SCOTTISH BOARD OF HEALTH.

HC Deb 11 June 1928 vol 218 cc718-72

Motion made, and Question proposed; That a sum not exceeding £2,037,515, be granted to His Majesty, to complete the sum necessary to defray the Charge which will come in course of payment during the year ending on the 31st day of March, 1929, for the salaries and Expenses of the Scottish Board of Health, including Grants and other expenses in connection with Housing, Grants to Local Authorities, etc., in connection with Public Health Services, Grant, in-Aid of the Highlands and Islands Medical Service, Grants-in-Aid in respect of Benefits and Expenses of Administration under the National Health Insurance Acts, certain Expenses in connection with the Widows' Orphans', and Old Age contributory Pensions Act, 1925, and certain special services—[Note.—£830,000 has been voted or, account.]

Mr. ERNEST BROWN

I am sure that the time; permitted for the discussion of this Vote will not permit us to ask the innumerable questions that we would like to ask about the Report of the Board of Health for 1927. This being the swan song, I suppose, of the Board of Health, the Committee will want to have this Vote before it more than once, because there are so many questions that Members want, to discuss. There is the extraordinarily valuable chapter on maternity and child welfare, and there are the references to infectious diseases, the problem of the Highland Medical Fund, and I am sure we ought to have a whole day to discuss the report of the Board on administration of the Poor Law, especially the passage dealing with the able, bodied unemployed poor. This evening I content myself by asking one question about the administration of the National Health Insurance Fund, and I also wish to raise points relating to the administration of pensions and housing, with special reference to slum clearances. The Committee will have noticed with great regret that the hopes expressed by the Board in last year's Report, with reference to the total amount of sick benefit paid, have not been realised, but that in 1927 there has been an even larger demand for sick benefit than there was in 1926. The Board states: Although the year 1926, the year of disturbance in the coal industry, saw a great increase in the amount of sickness and disablement benefit granted under the system of National Health Insurance, it was anticipated that the increase was only temporary and that 1927 would show a return to normal expenditure. This has not proved to be the case. The expenditure on these benefits was greater in 1927 than in 1926. This increase was surprising and disappointing. It cannot be said that the causes of the progressive increase are fully understood, but the experience of individual societies has been carefully followed, and steps have been taken to improve the scrutiny of claims for benefit and to bring the disturbing position before certifying insurance practitioners and others concerned with health insurance administration. We wish to place on record our considered view that we attach the greatest importance to correct certification of incapacity for work under the conditions of the National Health Insurance Acts, as our deliberate conviction is that a reliable and correct system of true certification is bound up with and necessary for the financial stability of any scheme of sickness insurance. I wish to ask, in relation to the experiences of individual societies to which the Report refers, if any wide difference is shown in the administration of varying types of societies? If we find, on examination, that this large increase is, broadly speaking, spread equally over all types of societies, there is need for a close investigation of the whole problem. If it should be found, however, that one type of society shows a larger measure of increase as compared with others, then the increase may be due to the administration of those particular societies. I desire the Under-Secretary to give the Committee some information on that point. Then as to the administration of the Pensions Act, there are certain matters on which I should like explanations. Every Member from Scotland and, indeed, from England and Wales also, in the year before last, regarded himself not merely as the representative of his constituents but the representatives of the widows in his constituency. The principal question discussed in connection with the early administration of the Act was the question of the pre-Act widow. Just as that was so in 1926, so in 1927 Members have taken an interest in the position as if affects the wives of a certain number of insured persons particularly those who attained the age of 70 before the benefit for those between 65 and 70 became operative.

Political life should not be so narrow as to deny credit to opponents when progress is made in social legislation. Even when we think there are defects it is our duty to give credit where credit is due. The Pensions Act has undoubtedly given relief in thousands of homes. It has lightened the lot of many widows and orphans and is easing the lot of many old people. The Report shows that there are contributors, for both health and pensions benefits, in Scotland, numbering 1,781,300 persons and that the total number of contributors for all pension benefits is 1,804,400. Pension payments are being made annually to 150,000 persons, that is to say to three-hundredths of the population or to one-twelfth of the total number of insured persons in Scotland. Widows' and orphans' pensions have a backing not merely in sentiment but in the appreciation of the difficulties which fall upon a family deprived of the breadwinner and I wish to put certain questions about the administration of the Act, not merely in order to he critical, but in order to get at the mind of the Board as to future administration and any possible alterations.

Notice taken that 40 Members were not present; Committee counted; and 40 Members being present—

Mr. BROWN

With regard to contributory old age pensions for persons between 65 and 70, the actuarial estimate was that in Scotland about 51,000 persons would be receiving such pensions on 2nd January, 1928. There was to be a certain limitation of the right to cash benefits under the National Health Insurance Act, and to unemployment benefit under the Unemployment Insurance Act, to persons who had not attained the age of 65, but we find that in May 41,688 claims had been issued—that is as regards forms—and in December 60,948 claims had been received. The claims awarded were 45,097 and 5,826 were disallowed, while 1,707 were otherwise disposed of and there are still outstanding 8,318. Of the claims disallowed 3,973 were due to one particular misapprehension as to the possibility of benefit and I notice also that there were 664 premature claims. In a number of eases the age wan not determined. In cases of persons of Irish descent particularly it was found difficult to determine ages. There were 738 claims disallowed because of deficiency in the insurance record and on these matters I wish to put the following questions.

First, what happens when it has been found impossible to establish the age of a claimant? Those who have numbers of insured persons in their constituencies know how difficult it has been to determine ages in many cases, particularly in cases of persons born in Ire land or of Irish descent. Secondly, is there any evidence of dismissal from employment when the age of 65 has been reached? The Committee will remember that fears were expressed on this point. Thirdly, has the Board of Health discovered any anomalies which can be rectified without altering the structure of the Act, in order to lessen the number of disallowances recorded in these figures? I am sure the Committee would welcome any such alteration. Fourthly, is any estimate being made as to the cost to the scheme of including wives whose husbands were 70 before the scheme operated? According to the Report that. would affect 4,000 persons, in round figures. There was and still is a great deal of feeling about the pre-Act widow, and I assure the Minister that whatever may be in the minds of the logicians, there is a great deal of feeling in the constituencies about these border-line cases. If anything can be done to meet them, we would like to have an estimate of the cost. I would also like to know what is the position of the totally disabled ex-service man with regard to the receipt of sickness disablement benefit under the scheme. Is such a man entitled to the full 16s. sickness pay and his full 7s. 6d. or not? Statements have been made that he is not so entitled, owing to a flaw in the drafting. Perhaps the hon. and gallant Gentleman will tell us what are the facts. In the analysis of the scheme we find many cases of rejection because of inadequacy of period or shortage of contributions. People write in this way: I am deprived of my pension because my husband died before the Act was passed. He had been insured from the time it started until the day he died. I am 68 and quite unable to work. My son, who has supported me since my husband's death, is now in a mental hospital, suffering from complete mental breakdown from the War, and I have a no private means. A letter of that kind is written under a misapprehension as to the basis of the scheme, but I think, in discussing the administration of the scheme, a point of that kind ought to be brought out because great many people have been sending in claims under the impression that the period of insurance beginning with 1912 would count in all cases towards the granting of pensions under the scheme. I would also raise the question of the widow whose husband was 70 before 2nd January, 1928. We under-stand that there are 45,000 of these persons in Scotland. A great many people of this type, however, have not made claims because their friends hay e had claims rejected, and we must not take this figure: as representing the total number of persons of that type. The Board itself has felt the pressure of these rejections, rid on page 235 and the following pages pains are taken to argue the case. In connection with that argument I would pat a further question. The Report states: Some criticism was occasioned by the exclusion of certain types of uninsured women, particularly of wives under 70, of men who attained 70 before the provisions relating to pensions between the ages of 65 and 70 came into operation. The representations received were based generally on the argument that the woman should not be deprived of pension merely because her husband was too old and on the assumption that had the husband been under 70 it would have automatically followed that the wife would hay?, become entitled in right of his insurance to a pension between the ages of 65 and 70. 8.0 p.m.

I have already asked if any calculations have been made as to the cost of bringing such persons into the scheme. Although over 4,000, they must be a limited number because of the type, and I think that under the scheme the Minister ought to take into consideration not merely the logical effect of the structure of the scheme, but the feeling about these shortcomings which is present in every constituency. It says, on page 236: It was represented also that a woman should not have to wait for an old age pension until her husband attained the age of 65. This again ignored the actuarial foundations of the scheme. There is involved also the suggestion that it can be determined while the husband is still under 65 whether or not he will be entitled to a pension on attaining the age of 65. I notice that it states: Only 738 claims had been disallowed by the end of the year because of some deficiency in the insurance record that debarred the claimant from satisfying the conditions as to insurance which are required by the … I would like a reply from the Minister about these points, because we have had a ruling to this effect on a definite case as follows: The applicant claims an old age pension under Section 7 of the Act as being a person who has before the 2nd January, 1928, attained the age of 65, and has not attained the ago of 70. She is a married woman and does not make the claim as being an insured person herself, but as being the wife of an insured person. In order to succeed on this ground, it is necessary to show that her husband is or has been entitled to an old age pension under Section 7 of the Act, that is to say, that he is or has been so entitled to an old age pension between the ages of 65 and 70 under the Act. In fact, her husband was born on the 16th January, 1857, so that he attained the age of 70 before the 2nd January, 1928, and, therefore, he is not and has not been entitled to an old age pension under the provisions of Section 7 of the Act. The applicant's claim in right of her husband's insurance therefore fails. Although on the basis of the Act the argument appears to be sound, I do not think it was the intention of Parliament to shut out this type of person, and it would be valuable to get the mind of the Board as to whether anything could be done for these persons who have been debarred under this ruling. I do not overlook the fact that the Act provides, for persons who were on the point ofreceiving benefit, and just approaching the ages of 65 and 70, benefits out of all proportion to anything that could be obtained from any comparative premium, but, nevertheless, I assure the Minister that the feeling about this matter exists very widely in various parts of Scotland which I have visited since the operation of this particular Section of the Act.

I wish to elaborate a point about totally disabled ex-service men. A statement has been made that under the Act of 1924, Section 60, Sub-sections (1) and (2), there is a provision which prevents totally disabled ex-service men receiving the whole of the disablement and sickness benefits, namely, 15s. for sickness and 7s. 6d. for disablement, which are ordinarily paid, unless they have been in insurable employment for 26 weeks in the case of sickness benefit, and 104 weeks in the case of disablement benefit. It is obvious that this cannot have been the intention of Parliament in drafting the Act, and I would like to know whether these statements really are facts, or whether there has been a misapprehension on the part of those who have made them.

Now I wish to turn to the question of housing, with special reference to slum clearance. This problem is one of the first political problems of the day. Whether it becomes a party political problem will depend entirely upon what happens inside the next four or five years from the point of view of administering the present Acts and devising new plans to meet the awful question of the condition of the slums, especially in our great cities. The problem before the past generation was the provision of gas and water, but the problem of this and the next generation will be the provision of air and light. One of the biggest troubles we have, as we have hinted at Question time, in regard to England and Wales to-day is that we have not the knowledge of the facts. We are better off in Scotland than they are South of the Border with regard to the facts, because we have had a later comprehensive inquiry in Scotland than has been held in England and Wales. The facts are that some people know many of the facts, all know a few of the facts, but none know all the facts. Whether the estimates that are made as to the number of houses required are those of the experts, or popular estimates, or Departmental estimates, none of them at the moment really face up to the problem.

