HC Deb 22 March 1929 vol 226 cc1988-2006

The council of every county and county borough shall, when making provision for hospital accommodation in discharge of the functions transferred to them under this Part of this Act, consult such committee or other body as they consider to represent both the governing bodies and the medical and surgical staffs of the voluntary hospitals providing services in or for the benefit of the county or county borough, as to the accommodation to be provided and as to the purposes for which it is to be used.


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

This Amendment raises a matter of some importance, and was the subject of a considerable amount of discussion in another place. The purpose of the discussion was to try to ensure that there should be full and ample opportunities for the representatives of voluntary hospitals in any area, including not merely the lay members, but also the medical and surgical staffs, to offer their experience and their views before a local authority sets to work to revise its hospital accommodation. Perhaps I should say why, if we approve of this Clause, we did not ourselves insert it. I think our view was that consultations of this kind must necessarily take place, and we did not desire to put into the statute more than was necessary; but it became clear in another place that people of very considerable weight and standing in what I may call the voluntary hospital world were not satisfied that without some statutory provision there would be that measure of consultation with the representatives of voluntary hospitals which they felt to be not merely desirable but really vital for the proper development of the hospital service of the country in the future. With the object of this Amendment I have always been fully in sympathy. I have a very strong view that the assistance of the voluntary hospitals will be absolutely essential if the municipal hospitals, which will be reorganised and conducted by the local authorities in the future, are to be placed upon a proper footing. They start from a different level from the voluntary hospitals, and it will be a work of time and care and of tact to bring them up, generally speaking, to the same level as that attained by the voluntary hospitals. I am sure it can only be done by the exercise of co-operation and goodwill on both sides, and I hope the provisions of this Clause, under which a duty is laid on the local authorities to consult with bodies representative of the voluntary hospitals, will bring about that co-operation.

There is just one other point. It will be seen that the body which is to be consulted is— such committee or other body as they consider to represent both the governing bodies and the medical and surgical staffs of the voluntary hospitals. It will be said that perhaps there will be no such body in one area or another. I think it is quite possible that at the present time there is no such body in some areas. But, on the other hand, it is most desirable that there should be such a body, because voluntary hospitals would never be able to exercise the full influence which they ought to do upon the health and the institutional services of the area unless there is co-ordination among themselves, and unless there is some body which will represent the various hospitals concerned, and can speak for the whole of them when dealing with the local authorities. I regard this Clause, therefore, as one which is likely to have the effect of stimulating the formation of such representative bodies, and from that point of view I believe it to be a valuable addition to the Bill.


I think it is quite clear, if we are to make the best use of the hospital accommodation, that there must be consultation between the local authorities and the voluntary hospitals. At the same time I look upon this new Clause with a little apprehension. The right hon. Gentleman seems to be taking in hand a new organisation of the voluntary hospitals with a view to preventing the development of other public hospitals, but the words that alarm me particularly are those relating to the medical and surgical staffs of the voluntary hospitals providing services. It is perfectly right and proper, and I do not complain, that the local authorities, when working out their schemes, should consult the hospitals whose services are to be used, but I see no reason why that consultation should not have been confined to the representatives of the governing committees of those hospitals. Has the Conservative party now turned Syndicalist that public authorities have to call into consultation, whether they like it or not, the employés of the voluntary hospitals. If we had suggested in some of these new Bills that there should be co-operation with the trade unions, I am quite sure it would have been rejected by hon. Members opposite, but these very words have been put in by the most powerful trade union organisation in this country. It is perfectly true, as the right hon. Gentleman says, that this matter was brought forward by noble Lords who have had special knowledge of this problem, but it also happens to be true that the proposal was initiated and supported by very influential members of the medical trade union.

Lieut.-Colonel FREMANTLE

May I ask the hon. Member what he means by that? Does he mean the British Medical Association?


I mean the organised medical profession of this country.

Lieut.-Colonel FREMANTLE

Which organisation does he mean?


There is more than one, I understand, but I will take the hon. and gallant Gentleman's words, if he likes. I see no reason why he should be ashamed of his trade union.

Lieut.-Colonel FREMANTLE

I am not ashamed of it, but I want the hon. Member to be precise in what he says.


