The DEPUTY-CHAIRMANThe first Amendment on the Paper, in the name of the hon. Member for Middlesbrough West (Mr. Kingsley Griffith)—in page 11, line 24, at the beginning, to insert the words "Save as hereinafter provided"—is out of order on the ground of redundancy.
§ Mr. ERNEST BROWNOn a point of Order. May I ask for advice? The Amendment that you have ruled out of order raises a point about which there is some doubt, as to whether an Amendment in the name of the hon. Member for Consett (Mr. Dunnico)—in page 11, line 13, to leave out the words "maternity home"—also covers the point laid down in the Clause about the operation of the Maternity and Child Welfare Act. I take it that that will not be in order, according to our drafting, unless there is an Amendment of this kind preceding it.
The DEPUTY-CHAIRMANThe hon. Member is under a misapprehension. I have been advised that these words are not necessary to enable the hon. Member for West Middlesbrough to move his Amendment on the next page. The next two Amendments, in the name of the right hon. Member for Seaham (Mr. Webb)—in page 11, line 24, to leave out the words "it shall be the duty of," and, in line 26, to leave out the word "to" and to insert instead thereof the word "may"—obviously go together. I therefore hope he will be able to discuss them as one.
§ Mr. SIDNEY WEBBI beg to move, in page 11, line 24, to leave out the words "it shall be the duty of."
This and the following Amendment, as you have said, Sir, hang together. The very emphatic words in this Clause make it obligatory on a council to present a bill in every case of a person entering one of these institutions, and a bill of the full 2846 amount, and the full amount as the Clause now stands appears to be an amount to include the whole cost of all the medical treatment, however expensive it may be. My first point is to discuss the inadvisability of making it obligatory on these councils to present in every case this full bill. I have got the particulars of what I believe to be a very typical case of an institution at present under a board of guardians but which will undoubtedly pass, under the Bill, to the county council. I remember that the right hon. Gentleman the Minister of Health, in introducing the Bill, said very emphatically that his desire was that there should be one rule for those Poor Law institutions and the institutions under the councils—one rule, that is, in regard to their future action in making a charge.
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The institution to which I am referring is that very excellent one called the North Middlesex Hospital, which is under the administration of the Edmonton Board of Guardians. This is a Poor Law institution, and it has just obtained the sanction of the Minister for an expenditure of £6,000 on radium in order to bring its equipment up to date. It is an institution, therefore, though legally a workhouse, which is better equipped than a good many voluntary hospitals, at any rate in certain respects. It is not material to discuss whether or not it is as good as a voluntary hospital, but it is a good institution. The practice here is to recover from the patients as much as the board of guardians thinks it can recover, up to the total limit of cost, and in that connection no question arises. The amount that they do actually recover is £18,000, out of £113,000, which is the annual cost of maintenance. At present the board of guardians, as I say, whenever it thinks a patient is in a position to pay makes a charge, and in some cases a high charge, up to the total amount or the cost, which during 4he past year amounted to 49s. per week per patient. I cannot say exactly how many do pay, or how many do not, but in the last 12 months only about 15 per cent. of the patients paid any contribution at all. Assuming that this institution is handed over to the Middlesex County Council, as it undoubtedly will be, it means that the Bill as it now stands will require the county council to present a bill of 2847 49s. a week to every one of the patients who has occasion to use that institution, although in the case of the board of guardians, with every desire to get as much as they can, only about 15 per cent. of the patients pay any contribution, and in 85 per cent. of the cases there is at present nothing recovered. I submit that it would be a very serious change to make if, instead of presenting a bill for 55., 10s., 20s. up to 49s., according to the means of the person in 15 per cent. of the cases, the local authority should be practically required—and required in such a way that the district auditor would have no option but to complain seriously if it were not done—to make the full charge of 49s. in all cases. If everyone who goes into this hospital is told that he or she will receive a bib necessarily at the rate of 49s. per week, with some prospect of the amount being reduced, it will be, as I am informed by medical people concerned, a very serious deterrent to people going into that hospital at the earliest possible date.
To take one very important example. A ward is being fitted up with radium at very great expense for the treatment of cancer. The mortality in cancer to-day is very serious, and every effort is being made by public health people to induce patients at the very earliest moment they detect the least sign of cancer at once to go to the hospital. The poor woman for whose benefit this is being done runs very great danger, because, being unwilling to leave her home and family, she is tempted to put off this consultation, and for that reason special treatment is being provided for such a patient. Now every poor woman is to be told that she will be presented with a bill for 49s. a week if she goes into that hospital. It seems to me that it cannot fail to have a very deterrent effect on the use of the hospital. Under the Poor Law, without objection from the Ministry of Health, the board of guardians have exercised their discretion, and have recognised that 85 per cent. of the patients are not in a position to pay anything whatever.
I submit that it would not be in accordance with the right hon. Gentleman's own intentions or desires to make this emphatic change. He said that he wanted one rule of procedure in this matter in the Poor Law institutions and 2848 the public health institutions. In the case I have mentioned this momentous change will mean that, instead of only 15 per cent. of the patients being presented with a bill, the whole 100 per cent. will be. Instead of the bill being graduated according to the means of the patient, it will have to be presented for the full amount in each case, and I put it to the right hon. Gentleman whether he cannot make some Amendment which will carry out what I believe to be his intentions? I do not want to dwell unnecessarily on that. I think the right hon. Gentleman will see exactly my point. It seems to me that you do not want to put up over the doors of these hospitals: "Anyone who enters here will have a perfectly impossible bill presented to him, whether he can pay it or not," and then, the day after, get relief from such a bill. The psychological effect of that undoubtedly would he a deterrent to people entering these institutions, and, what is more, in this particular case would be a very strong argument against handing over the North Middlesex Hospital to the Middlesex County Council, as it would probably be of more use to the people in the district if it were retained in the hands of the Edmonton Board of Guardians.
§ Mr. PETHICK-LAWRENCEI rise to support the Amendment of my right hon. Friend. I had rather anticipated, as a result of our discussion on the Second Reading, that the Minister of Health would have to come to the Committee to-day and proposed some concession in this matter. As I see from the Order Paper that there is no Amendment standing in his name, I have come to the conclusion that he intends to stand pat on the Clause as it is at the present time. That being so, I wish that a larger number of Members of all parties ere inside this Chamber to have heard the speech of my right hon. Friend, in order that they could bring pressure to bear on the Minister to do what, I am certain, if they understood it, they would recognise is essentially the right thing to do with regard to this Clause. Let us see what is the present position. Where services are given under the Poor Law, the guardians recover what they can, but by the nature of the case the amount they can recover is necessarily small. On the other hand, the local authorities are not 2849 under any obligation to recover from the patients. The position is defined by Section 152 of the Public Health 1875, where it says:
Any expenses incurred by a local authority in maintaining a patient in a hospital, may be recovered from him at any time within six months after his discharge.This Clause makes two alterations. In the first place it, in effect, uses the word "must" instead of the word "may," and, in the second place, it defines the amount to be recovered.
The DEPUTY-CHAIRMANI ought to point out that this Amendment does not deal with the amount to be recovered, and the Committee must not enter into a discussion in regard to that matter on this Amendment. We are now dealing with the question whether the local authority "must" or "may" recover.
§ Mr. PETHICK-LAWRENCEWith all respect, there is difficulty in dividing those two questions, because the whole point in the argument is that, under the Clause as it stands, the local authority may send in a bill for the whole amount, subject to what is said later in the Clause, and if we are to divide it into two, the argument will be somewhat difficult to carry through. My suggestion is that your permission should be given to discuss these two points together, and so save the time of the Committee and enable us to discuss the subject much better.
The DEPUTY-CHAIRMANOf course, in that matter I am in the hands of the Committee. If they wish to discuss this Amendment and the one standing in the name of the hon. Member for Preston (Mr. A. R. Kennedy)—in page 11, line 31, to leave out the words "the whole of the," and to insert instead thereof the words "a reasonable sure for"—and also the consequential Amendment standing in his name where he defines what is a reasonable sum, I do not think it would be out of order, but I am entirely in the hands of the Committee as to whether they wish to take the discussion on both Amendments at the same time.
§ The MINISTER of HEALTH (Mr. Chamberlain)I submit that they are two entirely different points, and it would be very confusing if we discussed them 2850 at the same time. One deals with the question as to whether the local authority shall or shall not have discretionary power, and the other with the amount which the local authority shall he allowed to recover.
§ Mr. A. R. KENNEDYAs the Member responsible for the Amendment referred, to, while I desire to act in accord with the general wishes of the Committee, I should like to feel assured that my Amendment will be reached, and I cannot be quite certain on that point.
The DEPUTY-CHAIRMANWith regard to that, it is, of course, a matter outside my control. With regard to the point of view raised by the hon. Member for West Leicester (Mr. Pethick-Lawrence), if any member of the Committee objects to discussing the two Amendments together, I am bound to rule against that being done.
§ Mr. PETHICK-LAWRENCEAs I understand the right hon. Gentleman objects, I must obey your Ruling and confine my remarks to the one Amendment. I mast, however, say this on the other point, that if the further Amendment be not reached, that will be a reason why the Minister should give way and make some concession on this proposal. To confine our attention solely to the question of the word "shall" instead of "may" we have this fact, that in the Act of 1875 the word used is "may," and the principal change which the Bill is proposing in this respect is to lay down that it shall be the duty of the local authority to recover expenses under this Clause.
I would like to draw the attention of the Minister to the case of the unmarried mother. At the present time, whether the unmarried mother be treated in a voluntary hospital, or special nursing home or in an institution under the local authority, great care is taken to preserve the secrecy which may be necessary in these cases. Under the Clause, as I understand it, if the woman herself is unable to produce any money, application will be made at once to members of her family—her father, or whoever may be responsible in law for that woman. Some hon. Members may regard this as an unimportant point, but it is a matter of extreme importance, because the result 2851 of that will be that these women will not go into a home or institution to be treated, and the unmarried mother will be kept outside. The consequence will be that these institutions will not be put to the use for which they are intended, and there will be the irregular proceedings that were in existence before, to the great detriment of society and public health generally.
I do not want hon. Members to think that in urging our claim for this point of view we are urging it because of sentimental pity for individuals. It may be true that the voluntary hospitals are founded on some idea of compassion for individuals who suffer and require treatment, and it may be true that the Poor Law institutions are founded on the desire to prevent vagrancy and destitution, but the Public Health services under the local authorities exist for a social purpose, to stamp out illness and to improve the general health of the community. They represent in practice the expression of a very great truth. When the sacred writer said that we are
every one members one of another,he was expressing a great mystic principle, but, like many great spiritual truths, this text does express in practical everyday form the principle of the administration of public health by local authorities. The time was when persons suffering from venereal disease had to fight their battle unaided by the community; to-day we realise that that is not merely individually cruel, but socially disastrous. The time was when persons suffering from infectious disease had to fight their own battles, and we recognise to-day the folly of that course. When we come to cancer, maternity and child-welfare, is it suggested that the position is entirely different? If it be so, I can only say that to omit public provision for these matters is to injure the race of the future. So-called economy in these matters is really gross extravagance, and it is because the community needs and demands that persons shall receive attention in these hospitals, and because they will be deterred from going for such treatment by the provisions of this Clause, particularly unless the Amendment which we cannot now discuss is made, that we ask the Committee to support this Amendment.
§ Mr. CHAMBERLAINThe Committee will not have failed to notice that we have spent 40 minutes in discussing a simple point, time which might have been given to more important matters.
§ Mr. PETH1CK-LAWRENCEWe did not begin until five minutes to four, and it is now 20 minutes past.
§ Mr. CHAMBERLAINAt any rate, whatever time we have spent has been longer than is necessary. The right hon. Gentleman the Member for Seaham (Mr. Webb) repeated over and over again about 12 times the point which was really the sole point that he wanted to make. The hon. Member for West Leicester (Mr. Pethick-Lawrence) took a wider view, and if there be any logic in his view at all, there ought to be no charge for treatment in an institution, either by a local authority or by a Poor Law authority. However, I prefer to take the point that was made by the right hon. Gentleman the Member for Seaham. Of course, if his Amendment were carried, we should be exactly where we are now. Local authorities have this power now, and therefore the Amendment would be quite unnecessary, and would perpetuate the present state of affairs. The right hon. Gentleman did not argue that it is not right that a local authority should recover from a person receiving treatment in an institution such part of the cost of his maintenance and treatment as that person could afford. He suggested that the Bill would force local authorities to present such person with a bill. Where does he find that in the Bill? I heard him say it, I do not know how many times. There is nothing in the Bill which says that the authority must present a hill for the whole of the expense to a person receiving treatment. In fact it is not contemplated that the local authority should do anything of the kind.
What the local authority would do would be precisely what is done now in similar cases. The local authoities, have their officers and means of making investigations, and of finding out whether a person is able to pay anything, and if so how much, and they make these inquiries before they send in any bill at all. Therefore, the charge that would be made to the person would be made after the local authority had 2853 ascertained what the person would be able to pay, and no such revolutionary alteration in the practice of local authorities is contemplated as apparently the right hon. Gentleman has in his mind. The object of this Clause is to have one rule for both kinds of institutions. If we had not a provision of this sort, the position would be that in the case of a destitute person treated under the Poor Law, it would be the duty of the local authority to recover the whole of the costs from him, or such part as he was able to pay; but in the case of a person who was not destitute and was able to pay, there would be a discretion with the local authority. That is a very topsy-turvy state of things, and an anomaly which is being removed by this Clause.
§ Mr. ARTHUR GREENWOODI must protest strongly against the attitude of the Minister in his statement about the waste of time. No one can accuse any Member on this side of the House of obstructive methods. [Laughter.] I am speaking perfectly seriously. We have had on many occasions to restrict discussion far below what is reasonable under the circumstances, and if it be that hon. Members opposite have to sit and wring their hands because their Amendments cannot be discussed, the person responsible is the Minister. We ore being asked to discuss Clauses 13 to 16 in three-and-a-had hours; it is a physical impossibility, and when there are Amendments of this kind, which are Amendments of substance, my friends are going to have the maximum opportunity of discussing them. The guillotine is imposed on us, and we must choose the things which we de-sire to discuss. Unfortunately, we have a very wide range of choice, and many points which we would discuss will, by the operation of the guillotine, remain undiscussed.
The present Amendment is not a small point, but one of substantial importance. When we were discussing Clauses 4 and 5, and wished to make certain powers of local authorities mandatory, the Minister rose in all his majesty to protect the freedom of local authorities. Now, when he is imposing new duties upon local authorities, and we wish them to maintain their freedom and initiative, the right hon. Gentleman quotes arguments opposite to those which he quoted against us on Clauses 4 and 5. The right hon. Gentleman cannot expect to have it both ways. The object of this 2854 Amendment is to maintain the law as it is now, so that local authorities shall have the power to make such charges as they may think fit, but not to impose upon them the duty of examining every case, and of making a charge in every, case to fit the circumstances of a beneficiary in one of the institutions referred to in the Bill. I regard any general collective expenditure as that which yields the maximum return. I would rather pay through the rates for such services as I may require than be badgered to death by the registrar of a hospital making detailed examinations into my ability to pay. Presumably we ought to accept the hypothesis that people are rated according to their ability to pay. We are not in fact so rated, and the whole rating system ought to be altered, but so long as it exists as it is, we are entitled to say that people are paying rates according to their means. If that be so, this additional imposition of a poll-tax upon individuals who are receiving particular services is quite unnecessary.
See how it will work out in practice. It will mean that some of the energy and time of the administrative staffs of our public departments will be diverted to this business of collecting money. As I said on Second Reading, public health authorities, instead of being authorities primarily concerned with rooting out the causes of disease, and securing the earliest possible treatment of disease in its incipient stages, will become glorified debt collectors, and there is bound to follow an increase in that bureaucracy which hon. Members opposite profess to loathe. I have always held that the real friends and creators of bureaucracy in this country are the Tory party. Wherever it is possible for them to badger the poor and to extract small sums in payment for services, you may be sure that they will do it, and in order to do it, they erect an elaborate bureaucracy of officials and collectors, and possibly solicitors to take cases to the local courts. All the effort is far beyond any real value that can ever accrue from the collection of these amounts. Suppose that you were to extract out of individual cases of institutional treatment the maximum amount that even a hard-hearted person would extract, and that you made the largest claim that anybody could reasonably demand, the 2855 total contributions of all the cases dealt with in a year would be so small relatively to the total expenditure, that it really would not be worth while for the amount of effort that was expended on it.
That is our fear, and if it has to be put 12 times, I do not mind, because hon. Members opposite need a certain amount of repetition in order to understand our point of view. This is our point of view. It is not so much the mere collection of the money that we regard as obnoxious, but that the new duty which is imposed on local authorities is bound to be a deterrent, and will lead to numbers of people who ought at an early stage to seek institutional treatment to postpone it or not to go at all. We know that has been so in the past, and any deterrent in the way of people who need institutional treatment seeking that treatment is against the public wellbeing. When the right hon. Gentleman was defending this Clause on Second Reading, he definitely excluded certain cases, saying, "I exclude them because it is in the public interest that those people should have nothing put in the way of their securing early treatment, which is necessary in the public interest."
We submit that you cannot single out one disease and say that it is a public danger, while other diseases are not. All diseases stand in the same category; if they are preventable, they ought to be prevented by every means in our power, and if the right hon. Gentleman is prepared to make any exception at all he is really conceding our case. If a person has a disease like cancer, which can be treated by that radiological treatment which the Minister is encouraging, then clearly nothing ought to stand in the way of that person receiving treatment at the earliest possible moment. The same can be said of any other disease. From the point of view of the public health and of stamping out disease, Parliament ought to do nothing which will in any way hamper the public health authorities, and it is our view that in imposing this other duty on local authorities we shall be hampering their work, particularly in the case of those progressive local authorities which have been more concerned to provide treatment than to recover money.
2856 As I understand it, the point of view of the right hon. Gentleman and many members of his party is that it is far more important to drag a few coppers out of the person who has been treated than to make certain that he secures early treatment. We utterly dissent from that point of view. [Interruption.] If that be so, then I hope many hon. Members opposite will follow us into the Lobby. Evidently we are doing better than I thought, by this repetition of our case 12 times. If hon. Members think that early treatment is more important than the recovery of money, quite clearly they cannot conscientiously support a proposal which makes it obligatory upon all local authorities to put the question of the charge before anything else, which is what this Clause actually does. I hope we shall have the support of the benches opposite for our plea for the early treatment of disease and our contention that local authorities shall not have imposed upon them a duty which will be repugnant to a large number of the more progressive authorities.
Dr. VERNON DAVIESThe hon. Member for Nelson and Colne (Mr. Greenwood) showed extreme lack of knowledge of the subject on which he had been speaking. Perhaps he will allow me, as an old medical officer of the Poor Law, as a hospital official, and as a general practitioner, to let him know what really happens. In the majority of cases, a person who is sick goes first of all to his private doctor, without any thought of what it is going to cost. The doctor examines him and, if the case requires treatment in an institution, sends the man to the institution. In some of the large towns you will find, occasionally, that the patient, instead of going to a doctor, goes to the out-patients' department of a voluntary hospital and gets some attention there, without any cost at all to himself. For the hon. Member to say that the Government by this Bill are trying to prevent people seeking medical assistance at the earliest possible moment is to say what is not true, and to put a false construction on the Bill.
The people of this country know, and have known for years, that they can always get medical assistance either from hospitals. Poor Law institutions or 2857 doctors without any thought of the ultimate cost. Take the case of a genera] practitioner in an industrial district—in the huge majority of cases. He does not ask a patient, "Where is your fee, and then I will tell you what is the matter with you." [Interruption.] Oh, no. Pardon me! I am speaking from actual experience. [HON. MEMBERS: "So are we!"] Hon. Members in the Labour party may speak from rumour or hear say—[Interruption]—but their attitude is a distinct reflection and libel on a most honourable profession. I maintain without fear of contradiction that no man or woman in this country need delay for one moment in getting the most expert advice and the most expert treatment through fear of poverty, or fear of the cost, and there is nothing in this Bill which will hinder them in the slightest degree. It is absolutely wrong for an hon. Member on the Opposition Front Bench to make the statements we have heard this afternoon, but I will ask hon. Members and the people of the country to notice that this is the policy of the Labour party, that the destitute poor should be charged for medical attention, but that the public health authorities need not make a charge. [Interruption.] That is what you are asking for—to charge the destitute poor, but not allow the public authority to do so—and that is a scandal.
