MINISTRY OF HEALTH.

HC Deb 01 May 1929 vol 227 cc1555-622

Motion made, and Question proposed, That a sum, not exceeding £14,228,664, be granted to His Majesty, to complete the sum necessary to defray the Charge which will come in course of payment during the year ending on the 31st day of March, 1930, for the Salaries and Expenses of the Ministry of Health, including Grants and other expenses in connection with Housing, Grants to Local Authorities, etc., in connection with Public Health Services, including a Grant-in-Aid, Grants-in-Aid in respect of Benefits and Expenses of Administration under the National Health Insurance Acts, certain Expenses in connection with the Widows', Orphans' and Old Age Contributory Pensions Act, 1925, and certain Special Services."—[NOTE.—£7,000,000 has been voted on account.]

The MINISTER of HEALTH (Mr. Chamberlain)

It has never been my practice in past years, when presenting the Estimates of the Ministry of Health, to enter into any very elaborate explanation of the increases which have been a constantly recurring feature of these proposals. I think the Committee has always realised that these increases were not due to any extravagance or carelessness in the administration of the Department, but were the natural and normal developments of services and policies approved by the House of Commons; that they naturally grew with the increase of population and were keeping pace with the expanding appreciation on the part of the people of the benefits which they receive from those services. Indeed, I think the Committee has felt that in so far as it would be possible to check or stop those increases at all, that could only have been done by reversing the wheels of progress and thereby undoing a great deal of the work which had already been done. Therefore, I have not, as a rule, troubled the Committee with many figures. I have preferred to confine myself to a review of some of the more salient or more interesting features of the work of the Ministry during the preceding year, and I do not think there is any reason on this occasion to make any departure from that procedure, which, I believe, has generally commended itself to the Committee.

The Committee is aware that the work of the Ministry falls into four main divisions—housing; pensions and national health insurance; the administration of the Poor Law; and the health services themselves. I propose to touch upon some points in connection with each of these four sections, but not, I hope, at any undue length. I begin with housing. Housing is, of course, the largest single item of cost to be found in the Estimates. The increase in the total Estimates this year is £454,000. The increase in the item for housing alone is £485,000, so that the increase in this one item is actually rather greater than the increase in the whole Estimates. That discrepancy is, of course, accounted for by the fact that it is the product of a number of different items, some of which fall on one side of the account and some on the other. It will be seen that, out of a net total of £21,250,000, housing grants are responsible for no less than £11,150,000, and, before I touch upon the general policy and work of the Ministry in connection with housing during this past year, I think I must again call the attention of the Committee to what is certainly the outstanding feature of the housing position and, indeed, of the whole of these Estimates. Out of this sum of a little over £11,000,000, no less than £6,680,000 is in respect of a comparatively small number of houses—171,000 houses to be exact—built under the administration of the right hon. Member for Carnarvon Boroughs (Mr. Lloyd George).

The capital cost of those 171,000 houses was £172,000,000, so that makes the average capital cost per house a little over £1,000, and, if we look, not at the capital cost, but at the actual annual cost which falls upon the taxpayers, and compare it with that which is involved in the case of the houses built under other Acts, I may remind the Committee that every Chamberlain house, as it is sometimes called, built under the 1923 Act, and which is being completed at the present time, involves the taxpayer in an annual cost of £4 for 20 years; every completed house built under the 1924 Act involves a cost upon the taxpayer of nearly twice that amount and for twice the period, that is to say, of £7 10s. per-house for 40 years. But when you look at the Lloyd George houses, you find that those houses, which have now been completed some time, are still placing upon the unfortunate taxpayer an annual charge of £38 10s. per house, which will continue for a period of something like 60 years from the completion of the house. I do not, of course, draw attention to these figures in order that the Committee may realise the relative advantages, from the taxpayers' point of view, of the Conservative Government's housing policy, or for the purpose of casting any aspersions upon the right hon. Member for Carnarvon Boroughs, but I do think it is necessary from time to time to remind the taxpayers of these facts, because they serve as a monumental warning against making pledges which are of such an extravagant character that they cannot possibly be fulfilled, and against attempting to force through gigantic programmes at a speed which is far beyond that of which the resources of the country are capable.

When I come to the general policy of the Government, I do not think I need have any difficulty in anticipating the criticism which will be made by the hon. Member for Nelson and Colne (Mr. A. Greenwood) in the course of our proceedings this afternoon, because he has made it already, and I have observed that the party opposite are not very fertile in criticism and that once they have found or been provided with a line of criticism they go on repeating the same assertion over and over again, and without finding any new arguments with which to refute any contrary statements or assertions that may have been made on the other side. Therefore, I think I may safely anticipate that the hon. Member will tell us presently that, by reducing the subsidy, the Government have paralysed the building industry, and that, until the subsidy is once more restored to something like what it was before, we shall not have any considerable output of building. I do not anticipate that I shall get any reply from the hon. Member to my question, but I will invite him, when he comes to repeat that assertion once more, to explain to the Committee how a reduction of the subsidy can possibly have hindered local authorities from proceeding with their building programmes unless the subsidy has resulted in an increase in the cost. He is quite aware that exactly the opposite thing has happened. In December, 1926, just before the coming reduction in the subsidy was announced, the average price of a non-parlour house throughout the country was £448. Last March it was £336, so that you have this position, that after a reduction of the subsidy equivalent to £25 a house, there has followed a reduction in the cost of the house of no less than £112.

Miss LAWRENCE

Does that include Scotland?

Mr. CHAMBERLAIN

I am not responsible for Scotland. Quite clearly, therefore, the local authorities are in a position to-day, in spite of the reduction of the subsidy, to place their orders for houses at a price substantially lower than they were before the reduction took place, and, in these circumstances, I think it is a little difficult to explain how a reduction in the buildng programme can have been brought about by the reduction in the subsidy. Again, I must anticipate another argument of the hon. Member, because I know he will repeat it again, as he has so often repeated it before. He will say that a reduction of price is not the cause of what has happened, but that a reduction of price has followed on a reduction of building. It is only, he will say, when you get a check in the programme of building that, of course, you get a reduction in the price. But that is not borne out by the facts, because the reduction in the price came first, before there was any reduction in the building, and it began the moment the coming cut was announced, and went on steadily, even though, as a matter of fact, the number of houses being completed every month was steadily increasing, and by the end of September, 1927, when the programme of house building reached its peak, already there was a reduction of no less than £45 per house. Therefore, I think I have established, to the satisfaction of any impartial person, that the policy of a reduction in the subsidy has been absolutely justified by the results and that it has brought about what at least nobody in this House will challenge, namely, the thing that is most necessary to-day in housing, a reduction in building costs which will allow houses to be let at lower rents.