In my judgment, the housing question depends on the view of the Department and of the country as to four words which are the keywords, namely, "persons," "room," "family," and "dwelling." If we are going to under- stand the size of the problem, we shall have to envisage the problem in relation to these four words. How many persons do we intend to live in a room, and how many families in a dwelling? If we are to set up a standard for inquiry as to how many houses we want in Scotland, if we are not going to accept the rough estimate of 10,000 given us in the Report, if we are going to say that we mean by a housing standard every family a separate dwelling—I am not saying whether it is a house or an. apartment or fiat—and if, on top of that, we say we require for every adult person a separate room, it is obvious that the estimates given in the Board of Health Report and in the Royal Commission's Report have no relation to the real needs of Scotland.

This is a domestic, political problem of the first class. The slum question especially has been looked at but never really examined over the whole range of the nations. Some of the cities have made careful investigations. Edinburgh at the moment is engaged on a very exhaustive examination, and I am asking these questions to-day because the figures recently given to the City Council in Edinburgh in. the preliminary reports show that there are 5,000 houses in Edinburgh alone which should be marked down as unfit for human habitation, so that the previous estimates in the eight Reports that have gone before the 1927 Report have no relation to the real needs if you set up a decent standard of comfort for your people. There are so many factors underlying this question that I am sure it will require a great and united effort if we are to cleanse our cities of slums.

I desire to point out that this year we welcome the fact that 21,660 houses have been built, as compared with 14,930 in 1926, and we equally welcome the prophecy that next year the Board hope, by administering the present Acts, to go over the 20,000 mark. But I notice the statement that we want 10,000 houses to meet normal needs, and it is because of that statement that I propose to put these questions to the Minister: What is the present estimate of the Board of Health as to the annual housing needs of Scotland, bearing three things in mind, namely, normal growth, replacement, and slum clearance, and on what standard of accommodation is the estimate based? Secondly, is there any national estimate of the number of insanitary dwellings in Scotland? There are, for certain parts of Scotland, but is there any estimate in, the archives of the Board of Health giving the total number of insanitary dwellings reported upon throughout the whole of Scotland Then I would like to ask, What is the latest estimate of overcrowded dwellings on the old standard of three persons per room, which I, personally, regard as much too low a standard? What proportion of the estimated needs do the present schemes for slum cleirance cover, on the old basis? Lastly, have the Board of Health considered any scheme of co-operation with the building societies in Scotland as to slum replacement?

When I talk of a standard of accommodation, I have in mind these things: When we talk about the home, we think of all kinds of sweet sanctities, of shelter and hospitality, which are the basis of civilisation, and if we are to get a sufficient standard, I think we have to answer these questions. At any rate, I ask myself these questions: How many people are then? Where are they? How many houses are there? How many of them are occupied and how many unoccupied? What do you mean by a house? How many rooms Is it a house, a separate dwelling, or a flat? Do you mean sculleries and bathrooms as rooms, or are there any? How many square feet are these rooms in area and how many cubic feet in contents? How many groups of persons galled families are there? How many groups of rooms? Do they fit the groups o persons? Do they fit the subgroups families in terms of sex—father, mother, sons, and daughters of various ages? Are there separate entrances to these houses, and water supplies, and sanitary arrangements, and food stores? Are these dwellings where the people are? Do they allow a margin for movement? What are the rents? Will the rents fit the wages? These are questions that have to be asked by everyone who wishes, in approaching the problem of slum clearance, to get at the roots of the problem, and I venture to ask myself, not the Minister, these last questions, in order that he may know what is in my mind when I am asking what estimate there is as to the need from the point of view of slums, or as to the whole problem in Scotland, upon. a standard of accommodation which would adequately cover these points.

Then I noticed that, with regard to the unfit houses, on page 362 of the Report we have reports about houses unfit for habitation in 7,892 cases, out of 43,888 examinations, and that, under Heading B, there were notices issued with regard to unfit houses in 4,174 cases. I would like to know what relation these have to the estimated insanitary dwellings in the whole country. With regard to slum clearance, the facts are very simple. In Scotland, we have not begun to touch the real problem. We have now 38 schemes, touching 11,935 houses to be replaced, 11,558 new houses to be constructed and, 158 to be reconditioned. The point has been made in regard to clearing the slums that the slum dweller will take the slum mind with him where-ever he goes. An examination of 300 cases last year showed that 62 per cent. of those who moved had kept their dwellings in good condition. The experience of last year is again borne out in this year's Report of the Scottish Board of Health, for I notice that the Report says: The further inspections that have taken place during 1927 show that a genine effort is being made by the majority of the tenants to keep their houses clean and tidy. It is, however, manifest that a certain proportion of the tenants will for a time at least require constant supervision. In view of the conditions under which these tenants have previously lived and of the very unsatisfactory environment that has probably surrounded them all their lives, it cannot in reason be expected that they will at once prove ideal tenants. That statement will be welcomed as giving the lie to the oft-repeated fable that you cannot take the slum dweller out of the slum without his making a slum where he goes. If we understand the Old Book rightly, Adam did not fall in a slum; he fell in a garden. The removal of people from slum areas to better areas has proved that those who come out of slums may help to keep a house much more like a garden if they get the chance. The five schemes of slum clearance that were certified this year did not go very far. In Aberdeen 317 houses are concerned, and of these 126 are one-roomed dwellings. In Kirkcaldy, there are 162 houses, of which 52 are one-roomed. In the first Glasgow scheme of 1926, there were 1,051 houses, of which 490 were one-apartment dwellings. In the second scheme of 1927, out of 1,019 houses, 485 were one-apartment dwellings. It is obvious that these schemes must mean, for those who move to better houses, a tremendous improvement over the over-crowded conditions in which they previously lived. I should like to call attention to the inquiry that is being made in regard to Edinburgh. Preliminary observations have been taking place among various committees of the Town Council with regard to a suitable programme, and the Chief Sanitary Inspector has come to the conclusion that approximately 5,000 houses, which might be classified as unfit for human habitation, are at present in the City. The result is that there has been a reference to the Treasurer's Committee for a discussion of the principles of the scheme, and of the means to meet the cost of the scheme. It will be seen that if 5,000 new houses are built at an average cost of £430, it means an expenditure on this one scheme alone of £2,150,000. If they were built at the rate of 500 houses a year for ten years, there would be a vast annual expenditure for Edinburgh alone; or, they might build 250 per year for 20 years. In each case we have to consider if there are any alternative means of meeting the problem.

It is with regard to this point that I ventured to put the question about the building societies to the Minister. We welcome the great advance that has been made in the operations of the building societies, not merely south of the Border, but north of the Border, recently. I would call the attention of the Minister to a passage in a book called "The Silent Revolution," by Mr. Harold Bell-man, the secretary of one of the largest building societies in Great Britain. When discussing the question of slums, he asked this question: Yet, is it completely beyond the wit of men to devise a practical scheme whereby even the poorer classes can be helped Must they be eternally dependent upon others and be denied the opportunity of helping themselves? If their wage precludes them from purchasing a house, does it completely exclude the possibility that the more respectable workers in this particular stratum who are compelled to live in the congested areas, might purchase—by building society or similar methods—a flat in a model dwelling. Would it be possible for new and model dwellings to be erected at the public expense and the agreed purchase price of a flat to be provided by a building society, subject to effective guarantees from the local authority in lieu of the ordinary margin of security the weekly rental payments of the dweller being applied to the repayment of the purchase and to the extension of his stake in the security. That is a passage which might well have the consideration of the Board of Health in Scotland, and of the Minister of Health in England, because it is obvious that it is not always the lack of the means to pay the rent that keeps people in congested areas. I am sure that, if it be found practicable, it would help the local authorities to face the immense capital expenditure envisaged in such a scheme as came recently before the City Council in Edinburgh. It ins true that some of the older people who move from shim dwellings to better conditions do not like it. I met a man the other day, when I went to see some new houses, and he was not very happy. He said he had "no seen a fecht nor a polisman." Two flats away I asked an old lady how she liked it, and she said she did not like it because the new houses were "too cold." The younger people like it very much, and, whereas the older people rather like the companionship which they have in the congested areas, there is no question that, on the whole, the younger people, especially the younger women with children, welcome any chance of getting out of the slum areas. I have ventured to put questions which I think go to the root of the problem, and to make suggestions about building societies, because I regard the slums as a menace to civilisation, as a breeder of disease, as an affront to the conscience, and as a crime, not merely against man, but against his Maker. John Ruskin once said: God is in the poorest man's cottage; it is advisable that He should be well housed. In so far as 21,000 houses were built last year, we welcome it as progress, but we want to envisage this problem on a far ampler scale than we have done yet, if we are to meet the real and effective need.

Mr. STEWART

The remarks that have been made by the hon. Menber for Leith (Mr. E. Brown), and the questions which he has put to the Secretary for Scotland, will take the right hon. Gentleman some time in order to give anything like a complete answer. I should like to refer to a matter which is of considerable importance, and that is the question of the rents that are being charged and what will happen when the Rent Restrictions Act expires? The Rent Restrictions Act should have expired in May this year, but it has been continued for a further period, and is now to expire in 1929. As things are now, if a person leaves a house for any other reason than non-payment of rent or being put out of the house, that house becomes automatically decontrolled, and the landlord is entitled to charge whatever rent a tenant is, willing to pay. In Glasgow, a number of houses have been de-controlled; in 1926–27 the number was something like 1,100. That is only the number recorded, but it is not the total number, because the landlords have different ways of evading the law. The rents of those houses when relet were increased from £90,000 to practically £100,000; less than. 10 per cent increase, but approximating to it.

At the beginning of this year landlords held a meeting in Glasgow and decided that the time had arrived when they ought to get a further 10 per cent. increase in their rent. Under the 1922 Act, I think it was, landlords could raise their rents 133. nearly 50 per cont.—at least, it worked out at something like that in round f4;ures, as I can say from my own experien3e as a tenant whose rent was increased by almost exactly 50 per cent., with, of course, the consequence that the rates rote proportionately. If the Rent Restrictions Act expires and the housing position remains as it is now, rents in Glasgow will increase all round, adding to the 'burdens of people who already are pretty well overburdened in every direction, and then there will follow an outcry twat may have some damage in certain directions with regard to the landlords, being allowed to put on the rents.

It has to be remembered that since the law gave the landlords power to charge increased rents the cost of repairs, material and of everything connected with houses has been falling, and wages have fallen. One of the reasons for allowing the extraordinary increase which they were permitted to make was the high cost of repairs. I hope the Govern- ment will pay attention to this matter, and that so long as the present shortage of houses continues no opportunity will be given to the landlords to do what they have foreshadowed they will do, and that is put a further increase of rent on a class of people not very well able to bear it. The rents now being charged for the new houses—X26 for the three-apartment houses, plus rates—make it almost impossible for the average artisan, and certainly impossible for the average unskilled labourer, to move into those houses, although they were built with public money for the ostensible purpose of housing the artisan class.

