HC Deb 23 May 1928 vol 217 cc2012-40

I beg to move, in page 29, line 23, to leave out the words "at least one-half," and to insert instead thereof the words "two-thirds."

9.0 p.m.

The right hon. Gentleman has had rather an easy time up to now, but we cannot promise him quite as easy a passage from this moment onwards. This Schedule amends several Sections of the original Act, and goes on to state: The seamen's special fund shall be vested in and administered by a body or bodies constituted in accordance with a scheme to be prepared by the joint committee, after consultation with the Board of Trade, and comprising persons representing shipowners and masters and seamen. Now comes the point to which I wish particularly to direct the attention of the right hon. Gentleman. It says: Provided that at least one-half of the governing body shall he representative of all classes of persons entitled to benefits out of the fund. We want to alter the "one-half" to "two-thirds." If the Bill passes as it now stands, it will be one-half shipowners and one-half seamen, but we want two-thirds seamen and one-third shipowners. I was not very much opposed to the words as they now appear in the Schedule until I read the Report of the Royal Commission on the subject, and I am convinced that the right hon. Gentle- man and his Department are in this case, at any rate, violating an understanding—it may be a silent understanding—which was arrived at in connection with the Royal Commission. Up to now what is called the Lascar Fund, which is made up of contributions of shipowners in respect of lascars, who can never receive any benefits—[HON. MEMBERS: "Lascars and others!"] Yes, but in the main they are lascars, and it is called the Lascar Fund in consequence.

In this fund there is at the moment nearly £1,000,000, and it is managed by six persons representing seamen and three representing shipowners. Out of the six persons representing seamen, the right hon. Gentleman and his friends will have it that three, because they represent seamen's approved societies, are thereby representing jointly the insured and the employers. Surely that is a new doctrine. Let me take, for the sake of my argument, the case of the average approved society. I happen to be the secretary of an approved society with 36,000 members. If I attend a conference on behalf of my approved society anywhere, does the right hon. Gentleman mean to say that, in my capacity as a delegate from my society, I am representing the employers, my members, and the State? I say, "No," definitely. Whenever I am sent as a delegate on behalf of my Society, it is always understood that I represent the membership of my society and their interests, and nobody else. I have attended conferences, at the Ministry of Health, of approved societies' associations, and this is the first time that I have ever heard it stated that a delegate from an approved society, when he is speaking on behalf of his society, is speaking on behalf of the three parties to the contributions, namely, the insured persons, the State, and the employers. I say, therefore, that the claim of the right hon. Gentleman is not a good one, and I want to lay it down very definitely that the board of management of the Seamen's Special Fund shall have three representing the shipowners and then, on the other side, six representing directly the seamen, and nobody else.

I agree that there is a change in the method of collecting contributions. I agree, too, that under the new scheme the position of the workmen in this case is altered considerably. He is no longer an insured person in the way that has already been indicated, but the employer is compelled by law to pay contributions in respect even of exempt persons employed by him, and it is no argument to say that, because he is compelled to pay contributions by law, he must have half the representation on the board of management of this fund. I could almost understand the State coming in and claiming some representation, but I submit—and this is the strongest point I want to make—that the people mainly concerned are the beneficiaries of the pensions payable out of the fund, and the persons who get benefit out of the fund are much more concerned than the people who pay contributions into the fund. The argument of the right hon. Gentleman that there ought to be a 50–50 basis, is equal to saying that no approved society ought to have its affairs administered unless the empoyers come in in respect of the contributions which they pay. There are some approved societies with 5,000 members, all employés of one firm. I have never vet heard is stated, or suggested from any quarter, that, because the employer pays the contributions under the State Insurance Scheme in respect of the 5,000, they must sit on the committee of management of the approved society. No employer has any right in any approved society to have any say in the benefits of that society.


In the approved society the hon. Gentleman has in mind, quite rightly the employers are not represented, but, if he will look at Section 63 of the Act of 1924, he will find there that the Seamen's National Insurance Society is constituted in a different way altogether from the other approved societies, and also that the affairs of the society shall be managed by a committee constituted in accordance with a scheme … comprising representatives of the Board of Trade, of shipowners, and of members of the society, in equal proportions. It is because this is a special society in which employers are represented that I have always put forward the contention, which I think is correct, that when these representatives sit on the governing body of the fund, they do in fact represent both employers and employed.


It is beyond my comprehension to find the right hon. Gentle- man and the Minister of Health, when it suits their purpose, turning to what they call the Charter of the Insured—the original Act. I wish they had carried out that idea throughout. When it came to the Economy Bill, and taking money from the insured people, the Charter of the Insured counted for nothing. I protest, therefore, that when it suits the right hon. Gentleman, he calls the original Act the Charter of the Insured, but it does not matter when the Government want to destroy part of that Charter. Let me follow this point a little further. The right hon. Gentleman has said several times to-day that the Royal Commission has declared this and that, that the members of the Commission are experts and have received advice and evidence, that they have sat for years, and that their recommendations must be regarded as sacrosanct; but on this point there is no recommendation at all. If the board of management of this fund was to be changed the suggestion ought to have been put before the Royal Commission, and dealt with by them; but what do we find on page 231 of their Report? Sir Walter Kinnear made the suggestion that there ought to be a change in the method of dealing with the contributions of these people, but there is nothing in this document, which is regarded by the right hon. Gentleman when it suits his purpose as a Bible, a New Testament and a Book of Common Prayer, to support the present proposal, and we are entitled to protest against the new proposal which was put into the Bill upstairs.

I move this Amendment in order to do the fair thing by the seamen, because this is the first time that employers have ever asked for representation in the administration of any benefits under this scheme at all. If the reply is forthcoming that this scheme differs from the ordinary approved society, my contention is that the method of taking the contributions is exactly the same, and I do not see why the employers should have a greater right to a part in the administration of this Fund than if they claimed to do so in connection with an approved society. For these reasons, I hope that the House will revert to the status quo. I am not asking for anything new. This Bill does put something new into the scheme, and I have my own suspicions from whence the suggestion comes. The Government are more or less in the hands of the shipowners. They are in the hands of every capitalist group in the country, and anybody who knows anything of the political history of this country knows that much. I move this Amendment in order, as I said, to revert to the status quo. It is the right hon. Gentleman and his friend who brought in the first Amendment to get what is called the fifty-fifty basis. I want to revert to the two-thirds on behalf of the work-people, and one-third on behalf of the employers, and thereby get what I think is the right proportion, because, after all, it is not the employers who pay contributions who have the most say in this connection, but the hundreds of thousands of old people who become the beneficiaries under the scheme.