If I am asked, "How then do you account for the undoubted fact that houses are not now or have not in the last 12 months been built at such a high rate as they were just before the termination of the subsidy?" I can tell hon. Members opposite what, in my opinion, is the reason for the reduction. In the first place, it has been due to the natural reaction from the tremendous scramble that took place on the part of local authorities to get as many houses completed as possible before there was a change in the subsidy. The effect was that there was an abnormal rate of building, which came to an end in September, 1927, and after that everybody sat down and began to take breath. That has possibly passed away by now, but something else which has not passed away is the continued crumbling in the price of houses. Naturally, no prudent local authority, seeing that prices were not stable, but day after day and week after week continued to fall, were willing to place large contracts in a falling market. They were content to place small contracts, and nothing like the enormous number of houses that were completed in September, 1927, will be completed until local authorities are satisfied that prices have touched bottom. [Interruption.] It is a subject of continual grievance to hon. Members opposite that this fall in prices has taken place, but to people who are looking for houses which they can afford to rent it must be a source of satisfaction.

As a matter of fact, the fall in the production of houses has not been anything like so serious as hon. Members opposite are fond of making out. Of course, for political purposes they prefer to take the figure of State-assisted houses, but, if you are to get a true picture of what is going on, and of how far the needs of the country are being supplied, you cannot confine yourself to houses on which there has been paid a subsidy by the State or local authority. You must take into account all the houses that are being erected, whether with a subsidy or without, and, if you do that, you find that the total output of houses completed in the year 1928 was no less than 169,000. Pick whatever figure you like as that which is required to meet the ordinary growth in the population, and to replace the wastage of old buildings—it is generally put at 100,000, though I think that that is much too high—but even if you put it at that figure there is a surplus of 69,000 houses in one year, which may be taken as indicating how largely the arrears have been eaten into and that the situation has therefore improved. If you compare that with the number which was built in 1924, the year when hon. Members opposite were able to show us what they could do, the figure was only 126,000. If you take State-assisted houses only, it was exactly half our's, and only 52,000 to our 104,000.

Miss WILKINSON

Did the 169,000 include houses built for the middle and upper classes?

Mr. CHAMBERLAIN

The vast majority of these houses, as is well known, are under an annual value of £26 a year, and therefore it is not really to be asserted that the majority of these houses were built for the middle and upper classes. For the purpose of my argument, however, I do not care for whom they were built. My argument is that you must take the whole pool of houses, and, if you provide a large number of houses which are occupied, that must lessen the congestion in the country. Altogether, there have been built in this country since the Armistice no less than 1,241,500 houses, and the Committee might like to know how these were distributed between local authorities and private enterprise. Local authorities were responsible for 467,500, and private enterprise for 774,000. Any contemplation of these figures will indicate where we should have been if we had had to rely solely on local authorities for this purpose, and if we had not taken steps for the revival of private enterprise in building.

This year we have been unfortunate in the weather. There has been frosty weather of exceptional severity and prolonged over an unusual period of time. Of course, while that weather lasted, building operations were undoubtedly held up to a very considerable degree, but now that the weather is milder the renewal of building activity is proceeding very fast. I find that in March this year, the number of houses approved for subsidy is 50 per cent. greater than it was in the corresponding month last year. While unemployment among bricklayers had on the 1st March risen to nearly 20,000, it had by the 25th March fallen to 5,000, and I anticipate that, as these new approvals begin to occupy labour, these figures will be reduced to very trifling dimensions. Before leaving this subject, I will only make this last observation. In considering figures of unemployment in the building industry, people sometimes talk as though the building industry meant the house building industry only. Of course, the figures we get do not apply only to people who are engaged on building houses. There are a great many other forms of building activity, and therefore it is not to be put down to the housing programme alone if from time to time there are variations in the number who are employed.

4.0 p.m.

Let me turn to the next section of our work—that of pensions—which is proceeding now, I think, with satisfactory regularity. I know that hon. Members from time to time have received a complaint from a constituent that an application has been put in and that there has been a very considerable delay in answering it. When one considers the extras ordinary number with which we are dealing, and the amount of information which has to be obtained in particular cases, requiring sometimes reference to a number of persons or bodies outside the Ministry of Health, I am surprised that the number of complaints of delay is so small. It may perhaps surprise hon. Members to know that even now the communications in and out of the Ministry of Health upon this subject alone average 100,000 a week, and that in a single week, at the time of the greatest pressure, we had no less than 400,000 applications or communications coming into the Ministry. It would indeed be surprising if work of that magnitude did not sometimes lead to delays, which to the applicant may seem intolerable, but which are hardly to be avoided in a work of such magnitude. We really could not get through the work with the staff that we have if we had not adopted some mechanical aids. The use of office machines is now extended in this part of the Ministry of Health. We have a number of ingenious machines which are used for the routine work, and which are performing now something like 9,500 operations a day. These will be added to, and probably reach, eventually, the neighbourhood of 15,000 a day.

One aspect of pensions which was the subject of some speculation before the Act was brought into force was how far the relief afforded by the pension system to old people and to widows would be reflected in the reduced number of those who found it necessary to apply to the Poor Law authorities. I made some inquiry to see whether our anticipations in that respect had been fulfilled. I am very pleased, indeed, to find that no less than 88,560 persons, including the dependent children, who were before in receipt of Poor Law relief, have been able to free themselves entirely from the dependence on the guardians since they began to receive their pensions and allowances. That is not really the whole measure of the relief that is being made, because one has to add to that the number of all those who would have applied if they had not received the pension, but have been spared the necessity of coming to the guardians.

Turning to the other side of health insurance, the feature of last year has been the coming into force of the recent Act. That Act contains a number of provisions which, I think, have been proved to be very beneficial to those who come under them. The system under which health benefits were suspended or cancelled because of arrears due to genuine unemployment was one which one could not regard as satisfactory. That has now been abolished under the Act. Now the genuinely unemployed loses nothing of his health benefit by reason of his arrears. He is credited with weeks of contribution by the franking of his card at the Employment Exchanges, and, as a matter of fact, although the arrears system has only begun to operate since July of last year, I am happy to find that there has been quite a number of persons who have been credited to an amount reaching the sum of 42s. 6d. for the 27 weeks of the last half yearly period. The Act of 1925 brought in a large number of voluntary contributors who had been previously excluded, and some 200,000 persons have taken advantage of that provision of the Act. In the Act of last year a grievance was removed in respect of share-fishermen, and also certain other workers who were really in the same sort of economic position as employed persons, but who would not be insured because they were not under contract of service. The provision which has brought them in has been received with great satisfaction, because when it was a question of pensions as well as health insurance, then they did feel that they had a serious grievance in being excluded from the benefits of that Act.