When the great housing schemes were foreshadowed, and we were talking of creating an A 1 nation by removing the conditions which led to a C 3 population, it was intended that these houses should be for the artisan or working class. To-day they are occupied, in the main, by a class which is slightly superior in the matter of wages and conditions of life to the class for whom the houses were intended. That is because the rents fixed by the Government are too high. In equity and fairness, and in view of the changes which have taken place, the rents ought to be lowered. I know the reply will be that as the country is so heavily burdened, such a claim ought not to be made, and that it cannot be acceded to, but if we are to bring about the conditions which have been foreshadowed by all statesmen for many years, we must make it easier for people with large families and small incomes to get into houses where they can live under healthier conditions, with a consequent lowering of the cost of health administration.

There is another matter which requires attention. A good many years ago an Act was passed making it compulsory to notify cases of consumption. I thought that under that Act we had the power to provide separate sleeping accommodation for anyone who had contracted tuberculosis, whether it were phthisis or surgical tuberculosis. Seemingly I made a mistake in assuming that to be so. In Glasgow to-day more than 6,000 people are suffering from tuberculosis. The figures concerning them compiled by the medical officer are worthy of wide publicity. Of those suffering from this disease who are living in one-apartment houses, only 57 have a room to themselves; 145 have a bed to themselves, though living in the same apartment with others; and 976 are sleeping in bed with other people. Out of a total of 1,173, only 57 have an apartment to themselves. In two-apartment houses the story is the same. There are 441 with a room to themselves, 569 with a bed to themselves, and 2,506 sleeping in beds with others. Out of a total of 3,415 fewer than 1,000 have either a bed or a room to themselves.

Can one wonder that tuberculosis still persists? Despite all the money, the skill and the care which have been lavished on providing people with the necessary bedding, with the necessary shelter and with the necessary freshair and sunshine, there are still 6,000 people in Glasgow living under the conditions I have described, disseminating the disease and nullifying all the efforts made to stamp it out. To-day in Glasgow we are facing the erection of another sanatorium for 400 patients which, before it is finished, will have cost something approaching £500,000. That is to provide decent accommodation for 400 people whom we have allowed to contract this disease. To provide a separate bed for over 5,600 consumptive patients would require an annual addition of 1,360 houses. Surely the Secretary of State for Scotland or the Under-Secretary of State, who are responsible for the health administration, could do something to give the local health authority the power to provide sleeping accommodation for these people, and to provide a separate room for a person suffering from this disease. This ought to be done, not for philanthropic reasons, but in order to protect the rest of the community against infection by a disease which none of us can contemplate with equanimity.

I should like to refer to the question of the houses which are unfit for human habitation. In 1910, when I was a member of the Health Committee of the Corporation of Glasgow, T was informed that there were in Glasgow 13,000 houses unfit for human habitation. At that time, Glasgow was a city of 12,000 acres with a population of 800,000. Some years later the area of the City of Glasgow was increased by 7,000 acres and 200,000 were added to the population. To-day, in Glasgow, we have a population of about 1,250,000, and still there are 13,000 houses unfit for human habitation. I have it on the authority of the medical officer that at the present time there is no desire to make a fresh investigation into this question, because there is no chance of being able to deal with it. The problem is so insurmountable and stupendous and the cost involved is so enormous that the local authorities and the medical officers representing them are afraid of facing the task of making the necessary investigation as to the number of houses which are unfit for human habitation. If such an investigation were undertaken, I am bound to say that I believe there would not be less than 20,000, and that is after allowing for all the Government have done and all we have done in the matter of slum clearances. No less than 2,100 houses in Glasgow have been put out of existence and 2,100 houses completed between 1926 and 1927. Altogether, in the whole of Scotland, some 6,200 houses have been completed under slum clearance schemes, and 2,200 are it the course of construction to deal with this problem in the whole of Scotland.

Another matter which I wish to mention is the fact that the State has seen fit and considered it wise to make 50 per cent. of the houses which it proposed to construct two-roomed houses and 50 per cent, three-roomed houses. I hope I am mistaken in my figures, but I took them from the Annual Report issued this year. I am dealing with 1920 and 1927, and the Report states in the Appendix dealing with housing in Glasgow that of the 1,000 houses which are being built this year 50 per cent. are to be two-roomed houses and 50 per cent. are to be three-roomed houses.

The UNDER-SECRETARY of STATE for SCOTLAND (Major Elliot)

Is the hon. Gentleman quoting from the Board of Health Annual Report or the Annual Report issued by the City of Glasgow?

Mr. STEWART

I am quoting from the Annual Report of the Board of Health, and it states: A total of 1,094 houses were erected under the 1926 scheme. Of the new houses to be provided approximately 50 per cent. will be two-roomed apartments, and the balance will he three-roomed apartments. The Glasgow improvement scheme for 1927 embraces 21 areas, and, in order to accommodate the displaced tenants, 1,200 new houses are to be built, and 50 per cent. of them are to be two-apartment houses and 50 per cent. three-apartment houses. I cannot say whether that has been ordered to be done by the local authority or by the Board of Health, but my complaint is that such a thing ought not to be permitted at all. As the hon. Member for Leith (Mr. E. Brown) has pointed out, we have the extraordinary standard in Scotland of over three persons per room as the recognised standard for decency and health. At the same time, we are having over four persons per house on the average living in these two-roomed houses, and in many cases in Glasgow there are six, eight., 10 and even 12 persons living in some of the two-roomed houses. I also wish to refer to the question of overcrowding which is taking place in other houses as well as slum dwellings. The medical officer of Glasgow says: I made a survey of 2,110 houses in Kingston. Binning Park, and Govan, and it was found that 254, or 12 per cent. of those houses, contained two families. A significant aspect of this is that 278 of the two-apartment; houses, or 13 per cent. of the total, were found to contain two families. This form of sub-letting has become fairly common in certain districts, and this problem, instead of getting better, tends to grow worse, because these conditions are being alb wed to grow up, I would conclude by drawing attention to a fact which has already been dwelt upon by the hon. Member for Leith. In 1917, the Royal Commission on Housing in Scotland reported. They then said that there were immediately required 121,000 houses, and that, in order to raise the standard of housing in Scotland, there were required another £124,000 houses, s) that then, in 1917, there were required 245,000 houses to raise the standard. I want to give my little meed of praise for the effort that has been made in increasing the production of houses up to the figure of 21,000, but !here is little for any one of us in the House of Commons to boast about, or take credit to ourselves for, in what has been done towards building those 245,000 houses that were required in 1917. In 1919, committees were set up in every part of Scotland by order of the Government of that time, an investigation was made, and it was reported that, over 120,000 houses were immediately required. The Government said, bearing out the figures of the local authorities, that 10,000 houses were needed annually to meet the immediate requirements, and that to meet the deficiency another 10,000 must be added. Between 1919 and the 31st December, 1927, in round figures, 70,000 houses were built and 17,000 were in course of construction, so that, while we should have been building at the rate of 10,000 per annum to meet the immediate requirements, we have only built 70,000 in the course of eight years, or much fewer than the 10,000 that were required to meet the immediate need, leaving nothing for the leeway. All this time the problem of the slums was growing, and houses in Glasgow—I cannot speak for Edinburgh or other parts—were in such a condition of disrepair, worn out with old age and neglect, that we have had in the city several instances of properties falling about the tenants while the tenants were in occupation.

This housing problem is an old story. It is a story that must be told, and if the Government of the day, whatever Government it may be, does not pay attention to it, the problem must of necessity develop to such an extent that it will cause distress, and, out of distress, worse happenings. If the Government desire to make our people feel that they have a stake in the country, that it is a country for them that is worth living in, it behoves the Government, who represent the power of the great majority, who have great power in every direction, to take steps to improve these conditions and do away with the menace to which bad housing gives rise. With regard to the question of rent, the Government put down, and they take credit to themselves this year, again, I think, with some degree of righteousness—I mean that. of course, in a complimentary sense—they put the cost of a four-roomed house at £455. That house, in 1910–11, could have been built for £200, and it would have been a better house than that which is now being built at £455. But we could borrow money in those days at 3 per cent., so that all the interest that would have had to be borne on that £200 house would have been £6 per annum. Then our sinking fund would only have been twice £1 13s. 4d., or £3 7s., making a total of something like £9 or £10. If that house had been built in 1911, it could have been let at a rent of £14, and that would have left the Corporation with £1 of profit per house.

What is the position to-day? Your £455 house will cost you £22 for interest and £7 10s. for sinking fund, making a total rent of something like £30. Then there is the fact that the tenant's rates and the landlord's rates so far as Glasgow is concerned, have gone up to something like 14s. in the £. All this, as I have already said, makes it impossible for the average artisan, and absolutely impossible for the labouring class, ever to hope to occupy these houses, or to realise that dream of the cottage, of 12 houses to the acre—not eight to the acre as at Port Sunlight, or 10 to the acre as at Bournville, but 12 to the acre, as in any of the garden suburbs or garden cities which have been and are being created, and which are necessary just to give decency, to give that freshair and sunshine which nearly everyone of the Members of this House enjoys to the maximum degree, while, on the other hand, the people of that other nation, about whom Disraeli wrote, are living under conditions that bring trouble and strife. The rats can come out of their homes, they can gnaw the pillars of State, and, if the House of Commons is wise, it will decree that the people who produce all the good things of life, and work and strive under conditions that none of us would care to suffer if we could avoid it, shall have some share, lest worse befall.

Mr. MACPHERSON

I propose only to detain the Committee for a few minutes on this very important subject, and I am not going to follow the very admirable speech which has just been delivered by my hon. Friend the Member for St. Rollox (Mr. Stewart). I think that no one could fail to be touched by the very moving appeal that he has made for better conditions in the great city to which he belongs and of which he is a representative. Let me leave that great city, and go to the part of the country which I have the honour to represent. I am only going to ask a question or two with regard to the Highlands and Islands Medical Services. I have read, in common with my colleagues, the very admirable Report of the Scottish Board of Health. Few Reports are so admirable, so full and so convincing, and it is always a pleasure to read the account that the Board of Health gives of its admirable work during the year. One of the very best instruments that has ever been introduced into the medical service of any country has been the Highlands and Islands Medical Service. I do not think that anyone who knows the Highlands can fail to appreciate the wonderful work that has been done, but, when I look at the Estimates which are before us tonight I find that the amount which is annually allocated for this particular service is only £42,000. I was one of those who advocated a special service of this kind for the Highlands, and I must say for all my colleagues who represented Scotland at that time, including the Secretary of State himself, that we were agreed that something of this nature should be provided for the remote parts of the Highlands and Islands.

The very special work that the service performs cannot be done on £42,000 a year. I believe a sum of round about £60,000 a year is what is actually spent in the service. What do the Government propose to do to keep this fund solvent That it must be kept solvent is obvious, because I am quite certain whatever Government is in power will continue this work and will continue to add to its usefulness, and there is not any doubt at all that a sum of about £20,000 or £30,000 is urgently needed in view of the special and clamant needs of the Highlands and Islands. I should like the Under-Secretary to tell us what the proposal of the Government is with regard to this matter. I noticed with great pleasure that he went to the Highlands quite recently and, as usual, delivered one or two very admirable speeches. He went to the opening ceremony of the Northern Infirmary at Inverness, and I looked to see whether I could find any promise as to what the Government propose to do with regard to that almost unique institution. As he knows very well—and if he did not know before he went there, he would have appreciated the fact by being there—that institution is In a unique position. I am convinced that no better proof of its value could have been given to the world that that which was given by the admirable response to an appeal for contribution s from local authorities and from rich and poor in the Islands and Highlands. I am a strong believer in the theory that, when the public as a whole have done their level best out, of their means to support an institution of this kind, the remainder of the support required should be provided by the State.

