there have been experiments in substitutes for our present building methods. The substitutes for plastering have always been a failure, but, even if they were practicable, we must get the necessary skilled labour, and that can only be done by good will and pressure on the Government, through the Minister of Health. Many people run away from this question. If we are really in earnest to provide the necessary houses then, surely, the necessary skilled labour must be found. If we get the skilled labour it will mean not only more employment in the building industry, but employment for thousands of other men who are depending for employment upon the skilled trades. I should have liked to elaborate that point, but I have exceeded my time. I hope the Parliamentary Secretary, who is never lacking in courage, will tell us his views and whether there is any prospect in the immediate future of the shortage in one or two branches of skilled labour in house building being made good, because it is only by the shortage being met that we can hope to make up for the shortage of houses.
§ Sir K. WOOD
There is one preliminary observation that I desire to make before dealing with the general questions. The Committee will remember that in his opening speech my right hon. Friend dealt with a statement which had been made by the hon. Member for the Stratford Division of West Ham (Mr. Groves) regarding the attacks on the newly-appointed West Ham Board of Guardians. My right hon. Friend made a complete statement as far as the allegations were concerned which were made the other night, and I have received a message from the hon. Member, which I promised that I would convey to the Committee, that he desires, after having heard the statement of my right hon. Friend, further to investigate the facts, and that he will in that event propose to deal with the matter on a suitable opportunity, which may possibly be afforded to him next week. My right hon. Friend and mys0elf would welcome every investigation of the facts by the hon. Member, and I quite understand his desire to do so before he makes a further statement on the matter.
485 My right hon. Friend may congratulate himself upon the reception of his Estimates to-day. Anyone who has listened to the Debate will agree with me when I say that, beyond a certain number of important but minor criticisms, some of a very technical kind, there have been practically no major or important criticisms concerning the administration of the Ministry of Health during the past year. I expected to see present this afternoon the right hon. Member for Carnarvon Boroughs (Mr. Lloyd George), because in the country he has been taking up a very different attitude from that taken by his supporters this afternoon. I was hoping that he would have given my right hon. Friend and myself an opportunity of replying to some of the statements he has made. On the 13th June, speaking at a Liberal demonstration in the Alexandra Theatre, Stoke Newington, the right hon. Gentleman said:There had been an increase of unnecessary armaments and by that means a piling up of the burdens of taxation, whilst at the same time they (the Government) had diminished national expenditure on real developments.He instanced the developments on health. One does not expect particular accuracy from the right hon. Gentleman as far as figures are concerned; but I think that anyone who has given even a cursory glance to the Estimates of my right hon. Friend's Department must see that a more unfounded statement could not possibly have been made. If hon. Members look at almost any branch of the very many matters which have to be administered by the Minister of Health, they will see that the health services of the country are being well maintained and that increased provision is being made by the State as far as the most important services are concerned. For instance, in connection with housing grants there is an additional expenditure of £965,000 a year. In regard to health insurance grants and miscellaneous grants, mainly of a public health character, and various matters of that kind, there have been increased contributions. Therefore, it is a matter of regret to me that statements should be made on a public platform when there is no foundation for them, and that this afternoon when we have a Liberal Motion, and a Liberal Member making a certain 486 amount of criticism of a perfectly proper character, we should have no suggestions made such as those made by the right hon. Member for Carnarvon Boroughs; suggestions which could not possibly be made in this House.