I beg to second the Amendment.

The right hon. Gentleman will by this time have seen that there is no justification for the alteration that is being made, by the proposal in this Bill. I hope that he will realise that it is the people who are the beneficiaries under the Act who ought to form the major portion of this particular Committee.


Why not say all?


I would be prepared to say that, and if the hon. Member will move an Amendment to that effect I am ready to follow him into the Lobby in support of it. There have been endeavours with regard to other funds concerned with Unemployment Insurance and Health Insurance for employers to secure a representation, but I am convinced they are not entitled to it. I trust that, even in spite of what was said upstairs in Committee, the right hon. Gentleman will agree that two-thirds of the representations should be given to the insured people.


I have just refreshed my memory as to what took place in Committee. I thought we came to an agreement on this matter. Certainly no Division was challenged, and, so far as I am able to observe, everyone seems perfectly satisfied, except, of course, the hon. Member for Westhoughton (Mr. R. Davies), and I cannot recollect him ever being satisfied with the conclusions we reach. I thought the proposal in the Bill was reasonable. Half are to represent the employers and half the seamen. It is only fair to point out that the whole of this fund is derived from the contributions of the shipowners. Surely that has a little bearing upon this not very important problem, and I think it ought to be stated. As the employers are finding the whole income of the fund, I could have understood a contention being put forward that they ought to have more than half representation, but, so far as I know, that has not been put forward. Let us look at the old position. I know the hon. Member for Leith (Mr. E. Brown) is very anxious to talk about Section 64 (2) and Section 63 of the old Act, and this is the old position. Under the old management of the fund there were nine members, three being appointed by the shipowners, three by the Seamen's Union, and three by the committee of the Seamen's National Insurance Society.

Where the hon. Member for Westhoughton, who does not often make a, mistake, went wrong in his speech was in saying there was no approved society which had employers on the committee of management, and that, therefore, you could not say that these three individuals representing the Seamen's National Insurance Society represented the employers and the men as well. As a matter of fact, he had forgotten, quite naturally, because it is difficult to remember everything in this scheme, that this Seamen's National Insurance Society was specially constituted and that representation was given to the employers on the Committee of this particular society. Therefore, I do not think it is unreasonable to say that when these three people went to help to administer this fund, they were equally representing employers and men. This matter is not one which is going to shake the scheme to its foundation, but with the suggestion that half should represent the employers and half the men I thought everyone was perfectly satisfied in Committee, with one or two exceptions. I do not think we need unduly delay our proceedings over this not very vital matter, because, so far as I am aware, the committee of this society is not ranged into opposite camps, and I think they act in the general interests of the society; but when we come to choose the figures I think it is not an unfair thing to give half to one side and half to the other.


I think the right hon. Gentleman was a little too definite in the concluding part of his speech. If the representation is divided between three sections, I believe it is done not on the basis of this schedule but on the basis of Section 64 (2) of the old Act, which I will now read to the House, because when the right hon. Gentleman unintentionally went on to 63 (2) he misled the House. It is perfectly true, as he says, that Section 63 does arrange for a special board to manage the affairs of the society, but an entirely different arrangement was made under the Act of 1924 for the management of the fund, expressly and deliberately made in order that the insured person should have two-thirds and the employers one-third. Section 64 (2) states: The seamen's special fund shall be vested in trustees nominated under, and managed by a governing body constituted in accordance with, a scheme prepared by the joint committee"— that is the committee to which the right hon. Gentleman referred— after consultation with the Board of Trade, and comprising three representatives of shipowners and six representatives of insured persons"— I repeat, three representatives of shipowners and six representatives of insured persons— and the scheme shall provide for the representatives of insured persons being selected from the members of the society and of any other societies more than three-fourths of whose members are masters or seamen, as nearly as may be in proportion to the membership of those societies respectively. I submit to the House that the case for the Amendment is made out on two grounds, first that when the law was framed in 1924 it was obviously the intention of Parliament to give insured persons two-thirds of the representation and the owners only one-third, and, secondly, by the speech of the right hon. Gentleman, who has admitted that of the nine persons now managing the fund the insured persons have, in fact, two-thirds. It is quite obvious that while the shipowners pay the contributions of these seamen, lascars and others, who are not domiciled in this country, and, therefore, not insured persons under the Act, yet the administration of the fund as apart from the society is a very vital thing to insured persons, because difficult and delicate problems have to be settled as to which disabled persons or old people are to get these benefits, and it is quite obvious that the representatives of insured persons must have more detailed knowledge of the people deserving benefits than do the representatives of the owners, although these may provide the fund. Unless I can get a very much better reason in favour of the Schedule as it now stands, I shall propose to vote in favour of reverting to the provisions of Section 64 (2) of the Act of 1924, which the right hon. Gentleman did not see fit to read in his speech.


I am very glad the hon. Member for Leith (Mr. E. Brown) brought the right hon. Gentleman back to the original position which provides for the government of this special fund. Of course, I am aware that he said there were three from the Seamen's Society, but those three might be actual insured persons or might be some others, so that the alteration which he seeks to bring about under the present Bill means that the possibility of these three being actual representatives of the insured persons or insured persons themselves is eliminated altogether. With regard to his claim for a 50–50 representation, he said ship-

owners paid the whole of the contributions. That condition applies to other cases. The miners themselves pay their own contributions and 85 per cent. of the owners' contributions, but surely no one would suggest that the government of the affairs of approved societies for miners should be shared by the mine-owners. This is another attempt to alter the basis of the constitution of control under National Health Insurance. On the second Clause discussed to-night we had a Debate dealing with the control by insured persons of their own affairs. It has been very much limited under this scheme by the fact that that Clause was not accepted. Now we have another inroad made into this, and I say that this is really getting beyond the intention of National Health Insurance, because, after all, it is a scheme for insured persons to govern their own affairs, and, if we allow this kind of thing to go from one stage to another, as it is doing by these proposals which we are now discussing, then the democratic control which the Measure originally pint into operation will be taken away from the insured person altogether.