9.0 p.m.

Is it the intention of the Government to give an additional grant to the Northern Infirmary, which provides the one great institution for almost all types of cases in that great and broad and scattered district? It is in the key position of the North. There is no other institution like it. Other institutions are of a smaller character. They do not pretend to cater for the needs of the entire locality. There are one or two hospitals in my own constituency, admirable institutions, but they cater for a more local sphere. This institution has set itself up to cater for a wide and scattered district. It is impossible for people who are taken suddenly ill and have, very likely on the spur of the moment. to be diagnosed, and probably to be operated upon for a major operation, to endure the long travel to the better known ii firmaries in Edinburgh and Glasgow, and it has become quite necessary in the interests of humanity, in the interests of the Highlands as a whole, that this institution, which has been publicly supported to a wonderful extent by the generosity of rich and poor alike, should at this moment become what it is destined to be, a really first-class institution. Thee is no doubt that an institution of that., kind would require a complete staff of specialists. The doctors and surgeons at Inverness are really at the top of their profession. You want all the recent appliances of science, of medicine, and of surgery. You want the infirmary to be thoroughly equipped and maintained, and you cannot do that unless you have a permanent grant, such as I am asking for, from the Board of Health or from tare Government or from the Highlands and Islands Medical Service Fund. I appeal to the Government—and I am appealing for the whole of the people of the North of Scotland—that a substantial grant should be given to this institution, which is the key institution of its kind in the North of Scotland, catering for a very wide, large and scattered district, in order to maintain it and to equip it and make it what it was meant to be, a really genuine boon to a very large and deserving community.

Dr. DRUMMOND SHIELS

It is a matter of satisfaction to all of us that on this occasion we have the report of the Board of Health before us. I quite agree with what has been said about the very excellent nature of that report. It is always a mine of information, and I think at this time it would be fitting to pay tribute to the valuable work that has been done in connection with it by Sir Leslie Mackenzie, who has now retired and who has been responsible for some very important sections of that report for a good many years. There is one interesting section at the beginning dealing with a subject which, though probably not so important as some that have been raised, is yet one of considerable interest. That is river pollution. I am glad to say that matter is being taken up seriously by the Board of Health. There is no doubt that, both on aesthetic grounds and on grounds of health, it is one of considerable importance. The case I know best is that of the river Esk, in Midlothian, and the condition of the river at the mouth is such as to have caused the Town Council of Mussel-burgh to protest very strongly to the county authorities in whose area the pollution takes place. The Report speaks about the difficulty of prosecution, but it is obvious that in many county areas the composition of the county council is such that it makes for reluctance to prosecute. While it is true that an aggrieved authority can prosecute, even where the pollution is outside its own area, the cost of such a prosecution is a very serious item. I hope that the new advisory Committee which has been set up will achieve the results which are hoped for. At any rate, it is a move in the right direction.

In connection with the distribution of this report of the Board of Health, there is one point that I would like to make which I have made before in these discussions. That arrangements should be made for this report to reach members of local authorities in Scotland. The price of 6s. 6d. is substantial, and my experience of members of local authorities in Scotland is that very few of them are familiar with this report which gives information which would be most valuable to all of them. I think I suggested before that the Board might circularise local authorities and suggest that they should buy supplies for their members. I am sure it would be to the advantage of the local authorities and to the advantage of health administration in Scotland. I do not know whether this has ever been done, but I should like to pass on the suggestion again.

In regard to the chapter on tuberculosis, I think it is a matter for regret that the progressive fall in the death-rate was not maintained during the last year, but probably the reason given—the very severe climatic conditions in Scotland last year—may be part of the explanation. I agree with what has been said by my hon. Friend the Member for St. Rollox (Mr. Stewart), that undoubtedly we are still retaining in some of our houses in Scotland many cases in an infectious stage of the disease, and, so far as we do that, we are really wasting public money in our other efforts to get rid of this disease. I am glad to notice that there is a slight fall in the death-rate from non-pulmonary tuberculosis. I would like to ask in that connection if the Board of Health are quite satisfied that all is being done that can be done with regard to the milk supply. We know that the milk supply in Scotland for a good many years was responsible for a considerable number of cases of non-pulmonary tuberculosis. We have had in recent years the licensing system, having tuberculin tested and graded milk and so on, and there is no doubt that this has provided milk which is a great improvement on any of the milk which was supplied before. But it must be remembered that licensed milk is dearer in price, and what I am anxious to know is whether the average of the non-graded milk is not perhaps lower than what was the average before the graded system was instituted. We know that the ordinary milk, being cheaper, is naturally bought by the humbler people and is used for children who have poor qualities of resistance. I would urge that continued attention so as to secure a pure milk supply is of great importance. Here, again, the housing question comes in because it is not only human beings who are badly housed; cattle are also badly housed. There is no doubt that some of the conditions in this respect in some of the large cities and in proximity to them in Scotland are very far from being satisfactory.

The right hon. Gentleman the Member for Ross and Cromarty (Mr. Macpherson) has referred to the Highlands and Islands Medical Services, and I agree with him that they have done a very great work. One need only go to Shetland, for instance, and see the difference in the happiness of the people there in knowing that they can have first-class surgical services at their immediate disposal to realise how important this work has been. It is the same with regard to the other medical and nursing services throughout the Highlands. I was very gild that the Report called attention to the very serious condition in regard to tuberculosis in the Highlands and Islands of Scotland. If you take the 15 to 34 age group and look at it in relation to Scotland generally and the Highlands and Islands in particular, you find that the general average rate for Scotland is 12.2, for the County of Inverness it is 20.5, for Ross and Cromarty, excluding Lewis, it is 26.9, for 'Shetland 28.1, for Sutherland 31 and for Lewis 37.1. These are extraordinary figures.

The report goes on to say that the reason for this state of things is a matter for surmise and that research is being conducted. Those who know the Highlands and Islands, do not require to look very far for at least the major causes of this condition. I think that the first of these is housing. There is no doubt that very many of the Highlands and Islands people are shockingly housed. The houses are old, damp, and often badly overcrowded, and I think that there is no doubt that the housing of the people in the Highlands and Islands is one of the main causes of this extraordinarily high incidence of pulmonary tuberculosis. Again, it is quite possible that the feeding of some of these people is not satisfactory. They do not get adequate food and they are not in a position to resist disease. These figures bear out the need for the investigation which was dealt with in this House a short time ago, and it is to be hoped that general improvement in the pros- perity of the Highlands and Islands will result in the reduction of these very alarming and very unsatisfactory figures. It is at east satisfactory that the Board of Health has recognised these things and has galled attention to them.

I should like to have said something about Rairmyers Colony and of that method of dealing with certain types of tuberculosis. There is no doubt that such a labour colony is on right lines, but I will not go into details about it now in view of the fact that there are some other Members who want to speak. I think that the Middle Ward District of Lanarkshire and the Board of Health are to be congratulated on co-operating in this effort to deal with tuberculosis on up-to-date lines. I should like to ask the Under-Secretary of State, who we know is an authority on the subject, how the light treatment for surgical tuberculosis is proceeding. Does he consider that the facilities for this treatment, which I think it is now admitted is very successful in these cases, are satisfactory. I see that in the report reference is made to a number of dispensaries being fitted up with light equipment. I should like to know what, in his opinion, is the position generally in Scotland.

The references to venereal diseases in the Repert are also very interesting, especially in view of the recent discussion in this House. They deal with the general propaganda methods which are undertaken, with the encouragement of the Board of Health, and also with the possibility of preventive methods. They say, in regard to these, that certain careful observers believe that these preventive methods may be contributory to the spread of the disease. I think that I have heard an echo of that in other quarters. It is not the opinion of the Army and Navy. The Army and the Navy have reduced their figures in connection with these diseases by the methods which are so sceptically referred to in the Report. The Trevethin Committee also favoured them. I was interested to find that the Board came to the conclusion that secrecy which was so much stressed in the Debate in this House a few weeks ago, did not seem to be of great importance, at least as regards the great cities. One can see quite well that, while the language used is guarded, the Board of Health, as they have shown on several occasions before, are not satisfied that the present arrangements and system are satisfactory or capable of dealing adequately with these serious diseases. This certainly justifies the attitude of the Edinburgh Corporation and other Scottish local authorities in the matter. It is an appalling fact that last year in Scotland the number of defaulters was 51 per cent. In view of the very large amount of public money which is spent in dealing with this subject it is obvious that a great deal of that money is wasted and, in the name of economy, if humanity is not enough, something else should be tried.

In regard to national health insurance, I do not intend to say very much, although I would have liked to have said a great deal. There is a return in the Report to the attack last year on the medical profession in regard to classification of people as unfit for employment. I hoped that we had heard the last of that because, in my opinion, this attack, while it may have been justified in some cases, has been altogether overdone. I had intended to quote something in the same connection in regard to prescribing, where a great deal is made of the fact that insurance doctors prescribe expensive drugs, and give sweetening and flavouring materials to medicines to make them less unpalatable, a mitigation of suffering which, apparently, is not considered desirable in the case of the insured patient. Altogether, an attitude is taken up in regard to the medical profession, and incidentally in regard to the patients, which, I think, is quite unjustifiable. The Report does not sufficiently recognise that the condition of our people in Scotland during the last few years, with the amount of unemployment there has been, has been such in many cases that they were more liable than formerly to illness, and that their general condition was very much below par. It is unfortunate that by means of threats and suggestions of surcharges and referees and so on, medical men should have it suggested to them that they should cut down prescribing to the very minimum amount. I have never seen or heard of any investigation to find out if medical men are supplying sufficient good medicines, and the tonics and building up preparations which are often necessary. So long as the medi- cine is cut down and the cost of prescribing is low, there is evidently no worry as to whether the insured person is getting proper remedies. The whole tendency of the system is to cause the doctor to be afraid to give what, in many cases, would only be adequate for the nature of the case.

I should have liked to deal with housing and slums, but that subject has been referred to by my colleagues on these benches, and also very effectively by the hon. Member for Leith (Mr. E. Brown). I wish to associate myself with all that has been said about the great importance of dealing radically with this subject. There can be no doubt that if we had adequate and proper housing tuberculosis could be swept away in a generation. It is very largely a disease of housing, and it does seem foolish as well as inhuman that we should go on spending enormous sums on public health which would not be necessary if proper housing were provided. It is, of course, a very difficult problem because we are dealing with a state of things which should never have been allowed to grow up. We are paying for the sins of our forefathers. It will be found, if we do tackle housing thoroughly, that the cost of it will be to some extent compensated for by the saving in many public health services. I am glad that the Board of Health are tackling this subject, and I hope they will be encouraged by the expressions of opinion from all quarters of the House to go on with their good work, and remove from Scotland the reproach that it has had some of the worst slums in the British Empire.