With regard to the administration of the Poor Law, I think that we have now passed the worst period, and during the past year, although there may be not a very large reduction in the total numbers on the list we have seen a substantial reduction in the numbers of those who were in receipt of relief on account of unemployment. I should like to say a word about the provision of test work in connection with relief regulation orders, in connection with which a number of questions have been put to me from time to time in this House. It is a fact, as I am informed, that in very many cases the men themselves welcomed this test work, because it is a relief from the intolerable monotony of existence without anything whatever to do. But, of course, one would desire and I hope that we may achieve in time a system under which the test work is not merely the actual physical exercise which is involved in it, but is in itself some preparation for a life of permanent employment when the man is free from the Poor Law and is able to resume his occupation. I would like, in this connection, to say a word or two of commendation of an experiment which, I think, was initiated originally in the Salford Union, but which is now being taken up in three other places—Sheffield, Norwich and, last of all, Poplar, although Poplar has not actually begun the experiment yet. This was an experiment under which persons applying for outdoor relief were given a sort of education course. They were given instruction and training in handicrafts and physical exercises, and, as showing how valuable a system of this kind may be, I may say that in the Salford Union out of 441 men who passed from this training course, no less than 382 have gone off relief, and it is believed, with good reason, that most of them have found employment. That is certainly a very vast improvement upon the old system, and I hope very much that the experiment may be followed up.

Mr. GREENALL

It was suggested by a Socialist chairman.

Mr. CHAMBERLAIN

I come to the health services themselves. There are four services which come under the purview of the Ministry of Health, and which have been the subject of percentage grants. This, I suppose, is the last occasion on which the main Estimates of my Department will be presented showing provision for percentage grants of this kind. There is also another service for which the Board of Control have been responsible, and which also is aided by a similar grant. The Board of Control are responsible for the treatment of insane persons and also mental deficients, and, as I did not on the last occasion touch at all on their work, I should like to take this opportunity of saying something about it now, because it is very important work. It is not work which is very attractive, perhaps, but it is work which is very valuable in the general interests of the community.

The CHAIRMAN

I think I ought to point out that this question comes under another Vote, but as it is kindred to the subject with which the Minister is dealing, perhaps the Committee will not insist on the objection on that point.

Mr. CHAMBERLAIN

I am touching on this feature here in order to give the Committee one or two facts about the position which I think may be useful. As to the magnitude of the problem, I may say that there are, at present, about 141,000 insane persons who are under care in England and Wales, and that number shows a fairly regular increase of about 2,000 a year. That may sound, at first, rather disquieting, but the increase must not be taken necessarily to mean that the number of insane persons in proportion to the population is increasing at that rate. Insanity is a disease which affects adults and not children and, of course, as the expectation of life continually increases, so a larger and larger proportion of the population reach the later ages, and become susceptible to this particular form of disease. Therefore, although the actual number we have to provide for is increasing, I do not think that we need draw from that any conclusion that would be serious to the general mental condition of the people of this country. There is another figure which is less satisfactory, I mean the figure of recovery. One must distinguish between insanity and mental deficiency. Insanity is a disease from which people may recover. Mental deficiency is an arrest of mental development from which there cannot possibly be recovery, but it is rather surprising and a little disquieting that the rate of recovery among insane persons seems always to remain about the same point, namely, about 30 per cent. I think, however, one may perhaps assume safely that with the greater knowledge we have to-day, medical superintendents are more careful in classifying cases as cases of recovery than they used to be, and that there may be an increase which is not accurately reflected in the figures at our disposal.

Viscount SANDON

Can my right hon. Friend say how these recovery figures compare with foreign countries?

Mr. CHAMBERLAIN

I am afraid I cannot say out of my head, but I could get the information for my hon. Friend. There is one class of case, however, in which there is a definite improvement in the matter of recovery, and that is the case of the general paralysis of the insane which was for a long time considered incurable. It was very often fatal. The discovery which has been made reminds one rather of an old story of an American. A new practitioner came to his village with a medicine which he said was applicable to any complaint, and the man having gone to him and complained that he had the gout, the practitioner prepared to apply the medicine. The patient asked if it was good for gout, and the practitioner, after the usual reference to the nether regions, replied: "Gout? No! but it will give you fits, and I am death on fits." The new treatment of the general paralysis of the insane is to give the patient another disease, and that is malaria. It is a discovery which, I believe, came from Vienna. It has been found that by introducing malaria, a patient suffering from general paralysis of the insane, which before was very often incurable, is now in many cases capable of very considerable improvement, and possibly of cure. In going round a mental hospital to-day, one may see as part of the equipment a portion of the ward shut off and surrounded by mosquito curtains, with, perhaps, one or two beds in it. The patient is brought into this place, the infected mosquito is brought down from London, introduced into the mosquito curtains, and after that the matter works itself out in its own way. There is one direction in which I wish we could make further progress, and that is in the matter of research. At the present time, local authorities have no power to devote money to research. It is one of the matters which I certainly do not wish to discuss this afternoon, but it may well arise out of the Report of the recent Royal Commission, which, I hope, will form part of the work of another Parliament.

Now I come to mental deficiency. Some misunderstanding seems to have arisen in the minds of some people as to the attitude of the Ministry of Health with regard to what is known as the Wood Report. The Wood Report is the Report of a, committee which inquired into various matters connected with mental deficiency. The Committee issued two very long Reports. One of them has been published, and I have been asked frequently whether and when I was prepared to publish that part of the Report which dealt with adults. It is a very long Report, and one of considerable complexity, and I have said that I really must have time to consider it before I can say whether all or how much of the Report should be published. But I hope hon. Members will not think there is any intention on my part to withhold from local authorities anything which they ought to know which is contained in this Report. Probably the most important part of it to them consists of the figures of Dr. Lewis's investigation into mental deficiency, which have already been published. As to the rest, it is having my personal consideration, and I hope to be able to make a decision before very long.

The serious aspect of the figures is that Dr. Lewis estimates that there are 300,000 mental deficients in this country, a number which is about double what was estimated by the Royal Commission in 1908. That must give rise to serious anxiety and apprehension among all who care about the future physical and mental condition of our people. Naturally, a good many people have asked whether it would not be possible to take some steps which would prevent the propagation of a class of people who will never take their proper place in society. We are told that in some countries a system of sterilisation is practised, and we are asked why we should not follow that example. Personally, I think that some day there will have to be a proper scientific inquiry into this matter, because undoubtedly, up to the present, we have not sufficient data to enable us to come to any satisfactory and definite conclusion. But I would say this: The mental deficients in this country to-day are, broadly speaking, the product of one-tenth of the population, that is to say, it is only 10 per cent. of the population who are responsible for the production of mental deficients, and out of that one-tenth only one-tenth, or 1 per cent. of the whole, are themselves definitely defective. The others may be indefinitely defective, un-recognisable as such, they may even be only carriers, and therefore it must be clear that any process of sterilisation could not possibly deal satisfactorily with the problem.