I shall not be in a position, having regard to my anxiety to fall in with the arrangements made to deal with other subjects which the Liberal party desire to raise at a later stage, to deal with every question that has been brought forward to-day. I suppose no Department in the State has such a variety of business to deal with as the Ministry of Health as will be seen from the questions brought forward to-day. I will do my best to give a reply in the short time that is allowed to me. I will deal, first, with the criticism made in the very moderate, able and admirable speech of the hon. Member for Walthamstow West (Mr. Crawfurd), who moved a reduction of the Vote. He raised, first, the question of the operations of the Central Valuation Committee in relation to the Rating and Valuation Act, and made some criticisms in regard to the action of my right hon. Friend and his Department in connection with the work of that Committee. His first complaint was that the action which the Central Valuation Committee had taken and the action which had been taken subsequently by my right hon. Friend was wholly wrong, and that my right hon. Friend had misconceived the position altogether, because, in putting into operation such matters, he should have proceeded by way of a scheme, and that scheme should have been laid before the House and have received the approval and sanction of the House. He suggested that my right hon. Friend was attempting by some backdoor means to avoid the operation of Section 57 of the Rating and Valuation Act. Section 57 says:For the purpose of promoting uniformity in valuation there shall be constituted in accordance with a scheme to be made by the Minister after consultation with the local authorities … a Central Valuation Committee, consisting of members of rating authorities. …as enumerated in the Section. Therefore, the only thing which has to take the form of a scheme is the constitution of the Central Valuation Committee. That has been done. There is no provision in this Section for making the 487 matters about which the hon. Member complained the subject of any other scheme. To a very large extent that disposes of the major criticism made by the hon. Member, but he went further and said that this Committee is exceeding its functions, and that the Minister has improperly endorsed decisions of the Committee. In the first place, this Committee—and a very valuable Committee it Is—is composed of the representatives of local authorities. Of the 32 members of the Committee, 26 are members of local authorities, and 24 of them have been appointed by the representative associations. The remainder are experienced local government officials. Only one official is from the Ministry of Health, and he is the Statistical Officer. The powers of this Committee are advisory only. If the hon. Member will look at the Act he will see that neither the Committee nor the Minister can give directions to the local authorities or assessment committees who are responsible for the preparation and revision of the valuation lists.
What, in fact, has happened is that the Committee have considered a number of matters and have submitted to the Ministry representations designed to promote uniformity—I should have thought a very proper object indeed. The Minister, in his turn, felt that he was not in a position to criticise the recommendations made by this responsible body, many of which are of a technical character, so he did what it was his duty to do and brought them to the notice of the local authorities. After all we must, as I believe we can, treat local authorities as responsible people, containing many educated members undoubtedly, and no one who carefully reads the Report of the Central Valuation Committee and the document that has been circulated to local authorities, could for a moment contend that the advice given by the Committee could be anything in the nature of a direction. So that my right hon. Friend has done nothing more than circulate a number of these recommendations to local authorities.
In the letter addressed to local authorities enclosing this document my right hon. Friend said most specifically that it consisted of a series of representations made by the Central Valuation Committee 488 under Section 57 and that they were circulated to them in the form in which they were submitted to him. I do not think anything could be much clearer or more definite. So far from belittling the work of the Central Valuation Committee, if the hon. Member went to responsible representatives of the great majority of the local authorities up and down the country, they would say their work had been most valuable and their recommendations have been very gratefully received. Local authorities are very carefully advised in all they do, and when they receive these representations they adopt them or not as they think fit. The matter rests with them, and when they take certain steps it is on their own decision and, right or wrong, that is our system of representative municipal government.
§ Mr. CRAWFURD
I thank the hon. Gentleman for the courteous way he has dealt with the case, but the main point I wished to bring to bear was that these recommendations contained at the bottom of page 24 are contrary to the spirit of the Act of 1925, in so far as they encourage the valuation authority to take up an attitude rather than imposing its will upon rating authorities.
§ Sir K. WOOD
I do not agree with that. Directly I hear anyone allege that something is contrary to the spirit of an Act of Parliament I am always very careful, because I know that means that at any rate the letter is not being disobeyed. I also know that on the question of the spirit of an Act of Parliament we all have our own differing views, and the law lays down very clearly that we have to deal with what the Act of Parliament says and what it means. I do not for a moment agree that either in the spirit or in the letter the Central Valuation Committee has, in any way, gone outside its proper functions.
The hon. Member raised the question of the panel of referees and complained of its composition. When I tell him how it was arrived at, I think he will agree that a very fair system has been adopted in order to get independent and expert officers. The panel of referees is appointed by the Lord Chief Justice from names submitted to him by the Institution of Civil Engineers and the Surveyors' Institution. There are 39 people on this 489 panel from which those concerned with this part of the administration of the Act can make their choice. Something more is done in order to make the matter perfectly fair. If any of the parties concerned cannot agree upon one of the 39 under the rules made by the Lord Chief Justice they can go to the Lord Chief Justice and say, "Please select one of these persons from the list." I cannot, and I doubt whether the hon. Member can, think of a system that is fairer or more likely to get an independent body to deal with what, I agree, is a very difficult matter. I hope he will feel that on these two matters I have endeavoured to give him a reasonable explanation and one which has justified the procedure adopted by my right hon. Friend.