Mr. BARR

I should like to revert to the subject of housing. I regret that I have not had time to study the Report, which only came into my hands a few minutes ago. I am very anxious that we should know more as to the position of the subsidy in regard to housing. I do not know whether this is the occasion to press the Minister on that matter, but it bears very directly on the general subject of housing. We have special conditions in Scotland. We have not the same amount of skilled labour, and we have climatic conditions of a particular character and our housing problem has proceeded so far much more slowly than the corresponding programme in England. The consequence is that we lag behind in the amount we have received, as we as in the proportion of houses supplied. We are due something like eleven-eightieths on this account, and I would put in a plea that the subsidy, so far as Scotland is concerned, should not be reduced in any degree until we have received eleven-eightieths of the amount that has been expended on the full subsidy in England, and that in regard to the impending reduced subsidy in England we should have our full quota and that reference should be made by the Minister to the Act of 1924 in which it was stipulated that the Minister and the Scottish Board of Health should confer with the Minister of Health for England before the reduction takes place.

I would point out some of the effects that follow immediately on the reduction of the subsidy. It tends to an increase of rents, and still further exaggerates the stringency of money. I might refer to my own burgh, where we have now something like 1,314 houses that have been completed or are in progress, and that does not at all meet the abnormal conditions there. We are at a dead stand in the matter. I recognise the kindly feeling, particularly of the Under-Secretary, and doubtless of the Secretary of State for Scotland also, in this matter, but the fact is that we made a special application to get more than our quota, considering the conditions in the burgh of Motherwell, and it was found that, owing to our having certain restrictions, we could have no advance and no loan at reasonable rates. Consequently, our housing is at a standstill in that regard.

I consider that, instead of reducing the subsidy and of bringing these loans to an end, the Minister and the Government should be seeking to provide new ways for securing money on easy terms to go forward with building schemes in constituencies like my own. Another thing which happens when we reduce the subsidy is that there is a tendency to depress the standard of the houses. That has been recognised in England. We have enough houses already that are of a low standard, and the question of subsidies is intimately related to the quality and the standard of houses. It also tends to the increase of rent. I would like to look at this subject from the point of view of the supply of houses. When the Royal Commission made its estimate as to the number of houses that were required in Scotland, they calculated that, in order to meet the needs of those who are living in overcrowded conditions, and to meet the case of those who are living in uninhabitable horses, 121,000 houses were needed and that, further, to raise somewhat the very low standard, 114,000 further houses should be built, making 235,000 houses in all. I think it was when the Board of Health consulted the local authorities about 1919 that they reported a deficit in Scotland of 131,000 houses, and in the Report for 1924 is was calculated that there was a deficit of 150,000 houses. For the 15 years' programme, with 10,000 houses a year necessary to meet the normal needs, you have 300,000 houses that you should provide in that 15 years—an average of 20,000 a year. This is the only year you have come up to that average. You have this year 21,660 houses, but it is evident that there is still a vast shortage of houses—and of housing of a worthy standard.

I was very much struck by a statement by ex-Bailie Morton, for long Convener of the Housing Committee in Glasgow. He said that the housing shortage was, in his opinion, more acute to-day than when they began building. You reach the same position when you take the subject from the point of view of overcrowding. As has already been pointed out here this afternoon, we do not take the standard of England and of the Registrar-General, which is an average of two per room, because if we did we should realise that more than half the population of Scotland was living in overcrowded conditions. So to save the face of Scotland, so to speak, we make it an average of three per room. Even then it was found by the Boyal Commission that with an average of three per room as the normal, and as not being overcrowded, there were 1,005,000 people living in overcrowded conditions The Medical Officer of Health for Glasgow made a report not long ago to which reference was made by the hon. Member for St. Rollox (Mr. Stewart). I was struck with the fact that in the farmed-out houses which were examined there was a population there of 18,000 and 15 per cent. of them were living in overcrowded conditions even at that standard—double the overcrowding that there was before the War. Figures were given by the hon. Member ft r St. Rollox of 12 per cent. in a certain class of house, with two families living in a house. In another class of house it was 6.4 per cent.—these being far above the lowest grade of house. Taking the one-roomed house, 10 living in a single-apartment house was fairly common. Eleven was common enough, and 12 or 13 was known. I would like to refer to the appalling conclusions that were reached by the Royal Commission on Sexual Offences against Young Persons, where you find the most atrocious and revolting form of sexual immorality attributed to this over-crowding.

I need not go into the subject of slum areas, to which reference has been made. The Minister of Health himself, some time ago, complained that so little progress was being made. I think five improvement schemes are proceeding, and we have to recognise that progress in these slum areas is at present determined by the low economic and depressed conditions of the people. In my own burgh of Motherwell 69 families that were removed from slum conditions into better areas—and it is so difficult to remove them, because they realise that they cannot pay even the modified figures for these new houses—and of these 69 families, 41 since Christmas last have been found already to be in arrears of rate, not for lack of willingness to pay, but because of the economic conditions. Therefore, the whole question of this housing comes back, in part, on Government support, and, on the other hand, to providing a worthy living wage and better economic conditions. This withdrawal or reduction of the subsidy is, in the view of many people, a means of throwing back the housing question on private enterprise once more. I do not think that that is possible, and I do riot think it is desirable.

The Royal Commission on Housing in Scotland reported that even before the War, and before the land taxes of which mention is made in this connection—for they declare the Finance Act had no real effect on the non-provision of houses—private enterprise had failed in the supply of houses on the private enterprise system, that housing must be on a national scale, that it must be done by the national resources, by local authorities undertaking the task. In 1916–27 the National Institute of Surveyors, which is not composed of Socialists at all, but men who have some regard for private enterprise, declared that much as they desired that private enterprise should go on to complete the work, it was now impossible to provide sufficient housing for the people save by the nation with its national resources. I do not want a return, I say it quite frankly, to the system under which the speculative builder provided houses where it was profitable to build and stopped building when it was unprofitable to build. It is the fundamental and primary duty of the nation to provide worthy houses.

Lastly, I come to the reason which is given for the reduction of the subsidy and the withdrawal of the housing effort on a national basis; and that is, that the nation cannot afford it. The amount that has been spent on the subsidy from 1919 to 1927 is £53,900,000, that is, over the whole of the country.; for Scotland only £6,500,000 has been spent on the subsidy. Cannot we afford more? In Scotland we are spending on strong liquor £27,000,000. In one year we are spending four times as much as has has been spent on housing in Scotland by the Government in eight years. Lately I made a visit, like other hon. Members, to a battleship, and I found an instrument of destruction which was perfect. That battleship cost £9,000,000. One battleship cost more than we have spent on housing from 1919 to 1927, that is on the whole housing subsidy for Scotland. I suppose if we were to carry out to its full the scheme of 1924 we should have to spend something like £1,000,000,000. During the great War the country in the five years spent, not £1,000,000,000,£11,000,000,000. Surely, if in five years this country can afford to spend £11,000,000,000 on the work of human destruction, it can afford to spend one-eleventh part of that sum in 40 years, not on the work of destruction but on the work of reconstruction, the rebuilding and repairing of the old wastes, with better homes for the people and better people for the homes. You say that the country cannot afford it. I recall the words which were used by Captain Scott in the Antarctic when he said that: Surely, surely a great rich country like ours will see that those who are dependent on us are properly provided for. Surely a great rich country like ours, as is shown in the revenue returns and may other ways, can well afford, and should afford, as its first duty the worthy housing of its people.

Sir R. HAMLTON

In the excellent Report we have before us for our consideration to-night there are many matters worthy of serious and grave discussion, but I propose to refer only to one, and that is the question of the Highlands and Islands Medical Service Fund, which does a work of enormous value to the Highlands and Islands of Scotland. With the permission of the Committee may I quote from the Report of the Consultative Council on the Highlands and Islands in order to show the position at present with regard to finance and what it is likely to he in the near future? On page 197 of the Report it say: The financial disabilities of the Highlands have been intensified since the War by various circumstances, including a further loss of population without a concurrent increase in employment; a tendency towards a decrease in valuation accompanied by a fairly uniform increase in expenditure; the lack of new industries throughout the Highlands as a whole; a falling off in the returns of fishing; and the handicap under which producers in the greater part of the Highlands and Islands suffer owing to the difficulties of transport and the burden of freights. On the following page it says: In view of these general considerations we have come to the conclusion that since local resources, both communal and individual, in many parts of the Highlands and Islands are already severely taxed in the provision of the basic medical and nursing services, any new services required in these localities will have to be heavily subsidised from the Fund. On the following page the Report says: It is our considered opinion that on the various grounds set out in the preceding paragraph the comprehensive system of services contemplated in the schemes approved for the application of the Highlands and Islands (Medical Service) Fund is urgently required in the interests of health in the Highlands. As to the period that may elapse before the system can be fully built up, we would deprecate a policy which allowed the health services in the Highlands to lag unduly behind the provision made for the prevention of disease in other parts of the country. That shows generally the opinion of the Consultative Committee as regards the position of the fund. It is of great importance that the services which are rendered by this fund should be kept up and not allowed to fall behind the standard at which they have been kept during the past years. This fund was instituted in the year 1913, and since that date money values have altered enormously. I do not believe that the annual contribuion to the fund of £42,000 a year has been increased to meet the change in money values, and the fund is expected to do the same work to-day, when costs are infinitely higher than they were then, as it was doing in 1913. As one who has had soma experience as to how this fund is administered, I can say that there is probably no fund in any part of the world which is more economically administered and which does a greater amount of good. It is really astonishing the provision which this fund makes for medical services in the Highlands and Islands. I do not know what we should do without it. The Secretary of State knows that in a short time, unless a further contribution is made, the work of this fund cannot be carried on, and that it would have to come to an end in 18 months. Some provision will have to be made. T have it on the best authority that another £25,000 a year is required.

I ask she Secretary of State whether he can assure us that provisions will be made so that the work of this Fund shall not be allowed in any way to diminish. A branch of the work that has been an outstanding success has been the appointment of consulting surgeons in the out islands. In Shetland, particularly, where a most excellent surgeon was appointed, the result was that operations of importance could be performed in cases which otherwise would have had to be sent South. In out islands like that it is exceedingly difficult to get people in the first place to go into the hospitals, and it increases that difficulty if they have to be sent away on long sea journeys to Aberdeen or Leith or somewhere else in the South. When they can be sent into a hospital in their own county, where their people can come and live near them without any heavy extra expense being incurred, they are more willing to enter a hospital. The arrangement has the result of getting the patient under treatment ear y, and hospitals in the South, whose beds are only too full already, unfortunately, are also relieved. I wish to impress upon the Secretary of State the importance of a continuance of the services of this Fund, and I hope that he will be able to tell us that steps are being taken so that the work of the Fund shall not be decreased in any way in future.