Question put, "That the words proposed to be left out stand part of the Bill."

The House divided: Ayes, 157; Noes, 115.

Division No. 151.] AYES. [9.27 p.m.
Acland-Troyte, Lieut. -Colonel Courtauld, Major J. S. Harvey, Major S. E. (Devon, Totnes)
Alexander, E. E. (Leyton) Cowan Sir Wm. Henry (Islingtn, N.) Haslam, Henry C
Alexander, sir Wm. (Glasgow, Cent'l) Craig, Sir Ernest (Chester, Crewe) Headlam, Lieut.-Colonel C. M.
Allen. J. Sandeman (L'pool, W. Derby) Crooke, J. Smedley (Derltend) Henn, Sir Sydney h.
Astbury, Lieut.-Commander F. W. Crookshank, Cpt. H. (Lindsay, Gainsbro) Hilton, Cecil
Atholl, Duchess of Davidson, Rt. Hon. J. (Hertford) Hope, Capt. A. O. J. (Warw'k, Nun.)
Atkinson, C. Davidson, Major-General Sir J. H. Hopkins, J. W. W.
Baldwin, Rt. Hon. Stanley Davies, Sir Thomas (Cirencester) Hopkinson, A. (Lancaster, Mossley)
Balfour, George (Hampstead) Davies, Dr. Vernon Hudson, Capt. A. U. M. (Hackney, N.)
Balniel, Lord Dixey, A. C. Hudson, R. S. (Cumberl'nd, Whiteh'n)
Barclay-Harvey, C. M. Drewe, C. Hume, Sir G. H.
Barnett, Major Sir Richard Edmondson, Major A. J Iliffe, Sir Edward M.
Beamish, Rear-Admiral T. P. H. Elliott, Major Walter E. Inskip, Sir Thomas Walker H.
Berry, Sir George Erskine, Lord (Somerset, Weston-s.-M.) Jackson, Sir H. (Wandsworth, Cen'l)
Betterton, Henry B. Everard, W. Lindsay Jones, Sir G. W. H. (Stoke New'gton)
Birchall, Major J. Dearman Fairfax, Captain J. G. Kindersley, Major G. M.
Bowyer, Captain G. E. W. Foster, Sir Harry S. King, Commodore Henry Douglas
Briscoe, Richard George Foxcroft, Captain C. T. Knox, Sir Alfred
Brocklebank, C. E. R. Fraser. Captain Ian Lamb, J. Q.
Brown, Col. D. C. (N'th'l'd., Hexham) Fremantle, Lieut.-Colonel Francis E. Lougher, Lewis
Brown, Brig.-Gen. H. C. (Berks, Newb'y) Gadle, Lieut.-Col. Anthony Lucas-Tooth, Sir Hugh Vere
Buchan. John Ganzoni, Sir John Luce, Maj.-Gen. Sir Richard Harman
Buckingham, Sir H. Gates, Percy Lynn, Sir R. J.
Bullock, Captain M. Gilmour, Lt.-Col. Rt. Hon. Sir John MacAndrew, Major Charles Glen
Cadogan, Major Hon. Edward Glyn, Major R. G. C. Macdonald, Capt. P. D. (I. of W.)
Cayzer, Sir C. (Chester, City) Gower, Sir Robert MacIntyre, Ian
Cayzer, Maj. Sir Herbt, R.(Prtsmth, S.) Graham, Fergus (Cumberland, N.) McLean, Major A.
Chamberlain, Rt. Hon. N. (Ladywood) Grant, Sir J. A. Macquisten, F. k.
Chapman, Sir S. Hall, Capt. W. D'A. (Brecon & Rad.) Makins, Brigadier-General D.
Cochrane, Commander Hon. A. D. Hamilton, sir George Margesson, Captain D
Colman, N. C. D. Harland, A. Marriott, Sir J. A. R.
Couper, J. B. Harrison, G. J. C. Meller, R. J.
Meyer, Sir Frank Salmon, Major I. Titchfield, Major the Marquess of
Monsell, Eyres, Com. Ht. Hon. B. M. Samuel, A. M. (Surrey, Farnham) Tryon, Rt. Hon. George Clement
Morrison-Bell, Sir Arthur Clive Samuel, Samuel (W'dsworth, Putney) Vaughan-Morgan, Col. K. P.
Murchison, Sir Kenneth Sandeman, N. Stewart Waddington, R.
Nail, Colonel Sir Joseph Sanderson, Sir Frank Waterhouse, Captain Charles
Nelson, Sir Frank Savery, S. S. Watson, Sir F. (Pudsey and Otley)
Newman, sir R. H. S. D. L. (Exeter) Sheffield, Sir Berkeley Watson, Rt. Hon. W. (Carlisle)
Nuttall, Ellis Sinclair, Col. T. (Queen's Univ., Belfast) Wells, S. R.
Penny, Frederick George Skelton, A. N. Williams, A. M. (Cornwall, Northern)
Perkins, Colonel E. K. Staney, Major P. Kenyon Williams, Com. C. (Devon, Torquay)
Peto, G. (Somerset, Froms) Smith, R. W.(Aberd'n & Kinc'dine, C.) Williams, Herbert G. (Reading)
Pilcher, G. Smith-Carington, Neville W. Wilson, R. R. (Stafford, Lichfield)
Price, Major C. W. M. Smithers, Waldron Windsor-Clive, Lieut.-Colonel George
Ramsden, E. Somerville, A. A. (Windsor) Withers, John James
Remer, J. R. Spender-Clay, Colonel H. Womersley, W. J.
Rentoul, G. S. Sprot, Sir Alexander Wood, E. (Chest'r, Stalyb'dge & Hyde)
Rhys, Hon. C. A. U. Stanley, Lieut.-Colonel Rt. Hon. G. F. Wood, Rt. Hon. Sir Kingsley
Rice, Sir Frederick Streatfeild, Captain S. R.
Roberts, Sir Samuel (Hereford) Sugden, Sir Wilfrid TELLERS FOR THE AYES.
Rodd, Rt. Hon. Sir James Rennell Tasker, R. Inlgo. Captain Wallace and Sir Victor
Ropner, Major L. Templeton, W. P. Warrender.
Rye, F. G. Thorn, Lt.-Col. J. G. (Dumbarton)
Adamson, Rt. Hon. W. (File, West) Hardie, George D. Saklatvala, Shapurji
Adamson, W. M. (Staff., Cannock) Hartshorn, Rt. Hon. Vernon Scrymgeour, E.
Alexander, A. v. (Sheffield, Hillsbro') Hayday, Arthur Scurr, John
Ammon, Charles George Hayes, John Henry Sexton, James
Attlee, Clement Richard Henderson, Right Hon. A. (Burnley) Shepherd, Arthur Lewis
Baker, J. (Wolverhampton, Bilston) Henderson, T. (Glasgow) Shiels, Dr. Drummond
Baker, Walter Hirst, W. (Bradford, South) Shinwell, E.
Barnes, A. Hudson, J. H. (Huddersfield) Short, Alfred (Wednesbury)
Batey, Joseph John, William (Rhondda, West) Sitch, Charles H.
Bondfield, Margaret Johnston, Thomas (Dundee) Smillie, Robert
Broad, F. A. Jones, J. J. (West Ham, Silvertown) Smith, Rennie (Penistone)
Bromfield, William Jones, Morgan (Caerphilly) Snell, Harry
Bromley, J. Kelly, W. T. Snowden, Rt. Hon. Philip
Brown, Ernest (Leith) Kennedy, T. Stamford, T. W.
Buchanan, G. Kenworthy, Lt.-Com. Hon. Joseph M. Stephen, Campbell
Cape, Thomas Kirkwood, D. Sullivan, J.
Charleton, H. C. Lawrence, Susan Sutton, J. E.
Cluse, W. S. Lindley, F. W. Thorne, G. R. (Wolverhampton, E.)
Clynes, Rt. Hon. John R. Lowth, T. Thorne, W. (West Ham, plaistow)
Compton, Joseph Lunn, William Thurtle, Ernest
Connolly, M. MacDonald, Rt. Hon. J. R. (Aberavon) Tinker, John Joseph
Crawfurd, H. E. Macdonald, Sir Murdoch (Inverness) Tomlinson, R. P.
Dalton, Hugh Mackinder, W. viant, S. P.
Davies, Rhys John (Westhoughton) Maclean, Nell (Glasgow, Govan) Wallhead, Richard C.
Day, Harry Malone, C. L'Estrange (N'thampton) Watts-Morgan, Lt.-Col. D. (Rhondda)
Duncan, C. March, S. Wellock, Wilfred
Dunnico, H. Morrison, R. C. (Tottenham, N.) Welsh, J. C.
Edge, Sir William Murnin, H. Westwood, J.
Edwards, J. Hugh (Accrington) Naylor, T. E. Wilkinson, Ellen C
England, Colonel A. Oliver, George Harold Williams, C. P. (Denbigh, Wrexham)
Fenby, T. D. Palin, John Henry Williams. David (Swansea, East)
Garro-Jones, Captain G. M. Paling, W. Williams, T. (York, Don Valley)
Gibbins, Joseph Pethick-Lawrence, F. W. Wilson, R. J. (Jarrow)
Gillett, George M. Ponsonby, Arthur Wright, W.
Graham, D. M. (Lanark, Hamilton) Potts, John S. Young, Robert (Lancaster, Newton)
Greenwood, A. (Nelson and Colne) Richardson, R. (Houghton-le-Spring)
Griffith, F. Kingsley Riley, Ben TELLERS FOR THE NOES.
Groves, T. Ritson, J. Mr. Charles Edwards and Mr.
Hall, F. (York, W. R., Normanton) Roberts, Rt. Hon. F. O. (W. Bromwich) Whiteley.
Hall, G. H. (Merthyr Tydvil) Rose, Frank H.