A matter of greater importance which has been raised is the question of housing, which my right hon. Friend dealt with so fully, and I think to the general satisfaction of the Committee. I have heard the speech of the hon. Member for South-West Bethnal Green (Mr. Harris) many times, and I often wonder whether if we had as many skilled labourers as the number of speeches he has made on the subject, we should advance faster still with our housing activities. I know it will cheer him up to know that apart from the 217,000 houses erected during the 12 months ended 31st March last—a world record, greater than has been achieved by any other country—arrangements have been definitely made for 160,000 new houses which were either under construction or definitely arranged for on 1st June. Therefore there is no reason why anyone should have any anxiety that the number of houses for the approaching year will be any less than the number for the last 12 months, and when the hon. Member can bring forward a practical plan for increasing that augmentation, in black and white and not in general phrases it will receive my right hon. Friend's most careful consideration. It is not speeches that build houses.
§ Mr. HARRIS
I was suggesting a greater supply of skilled labour, especially plasterers, of whom there is a great shortage.
§ Sir K. WOOD
When the hon. Member said he wanted more skilled labour, he said one of the methods to obtain it was to approach the building unions and demand it from them. I would advise him 490 to consult the leader of his party, who will tell him that efforts have been made in that direction. I think he can be well content to leave the matter there. Everyone must appreciate the need of continuing our efforts. Not a word has been said by my right hon. Friend or myself that we are not fully alive to that side of the situation. We agree that this great progress must be maintained and, if possible, exceeded, but I do not think this is the occasion for carping criticism, if no real practical suggestions are made to assist us in our task.
My right hon. Friend made a statement with regard to the necessity of obtaining houses at lower cost and, if possible, at a lower rent, and he made two suggestions which, I think, will commend themselves to anyone who endeavours to bring a practical mind to this problem. In the first place, he said the subsidy should be reduced, and that is one of the best ways of getting cheaper houses. That, undoubtedly, has been proved to be perfectly true. My experience is that the higher the subsidy the higher has been the cost of the house. In the days of Dr. Addison, for whom there is a good deal to be said, when the largest subsidy was given you had the highest prices. They went sky high—£1,200 and £1,300 a piece. To-day we are starting on a policy of a gradual reduction of the subsidy, and that is undoubtedly one of the means which should be pursued to get cheaper houses. Subsidies are just as vicious in connection with housing as with any other industry.
A matter which has, perhaps, provoked a certain amount of criticism is the suggestion my right hon. Friend made in regard to smaller houses. In considering this matter you ought to compare the conditions in which so many people are unfortunately living to-day with the proposals my right hon. Friend is making. I think this can be said by way of criticism of the present position of the housing situation, that a great deal has been done at a great deal of cost for the middle classes, what we might call the superior artisan, and, if you like, the smaller professional people. But the great problem that undoubtedly concerns anyone who gives serious attention to housing is the fact that we are not getting houses built at such rents as would permit them to be occupied by people with very small wages. When an hon. 491 Member opposite criticises the suggestion of smaller houses, it would be a thousand times better for these people to come out of the dreadful conditions under which they are living to-day, some in slums, and go into smaller houses with much better amenities, because the houses built by local authorities have an ample lay-out and open spaces, and it is ridiculous to condemn these people to live in bad conditions, or in slums, because we take the attitude that they must live in larger houses than they can afford. Any practical person who approaches the subject must come to the conclusion that that, at any rate, is not an improper step, and it would be of great benefit to the health of very many people to-day who are living, undoubtedly, in unsatisfactory conditions because of the high rent that has to be paid, and because there is no other practical alternative by which rents can be reduced.
One or two points have been raised in connection with National Insurance, and I should like to answer representations which have been made to me by the hon. Member for Grimsby (Mr. Womersley) and the right hon. Member for Banff (Mr. Templeton) in relation to the question of share fishermen and the difficulty they are in in connection with the National Insurance Act. Both hon. Members have been unceasing in their applications to the Ministry, and representations have been made as to the unfortunate and unfair position in which these men are placed. I am very glad to state that, after we have very carefully considered the case that they have put forward, we agree that something will have to be done, by which these men shall be incorporated in the National Health Insurance scheme. We propose, when we bring forward our new National Health Insurance Bill, which we will have to bring forward in accordance with the recommendations of the Royal Commission, to do our best to deal with the situation put forward by both the hon. Members. I hope that that will give satisfaction to a very deserving body of men up and down the country. The hon. Member for Westhoughton (Mr. R. Davies) criticised certain matters in connection with national health insurance, and raised very complicated questions, as did also the hon. Member for West Walthamstow, 492 I have here a complete explanation, which I think it would be better if I handed to the hon. Gentlemen, because I have not time to reply at length to-night. But I do want to say a word in connection with the position of the approved societies, and I am glad to say that I can report a very much more satisfactory position than I was able to state when I spoke in this House, I think on the Supplementary Estimate, some months ago.