Well, to meet the hon. and gallant Member's wishes, shall I say the British Medical Association?

Lieut.-Colonel FREMANTLE

May I ask if Lord Dawson has anything to do with the British Medical Association?


I should think it very unlikely, but I should say at the same time that he is, no doubt, a loyal paying member of that trade union, and he is in a position to represent its case in the House of Lords. The real objection I take to this new Clause is not the consultation with the governing body because they are the responsible body and they are directly responsible to the locality. Why it should be made compulsory upon the local authorities to consult with the servants and committees of the voluntary hospitals I cannot understand, although I admit that many of those in charge of voluntary hospitals are public spirited men. Why should the local authorities not be called upon to consult their own medical staff, who have an equal right to be given representation on any committee for consultations of this kind? I am sorry that the Minister of Health should have lent himself to this new development of Sovietism in what is really a very Conservative profession.

It looks suspicious to me, and it seems to me that a body like the British Medical Association will oppose any arrangements which do not harmonise with their own professional interest. The governing bodies of many voluntary hospitals may be admirable for administrative purposes connected with their hospitals, but when it comes to a question of general policy it would be quite easy for them to unduly influence that policy through the specialists on their staffs. I think this new Clause gives cause for a certain amount of alarm, and I am sorry that the Government should have extended unnecessarily the number of people who are to be consulted on this question. No one would have objected to the council of the county of the governing body of the voluntary hospitals being consulted, although I fear that this is an attempt to make more effective the organisation of voluntary hospitals as against the growth and future development of municipal hospitals.

Major-General Sir RICHARD LUCE

I wish to say a word or two in favour of this new Clause. I regret that pressure of time prevented a similar proposal to the one we are considering being dealt with in this House. [HON. MEMBERS: "The guillotine."] However, the Amendments we put on the Amendment Paper were not reached, and another place has fulfilled a useful function on this occasion. We welcome this new Clause because we are deeply interested in the future development of hospitals, and because we feel that some sort of co-ordination should be established in the future between the voluntary system and the development of local government hospitals which is now sanctioned by this Bill and which is absolutely necessary in order to prevent a great deal of the overlapping which is likely to take place without the adoption of some method of co-ordination. I should have thought that the hon. Member for Nelson and Colne (Mr. Greenwood) would have agreed that consultation with the profession would be extremely useful in a matter of this kind. There is a vast amount of experience which has been gained by voluntary hospitals, not only in the matter of administration, but also in the matter of the co-ordination of work in the hospitals.

There is need for a separation of the different kinds of treatment. A vast amount of work is necessary in connection with reorganisation and co-ordination of the work of hospitals in order to secure that one sort of work is done by one hospital and another sort of work by another, and in such matters a large amount of medical advice is necessary. I think it is a little unfair on the part of the hon. Member for Nelson and Colne to imply that the medical profession should not be consulted in this matter. I think it is very much better that we should not be left to the scheme alone, but such a provision as that which is contained in this new Clause should be definitely laid down in the Bill. I welcome this Clause very heartily on behalf of those interested in the development of our hospital system, as an assurance that the wonderful old system of voluntary hospitals shall not be elbowed out and that a new development of hospitals will be the ultimate result. We owe to the Noble Lord who so eloquently and persistently urged the adoption of a new Clause of this kind another debt added to that great debt which the nation owes to him to-day and which the nation will never be able to pay to him.


I view this Clause with some slight apprehension. The Minister of Health who has asked us to agree with this new Clause put a certain poser to himself, and it was what will happen if the voluntary hospitals do not possess such a committee as that which is suggested. In that case what are the local authorities to do. Like Dogberry when he put a similar question, "What if they won't stop?" The right hon. Gentleman did not give us any real answer to that question, but he said the fact that they might form such a committee would have a salutary effect upon the voluntary associations. The right hon. Gentleman gave us no indication of what the local authorities were to do in a case where no such committee existed.