Bill read the Third time, and passed.


I beg to move, in page 30, to leave out lines 16 to 26, inclusive.

These particular words contain what is considered to be a definition of unemployment. It lays down that the Health Minister should leave it to the Ministry of Labour and the Unemployment Insurance Acts to decide the conditions that affect health insurance. Not only that, but it also lays down the counting of arrears as a disqualification for pen- sions. I think it is wrong for the Minister of Health to leave it to the Minister of Labour to decide these points, and the Ministry of Health should have a definition of their own that covers health insurance. They should lay down clearly what they consider unemployment is in the matter of arrears, and we ought not to allow one Act of Parliament to decide what should be done under another Act of Parliament. I can quite see that many of these people who would be deemed to be available for but unable to obtain employment in the legal sense by the Minister of Labour, would still be unemployed in the sense that their arrears ought to be counted as a disqualification for health insurance, and pensions would be affected later. For these reasons I claim that the Minister of Health should have his own definition of arrears, and that is why I have moved the omission of those words.


I beg to second the Amendment. Approved societies in the past have been in a position to give satisfactory reasons to the Government auditor in regard to unemployment, and the reasons supplied have been quite satisfactory. Now this duty is to be taken out of the hands of the approved societies and transferred to the Ministry of Labour. We have had a good deal of experience of what the Ministry of Labour consider to be genuine unemployment, and that Department has taken away much of our freedom and many rights we used to enjoy as approved societies. Five reasons were given by the Minister of Labour as to when a man is not supposed to be genuinely unemployed. You may have a young man applying for unemployment benefit and he may be living with his parents; but because the Ministry of Labour feel that the parents are responsible and not the Unemployment Fund, they say that that young man should not receive unemployment benefit and he goes out of benefit. After he has been out of benefit for a certain time he is removed from the register and he will be considered not to be unemployed for the purpose of being covered by this Act in the shape of arrears and other matters.

There is the point when the Ministry of Labour decides that a man would no longer be able to secure employment if times were normal. There have been many cases recently where men have been deemed not to be available for employment if employment was normal, and often these are men whom we know could commence work to-morrow if they had the opportunity. If this power is going to be put into the hands of the Ministry of Labour, and if that Department is going to be allowed to decide what is genuine unemployment and what is not, then so far as the National Health Insurance Act is concerned, their position is going to be very much weakened. This is a very dangerous provision in the Bill, and I hope we shall agree that the power shall be left in the hands of the approved societies who should be the bodies to decide these questions because they know the circumstances better than the Ministry of Labour. The officials of the approved societies receive the insurance cards; they know whether these men have been in receipt of compensation, and they know all about the other matters which are dealt with by approved societies. Consequently, the approved societies are in a much better position to decide the question than the Ministry of Labour.


