HC Deb 22 March 1929 vol 226 cc2006-10

Lords Amendment: In page 13, line 20, at the end, insert: Provided that any such council or authority may, by agreement with the governing body of any association or fund established for the purpose of providing benefits to members or other beneficiaries thereof, accept from the association or fund, in respect of the expenses incurred by the council or authority in the maintenance of any member or beneficiary of the association or fund, payment of such sums as may be provided by the agreement, in lieu of recovering the whole or any part of the said expenses from the member or beneficiary, or from any person legally liable to maintain him.


I beg to move, "That this House doth agree with the Lords in the said Amendment."

It will be within the knowledge of many hon. Members that there is a growing practice to form associations amongst wage-earners or persons not in receipt of large incomes to contribute regular sums weekly for the support of voluntary hospitals in their neighbourhood, who get in return treatment, where treatment can be given at those hospitals, when they require it, without their being asked to make any special contributions towards the funds. In more than one place there has grown up a practice which I think is rather doubtful from the point of view of its legality, but which certainly is not undesirable in itself, to include among the hospitals in such schemes, Poor Law hospitals. In a case which came to my notice last year, a sum of very nearly £10,000 was paid to the guardians in respect of services rendered by a Poor Law hospital. Now that Poor Law hospitals are to be taken over by the local authorities, the county and borough councils, it seems desirable that we should regularise this procedure and make it possible in future for the associations to pay a sum to the local authorities which otherwise would be recoverable from the patients, where those patients have become members of an association of this sort. That is the purpose of the Amendment.


I desire to draw the attention of the House to the extraordinary capricious and unsatisfactory manner in which we have now left this method of obtaining remission of relief. I must point out the anomalies which will arise from the operation of this Amendment read in connection with the original Clause. Under the old Acts a public health authority may remit the costs to a patient, and under the old laws a Poor Law authority may recover. The word in the Poor Law Acts was "may," not "shall," although the Minister of Health assured the House that the Poor Law authorities were under an obligation in this matter. We start with a state of affairs in which the poor law authorities "may" recover contributions. There is nothing whatever about their being under an obligation to do so. The word in the Poor Law Acts is "may," not "shall," and the word in the Public Health Acts is "may," not "shall." We then imported the word "shall," and applied it alike to public health authorities and to poor law authorities. We changed the word "may" to "shall" in both instances, and imposed a general order on public health authorities and on poor law authorities that they should recover as much of the cost of treatment as the patients or their relatives could reasonably afford. Now we are going to make an exception and to restore the old position of Poor Law authorities and public health authorities in the one case in which a person is a member of an association of some kind or other.

I am very glad to let anybody off; I am glad to restore the old position under the Poor Law Acts or the Public Health Acts in any single case. I am delighted that local authorities in England are to be in the same position as local authorities in Scotland with regard to any single class of persons. If the right hon. Gentleman had put in an arbitrary distinction, removing certain people from the operation of the present laws, I should have been delighted; butt the people whom the right hon. Gentleman is relieving from the obligation to repay and from the necessity of an inquiry into their circumstances, are not the poorest class in the land. When we are dealing with voluntary societies everybody knows that lapsing of payments is one result of poverty and illness. You may have two people in the same street, one in comfortable circumstances who has been able to keep up his payments to his voluntary society, and the man next door who is unable to keep up his payments. In the case of the man who is pretty well off no questions will be asked as his subscriptions will cover him, but in the case of the poor fellow who has been forced to let his subscriptions lapse, the cruel obligation of recovery imposed by the original Clause and the necessity of an inquiry into his circumstances will be enforced. That is an entirely irrational proceeding.

I want to know something about these societies. If the right hon. Gentleman had said approved societies I could have understood it, but even if it is a question of an approved society making a contribution to a hospital, it will be the comparatively rich society which will be able to do so; the extremely poor approved society will not be able to afford these benefits for their members. So far as approved societies are concerned, the distinction will benefit those who are comfortably off as against those who are less comfortably off. And what sort of a society is it? It does not say an approved society. It might be the annual goose club, or any little hole and corner rat-catching society. The Clause is badly drafted. If we were dealing with approved societies—


The hon. Member is discussing the whole Clause. She must confine her remarks to the Amendment which it is proposed to add to the Clause.


I was discussing the Amendment. I was dealing with those associations on whose behalf contributions will be accepted. There is no distinction. If you take approved societies, it is those which are best off which make these contributions; the poor approved societies cannot make them, and their members do not get these extra benefits. I am speaking of the associations which may make contributions to a hospital. Approved societies which are well off give their members medical benefit, but approved societies supported by groups of poor persons cannot afford these additional benefits. Therefore, there will be a distinction between the members of a rich approved society and the members of a poor approved society. Then the persons who make extra contributions to some societies will be those who are more comfortably off, who will be able to keep them up, while poor people will be unable to do so. The whole effect of the Amendment is to take out of the present provisions the class of people who are tolerably well off. I look back with regret to the absolutely simple state of the law before the Amendment was introduced and before the Clause was modified, when the poor law authority might remit the charge if they pleased and the public health authority might charge if they pleased. The Amendment is a confession of the folly of the original Clause and I hope it will undergo an amendment in another stage.

Question, "That this House doth agree with the Lords in the said Amendment," put, and agreed to.

Subsequent Lords Amendments, to page 14, line 7, agreed to.