I think this is a very serious matter, because we are not really asking the local authority to consult this body, but we are instructing it to do so. The words of the new Clause are, "shall consult." Supposing the voluntary hospitals have no such committee as that which is described in this new Clause. In that case there is no obligation upon the voluntary hospitals under this Bill to form such a committee, and I do not see what the local authority is to do under such circumstances. Has the local authority to itself organise such a committee representing voluntary hospitals, or has it to run round to all the hospitals asking if they have such a committee? Supposing no such committee is formed, what is the position of the local authority? If the voluntary hospitals do not provide what is required, will the whole of the scheme being prepared by the local authority be held up? Is there any power vested in the local authority to get a mandamus to compel the voluntary hospitals to form such a committee? It seems to me that under this new Clause, the voluntary hospitals will be able to delay indefinitely or at any rate to hang up any suitable scheme proposed by the local authority. It must be realised that to some extent the voluntary hospitals and the institutions provided by the local authority are rival institutions, and that the voluntary hospitals will, to some extent, be anxious at any rate to delay the formation of institutions to be provided by the local authority.

I think this is a matter which requires very careful attention. I should not like to exaggerate, and I am not saying that the voluntary hospitals are not anxious that people should be attended to in the best way, nor am I going to say that the great bulk of them will not welcome such assistance from the local authority as may make the hospital accommodation more complete; but you will get cases, and it will be just in those cases that the position will arise where the voluntary hospitals will be jealous of any suggestion on the part of the local authority that the existing accommodation is inadequate, and that they propose to provide additional accommodation. Therefore, I think we need an answer to the question which the right hon. Gentleman himself put, but to which he has not supplied any answer.


I should not have ventured to intervene in this Debate unless it had been my lot to have to deal with some of the very questions for which this most admirable Clause is intended to provide. As a member of the governing bodies of two or three voluntary hospitals in a large city in the North, I have had to deal with these questions of co-ordination, which are absolutely vital and of the utmost importance. We have had definite cases of overlapping by different hospitals, where, by a little reasonable co-ordination, it has been possible to secure that each should confine itself to its own sphere of work. If anyone has any doubt on the matter, I am perfectly willing to give the names of two or three hospitals in Manchester which prove that up to the hilt. But the question which has been raised is not so much the question of consulting with the actual governing bodies of these hospitals, admirable as they are, and made up of business people, many of whom have devoted their lives and a good part of their fortunes to these objects. They are the best advisers that can possibly be had if it is desired that the work shall be done properly. In addition, however, the medical staffs must be consulted. They are the people who really know the points in question, and it is absolutely vital to have their views.

In the co-ordination of the hospitals in Manchester, we have had the loyal co-operation of those medical men who give a very large proportion of their lives to this kind of work, to a great extent voluntarily. I do wish that we could get rid of this talk about trade unions, and simply say that we want to get the work done properly by the right people who know how it should be done. Who are those people? I quite agree that it is very often best to leave the judgment in the hands of laymen, guided by the opinion which only the medical staffs of the voluntary hospitals can give. It is not only a question of healing, but also a question of research, of prevention, and of getting further knowledge. How is it possible to know what steps should be taken unless you consult the very people who have been doing the work for years in connection with voluntary hospitals in various parts of the country?

Then we must not forget, and I speak with some feeling on this matter, the question of the training of the medical men and the nurses. On that point I have come to the conclusion, after many years' experience, that the co-operation of the layman, the local authority, and the trained medical man is vital and essential, and I do think that, from all these points of view, it would be wrong if those who have had to deal with these very questions in practice under a large system did not say how grateful we are to those who have framed this Clause, and how grateful we are to the Govern- ment for having accepted it. We look forward to this Clause as one of the best possible aids to ensure that the right work is done in healing, research, adequate knowledge, and the proper training of those who have the care of sick people.