The Amendment which has been moved by the hon. Member for Rochdale (Mr. Kelly) is founded on a misapprehension of the actual effect of the words which he has proposed to leave out of the Schedule. Both the Mover and Seconder of this Amendment have treated these words as though they made the Ministry of Labour the sole authority as to the interpretation of the words shall be deemed to be available for but unable to obtain employment. That is not the effect of the paragraph which says that certain persons are to be deemed to be available for but unable to obtain employment if they can prove that for the purposes of the Unemployment Insurance Acts, 1920–1927, they were, or would have been if they had been insured under those Acts, deemed to be unemployed. Therefore, we do not wish to restrict the definition but to extend it.

If this Amendment is carried, it will mean that a number of persons will be excluded from the benefits of Clause 1 and be without the prolongation of insurance and the excusal of arrears which will be given under the Bill if these words are left in. There are cases of persons now eligible for unemployment benefits who would not come strictly under the words available for but unable to obtain employment. A man who does an hour's work at some other trade in the evening would be brought in by these words, but, if they are taken out, he would be left out altogether. To use a common expression, I think hon. Members are "barking up the wrong tree," when they move to leave out these words, under the impression that they restrict the definition, because they do not do that at all, and they really extend it.


May I put the question to the right hon. Gentleman in this form? If these words are left out, wilt it still be competent for an approved society to determine for itself whether an insured person in that society is unemployed, without reference to the employment exchange for a definition of his unemployment?


I am not quite certain that it is correct to say that the approved societies can determine, but certainly the approved society could bring evidence if it could not be decided definitely whether the person concerned came under the Ministry of Labour's definition.


Let me pursue the matter by another question. Where the approved society has not the evidence of the employment exchange that an insured person is unemployed, can it take other evidence into account?


Oh, yes, certainly.


When the Contributory Pensions Act was going through the House, a similar question cropped up, as to a man being genuinely seeking work, in connection with the definition of a widow's pension, and, if my memory serves me rightly, the determination of that question was left to the approved societies. I presume that what the right hon. Gentleman means is that, wherever a person is deemed by the Ministry of Labour to be genuinely seeking work, he will automatically be classified as being a correct person to come within the scope of the Act. But does the last explanation of the right hon. Gentleman mean that a person who is refused by the Ministry of Labour is definitely refused as regards this Measure?


No, not necessarily.


I think that my hon. Friend the Member for Blaydon (Mr. Whiteley) was, if I may say so, slightly mistaken in what he said about young persons, because now, under the new Act, they are not disqualified if they live with their parents. That has been abolished. But quite a large number of people, under the new Act, will not qualify for the 30 stamps within two years, and they are automatically refused benefit if they have not 30 stamps within the past two years. It is, therefore, no use their applying for benefit, because they are automatically ruled out. Those people will not sign at the exchange, and the Ministry of Labour has no record either for or against them; it knows nothing about them, and so far as the Ministry is concerned, they have ceased to come under official notice. It is not fair, in my opinion, that the Ministry of Labour should be the judges as to whether people are genuinely seeking work or not. There is also the case of the person who, it may be, is working in a business for part of the year, and is working with a firm during another part of the year. He never really comes within the scope of the Unemployment insurance Act in the same way in which a regularly employed person does. I should like to know whether the right hon. Gentleman is quite clear that the judgment of the Ministry of Labour will only apply automatically in regard to allowing persons to be brought in, and will not apply to exclude anyone. I think that that makes a difference from our point of view.


That is absolutely correct. Where the Ministry of Labour does not give it, it will be for the society itself to decide, and, of course, there will be a great number of persons who, as the hon. Member says, do not come within the scope of the Unemployment Insurance Act, such as agricultural labourers and domestic workers.


Will those persons who partly come in be covered?

Lieut.-Commander KENWORTHY

Is not the trouble in regard to this matter due to the fact that the Ministry have not been very careful in drafting this Bill? When a provision of this kind is misunderstood by my hon. Friend the Member for Rochdale (Mr. Kelly), who is dealing weekly with these cases as a trade union official, and when he is led into a misunderstanding or difference of opinion with the Minister of Health, what chance has the ordinary working man? I must say that, reading the words very carefully, I do not think the English is very clear, and I think that the Minister of Health should be very careful to send out instructions to his representative explaining exactly what this provision in the Schedule really means.


In view of the statement of the right hon. Gentleman that the approved societies will have the opportunity of coming to a decision in these cases, I ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.


I beg to move, "That the Bill be now read the Third time."

I think we may congratulate ourselves that this Measure has had, on the whole, a very favourable reception, and that it has been recognised that the various provisions which it contains will result in considerable improvement in the administration of the National Health Insurance scheme. I do not forget that some hon. Members opposite have indicated at various stages that they would have preferred a Bill of a different character—a Bill which would have more widely extended the scope of the National Health Insurance scheme; but from the first we have made it plain that what we were endeavouring to do in the Bill was not to extend the scope of the National Health Insurance scheme, but, within its present financial limits, to improve the machinery, and, in particular, to give some relief in cases where relief was required.

I think it will be recognised that, under the provisions of Clause 1 of the Bill, the scheme offers very generous and liberal treatment to insured persons who, by reason of genuine unemployment—that is to say, by reason of the fact that they have been unable to obtain employment, though they were anxious to obtain it—have fallen into arrears with their contributions. As I explained to the House in moving the Second Reading, under the new provisions insured persons who have ceased to make contributions and have become unemployed will get, on the average, one year and nine months of free insurance with full benefits, and, if they can prove, at the end of that time, that they were genuinely unable to find employment during that period, they get another year of insurance, if not with full benefits, at any rate with a stipulation that their benefits shall not be reduced by more than one-half of the standard rate. They, therefore, get, on the average, between 2½ and three years after they have ceased to pay their contributions, if the reason for that cessation is the fact that they were unable to obtain work.