Mr. LANSBURY

Has the Minister any figures or any information showing the districts from which they come?

Mr. CHAMBERLAIN

I do not think they can be said to come from any special districts. They are widely distributed all over the country.

Mr. LANSBURY

Can the right hon. Gentleman say what class, what section, of the community?

Mr. CHAMBERLAIN

I could not say. The ideal method of dealing with these people, in the light of our present knowledge, is in colonies, which should consist of, probably, not less than 1,000 persons if they are to be carried on with the greatest efficiency. These colonies must be considered, not as places in which mental deficients shall be kept for the rest of their lives, but rather as places where they shall as far as possible be trained up to a point at which they can be released and allowed to go out on licence and under supervision. But, of course, it is not possible to carry out an ideal of that kind at a single step. It is a costly matter to provide one of these colonies; we have to have some regard to the financial limitations of the country, and I think we shall have to proceed slowly, bearing in mind that we can even now do a good deal to mitigate the lot of these unfortunate people and to render them less dangerous to society and to themselves. I believe that under the Local Government Act, by which a large number of institutions are placed in the hands of the county and county borough authorities, it will be possible to devote some of those institutions to the reception of certain types both of mental deficients and of insane persons, and, seeing that the cost of a bed in a mental hospital is about twice that in a mental deficiency colony, perhaps local authorities will make the best bargain for themselves if they allot some of these institutions to the treatment of insanity.

Miss WILKINSON

Before the right hon. Gentleman leaves this question, could he say one word as to whether he proposes to do anything to increase the care of the border-line cases—to make further provision for the treatment of border-line cases which are not yet certified?

Mr. CHAMBERLAIN

I do not know whether the hon. Lady means that I should do it by legislation, because, if so, I could not discuss that question now; but, as far as the present administration is concerned, the answer is "Yes." It is part of the general policy which is being pursued by the Board of Control all over the country at the present time.

The four State-aided health services which come under the Ministry of Health are tuberculosis, venereal disease, the welfare of the blind, and maternity and child welfare. Perhaps the Committee would like me to glance at some of these, to see whether we have been justified in the money which we have spent upon them in the past. In regard to tuberculosis, I am happy to be able to tell the Committee that last year, 1928, gave us the lowest death-rate on record both for pulmonary and non-pulmonary cases. I would particularly like to call attention to the non-pulmonary tuberculosis cases, because 80 per cent. of the decline has occurred among children, and I think it is very satisfactory to know that, whereas the death-rate among these cases in the 10 years from 1901 to 1910 was 500 per 1,000,000, last year it came down to 173. That is due to the greater care taken and the greater knowledge which now exists as to the best method of treating these cripples, as they generally are in the case of children. It is a source of satisfaction to think that the death-rate has been so much reduced, because one must bear in mind that at the same time the condition of those who have survived is very much better than it used to be, and many a child is to-day going about with straight limbs who formerly would have been a permanent cripple.

As to blind persons, I think I may say, generally, that they are better looked after to-day than they ever were before. More of them have come under the attention of the local authorities, and there are more means and better means of making their sad lot tolerable. I must draw attention, in particular, to the cases of ophthalmia neonatorum, which in the past have given rise to so many cases of permanent blindness. In 1922, there were 8,000 patients of this most distressing disease. In 1927, the latest year for which I have the figures, that 8,000 had fallen to 5,000. The maternity and child welfare work has produced the most striking results of all our health services in the last generation. Last year, the infant mortality rate came down from 70 per 1,000, as it was in the year before, to 65. In the five years since I have been at the Ministry of Health, the figure has declined 10 points, from 75 to 65 per 1,000. Since it is rather difficult to visualise the effect of that, I will put it in this way, that in 1928 6,560 babies survived who would have died if they had been born under the conditions that existed in 1924. There, again, we must not look only at the actual lives saved; they are, as it were, a barometer of the general rise in the standards of health among young children, and we may be quite certain that for every one whose life has been saved there are half-a-dozen others who are stronger and healthier than they would have been. I cannot say that this wonderful fall of the death-rate in a single year was due to the actual work done during that year. It is the product of a number of causes all combining to work in the same direction, but I would give the figure of the actual expenditure in grants, which shows that there is a steadily expanding service, and I think we may fairly claim for that service at least a major share in the very satisfactory results. In the year 1924–25, the total amount spent by way of Exchequer grants on maternity and child welfare services was £814,000. In 1928–29, the sum was £1,072,000, and in the present Estimates the amount set aside for this purpose is £1,163,000.

The Committee may remember that, after speaking of this same service last year, I indicated that there was one part of it on which I could not look with satisfaction. The figures of maternal mortality, the deaths of mothers in childbirth, had practically not moved for the last 20 years. I said then that I felt the time had come when it was necessary to make some new and vigorous attempt to deal with this very distressing problem. I set up two Committees, one to inquire into the whole conditions affecting the practice and profession of midwifery, and that is what I call the foundation stone of this matter. That Committee has been at work. It has nearly completed its labours, and I am hoping that in a few weeks I shall have its Report. The other Committee was one which was directed to trying to throw more light upon the causes of these deaths. It is a fact that even now we are, to a large extent, ignorant of what are the causes of this persistent maternal mortality. I set on foot an investigation with the help of the general practitioners of the British Medical Association and the local authorities with a view to getting a Report on every case of maternal death right through the country, and that work has been going on. The Committee began to function in the latter part of last year, and 311 deaths formed the subject of Reports. This year already we have had reports of 448 more cases.

It is too soon to be able to say what conclusions we shall be able to draw from this evidence, but I can say to the committee that already the focussing of the evidence upon these cases, and the concentration of attention upon the whole subject has begun to show indications from which we believe we can see some of the flaws and weaknesses in our system which will enable us presently to direct our efforts to the weak spots. The general arousing of public interest, the fixing of attention upon this particular set of circumstances, upon the lamentable results to the health and life of this nation which come from this persistent mortality in itself has meant that greater care is being given already to these matters before and after birth, and, although I do not prophesy as a rule, I say with some confidence that from the mere fact of this attention being given without any special steps having been taken, we shall see a large reduction in this figure which has persisted for so many years.

There are two other points to which I should like to refer. There has been a good deal of discussion on the question of small-pox within the last few weeks, and some very embarrassing restrictions have been placed upon the entry of our nationals into another country. That has arisen partly owing to the presence of certain cases of virulent small-pox which came to this country on a ship. I do not think that this state of affairs would have arisen at all had it not been that the attention of other countries had been drawn to the mounting figures of cases of small-pox of a mild character which have been so remarkable a feature of the last few years. In 1927, there were upwards of 14,000 such cases. Last year, there were not quite so many. Although the very fact of these cases being mild has tended to prevent anxiety, I feel myself that as long as we have a large part of our population unvaccinated we are running a risk which may seem to be small to-day, but which, if we should get any spread of a really virulent type, might cause something like a panic.