I am sure that the House will be surprised at the attitude taken on this matter by hon. Members on the benches above the Gangway. In my judgment, the issue is a very simple one; it is the issue of abstraction and theory as against practice. The hon. Member for Nelson and Colne (Mr. A. Greenwood) raised objection to action being taken in consultation with a trade union, but I should have thought that that would have been welcomed, and not opposed, on the benches above the Gangway. I was also interested to notice, a little later in the hon. Gentleman's speech, the grudging way in which he covered his tracks by dragging in a reference to the voluntary services of the members of that particular trade union. I should have thought that, if any reference had been made to the voluntary services rendered to the hospitals by medical men, it would not have been in any grudging sense, but with a full recognition of the magnificent work that they do for the sick and poor of the country. I am quite sure that the insertion of this Clause will allay the alarms which have existed, and which were not based on abstraction and theory muffled in robes of Sovietism and phrases of that kind, which may fill the mouth but do not illuminate the mind. Those of us who serve on the committees of voluntary hospitals know quite well that the bulk of the work done by those hospitals is in the direction of cure, whereas the work done by the other hospitals is more in the direction of prevention, and, if there is to be thorough co-ordination, some effective link is necessary between those who serve voluntarily and whose main work is done to cure sufferers from accident and sickness, and those who new undertake the task of bringing together all the forces that make for the healing and prevention of disease.


I am glad to find that the hon. Member for Leith (Mr. E. Brown) has said a great deal of what I wanted to say myself, as one who has been directly associated with voluntary hospitals for many years, regarding the ungenerous statements which have been made from the other side. I will confine myself to pointing out that the hon. Member for West Leicester (Mr. Pethick-Lawrence) surely has not read the Clause. He talks about the possibility of delay, and rather suggests bad faith on the part of the governing committees and medical staffs of the voluntary hospitals, but he fails to see that it is the county council or the county borough council that has to determine who it is that is considered to represent the governing body and medical staff. The council may come to the conclusion that there is no one that they can call to their aid, or, at any rate, they have such a wide discretion that it is impossible to say that public services will be delayed deliberately, either by the governing body or by the medical staff.


The hon. and learned Member has not understood what I said. I said that, supposing there were no such body—and it may perfectly well happen that there may be no such body—I wanted to know in that event what the county council were to do.


The county council will go to work without reference to that body. It is not conceivable, surely, that, in order to consult under this Clause, the county council should create a body in an institution with which they have no direct concern. As has been pointed out by my hon. and learned Friend the Member for the English Universities (Sir A. Hopkinson), it is only by voluntary effort and good will that these services can be made effective, and it is peculiarly ungenerous that such criticism should come from those who pretend to be the friends of the poor, who are the very persons to benefit by consultation of this sort, which will make the hospital service a reality without jealousy or bitterness. I sincerely hope that we shall not hear any more of this ungenerous criticism of the medical profession who give their lives to this work. All that can be said against them is that they have to buy their experience, and that really they are giving their voluntary services to the hospitals in order to gain experience for themselves, and, it may be, turn it into money in their private practice. That is the only way in which it is possible to depreciate the voluntary efforts of the medical pro- fession.When one knows what they do at all hours of the day or night on behalf of the poor, one can only resent very warmly the least suggestion that they are actuated otherwise than from the highest motives.


I presume the proximity of the General Election has led the right hon. Gentleman to make a speech which may or may not be calculated to bring in the suffrages of certain doctors.


The imputation of personal motives is contemptible.


The hon. and learned Gentleman ought not to impute motives.


I have no desire whatever to impute motives, but the right hon. and learned Gentleman accused us of speaking on behalf of the poor, when no-one had said a word against the doctors on this side, and I am entitled to draw attention to the fact that we are in close proximity to a General Election and that the irrelevant matter could only have been introduced for political purposes. There is no personal imputation on the right hon. Gentleman at all. I was rather surprised to hear the hon. Member for Leith (Mr. Brown) say we are concerned with abstraction and theory as against practice. I am concerned solely with the drafting of this Clause which it is suggested we should add to the Bill. Most of the discussion we have had this morning has been in truth abstraction and theory about the rights, status and qualifications of doctors, in which we all agree in giving them the greatest possible tribute, but after all we are here to consider the proposed Clause, and the question of the merits or demerits of doctors or anyone else has nothing to do with it. The first exception I take to the Clause is-this. It is a most unfortunate tendency, which has developed very rapidly, to overload legislation with minute and particular directions to particular bodies how they are or are not to carry on their duty. Even the hon. Member for York (Sir J. Marriott), who, I believe, in principle agrees with this consultation with the doctors, will agree that, other things being equal, the less minute directions you put into an Act of Parliament of a rigid kind dealing with a temporary situation the better, and this Clause seems to me, from the point of view of drafting, most offen- sive to that principle. The Bill is already complicated beyond all measure. There are directions, there are controls, there are conditions, there is every kind of device put into it to make it complicated and unworkable and, therefore, we should approach a clause of this kind with some suspicion. It is much better to allow local authorities to use their discretion and their wisdom in whom they will consult rather than to lay down Acts of Parliament rigid direction as to consultation.