At the same time we have the provision which deals with the state of things under which insured persons who had fallen into arrears were penalised by reduction of their benefit. That is done away with by Sub-section (5) of Clause 1, and that, too, will, I think, be recognised as a very great improvement. We have also improved the position of the married woman who has been insured and who ceases to be employed upon marriage. She now will have the full sickness benefit of 12s., instead of a reduced benefit of only 7s. 6d., and there is no reduction in the maternity benefit. During the passage of the Bill through Committee, a provision was inserted, I think in Clause 10, under which insurance committees are able to contribute towards the superannuation of their officers and staffs, and that also is an improvement in the Bill.

We have had a good deal of discussion as to the administration of additional benefits. I think it has served to clear the minds of all who are interested in the subject upon that provision which dealt with the administration of benefits that are of the nature of medical benefits. It is clearly understood, and agreed now, that there are certain kinds of benefits which are of the nature of medical benefits, but are really not suitable for administration by insurance committees, or even solely by the approved societies.

We have to contemplate in future, particularly in the administration of clinics, some of which will be set up under this Bill, an arrangement under which there will be a joint representation of the professional men who are concerned in the carrying out of the service and the approved societies, and I hope, under the Regulations which will be made under the Bill, we shall be able to set up a more satisfactory administration of these benefits than we have been able to do in the past. That has given an opportunity to insert in the Bill a definite statement which embodies the assurance I have given more than once as to the right of the insured person to a free choice of his dentist or doctor. Under Clause 16 (3), there is a proviso which specifically states that Regulations are not to restrict the right on the part of any insured person to obtain treatment from any practitioner, clinic, or other institution with whom arrangements in respect of that form of treatment have been made in accordance with the Regulations. That we have always stated we regard as a cardinal feature of any arrangements that were made, and I believe that will receive general acceptance.

10.0 p.m.

The only other point I will mention is the question of specialist treatment. My right hon. Friend to-day has expressed the regret which he and I feel that it has not been possible to include an arrangement by which a specialist service could be provided for insured persons. I hold very strongly that that is the greatest improvement that could be made at this stage to the general scheme of National Health Insurance. I do not think it will be easy to exaggerate the importance of the addition of such a service as that in the interests of insured persons. I certainly hope that in course of time it may be possible to make arrangements under which we can ensure the provision of specialist advice, but the recommendation of the Royal Commission upon this subject was accompanied by a proposal that the specialist service should be obtained by means of a partial pooling of surpluses. That was not a proposal that commended itself to approved societies generally, and there is a considerable body of opinion in the House which will support the approved societies in that view. Therefore I did net feel that it was possible for us to put that forward in the Bill. But we have perhaps made some little advance towards it by adding to the list of additional benefits in the first Schedule No. 16, which deals with payments to approved charitable institu- tions where insured persons may get the benefit of specialist treatment, and as it was represented to us that that perhaps was a little unfair to the private practitioner or private specialist who ought to be allowed to give treatment if approved societies desired to offer an additional benefit which would enable treatment of that kind to be given, we have made an addition to paragraph 8 by which a service of that kind which is not within the scope of medical benefit may be made possible.

The treatment of the Bill in Committee and on Report has been characterised by a genuine desire on the part of Members in all quarters of the House to make constructive and useful suggestions for the improvement of it. I should like to make my acknowledgments and offer my thanks to Members who have really been of assistance to the Government in the interest of insured persons in effecting a number of genuine and definite improvements to the Bill. I hope now, after some comment which no doubt we shall have from the hon. Gentleman opposite, the House will see its way to giving unanimous approval to the Third Reading.


We do not propose to divide on the Third Reading, not that we are satisfied with everything the Bill contains—we never are, and it will be a bad day for the country when we are satisfied with all this Government is doing. The right hon. Gentleman has said quite rightly that the Bill has received very friendly criticism from all quarters of the House. The only time I have seen any anger at all on the part of hon. Members opposite was when I mentioned the Economy Act. Somehow of other they seemed to regard that as a red rag to a bull. Otherwise the proceedings have been more or less pleasant. The Amendment in relation to bankrupt employers will help the approved societies considerably, and the same applies to the abolition of Section 26 of the old Act. On that point I should like to make a suggestion. The right hon. Gentleman will be setting up clinics. I did not quite catch his words about freedom of choice of dentists and doctors. The insured person already has freedom of choice in respect of his medical practitioner.


I should have said freedom of choice as to his dentist as he already has as to his doctor.


What I meant was that in abolishing Section 26—the right hon. Gentleman knows my views on the abolition of Section 26—I am very anxious particularly in respect of South Wales that if any arrangement is set up we shall experiment in that part, because there are no additional benefits possible at all with some of the societies in South Wales. I would appeal to him to try to meet the case they have put to me, and probably to him as well. Under Section 26 they have a dental and an optical benefit of a kind. Now that we have cleared all that up and are going to do the thing on right lines, I would plead that if we are going to experiment in clinics, we might experiment where the need is greatest and where there is no chance of any additional benefits in the usual way. I am not quite clear yet as to what is going to happen in connection with opticians. Probably we shall be able to get that cleared up later on. I welcome the Bill from the point of view of the machinery of the approved societies. Every official of an approved society will be glad to see it becoming law. Its deficiencies, of course, are many. I had expected something more from the Government in amending the present law. I wanted to see something done in connection with maternity mortality and in connection with rheumatism and some of these new diseases that are cropping up. But anyway we are anxious to get the Bill through. It is just an instalment of what we ought to get. We do not propose to divide on the Third Reading.


On Third Reading of the Bill I would like to congratulate the Ministry upon the success which has attended their efforts upon a Bill which has caused a very great deal of satisfaction throughout the country. I wish to mention, however, that there is, perhaps, one section of the community who have viewed the Bill with certain suspicions, and who are still not quite happy as to what may in future years be the result. I refer, of course, to the medical profession. Before the National Health Insurance started there was a certain amount of friction and discussion between the approved societies and the medical men, and it was found necessary to include in the first Bill certain statutory provisions concerning medical benefit. That statutory right has been retained by the medical profession up to the present Bill. The Minister of Health has now withdrawn that statutory right, and given the profession the promise of Departmental Regulations instead. The medical profession, rightly or wrongly, feel that a Statutory provision is of very much more value to them than any Departmental Regulation. I tried in Committee upstairs to get that view accepted, but was unsuccessful. I would like to point out that the medical profession view the present Measure with a certain amount of I hardly like to say suspicion, but with slight misgiving, although we have absolute confidence in the present Minister of Health. If I may say so, we recognise that he will hold the scales absolutely fairly between the medical profession and the approved societies, but the time may come, indeed it will come, when the right hon. Gentleman will not be the Minister of Health, and at that time the medical profession will be more or less in the hands of a Gentleman who may hold different views.