§ Mr. HARNEYI really think the hon. Member for Royton (Dr. Davies) has missed the point. I think the Minister has answered the point which I understood to be put by the Mover and Seconder of the Amendment. I understood the right hon. Gentleman to say that at the present time there was nothing to prevent a person going to an institution without the fear of there being any inquiry into his means or his being charged. But listen to the words of the Clause:
It shall he the duty of the council"—to recover the cost of treatment in any institution, with the exception of infectious disease. The only qualification of that absolute obligation to recover is this:If the council or authority are satisfied that the persons from whom the expenses are recoverable are unable by reason of circumstances"—2858 to pay those expenses. There are cases where circumstances would make it highly inadvisable to bring about an inquisition, involving publicity, in an effort to recover the expenses. As an illustraton of that, the ease of the illegitimate child has been mentioned. I do not think the Mover and the Seconder of the Amendment desire to see any lack of uniformity, but they desire that it should be a uniformity on a line different from that indicated by the right hon. Gentleman. At the present time, as I understand things, if you go into an institution under the status of a pauper the authority must sue you whet her they like it or not. If you are of a pauper status and you have the means to pay, it is an obligation upon the authority to make you pay. But if you go into an institution not under the status of a pauper, the authority are left with the option of suing you or of not suing you, as they may decide. In maternity cases, as I understand the law, there is an obligation not to sue. This Clause says that we are to knock the three together, and that in every case the authorities shall do what they must do at present in the case of a pauper.Take the case of anyone going into an institution suffering, say, from infectious disease, suffering from cancer, or suffering from a venereal disease, or, in the case of a poor woman, going into a maternity home where she hopes to keep dark the misfortune she has got into. If you say that in everyone of those cases there is an obligation to sue provided the persons treated or their friends have money, then undoubtedly that will deter those persons from seeking this form of assistance. I know you would certainly deter me if I were a poor person. If I found that I were suffering from a disease and that the only way in which I could get cured was by going into a hospital and running the risk of the publicity of being sued, then I would suffer for a very long time. If I were an unfortunate young woman covering up what is called her shame, but what I would call her misfortune, I would do a great number of things indeed before going into an institution if I knew that there was an obligation upon the authorities to sue my parents or my relatives should they have money. That is the real objection to the Bill. The Mover and the Seconder would be satisfied with this uniformity—that you should apply to all institutions the 2859 rule you now apply to non-pauper institutions, that is, leave it to the discretion of the local authority to sue or not to sue as they think reasonable in the circumstances.
§ Mr. R. RICHARDSONI feel sure that if the Minister had consulted the local authorities on this point he would have found that they do not concur in his opinion. I ask the Minister who is to determine whether people are in a position to pay, or otherwise. Presumably the authorities will take the amount of income going into a house; but there are other things to be considered. First of all, they ought to take into consideration the commitments which a man may have undertaken when in good health out of a desire to do the best he can for his family. He may have made provision for insuring them. He will want to see that at a certain time in their life they have something to go on with. Are these things to he taken into consideration by the members of the council in determining whether people are in a position to pay? I have had some experience in these matters, and I contend that it is in the interests of persons themselves and of the public health that they should seek treatment as early as possible, because if they neglect to do so more serious consequences may follow. I want the Minister to consider this from a broader standpoint than from the mere localised point of view of making somebody pay a few shillings who would possibly be much better off if he were allowed to keep those few shillings.
There is a still more serious point. A man may be ill in one of these institutions, and his friends may be in a position to pay his expenses, but the man may not want anybody to pay his expenses because that would take away his individuality. The local authorities have carried out their duties satisfactorily in the past in this respect, and I think it is quite clear that if we upset them, as is now proposed by this Bill, our action will produce results in an entirely wrong direction.
§ Mr. A. R. KENNEDYIt has been said that under this Clause one authority may recover these expenses and another authority has the discretion to accept such part of the expenses as the persons 2860 who have been maintained are able to pay. The suggestion now is that this should be made uniform by placing on the second authority the same responsibility as is placed on the first authority. What is the duty of the council? Its duty is to recover certain expenses for maintenance in an institution where the circumstances show there is a reasonable chance of recovering such expenses. Is there anybody in this House who does not think it is quite reasonable that those expenses should be recovered if the persons maintained are in a position to pay? If that is conceded, surely the objection to this Clause as it stands rests only in the fear expressed—I hope quite unreasonably—that the provision made in this Clause would act as a deterrent to those who in the interests of others should be encouraged to enter these institutions.
If I thought that this provision would act as a deterrent in those cases, then I should be inclined to vote for the Amendment, but surely it is not giving sufficient credit to the local authorities to assume that they will do anything in such cases that will act as a deterrent to persons going into those institutions for treatment. If an officer was in the habit of meeting a would-be patient at the door of the institution and saying to him, "I understand that you want to come into this institution; if so, you will have to pay 49s. a week," it is quite conceivable that the person addressed in that way might turn away and go, but that is not the practice now in the case of these institutions, and I decline to believe that it will be the practice under this Bill. The local authorities desire these people to come in in order that they may receive the necessary treatment, and surely they would not be so foolish as to do anything that would act as a deterrent. To take such a view as that is not doing justice to those who will have to exercise these powers in the future, and we have no right to assume that they would do other than that which any one of us would do under similar circumstances. Therefore, I think it is unfair to assume that there will be any deterrent if these words are retained in the Clause. The only uniformity that would be attained is that suggested by the hon. and learned Member for South Shields (Mr. Harney), namely, giving a discretion 2861 in the case of the Poor Law authority. I think there is a good deal to be said for laying down that there is a prima facie duty on the part of the authorities to recover the expenses, and the actual case in which that duty will be exercised must be left to the authorities. I believe that those authorities will act with reason and discretion as other authorities have acted under similar circumstances in the past.
§ Mr. MORRISI am inclined to agree kith the Amendment which has been moved dealing with the point we are considering. I think it is the duty of the local authority to recover the expenses in certain cases, but under the second part of the Clause there is a discretionary power to relieve the person maintained of part of the expenses. I want to put a question on this point. First of all it is the duty of the local authority, presumably, to recover the expenses, and the local authority must show to the auditor at the end of the year that it has discharged that duty. How is the local authority going to show that? Will it have to produce evidence that it has made proper inquiries? The second part of Sub-section (1) provides that:
If the council or authority are satisfied.Presumably in that case the matter does not come before the auditor at all. If the local authority is merely to satisfy itself on this point, then there is no necessity to make what is provided in the first part of Sub-section (1) a duty of the council. I think it would be better if the whole of the clause was permissible.
§ Sir HENRY SLESSERI want to follow up what my hon. and learned Friend the Member for Preston (Mr. A. R. Kennedy) has said by asking a further question. I understand that the obligation in the first part, of the Clause to recover the whole of the expenses must be read in conjunction with the provisions in the second part of the Sub-section which reads:
If the council or authority are satisfied that the persons from whom the expenses are recoverable are unable by reason of circumstances other than their own default, to pay the whole of those expenses, such part if any of the expenses as they are in the opinion of the council or authority able to pay.2862 I want to ask the meaning of the qualifying words "other than their own default." The way it reads in the Subsection is:If the council are satisfied that the persons from whom the expenses are recoverable are unable, by reason of circumstances other than their own default, to pay the whole of those expenses.Therefore, if the circumstances are circumstances caused by their own default then they may not ask for a part but they must demand the whole of the expenses. I notice the words are not "wilful default" but "their own default" so that if they default in payment that is not a case in which they must ask for the part but for the whole. That seems to me to be a contradiction in purpose or intention to relieve them of paying a part when they are not able to do it. I could understand the phrase if it contained the words "wilful default" because that would mean that the people relieved were in possession of funds and refused to pay but if the words remain "own default" the position is quite different.With regard to the second part, it is quite true that circumstances may exist which make persons unable to pay, but they may not be circumstances caused by "their own default." We must pay attention to the meaning of the word "default" because "own default" means one thing and "wilful default" another thing. If the words "own default" remain, they go very far to justify what my right hon. Friend the Member for Seaham (Mr. Webb) said, that in any event they would have to pay the whole of the expenses, but my right hon. Friend did not mean any such thing.
§ The PARLIAMENTARY SECRETARY to the MINISTRY of HEALTH (Sir Kingsley Wood)Some of the arguments which have been used seem to be a long way from the Amendment. It has been argued that our proposal would mean presenting a bill in the first instance in full to the person who had received treatment, and that the presentation of such a bill in full might have detrimental effects even if it was afterwards reduced according to the circumstances. There is no ground for that assumption and there is no duty on the local authority to present the bill in full. We are advised that there is no obligation upon the 2863 authority to do that. Therefore, so far as that objection is concerned the right hon. Gentleman need have no anxiety in that respect.
5.0 p.m.
Then we come to the position which has been put by the hon. and learned Member for South Shields (Mr. Harney) who endeavoured to draw a distinction between this Clause and the practice of the law in relation to maternity cases. The hon. and learned Member is very careful as A, rule, but I think he may take it from me that so far as municipal and voluntary maternity homes are concerned—there are some 60 or 70 municipal maternity homes—in every case it is the practice to do what we are suggesting and it has been done without detriment to a single expectant mother. In all these cases regard is had to the circumstances of the family. The only other objection is whether we should make the Clause permissive or mandatory. I thought the Minister of Health had made that point perfectly plain. In fairness to the local authority and to the country generally I should have thought that very few people would dispute the contention, except the hon. Member for Nelson and Collie (Mr. Greenwood), that where people can pay they ought to pay a reasonable amount for treatment. Take the case which has been put forward, namely, that of a mother. If a mother goes into one of these maternity homes, and if she can reasonably afford to pay some amount in respect of treatment, it has always been the practice for her to do so. All that we are saying in this Clause is that in such cases local authorities should have this right and this duty, after inquiring into the circumstances of the case, as they have always done; and, indeed, all that the Clause does is to follow out what the voluntary hospitals in this country are doing to an increasing extent.
I now come to the final point of the hon. and learned Member for South-East Leeds (Sir H. Slesser), although it is not really a subject that comes under this Amendment at all. He has drawn attention to the words "other than their own default." Those words mean that, if a person has dissipated the money which he ought to have used for this particular purpose, it is the duty of the local authority to proceed against him. That, 2864 I should have thought, is a perfectly proper and fitting thing for the local authority to do, but, if there is any question as to the use of the word "wilful", that matter can be considered. It is a minor matter. From the point of view of the general intention and desirability of the Clause, I do not think there can be any question, at any rate among the great majority of the Members of the House, that it is a fit and proper Clause to put into the Bill.
§ Mr. WEBBPerhaps the Committee will bear with me for a few moments while I ask a question. I do not want to believe that any controversial point is involved here; it is really a question of getting the right wording. The right hon. Gentleman has dealt with the point about the word "default," and has said that that will be a matter for consideration. There is, however, another point. As I understand it, what is intended is that the practice hitherto prevailing in what I would call the public health hospitals should be continued; but the practice, as between Poor Law hospitals and public hospitals, is different. I think I am right in saying that the position is that a Poor Law authority can recover, and ought by law to recover, the amount of the expenses incurred, but only the expenses of maintenance, and not the expenses of treatment, and Poor Law authorities do not in the majority of cases divide up the salaries of their medical officers and recover those from the patients. That, however, is not my point. My point is that, when they recover, they can recover, not only from the patient, but from the person who is liable to maintain that patient—the father in the case of a child, the husband in the case of a wife, and so on.
I do not think that under the Public Health Act there is any power to do more than recover from the patient, and I would suggest to the right hon. Gentleman that he might look into that point. I understand that he does not want to increase the deterrent effect in regard to the public health hospitals, and at present I do not think the public health authority can recover except from the patient himself. I am sure that the right hon. Gentleman wants to get the wording right, and I would ask him to be good enough, between now and the Report stage, to consider the point made by my 2865 hon. and learned Friend the Member for South-East Leeds (Sir H. Slesser) as to the meaning of the word "default," and whether it really does actually mean that a patient who has dissipated his money is to be sued for the amount if he has not got it. That would be opening a very serious door, and I do not think that that can be the meaning. You cannot get more out of a patient than the patient has got, and you cannot, I suggest, go back and say that if he had acted otherwise he would have had more money which you might have expected to receive from him. I do not think that that is feasible. In the second place, is it desired to extend the right of the public health hospital to recover, not merely from the patient, but from any relatives who can be made liable under the Poor Law to maintain that patient? I do not think that the right hon. Gentleman means that, but that is practically what the Clause means. As to the third point, with regard to the question of medical treatment, we shall come to that later.
§ Mr. PETHICK-LAWRENCEI should like to ask the right hon. Gentleman one question, because I want to be clear on this matter. In the case, say, of a labourer in receipt of £2 a week, who, as a result of saving, has put aside £50, under the present practice of the local authorities they would not charge that man any considerable sum on account of his own or his wife's stay in one of these institutions; but, as I read this Clause, the local authority would be obliged to go to the full length of taking the whole of the £50 that that labourer had saved, if they discovered that he had it, because otherwise they would not be carrying out their duty under the Clause. If that be correct, as I think it is, I put it to the Minister that there is a very grave distinction between the position which exists at present, and which may be described as reasonable, and the wholly unreasonable attitude which I think will occur under this Clause.
§ Mr. W. PALINGThe Parliamentary Secretary in his speech said that we need not be afraid that anyone would be presented with a bill, and I think he said that the local authority would have the power, as these words stand now, to excuse anyone from payment without presenting him with a bill or going to his 2866 house at all, and that they would make inquiries before they presented a bill. I am not quite so sure. The right hon. Gentleman tells us that it does not matter what the Bill says, it is all right; but this is a definite attempt to stiffen the law with regard to the recovery of money as compared with the present position, and we are rather afraid that, if these words remain, the Clause will operate in exactly the same manner as the law operates with regard to the recovery of money from persons whose children have been fed at school. I remember that in 1921 and 1926, when school children had meals at school, the parents were presented with bills, and every attempt was made, by badgering them in season and out of season, to recover every penny of the money that had been spent on feeding their children; and it was left to the parents themselves to prove, after, in some cases, 18 months or two years, that they were not able to pay this money, before they were forgiven it. I am suspicious that exactly the same procedure will operate with regard to the recovery of money under this Clause also.
The fact that parents know that they are going to be badgered for the money if their child is fed at school makes them do everything that they possibly can to avoid having the child fed, often to the detriment of the child. They are terrified at the prospect of these bills being sent in afterwards, to add to the load of debt that they already have round their necks. There is, therefore, a deterrent effect, and if these people, however great their need for treatment may be, know that the same thing is going to operate in regard to them, it will have exactly the same effect as it has in the case of the feeding of school children. It is because we are afraid of that that we are supporting this Amendment. If it is going to operate as the right hon. Gentleman says, why should he put up such a stiff opposition to the Amendment? He says that we all want to get at the same thing, but, if that be so, why not put these words in? That would suit both parties. The present words do not suit us, for we are afraid that they will have the effect that we have described. The Minister says that they will not. Apparently there is no difference as to what we want to get at, but there is a difference of opinion as to whether the words mean that or not. I suggest 2867 that, if the right hon. Gentleman can give us an assurance now, we might get on with the business.
§ Mr. CHAMBERLAINWith regard to the hypothetical case put by the hon. Member for West Leicester (Mr. Pethick-Lawrence), of a person who had saved money, I think it would be very difficult to distinguish between the possessions of a person who had inherited them and the possessions of a, person who had saved them, and, so long as a person had the money to pay, it would appear to me that he would be liable to pay under the law as it stands at present. If hon. Members say that they do not agree with that view, I suggest that the point would be a reasonable one to discuss on the Amendment which stands later on the Paper in the name of my hon. and learned Friend the Member for Preston (Mr. A. R. Kennedy)—in page 12, to leave out lines 7 to 15, and to insert instead thereof the words:
'A reasonable sum for expenses' shall be such reasonable sum in respect of each day of maintenance in the institution not exceeding a such representing the average daily cost per patient of the maintenance of the institution and the staff thereof and the maintenance and treatment of patients therein as shall be fixed from time to time by the council or authority.That is an alternative suggestion for dealing with this matter, and I think it is one that we might discuss when we come to that Amendment. The purely drafting and semi-legal point raised by the hon. and learned Member for South-East Leeds (Sir H. Slesser), as to the meaning of the word "default," is one which is new to me, and is one upon which I do not feel competent to give an opinion, but I will certainly look into it between now and Report, and see whether it is necessary to alter or supplement the present wording. With regard to the question of the liability of persons other than those actually receiving treatment, I think it will be seen that here we are confining ourselves to a person or the person who is liable to maintain that person. That is not extending the power which local authorities now have. Under the Public Health Act, they have power, although it is not quite the same as the Poor Law power, to recover, not merely from the person 2868 who is actually receiving treatment, but from anyone who is liable to maintain that person.
§ Mr. HARNEYThere is one question that I should like to ask. Suppose that a person went into an institution, and he was a person who unquestionably answered the description of one who could pay, but that there were various circumstances that would render it inadvisable to recover or to sue. In these circumstances, is not the council bound to sue, and to disregard any of the other circumstances? At the present time, although the person in question could pay, the council might think fit, looking at all the circumstances of the case, to stay their hand; but here, if once there is the ability to pay, they are bound, are they not, to disregard every other possible circumstance?
§ Mr. CHAMBERLAINThat, if I may say so, is a matter which might be discussed on the Amendment of my hon. and learned Friend the Member for Preston (Mr. A. R. Kennedy).
§ Mr. T. WILLIAMSI want to submit another point to the right hon. Gentleman. The Parliamentary Secretary a few moments ago said that there was little or no difference in the Committee, but, if this Clause is not designed to enlarge the power of the local authority to recover, will he tell us what would happen in a case of the following description? Under the existing law, should a person find himself in need of institutional treatment, and, there being no voluntary hospital accommodation available, he is obliged to go to a Poor Law infirmary, no charge can be made by the institution—
§ Sir K. WOODA charge must be made.
§ Mr. WILLIAMSMy membership of a hoard of guardians has taught me that, when any person goes into a Poor Law institution for treatment, the guardians seldom, if ever, make a charge upon him when he has recovered and is in a position to earn wages. In such a case the patient is seldom or never charged with any sum for maintenance during the period of his stay in the institution. Here the right hon. Gentleman states, in effect, that authorities are obliged to charge a person in that position for main- 2869 tenance during the period in which he has received treatment. However the right hon. Gentleman may theorise, in practice there are very many Poor Law guardians who, in circumstances similar to those I have described, never made a charge.
§ Mr. CHAMBERLAINThey must be satisfied that the person can pay.
§ Mr. T. WILLIAMSThe right hon. Gentleman makes it compulsory here.
§ Mr. CHAMBERLAINNot if the authority is satisfied that the person cannot pay. It is exactly the same.
§ Mr. WILLIAMSI am suggesting that, if this does not impose a duty upon the local authority to hand in a bill to an individual in the circumstances I have described, it at least stiffens the position so far as local authorities are concerned. If the Minister's argument on Clause 5 was correct when he referred to the question of co-option and said we ought at least to have sufficient confidence in the county councils to elect the right representatives, and that we ought to give them some power over their own destiny, his argument on this Clause is wholly inconsistent, since all we are saying is that in all these various cases the power ought to be left with the local authority to define whether or not a bill should be sent in for treatment that has been received. The right hon. Gentleman said a moment ago that power is still in the hands of Poor Law guardians to hand a bill to any other person than, shall we say, a parent, who may be responsible for the maintenance either of his son or his daughter or grandson or granddaughter. Here again that principle is carried forward with special emphasis that the authority must charge the grandfather or grandmother in case of need, whether the charge is justifiable or whether it can be corrected or not. It seems to me in a case of that kind the permissive word ought to be included and the compulsory word deleted.
The right hon. Gentleman is always against any suggestion that may be made from these benches. He has never known the real meaning of poverty, but if he would go to one of these industrial areas and learn something about working class homes, he would realise our keenness on such matters as this. No argument the right hon. Gentleman can use could 2870 be effective as against our suggestion that the matter should be left purely permissive, so that the county council, who know the people and know all the circumstances, should decide whether a bill should be served or not. So long as the Opposition are prepared to go so far, the Minister ought to condescend to say that, so long as the power will be in the hands of a responsible body, he is not going to compel them to use it whether they want to or not.
§ Mr. TOWNENDI should not have risen but for the charge made by the Parliamentary Secretary against the hon. Member for Nelson and Collie (Mr. Greenwood) that he desired that those who were well able to pay for treatment should get it free. No such statement was made. What was said was that we desire that treatment should be paid for according to the ability of the individual to pay, which is quite a different thing. There is another matter I would refer to. An ounce of experience is worth a ton of theory, and when we say that the stiffening process in this Clause is going to act as a deterrent, a little experience will go a long way to prove it. The hon. Member for Preston (Mr. A. R. Kennedy) said the fact that a bill might be presented to someone who went to an institution for assistance, was a matter of not so very much concern if he could afford to pay. What we have in mind in emphasing the deterrent effect of this Clause is not so very much the ability of certain people to pay but the apprehension in the minds of many who would otherwise go to an institution for treatment as to the position in which they might find themselves. I know of one case where, because of a bill having been presented which the recipient could not afford to pay, a neighbour who required treatment hesitated so long that the complaint became incurable.
I therefore ask the Minister to see if it is not possible to accept the suggestion that the law as it stands should be allowed to continue. There is no gainsaying that the words in the Clause have a very stiffening effect, and if we are going to find that the purpose for which our institutions were created is defeated, and ultimately the expense to the community is going to be far larger than anything that could be obtained by demanding accounts for a few coppers here 2871 and there, surely, weighing both sides in the balance, the advantage to the community as compared with the expense of collecting these small accounts plus the few small additional items that might flow into the coffers of these institutions the right hon. Gentleman should accept the Amendment and do away with the
§ suffering that must inevitably follow if he insists on the position he has taken up in this Clause.
§ Question put, "That the words proposed to be left out stand part of the Clause."
§ The Committee divided: Ayes, 236; Noes, 130.