Mr. SCRYMGEOUR

There are two matters which I would like to bring to the notice of the Secretary of State. The first is that to which reference has already been made, the subject of venereal disease. In page 106 of the Report of the Board of Health there appears this statement: It may be said with conviction that those whose professional duties bring them into close acquaintance with these diseases, are, without exception, of the belief that both maladies are widely disseminated throughout the community. Statutory notification gives an accurate indication of the prevalence of scarlet fever, and, read with vital statistics, fairly accurate information as to the number of cases of tuberculosis in the community; there is no similar method of ascertaining the incidence of syphilis and gonorrhea. Again, the death returns state, with a high measure of reliability, the number of deaths from pneumonia or cancer; deaths from syphilis, on the contrary, are rarely certified as due to that disease. Then on page 117 of the Report, under the heading "The Problem of the Defaulter," there is this statement: This problem has provided much ground of anxiety and perplexity to local authorities and their officials, and it has been represented that, alike for the general good of the community and with the object of preventing waste of money on curtailed, and so ineffectual, treatment, some further measure of control is necessary. Further down, the Report states: It does not seem right that once the mother's condition is diagnosed, she should be at liberty to evade a process of treatment which, if irksome and protracted, is neither acutely painful nor substantially dangerous, and so confer upon her child a high probability of a short life of acute misery, or a longer one of such disability and distress that perhaps early death were preferable. These statements in themselves are confirmatory of the view that some of us take very seriously, that the Scottish Board of Health is really convinced of the necessity of further legislation.

The CHAIRMAN

I am afraid that the hon. Member cannot pursue that subject. It is not within the present powers of the Board of Health to do that which he suggests.

Mr. SCRYMGEOUR

It is one of the great difficulties for myself, that when it comes to a matter of this kind it seems hardly any good to talk about business at all, if it is only a matter of giving recitations on all these things.

The CHAIRMAN

The rule in these Debates is that the Vote for the Ministry is brought forward, and anything for which the Ministry are responsible is in order as a subject of discussion, and the Ministry can be criticised for what they have done or failed to do. When it comes to a question of legislation and of new powers being asked for, it: is not in order. The hon. Member will see the obvious reason why. If it were in order, discussion would roam over a number of proposals for possible legislation, and the actual default of the Minister would escape observation.

Mr. BUCHANAN

On a point of Order. Let me state what is happening in Scotland in connection with venereal disease and the question of compulsory powers. The Glasgow Corporation and the Edinburgh Corporation both applied for compulsory powers last year, but the Scottish Board of Health opposed the proposal. Is my hon. Friend not entitled to criticise the Secretary for Scotland because of his action in preventing these local authorities from getting compulsory powers under the local legislation that they sought?

The CHAIRMAN

No. The Secretary of State can be criticised as an administrator, but not as a legislator or for failing to be a legislator.

Mr. SCRYMGEOUR

I thank you, Mr. Chairman, for the suggestion, and I will start with the right hon. Gentleman's administration. I want to quote the report of the Convention of Royal Burgs, at which the following resolution was adopted: That this Convention reiterates the opinion of previous Conventions, that it is in the interests of public health and economy and of the welfare of future generations that some form of notification and ensured treatment of venereal disease should be provided for by legislative enactment. That Resolution was carried unanimously by the Convention, and Sir Henry Keith proceeded to state the point that I feel it is so necessary to urge on this occasion. What I want to deal with is Sir Henry Keith's deliverance concerning the Scottish Board of Health. He says the attitude of the Board in August, 1922, was briefly that they were still of the opinion that the first step should be, not notification of venereal diseases but compulsion of persons knowing or having reason to suspect that they are suffering from these diseases to submit themselves to treatment and, having so submitted themselves, to continue under treatment until discharge by the medical officer in charge of the treatment.

The CHAIRMAN

Is not that a matter which involves legislation?

Mr. BUCHANAN

Again, Sir, I wish to put a point of Order in regard to this subject. The compulsory notification of diseases in Scotland does not require legislation in this House. The Secretary of State, under the Public Health Acts, has the power to make any disease notifiable.

The CHAIRMAN

If that is so, then the matter can be discussed.

Mr. SCRYMGEOUR

The point which I want to bring out is in the statement which I am quoting. Sir Henry Keith goes on: If we could get that we would be perfectly satisfied. That, he says, is the official position of the Scottish Board of Health. I do not think that the English Ministry of Health is quite so far forward. The principle medical officer of health in England has always been a negative quantity in regard to this question, but we in Scotland are further advanced. He adds that those who have been connected with the subject for more than 12 or 15 years know how futile is the work that is proceeding. As on many other issues, we have evidence here that the Scottish Board of Health would like to do something more but are being held back by the English Ministry of Health. The Liverpol Bill reached the Second Reading stage without any challenge, but, thereafter, when the Edinburgh Bill came up for discussion exception was taken to it, the Whips were put on against it and the Measure was defeated.

Mr. BROWN

The Whips were not put on against it.

10.0 p.m.

Mr. SCRYMGEOUR

In any case the instigation of the Government on representations from the Secretary of State "was against the Bill. The Scottish Board of Health has issued an excellent compendium of information on the various activities of the Department but, in regard to this particular issue which is so important, with regard to this terrible disease, the Board puts in veiled language evidence that they would like to do something better but that they are being held back from going further forward on account of the position of the English Ministry of Health. That is a situation which once more proves the futility of trying to do anything in this connection at all. It may be a humorous matter to the Lord Advocate, who has been enjoying himself at Longforgan, but we here are not professionally engaged. We are only endeavouring to serve our constituencies and the country. On page 207 of the report, reference is made to a serious development in connection with infectious diseases. It is in regard to the case of one of the milch cows in a dairy close to Dundee and it is the second case of the kind affecting a considerable number of people. A tribute is paid in the report to the promptitude with which these cases were handled. This reference is as follows: These outbreaks provide a signal demonstration that the provisions in the Milk and Dairies Act have not yet proved to be a practical means for avoiding outbreaks of infectious disease due to milk. If such outbreaks continue to occur, and if the existing system cannot prevent them, it will be necessary to devise other measures for the prevention of outbreaks of disease. When its. Report shows such serious circumstancs and when the Board of Health come down to a recognition of the fact that the real failure is in the Act as it stands then, logically, we ought to expect the representatives of the Scottish Board of Health to do something more than administer the Act which they admit fails to meet the case.

The CHAIRMAN rose—

Mr. SCRYMGEOUR

I have got in all I want to say at the moment.

Sir A. SINCLAIR

In view of the fact that many other Members wish to speak I shall confine myself to two points. The general position of the medical service in the Highlands and Islands has been adequately dealt with by the hon. Member for Orkney and Shetland (Sir R. Hamilton) but I wish to draw attention to the urgency of the situation there and I would quote a little further from the Report: In particular we could not view with equanimity any negative policy which allowed the gap between the standard of service in the Highlands and the Lowlands to be widened—a process which seems to us indeed to be actually going on at present in certain branches of public health work. At present, therefore, the service in the Highlands is actually getting worse than the service in the Lowlands and I therefore appeal to the Under-Secretary to make it quite clear, not only that the service is going to be kept up to the pitch which it has now reached but that in the branches of public health work to which reference is made in the Report, there will be a definite and immediate effort to make up the leeway in the Highland areas. On the following page the Board of Health say: For the financial reasons explained in recent reports, activity during 1927 has been confined almost entirely to the maintenance of the services in being before the beginning of the year. Apparently there has been none of the expansion which ought to be made in these services. There was one very important point in the Report of the Board of Health for 1925 to which no reference has been made since. It is a matter of particular importance to many parts of the Highlands, namely, the question of communication. The Report for 1925 stated: The need for an extension of telephone services in the Highlands and Islands is becoming clearer as the medical and allied services develop. It is now apparent … that the greatest good cannot he secured from hospital or other special services unless the doctors' and nurses' houses, the general hospital, the infectious diseases hospital, the sanatorium and the headquarters of the local authorities and the medical officer of health, are linked together by telephone. …The problem is even more acute in the case of some of the smaller islands, which have no means of communication with their neighbours except by boat, and then only when weather conditions permit. I have two of these islands in my constituency and I have, before now, approached the Board of Health in regard to the fairly large island of Stroma asking if we could not have a wireless apparatus similar to that which has been tried out in the Orkney and Shetland Islands. I would like to know if that proposal has been receiving or will receive consideration? There is a real need, on grounds mainly of health, for improving the communications between the island of Stroma and the mainland.

I should like also briefly to emphasise what was said by my hon. Friend the Member for East Edinburgh (Dr. Shiels) about harrying the doctors for over-prescribing. There have been cases in. my constituency of well-known and very much respected doctors who are accused of over-prescribing—most careful men, who hold important public positions in the county, and of whom such an accusation cannot for one moment be entertained by those who know them; and I hope that that will not be resorted to in the future. I was glad to hear my right hon. Friend the Member for Ross and Cromarty (Mr. Macpherson) referring to the most important and valuable work which is being done by the Northern Infirmary in Inverness, but I must enter one caveat about it. I do not in the least wish to detract from the most valuable work of that hospital within a very large radius, but that radius does not reach to Caithness. There we have two admirable hospitals, one the Bignold Hospital in Wick and the other the Dunbar Hospital in Thurso, and great efforts are being made by the local people to maintain and improve the equipment of those hospitals. I hope we may have an assurance to-night from my hon. and gallant Friend that these efforts are being recognised by the Board of Health and that they are prepared to support us in the efforts which we are making there, at Wick and Thurso, and in particular that we shall be able to obtain the much needed services of a surgeon. For really serious, critical cases Inverness is too far off, and in other cases people prefer to go to Edinburgh and Glasgow, where they have many more friends and better accommodation.

I now come to the second point. After all, the shelter of the people and their environment is a fundamental factor in the problem of health, and the fringe of the rural housing question in the Highlands of Scotland has scarcely been touched by the Housing (Rural Workers) Act. The medical officer of health for Argyllshire, in a recent report, says that the chief causes of ill health are climate and unsatisfactory housing and that nothing can be done short of rebuilding half the houses on different sites. The only thing that has been done by the Government has been the passing of the Housing (Rural Workers) Act. What progress has been made? Unfortunately it is clear from the Report of the Board of Health that very little progress has been made under that Act. Actually improvements covering only 62 houses have been completed, and grants amounting to only £4,381 have been paid. As regards schemes in contemplation and grants promised, they amount to only £26,000 or less in respect of some 270 houses to be improved, whereas we know from the Reports of the Board itself that the short age of rural houses in Scotland amounts to something like 21,000. These 270 houses, therefore, barely touch the fringe of the question.

Some of my hon. Friends have impressed upon the Government the fact that there is an intolerable burden on the local ratepayers in this connection. They have to pay half the charges on the grants to bear the whole of the loan liabilities and the whole of the administrative expenses of the scheme. This, in a county like Sutherland, where a penny rate raises only £400, means that the Act is unworkable, and Sutherland is one of those many authorities who are unable, admittedly, to put the Act into operation. For the majority of the ratepayers there, it means only additional rates. How many authorities are not working the Act at the present time, and what do the Government propose to do for the people in those cases, whose need is as urgent as that of people in any other part of the country? Another defect of the Act is that it only touches the actual rural workers and does not cover postmasters, tailors, and other people whose work is essential to the social and economic life of the rural communities, but who cannot come under the Wheatley Act and have not the resources to break down their little houses, which have some good walls left, and to start afresh building new houses, as they would have to do to qualify for subsidy under the Wheatley or Chamberlain Acts. They want really to improve their houses, yet because they are not actually agricultural labourers they are not able to obtain a subsidy under this Act.