The other matter to which I wish to refer is cancer. Unfortunately, I have to report that the number of cases of cancer is still on the increase in this country, nor have we been able so far, in spite of the amount of research, to say that we have got down to the real cause of cancer or of the agencies which encourage its development in the human body. What we can say is that after many experiments and some mistakes we have obtained now a fairly practical working knowledge of the method of treatment which has, been singularly successful, and has in fact quite superseded the older methods of surgery—I mean of course treatment by radium in one form or another. So established is the practice now of treatment of cancer in many cases by radium that the demands for that substance have become pressing and urgent. It is a substance which is only found in workable quantities in very few spots in the world, and it is a substance which, owing to its powerful character, requires most careful handling in its preparation. It is therefore a very costly substance, but a sub-committee, appointed by the Committee of Civil and Industrial Research examined into this matter and informed us that 20 grammes of radium were all that could be properly and efficiently used at this moment. Twenty grammes of radium were required and could be obtained at a cost of £200,000, and in the opinion of the sub-committee it was thought to be desirable that the Government should offer pound for pound for any sums raised for this purpose by the public. In view of that statement, the Government felt that they must at once accept that recommendation, and they undertook to find their share of the necessary money. I am sure the Committee will have seen with very great satisfaction that, as a result of the appeals made in the Press, a very large share of the sum required has already been forthcoming. Many generous donors have come forward, and I believe this is an appeal which is likely to have the sympathy of many people, for who knows which of us may not presently require the very treatment made available by this substance, and which of us, if that were so, would not be prepared to find any sum within his means to escape the anguish, the torture, and possibly death which might follow. It is a great satisfaction to me at the end of this period of my office to find that something has been done to bring relief to many sufferers in the future from this most terrible and terrifying of diseases, and I am confident that in a very few days we shall find that the necessary money has been secured and that we shall be able to proceed to the use of this most beneficent discovery.

If I endeavoured to make a survey of all the departments of the Ministry of Health I should require many days to do it, and I am afraid that I should weary the Committee. I have to-day been able to touch upon one or two of the important subjects with which we deal, and I hope that what I have said to the Committee may be sufficient to convince them that the money which we spend on the health services of the Ministry of Health is an investment which brings us an ample return in the improved health and efficiency of the people.

Mr. A. GREENWOOD

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

On these occasions, we always listen to a most interesting speech from the Minister when he is reviewing the work of the year, and, if I may say so, the speech to which we have just listened has been as interesting as any of the right hon. Gentleman's speeches which I remember. With most of what the right hon. Gentleman has said, I think the Committee will be in general sympathy. There was a passage in his speech which we on this side challenge, in which he referred to housing, and it is there that I must cease my compliments and put the case of the Minister's record in administering the Housing Act as we on these benches see it. The Minister of Health to-day is presenting his last Estimates, it may be, for many years. I know that hon. Members opposite regard some of the work of the right hon. Gentleman with admiration, and he is considered to be one of the great assets of the Government, but we on this side regard the major part of his record as inglorious.

I propose to confine my remarks principally to the question of housing, but I cannot forget the right hon. Gentleman's administration of the Poor Law during the last three or four years; in fact, there is very little which would lead the public to believe that the administrator of the Poor Law was the same Minister who has just spoken so feelingly and sincerely on the questions of cancer and maternal mortality. The Minister of Health has not given the same sympathetic treatment to the administration of the Poor Law as he has given to the work of other Departments of his Ministry, and it seems to me that an attempt has been made to revive the old system which used to regard the poor as people who ought to be suppressed and harried from pillar to post. In the record of the Minister of Health for the last five years on the subject of housing, I think we have perhaps one of our strongest cases against him. We hear nothing about steel houses to-day. That lamentable experiment came to an unfortunate end for the Minister of Health. We have not heard to-day one single word about the right hon. Gentleman's administration of the Housing (Rural Workers) Act nor have we heard to-day a real defence of his administration of the two Housing Acts which are now on the Statute Book. The right hon. Gentleman told us that on this side of the House we were not fertile in criticism and that much of our criticism consisted of repeating old arguments. We shall go on repeating the old criticisms, because it is essential that we should seize every opportunity for putting these criticisms until they have percolated into the minds of hon. Members opposite. There is no need for us to try and discover new arguments, because our arguments are overpowering and the Minister of Health has never answered them. The right hon. Gentleman speaks of our using these arguments for political purposes. I have been giving a little attention recently to party leaflets. Here is a Conservative leaflet: Mere and more Homes. I think it was published before they reduced the subsidy, and it includes a passage which I had not intended to read but for that remark of the Minister. It tells how many houses were built in 1924, in 1925, and in 1926, and then it goes on: Unless the Socialists stir up trouble in the building trade, and so hold up housing, the number of houses built in the 12 months to 30th September, 1927, should be over 200,000. If that is not a really bad piece of political propaganda on behalf of the Conservative party, and most unfair to this party, I do not know what is, because, as a matter of fact, we more than reached that figure. We did not stir up trouble in the building trade; it was the Labour Government of 1924 who made that output possible by the agreement which they reached with the building trade. Another leaflet puts the Conservative party's policy in phrases of two or three words, and in regard to housing we have this: Rural Housing Improvement. Vigorous Housing Policy. I want to bring that to the test of actual achievement and accomplishment. Up and down the country, hon. Members are now claiming, and the hoardings bear witness to it, that the right hon. Gentleman and his Department have been responsible for the building of 800,000 houses during the time this Government have been in office. We have now entered upon a period of self-congratulation on the part of the Government. The Prime Minister himself has been patting the Minister of Health on the back for this large output of houses. Let us look at what these 800,000 houses are, because this bubble is going to be pricked before the General Election. The right hon. Gentleman says that we must include all houses; that it is true that on the Devonshire House site flats have been put up for American millionaires, but never mind, let them be counted in the 800,000; every new house relieves the congestion in the country, and there is an ultimate transfer which makes it much easier for the people at the bottom.

That is not true, and never has been true since the War. Among those 800,000 houses there are included something like 300,000 which have been built by private enterprise without a penny of public assistance, and for which the Minister is in no way responsible at all. He will be claiming next the fine summer of last year as part of the Conservative achievements. That immediately brings down this wonderful total of 800,000 to 500,000. In no way can the Government claim credit for the 300,000; that is obvious. They can claim credit for the 500,000 which have been built with the aid of public assistance during their period of office, but an examination of that figure of 500,000 houses shows that roughly 250,000 have been built by private enterprise for sale, and that only 250,000 of that great total of 800,000 consist of houses which have been built to let to working people. That deflates the whole of this wonderful claim. It has been said time and again by the Minister and the Parliamentary Secretary that the problem which is left to-day is the problem of providing houses to let at rents that working people can pay. That formula they borrowed from us; I hope they will make good use of it. That is the problem; but in four and a-half years only 250,000 of these houses have been built for that pur- pose, and, therefore, this enormous claim which is made proves on examination, like many other claims made by hon. Members opposite, to have little substance in it.