2873| Division No. 84.] | AYES. | [5.25 p.m. |
| Acland-Troyte, Lieut.-Colonel | Erskine, Lord (Somerset, Weston-s.-M.) | Locker-Lampson, Rt. Hon. Godfrey |
| Ainsworth, Lieut.-Col, Charles | Erskine, James Malcolm Monteith | Loder, J. de V. |
| Albery, Irving James | Everard, W. Lindsay | Long, Major Eric |
| Alexander, E. E. (Leyton) | Falle, Sir Bertram G. | Looker, Herbert William |
| Allen, Sir J. Sandeman | Fanshawe, Captain G. D. | Lougher, Lewis |
| Applin, Colonel R. V. K. | Fermoy, Lord | Lucas-Tooth, Sir Hugh Vere |
| Apsley, Lord | Fielden, E. B. | MacAndrew, Major Charles Glen |
| Ashley, Lt.-Col. Rt. Hon. Wilfrid W. | Forestler-Walker, Sir L. | Macdonald, Capt. P. D. (I. of W.) |
| Atholl, Duchess of | Forrest, W. | Macdonald, R. (Glasgow, Cathcart) |
| Atkinson, C. | Foster, Sir Harry S. | Macmillan, Captain H. |
| Barclay-Harvey, C. M. | Fraser, Captain Ian | Macquisten, F. A. |
| Benn, Sir A. S. (Plymouth, Drake) | Fremantle, Lieut.-Colonel Francis E. | MacRobert, Alexander M. |
| Bennett, A. J. | Gadie, Lieut.-Col. Anthony | Maitland, A. (Kent, Faversham) |
| Bentinck, Lord Henry Cavendish | Galbraith, J. F. W. | Maitland, Sir Arthur D. Steel- |
| Berry, Sir George | Ganzonl, Sir John | Manningham-Buller, Sir Mervyn |
| Betterton, Henry B. | Gates, Percy | Margesson, Captain D. |
| Birchall, Major J. Dearman | Gauit, Lieut.-Col. Andrew Hamilton | Marriott, Sir J. A. R. |
| Bird, E. R. (Yorks, W. R., Skipton) | Gilmour, Lt.-Col. Rt. Hon. Sir John | Meyer, Sir Frank |
| Boothby, R. J. G. | Glyn, Major R. G. C. | Milne, J. S. Wardlaw- |
| Bowater, Col. Sir T. Vansittart | Goff, Sir Park | Mitchell, S. (Lanark, Lanark) |
| Bowyer, Capt. G. E. W. | Gower, Sir Robert | Mitchell, W. Foot (Saffron Walden) |
| Brass, Captain W. | Grace, John | Mitchell, Sir W. Lane (Streatham) |
| Bridgeman, Rt. Hon. William Clive | Graham, Fergus (Cumberland, N.) | Monsell, Eyres, Com. Rt. Hon. B. M. |
| Briggs, J. Harold | Grant, Sir J. A. | Moore, Lieut.-Colonel T. C. R. (Ayr) |
| Briscoe, Richard George | Grattan-Doyle, Sir N. | Moore, Sir Newton J. |
| Brittain, Sir Harry | Greaves-Lord, Sir Walter | Morrison, H. (Wilts, Salisbury) |
| Brocklebank, C. E. R. | Gretton, Colonel Rt. Hon. John | Morrison-Bell, Sir Arthur Clive |
| Brooke, Brigadier-General C. R. I. | Guinness, Rt. Hon. Walter E. | Murchison, Sir Kenneth |
| Broun-Lindsay, Major H. | Gunston, Captain D. W. | Nail, Colonel Sir Joseph |
| Brown. Col. D. C. (N'th'l'd., Hexham) | Hacking, Douglas H. | Neville, Sir Reginald J. |
| Brown, Brig.-Gen. H.C.(Berks, Nowb'y) | Hall, Capt. W. D'A. (Brecon & Rad.) | Newton, Sir D. G. C. (Cambridge) |
| Buchan, John | Hamilton, Sir George | Nicholson, O. (Westminster) |
| Buckingham, Sir H. | Hanbury, C. | Nicholson, Col. Rt. Hn W. G. (Ptref'ld.) |
| Bull, Rt. Hon. Sir William James | Hannon, Patrick Joseph Henry | Nield, Rt. Hon. Sir Herbert |
| Bullock, Captain M. | Harland, A. | Nuttall, Ellis |
| Burman, J. B. | Harrison, G. J. C. | Oakley, T. |
| Campbell. E. T. | Hartington, Marquess of | Ormsby-Gore, Rt. Hon. William |
| Carver, Major W. H. | Harvey, G. (Lambeth, Kennington) | Pennefather, Sir John |
| Cayzer, Sir C. (Chester, City) | Harvey, Major S. E. (Devon, Totnes) | Penny, Frederick George |
| Cazalet, Captain Victor A. | Haslam, Henry C. | Percy, Lord Eustace (Hastings) |
| Cecil, Rt. Hon. Sir Evelyn (Aston) | Headlam, Lieut.-Colonel C. M. | Perkins, Colonel E. K. |
| Chamberlain, Rt. Hon. N. (Ladywood) | Henderson, Capt. R. R. (Oxl'd, Henley) | Perring, Sir William George |
| Charteris, Brigadier-General J. | Heneage, Lieut.-Colonel Arthur P. | Peto, Sir Basil E. (Devon, Barnstaple) |
| Christie, J. A | Henn, Sir Sydney H. | Peto, G. (Somerset, Frome) |
| Churchman, Sir Arthur C. | Hennessy, Major Sir G. R. J. | Pitcher, G. |
| Clarry, Reginald George | Hilton, Cecil | Power, Sir John Cecil |
| Cochrane, Commander Hon. A. D. | Hohler, Sir Gerald Fitzroy | Pownall, Sir Assheton |
| Cohen, Major J. Brunei | Holbrook, Sir Arthur Richard | Preston, William |
| Coltox, Major Wm. Phillips | Holt, Capt. H. P. | Price, Major C. W. M. |
| Colman, N. C. D. | Hope, Capt. A. O. J. (Warw'k, Nun.) | Raine, Sir Walter |
| Cooper. A. Duff | Hope, Sir Harry (Forfar) | Ramsden, E. |
| Cope, Major Sir William | Hopkins. J. W. W. | Reid, Capt. Cunningham (Warrington) |
| Courthope, Colonel Sir G. L. | Hopkinson, A. (Lancaster, Mossley) | Rentoul, G. S. |
| Craig, Sir Ernest (Chester, Crewe) | Home, Rt. Hon. Sir Robert S. | Rhys, Hon. C. A. U. |
| Crooke, J. Smedley (Deritend) | Howard-Bury, Colonel C. K. | Richardson, Sir P. W. (Sur'y, Ch'ts'y) |
| Crookshank, Col. C. de W. (Berwick) | Hudson, R. S. (Cumberl'and, Whiteh'n) | Rodd, Rt. Hon. Sir James Rennell |
| Crookshank, Cpt. H. (Lindsey, Gainsbro) | Hume, Sir G. H. | Ropner, Major L. |
| Culverwell, C. T. (Bristol, West) | Hurd, Percy A. | Ruggles-Brise, Lieut.-Colonel E. A. |
| Davies, Maj. Geo. F. (Somerset, Yeovil) | Hurst, Gerald B. | Russell, Alexander West (Tynemouth) |
| Davies, Sir Thomas (Cirencester) | Iliffe, Sir Edward M. | Samuel, A. M (Surrey, Farnham) |
| Davies, Dr. Vernon | Inskip, Sir Thomas Walker H. | Sandeman, N. Stewart |
| Davison, Sir W. H. (Kensington, S.) | Iveagh, Countess of | Sanders, Sir Robert A. |
| Dawson, Sir Philip | James, Lieut.-Colonel Hon. Cuthbert | Sandon, Lord |
| Dean, Arthur Wellesley | Kennedy, A. R. (Preston) | Sassoon. Sir Philip Albert Gustave D. |
| Dixon, Captain Rt. Hon. Herbert | Kindersley, Major G. M. | Savery, S. S. |
| Eden, Captain Anthony | King, Commodore Henry Douglas | Skelton, A. N |
| Edmondson, Major A. J. | Knox, Sir Alfred | Smith, Louis W. (Sheffield, Hallam) |
| Elliot, Major Walter E. | Lamb, J. Q. | Somerville, A. A. (Windsor) |
| Southby, Commander A. R. J | Waddington, R. | Williams, Herbert G. (Reading) |
| Spender-Clay, Colonel H. | Ward, Lt.-Col. A. L.(Kingston-on-Hull) | Wilson, Sir C. H. (Leeds, Central! |
| Stanley, Lieut.-Colonel Kt. Hon. G. F. | Warner, Brigadier-General W. W, | Winby, Colonel L. P. |
| Stott, Lieut.-Colonel W. H. | Warrender, Sir Victor | Womersley, W. J. |
| Streatfeild, Captain S. R. | Watson, Sir F. (Pudsey and Otley) | Wood, E. (Chester. Stalyb'ge a Hyde) |
| Thorn, Lt.-Col. J. G. (Dumbarton) | Watson, Rt. Hon. W. (Carlisle) | Wood, Rt. Hon. Sir Kingsley |
| Thompson, Luke (Sunderland) | Watts, Sir Thomas | Worthington Evans, Rt. Hon. Sir L. |
| Thomson, F. c. (Aberdeen, South) | Wayland, Sir William A. | Wright, Brig. General W. D. |
| Thomson, Rt. Hon. Sir W. Mitchell- | Wells, S. R. | |
| Tinne, J. A. | White, Lieut.-Col. Sir G. Dalrymple- | TELLERS FOR THE AYES.— |
| Tryon, Rt. Hon. George Clement | Williams, A. M. (Cornwall, Northern) | Major the Marquess of Titchfield |
| Vaughan-Morgan, Col. K. P. | Williams, Com. C. (Devon, Torquay) | and Captain Wallace. |
| NOES. | ||
| Alexander, A. V. (Sheffield, Hillsbro') | Hirst, G. H. | Runciman, Hilda (Cornwall, St. Ives) |
| Baker, Walter | Hirst, W. (Bradford, South) | Saklatvala, Shapurji |
| Barker, G. (Monmouth, Abertillery) | Hollins, A. | Salter, Dr. Alfred |
| Barr, J. | Hudson, J. H. (Huddersfield) | Sexton, James |
| Batey, Joseph | Hutchison, Sir Robert (Montrose) | Shaw, Rt. Hon. Thomas (Preston) |
| Bellamy, A. | John, William (Rhondda, West) | Shepherd, Arthur Lewis |
| Bondfield, Margaret | Johnston, Thomas (Dundee) | Shiels, Dr. Drummond. |
| Bowerman, Rt. Hon. Charles W. | Jones, Henry Haydn (Merioneth) | Shinwell, E. |
| Briant, Frank | Jones, Morgan (Caerphilly) | Slesser, Sir Henry H. |
| Bromfield, William | Jones, T. I. Mardy (Pontypridd) | Smillie, Robert |
| Brown, Ernest (Leith) | Kelly, W. T. | Smith, Rennie (Penistone) |
| Buchanan, G. | Kennedy, T. | Snowden, Rt. Hon. Philip |
| Buxton, Rt. Hon. Noel | Lawrence, Susan | Stamford, T. W. |
| Charleton, H. C. | Lawson, John James | Stephen, Campbell |
| Cluse, W. S. | Lee. F. | Strauss, E. A. |
| Compton, Joseph | Lindley, F. W, | Sullivan, J. |
| Connolly, M. | Livingstone, A. M. | Sutton, J. E. |
| Cove, W. G. | Longbottom, A. W. | Taylor, R. A. |
| Cowan, D. M. (Scottish Universities) | Lowth, T. | Thomas, Rt. Hon. James H. (Derby) |
| Crawfurd, H. E. | Lunn, William | Thorne, W. (West Ham, Plaistow) |
| Davies, David (Montgomery) | MacDonald, Rt. Hon. J. R. (Aberavon) | Thurtle, Ernest |
| Davies, Ellis (Denbigh, Denbigh) | Mackinder, W. | Tinker, John Joseph |
| Davies, Evan (Ebbw vale) | MacLaren, Andrew | Tomlinson, R. P. |
| Davies, Rhys John (Westhoughton) | Macpherson, Rt. Hon. James 1. | Townend, A E. |
| Day, Harry | Malone, C. L'Estrange (N'thampton) | Trevelyan, Rt. Hon. Sir Charles |
| Dennison, R. | March, S. | Viant, S. P. |
| Dunnico, H. | Maxton, James | Wallhead, Richard C. |
| Edwards, C. (Monmouth, Bedwellty) | Montague, Frederick | Walsh, Rt. Hon. Stephen |
| Fenby, T. D. | Morris, R. H. | Warne, G. H. |
| Gardner, J. P. | Morrison, R. C. (Tottenham, N.) | Watts-Morgan, Lt.-Col. D. (Rhondds) |
| Gibbins, Joseph | Mosley, Sir Oswald | Webb, Rt. Hon. Sidney |
| Gillett. George M. | Naylor, T. E. | Wedgwood. Rt. Hon. Joslah |
| Graham, Rt. Hon. Win. (Edin., Cent.) | Oliver, George Harold | Wellock, Wilfred |
| Greenwood. A. (Nelson and Colne) | Oman, Sir Charles William C. | Williams. C. P. (Denbigh, Wrexham) |
| Grenfell, D. R. (Glamorgan) | Palin, John Henry | Williams, David (Swansea, East) |
| Grundy, T. W. | Paling, W. | Williams, Dr. J. H. (Llanelly) |
| Hall. F (York. W.R., Normanton) | Parkinson, John Allen (Wigan) | Williams, T. (York, Don Valley) |
| Hall, G. H. (Merthyr Tydvil) | Pethick-Lawrence, F. W | Wilson, C. H. (Sheffield, Attercliffe) |
| Hamilton, sir R. (Orkney & Shetland) | Ponsonby, Arthur | Wilson, R. J. (Jarrow) |
| Hardie, George D. | Potts, John S. | Windsor, Walter |
| Harney, E. A. | Richardson, R. (Houghton-le-Spring) | Wright, W. |
| Harris, Percy A. | Riley, Ben | Young, Robert (Lancaster, Newton) |
| Henderson, Right Hon. A. (Burnley) | Ritson, J. | |
| Henderson, T. (Glasgow) | Roberts, Rt. Hon. F. O.(W.Bromwich) | TELLERS FOR THE NOES.— |
| Mr. Whiteley and Mr. A. Barnes. |
The DEPUTY-CHAIRMANWith regard to the next three Amendments standing in the names of the hon. Member for Wallsend (Miss Bondfield)—in page 11, line 28, after the word "inmate," to insert the words "of a maternity home or"—the hon. Member for Nelson and Colne (Mr. Greenwood)—in page 11, line 30, after the word "for," to insert the words "cancer or"—and the hon. Member for Neath (Mr. Jenkins)—in page 11, line 30, after the word "disease," to insert the words "including tuberculosis and venereal disease"—I think that they should be discussed together, and that, if the hon. Members so desire, they should 2874 move the second and third Amendments formally.
§ Miss BONDFIELDI beg to move, in page 11, line 28, after the word "in—mate," to insert the words "of a maternity home or."
The object, of this Amendment of course, is to remove maternity homes from the operation of Clause 13 and particularly from the operation of the uniform enforcement of the provision which we have just been discussing. I think that some hon. Members will know, that, as far as the development of maternity work is concerned, I can speak 2875 with a certain amount of authority. The campaign to get maternity homes established in this country and to get them recognised, not as Poor Law institutions but as municipal institutions, lasted three years, and I took part in it, and tried to convince women, for whom these homes were intended, that it was in their best interests that they should go to them. We had to fight the perfectly natural prejudice which existed at that time against any attempt at moving a woman from her borne on two grounds. First, because she did not know anything about the great care and attention she would get in the maternity home, and secondly, because she felt in view of the stringency of the family income that it would be cheaper for her to be in her own home. We all know how public opinion and the opinion of many women was gradually converted to the belief that it was better to go to one of these homes, not only on account of the shocking housing conditions making a woman's confinement in the home so dangerous, but also because the growing complexity of modern civilisation created a category of cases that required far more expert attention than the ordinary general practitioner could give.
We have fought through all those points, and we have now a public opinion established that it is a wise thing that where there is any abnormality in connection with maternity women should go into maternity homes and be properly treated. But we are still in the experimental stage with regard to persuading women to take advantage of these homes. We have not got anything like enough of these homes really to meet the situation from the standpoint of the health of the public. We know that maternity mortality is a tremendous and an appalling problem which not the whole of the development of our health service has been able to diminish in 20 years. We know that it is work in which large numbers of progressive health authorities, including the right hon. Gentleman's own Department, have the most serious and grave concern. It is not an appropriate occasion to quote from the right hon. Gentleman's own report on the question of maternity, but the right hon. Gentleman will know to what I refer when I say that it is still in the experimental stage, and because it is still in the ex- 2876 perimental stage, anything that shakes the present position is bound to act to the detriment of the service. For instance, the psychological effect of making a provision so that the operation of the financial arrangements in regard to municipal maternity centres are on precisely the same lines as those of the Poor Law, will in itself be a deterrent as far as a great many women are concerned. Many women would sooner die than go into the Poor Law institutions. If they think that it is merely an extension of the Poor Law institution, they will decline on that ground alone, not because it will cost more money but because they will feel that it is somehow or other going to be connected with the Poor Law.
I am not raising the question at all from the standpoint of the advisability of people paying. I am raising it from the standpoint of the whole problem, which is that you should not swop horses in the middle of the stream. Today we have a terrible rate of maternal mortality. We have a system growing up among the great health authorities as a result of which they are slowly establishing maternity homes and carrying on propaganda, and for the sake of the nation and the health of the children, that the children may be well-born, women who live in these miserable inadequate homes should, even if it is a normal confinement, allow their confinement to take place in a maternity home where they can have the benefit of all the appliances that modern science can devise. If at this time you change the system or the local authorities' present percentage grant basis, and bring this category of work inside the ambit of this Clause, I fear that it will very definitely cause a set-back to the development of these homes.
I do not propose to go over the ground and weary the Committee by reiterating arguments which have already been used. I would say, however, in regard to this method of collecting money, that have a very intimate knowledge of the mind of thousands of working women which I obtained while trying to popularise the idea of women receiving institutional treatment at maternity centres and following it up by having their confinements in maternity homes and I know that the question of incurring an expenditure in addition to the 2877 sum which may be covered by the maternity benefit, which, if the husband is an insured person, a woman may get, or any larger expenditure than they would have incurred if they were confined at home, would make all the difference between their willingness to go into a home and their determination to stop out of it. Housewives, we know, are often very mean when it is a question of expenditure on themselves as compared with expenditure on their husbands and children. I think that they ought to take more than they do of the family income and spend it on themselves and their well-being. But that is the attitude of large masses of women to-day. They will suffer inconvenience and possibly danger in having this great experience—this great danger, going down very often, as they do, into the valley of the shadow of death—in their own homes, with all its inconvenience rather than be the cause of adding to the burden of the family by going into an institution where they may be charged more than they think they can afford.
I want the Committee and the right hon. Gentleman to look at this, not from the standpoint of pounds, shillings and pence, but from the standpoint of the importance to the community that children should be well born, and from the long economic view of what we shall save to the nation when children are well born and the women are well cared for. I can conceive of no worse danger than to do anything to change the present machinery by which the experimental work is being slowly developed. There should be more encouragement given under existing legislation to local authorities, so that they can go on and extend this experiment in every possible way.
§ Sir K. WOODI am sure that we all agree with the hon. Member for Wallsend (Miss Bondfield) as to the importance of making due provision for maternity and encouraging as many mothers as possible to enter maternity homes. There is no division in any quarter of the Committee on the importance of that matter and the necessity of encouragement, but I am afraid that, although the hon. Member says she has taken a considerable part in this kind of work, she has not kept very much in touch 2878 with it lately, because, if she thinks that, under this Clause, we are swopping horses and altering the present practice, she is certainly very greatly mistaken. The provision which we are inserting in this Clause generally is already the invariable practice as far as maternity homes, both municipal and voluntary, in the country are concerned. So far from making any alteration, this Clause really sets out what is the universal practice of the voluntary maternity hospitals and homes to require that inmates or their relatives should pay what they can for the service. Some 60 or 70 municipal maternity homes up and down the country, all of them, recover appropriate contributions unless they are satisfied, having regard to the circumstances of the inmate, that nothing can be paid. Therefore, there is no ground whatever for saying there is any alteration in the practice or for anyone being frightened away from the maternity homes of the country by the application of this Clause. If the hon. Member had made inquiries, she would have found that it is exactly the practice that is in operation with regard both to municipal and voluntary homes at the present time. In all cases where the authorities are satisfied, as will be set out in this Clause, that the inmates can pay a reasonable amount, that amount is charged. Therefore, as far as maternity homes are concerned under this Clause there is no alteration in the practice. We are simply setting up in this Clause exactly the practice in regard to voluntary and municipal homes which exists at the present time.
§ Mr. GREENWOODThe defence which is being put up becomes more and more extraordinary as we proceed. On the last Amendment it was admitted that we were making a substantial change in the law and the practice now the Bill is being defended on the ground that no change whatever is being made in the practice of local authorities. That is not the fact. If it be true that the maternity hospitals are now charging their inmates up t) the hilt then, quite clearly, there is no need for this Clause.