In the first place, a consultation in itself means in law nothing at all. It is like that precious phrase which has crept so much into modern legislation, "shall have regard to" this, that or the other. It has no real legal meaning at all and it, therefore, merely confuses the law. But this Clause is even more objectionable than that, because it not only uses such a phrase as "shall have regard to," but imposes a direct obligation on the council of every county to do a certain act. It says they shall, when making provision for hospital accommodation, consult certain bodies. Then my hon. Friend the Member for Leicester (Mr. Pethick-Lawrence) asks pertinently, "What are you going to do if the body does not exist?" I do not thing the right hon. and learned Gentleman the Member for Ealing (Sir H. Nield) meets the point at all when he says that in that case it will carry on without it. The Clause says in terms that you are bound to consult this body. It gives no guidance as to where it is to be found or what body it is. "Consult such a Committee as it considers represents the hospitals and the staff." Is there such a committee in existence? There may or may not be. Those hon. Members opposite who understand more fully than I do the workings of the medical profession can tell us whether, in the case of most or all voluntary hospitals, there is a committee representing the governing body and the staff. There may or may not be, but there is not the slightest indication in the Clause as to where such a body is to be found or how it is to be constituted, or how you are to constitute it if it does not exist. Nevertheless, this uncertain, inchoate and doubtful body is to be consulted. What is going to happen if you do not consult it I do not know. My hon. Friend raised the question whether you could get a mandamus in a court of law to compel them to consult it. I am not on abstractions at all but on realities. If there is an obligation to do a certain act, how is it to be performed? There may be a case for putting an obligation within the Clause, but it is very badly drafted and utterly inapt to produce the result that is desired. You have to consult this committee which represents the medical and surgical staff of the hospital. What is the medical staff of the hospital? Does it mean the doctors? Does it include the nurses? Does it include the ladies who carry out the slops and do the subordinate medical and surgical work? There is no definition at all.

When this consultation has taken place, what is to happen? There is no provision as to what is to be done as the result of the consultation, whether they are to ignore it or to have regard to it. Again, are they to have a consultation with the medical governing bodies of every single voluntary hospital in the area, or are they to form one joint committee to represent all the hospitals? In a large city you get a number of hospitals. The real truth is that this is not legislation. This is journalism, as so many Clauses are. It is a Clause on which the right hon. Gentleman the Member for Ealing may hang a speech in praise of the doctors, with the sentiment of which we should all agree, but it is not really a Clause which would possibly be interpreted or administered in a court of law. In other words, it is meaningless, like so much modern legislation. One of the objects of legislation is to give directions to His Majesty's subjects how they shall behave, and to intimate to the courts of law how they shall interpret the law. Judged by such an object, and not merely by politics or journalism, this Clause means nothing, and I protest against the overburdening of a Bill, already far too complicated, with mere pious aspirations of this kind, which may or may not have political advantages but which cannot have any real legal result at all. If we must have such a Clause it should have the word "may" and not the word "shall." I have never in the whole of my experience known a Clause, or a part of an Act of Parliament, which has compelled one body to do an act when the machinery is not there in order that it may do it, and I am surprised that the right hon. Gentleman the Member for Ealing, who has such great experience of the administration of the law, should seriously tell the House that when someone is required by Act of Parliament to do something, and the thing he is required to do becomes impossible, there the matter may end. These people are compelled to consult the committees. There is no machinery for setting up the committees, and we ask what is to happen to an unfortunate county when it is compelled to consult a committee which does not exist.