It is important that we should consider in this Committee the history of house building during the last year or two, and the position in which we are to-day. It is undoubtedly true that from 1924 onwards there was a steady and substantial expansion of house-building. That was due to the increased incentive which we gave to local authorities to build houses, and was due also to the scheme for augmenting the personnel of the industry, which could not have been carried through by any other than a Labour Government. There has been, therefore, a very substantial and steadily increasing output of houses from 1924 onwards. The second period came when the right hon. Gentleman announced the prospective reduction of the subsidy. That led to a few months of spurt. According to the Minister's view, that spurt made such demands upon the industry that it has had to rest for two years since. There was a period of spurt, when the output was increased beyond what it would have been but for the fact that local authorities and private builders were engaged in getting their houses finished by the 30th September, before the new reduced housing subsidy began to operate.

Immediately after the reduced subsidy began to operate, house-building fell off. The right hon. Gentleman's case is that that was due to reaction, that it would be all right in course of time. The song which the Minister has sung to-day is rather different from the song that he sang a year ago. House-building has failed to recover, and we attribute that almost entirely to the Government's misguided reduction of the subsidy. I do not mind how often it is repeated that the great slump in the building of working-class houses has been due to the reduction of the subsidy. [Interruption.] The right hon. Gentleman says that he knew I would say that. Of course I say it, because it is so true. The right hon. Gentleman told us his story again this afternoon of the relation between house-building prices and the subsidy, but I destroyed that in May of last year. I have hardly time to say it all over again, but I do not mind repeating some of it if it will in any way influence the minds of hon. Members opposite.

The reason for the reduced subsidy, we were told officially, was because it was held by the Government that the subsidy was inflating prices. Then, when we come to read a little booklet of a colour that will be familiar to hon. Members below the Gangway, on "Three and a Half Years' Work" of this Government, I find in the section on housing a special section, as there would be, on private enterprise, which says: Features of the Conservative period have been the number of houses built (a) by private enterprise with subsidy; (b) by private enterprise without subsidy. This return to private enterprise encouraged the Government to decide to reduce the heavy charge on the taxpayers for subsidies by about £25 a house from 1st October, 1927. I am driven to wonder whether that, perhaps, was not the real reason why the subsidy was reduced, and whether it was not the first step in the process of handing back house-building entirely, lock stock and barrel, to private enterprise and the jerry-builder. But then there is another reason, which is borne in on my mind by the Prime Minister's statement over the wireless the other night. He said that the Minister of Health had produced the goods, and we have so overcome now the shortage of houses which was so great at the conclusion of the War that we feel that half our work is now done, and we are anxious and eager to get on with the next chapter, which is an attack in force upon the slums. Whether the reason which moved the Government to this policy was that they wished to bring down the price of houses, or whether it was, as this official publication tells us, a desire on the part of the Conservative Government to hand back the business to private enterprise, or whether it was that in the view of the Prime Minister half the problem had now-been solved, the fact remains the same, that house-building has been paralysed ever since the 1st October, 1927. The right hon. Gentleman has given us His argument about the effect of the subsidy on prices. There was a reduction of the subsidy by £25, and down came the prices by £112. It is very illogical for the right hon. Gentleman only to have reduced the subsidy by £25. He ought to have taken off the whole £75. That would have been the only proper and logical thing to do, because, although I do not suppose that prices would have come down in proportion, it might have reduced them by something like £300. Indeed, if the subsidy had been swept away altogether, I can see visions of happy builders begging applicants to accept houses for nothing.

Prices have come down, not for one reason, but for at least a dozen reasons, which have operated throughout the length and breadth of Great Britain, as I explained to the Committee a year ago; and the fall which took place in Scotland was as great as in England and Wales, notwithstanding the fact that there had been no reduction of subsidy in Scotland. I do not want to go over the ground again, but there are a dozen different reasons why prices should have come down, and it is no use bringing in one other factor and trying to argue that that new factor was the sole cause of the fall in prices, particularly when it happens that that factor is not operating in Scotland, where, in 1927–28, the cost of house-building fell fully as much as it did in England and Wales.

Whatever may be the truth about it, the right hon. Gentleman says that his policy has been justified. The Minister's business, however, is not to get down the price of houses and then build no houses; his primary business is to build houses. It is no satisfaction to people who are clamouring for houses to know that the right hon. Gentleman has succeeded in bringing the price down by £100, if there is not a house for the person who wants it. That is the real test. In May of last year, when we were discussing the Estimate, the Minister was whistling to keep his heart up. He was getting a little dubious about this protracted slump in the building of houses. He had said before that it was all right, that this reaction would soon be over, and that we should get building again. In the middle of May he tried to sing the same tune, and these were the words that he used then: Therefore, although we have undoubtedly seen a certain temporary slackening in the provision of new houses, I think we may confidently look forward to a considerable increase in the figures during the ensuing summer, and, while the local authorities have naturally been anxious to know whether they could rely upon a continuance of the present subsidies at their present rates, I have"— and then he went on to say that, while he was unable at the moment to give a final reply, he could say that the subsidy would at least be fixed until the 31st March, 1929. He said in the same speech: I have never felt any anxiety whatever about this slump in house building which has taken place in the last few months."—[OFFICIAL REPORT, 15th May, 1928; col. 879, Vol. 217.] 5.0 p.m.

Here he was a year ago trying to persuade his friends that, as a matter of fact, things would be all right. The position today is that all the arguments the right hon. Gentleman is using have changed. In December of last year, when we were discussing the reduction of the subsidy which is to take place on 1st October of this year, the Minister said: I think I can pass from the question of output, having clearly shown that, while there has been undoubtedly a remarkable rise, followed by an unpleasant fall, it is only a temporary disturbance which will pass away."—[OFFICIAL REPORT, 12th December, 1923; col. 2161, Vol. 223.] That was 15 months after the subsidy had been reduced. It was still a certain temporary slackening, but no progress has in fact been made. I took occasion during that Debate to read some words of warning which I had used in 1926, when we were first asked to commit ourselves to a reduction in the housing subsidy. I repeat them. This was when the proposal had been made public that the subsidy was to be reduced: I have within the last few days received letters and reports from many parts of the country, and almost everywhere the same story is told by local authorities, by building experts, by mayors and town councillors, that the only effect of this proposal will be to reduce the building of working-class houses."—[OFFICIAL REPORT, 2nd December, 1926; col. 1494, Vol. 200.] I said that over two years ago, and it is borne out by the facts to-day, and it is that which we wish to bring home to the right hon. Gentleman. He explains it by the feeling of lassitude following six months of great effort. He cannot bring that forward seriously on 1st May, 1929. His next reason is that local authorities are waiting for prices to fall. That is absurd. The price of houses has not fallen very much in the last two or three months. Local authorities, in my experience, are only too anxious to build houses, and they have not been holding back since 1st October, 1927, when they had long lists of people asking for new houses, waiting for prices to drop still further. It is a poor excuse. When we come to the frosty weather, of course there has been frosty weather, but you can take the frosty weather and you can double the effect of it on house building, and it does not explain away the continuance of this slackening of house building.