§ Sir K. WOODI did not say that.
§ Mr. GREENWOODThat is what the Clause says.
§ Sir K. WOODNo.
§ Mr. GREENWOODI think we are quite clear about that.
§ Sir K. WOODNo.
§ Mr. GREENWOODIf there is one thing that my hon. Friends have been led to believe as the result of the discussion on the last Amendment, it was that it is the duty of the local authority to charge as much as can be got out of the inmates. That is, surely, what Clause 13 will mean. If that is to be the law, and I understand that is so, then, clearly, the right hon. Gentleman cannot defend the present position as against this Amendment by saying that the practice is not being altered. It is not the practice to-day for municipal authorities to charge up to the hilt for maintenance in maternity hospitals. In most cases, I think I am right in saying, there is a maximum charge which I believe is far too high and which many medical officers know to be a deterrent, and in many cases reductions are made below that charge, having regard to the circumstances of the case, and not having regard to the £50 which is in the bank, to which my hon. Friend referred.
There has been a great campaign in favour of dealing more drastically and more successfully with the problem of maternal mortality. There is a widespread recognition of the need for a large increase in the number of maternity homes and hospitals. The supply is inadequate. Those that exist, in my opinion, and, I think, in the opinion of many medical officers, are not as valuable as they might be because the charges that are already being made are prohibitive and deter women from going there during their period of confinement. I think that is beyond any contradiction, and the only effect of Clause 13 will be to make it even more prohibitive in the case of the poor people. It is not only here that the right hon. Gentleman is hitting the maternity service. He is going to abolish the percentage grant, to discourage the local authorities from carrying on this work, and to penalise those who have carried it on in the past, and now he is going to impose a maximum charge upon the people who are inmates of maternity homes and hospitals during confinement.
The right hon. Gentleman told us that we are all agreed in wanting the maximum amount of provision and that 2880 we all desire to care for the mothers. Those are good intentions. The way to hell is paved with good intentions, and we are getting very little out of the Government except expressions of good intentions. We must insist on this Amendment which is a substantial one and one on which we did think the right hon. Gentleman would have been prepared to make a small concession. The fact that he is not prepared to do so only confirms me in my view of the Clause as one of the most dangerous, most unfortunate and most disastrous Clauses in a disastrous Bill.
§ Captain MACMILLANThe hon. Member for Nelson and Colne (Mr. Greenwood) is very fond of dealing in superlatives. I think that in regard to this Amendment and the one before it the confusion, if any, exists largely on the side of the Opposition. In the early part of their argument they led us to think that they disapproved of any contribution at all from those who were treated in the institutions. Then they went on to argue that they approved of the contributory principle, so long as it was based upon a due relation to the circumstances of the patient. In this particular Amendment we are only arguing whether or not maternity homes should be one of those cases upon which contributions should be levied. We are not arguing the point which was raised on the last Amendment. The Minister met that point and gave his reasons for thinking that the legal effect of the Clause was simply to extend the present system, and he promised to look into any specific point raised by the hon. and learned Member opposite. Now, we are only discussing whether the Clause being so drawn this particular class of treatment is or is not to be among those classes in respect of which payment is to be recovered.
As I understand the Clause, and I think the Minister has already confirmed it, all that the Clause does, broadly speaking, is to say that certain duties are now performed by certain local authorities, that those duties will be transferred to other authorities, and that as the duty of carrying out this work is to be transferred, so the obligations in regard to the recovery of payments are to be transferred. We abolish certain authorities and give their duties to other 2881 authorities, and as we change the authority which is to carry on the work so we transfer to the new authority the present obligations of the old authority. The Clause will be supported on this side from that point of view, if we understand it to mean that the Clause, broadly speaking, has the legal effect of carrying out the present system.
§ Mr. HARNEYThe right hon. Gentleman says that in this Clause they are only doing with reference to maternity institutions what has been the practice with regard to maternity homes and voluntary institutions. I accept that statement, but it seems to me that there is all the difference in the world between practice and law, and the objection which I have to this Clause is that what you do as a matter of practice and what you might or might not follow, you now place yourselves under the obligation to do, and cannot depart from it. The vice of this Clause is this, that in the voluntary institutions at the present time it is possible for, say, a poor girl who has given birth or is about to give birth to an illegitimate child to go for treatment. Her father may be in a position to pay, but at present she can say to the authorities of that voluntary home: "In mercy to me, do not sue my father. Do not let my father know, because it will mean ruin to me." A score of other circumstances, any sympathetic person, knowing the world, can conjure up. What does this Clause say? It says: "Let that girl go into the home and let her circumstances be such that any kindly or fair-minded person in the world would say 'Mum!'," but the Clause goes on to say: "You must not be Mum, if her father has money. You must sue him, you must recover and you must expose the girl. Unless you do so, you will be surcharged by the auditors." That, to my mind, is the real vice of the Clause.
When we were debating the previous Amendment, I pointed out that persons who went into these institutions which were not of the pauper status had the benefit of being able to exercise an option as to whether they would be sued or not, but I said that this option was taken away provided there was money available. We say that in the case of maternity homes there should be the same opportunities for secrecy that the 2882 Bill provides in the case of infectious diseases hospitals. Why do you make an exception in the case of infectious diseases? Because you know that it would be a cruel thing if, say, a young man went into a home suffering from venereal disease, and you were to tell his father, because the father happened to have money and could pay for his treatment. Do hon. Members think that that would be fair? In regard to a young man suffering from such a disease you say to him that if his circumstances are brought to the notice of the authorities they would consider it right to place a blanket of protection and secrecy over his misfortune, even though the father might have money and could pay for his treatment. That exception is made. Surely hundreds of cases must arise where the same salutary obscurity should be given in regard to the misfortune of a woman.
§ Sir FRANK MEYERWhile everyone must have sympathy with the case put forward by the hon. and learned Member for South Shields (Mr. Harney) and for similar cases where it would be a very grave hardship that very desirable secrecy should not, be maintained, I do not think that the Amendment which we are discussing deals in a proper way with such a case, because the Amendment, if we were to pass it, would mean that in no case could there be any charge if anyone went into a maternity home. If that is not so, I entirely misunderstand the purport of the Amendment.
§ Mr. GREENWOODThe purpose of the Amendment is to take maternity homes out of the Clause just as infectious diseases hospitals are taken out of the Clause, and whereas in the one case no charge is made, in the case of maternity hospitals the law will remain as it is now, where a charge can be made if the local authorities think fit.
§ Sir F. MEYERIf that can be accepted as the purport of the Amendment, it alters one's view. On reading the Clause along with the Amendment it seemed to me that maternity homes would be excluded entirely, just as infectious diseases hospitals are excluded. There is a good reason for not making the charge in regard to treatment for infectious disease because a person has no option, and is compelled to go into a hospital or institution when suffering from certain in- 2883 fectious diseases, whereas maternity cases are entirely optional. The number of people who go into maternity homes in proportion to the population is very small. I shall be interested to hear in further discussion of the Clause whether the view which I take of the Amendment is correct, or whether the view put forward by the hon. Member for Nelson and Colne is correct.
§ 6.0 p.m.
§ Mr. PETHICK-LAWRENCEI should not have risen except for the misstatements which have been made by the hon. Member for Great Yarmouth (Sir F. Meyer) and the hon. Member for Stockton-on-Tees (Captain Macmillan) who, quite erroneously, said that the effect of the Amendment, if carried, would be that no local authorities could make any charge in respect of a maternity institution. That is entirely incorrect. The effect of the Amendment would be to leave the law as it, is at present. I am quite sure the Minister of Health will agree with that statement. A charge can be made by a local authority of such an amount as it thinks reasonable.
§ Captain MACMILLANThe hon. Member has misunderstood what I said about the effect of the Amendment. Hon. Members opposite say that the Amendment would leave the law as it is to-day. The Government say that the Clause leaves the law as it is at present.
§ Mr. PETHICK-LAWRENCEThat is the second point to which I was coming. The hon. Member for Stockton-on-Tees says that the effect of the Clause is to leave the law as it is at present. The Minister of Health says nothing of the kind. He says that there is a change in the law; a change which he thinks is desirable. Let us see what the change is. It is threefold. In the first place, a local authority must make a charge. At the present time it is within their option whether they make a charge or not. In the second place, a local authority must make the whole charge. At the present time it can make a part charge if it so desires. In the third place, a local authority, in estimating the charge, must take the whole of the expenses into account. The Minister of Health himself admits that where a man has any means in the shape of savings a local authority under this Bill must take the whole of 2884 those savings in order to cover the charge. A local authority can strip, must strip, a man of all he has got in order to satisfy the provisions of this Bill. The Minister has, in fact, admitted that, and all that this part of the Clause says is that where a local authority is satisfied that a man has money, then it is obliged by this Clause to strip him of all that money in order to meet the charge. The Minister of Health does not say that there is no change in the law. There is a change, and the object of the Amendment is to say that, as far as maternity homes are concerned, they shall remain as they are at present.
§ Mr. CHAMBERLAINI do not think that even the hon. Member for Leicester West (Mr. Pethick-Lawrence) has completely elucidated the position. I propose to have a still further try. It is quite true that, if the Amendment is carried it will not deprive local authorities as the successors of boards of guardians of any of the power to recover, but in Sub-section (4) there is a saving Clause to the effect that:
Nothing in this section shall affect any right which a local authority may have under any enactment or otherwise, to recover expenses other than those to which the foregoing provisions of this Section apply.I think it is true that it would still leave power to the local authority, and in so far as the guardians are concerned, or the local authority is concerned, if it works under the Poor Law there still remains the duty on the local authority as the successor to the board of guardians to recover the expenses of a person treated in a maternity home and in an institution under the Poor Law. That is how the law stands at present and that is how the law would be in future. My right hon. Friend argued that although there would be a change in the law, it would not make any change in the present practice. That is a very important matter. What we have to consider is whether, in fact, the present practice is so deterrent that inmates will not go into these maternity homes because of the charges which are made. I am bound to say that I have no evidence of that. On the contrary, I think the great difficulty is not so much that people will not go into these institutions as the fact that there are not sufficient homes 2885 to accommodate them. What would be the result of the Amendment? You are going now to single out maternity homes and say that they are to be treated in the same way as infectious hospitals. It is true that local authorities would still have power; but the fact that you exempt or except these maternity homes from the treatment you give to every other kind of institution clearly points to an intention of Parliament that local authorities shall not make the same rules in regard to them as they make in regard to other institutions, and if the Amendment is carried the effect in practice would be, at any rate, largely to abolish payment for treatment in maternity homes.That may or may not be a good thing. Hon. Members opposite think it would be good, but as one who desires to see the maternity services developed I ask them to consider two points. The first is that we are faced with this fact, that there are not a sufficient number of maternity homes. We want more provided; but if there is some difficulty to-day in getting local authorities to provide more maternity homes there will be still greater difficulty in the future to get them to build new homes if they are faced with the prospect that when they have built them they are going to be a heavy charge upon them because they will not be able to recover expenses. In the second place, the hon. and learned Member for South Shields (Mr. Harney) said: why not put maternity homes in
§ the same category as infectious hospitals? There is one reason, and a very good reason. There is no competition between infectious hospitals provided by a local authority and a voluntary hospital. The infectious disease hospitals have a monopoly; but there is competition in maternity homes between private and voluntary maternity homes; and if hon. Members say that the voluntary homes shall be free—
§ Mr. PETHICK-LAWRENCEWe do not say that.
§ Mr. CHAMBERLAINNo, I know, but I am trying to point out that that must inevitably be the effect. It is my opinion that it would make it very difficult for local authorities to make any charge for maternity purposes. That would be a very bad thing for the maternity services and it would discourage local authorities in the provision of maternity homes. I take this opportunity of saying what I rather hinted at a little while ago, that when we come to the Amendment on the Paper relating to the question of some alteration in the scope of this Clause—I cannot discuss it now—I am prepared to consider widening the scope of the discretion of local authorities, not in regard to maternity homes alone but to all the institutions covered by the Clause.
§ Question put, "That those word; be there inserted?"
§ The Committee divided: Ayes, 145; Noes, 250.
2889| Division No. 85.] | AYES. | [6.11 p.m. |
| Adamson, Rt. Hon. W. (Fife, West) | Davies, Ellis (Denbigh, Denbigh) | Hirst, G. H. |
| Alexander, A. V. (Sheffield, Hillsbro') | Davies, Evan (Ebbw Vain) | Hirst, W. (Bradford, South) |
| Baker, Walter | Davies, Rhys John (Westhoughton) | Hollins, A. |
| Barker, G. (Monmouth, Abertillery) | Day, Harry | Hudson, J. H. (Huddersfield) |
| Barr, J. | Dennison, R. | Hutchison, Sir Robert (Montrose) |
| Batey, Joseph | Duncan, C. | Jenkins. W. (Glamorgan, Neath) |
| Bellamy, A. | Dunnico, H. | John, William (Rhondda, West) |
| Bondfield, Margaret | Edge, Sir William | Johnston, Thomas (Dundee) |
| Bowerman, Rt. Hon. Charles W. | Edwards, C. (Monmouth, Bedwellty) | Jones, Henry Haydn (Merioneth) |
| Briant, Frank | Fenby, T. D. | Jones, Morgan (Caerphilly) |
| Broad, F. A. | Gardner, J. P. | Jones, T. I. Mardy (Pontypridd) |
| Bromfield, William | George, Rt. Hon. David Lloyd | Kelly, W. T. |
| Brown, Ernest (Leith) | Gibbins, Joseph | Kennedy, T. |
| Brown, James (Ayr and Bute) | Gillett, George M. | Lawrence, Susan |
| Buchanan, G. | Graham, Rt. Hon Wm. (Edin., Cent.) | Lawson, John James |
| Buxton, Rt. Hon. Noel | Greenwood, A. (Nelson and Colne) | Lee, F. |
| Cape, Thomas | Grenfell, D. R. (Glamorgan) | Lindley, F. W. |
| Charleton, H. C. | Grundy, T. W. | Livingstone, A. M. |
| Cluse, W. S. | Hall, F. (York, W.R. Normanton) | Longbottom, A. W. |
| Compton, Joseph | Hall, G. H. (Merthyr Tydvil) | Lowth, T. |
| Connolly, M. | Hamilton, Sir R. (Orkney & Shetland) | Lunn, William |
| Cove, W. G. | Hardie, George D. | MacDonald, Rt. Hon. J. R. (Aberavon) |
| Cowan, D. M. (Scottish Universities) | Harney, E. A. | MackInder, W. |
| Crawfurd, H. E. | Harris, Percy A. | MacLaren, Andrew |
| Dalton, Hugh | Henderson, Right Hon. A. (Burnley) | Macpherson, Rt. Hon. James I. |
| Davies, David (Montgomery) | Henderson, T. (Glasgow) | Malone, C. L' Estrange (N'thampton) |
| March, S. | Saklatvala, Shapurji | Trevelyan, Rt. Hon. Sir Charles |
| Maxton, James | Salter, Dr. Alfred | Viant, S. P. |
| Montague, Frederick | Sexton, James | Wallhead, Richard C. |
| Morris, R. H. | Shaw, Rt. Hon. Thomas (Preston) | Walsh, Rt. Hon. Stephen |
| Morrison, R. C. (Tottenham, N.) | Shepherd, Arthur Lewis | Warne, G. H. |
| Mosley, Sir Oswald | Shiels, Dr. Drummond. | Watts-Morgan, Lt.-Col. D. (Rhondda) |
| Murnin, H. | Shinwell, E. | Webb, Rt. Hon. Sidney |
| Naylor, T. E. | Slesser, Sir Henry H. | Wedgwood, Rt. Hon. Joslah |
| Oliver, George Harold | Smillie, Robert | Wellock, Wilfred |
| Owen, Major G. | Smith, Rennie (Penistone) | Welsh, J. C. |
| Palln, John Henry | Snowden, Rt. Hon. Philip | Westwood, J. |
| Paling, W. | Stamford, T. W. | Wiggins, William Martin |
| Parkinson, John Allen (Wigan) | Stephen, Campbell | Williams, C. P. (Denbigh, Wrexham) |
| Pethick-Lawrence, F. W. | Strauss, E. A. | Williams, David (Swansea, East) |
| Ponsonby, Arthur | Sullivan, J. | Williams, Dr. J. H. (Llanelly) |
| Potts, John S. | Sutton, J. E. | Williams, T. (York, Don Valley) |
| Rees, Sir Beddoe | Taylor, R. A. | Wilson, C. H. (Sheffield, Attercliffe) |
| Richardson, R. (Houghton-le-Spring) | Thomas, Rt. Hon. James H. (Derby) | Wilson, R. J. (Jarrow) |
| Riley, Ben | Thorns, W. (West Ham, Plaistow) | Windsor, Walter |
| Ritson, J. | Thurtle, Ernest | Wright, W. |
| Roberts, Rt. Hon. F. O. (W. Bromwich) | Tinker, John Joseph | Young, Robert (Lancaster, Newton) |
| Runciman, Hilda (Cornwall, St. Ives) | Tomlinson, R. P. | |
| Runciman, Rt. Hon. Walter | Townend, A. E. | TELLERS FOR THE AYES.— |
| Mr. A. Barnes and Mr. Whiteley. | ||
| NOES. | ||
| Acland-Troyte, Lieut.-Colonel | Cope, Major Sir William | Haslam, Henry C. |
| Ainsworth, Lieut.-Col. Charles | Courthope, Colonel Sir G. L. | Headlam, Lieut.-Colonel C. M. |
| Albery, Irving James | Craig, Sir Ernest (Chester, Crewe) | Henderson, Capt. R. R. (Oxf'd, Henley) |
| Alexander, E. E. (Leyton) | Crooke, J. Smedley (Deritend) | Heneage, Lieut.-Colonel Arthur P. |
| Applin, Colonel R. V. K. | Crookshank, Col. C. de W. (Berwick) | Henn, Sir Sydney H. |
| Ashley, Lt.-Col. Rt. Hon. Wilfrid W. | Crookshank, Cpt. H. (Lindsey, Gainsbro) | Hennessy, Major Sir G. R. J. |
| Atholl, Duchess of | Culverwell, C. T. (Bristol, West) | Hills, Major John Waller |
| Atkinson, C. | Curzon, Captain Viscount | Hilton, Cecil |
| Baldwin, Rt. Hon. Stanley | Davies, Maj. Geo. F. (Somerset, Yeovil) | Hohler, Sir Gerald Fitzroy |
| Barclay-Harvey, C. M. | Davies, Sir Thomas (Cirencester) | Holbrook, Sir Arthur Richard |
| Beamish, Rear-Admiral T. P. H. | Davies, Dr. Vernon | Holt, Capt. H. P |