The hon. and learned Gentleman has invited the House to approach this Clause with some suspicion. I ask the House to approach it with some sympathy and to give it its support. The hon. and learned Gentleman has given us what he thinks is the law, and the legal effect of the Clause. Happily, in another place many distinguished lawyers including men who sit upon the highest Appeal Tribunal in the country and judges of the land took part in the discussion. They devoted considerable time and discussion to the framing of this Clause. One of the Members who gave considerable assistance to the Government and who very earnestly desired to see some Clause of this kind placed upon the Statute Book was the Master of the Rolls.


Some Clause; not this particular Clause.


I prefer, if the hon. and learned Member for South-East Leeds (Sir H. Slesser) will permit me to say so, their view as to whether a Clause of this kind is likely to have any legal or practical effect rather than the view which he has just expressed. I have no doubt that the expression of opinion which I have taken will generally be accepted by Members in all quarters of the House. What is the object of this Clause? Will it have any legal effect? Is it merely waste paper, as the hon. and learned Gentleman says? The object of this Clause is a very natural one, and, I should have thought, a very desirable one, and it has been put forward in the interests of the voluntary hospitals of the country. They say, inasmuch as under this particular Measure new duties will be cast upon the counties and the borough councils in the provision of hospital accommodation, that before any new scheme can be embarked upon there shall be consultation with representatives of the voluntary hospitals and of their staffs with reference to the use to which such accommodation shall be put. I should have thought that the object of that would have been seen by Members in all quarters of the House.

No legal obligation is cast upon the local authorities to accept that advice, but I think it will again be generally accepted that when the local authorities enter into consultation with representatives of the voluntary hospitals of the country it will be a friendly consultation and one entered upon in order to do the best for the municipalities and for the hospitals of the country. My opinion of the local authorities is not that of the hon. and learned Gentleman. I do not for a moment think that this will be an empty consultation. It will be a consultation designed really in the interests of the poor and of the sick people of this country to avoid overlapping and to see that the very best provision is made to remove the difficulties from which the people are suffering at the present time. Obviously, this Clause is a very desirable one, and I think that it will receive the acceptance of the House.

The hon. Member for West Leicester (Mr. Pethick-Lawrence) asks: "What is to happen if there is no committee or other body?" That matter has received consideration, and consideration from the legal point of view also. From the point of view of the practical effect of this Clause, it is within the knowledge of the Ministry, and of most people who are interested in hospital work, that already there are in existence a very large number of associations in the various areas. Where there are no such associations at the present time my right hon. Friend is assured, and this House can be assured—and we have good evidence to the effect—that the voluntary hospitals in the areas where there is no such body or committee will see to it that one is formed. It is obviously in their interests to do so. They are not going to sit tight and lose an opportunity which is for their own advancement, and for the benefit of the voluntary hospital movement. Where there is no committee or body one will be formed.

12 n.

The only other point is a purely legal one. The hon. Gentleman will remember, as he followed the matter when this question was discussed, that when the Clause was originally drafted the words "if any" appeared in it. One of the greatest lawyers in another place, a man who at one time occupied the position of Lord Chief Justice in this country, said that there was no need to have in the words "if any." If there was no such body, from the legal point of view, the duty cast upon the particular local authorities would fall to the ground. He was very anxious to promote this consultation between the local authorities and the voluntary hospitals, and he said, "If we put in these words, it will look like an invitation to some voluntary hospital organisations in the various districts not to have a committee or body. Do not put in anything that makes any alteration in the legal point of view or that will imply to any of those areas that there shall not be instituted any body representing the voluntary hospitals of the country."

Surely, on a Clause of this kind we ought to have unanimous agreement. The points put by the hon. and learned Gentleman the Member for South East Leeds are really not worthy of our consideration. This is a Clause which I should have thought that all parties would have been united and agreeable to having on the Statute Book in order that we might have the voluntary hospitals on the one hand and the local authorities on the other holding a genuine and friendly consultation. We do not want to see, as was implied in the criticism of the hon. and learned Gentleman, some mandatory direction to the local authorities as to what they shall do. That is not the way to get a reasonable arrangement as regards hospital accommodation in this country. I think that we are carrying out this matter in the very best way and that we can trust the local authorities and the bodies representing the voluntary hospitals genuinely to consult in this matter and come to conclusions in the best interests of all concerned. I hope, therefore, that we shall be content to pass the Clause in the form proposed as being one to which consideration has been given by a large number of people interested in the voluntary hospital movement and by the local authorities.