Let me quote the figures of houses which are in course of construction month by month. The right hon. Gentleman generally quotes figures of houses which have been approved. Large numbers are approved and never built. I am going to give what is the real test of house building, the number of houses actually in course of erection month by month. What is the position? During the months before the announcement was made of the reduction of the subsidy, when the local authorities were developing their activities, there were at any given moment being built by local authorities—I am taking their houses only—about 49,000 houses. At the end of October, 1926, local authorities, operating the Act of 1924, were building under that Act 49,279 houses. That was about the normal rate of building at that time for municipal houses under the 1924 Act. With the announcement of the reduced subsidy, to take effect at the end of September in the following year, house building of course speeded up, and then immediately fell off, and it has never recovered. At the end of March of this year, the latest figures available, local authorities in England and Wales had 27,089 Wheatley houses in course of erection as against 29,773 on the same day last year. It is even less than it was a year ago, and that is so with some of the other months. I find that in October, 1927, the very first month after the reduction of the subsidy, there were 30,714 Wheatley houses in course of erection by local authorities as against only 28,800 in October, 1928. To-day local authorities are still building at half the rate at which they were building before the subsidy was reduced in October, 1927.

That is the real outstanding fact. In the 12 months prior to the reduction of the subsidy we built in England and Wales over 212,000. During the 12 months after the reduction of the sub- sidy we built only 101,000 houses. We were 110,000 houses short. Let us assume, if you like, that some of those 212,000 houses would have been built in a later period. They would not all have been, because we have a shortage which you cannot explain away except on the ground that the heart has been knocked out of the local authorities by this reduction of the public subsidy. That is the capital fact of the housing situation at present. The right hon. Gentleman says that last year we built, all told, 169,000 houses, many of them in Park Lane and near Hyde Park. But, anyhow, there were 169,000 houses, and that was a surplus of 69,000. A surplus of 69,000 houses is not good enough. There is no reason why any single operative in the building industry should be idle.

The housing need is still sufficiently great to demand the employment of all the people within the industry, and the fact that we have got up to the 200,000 houses a year mark, which we always said could be done—and we were derided by hon. Members opposite when we made that proposal—and that last year we got down to 169,000 is not a surplus in my view of 69,000 but a shortage of 31,000. It is 31,000 houses fewer than could have been built. It is all very well for the Parliamentary Secretary to regard it as amusing that he and the Minister of Health between them have succeeded in depriving 150,000 families in England and Wales of new houses which might have been in existence to-day. By this reduction in the rate of building in the last 18 months, by not keeping up the speed which the industry was capable of keeping up, we are 150,000 houses poorer. That lies at the door of the Minister and the Parliamentary Secretary. It may be the most screaming joke of their lives, but I think they will probably find that it has a more serious side, the results of which will become obvious within the next few weeks.

Let me say a few words about the Housing (Rural Workers) Act, on which the Minister was so discreetly silent. This happens to be another of his great fiascoes. This was brought forward as a contribution to the solution of the great problem of the rural cottages. The Act was put on the Statute Book, but nothing happened. The right hon. Gentleman sent his circulars round to the local authorities in the county areas, doing his best to persuade them to work the Act, and the Conservative party was so public-spirited that it produced a three-fold leaflet, expensively produced, as their wares invariably are, called, "Our village homes and the way to better them. A simple guide for cottage owners and tenants to the Housing (Rural Workers) Act, 1926." I do not know how many of these have been sent round the country, because the imprint does not give the numbers that were printed, but I have no doubt a very substantial number, and we ought to congratulate the Tory party on its public spirit in trying to enlighten the people in the rural areas on the benefits of this great piece of legislation. After these circulars to local authorities, after flooding the countryside with this three-fold leaflet, what is the effect of it? In May of last year the right hon. Gentleman had to admit that his Act had not been a success. He said: I must admit that the progress of reconditioning old cottages in the Country under the Housing (Rural Workers) Act has been up to the present disappointingly slow."—[OFFICIAL REPORT, 15th May, 1928; col. 880, Vol. 217.] After that, one wondered whether he was going to take steps to speed up the administration of the Act. I think the latest figures which have been given relate to 30th September, 1928, when as the result of two years' operation of the Act, as the result of circulating "Our village homes," as the result of circulars to local authorities, 343 houses had been reconditioned, and work was in progress on a larger number than that—on 518 houses. So that, if that work has been completed, something like 850 houses have been subsidised out of public funds among the hundreds of thousands of rural cottages which stand in need not merely of reconditioning but of replacement. One would not mind a single failure very much, seeing that the right hon. Gentleman has dropped this Act from his programme for the time being. One would not have minded if he had turned his attention to building new cottages in rural areas. The same story of reduced building for the country as a whole following upon the reduction of the subsidy applies in the rural areas, and I have no doubt that this Government will be known in the rural areas as the Government that damped down the building of new rural cottages. In 1926, there were 2,538 cottages built in agricultural parishes and getting the additional special subsidy that was provided for in the Labour Government's Act of 1924. That was the first occasion when any Government had gone out of its way to do something special for the agricultural cottager. Under that Act 2,538 houses were built in 1926, and in the following year, which included nine months of this period of spurt 6,373 houses were built. As in the towns, house-building has not recovered, and in 1928 only 2,113 were built as against 2,500 two years previously. Even on the showing of 1926, before we had got up to the rate of building which is possible now, there were 2,500, and last year just over 2,100, or 400 fewer new rural houses. All that the right hon. Gentleman has been able to do in just over two years under his wretched little reconditioning Act is to patch up 343 cottages. So that while his reconditioning scheme has failed, he has also failed to promote house-building in those rural areas where housing is so very badly needed.