| Benn, Sir A. S. (Plymouth, Drake) | Dawson, Sir Philip | Hope, Sir Harry (Forfar) |
| Bennett, A. J. | Dean, Arthur Wellesley | Hopkins, J. W. W. |
| Bentinck, Lord Henry Cavendish | Dixon, Captain Rt. Hon. Herbert | Hopkinson, A. (Lancaster, Mossley) |
| Berry, Sir George | Eden, Captain Anthony | Home, Rt. Hon. Sir Robert S. |
| Bethel, A. | Edmondson, Major A. J. | Howard-Bury, Colonel C. K. |
| Betterton, Henry B. | Elliot, Major Walter E. | Hudson, R. S. (Cumb'l'nd, Whiteh'n) |
| Birchall, Major J. Dearman | Erskine, Lord (Somerset, Weston-s.-M.) | Hume, Sir G. H. |
| Bird, E. R. (Yorks, W. R., Skipton) | Ertkine, James Malcolm Monteith | Hurd, Percy A. |
| Bird, Sir R. B. (Wolverhampton, W.) | Evans, Captain A. (Cardiff, South) | Iliffe, Sir Edward M. |
| Boothby, R. J. G. | Everard, W. Lindsay | Inskip, Sir Thomas Walker H. |
| Bowater, Col. Sir T. Vansittart | Falle, Sir Bertram G. | Iveagh, Countess of |
| Braithwaite, Major A. N. | Fanshawe, Captain G. D. | Kennedy, A. R. (Preston) |
| Brass, Captain W. | Fermoy, Lord | Kindersley, Major Guy M. |
| Bridgeman, Rt. Hon. William Clive | Fleiden, E. B. | King, Commodore Henry Douglas |
| Briggs, J. Harold | Forestler-Walker, Sir L. | Knox, Sir Alfred |
| Briscoe, Richard George | Forrest, W. | Lamb, J. O. |
| Brittain, Sir Harry | Foster, Sir Harry S. | Loder, J. de V. |
| Brocklebank, C. E. R. | Fraser, Captain Ian | Long, Major Eric |
| Brooke, Brigadier-General C. R. I. | Fremantle, Lieut.-Colonel Francis E. | Looker, Herbert William |
| Broun-Lindsay, Major H. | Gadie, Lieut.-Col. Anthony | Lougher, Lewis |
| Brown, Col. D. C. (N'th'l'd., Hexham) | Ganzonl, Sir John | Lucas-Tooth, Sir Hugh Vere |
| Brown, Brig.-Gen. H. C. (Berks, Newb'y) | Gates, Percy | MacAndrew, Major Charles Glen |
| Buchan, John | Gault, Lieut.-Col. Andrew Hamilton | Macdonald, Capt. P. D. (I. of W.) |
| Buckingham, Sir H. | Gilmour, Lt.-Col. Rt. Hon. Sir John | Macdonald, R. (Glasgow, Cathcart) |
| Bull, Rt. Hon. Sir William James | Glyn, Major R, G. C. | Macmillan, Captain H. |
| Bullock, Captain M. | Goff, Sir Park | Macquisten, F. A. |
| Burman, J. B. | Gower, Sir Robert | Mac Robert, Alexander M. |
| Burney, Lieut.-Com. Charles D. | Grace, John | Maitland, A. (Kent, Faversham) |
| Campbell, E. T. | Graham, Fergus (Cumberland, N.) | Maitland, Sir Arthur D. Steel. |
| Carver, Major W. H. | Grant, Sir J. A. | Manningham-Buller, Sir Mervyn |
| Cayzer, Sir C. (Chester, City) | Grattan-Doyle, Sir N. | Margesson, Captain D. |
| Cayzer, Maj. Sir Herbt. R. (Prtsmth, S.) | Greaves-Lord, Sir Walter | Marriott, Sir J. A. R. |
| Cazalet, Captain Victor A. | Gretton, Colonel Rt. Hon. John | Mason, Colonel Glyn K. |
| Cecil, Rt. Hon. Sir Evelyn (Aston) | Guinness, Rt. Hon. Walter E. | Merriman, Sir F. Boyd |
| Chamberlain, Rt. Hon. N. (Ladywood) | Gunston, Captain D. W. | Meyer, Sir Frank |
| Charteris, Brigadier-General J. | Hacking, Douglas H. | Mitchell, S. (Lanark, Lanark) |
| Christie, J. A. | Hall, Capt. W. D. A. (Brecon & Rad.) | Mitchell, W. Foot (Saffron Walden) |
| Churchman, Sir Arthur C. | Hamilton, Sir George | Mitchell, Sir W. Lane (Streatham) |
| Clarry, Reginald George | Hammersley, S. S. | Monsell, Eyres, Com. Rt. Hon. B. M. |
| Cobb, Sir Cyril | Hanbury, C. | Moore, Lieut.-Col. T. C. R. (Ayr) |
| Cochrane, Commander Hon. A. D. | Hannon, Patrick Joseph Henry | Moore, Sir Newton J. |
| Cockerill, Brig.-General Sir George | Harland, A. | Morrison, H. (Wilts, Salisbury) |
| Cohen, Major J. Brunei | Harrison, G. J. C. | Morrison-Bell, Sir Arthur Clive |
| Colfox, Major William Phillips | Hartington, Marquess of | Murchison, Sir Kenneth |
| Colman, N. C. D. | Harvey, G. (Lambeth, Kennington) | Nall, Colonel Sir Joseph |
| Cooper, A. Duff | Harvey, Major S. E. (Devon, Totnes) | Neville, Sir Reginald J. |
| Newton, Sir D. G. C. (Cambridge) | Sandeman, N. Stewart | Vaughan-Morgan, Col. K. P. |
| Nicholson, 0. (Westminster) | Sanders, Sir Robert A. | Waddington, R. |
| Nicholson, Col. Rt. Hn. W. G.(Ptrsf'ld) | Sanderson, Sir Frank | Wallace, Captain D. E. |
| Nield, Rt. Hon. Sir Herbert | Sandon, Lord | Ward. Lt.-Col. A. L. (Kingston-on-Hull) |
| Nuttall, Ellis | Sassoon, Sir Philip Albert Gustave D. | Warner Brigadier-General W. W. |
| Oakley, T. | Savory, S. S. | Watson, Sir F. (Pudsey and Otley) |
| Ormsby-Gore, Rt. Hon. William | Sheffield, Sir Berkeley | Watson, Rt. Hon. W. (Carlisle) |
| Pennefather, Sir John | Shepperson, E. W. | Watts, Sir Thomas |
| Penny, Frederick George | Skelton, A. N. | Wayland, Sir William A. |
| Perkins, Colonel E. K. | Smith, Louis W. (Sheffield, Hallam) | Wells, S. R. |
| Perring, sir William George | Smith, R. W. (Aberd'n & Kinc'dine, C.) | White, Lieut.-Col. Sir G. Dalrymple |
| Peto, Sir Basil E. (Devon, Barnstaple) | Smith-Carington, Neville W. | Williams, A. M. (Cornwall, Northern) |
| Peto, G. (Somerset, Frome) | Smithers, Waldron | Williams, Com. C. (Devon, Torquay) |
| Pitcher, G. | Somerville, A. A. (Windsor) | Williams, Herbert G. (Reading) |
| Preston, William | Southby, Commander A. R. J. | Wilson, Sir C. H. (Leeds, Central) |
| Price, Major C. W. M. | Spender-Clay, Colonel H. | Wilson, R. R. (Stafford, Lichfield) |
| Raine, Sir Walter | Stanley, Lieut.-Colonel Rt. Hon. G. F. | Winby, Colonel L. P. |
| Ramsden, E. | Storry-Deans, R. | Winterton, Rt. Hon. Earl |
| Reid, Capt. Cunningham(Warrington) | Stott, Lieut.-Colonel W. H. | Womersley, W. J. |
| Rentoul, G. S. | Streatfeild, Captain S. R. | Wood, E. (Chest'r, Stalyb'ge & Hyde) |
| Rhys, Hon. C. A. U. | Sugden, Sir Wilfrid | Wood, Rt. Hon. Sir Kingsley |
| Richardson, Sir P. W. (Sur'y, Ch'ts'y) | Thorn, Lt.-Col. J. G. (Dumbarton) | Worthington-Evans, Rt. Hon. Sir L. |
| Rodd, Rt. Hon. Sir James Rennell | Thompson, Luke (Sunderland) | Wright, Brig.-General W. D. |
| Ropner, Major L. | Thomson, F. C. (Aberdeen, South) | |
| Ruggles-Brise, Lieut.-Colonel E. A. | Thomson, Rt. Hon. Sir W. Mitchell. | TELLERS FOR THE NOES.— |
| Russell, Alexander West (Tynemouth) | Tinne, J. A. | Captain Bowyer and Sir Victor |
| Rye, F. G. | Titchfield, Major the Marquess of | Warrender. |
| Samuel, A. M. (Surrey, Farnham) | Tryon, Rt. Hon. George Clement |
§ The CHAIRMAN (Mr. James Hope)Mr. Bennie Smith.
§ Mr. GREENWOODI understood that the three Amendments dealing with cancer, tuberculosis and venereal disease were to be taken as one discussion.
§ The CHAIRMANIt appears to me that these subjects were not discussed on the previous Amendment and I do not think I could very well take Divisions on them.
§ Mr. T. WILLIAMSCan we put a question to the Minister on one of the Amendments?
§ The CHAIRMANYes, if some information is wanted. Does the hon. Member wish to raise any particular point?
§ Mr. WILLIAMSYes, on the second of the Amendments, which refers to tuberculosis and venereal disease.
§ The CHAIRMANPerhaps the hon. Member for Penistone (Mr. Rennie Smith) will move the Amendment standing in his name.
§ Mr. RENNIE SMITHI beg to move, in page 11, line 30, after the word "disease," to insert the words "including tuberculosis and venereal disease."
I was under the impression that we were to have a general discussion not only affecting maternity cases and homes, but also tuberculosis and venereal disease, and that in the discussion on the Amendment relating to maternity homes we were dealing with all the subjects 2890 raised in this Amendment. I hope it may be possible for you to rule that, although tuberculosis and venereal disease have not been specifically mentioned in the previous discussion, it may nevertheless be possible for the Committee to express its opinion by dividing on these two classes of cases—tuberculosis and venereal disease cases.
§ The CHAIRMANIf the Amendment is put, I cannot well prevent discussion.
§ Sir K. WOODIt may save time and discussion if I say that we put this particular Amendment before our legal advisers, and they advised us that both tuberculosis and venereal disease could be regarded as coming within the meaning of this Clause relating to infectious diseases, and that therefore the Amendment was unnecessary.
§ Mr. WEBBI would like to ask a further question as to what is included among infectious diseases. We are told that tuberculosis is included. I do not want to contradict or to express any objection to the medical point of view, but as a matter of fact the infection from tuberculosis is a very slow one and not as important, for instance, as infection from small-pox. I want to know whether the words "infectious disease," which we are told include tuberculosis, also include cancer. Is the Minister prepared to say that cancer is not infectious in much the same sense that tuberculosis is? I want to know what the law is. I do not dispute about venereal disease, although I should have thought 2891 that that was contagious rather than infectious. Will anyone assert with conviction that cancer is not slowly infectious? It is important that the Minister should consider on Report whether he ought to add cancer in order to cover it in the Clause. This Amendment merely suggests adding tuberculosis and venereal disease. If the right hon. Gentleman means to include tuberculosis, how can he exclude cancer? There is far greater public interest, or at least as much, in the one as in the other.
§ Sir K. WOODAll that I have stated to the Committee is that there is no need to add to the Clause the words of this Amendment, because tuberculosis and venereal disease are already included. Cancer is another matter altogether.
Dr. DAVIESThe Minister is taking rather an important step now. If you are to say that infectious diseases are to include, in all cases, tuberculosis and venereal disease, how are you going to keep out infantile paralysis, encephalitis lethargica and influenza?
§ The CHAIRMANWe are now embarking on a subject which there are very few Members capable of following. The Minister has merely stated that these words as a matter of definition will include certain complaints.
§ Sir H. SLESSERI want to know where we are in the matter of definition. There is in the Bill no definition at all of infectious disease. We are told by the Parliamentary Secretary that he is advised that infectious disease includes tuberculosis. The position is very unsatisfactory. I am not asking on what basis his advice proceeded, but I want to know where we are. Is there no Act that defines infectious disease? If so, this Bill ought to be re-drafted so as to say that the words "infectious disease" here have the meaning attached to them in some other Act. Or does the right hon. Gentleman mean that as a question of medical fact infectious disease includes these particular things? It is very little use his telling the Committee that he is advised that the words mean this or that unless he says in what Statute they have that meaning. If there be any doubt on the question, what is the objection to adding to the defini- 2892 tion of "infectious disease" certain specific diseases which are on the borderline and which the Government intend to include?
§ The ATTORNEY-GENERAL (Sir Thomas Inskip)The last words of the hon. and learned Member give colour to his interpositions in these debates—interpositions which raise interesting legal arguments. The Committee, I am sure, never wants the legal arguments if a little common-sense will solve the problem. Fortunately most of us understand the English language, and the words "infectious disease" are not a term of art which lawyers use and which require an interpretation Act. They are words which mean that a disease is infectious and, that so long as people are at large, may result in injury to other persons. The result is that people who suffer from what are, in fact, infectious diseases are required in the public interest to go into an institution for treatment. The question is, what are in fact infectious diseases. Everyone agrees that tuberculosis and venereal disease are, in fact, infectious diseases. Then the question is as to whether some other diseases are not infectious diseases. You will not arrive at a solution of this question merely by putting in "tuberculosis and venereal disease," because by including some words you tend to the exclusion of others. I think it is better to leave the question of what is an infectious disease to be solved by proper evidence of fact, if ever such question arises, and I have very little doubt that these questions of fact will be solved by the common-sense of the doctors and authorities without any necessity to resort to a Court of Law.
Lieut.-Colonel WATTS-MORGANWill the hon. and learned Gentleman tell us the reason why these words cannot be added?
§ Lieut.-Colonel FREMANTLEI dissent from the reading which my hon. and learned Friend the Attorney-General has just given. I can foresee my colleagues of the medical profession having to administer this Measure, and they must know what cases they are dealing with, and what cases they are not dealing with under it. In the ordinary terminology of public health the phrase "infectious disease" has a definite meaning. It is defined by an Order of the Ministry of Health, interpreting certain Acts of Par- 2893 liament in relation to infectious diseases. There is a specific catalogue of the diseases which are included in this definition. It is easy to administer a Measure of this kind on those lines, but, if my hon. and learned Friend had the good fortune to belong to the medical instead of to the legal profession, and if he, as a medical officer, had to try to work the administration of Acts relating to infectious diseases on the lines which he himself has suggested, he would find it an impossible task. You must have it laid down what diseases are to be regarded as infectious diseases. For practical purposes, venereal disease is not called an infectious disease, and certainly nobody has ever suggested that cancer is an infectious disease. I suggest that the Minister of. Health might reconsider this question in order to insert in the definition Clause towards the end something as regards the words "infectious disease" being definitely associated with the term as generally interpreted in other Acts.
§ Miss LAWRENCEDoes the Minister tell us that surgical tuberculosis is included in this definition? I ask that question because there is no disease which afflicts children more than surgical tuberculosis. May I not have an answer to that question? I particularly want to know if surgical tuberculosis may be treated free, because it is a very important question?
§ The CHAIRMANI cannot extract answers from Ministers.
§ Mr. WALLHEADJudging from the conflict between Members on the Front Bench opposite and Members behind them, and the conflict between the representatives of the Ministry and the Attorney-General on the one side and the representatives of the medical profession on the other, it is evident that more clarity is needed in connection with this Clause. The Attorney-General has just said that persons suffering from infectious diseases are required to go into institutions but what are the infectious diseases the victims of which are required to go into institutions? Does that apply to all infectious diseases? If so, we want a definition of infectious diseases. [Laughter.] All this seems to cause merriment on the other side of the Committee but it will be no cause of 2894 merriment to those who may suffer later from the obscurities of this Clause. The hon. Member who has just asked the question about surgical tuberculosis is entitled to a clear answer because that is a vital question affecting a large number of persons. The Attorney-General and the Minister of Health would do well to accept the advice of the hon. and gallant Member for St. Albans (Lieut.-Colonel Fremantle) and take this Clause back in order to insert a definition of what the Government mean in this connection.
§ Mr. RENNIE SMITHThe Committee have now reached a stage at which I think the members of the medical profession and of the legal profession should be asked to retire and confer for the benefit of the Committee. The Parliamentary Secretary has shown a willingness to meet to a certain extent the proposals which have been made, but I would draw attention to the fact that, in any event, cases of cancer are not to be brought within the definition given by the Minister. The right hon. Member for Seaham (Mr. Webb) earlier in the Debate gave one instance of how the Clause would affect a hospital specially dealing with cases of cancer.
§ The CHAIRMANWe cannot go into the question of cancer. That arose on the earlier Amendment.
§ Mr. SMITHI understood that the Amendment, on which we recently voted dealt exclusively with the question of maternity homes. The reason why I raised the point of Order a little while ago was in order to ensure that the two subsequent Amendments might be given some consideration.
§ The CHAIRMANThe hon. Member has himself moved this Amendment which is to insert the words "including tuberculosis and venereal disease" and it comes after the Amendment relating to cancer.
§ Miss LAWRENCEAs has already been said, there seems to be a certain amount of merriment on the other side of the Committee about this question of infectious diseases. But the point which I am putting is a very important one. We are most anxiously concerned with the treatment of surgical tuberculosis, particularly in children. This is not the sort of tuberculosis that we 2895 all think about generally. It is a disease of the bones and it is very important for those children who suffer from it, if they are to have the long difficult and expensive treatment necessary, given to them free. It is little short of a scandal that the Minister of Health should not be able to tell us, here and now, whether he means that this particularly cruel disease is to be treated free or not. I ask him once more, does he intend that surgical tuberculosis shall come under free treatment or not?
§ Sir K. WOODI am very glad to do my best—as I always hope to do—to meet the wishes of the hon. Lady. It is not a question of my opinion but a question of fact as to whether a disease is infectious or not. If my opinion is of any value I should say certainly tuberculosis would be included, but that is only my opinion, and, as I say, this is a question of fact. I would also point out that the question does not arise as to whether this treatment ought to he free or not. What we have been discussing this whole afternoon since 4 o'clock has been a question of whether in certain circumstances a reasonable charge should he made. At any rate in dealing with the Amendment which is now before the Committee I have stated the advice which has been given to us and the point of view of my Department. The advice which we have received is that this Amendment is unnecessary. The question as to whether a particular disease does or does not come within the definition, is, I repeat, obviously a question of fact.
§ Miss LAWRENCEThen I understand that the Minister does not know what his own Clause means. Here is a business which has been for a very long time
§ exciting the most serious attention of the Minister and his Department. In Report after Report we find statements that they are making improvements in connection with this matter but that the treatment does not keep pace with the disease. Now we have the Minister telling the Committee that he does not know whether he is going to allow free treatment of this particular illness or not—an illness which his own Department is watching carefully. I say again that it is little short of a scandal that the Minister should seek to press this Clause through the Committee when he himself does not understand it.
§ Mr. WEBBI suggest one more point to the right hon. Gentleman. We are discussing this Bill on the faith of the Memorandum issued by his right hon. Friend the Minister of Health describing what it does. In that Memorandum is the definite statement that the term "infectious disease" includes tuberculosis. Therefore we are discussing the Bill on that assumption. It was because some of us had certain doubts that an Amendment was put down to make it clear. The right hon. Gentleman says it is clear that the term does include tuberculosis. The Memorandum made it definite that it included tuberculosis. You cannot say that the term includes tuberculosis, and then say that that does not mean surgical tuberculosis or any other kind of tuberculosis. We must take in on the faith of the Minister's statement that tuberculosis is included in the term "infectious disease" and that, therefore, it includes surgical and every other kind of tuberculosis.
§ Question put, "That those words be there inserted."
§ The Committee divided: Ayes, 145: Noes, 258.