I stated then that the claims made on approved societies had exceeded those of 1925, owing to the general strike and the coal stoppage, by a sum of over £2,000,000, and I also stated that people were being referred to referees at the rate of 400,000 or 500,000 as a consequence. I also stated that one of the unfortunate reasons for the position of approved societies at that moment was the fact that there was a serious shortage of contributions on account of unemployment. It is perfectly true that, following the coal stoppage, there was an unusual and unfortunate influenza epidemic in 1927, but I hope no one will think that, because of the unfortunate experiences of that year, the great financial strength of those societies can be said in any way to be disturbed. There are a good many indications of improved conditions. The sale of stamps at the post offices during the first five months of 1926 realised £8,125,000; the sale of stamps during the first five months of 1927 realised £8,480,000, an increase of about £350,000. The contribution income in 1926 was £740,000 less than in 1925 on the basis of the 1925 rates, and nearly the whole of that reduction was during the last eight months of the year. The hon. Gentleman made a point about the cash issues of approved societies. These during the first five months of 1926 were £7,720,000, and during the first five months of 1927, £7,940,000 apart from increases in additional benefits. Therefore, the hon. Gentleman can see that there is at any rate, a sign of improvement.
§ Mr. RHYS DAVIES
I asked a specific question as to whether, in view of the result of the Economy Act and the reduction of the contributions of the State, the societies will be in as good a position at the end of the present valuation period as they were at the end of the last valuation period?
§ Mr. CRAWFURD
I quite recognise that the hon. Gentleman cannot say what will be the state of affairs at the end of the valuation period, but could he state whether there is any prospect of a disposable balance for investment this year?
§ Sir K. WOOD
I think there is a good prospect of something being available for investment in that way, and there are signs of improvement in that connection. The only other matter with which I want to deal is the suggestion made by the hon. Member for Westhoughton that something more should be done for the trade union approved societies. He said that the trade unions took a greater interest in approved societies than any other bodies. I have in my possession a statement made by the President of the National Union of Trade Union Approved Societies, at their annual conference on 14th June. This is the statement made by the president:It was claimed before the Royal Commission that the apathy of insured persons indicated their contentment and satisfaction with the existing order of government in the Industrial Group, and the same apathy was lamented upon by friendly society representatives. This same negative quality is also the great barrier to our progress. It would be illogical to confess to the existence of apathy, and at the same time to claim that the democratic control of Health Insurance by insured members was in practice of any real value. A distinction should be drawn, however, between a type of society which affords real as distinct from theoretical opportunity for control by its members, and one which does not. The existence of apathy does not alter the fundamental difference between the two types. It nevertheless remains an indisputable fact that the approved society system of administration has not secured that active interest in its control which was predicted for it.But the matter was carried further than that in the course of the discussion, and this is the observation of the reporter:Some bitter references were made to the apathy of trade union leaders in general and to the Trades Union Congress in particular, who seemed to be concerned exclusively with industrial questions and to regard the insurance problem as a nuisance. It was suggested on the other hand that the trouble was the result of the apathy of the rank and file entirely, who, at the time the Insurance Act was passed, were inclined to regard it as a 'Lloyd George 494 stunt' and were not prepared to act until they were forestalled by the outside societies.Councillor Ernest Corbey of Salford, the general secretary, while admitting that there was nothing to be gained by attempting to apportion blame; said they had to face the facts that nine-tenths of trade union executives looked upon National Health Insurance as a damned nuisance, and did not co-operate with them as they ought to do.Therefore, I hope that the hon. Gentleman will not again repeat the statement about the great trade union interest in national health insurance. I wish I could have dealt with the very excellent speech, if I may say so, of the hon. Member for Royton (Dr. Davies), who dealt with small-pox and the necessary steps which should be taken by local authorities. I only want to make one observation on the hospital for post-graduate and medical education, because I do not want the hon. Gentleman, who, I know, has very great influence, or any other hon. Member, to be under the impression that there is any foundation for the statement that there is any idea in the mind of my right hon. Friend the Minister of Health that this should be a State institution. As a matter of fact, this institution is already acting under the auspices of a committee, of which the President of the Royal College of Surgeons, the President of the Royal College of Physicians, the representatives of the chief medical schools, and leading members of the profession like Lord Dawson of Penn are members. This institution will be in the same position as the others: there is no intention that we should start a State institution of that kind. The right hon. Gentleman the Minister of Health, and most hon. Members, believe in the voluntary principle, and I hope we shall do nothing to undermine it. I would like, in conclusion, to apologise to various hon. Members because I have not been able to answer the questions which they have put to me. I would like, on behalf of the right hon. Gentleman the Minister of Health, to thank the great majority of hon. Members who have spoken for the useful contributions which they have made to the Debate.