May I give the House an example of what I mean? It is possible that at some future date the Minister of Health may be a Member of this House with very strong views on co-operative societies, and may think that the co-operative system of trade is for the benefit of the community at large. He may honestly and sincerely think that the proper way would be for the co-operative societies to start a clinic either for eyes, ears, nose or throat, and then appoint their own doctor. He might be perfectly honest and well-meaning in his intentions, and under this Act he will be empowered to make regulations to enable that to be done. If such an unfortunate course were ever to happen, I am perfectly certain it would arouse again all that antagonism between the Approved Societies and the medical men which was so prevalent in 1911. That is a thing which we as members of the medical profession are particularly anxious to avoid. We are anxious that this National Health Insurance scheme should be a success, and that the insured persons should receive its full benefits. We recognise that that can only be done by hearty co-operation between the Approved Societies, the pro- fession and the State all working equally together for the good of the insured population. I am naturally particularly anxious that nothing should be said or done which would cause the slightest rift to occur between these three parties, and that we can hope that in the future this co-operation will be more pronounced than it has been in the past. We have to recognise that there have been difficulties, and we only hope that the Minister by his action has not increased those difficulties, but that he may be right in expecting that the present scheme will be a success and that our suspicions have not been justified.


I quite agree with what has been said as to the merits of this Bill as far as it goes, but I think we have a very reasonable complaint that it does not go nearly far enough. As an expression of the recommendations or an application of the recommendations of the Royal Commission it is extremely inadequate. The right hon. Gentleman the Minister of Health, in speaking about specialist services did not give a very clear idea of why these were not dealt with in this Bill. It is quite well known, the great importance that the Royal Commission placed on specialist services, and the right hon. Gentleman has indicated that he himself places the same value on these. I do not propose to take up time in emphasising that, but the fact is, that the Royal Commission did suggest a method by which specialist services could be carried out. While it is true, as the right hon. Gentleman said, that approved societies did not look enthusiastically upon that proposal, still if it were a right proposal, why did not the Minister of Health seek to carry it out? I would like to point out that Sir Walter Kinnear, who has control of the Health Insurance Section in the Ministry of Health and is a very great authority, as we all know, emphasised two years ago in regard to this matter that there is an urgent demand and a proved necessity for this specialist and consultant service. He then proceeded to deal with the financial matter and urged the importance and necessity of pooling as the Royal Commission suggested. While, no doubt, there are great difficulties, I think the Minister has been guilty of a lack of courage in not tackling this question. If it is desir- able and equally essential and certainly urgent that this specialist service should be provided, if there is no other obvious way of doing it, why is it not done in the way suggested by the Royal Commission and approved by others who have considered the subject? I think that as long as these services are not provided the National Health Insurance Scheme must be considered to be giving to the great mass of the population an incomplete and inadequate medical service.

The second point I would like to remark upon is that of maternal mortality, especially in the provision of midwives. As members of the Committee upstairs we tried by various Amendments to assure in the case of insured persons that their wives should have, in confinement, adequate midwifery service. At present money payment is very often used, and quite naturally often used, for some other purpose, and confinements take place without any medical or midwifery attendance. The Minister of Health and the Parliamentary Secretary and the whole Department of the Ministry of Health are extremely sympathetic on this subject, and they have in hand various schemes dealing with that matter. It was largely on that account that we did not on the Report stage press the point further, because we understand that some effort is being made by the Standing Joint Committee or one of its sub-committees to arrive at some method of achieving progress in this connection. While the problem of maternity mortality is very complicated and difficult, everyone is agreed that one thing to be done is to provide adequate midwifery attendance at the time of confinement. I do not know whether the Parliamentary Secretary is going to speak again to-night, but if he does the House will be glad to know whether any progress has been made in devising some method of seeing that the maternity benefit does take some form of midwifery attendance.

With regard to dental benefit, it has always been the practice up to now that dental benefit, like other additional benefits, was not provided until five years' membership had elapsed. The result is that we have had a very extraordinary position. We have had the school dental service, certainly a very inadequate school dental service, where the child could get dental treatment up to the age of 14 and then from 14 to 36 and up to 21 years there were seven years before there was an effective method of dental service. Dental service stands out specially as one of the services which should be given early and which young people require, because it saves a great deal of treatment afterwards. The unfortunate thing is that the present dental service for insured persons consists almost entirely of taking out teeth and supplying dentures instead of the service being, as it ought to be, that of stopping and making minor adjustments which would prevent these more serious things being required afterwards. It would not only be an economy ultimately—there are not many things that we can regard as an economy—but apart from the question of economy in dental service it would be an economy from the point of view of the general health.

I have made representations on that matter to the Minister, and I am glad to say that they are being favourably considered. I should be very glad to know if any decision has been arrived at. I know that it is a matter which does not come under statutory provisions but under Regulations for the administration of additional benefits. Can the Minister tell us whether anything has been decided which would make it possible for young people in regard to this one benefit to obtain attention for their teeth at or immediately after they become insured persons? That would be received, I am sure, with very great approval by all those who understand the subject, and I am sure by the officials of the approved societies. If something can be done on these lines we shall have very much greater satisfaction in this Bill, because I do feel that there is a tendency to concentrate too much under this scheme on the financial side and on the side of money benefits rather than on the providing of an efficient and comprehensive medical scheme for the insured person.


I do not intend to detain the House for more than a moment, but I do not think this Bill with its large extension of the scheme of 1911, should pass without a word from these benches. Hon. Members in all parts of the House have seen the scheme in working from 1911 right up to the present time, and have suggested all kinds of additions to it. I do not propose to make any contribution of that kind to the Debate, but I sincerely wish to congratulate the Minister on the step forward he has taken and to congratulate him without any reservation whatever. I hope the very difficult and delicate step forward which has been taken with regard to the fishermen will work out well in practice. When I was listening to the speech of the hon. Member for Royton (Dr. Davies) I could not help thinking of the paper which I only destroyed this Easter which I read before medical men and friendly societies at Torquay in 1911 on the Bill of 1911. Looking through that paper before destroying it I found that the first sentence read something like this: "This is a doctor's endowment Bill." It may not have proved to be quite that, but at any rate the fears and misgivings of the medical profession in 1911 were undoubtedly greatly exaggerated, and I hope the present fears are equally as exaggerated. I wish the Bill well.