2899| Division No. 86.] | AYES. | [6.43 p.m. |
| Adamson, Rt. Hon. W. (Fife, Wait) | Brown, Ernest (Leith) | Davies, Rhys John (Westhoughton) |
| Alexander, A. V. (Sheffield, Hillsbro') | Brown, James (Ayr and Bute) | Day, Harry |
| Ammon, Charles George | Buchanan, G. | Dennison, R. |
| Baker, Walter | Buxton, Rt. Hon. Noel | Duncan, C. |
| Barker, G. (Monmouth, Abertillery) | Cape, Thomas | Dunnico, H. |
| Barnes, A. | Charleton, H. C. | Edge, Sir William |
| Barr, J. | Cluse, W. S. | Fenby, T. D. |
| Batey, Joseph | Compton, Joseph | Forrest, W. |
| Beckett, John (Gateshead) | Connolly, M. | Gardner, J. P. |
| Bellamy, A. | Cove, W. G. | George, Rt. Hon. David Lloyd |
| Bondfield, Margaret | Cowan, D. M. (Scottish Universities) | Gibbins, Joseph |
| Bowerman, Rt. Hon. Charles W. | Dalton, Hugh | Gillett, George M. |
| Briant, Frank | Davies, David (Montgomery) | Graham, Rt. Hon. Wm. (Edin., Cant.) |
| Broad, F. A | Davies, Ellis (Denbigh, Denbigh) | Greenwood, A. (Nelson and Colne) |
| Bromfield, William | Davies, Evan (Ebbw Vale) | Grenfell, D. R. (Glamorgan) |
| Griffith, F. Kingsley | March, S. | Stewart, J. (St. Rollox) |
| Grundy, T. W. | Maxton, James | Sullivan, Joseph |
| Hall, F. (York, W. R., Normanton) | Montague, Frederick | Sutton, J. E. |
| Hall, G. H. (Merthyr Tydvil) | Morris, R. H. | Taylor, R. A. |
| Hamilton, Sir B. (Orkney & Shetland) | Morrison, R. C. (Tottenham, N.) | Thomas, Rt. Hon. James H. (Derby) |
| Hardie, George D. | Mosley, Sir Oswald | Thorns, W. (West Ham, Plaistow) |
| Harney, E. A. | Murnin, H. | Thurtle, Ernest |
| Harris, Percy A. | Naylor, T. E. | Tinker, John Joseph |
| Hayday, Arthur | Oliver, George Harold | Townend, A. E. |
| Henderson, Right Hon. A. (Burnley) | Owen, Major G. | Trevelyan, Rt. Hon. Sir Charles |
| Henderson, T. (Glasgow) | Palin, John Henry | Viant, S. P. |
| Hirst, G. H. | Paling, W. | Wallhead, Richard C. |
| Hirst, W. (Bradford, South) | Parkinson, John Allen (Wigan) | Walsh, Rt. Hon. Stephen |
| Hollins, A. | Pethick-Lawrence, F. W. | Warne, G. H. |
| Hudson, J. H. (Huddersfield) | Ponsonby, Arthur | Watts-Morgan, Lt.-Col. D. (Rhondda) |
| Hutchison, Sir Robert (Montrose) | Potts, John S. | Webb, Rt. Hon. Sidney |
| Jenkins, W. (Glamorgan, Neath) | Rees, Sir Boddoe | Wedgwood, Rt. Hon. Josiah |
| Johnston, Thomas (Dundee) | Richardson, R. (Houghton-le-Spring) | Wellock, Wilfred |
| Jones, Morgan (Caerphilly) | Riley, Ben | Welsh, J. C |
| Jones, T. I Mardy (Pontypridd) | Ritson, J. | Westwood, J. |
| Kelly, W. T. | Roberts, Rt. Hon. F. O. (W. Bromwich) | Wiggins, William Martin |
| Kennedy, T. | Saklatvala, Shapurji | Williams, C. P. (Denbigh, Wrexham) |
| Kenworthy, Lt.-Com. Hon. Joseph M. | Salter, Dr. Alfred | Williams, David (Swansea, East) |
| Lawrence, Susan | Sexton, James | Williams, Dr. J. H. (Llanelly) |
| Lawson, John James | Shaw, Rt. Hon. Thomas (Preston) | Williams, T. (York, Don Valley) |
| Lee, F. | Shepherd, Arthur Lewis | Wilson, C. H. (Sheffield, Attercliffe) |
| Lindley, F. W. | Shiels, Dr. Drummond. | Wilson, R. J. (Jarrow) |
| Livingstone, A. M. | Shinwell, E. | Windsor, Walter |
| Longbottom, A. W. | Sinclair, Major Sir A. (Caithness) | Wright, W. |
| Lowth, T. | Slesser, Sir Henry H. | Young, Robert (Lancaster, Newton) |
| Lunn, William | Smillie, Robert | |
| MacDonald, Rt. Hon. J. R.(Abersvon) | Smith, Rennie (Penistone) | TELLERS FOR THE AYES.— |
| Mackinder, W. | Snowden, Rt. Hon. Philip | Mr. Charles Edwards and Mr. |
| MacLaren, Andrew | Stamford, T. W. | Whiteley. |
| Malone, C. L'Estrange (N'thampton) | Stephen, Campbell | |
| NOES. | ||
| Acland-Troyte, Lieut.-Colonel | Cecil, Rt. Hon. Sir Evelyn (Aston) | Ganzonl, Sir John |
| Ainsworth, Lieut.-Col. Charles | Chamberlain, Rt. Hon. N. (Ladywood) | Gates, Percy |
| Albery, Irving James | Charteris, Brigadier-General J. | Gault, Lieut.-Col. Andrew Hamilton |
| Alexander, E. E. (Leyton) | Christie, J. A. | Gilmour, Lt.-Col. Rt. Hon. Sir John |
| Allen, Sir J. Sandeman | Churchman, Sir Arthur C. | Glyn, Major R. G. C. |
| Applin, Colonel R. V. K. | Clarry, Reginald George | Goff, Sir Park |
| Ashley, Lt.-Col. Rt. Hon. Wilfrid W. | Cobb, Sir Cyril | Gower, Sir Robert |
| Atholl, Duchess of | Cochrane, Commander Hon. A. D. | Grace, John |
| Baldwin, Rt. Hon. Stanley | Cockerill, Brig-General Sir George | Graham, Fergus (Cumberland, N.) |
| Barclay-Harvey, C. M. | Cohen, Major J. Brunel | Grant, Sir J. A. |
| Beamish, Rear-Admiral T. P. H. | Colfox, Major Wm. Phillips | Grattan-Doyle, Sir N. |
| Benn, Sir A. S. (Plymouth, Drake) | Colman, N. C. D. | Gretton, Colonel Rt. Hon. John |
| Bennett, A. J. | Cooper, A. Duff | Guinness, Rt. Hon. Walter E. |
| Bentinck, Lord Henry Cavendish- | Cope, Major Sir William | Gunston, Captain D. W. |
| Berry, Sir George | Courthope, Colonel Sir G. L. | Hacking, Douglas H. |
| Bethel, A. | Craig, Sir Ernest (Chester, Crewe) | Hall, Capt. W. D'A. (Brecon & Rad.) |
| Betterton, Henry B. | Crawfurd, H. E. | Hammersley, S. S. |
| Birchall, Major J. Dearman | Crooke, J. Smedley (Derltend) | Hanbury, C. |
| Bird, E. R. (Yorks, W. R., Skipton) | Crookshank, Col. C. de W. (Berwick) | Hannon, Patrick Joseph Henry |
| Bird, Sir R. B. (Wolverhampton, W.) | Crookshank, Cot. H. (Lindsey, Gainsbro) | Harland, A. |
| Boothby, R. J. G. | Culverwell, C. T. (Bristol, West) | Harrison, G. J. C. |
| Bowater, Col. Sir T. Vansittart | Curzon, Captain Viscount | Hartington, Marquess of |
| Boyd-Carpenter, Major Sir A. B. | Davidson, Rt. Hon. J. (Hertford) | Harvey, G. (Lambeth, Kennington) |
| Braithwaite, Major A. N. | Davies, Maj. Geo. F. (Somerset, Yeovil) | Harvey, Majors. E. (Devon, Totnes) |
| Brass, Captain W. | Davies, Sir Thomas (Cirencester) | Haslam, Henry C. |
| Bridgeman, Rt. Hon. William Clive | Davies, Dr. Vernon | Headlam, Lieut.-Colonel C. M. |
| Briggs, J. Harold | Dawson, Sir Philip | Henderson, Capt. R. R. (Oxf'd, Henley) |
| Briscoe, Richard George | Dean, Arthur Wellesley | Heneage, Lieut.-Colonel Arthur P. |
| Brittain, Sir Harry | Dixon, Captain Rt. Hon. Herbert | Henn, Sir Sydney H. |
| Brocklebank, C. E. R. | Eden, Captain Anthony | Hennessy, Major Sir G. R. J. |
| Brooke, Brigadier-General C. R. I. | Edmondson, Major A. J. | Hills, Major John Waller |
| Broun-Lindsay, Major H. | Elliot, Major Walter E. | Hilton, Cecil |
| Brown, Col. D. C. (N'th'l'd., Hexham) | Erskine, Lord (Somerset, Weston-s.-M.) | Holbrook, Sir Arthur Richard |
| Brown, Brig.-Gen. H. C.(Berks, Newb'y) | Erskine, James Malcolm Monteith | Holt, Captain H. P. |
| Buchan, John | Evans, Captain A. (Cardiff, South) | Hope, Sir Harry (Forfar) |
| Buckingham, Sir H. | Everard, W. Lindsay | Hopkins, J. W. W |
| Bull, Rt. Hon. Sir William James | Falle, Sir Bertram G. | Hopkinson, A. (Lancaster, Mossley) |
| Bullock, Captain M. | Fanshawe, Captain G. D. | Home, Rt. Hon. Sir Robert S. |
| Burman, J. B. | Fermoy, Lord | Howard-Bury, Colonel C. K. |
| Burney, Lieut.-Com. Charles D. | Fleiden, E. B. | Hudson, R. S. (Cumberl'nd, Whitch'n) |
| Campbell, E. T. | Forestier-Walker, Sir L. | Hume, Sir G. H. |
| Carver, Major W. H. | Foster, Sir Harry S. | Hurd, Percy A. |
| Cayzer Sir C. (Chester, City) | Fraser, Captain Ian | Iliffe, Sir Edward M. |
| Cayzer, Maj. Sir Herbt. R. (Prtsmth, S.) | Fremantle, Lieut.-Colonel Francis E. | Inskip, Sir Thomas Walker H. |
| Cazalet, Captain Victor A. | Gadle, Lieut.-Col. Anthony | Iveagh, Countess of |
| Jackson, Sir H. (Wandsworth, Cen'l) | Oakley, T. | stott, Lieut.-Colonel W. H. |
| Jones, Henry Haydn (Merioneth) | O'Connor, T. J. (Bedford, Luton) | Strauss, E. A. |
| Kennedy, A. R. (Preston) | Ormsby-Gore, Rt. Hon. William | Streatfeild, Captain S. R. |
| Kindersley, Major Guy M. | Pennefather, Sir John | Sugden, Sir Wilfrid |
| King, Commodore Henry Douglas | Perkins, Colonel E. K. | Thorn, Lt.-Col. J. G. (Dumbarton) |
| Knox, Sir Alfred | Perring, Sir William George | Thompson, Luke (Sunderland) |
| Lamb, J. Q. | Peto, Sir Basil E. (Devon, Barnstaple) | Thomson, F. C. (Aberdeen, South) |
| Lloyd, Cyril E. (Dudley) | Peto, G. (Somerset, Frome) | Thomson, Rt. Hon. Sir W. Mitchell- |
| Loder, J. de V. | Pilcher, G. | Tinne, J. A. |
| Long, Major Eric | Preston, William | Titchfield, Major the Marquess of |
| Looker, Herbert William | Price, Major C. W. M. | Tomlinson, R. P. |
| Lougher, Lewis | Raine, Sir Walter | Tryon, Rt. Hon. George Clement |
| Lucas-Tooth, sir Hugh Vere | Ramsden, E. | Vaughan-Morgan, Col. K. P. |
| Lynn, Sir Robert J. | Reid, Capt. Cunningham (Warrington) | Waddington, R. |
| MacAndrew, Major Charles Glen | Rentoul, G. S. | Wallace, Captain D. E. |
| Macdonald, Capt. P. D. (1. of W.) | Rhys, Hon. C. A. U. | Ward, Lt.-Col. A.L.(Kingston-on-Hull) |
| MacDonald, R. (Glasgow, Cathcart) | Richardson, Sir P. W. (Sur'y, Ch'ts'y) | Warner, Brigadier-General W. W. |
| Macmillan, Captain H. | Rodd, Rt. Hon. Sir James Rennell | Warrender, Sir Victor |
| MacRobert, Alexander M. | Ropner, Major L. | Watson, Sir F. (Pudsey and Otley) |
| Maitland, A. (Kent, Faversham) | Ruggles-Brise, Lieut.-Colonel E. A. | Watson, Rt. Hon. W. (Carlisle) |
| Manningham-Buller, sir Mervyn | Runciman, Hilda (Cornwall, St. Ives) | Watts, Sir Thomas |
| Margesson, Capt. D. | Runciman, Rt. Hon. Walter | Wayland, Sir William A. |
| Marriott, Sir J. A. R. | Russell, Alexander West (Tynemouth) | Wells, S. R. |
| Mason, Colonel Glyn K. | Rye, F. G. | White, Lieut.-Col. Sir G. Dalrymple |
| Merriman, Sir F. Boyd | Samuel, A. M. (Surrey, Farnham) | Williams, A. M. (Cornwall, Northern) |
| Meyer, Sir Frank | Samuel, Samuel (W'dsworth, Putney) | Williams, Com. C. (Devon, Torquay) |
| Mitchell, S. (Lanark, Lanark) | Sandeman, N. Stewart | Williams, Herbert G. (Reading) |
| Mitchell, W. Foot (Saffron Walden) | Sanders, Sir Robert A. | Wilson, Sir C. H. (Leeds, Central) |
| Mitchell, Sir W. Lane (Streatham) | Sanderson, Sir Frank | Wilson, R. R. (Stafford, Lichfield) |
| Monsell, Eyres, Com. Rt. Hon. B. M. | Sandon, Lord | Winterton, Rt. Hon. Earl |
| Moore, Lieut.-Colonel T. C. R. (Ayr) | Sassoon, Sir Philip Albert Gustave D. | Withers, John James |
| Morrison, H. (Wilts, Salisbury) | Savory, S. S. | Wolmer, Viscount |
| Morrison-Bell, Sir Arthur Clive | Sheffield, Sir Berkeley | Womersley, W. J. |
| Murchison, Sir Kenneth | Shepperson, E. W. | Wood, E. (Chest'r, Stalyb'dge & Hyde) |
| Nail, Colonel Sir Joseph | Skelton, A. N. | Wood, Rt. Hon. Sir Kingsley |
| Neville, Sir Reginald J. | Smith, Louis W. (Sheffield, Hallam) | Worthington-Evans, Rt. Hon. Sir L. |
| Newton, Sir D. G. C. (Cambridge) | Smith-Carington, Neville W. | Wright, Brig.-General W. D. |
| Nicholson, O. (Westminster) | Smithers, Waldron | |
| Nicholson, Col. Rt. Hn. W. G. (Ptrsf'ld.) | Somerville, A. A. (Windsor) | TELLERS FOR THE NOES.— |
| Nield, Rt. Hon. Sir Herbert | Southby, Commander A. R. J. | Captain Bowyer and Mr. Penny. |
| Nuttall, Ellis | Stanley, Lieut.-Colonel Rt. Hon. G. F. |
§ Mr. MORGAN JONESI beg to move, in page 11, to leave out from the word "disease" in line 30 to the first word "the" in line 31.
So far the Committee has been discussing as to the obligation that shall rest upon the local authority to demand payment in respect to treatment in an institution from the person who is so treated, but in addition to that particular proviso in the Clause, there is an amplification of the liability in this sense, that., not only shall the person who is so treated be liable, but also
any person legally liable to maintain that person.The problem, therefore, that arises is clearly this: Who is it that may be said to be legally liable for a person treated in an institution? Recent experience leads us to entertain some sort of apprehension as to what might be held to be the exact meaning of these words. Let me cite, from my own experience, a recent example, not, I admit, arising out of the administration of the Ministry of Health, but to show the spirit that is entering into this particular matter. Some time ago, the Committee will remember, a 2900 number of harvesters were sent from this country to Canada, and among them was a person from my own constituency. He left his family without any visible means of subsistence, and they became chargeable to the guardians. In due time the board of guardians, having this family-left upon their hands and not being able to apply to the husband because he was away, applied to the husband's father. Now, clearly if that kind of principle is going to be applied, no sort of relative will be entirely free from the implications of this phrase. Anyhow, it would be appropriate that we should get from the Minister what exactly is meant by this phrase "legally liable."The learned Attorney-General, in the last discussion, told us that the way out of our difficulty was to rely upon common-sense, but common-sense, I am afraid, does not assist us very much in this matter. Does it seem common-sense, for instance, that the father, an old gentleman, shall be held liable for the maintenance of his son's family? Take another case. Does it sound like common-sense that a grandfather who has long since given up work shall be held 2901 liable for the maintenance of his grandchild in charge of Poor Law guardians? Does it sound like common-sense that the grandmother, in the absence of a grandfather, who may be dead, shall be held liable? I am not imagining things at all. I am quoting things that have in fact happened in the experience of many Members on this side. It is quite easy for the hon. and learned Gentleman opposite to assure us that common-sense will apply, but there stands in the background of these discussions the somewhat ominous figure of the Ministry of Health auditor, and he may have views upon this matter that are not entirely dictated, from our point of view, by common-sense.
May I put one or two hypothetical cases that will perhaps help the Parliamentary Secretary to indicate what would be the law and the interpretation of the law in this case? Let us return for a moment to the discussion of a maternity case, and assume that a mother has entered a maternity home for the birth of her child. It may very well be that the father of this child may have died; it may be a posthumous child. The mother is too poor, and the father is dead; who, in that case, is to be held to be legally liable for the maintenance of this particular patient in a maternity home? What does common-sense say? I should like to hear the Attorney-General's view. If common-sense does not assist us, what does the law say? New let us assume another case, a perhaps more difficult case. Let us assume that an unmarried woman goes into a maternity home to give birth to her illegitimate child, and the putative father places the sea between him and his responsibility. The mother being too poor to maintain the child, who in that case is going to be held to be legally liable? Is it the putative father's father?
This is a most important matter, because, as we now find this particular Clause being interpreted in practice, all kinds of relations are being drawn into some sort of imaginary responsibility for these people. Step-fathers, step-brothers, step-mothers, relatives two or three times removed, are being called upon to face financial responsibility where relatives have become a burden on the public finances. It is all very well to regard this as a somewhat humorous subject, but we have to realise that large num- 2902 bers of these people who might quite rightly be regarded as legally responsible are nowadays, in very large areas of the country, passing through very distressing times; and if this Clause receives the endorsement of the House, it really becomes a serious matter for these persons, because if they are called upon to bear these responsibilities in addition to their own, which they find already sufficiently hard to bear, then the carrying of this particular phrase in the Clause will involve them in real financial hard ship. Therefore, in order to limit the responsibility involved in the maintenance of the patients to the patients concerned, I beg to move this Amendment.
§ 7.0 p.m.
§ Sir K. WOODI do not think there need be any difficulty about this matter or any prolonged Debate. There is a statutory provision in this matter, and I think it must have escaped the recollection of the hon. Member for Caerphilly (Mr. Morgan Jones), because I know he has had a large experience in local administration and that kind of work, and I do not know why there should be any doubt or difficulty in his mind on the subject. I am afraid he has forgotten the position. Of course, the definition is well known, and has been on the Statute Book ever since the days of Elizabeth. The hon. Member will find it now in Section 41 of the Poor Law Act, 1927. I do not suppose the hon. Member will desire to press the matter further, but, if he is pressing it on the merits, what it amounts to is this, that just because a person enters an institution, if the Amendment is carried, there is to be no liability upon the persons mentioned, whereas if he is outside the institution there is to be a liability. Obviously, one could not agree to a suggestion of that kind. There are also numerous cases where children would be receiving benefit, and no one would suggest that their parents should not pay in respect of them, but that would be one of the consequences of the Amendment. I oppose the Amendment, first, on the ground of liability to maintain and relieve as laid down in the definition; secondly, because one could not sustain the position of a person not being liable just because a person went into an institution; and, thirdly, because on the merits parents should pay, if they can 2903 afford it, in accordance with their circumstances. On all those grounds, I say that the Amendment must be rejected, and I ask the Committee to reject it.
§ Sir H. SLESSERThe right hon. Gentleman did not do justice to my hon. Friend's contention. It is true that under Section 41 of the Poor Law Act, 1927, it is made the duty of the father, mother, grandfather, grandmother and so on of a person not able to work or of a poor person to relieve and maintain such a person.
§ Sir K. WOODIf they are possessed of sufficient means.
§ Sir H. SLESSERThat is not my point at all. That liability for maintenance is confined entirely to cases of the Poor Law. Nobody is going to dispute for a moment that under the existing Poor Law that is the law, but here we have an entirely different situation. Under Clause 13 of this Bill I understood that the liability here was to be approximated more or less to the liability under the Public Health Acts. I am led to that conclusion particularly for this reason. When we look at the definition of an institution, for example, we find that it is an institution provided by the council of a county or county borough under the Public Health Acts. Again, the analogy was given us of the case of the maternity benefit where we were told that the practice there was so to use the Maternity Act that there persons might be made liable to pay. But that is outside the Poor Law and the obligation to maintain, which is contained in Section 41 of the Poor Law Act and is confined entirely to Poor Law cases, does not in itself apply at all to cases dealt with under the Public Health Act, the Maternity Act or any Act other than the Poor Law.
The right hon. Gentleman is entitled to say that on merits he is going to amend the law and extend the obligation to maintain their relatives, as laid down in the Poor Law, to this class of case. If he will say that quite frankly we know the case we have to meet. But it is no use confusing the Committee by suggesting that Section 41, which deals with the maintenance of persons who come under the Poor Law, is now to apply to persons who come under Clause 13 of this Bill. 2904 Therefore, following the invitation which was extended to me by the Attorney-General some time ago to come to common-sense, I say that the commonsense of the matter is that we are dealing with an entirely different situation from the Poor Law. The Committee will allow me to deal with the law first. It is all very well to say that we should come to common-sense in the matter of law, but when the law is confusing, we must clear away the bad law before we come to the facts. Let us sweep away the question of the Poor Law and ask the Minister of Health and the Government whether they intend, in the administration of this Clause, which would involve administration under the Public Health Acts and other Acts other than the Poor Law, to enforce the old obligation under the Elizabethan Poor Law and to apply it to cases where you had no Poor Law in the past. It is a most important question, and it is one to which we are entitled to have a concrete and definite reply. Is it going to be the fact, as my hon. Friend says, that for the first time every purely public health service is going to make the father, grandfather, son and grandson, and all such persons liable for expenditure incurred on persons relieved by the public health authorities? Having cleared away the law and got to common-sense, I hope we shall have an answer from the Government whether they do mean to apply the doctrine laid down under the Public Health Acts, or whether they do not.
§ Mr. MARCHI desire to support the Amendment. It is all very well for the Minister to brush these things aside as though they were a mere nothing, but it is puzzling to know what they really do mean. When we read the Clause, we find that they can charge the whole expenses. A little time ago the Minister of Health said there was no such thing as the whole of the expenses in this Clause, but it is there in two places. They can recover the whole of the expenses if the people are in a position to pay. I should like to bring to the notice of the Parliamentary Secretary some cases which have come to my knowledge. Close by where I am living there are a man and wife with four children. The man's mother is a widow unable to keep herself in her home, and she has come to live with him. He has taken 2905 her in because he has got a little room. She has gat a little money and is just able to maintain herself. Supposing she fell ill or met with an accident and had to go to an institution, are you going to hold that son fully responsible as being the legal representative to pay the expenses that might be legally incurred through that women being taken away? In another case I know of an elderly man with his wife and sister who has come to live with them because she is GO and has rheumatism, and cannot do her usual work. They have no money, but they are struggling on to try to keep her out of the workhouse. They never know when she may fall down and hurt herself. It would be too much of a liability for these two elderly people to look after her, and she would be taken into an institution. Is that man to be legally responsible for the maintenance of his sister? They have not been legally liable to maintain her at all. If they had not been sympathetic, she must probably have gone straight into an institution.