It is rather strange that so many Members opposite should think that we view this proposal with so much suspicion and that we should then be taunted with receiving the benefits of the voluntary hospitals. We in the Labour and Trade Union Movement know all about the work of the voluntary hospitals. In the East End of London especially, we have done something towards helping them. For nearly 50 years, I have been doing my share, along with others, in looking after the voluntary hospitals. If any hon. Members lived in the county in which I live and had had the report brought to their notice as was brought to my notice just recently, they would realise the seriousness of this problem. The local authority's medical superintendent had to report to his Board that within three weeks they had lost 100 patients. That was mainly owing to want of accommodation. It was distinctly stated that if they had had more accommodation in the local hospital, many lives would have been saved. Had the right hon. Gentleman been living in a district where people had lost their breadwinner, or where the life of the wife had been lost, he would view the proposal in the new Clause with a little suspicion, especially in view of the fact that this particular Board had approached the Minister of Health and asked for sanction to increase their hospital accommodation, but had not received his approval. They were desirous of spending something like £33,000 on enlarging their accommodation. If the Minister takes so long under the present arrangements to give his approval to such a scheme, what will happen when this new Clause comes into operation, if we have the same Minister of Health—I hope we shall not—and it becomes necessary to go round to these other bodies for consultation?


I do not think the hon. Member is now dealing with matters which are very relevant to the Amendment.


I thought that I should be in order in raising this matter, seeing that the Amendment says that the council shall consult such committee or other body. Therefore, if they have to consult other committees or bodies it will mean that they will be longer before they can get to the Minister of Health for the purpose of obtaining his sanction to any extension which they may wish to make. When they have only one channel to go to, and that channel is so slow in coming to a conclusion either to refuse or to sanction a scheme, and they are to be expected in future to consult with these other bodies, then it is time that we had something to say about it. I view this new Clause with a great deal of alarm and suspicion, and I contend that the local authorities ought to have the right to make their schemes to get sanction as quickly as possible, when they know that the accommodation is required.


I should have imagined that the whole substance of the speech just delivered was very strongly in support of the Clause. Every word of substance which fell from the hon. Member was a powerful plea in favour of passing this Clause, or some similar Clause. I am neither a lawyer nor a doctor. Not being a lawyer, I cannot respond to the courteous invitation of the hon. and learned Member for South East Leeds (Sir H. Slesser), but as a mere layman I should like to give very cordial support to the Clause from the point of view of one who is, like other members of this House, most keenly interested in the health and physical well-being of a great urban constituency. We ought to look at this Clause not from the point of view of the suspicion of a great profession, and lees from the point of view of the administration of the hospitals, but rather from the point of view of the health and well-being of the people whom we represent. I have not the slightest doubt that this Clause will tend to the better administration of the health services of our great urban communities.

I support the Clause, also, from the point of view of those who are keenly interested in the prevention of disease by research. I am quite clear that this Clause will help in the co-ordination of research work in our great urban communities. From that point of view, it is exceedingly important that the Clause should be passed. Over and over again during the discussion of this Bill we have had long debates about the health, good government, and welfare of our great local communities, and I heartily rejoice that in another place it has been found possible to insert a Clause which will work untold benefit for the people whom we severally represent. It is a mere matter of commonsense that when you are regarding the health of a community the governing body of that community should take into the closest consultation those who have devoted themselves to this work.

Although I do not wish to lay myself open to the rather unkind and unworthy suspicion which was expressed by the hon. and learned Member for South East Leeds as to the approximate date of the general election, I should like to be allowed to express, very modestly and very respectfully, my enormous admiration for the generous, unselfish, and devoted services of the physicians and surgeons in our great voluntary hospitals. No one who has not had some experience of the administration of those hospitals can possibly know the unselfish devotion which is given to that work, and I am exceedingly sorry that even one word should have been said in this debate which seemed to throw any ungenerous suspicion upon the motives of those who devote themselves to that work. I can speak for two great voluntary hospitals, and two important urban communities, and from my local knowledge of them I should like to say how cordially I support the Clause.

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