Lieut.-Colonel FREMANTLE

I do not want to make many remarks after the full Debate we have had, but I should like to refer to the point raised by the hon. Member for Leith (Mr. E. Brown). The medical Members of this House always look at insurance Bills not from the point of view of the pockets of the medical profession but from the point of view of the health of the community, with which we are naturally specially interested. If the hon. Member for Leith had not destroyed the paper which he read in 1911 but had produced it in the House to-day we should probably find some glowing passages as to how that Bill was going to prevent disease, reduce sickness, and how there was a wonderful Clause in the Act of 1911 by which the death rate in those districts where it was high was going to be "straffed"—in the language of the War. I am sorry the hon. Member for Leith shakes his head. It shows that he was rather a rebel in 1911. On that point the Bill has not been as successful as we had hoped. I entirely agree with what has been said by some hon. Members to-night.

We have to remember that the insurance scheme is watertight, so far as finance is concerned. I myself am not immune from the general error of constantly trying to put a quart into a pint pot; trying to provide further benefits under national insurance out of the same amount of money. Definite contributions are fixed and, therefore, what we really have to do is to rearrange the distribution of the fund, which is a much more difficult thing than to suggest other useful benefits of one kind or another. From that point of view the question is: are we using these funds aright? Look at the way in which these funds are distributed and the way in which the additional benefits are divided, and you find that the first seven of these new additional benefits are cash benefits. All the way through the cash benefits loom infinitely larger than the benefits in kind. [HON. MEMBERS: "Why not?"] Somebody asks, Why not? Because it is a balanced Measure for the improvement of the health of the people, and it is balanced between two things—the need of giving financial relief at the time of distress, and the need of giving technical treatment for the cure, and still more for the prevention of the causes, of that distress. It is that combined purpose which was the basis of the insurance scheme, originally. If it ever leads in other directions, it is failing in its purpose. I fear that in the scheme now there is too much given in free cash distribution and not enough given in the actual treatment.

I particularly want to show how that applies to maternity. There are few things that appeal to this House and to the public generally so much as the problem of maternity. We are glad to realise that the Minister himself has paid special attention to this subject and has appointed a Committee, the names of whose Members we were pleased to see in to-day's newspapers. But look at what the Bill does. Statutory benefit was originally 30s. for maternity and no professional attendance. That was increased to 40s. in cash maternity benefit and no treatment. It has been increased still more. What is the additional benefit? Again cash treatment only, an increase of cash benefit, and it is commonly understood that the average is 46s. and no treatment. Originally it was suggested that the payment of cash to the mother would secure proper treatment, but I ask my hon. Friends who from different points of view know how this Act works, is it true that these people who receive that money do get the best treatment that can be provided and such as was intended? We know that it is not the case.

Upstairs in Standing Committee we proposed a rearrangement. We proposed that anyhow, if additional benefit were to be given to maternity in the form of cash, it should also be given in the form of professional attendance by the midwife or doctor, whichever was chosen. It was suggested that that should be an addition. What was the opposition? The Government opposed that proposal, Why? Because it was only an additional benefit and would very seldom be used. And meanwhile they were promising attention to the subject. It was pointed out that it would be infinitely more important to get a general benefit, general treatment, maternity service as a statutory benefit, than to give a few extra additional benefits that a few approved societies would use in the form of professional treatment. I hope, therefore, that if we are to have a reply on this Debate we shall get a definite statement on that point as to the rearrangement of the cash benefits under this Bill. It is on that point that those of us who look after the health of the community are concerned. We hope that we may get more and more a professional and proper use made of the limited funds, although great funds, of the insurance scheme, and it is in that hope that we welcome this Bill as a steady step forward towards the improved health of the people. In that sense I am glad to add my tribute to the Minister for the very great help that he has given in forwarding this Bill.


The hon. and gallant Member who has just spoken is much concerned about the fact that the majority of the benefits under the Bill are cash benefits, and he suggests that these benefits have been provided to the extent of neglecting maternity and specialist and general medical treatment. The association to which the hon. and gallant Member belongs, was the strongest factor in removing from the original Act a Clause which made possible a much better system of maternity and specialist and general medical treatment than is given under this Bill. In the original Act there was a Clause which enabled the workers of this country to form medical schemes and to co-ordinate different forms of medical treatment. There are schemes in existence—which will be wiped out under this Bill—co-ordinating maternity, dental, surgical and medical treatment. The Medical Aid Society has brought certain pressure to bear upon the Ministry of Health and the possibility of co-ordinating these medical services is now being removed. If hon. Members opposite are so much concerned about the medical treatment of the workers, they ought to assist in retaining the schemes already in existence which provide medical aid on the lines I have indicated.

There are certain approved societies in South Wales which, unless the Minister pays special regard to them, will be wiped out under the Bill. There are in the aggregate about 40,000 members of approved societies there and, at the present time, in consequence of the depression in the mining industry there are no disposable surpluses. Under the original Act they could send subscriptions to a charitable institution and through the medium of that institution they were able to provide certain additional benefits. Those charitable institutions have been abolished and in consequence there is no possibility of these approved societies giving additional benefits. I ask the Minister to take into consideration the distressed condition of those societies. If, as the hon. Member for Westhoughton (Mr. Rhys Davies) suggested, it is the intention of the Minister to set up clinics, one of those clinics should be established in South Wales or else there should be some scheme under the auspices, say, of the Insurance Committee for Wales, whereby the approved societies in the distressed areas would be able to compete for additional benefits with the other societies. In the event of failure to do that it is inevitable that a deputation will wait upon the Minister prior to the drawing-up of the Regulations and I trust, if that is found necessary, that the Minister and the Parliamentary Secretary will be prepared to meet a deputation from these approved societies and to consider what would be the best course to adopt.