This Clause seems aimed at the people who are trying to assist their unfortunate friends. Take another case. What would happen in the case of a young woman who has been in service for six years. She went into service at 14 and is now 20. She has got into difficulties, and has to go into an institution to give birth to a child. Is her father to be held responsible for the maintenance of that girl though she has been away from home for six years maintaining herself in service? If hills are presented to those people, they will have recourse to the Courts if they dispute them, and will be involved in expense. Many of them would not try to defend themselves in Court, and would have to get someone to defend the case for them. It would, therefore, be much better if these words were left out, and people were not troubled in this manner.
§ Mr. E. BROWNThe Parliamentary Secretary's reply has shown the difficulty of the Committee right through the discussions to-day and the difficulty in the Clause. When it suits the Minister, he quotes the law of public health on the previous Amendment and in this case, when it does not suit him to do that, he quotes the Poor Law. Our objection to this Clause is that what the Minister is 2906 trying to do is to amalgamate two entirely different codes of law. The guardians "must"; the local authorities "may." We hold it is quite undesirable that, when you are co-ordinating the local government, you should assimilate the ordinary taxpaying citizens of the country to pauper citizens under the Poor Law. That seems to me the issue, and it is only illustrative of the lack of care the Government have given in the drafting of this Bill, and their lack of regard for ordinary citizens when they try to amalgamate two entirely different codes of law and of practice inside one code of this kind. Are the local authorities to be expected to interpret Clause 13 in the light of the mandatory law applied to boards of guardians or of the permissive law applied under the Public Health Acts?
§ The ATTORNEY-GENERALThe hon. Member's criticism on this occasion is a little unjustified. The provisions of this Clause merely 'amount to this, that, in connection with the relief which is given inside an institution, the local authority—that is, the council—shall be under a duty to recover from certain persons the cost of giving these services. If those services were given outside the institution, certain people would be liable to pay fir them—a father for a child or a husband for a wife. If that person goes into an institution, Clause 13 simply gives force to this principle, that the person responsible shall not escape liability because the services were given inside an institution instead of outside an institution. The question then is: who is to pay for the relief given inside the institution? We might, of course, have set out all the various persons who are liable to pay for the support of that individual, but, instead of setting it out at length, we used Section 41 of the Poor Law Act, 1927, as a dictionary, and anybody may discover who is the person legally liable by turning up that Section. This is not a question of mixing up Poor Law and Public Health Law, but merely a question of using a definition which already exists, of a certain class of person, so as to make it plain who is responsible for the payment of the expenses of relieving people inside institutions.
§ Mr. E. BROWNSupposing these words were not passed: Is it now the 2907 practice in these cases under the Public Health Acts to do what is now proposed to be done inside this definition?
§ The ATTORNEY-GENERALThat is another question—
§ The ATTORNEY-GENERAL—which has been dealt with in the preceding Amendment. We are not on the question whether we should require persons inside institutions to pay for the relief given to them. We are merely on the question whether we shall extend that liability to, say, the father in respect of a child or to the husband in respect of his wife. That is a principle which is involved in the Amendment under discussion. The specific legal point as to who is liable can be sufficiently answered by referring to Section 41 of the Poor Law Act, 1927.
§ Mr. WEBBThe hon. and learned Gentleman is presuming on the ignorance of the Committee. He said that this Clause, instead of setting out in a long way the kind of person who is to be liable, refers to the Poor Law Act and uses that as a sort of dictionary, which will tell the public who are the persons to be liable. The Clause does nothing of the kind. It does not refer to the Poor Law Act, it does not use it as a dictionary, and it does not therefore explain the people who are legally liable. The words are:
from any person legally liable to maintain that person.The hon. and learned Gentleman must know that these words are not in the least equivalent to words in Section 41 of the Poor Law Act. That Section, first of all, sets out the grandfather, the grandmother, and so on, and then defintiely limits that in various ways: first, by saying that the person to be paid for must not be able-bodied, so that, if he is able-bodied, there is no liability to maintain him at all; secondly, there is no legal liability under the Poor Law Act to maintain people as such. The liability only begins when a person is chargeable to the Poor Rate. Consequently, the words "legal liability to maintain" cannot simply be supposed to import the Poor Law Act, and the hon. and learned Gentleman was presuming on the ignorance 2908 of the Committee, because he must have been aware that that is so.On the point of legal drafting, these words are left entirely obscure. If the hon. and learned Gentleman means that they are to import the Poor Law Act, he must say so. They may merely import the Common Law liability to maintain. In fact, I venture to suggest that if the words "legal liability" are used alone, the Common Law liability is the very first liability of which one would think. That is very different from the liability under the Poor Law, and very much more limited. There is a third case, and that is the relevant one. This clause relates not to Poor Law institutions at all, but expressly to institutions maintained by a county or county borough under the Public Health Acts, and so on. The liability to maintain people who are in institutions run under the Public Health Acts is very much more limited than the liability to maintain under the Poor Law Acts. Section 32 of the Public Health Act, 1875, says:
Any expenses incurred by a local authority in maintaining in a hospital or in a temporary place for the reception of the sick (whether or not belonging to such authority), a patient who is not a pauper, shall be deemed to be a debt due from such patient to the local authority, and may be recovered from him.Where is the liability on the person legally liable to maintain that patient? Is there any liability on the grandfather, grandmother, father, mother, son, daughter, stepson, stepdaughter, stepfather, or stepmother, who are the persons liable to maintain a pauper in a Poor Law institution? The hon. and learned Gentleman said that no such liability at present obtains for patients in a public health hospital. Consequently, we are entitled to say that Clause 13 relates exclusively to institutions run under the Public Health Acts and analogous Acts, and not to Poor Law institutions, and the Government are proposing largely to extend the liability. At present the liability is on the patient only under the Public Health Act. Now the Government propose to extend that to any person who is legally liable to maintain the patient. Under the Common Law, a father is liable to maintain the child under 14, the husband is liable to maintain his wife, and the wife, if she has separate property, is liable to 2909 maintain the husband, but the grandfather, grandmother, and so on, do not come in. The public health law is that the patient only is liable.What do the Government mean when they say "legal liability"? There are three laws under which you may be legally liable. Both the right hon. Gentlemen have assumed that they meant the largest possible liability under the Poor Law, and throughout this Bill one can see the old Poor Law cropping up in the drafting. This Bill is drafted by Poor Law experts, and not by public health experts. To come to the point of this Amendment, are we not entitled to ask that on Report the Government shall make clear what legal liability they mean, whether they mean Common Law liability, public health liability, or Poor Law liability. Three different classes of persons would be liable under those three forms. As a matter of fact, we ask that the public health institutions, which have been maintained under present conditions without any liability except from the patient, should not be interfered with. There is no reason why, under a Measure which merely transfers the Poor Law to the public health authority, the work of the public health authority under the Public Health Acts should be seriously interfered with in this way.
§ Mr. PALINGThe hon. Member for Leith (Mr. E. Brown) accused the Government of drafting this Clause rather carelessly. But I am not sure that that is so, because the Government's whole intention in this Bill has been to bring public health services under the same law as applies to Poor Law services. Their policy has always been to scrape every penny they can from everybody who receives public assistance, and they are carrying out that intention in this Clause. It is true that up to the present public health authorities have not been able to claim much, and they have been limited to the number of persons from whom they can claim. Apparently, that number is not sufficient for the two Ministers who are conducting the business of the Ministry of Health, and they wan to extend it to as large a number of people as are liable under the Poor Law at present The Parliamentary Secretary said that everybody was aware of the definition of legal liability, and that it had been in operation since Queen Elizabeth. One 2910 wonders, when one sees the kind of legislation that the Parliamentary Secretary tries to put into operation, whether he does not belong to the time of Elizabeth also. It is time that he modernised his ideas in this respect. The definition of legal liability to which he refers is:
It shall be the duty of the father, grandfather, mother, grandmother, husband or child of a poor, old, blind, lame and impotent person or other poor person not axle to work or possessed of sufficient moans, to relieve and maintain that person.That is not the law at present with regard to public health services, and this beneficent Bill is intended to put public health services under the same operation of the law as Poor Law services. In other words, it is intended to put pressure upon more people in the future. I saw a cartoon the other week in a paper, which I think was "Punch." The Minister of Health was depicted as an executioner, and he was leading to execution a member of a board of guardians. There was a shadow of Bumble by the side of him, and Bumble said: "So you are going too." The Minister said: "No, we are only translating him."As a matter of fact, the Minister is keeping the worst aspect of the Poor Law, and is doing his best to revive Bumbledom. Every public health authority will resent it. They admit that, even with the limited number of persons from whom they can claim now, the persons are so poor that in the majority of cases they have not the heart to make a claim. When they know that the limited number of persons is to be added to, and that they are to be compelled to claim in thousands of cases where they are not compelled to claim to-day, and when they realise that the law has been stiffened up to this extent and that they are to be put in this unenviable position in future, the opposition that has been aroused among public health authorities will be infinitely increased.
§ Mr. RENNIE SMITHReference has been made to the law of Elizabeth, but this Debate is enough to make Queen Elizabeth turn in her grave. The Parliamentary Secretary has made it clear that, whatever else he wants to do, he does not want to get rid of the Poor Law, Poor Law institutions, or the 2911 spirit of the Poor Law in this country. He has sought to incorporate in the Public Health law a most retrograde definition. The right hon. Gentleman the Member for Seaham (Mr. Webb) has let the eat out of the bag, not only by showing what the Poor Law legal liability is, but by bringing out the public health definition of legal liability. We are seeking to provide the public health definition for all public health institutions, whereas the Government, under the cloak of abolishing boards of
§ guardians, are seeking here as in so many parts of the Bill to preserve intact—
§ It being half-past Seven of the Clock, the CHAIRMAN proceeded, pursuant to the Order of the House of 12th December, to put forthwith the Question on the Amendment already proposed from the Chair.
§ Question put, "That the words proposed to be left out stand part of the Clause."
§ The Committee divided: Ayes, 268, Noes, 145.
2913| Division No. 87.] | AYES. | [7.30 p.m. |
| Acland-Troyte, Lieut.-Colonel | Cohen, Major J. Brunei | Harrison, G. J. C. |
| Ainsworth, Lieut.-Col. Charles | Colfox, Major Wm. Phillips | Hartington, Marquess of |
| Albery, Irving James | Colman, N. C. D. | Harvey, G. (Lambeth, Kennington) |
| Alexander, E. E. (Leyton) | Conway, Sir W. Martin | Harvey, Majors. E. (Devon, Totnes) |
| Allen, Sir J. Sandeman | Cooper, A. Duff | Haslam, Henry C. |
| Amery, Rt. Hon. Leopold C. M. S. | Cope, Major Sir William | Headlam, Lieut.-Colonel C. M. |
| Apsley, Lord | Couper, J. B. | Henderson, Capt. R. R. (Oxf'd, Henley) |
| Ashley, Lt.-Col. Rt. Hon. Wilfrid W. | Courthope, Colonel Sir G. L. | Heneage, Lieut.-Col. Arthur P. |
| Astor, Viscountess | Craig, Sir Ernest (Chester, Crewe) | Henn, Sir Sydney H. |
| Atholl, Duchess of | Crooke, J. Smedley (Derltend) | Hennessy, Major Sir G. R. J. |
| Atkinson, C. | Crookshank, Col. C. de W. (Berwick) | Hills, Major John Waller |
| Baldwin, Rt. Hon. Stanley | Crookshank, Cpt. H. (Lindsey, Gainsbro) | Hilton, Cecil |
| Barclay-Harvey, C. M. | Culverwell, C. T. (Bristol, West) | Hohler, Sir Gerald Fitzroy |
| Beamish, Rear-Admiral T. p. H. | Curzon, Captain Viscount | Holbrook, Sir Arthur Richard |
| Benn, Sir A. S. (Plymouth, Drake) | Davidson, Rt. Hon. J. (Hertford) | Holt, Capt. H. P. |
| Bennett, A. J | Davies, Sir Thomas (Cirencester) | Hope, Sir Harry (Forfar) |
| Bentinck, Lord Henry Cavendish- | Davies, Dr. Vernon | Hopkins, J. W. W. |
| Berry, Sir George | Dawson, Sir Philip | Hopkinson, A. (Lancaster, Mossley) |
| Bethel, A. | Dean, Arthur Wellesley | Horne, Rt. Hon. Sir Robert S. |
| Betterton, Henry B. | Dixon, Captain Rt. Hon. Herbert | Howard-Bury, Colonel C. K. |
| Bevan, S. J. | Eden, Captain Anthony | Hume, Sir G. H. |
| Birchall, Major J. Dearman | Edmondson, Major A. J. | Hurd, Percy A. |
| Bird, E. R. (Yorks, W. R., Skipton) | Edwards, John H. (Accrington) | Hurst, Gerald B. |
| Boothby, R. J. G. | Elliot, Major Walter E. | Iliffe, Sir Edward M. |
| Bowater, Col. Sir T. Vansittart | Erskine, Lord (Somerset, Weston-s.-M.) | Inskip, Sir Thomas Walker H. |
| Bowyer, Captain G. E. w. | Erskine, James Malcolm Monteith | Iveagh, Countess of |
| Boyd-Carpenter, Major Sir A. B. | Evans, Captain A. (Cardiff, South) | Jackson, Sir H. (Wandsworth, Cen'l) |
| Braithwaite Major A. N. | Everard, W. Lindsay | Kennedy, A. R. (Preston) |
| Brass, Captain W. | Falle, Sir Bertram G. | Kindersley, Major Guy M. |
| Bridgeman, Rt. Hon. William Clive | Fielden, E. B. | King, Commodore Henry Douglas |
| Briggs, J. Harold | Forestier-Walker, Sir L. | Knox, Sir Alfred |
| Briscoe, Richard George | Forrest, W. | Lamb, J. O. |
| Brittain, Sir Harry | Foster, Sir Harry S. | Little, Dr. E. Graham |
| Brocklebank, C. E. R. | Fraser, Captain Ian | Lloyd, Cyril E. (Dudley) |
| Brooke, Brigadier-General C. R. I. | Fremantle, Lt.-Col. Francis E. | Loder, J. de V. |
| Broun-Lindsay, Major H. | Gadie, Lieut.-Col. Anthony | Long, Major Eric |
| Brown, Col. D. C. (N'th'l'd., Hexham) | Galbraith, J. F. W. | Looker, Herbert William |
| Brown, Brig.-Gen. H.C.(Berks, Newb'y) | Ganzonl, Sir John | Lougher, Lewis |
| Buchan, John | Gates, Percy | Lucas-Tooth, Sir Hugh Vere |
| Buckingham, Sir H. | Gault, Lieut.-Col. Andrew Hamilton | Lynn, Sir R. J. |
| Bull, Rt. Hon. Sir William James | Gilmour, Lt.-Col. Rt. Hon. Sir John | MacAndrew, Major Charles Glen |
| Bullock, Captain M. | Glyn, Major R. G. C. | Macdonald, Capt. P. D. (I. of W.) |
| Burman, J. B. | Goff, Sir Park | MacDonald, R. (Glasgow, Cathcart) |
| Burney, Lieut.-Com. Charles D. | Gower, Sir Robert | McDonnell, Colonel Hon. Angus |
| Burton, Colonel H. W. | Grace, John | MacRobert, Alexander M. |
| Campbell, E. T. | Graham, Fergus (Cumberland, N.) | Maitland, A. (Kent, Faversham) |
| Carver, Major W. H. | Grant, Sir J. A. | Manningham-Buller, Sir Mervyn |
| Cassels, J. D. | Grattan-Doyle, Sir N. | Margesson, Captain D |
| Cautley, Sir Henry S. | Greene, W. P. Crawford | Marriott, Sir J. A. R. |
| Cayzer, Sir C. (Chester, City) | Gretton, Colonel Rt. Hon. John | Mason, Colonel Glyn K. |
| Cayzer, Maj. Sir Herbt. R. (Prtsmth. S) | Grotrian, H. Brent | Merriman, Sir F. Boyd |
| Cazalet, Captain Victor A. | Guinness, Rt. Hon. Walter E. | Meyer, Sir Frank |
| Cecil, Rt. Hon. Sir Evelyn (Aston) | Gunston, Captain D. W. | Milne, J. S. Wardlaw- |
| Chamberlain, Rt. Hon. N. (Ladywood) | Hacking, Douglas H. | Mitchell, S. (Lanark, Lanark) |
| Chapman, Sir S. | Hall, Lieut.-Col. Sir F. (Dulwich) | Mitchell, W. Foot (Saffron Walden) |
| Charteris, Brigadier-General J. | Hall, Capt. W. D'A. (Brecon & Rad.) | Mitchell, Sir W. Lane (Streatham) |
| Christie, J. A. | Hamilton, Sir George | Monsell, Eyres, Com. Rt. Hon. B. M. |
| Churchman, Sir Arthur C. | Hammersley, S, S. | Morrison, H. (Wilts, Salisbury) |
| Clarry, Reginald George | Hanbury, C. | Morrison-Bell, Sir Arthur Clive |
| Cobb, Sir Cyril | Hannon, Patrick Joseph Henry | Murchison, Sir Kenneth |
| Cockerill, Brig.-General Sir George | Harland, A. | Nail, Colonel Sir Joseph |
| Neville, Sir Reginald J. | Samuel, A. M. (Surrey, Farnham) | Titchfield, Major the Marquess of |
| Newton, Sir D. G. C. (Cambridge) | Samuel, Samuel (W'dsworth, Putney) | Tryon, Rt. Hon. George Clement |
| Nicholson, O. (Westminster) | Sandeman, N. Stewart | Vaughan-Morgan, Col. K. P. |
| Nicholson, Col. Rt. Hn. W. G. (Ptrsf'ld.) | Sanders, Sir Robert A. | Waddington, R. |
| Nield, Rt. Hon. Sir Herbert | Sanderson, Sir Frank | Wallace, Captain D. E. |
| Nuttall, Ellis | Sandon, Lord | Ward, Lt.-Col. A. L. (Kingston-on-Hull) |
| Oakley, T. | Sassoon, Sir Philip Albert Gustave D. | Warner, Brigadier-General W. W. |
| O'Connor, T. J. (Bedford, Luton) | Savery, S. S. | Watson, Sir F. (Pudsey and Otley) |
| Oman, Sir Charles William C. | Shaw, Lt.-Col. A. D. Mcl. (Renfrew. W) | Watson, Rt. Hon. W. (Carlisle) |
| Ormsby-Gore, Rt. Hon. William | Sheffield, Sir Berkeley | Watts, Sir Thomas |
| Pennefather, Sir John | Shepperson, E. W. | Wayland, Sir William A. |
| Penny, Frederick George | Skelton, A. N. | Wells, S. R. |
| Perkins, Colonel E. K. | Smith. Louis W. (Sheffield, Hallam) | White, Lieut.-Col. Sir G. Dairymple |
| Perring, Sir William George | Smith-Carington, Neville W. | Williams, A. M. (Cornwall, Northern) |
| Peto, Sir Basil E. (Devon, Barnstaple) | Smithers, Waldron | Williams, Com. C. (Devon, Torquay) |
| Peto, G. (Somerset, Frome) | Somerville, A. A. (Windsor) | Williams, Herbert G. (Reading) |
| Preston, William | Southby, Commander A. R. J. | Wilson, Sir C. H. (Leeds, Central) |
| Price, Major C. W. M. | Spender-Clay, Colonel H. | Wilson, R. R. (Stafford, Lichfield) |
| Raine, sir Walter | Stanley, Lieut.-Colonel Rt. Hon. G. F. | Winterton, Rt. Hon. Earl |
| Ramsden, E. | Stanley, Lord (Fylde) | Withers, John James |
| Rees, Sir Beddoe | Storry-Deans, R. | Wolmer, Viscount |
| Reid, Capt. Cunningham (Warrington) | Stott, Lieut.-Colonel W. H. | Wood, E. (Chest'r, Stalyb'ge & Hyde) |
| Rentoul, G. S. | Streatfeild, Captain S. R. | Wood, Rt. Hon. Sir Kingsley |
| Richardson, Sir P. W. (Sur'y, Ch'ts'y) | Sugden, Sir Wilfrid | Worthington-Evans, Rt. Hon. Sir L. |
| Rodd, Rt. Hon. Sir James Rennell | Tasker, R. Inigo. | Wright, Brig.-General W. D. |
| Ropner, Major L. | Templeton, W. P | |
| Ruggles-Brise, Lieut.-Colonel E. A. | Thorn, Lt.-Col. J. G. (Dumbarton) | TELLERS FOR THE AYES.— |
| Russell, Alexander West (Tynemouth) | Thompson, Luke (Sunderland) | Mr. F. C. Thomson and Sir Victor Warrender. |
| Rye, F. G. | Thomson, Rt. Hon. Sir W. Mitchell | |
| Salmon, Major I. | Tinne, J. A. | |
| NOES. | ||
| Adamson, Rt. Hon. W. (Fife, West) | Hamilton, Sir R. (Orkney & Shetland) | Robinson, W.C. (Yorks, W.R., Elland) |
| Alexander, A. V. (Sheffield, Hillsbro') | Hardie, George D. | Runciman, Hilda (Cornwall, St. Ives) |
| Ammon, Charles George | Harney, E. A. | Runciman, Rt. Hon. Walter |
| Baker, Walter | Harris, Percy A. | Saklatvala, Shapurji |
| Barker, G. (Monmouth, Abertillery) | Hayday, Arthur | Salter, Dr. Alfred |
| Barnes, A. | Henderson, Rt. Hon. A. (Burnley) | Sexton, James |
| Barr, J. | Henderson. T. (Glasgow) | Shaw, Rt. Hon. Thomas (Preston) |
| Batey, Joseph | Hirst, G. H. | Shepherd, Arthur Lewis |
| Beckett, John (Gateshead) | Hirst, W. (Bradford, South) | Shiels, Dr. Drummond |
| Bellamy, A. | Hollins, A. | Shinwell, E. |
| Bondfield, Margaret | Hore-Belisha, Leslie | Sinclair, Major Sir A. (Caithness) |
| Bowerman, Rt. Hon. Charles W. | Hudson, J. H. (Huddersfield) | Slesser, Sir Henry H. |
| Broad, F. A. | Hutchison, Sir Robert (Montrose) | Smith, Rennie (Penistone) |
| Bromfield, William | Jenkins, W. (Glamorgan, Neath) | Snowden, Rt. Hon. Philip |
| Brown, Ernest (Leith) | Johnston, Thomas (Dundee) | Stamford, T. W. |
| Brown, James (Ayr and Bute) | Jones, Henry Haydn (Merioneth) | Stephen, Campbell |
| Buchanan, G. | Jones, Morgan (Caerphilly) | Stewart J. (St. Rollox) |
| Buxton, Rt. Hon. Noel | Jones, T, I. Mardy (Pontypridd) | Strauss, E. A. |
| Cape, Thomas | Kelly, W. T. | Sullivan, J. |
| Charleton, H. C. | Kennedy, T. | Sutton, J. E. |
| Cluse, W. S. | Kenworthy, Lt.-Com. Hon. Joseph M. | Taylor, R. A. |
| Connolly, M. | Kirkwood, D. | Thomas, Rt. Hon. James H. (Derby) |
| Cove, W. G. | Lawrence, Susan | Thorne, W. (West Ham, Plaistow) |
| Cowan, D. M. (Scottish Universities) | Lawson, John James | Thurtle, Ernest |
| Crawfurd, H. E. | Lee, F. | Tinker, John Joseph |
| Dalton, Hugh | Lindley, F. W. | Tomlinson, R. P. |
| Davies, David (Montgomery) | Livingstone, A. M. | Townend, A. E. |
| Davies, Ellis (Denbigh, Denbigh) | Longbottom, A. W. | Trevelyan, Rt. Hon. Sir Charles |
| Davies, Evan (Ebbw Vale) | Lowth, T. | Viant, S. P. |
| Davies, Rhys John (Westhoughton) | Lunn, William | Wallhead, Richard C. |
| Day, Harry | MacDonald, Rt. Hon. J. R. (Aberavon) | Walsh, Rt. Hon. Stephen |
| Dennison, R. | Mackinder, W. | Watts-Morgan, Lt. Col. D. (Rhondda) |
| Duncan, C. | MacLaren, Andrew | Webb, Rt. Hon. Sidney |
| Dunnico, H. | Malone, C. L'Estrange (N'thampton) | Wedgwood, Rt. Hon. Josiah |
| Edge, Sir William | March, S. | Wellock, Wilfred |
| Edwards, C. (Monmouth, Bedwellty) | Morrison, R. C. (Tottenham, N.) | Welsh, J. C. |
| Fenby, T. D. | Mosley, Sir Oswald | Westwood, J. |
| Gardner, J. P. | Murnin, H. | Whiteley, W. |
| George, Rt. Hon. David Lloyd | Naylor, T. E. | Williams, C. P. (Denbigh, Wrexham) |
| Gibbins, Joseph | Oliver, George Harold | Williams, David (Swansea, East) |
| Gillettt, George M. | Owen, Major G. | Williams, Dr. J. H. (Llanelly) |
| Graham, D. M. (Lanark, Hamilton) | Palin, John Henry | Williams, T. (York, Don Valley) |
| Graham, Rt. Hon. Wm. (Edin., Cent.) | Pethick-Lawrence, F. W. | Wilson, C. H. (Sheffield, Attercliffe) |
| Greenwood. A. (Nelson and Colne) | Ponsonby, Arthur | Wilson, R. J. (Jarrow) |
| Grenfell, D. R. (Glamorgan) | Potts, John S. | Windsor, Walter |
| Griffith, F. Kingsley | Richardson, R. (Houghton-le-Spring) | Wright, W. |
| Grundy, T. W. | Riley, Ben | Young, Robert (Lancaster, Newton) |
| Hall, F. (York., W.R., Normanton) | Ritson, J. | |
| Hall, G. H. (Merthyr Tydvil) | Roberts, Rt. Hon. F. O. (W. Bromwich) | TELLERS FOR THE NOES.— |
| Mr. Allen Parkinson and Mr. Paling |
§ The CHAIRMAN then proceeded successively to put forthwith the Questions on any Amendments moved by the Government of which notice had been given, and the Questions necessary to dispose of the
2916§ Business to be concluded at half-past Seven of the Clock at this day's Sitting.