Finally, on this question of housing, one of the most urgent cases of all in the rural districts is that of the men who were settled on the land by the Board of Agriculture, under their administration, immediately after the war, almost entirely ex-service men. They were given loans of about £1,000, for which they got houses and steading, which are nothing but temporary huts and which are already letting in the water and are useless as shelters. At present they are nothing short of death traps, but within 20 or 30 years they will have disappeared entirely, and in the meantime their occupiers have this obligation of the thousand pounds. They have no remedy against the Board of Agriculture, which says that it has finished with them, having supplied them with the houses and given them the loans. Therefore, the only people to whom they can look are the Board of Health, and I do appeal to the hon. and gallant Member to consider the case of these men. I was speaking to one list Autumn, a Mr. Sutherland, who has a holding in the parish of Reay. He told me that he was as comfortable in the mine craters of St. Eloi, on the Belgian war front, as in the conditions in which he found himself in his house at Reay. In wet weather, he said, he could not get I is children clean, and they were going about ankle-deep in-mud. The water streamed in, and, as a matter of fact, he is doing the only thing he can do and that is to emigrate. He is going away and leaving the hut, and that is the only course which confronts scores of these men, many of them in my own constituency. I would ask my hon. and gallant Friend to consider this problem. It is one of the most urgent problems in the rural districts at the present time and almost entirely affects ex-service men.

Mr. STEPHEN

There are two points I wish to raise in connection with this Report. I put a question to the Secretary of State for Scotland as to the number of houses inhabited and certified as unfit for human habitation in Glasgow in 1928, and he informed me that the number was 3,007. He also informed me that the number of houses in slum clearance schemes built and occupied was 2,716. When I got that answer, I was surprised because in 1922 there were about 13,000 houses inhabited and certi- fied as unfit for human habitation in Glasgow, and, as far as I can make out from inquiries, there have been nothing like 10,000 houses demolished, as would be the case under slum clearance schemes. I wonder whether this reduction to 3,000 is partly due to the fact that there has been a lower state of certification, and that houses that were formerly regarded as unfit for human habitation have tended to become regarded as fit for habitation. I also wish to draw the attention of the Committee to the fact that the 1924 Act is evidently beginning very largely to replace the 1925 Act as the Act that is effective in providing houses. I mention that because I have here a leaflet which has been circulated in my Division by the Unionist Association, entitled "The Harvest of Houses." It points out that in 1924, Socialist year, the number of houses built was 9,537: in 1925, Unionist year, the number of houses built was 10,053; in 1926, Unionist year, 14,286 houses: and in 1927, Unionist year, 22,156 houses. [HON. MEMBERS: "Hear, hear!"] Hon. Gentlemen cheer, but the leaflet is a thousand wrong with regard to 1927, according to this Report.

Major ELLIOT

I challenge that: it is untrue.

Mr. STEPHEN

The figure to which I was referring in the report, gives the total of completed houses for the year as 21,660, whereas in the leaflet it is 22,156.

Major ELLIOT

The hon. Member does not mind my pointing out that there are other houses built in Scotland than those built under State-assisted schemes. He must not assume that other people do not build houses except with the assistance of the State.

Mr. STEPHEN

That may be, but I am not so much concerned with the actual figures, as to point out the fact that evidently the Conservative Government require a Socialist Act in order to enable the houses to be built. The subsidy comes up for review in October. On several occasions I have asked the Secretary of State for Scotland questions regarding the amount of subsidy which has been paid in Scotland, and from the figures I have got of the amounts paid in Glasgow and some of the big English cities I notice that Glasgow is still a good way behind these other cities. I want to warn the Secretary of State, that we expect when this review takes place, that he will see that Scotland gets its due proportion of this expenditure. I think we are entitled to more proportionately because it has been generally admitted that the Scottish housing problem is ever so much worse than the English, and I do hope the Secretary of State will not let Scotland down and will allow us to retain the full subsidy. I must confess that I have not very much confidence in him, but I hope the warning we are giving him may produce something better in the future than we have had in the past.

I also want to complain about the paragraph on page 252 of the Report, already referred to, dealing with the certification of people by doctors under the National Health Insurance Scheme. I have previously challenged the Secretary of State regarding the implied reflection in those words, because they suggest that doctors in Scotland are not acting as professional men with the responsibilities which they undertake when they become doctors. I protest very strongly against people who themselves are living in comfortable circumstances, with every opportunity to maintain themselves in health and strength, writing on the assumption that doctors are not doing their duty and are allowing people to draw sick benefit who are not entitled to it. From the experience of our friends who have had to take advantage of national health insurance, we know that so far from its being easy to get a certificate of ill health the tendency is to send people back to work when they are unfit to go. It is quite obvious that this paragraph was written to try to terrorise the more timid members of the profession into sending people back to work before they are fit to return, or to keep them from giving certificates to members of the working class who through being unemployed and in consequence unable to get proper food, have tended to get into an unhealthy condition.

There is is one other matter I wish to mention. On page 331 there is a similar paragraph about parish councils not doing their duty. It is pointed out there: In most of the larger industrial parishes it is found that a considerable number, not a large percentage, but sufficient to call for comment, of unemployed persons have been continuously chargeable, or chargeable with only small breaks for long periods. Such cases should be specially and thoroughly considered by parish councils. It is noteworthy that the great majority of unemployed persons are now able to obtain spells of work periodically, and complete failure to do so over long periods would seem to justify a suspicion that reasonable efforts to find employment have not been made. Anyone who has had experience of the parish councils in Scotland knows that they are face to face with the fact that there is so much unemployment and so many burdens thrown upon the local authorities that there is a tendency for ever-increasing rates, and as a consequence the parish councils have been very stringent with regard to the granting of relief. Nearly every one of those parish councils has a majority of Conservative representatives, and we ail know that Conservatives are not very generous in dealing with the working classes. [HON. MEMBERS: "Oh"] There is no question about that. On this matter the Conservative viewpoint is that the whole business is very unfortunate, but they say that this is the best of all possible worlds and people must do their best in it. The administration of the Poor Law by those parish councils is very stringent, and consequently the only result of the policy adopted by the Scottish Board of Health is to make those councils absolutely callous with regard to the administration of poor relief. The other part of the paragraph I have quoted reads: There appears to be an increasing tendency to make application for relief as soon as employment ceases, and it is thought that some parish councils are inclined to admit such applicants too readily to relief. I wonder what the compiler of the Report was thinking about when he wrote that sentence. It is evident that the poor wages paid to these people, and the fact that employment is so casual, were overlooked. Long spells of idleness on the part of one member of the family or another contribute towards placing these people in a very difficult position. The Report goes on to state that the parish councils are far too generous in dealing with these people, but hon. Members cannot give a single example of such generosity, and if they could have found one it would most certainly have been printed in the Report in black type. The Report goes on to say: White the difficulties of the situation from the point of view of the parish councils are realised, it is nevertheless unfortunate that the impression should be created that Poor Law relief is available as soon as work ceases, and parish councils should endeavour to administer their duty by making it clear to the applicant that the primary responsibility for providing for their maintenance rests with themselves. It is true that the primary responsibility for maintenance rests with themselves, but when one Government after another finds itself unable to do anything material to solve the problem of unemployment; when on Government after another has found itself baffled by the industrial circurnstances to which those people who won the war and carried the country through in that great struggle are subjected to-day—many of them are ex-service men—all the Government can do to meet such a situation is to tell them that the primary responsibility for providing for their maintenance rests with themselves. I think it is intolerable that such paragraphs should come into this Report. I am quite willing to admit that every year, generally speaking, the Report seems to show some measure of improvement, and I think it is a great pity that a Report which might have been so much more valuable is really spoiled by inhuman, callous sentences such as these.

No one on this side of the House wants to make any plea for people who are themselves responsible for the conditions under which they are, but everyone knows that, in Glasgow and in other towns in Scotland, unemployment has been such a fearful scourge that the people there are in the most distressed circumstances, and the parish councils have been face to face with a very difficult problem. They have tried to meet it, and I am quite confident that, if they have erred, it has always been on the side of severity. They have, however, a very difficult problem to face, and I think that the Scottish Board of Health should not be complaining that these parish councils have been too generous. They know that it is not true, and it is no use trying to make the conditions of people who are in the most distressed circumstances even worse than they are. It is a disgrace to the Conservative party, it is a disgrace to any party, that there should be this attempt, in the admittedly difficult circumstances of the country, to increase the hardship of the conditions of the people in the poorer section of society. It would be far more creditable if the Government, viewing the position of the parish councils, were to come to their relief more generously than they ever have done, instead of trying to take it out of the stomachs of the men, women and children who have had to suffer so hardly, and have had to bear a big part of the sacrifices involved in those years of hardship imposed by the industrial crisis in this country.

The CHAIRMAN

Major Elliot.

Mr. BUCHANAN

I wanted to move a reduction of the Vote by £100, but I do not want to intervene now if I can get an opportunity for a minute later on.

The CHAIRMAN

That will depend on the Secretary to the Board of Health. If he consumes the 28 minutes that are available, the hon. Member will not have the opportunity.

Major ELLIOT

I have no objection; the hon. Member can move his reduction now if he so desires.

Mr. BUCHANAN

I beg to move to reduce the Vote by £100.

I thank the hon. and gallant Gentleman for his never-failing courtesy. I move this reduction formally, as I know that the hon. and gallant Gentleman has to reply.

Major ELLIOT

I thought it only fair to allow hon. Members opposite the opportunity of carrying into the Division Lobby the heat which they seem to have generated in the last few minutes. A refreshing breath of controversy blew through our discussions in the closing remarks of the hon. Member for Camlachie (Mr. Stephen), a breath of controversy which, perhaps, has receded too far from some of our discussions in the past few years, and which was reminiscent of the glorious days when hon. Members came down from the North brandishing a great number of flags and other implements, with the object of sweeping away the effete civilisation which had set itself up here on the banks of the Thames. I remember reading a review recently in that well-conducted paper "Forward," saying that, alas, that gallant expeditionary force suffered the fate of another expeditionary force, a second Flodden—

The CHAIRMAN

The hon. and gallant Gentleman is getting a little wide of his own Vote.

Major ELLIOT

I would only point out that a reduction has been moved. It has not been moved by the hon. Member who introduced the subject, and it has been moved at a very late stage of the proceedings. [Interruption.] I make no objection. I was merely indicating to the Chairman the reasons that led me to point out that a reduction was being moved. However, I think we may leave the hon. Member's remarks, and we may leave the hon. Member who spoke last to enjoy that extraordinary feeling of self-righteousness which he seems to revel in more than almost any other Member of the Committee and assure him that we on this side do not believe it is a service to the workers of the country to hide facts from them. There is no one who resents more the undoubted cases of undue drawing of relief by one member of the community or another than they do.

Mr. BUCHANAN

Can the hon. and gallant Gentleman give us one case where it happens? What parish council does it?