§ Mr. LAWSON
I have sat here all day in order to say a few words upon the subject which was raised by the right hon. Gentleman the Minister of Health as to the very alarming facts concerning the 495 spread of small-pox. I am not one of those who have any love for anti-vaccination, but one thing which has always struck me about the vaccination enthusiastis is that they persistently ignore the connection between good food, and plenty of food, and good health. Whatever the right hon. Gentleman the Minister of Health may say about the effects in areas where vaccination is being practised, they cannot get over the fact that the alarming spread of small-pox has kept pace with the growth of unemployment, reduction of wages, and reduction in the standard of life. It is in those areas where the standard of life is being reduced to the greatest extent that smallpox is growing at an alarming rate. The Minister of Health gave figures which showed that this disease was growing at an alarming rate, but he said it was a mild form of the disease compared with the usual small-pox. But I can speak with some knowledge of this subject, because of information I have had from my own district. No one must run away with the idea that this disease is not an extremely painful one, because it is. To some extent it runs in danger of marking the face like the old form of the disease, only in a milder way.
The right hon. Gentleman and the local authorities have a very great problem to deal with in this epidemic. I have watched it growing stage by stage, and, although I do not want to be an alarmist, I believe that if this disease is not dealt with more effectively than is the case at the present time, it will spread throughout the length and breadth of the country. I do not think the doctors have had to deal with anything like it before. The victims are ill for two days, and then, in most cases, they seem to be quite well. The average layman knows that it takes something like seven or eight days for small-pox to develop, or for the marks to become apparent. So that for five or six days a person may be carrying infection as he goes about his work or as he goes about the towns or villages. The right hon. Gentleman ought to get the doctors to make up their minds whether it is really small-pox and what are the symptoms of this particular disease. There is a well-known doctor in the North of England who says it is not small-pox at all, but a form of chicken-pox. 496 There are varying opinions as to what it is. There needs to be some con-census of opinion upon this matter. Whatever steps the right hon. Gentleman may take to prevent the spread of this disease, if he really gets down to the causes of it he will investigate the conditions of the people in those parts where small-pox exists. In my own area, the prevalence of the disease has been very extensive indeed. I am not going to say there are bad conditions existing in every family where small-pox breaks out. When fevers and other diseases break loose they spread among all sections of people. Here is what the medical officer of health for Chester-le-Street told the rural district council, and it is very interesting in view of the criticisms which have been levelled at Chester-le-Street as to the extravagant payments they are supposed to have made:I see children at meals, and it is very pitiful in some cases to witness the straits to which people are reduced. Three or four days ago I was in a house where the cupboard was bare and tie children were getting a dinner which was an absolute disgrace. There was nothing in it to build up health, bone and muscle. When I spoke to the mother and told her that the children were not getting an adequate meal, she said it was the best she had. Many houses get no milk except a tin of condensed milk, which is, perhaps, made to serve a fortnight. Milk is essential for growing children. Until the people get more money through their fingers, I am afraid these circumstances will continue.I use this material because I know it is first-hand, and because it is particularly in mining areas where small-pox is spreading. It would be impossible to convey to this Committee the physical deterioration which is taking place in the great minefields of this country at the present moment. It is one of the most pathetic sights, and I think it has had no parallel in our time. While the right hon. Gentleman may be right from the point of view of preventative purposes in emphasising the question of vaccination, he certainly will not do anything really effective unless he can pay strict attention to the proper feeding of the people in those areas where unemployment runs riot. While the right hon. Gentleman may be right, when we hear the elaborate statements as to the efficacy of vaccination, we say that vaccination is not very much good if people are not able to obtain a regular breakfast.
497 Question, "That a sum, riot exceeding £12,943,493, be granted for the said Service," put, and negatived.
§ Original Question again proposed.
§ Mr. LANSBURY rose—
§ Motion, by leave, withdrawn.