§ Question put, "That the Clause Stand part of the Bill."
§ The Committee divided: Ayes, 270; Noes, 147.
2917| Division No. 88.] | AYES. | [7.42 p.m. |
| Acland-Troyte, Lieut.-Colonel | Crooke, J. Smedley (Deritend) | Howard-Bury, Colonel C. K. |
| Ainsworth, Lieut.-Col. Charles | Crookshank, Col. C. de W. (Berwick) | Hume, Sir G. H. |
| Albery, Irving James | Crookshank, Cpt. H. (Lindsey, Gainsbro) | Hurd, Percy A. |
| Alexander, E. E. (Leyton) | Culverwell, C. T. (Bristol, West) | Hurst, Gerald B. |
| Allen, Sir J. Sandeman | Curzon, Captain Viscount | Iliffe, Sir Edward M. |
| Amery, Rt. Hon. Leopold C. M. S. | Davidson, Rt. Hon. J. (Hertford) | Inskip, Sir Thomas Walker H. |
| Apsley, Lord | Davies, Sir Thomas (Cirencester) | Iveagh, Countess of |
| Ashley, Lt.-Col. Rt. Hon. Wilfrid W. | Davies, Dr. Vernon | Jackson, Sir H. (Wandsworth, Cen'l) |
| Astor, viscountess | Dawson, Sir Philip | Kennedy, A. R. (Preston) |
| Atholl, Duchess of | Dean, Arthur Wellesley | Kindersley, Major G. M. |
| Atkinson, C. | Dixon, Captain Rt. Hon. Herbert | King, Commodore Henry Douglas |
| Baldwin, Rt. Hon. Stanley | Eden, Captain Anthony | Knox, Sir Alfred |
| Barclay-Harvey, C. M. | Edmondson, Major A. J. | Lamb, J Q. |
| Beamish, Rear-Admiral T. P. H. | Edwards. J. Hugh (Accrington) | Little, Dr. E. Graham |
| Benn, Sir A. S. (Plymouth, Drake) | Elliot, Major Walter E. | Lloyd, Cyril E. (Dudley) |
| Bennett, A. J. | Erskine, Lord (Somerset, Weston-s.-M.) | Loder, J. de V. |
| Bentinck, Lord Henry Cavendish | Erskine, James Malcolm Monteith | Long, Major Eric |
| Berry, Sir George | Evans, Captain A. (Cardiff, South) | Looker, Herbert William |
| Bethel, A. | Everard, W. Lindsay | Lougher, Lewis |
| Betterten, Henry B. | Falle, Sir Bertram G. | Lucas-Tooth, Sir Hugh Vere |
| Bevan, S. J. | Fermoy, Lord | Lynn, Sir R. J. |
| Birchall, Major J. Dearman | Fielden, E. B. | MacAndrew, Major Charles Glen |
| Bird, E. R. (Yorks, W. R., Skipton) | Forestler-Walker, Sir L. | Macdonald, R. (Glasgow, Cathcart) |
| Boothby, R. J. G. | Forrest, W. | McDonnell, Colonel Hon. Angus |
| Bowater, Col. Sir T. Vansittart | Foster, Sir Harry S. | MacRobert, Alexander M. |
| Bowyer, Captain G. E. W. | Fraser, Captain Ian | Maitland, A. (Kent, Faversham) |
| Boyd-Carpenter, Major Sir A. B. | Fremantle, Lt.-Col. Francis E. | Manningham-Buller, Sir Mervyn |
| Braithwaite, Major A. N. | Gadie, Lieut.-Col. Anthony | Margesson, Captain D. |
| Brass, Captain W. | Galbraith, J. F. W. | Marriott, Sir J. A. R. |
| Bridgeman, Rt. Hon. William Clive | Ganzonl, Sir John | Mason, Colonel Glyn K. |
| Briggs, J. Harold | Gates, Percy | Merriman, Sir F. Boyd |
| Briscoe, Richard George | Gault, Lieut.-Col. Andrew Hamilton | Meyer, Sir Frank |
| Brittain, Sir Harry | Gilmour, Lt.-Col. Rt. Hon. Sir John | Milne, J. S. Wardlaw |
| Brocklebank, C. E. R. | Glyn, Major R. G. C. | Mitchell, S. (Lanark, Lanark) |
| Brooke, Brigadier-General C. R. I | Goff, Sir Park | Mitchell, W. Foot (Saffron Walden) |
| Broun-Lindsay, Major H. | Gower, Sir Robert | Mitchell, Sir W. Lane (Streatham) |
| Brown, Col. D. C. (N'th'l'd., Hexham) | Grace, John | Monsell, Eyres. Com. Rt. Hon. B. M. |
| Brown, Brig-.Gen. H. C. (Berks, Newb'y) | Graham, Fergus (Cumberland, N.) | Morrison, H. (Wilts. Salisbury) |
| Buchan, John | Grant, Sir J. A. | Morrison-Bell, Sir Arthur Clive |
| Buckingham, Sir H. | Grattan-Doyle, Sir N. | Murchison, Sir Kenneth |
| Bull, Rt. Hon. Sir William James | Greene, W. P. Crawford | Nail, Colonel Sir Joseph |
| Bullock, Captain M. | Gretton, Colonel Rt. Hon. John | Neville, Sir Reginald J. |
| Burman, J. B. | Grotrlan, H. Brent | Newton, Sir D. G. C. (Cambridge) |
| Burney, Lieut.-Com. Charles D. | Guinness, Rt. Hon. Walter E. | Nicholson, O. (Westminster) |
| Burton, Colonel H. W. | Gunston, Captain D. W. | Nicholson, Col. Rt. Hn. W. G. (Ptrsf'ld.) |
| Campbell, E. T. | Hacking, Douglas H. | Nield, Rt. Hon. Sir Herbert |
| Carver, Major W. H. | Hall, Lieut.-Col. Sir F. (Dulwich) | Nuttall, Ellis |
| Cassels, J. D. | Hall, Capt. W. D'A. (Brecon & Rad.) | Oakley, T. |
| Cautley, Sir Henry S. | Hamilton, Sir George | O'Connor, T. J. (Bedford, Luton) |
| Cayzer, Sir C. (Chester, City) | Hanbury, C. | Oman, Sir Charles William C. |
| Cayzer, Maj. Sir Herbt. R. (Prtsmth. S.) | Hannon, Patrick Joseph Henry | Ormsby Gore, Rt. Hon. William |
| Cazalet, Captain Victor A. | Harland, A. | Pennefather, Sir John |
| Cecil, Rt. Hon. Sir Evelyn (Aston) | Harrison, G. J. C. | Percy, Lord Eustace (Hastings) |
| Chadwick, Sir Robert Burton | Hartington, Marquess of | Perkins, Colonel E. K. |
| Chamberlain, Rt. Hon. N. (Ladywood) | Harvey, G. (Lambeth, Kennington) | Perring, Sir William George |
| Chapman. Sir S. | Harvey, Major S. E. (Devon, Totnes) | Peto, Sir Basil E. (Devon, Barnstaple) |
| Charteris, Brigadler-General J. | Haslam, Henry C. | Peto, G. (Somerset, Frome) |
| Christie, J. A. | Headlam, Lieut.-Colonel C. M. | Pitcher, G. |
| Churchman, Sir Arthur C. | Henderson, Capt. R. R. (Oxf'd, Henley) | Preston, William |
| Clarry, Reginald George | Heneage, Lieut.-Colonel Arthur P. | Price, Major C. W. M. |
| Cobb, Sir Cyril | Henn, Sir Sydney H. | Raine, Sir Walter |
| Cockerill, Brig.-General Sir George | Hennessy, Major Sir G. R. J. | Ramsden, E. |
| Cohen, Major J. Brunei | Hills, Major John Waller | Rees, Sir Beddoe |
| Colfox, Major Wm. Phillips | Hilton, Cecil | Reid, Capt. Cunningham (Warrington) |
| Colman, N. C. D. | Hohler, Sir Gerald Fitzroy | Rentoul, G. S. |
| Conway, Sir W. Martin | Holbrook, Sir Arthur Richard | Richardson, Sir P. W. (Sur'y, Ch'ts'y) |
| Cooper, A. Duff | Holt, Capt. H. P. | Rodd, Rt. Hon. Sir James Rennell |
| Cope, Major Sir William | Hope, Sir Harry (Forfar) | Ropner, Major L. |
| Couper, J. B. | Hopkins, J. W. W. | Ruggles-Brise, Lieut.-Colonel E. A. |
| Courthope, Colonel Sir G. L. | Hopkinson, A. (Lancaster, Mossley) | Russell, Alexander West (Tynemouth) |
| Craig, Sir Ernest (Chester, Crewe) | Horne, Rt. Hon. Sir Robert S. | Rye, F. G. |
| Salmon, Major I. | Stanley, Lord (Fylde) | Watts, Sir Thomas |
| Samuel, A. M. (Surrey, Farnham) | Storry-Deans, R. | Wayland, Sir William A. |
| Samuel, Samuel (W'dsworth, Putney) | Stott, Lieut.-Colonel W. H. | Wells, S. R. |
| Sandeman, N. Stewart | Sugden, Sir Wilfrid | White, Lieut.-Col. Sir G. Dairymple |
| Sanders, Sir Robert A. | Tasker, R Inigo. | Williams, A. M. (Cornwall, Northern) |
| Sanderson, Sir Frank | Templeton, W. P. | Williams, Com. C. (Devon, Torquay) |
| Sandon, Lord | Thorn, Lt.-Col. J. G. (Dumbarton) | Williams, Herbert G. (Reading) |
| Sassoon, Sir Philip Albert Gustave D. | Thompson, Luke (Sunderland) | Wilson, Sir C. H. (Leeds, Central) |
| Savery, S. S. | Thomson, F. C. (Aberdeen, South) | Wilson, R. R. (Stafford, Lichfield) |
| Shaw. Lt.-Col. A.D. Mcl. (Renfrew. W.) | Thomson, Rt. Hon. Sir W. Mitchell- | Winterton, Rt. Hon. Earl |
| Sheffield, Sir Berkeley | Tinne, J. A. | Withers, John James |
| Shepperson, E. W. | Titchfield, Major the Marquess of | Wolmer, Viscount |
| Skelton, A. N. | Tryon, Rt. Hon. George Clement | Wood, E. (Chest'r, Stalyb'ge & Hyde) |
| Smith, Louis W. (Sheffield, Hallam) | Vaughan-Morgan, Col. K. P. | Wood, Rt. Hon. Sir Kingsley |
| Smith-Carington, Neville W. | Waddington, R. | Worthington-Evans, Rt. Hon. Sir L. |
| Smithers, Waldron | Wallace, Captain D. E. | Wright, Brig.-General W. D. |
| Somerville, A. A. (Windsor) | Ward. Lt.-Col. A. L. (Kingston-on-Hull) | |
| Southby, Commander A. R. J. | Warner, Brigadier-General W. W. | TELLERS FOR THE AYES.— |
| Spender-Clay, Colonel H. | Watson, Sir F. (Pudsey and Otley) | Mr. Penny and Sir Victor Warrender. |
| Stanley, Lieut.-Colonel Rt. Hon. G. F. | Watson, Rt. Hon. W. (Carlisle) | |
| NOES. | ||
| Adamson, Rt. Hon. W. (Fife, West) | Hardie, George D. | Runciman, Hilda (Cornwall, St. Ives) |
| Alexander. A. V. (Sheffield, Hillsbro') | Harney, E. A. | Runciman, Rt. Hon. Walter |
| Ammon, Charles George | Harris, Percy A. | Saklatvala, Shapurji |
| Baker, Walter | Hayday, Arthur | Salter, Dr. Alfred |
| Barker, G. (Monmouth, Abertillery) | Henderson, Rt. Hon. A. (Burnley) | Sexton, James |
| Barnes, A. | Hirst, G. H. | Shaw, Rt. Hon. Thomas (Preston) |
| Barr, J. | Hirst, W. (Bradford, South) | Shepherd, Arthur Lewis |
| Batey, Joseph | Hollins, A. | Shiels, Dr. Drummond. |
| Beckett, John (Gateshead) | Hore-Belisha, Leslie | Shinwell, E. |
| Bellamy, A. | Hudson, J. H. (Huddersfield) | Sinclair, Major Sir A. (Caithness) |
| Bondfield, Margaret | Hutchison, Sir Robert (Montrose) | Slesser, Sir Henry H. |
| Bowerman, Rt. Hon. Charles W. | Jenkins, W. (Glamorgan, Neath) | Smith, Rennie (Penistone) |
| Broad, F. A. | Johnston, Thomas (Dundee) | Snowden, Rt. Hon. Philip |
| Bromfield, William | Jones, Henry Haydn (Merioneth) | Stamford, T. W. |
| Brown, Ernest (Leith) | Jones, Morgan (Caerphilly) | Stephen, Campbell |
| Brown, James (Ayr and Bute) | Jones, T. I. Mardy (Pontypridd) | Stewart, J. (St. Rollox) |
| Buchanan, G. | Kelly, W. T. | Strauss, E. A. |
| Buxton, Rt. Hon. Noel | Kennedy, T. | Sullivan, J. |
| Cape, Thomas | Kenworthy, Lt.-Com. Hon. Joseph M | Sutton, J. E. |
| Charleton, H. C. | Kirkwood, D. | Taylor, R. A. |
| Cluse, W. S. | Lawrence, Susan | Thomas, Rt. Hon. James H. (Derby) |
| Connolly, M. | Lawson, John James | Thorne, W. (West Ham, Plaistow) |
| Cove. W. G. | Lee, F. | Thurtle, Ernest |
| Cowan, D. M. (Scottish Universities) | Lindley, F. W. | Tinker, John Joseph |
| Crawfurd, H. E. | Livingstone, A M. | Tomlinson, R. P. |
| Dalton, Hugh | Longbottom, A. W. | Townend, A. E. |
| Davies, David (Montgomery) | Lowth, T. | Trevelyan, Rt. Hon. Sir Charles |
| Davies, Ellis (Denbigh, Denbigh) | Lunn, William | Viant, S. P. |
| Davies, Evan (Ebbw Vale) | MacDonald, Rt. Hon, J. R. (Aberavon) | Wallhead, Richard C. |
| Davies, Rhys John (Westhoughton) | Mackinder, W | Walsh, Rt. Hon. Stephen |
| Day, Harry | MacLaren, Andrew | Watts-Morgan, Lt.-Col. D. (Rhondda) |
| Dennison, R. | Malone, C. L'Estrange (N'thampton) | Webb, Rt. Hon. Sidney |
| Duncan, C. | March, S. | Wedgwood, Rt. Hon. Josiah |
| Dunnico, H. | Maxton, James | Wellock, Wilfred |
| Edge, Sir William | Morrison, R. C (Tottenham, N.) | Welsh, J. C. |
| Edwards, C. (Monmouth, Bedwellty) | Mosley, Sir Oswald | Westwood, J. |
| Fenby, T. D. | Murnin, H. | Whiteley, W. |
| Gardner, J. P. | Naylor, T. E. | Wiggins, William Martin |
| George, Rt. Hon. David Lloyd | Oliver, George Harold | Williams, C. P. (Denbigh, Wrexham) |
| Gibbins, Joseph | Owen, Major G. | Williams, David (Swansea, E.) |
| Gillett, George M. | Palin, John Henry | Williams, Dr. J. H. (Llanelly) |
| Graham, D. M. (Lanark, Hamilton) | Parkinson, John Allen (Wigan) | Williams, T. (York, Don Valley) |
| Graham, Rt. Hon. Wm. (Edin., Cent.) | Pethick-Lawrence, F. W. | Wilson, C. H. (Sheffield, Attercliffe) |
| Greenwood, A. (Nelson and Colne) | Ponsonby, Arthur | Wilson, R. J. (Jarrow) |
| Grenfell, D. R. (Glamorgan) | Potts, John S. | Windsor, Walter |
| Griffith, F. Kingsley | Richardson, R. (Houghton-le-Spring) | Wright, W. |
| Grundy, T. W. | Riley, Ben | Young, Robert (Lancaster, Newton) |
| Hall, F. (York, W. R., Normanton) | Ritson, J. | |
| Hall, G. H. (Merthyr Tydvil) | Roberts, Rt. Hon. F. O. (W. Bromwich) | TELLERS FOR THE NOES.— |
| Hamilton, Sir R. (Orkney & Shetland) | Robinson, W. C. (Yorks, W. R., Elland) | Mr. T. Henderson and Mr. Paling. |