Major ELLIOT

It is not possible to go into details and publish the tables of figures of people having drawn relief for very long periods which it is possible for us to quote. I do not desire to make Scottish local government a sterile controversy as to whether or not certain particular individuals have drawn an undue amount of relief. We know that in fact—and hon. Members opposite complain of it as much as anyone—there is a tendency in modern life for the principle of doles and not work to be ingrained in any of us. In any of us who are subject to the temptations there is a tendency to yield to them, and hon. Members opposite know that as well as I do and have complained of it to me. [Interruption.] The hon. Member will excuse me for not entering into a discussion with him. Those who have remained throughout the discussion are entitled to have their questions answered. The hon. Member for Camlachie made a further remark that I should like to deal with. He spoke of the reflections and attacks on the medical profession contained in this Report. The spectacle of the hon. Member for Camlachie defending the medical profession against the attacks of Sir Leslie MacKenzie is one we may well leave to the delighted laughter of the medical profession of Scotland.

When the discussion was introduced the hon. Member for Leith (Mr. E. Brown) raised a number of questions of which he had the courtesy to give me notice in advance, and I must answer them as far as that is possible. He asked, with regard to the experience of societies in dealing with this high benefit rate, which is causing disquietude among approved societies and those who are responsible for their supervision, was there a difference in experience between one society and another? It would be incorrect to say there is any difference between one society and another, save that there is a difference between societies which deal with different areas. Societies in rural areas have not the same experience as societies in urban industrial areas or areas where this heavy sickness claim is concentrated. In rural areas one does not find the same weight of expenditure. We cannot attribute it, however, to a difference of administration between one society and another. Further, he raised certain questions regarding the Pensions Act, and notably the case of the wives of old age pensioners between 65 and 70. He will realise, I am sure, that this hinges on the fact that these are contributory insurance Acts and that benefits are paid in return for premiums. It is difficult and well-nigh impossible, without falsifying the whole structure of the Act, to make an alteration which will bring within the ambit of the Act those on behalf of whom no premium has been paid.

In general, while it is necessary to deal as sympathetically as possible with hard cases, yet wherever you draw the line hard cases will be met. Wherever you shut out persons and bring in persons, wherever you draw the line between these two—you are bound to find a feeling of hardship. He asks whether there were cases of anomalies which might be dealt with administratively without any legislative change. I do not think that the Act has been running long enough for any striking cases of anomalies to arise which could be remedied by administrative action. Wherever there may be cases that he or other Members of the House may bring to my right hon. Friend or myself, we shall try our utmost to examine them and see whether they are cases which can be remedied by administrative action or by subsequent legislation. But the Act must remain a Pension Act giving benefit in return for premiums paid. We have to remember that as the Act continues to work a greater proportion of the insured population will be brought within it, and these particular cases, the hard cases to which reference has been made, will by the nature of things become less.

He raises one or two particular points such as the establishment of the age of people and in particular of the establishment of age with regard to Irish claims. With regard to that, the Board do their utmost not to dismiss lightly the claim of a person of Irish birth, because we know it is impossible for such a person of present pensionable age to produce any regitration of the fact that he was born in such and such a year. As the hon. Member knows, correspondence has frequently taken place for weeks and indeed for months at a time with parish priests or with people of authority in Northern and Southern Ireland where the Boa-d has made every effort to obtain some evidence of age, either through marriage or through another claimant born previously or subsequently, or even by the recollection of unusual events. There is a ease in the Board of Health report which may have been brought to the notice of the hon. Member, where an old man was given a pension although the only ability to establish dates was that he remembered threepenny pieces coming into circulation while he was attending school.

Mr. HARDIE

Do not forget that it was the English people who made the threepenny bit.

Major ELLIOT

We were talking of whether people remembered things clearly when the question of registration did not apply. He raised a point of some difficulty, which has required more consideration than one would like, as to whether there had been any evidence of men having been dismissed from employment on having reached the age of 65 because a pension was available at that time. I do not think that we can say as a Board that we have had any evidence brought to us to indicate that such dismissals were taking place or had been taking place, but, undoubtedly, companies and others, considering that their employes had reached pensionable age, it may be are more apt to bring that age to 65, because of the existence of a pension, than they would have been otherwise. That is one of the difficulties which is inevitable in the introduction of a pension scheme, but, undoubtedly, it is not a matter which can be met by legislation. It is a matter for supervision, for bringing up hard cases and for reviewing those cases, where necessary, and making sure that in this section of society an Act which was intended to bring a benefit does not, in fact, make the position of certain individuals worse.

Mr. MAXTON

Why do you not caution the employers?

Major ELLIOT

We do that when we find that over a long-continued period some transgression has been taking place, but I do not think the hon. Member for Bridgeton (Mr. Maxton) would suggest that the necessity to caution and to give good advice is a thing which needed bringing to the notice of any Scottish Board.

Mr. MAXTON

I make the very definite assertion that while in your report you take steps to warn the parish councils that they must not be too generous to the poor people, you do not take any steps to warn the employers against the meanness of reducing the wages of their workers when they reach the age of 65.

Major ELLIOT

The hon. Member cannot have done us the honour of listening to the discussion which has been proceeding between my hon. Friend the Member for Leith (Mr. E. Brown) and myself. The question which the hon. Member for Bridgeton raises was not mentioned at all. The question which I was discussing with my hon. Friend was the question of the termination of employment at 65, and the hon. Member for Bridgeton will admit that as a policy that has been frequently advanced from his side of the House as a panacea for certain of our difficulties in the coal mines. The hon. Member must not raise some totally different question and then resent my comments on the question which he actually raises. We are now discussing the question of dismissals on the account of a man reaching the age of 65 where he becomes a beneficiary under the Pensions Act. In fact there is a warning in the Report that the Pensions Act may produce a certain difficulty for some of the pensionable population, instead of benefit. The preliminary warning is actually given in the Report, but no definite statement is made because no definite action had so far been brought to our notice. There is the preliminary warning that hard cases may arise.

Mr. MAXTON

You know that they have arisen.

Major ELLIOT

The other point which my hon. Friend the Member for Leith raised was in reference to the ex-service men. He asked about the position of the disabled ex-service man in regard to the pensions scheme. The Regulations lay down that: On discharge from the Forces, a man resumes his right to all the ordinary benefits in respect of health insurance, except that in the case of a man who receives a pension in respect of disablement in the highest degree, or an alternative pension, or an allowance in place thereof, on account of incapacity due to service in the late War, the rate of sickness or disablement benefit is reduced, as explained in K. above. That is a provision against the drawing of a double pension. The man who is in receipt of a whole-time pension when he is out of the Forces is out of insurance, but if he enters insurable occupation and works himself into insurance again then he is able to be an insured person. When he is out of the Forces and is drawing a full-time disablement pension only, then he is not eligible for the full-time benefit because he is already drawing one full-time pension and it is not the intention of the Government in any case that a person should draw from two alternative sources.

The hon. Member also dealt with the question of housing. This was also dealt with by several other hon. Members and the hon. Member will excuse me if I deal with it only in a very general fashion. The hon. Member said—as did other hon. Members, and notably the hon. Member for St. Rollox (Mr. Stewart), who spoke with his accustomed earnestness and knowledge on this subject—that the problem of the slums remained one of the gravest problems with which Scotland was faced. The hon. Member for Leith raised the question particularly of the standard which was being adopted and he asked how many houses would be needed and what were our standards. The number of houses needed was put down by the Board of Health at 10,000 per annum, and in doing so it did take into account wastage and the houses needed for the increase in the population. I agree that the number of houses needed depends very largely on the standards which one lays down. We have found time and time again that he standards of one generation are regarded as wholly unsuitable by the next.

At the present time it is quite true that we might be able to classify a much larger number of houses in Scotland as unfit for habitation, but let us deal with first things first. There are many houses in Scotland that not only we regard as unfit for habitation, but our fathers and grandfathers, and I think sometimes the very savages in the fields, would have classified as unfit. Those are the houses that we want to get rid of, in the first place, and until we make a beginning with them it is useless to reclassify houses and say no houses are satisfactory unless there are three rooms with bath room, water closet, and other modern conveniences.

We have clone our utmost to impress on the local authorities who were building houses that people at present are suffering acutely not only from unsatisfactory houses, but from overcrowding. The hon. Member for St. Rallox raised the question of two-roomed houses. That was a description of the Glasgow scheme, and not a statement of policy by the Board itself. It was an Appendix describing the Glasgow scheme. It was, I thought, clear it was a statement of the Glasgow position and not the enunciation of a policy by the Scottish Board of Health. The hon. Member commented on the fact that there was a large proportion of two-roomed houses allowed. It is quite true, but the lion. Member himself supplied the answer to that in his next paragraph, where he said that of the 2,000 families inspected a large percentage were living over two families in a house. You have two families living in a room in a two-roomed house, but if you can separate them and see that each family has two rooms, separate water closet and bath room, you make a tremendous advance in the life of the people, and we have no right to say that nobody shall have any new house of his own at all unless it is a three-roomed house with bath room, scullery and other offices. We are dealing with abnormal circumstances, and we have to permit anything and everything which will raise the standard of housing in that city. I would permit one-roomed houses if necessay to do away with the desperate and inhuman overcrowding which is going on in some parts of Glasgow to-day.

Let me now come to the question of the subsidy. We have been asked what the position is with regard to it. The Secretary of State has explained to the local authorities that he has secured a two years extension over that which was given in England. A cut took place in the English housing subsidy. No cut took place in the Scottish housing subsidy, and we have the assurance that no reduction is to be made until the 31st of March. We can trust the Secretary of State to put the case for Scotland at least as forcible as he did last year.

Mr. MAXTON

We cannot do anything of the sort.

Major ELLIOT

The majority of the Committee can and has done so. The case for Scotland has been sympathetically considered in the past and will be sympathetically considered in the future.

Mr. MAXTON

Why cannot you make an announcement of policy now and give the local authorities a chance?

Major ELLIOT

I remember what was done by the Opposition when an hon. colleague of mine made an announcement of Government policy. I remember how much of the time of the House was taken up in attempting to get a withdrawal; and Under-Secretaries are much more chary of making announcements now. Finally the right hon. bomber for Ross and Cromarty referred to the subsidy for the Highlands and Islands Medical Services. There again the subsidy will have to be reconsidered. It is now £42,000 a year, but the Fund is drawing on its unexpended balances to make up an expenditure of £62,000 a year. The Secre- tary of State will again approach the Treasury, and I have no doubt that we shall succeed in getting a substantial increase in the statutory rate of that subsidy. We cannot in every case simply approach the Treasury for an increase in every one of our grants. We must look to every chance of saving money where we can. The need is greatest in special areas, but in all these things the case of Scotland is the case of one portion of the United Kingdom, not the whole.

Mr. HARDIE

It is the whole.

Major ELLIOT

The Report of the Scottish Board of Health is a review of the work of local authorities. It points out many directions in which that work needs to be expanded and in which it could be greatly advantaged by a better system of co-operation among the local authorities. All these things are being brought up and considered and dealt with in the great financial Measures now before Parliament. We are bringing forward positive schemes dealing with the difficulties in which local authorities find themselves, and I am proud to belong to a Government which has found it possible to tackle this great problem, which I have seen more than one Government try to tackle and fail.

Mr. WESTWOOD

I feel sure the Committee will be interested by the caution exhibited by the Under-Secretary of State—

It being Eleven of the Clock, the CHAIRMAN left the Chair to make his Report to the House.

Committee report Progress; to sit again To-morrow.