The right hon. Gentleman is now paying the penalty of the very short-sighted policy of reducing the subsidy. He is paying the penalty in reduced house building. No amount of wangling with figures can get away from the brutal truth that house-building now is down below the normal, and I call the normal the figures that should have been obtained had the housing scheme of 1924 continued fully in operation. We should now have been building houses at a rate of well over 200,000 per year. We have not done it. We are not doing it. That is the price, not the price that the Minister himself is paying, but which the country is paying for a miscroscopic saving on the subsidy for houses. It is not merely that we have got an indictment against the Minister of Health for having followed this foolhardy policy, but that, seeing the results of it, he persists in his folly and determines to reduce the subsidy still further on the 1st October of this year. If that new subsidy is allowed to come into effect, there will be a still further shrinkage in house-building. He has not learnt—he refuses to learn—and he has refused, as far as one can gather, to take any special steps to encourage or to goad local authorities into fulfilling their responsibilities. He has sat with folded arms and just permitted the operation of the subsidy to damp down house-building by local authorities and by private builders building under the Housing Acts. As I said at the beginning, it is an inglorious record, and it is an inglorious end to an inglorious record. I hope that the country will realise the truth about the 800,000 houses. I hope that the country will also realise that it is to-day short of a very large number of houses which might have been built. The right hon. Gentleman says that only 5,000 bricklayers were out of work at the end of March. Only 5,000! What does that mean in house-building? It means a very large amount of house-building. I have forgotten what the output would be, but the right hon. Gentleman's policy has, on the one hand, diminished house-building, and, on the other hand, has intensified the unemployment problem. It has created, whether it is large or small at this moment, unemployment in an industry which above all others needs to utilise the last man.

I suppose that this will be my last word in this House. [Laughter.] I ask leave to withdraw the word "House" and to substitute the word "Parliament." I believe that I shall be in many other Parliaments. I could not have chosen a subject on which I should have more preferred to speak than this, and my very last words are that the Conservative party's recent policy of housing proves the insincerity of their claims to be a party that is concerned with the housing of the workers of the country. Whether that policy was designed with the object of reducing building or not, whether it was designed to hand over the whole problem again to the people who failed to solve it before the War, whether it is due to the mistaken idea of the Prime Minister that the job is nearly finished, we do know that the problem is as great to-day as it was eight years ago, that we have not yet really eaten into the great shortage, and that we are still left with a great housing problem. Eating into the housing shortage merely means making up the leeway. There is a bigger job than that. It is not merely a question of making up the leeway in numbers, but of making up the leeway in quality. As far as we are concerned, the policy of 1924—the building of 2,500,000 houses—still stands as our considered policy.

Mr. MORRIS

I am not going to go over the whole field of the speech of the right hon. Gentleman, nor am I going to follow the hon. Gentleman the Member for Nelson and Colne (Mr. A. Greenwood), but there is one particular portion of the speech of the right hon. Gentleman to which I want to devote attention. It is that part of the speech which dealt with mental defectives and with the Board of Control. I was hoping to-day that when he came to deal with that question he would have given us some assurance that the Report of the Wood Committee would now be issued. That Report has been presented since 19th of January of this year. The Committee, first of all, presented it as one whole Report, and not, as it now appears, as two Reports. I do not think that the right hon. Gentleman does himself justice in the attitude which he has taken up with regard to this Report, nor did he do himself justice this afternoon. The right hon. Gentleman said that he wanted the whole of this time to consider the Report, and he has taken up the attitude that he has not had sufficient opportunity to consider the position. As I have said, I do not think that such an attitude does him justice, because—and there can be no doubt about it—the right hon. Gentleman is one of the most competent Ministers sitting on that bench. One has great respect for his ability, and, when he comes down to this House and says that he has required all his time from the 19th January to the end of April to consider this Report, I again repeat that he is not doing himself justice. He must find a better reason than that. He complains to-day that there has been a good deal of misrepresentation.

Mr. CHAMBERLAIN

Not misrepresentation, but misapprehension.

Mr. MORRIS

I accept the correction. If there has been a good deal of misapprehension with regard to the Report, there is no one to blame except himself. He is responsible for the whole of that misapprehension. He gave an answer to a question which I put to him some time ago in this House, and I may say that Question Time in this House does not enable one to cross-examine effectively, and the right hon. Gentleman is not an easy subject for cross-examination. When I asked him why the President of the Board of Education was able to deal with this portion of the Report in a much shorter time than he was able to deal with it, his answer was that there were two reports. That was a correct answer swearing by the book. The Report, in the first instance, was a complete report. The right hon. Gentleman referred it back to the Committee, and asked them to divide it, and the Committee, under protest and very reluctantly, agreed that the Report should be divided. Obviously, the Committee regarded that section of the Report which dealt with the adult problem as part of the same problem relating to the children. The right hon. Gentleman referred it back, and he has not told us the reason. It would be rather interesting to know what is the reason. Perhaps the Parliamentary Secretary will be able to give some explanation as to why the Minister, notwithstanding the opinion of the commit tee, desired to have this Report sent back and subsequently presented as two separate reports. The right hon. Gentleman has repeatedly shelved the issue in this House. When the Report was sent to the President of the Board of Education he decided that the Report should be published, and he came to this decision as far back as last March. The right hon. Gentleman has gone to the end of April, and he still says that there has not been sufficient time to consider the position. Why should there be this distinction? I do not know whether the portion of the Report sent to the Minister of Health is longer than that which was sent to the President of the Board of Education, but I do not think there can be any special reason why it should not be published.

The right hon. Gentleman has said that there was misapprehension. There was an amusing account of the mystery of the Report in the "Daily News" on the 27th April of this year. It was written by the representative of that newspaper. He went to search for the Report. He went to the Ministry of Health and asked the representative of the Ministry: "Who is responsible?" The reply was: "Oh, we know nothing about it. It would be a matter for the Board of Control. They are a separate establishment." The representative then went to the Board of Control. The Board of Control said, "We have nothing to do with it. It may be that the Board of Education know about it." The representative went to the Board of Education and asked whether they had heard anything about the Report. The Board of Education said: "We know nothing at all about this part of the Report." Having gone round to all these Departments and each one knowing nothing about the Report, the representative came back again to the Ministry of Health, who said, "Oh yes, but we are afraid we cannot add anything to what the Minister said in the House." Therefore, by this time they knew something about it.

The question is very important as far as public authorities are concerned and very important in view of the Local Government Act which the right hon. Gentleman and his Government have passed this year. Why should the Local Authorities be debarred from a knowledge of this Report? What special reason can the Minister put forward? He has been invited time after time and almost week after week for the last few months to give some reason why the Report should not be presented. He has been pressed not only by Members of the Opposition parties above the gangway and below the gangway, but by hon. Gentlemen on the opposite side of the House. There is one hon. Member now sitting on the Government Benches who has also pressed for the publication of the Report. Why is there no reason given for the non-publication of the Report? Very strong language is being used about the matter. It is not a question of misapprehension merely on the part of members of the public, or on the part of members of local authorities, but even on the part of members of the committee who presented the Report. I invite the attention of the right hon. Gentleman—no doubt he has already seen it—to a speech of Dr. Tredgold, a very eminent authority, which was reported in the "Times" on 26th April. Hon. Members on the Government side know far more about the position of Dr. Tredgold than I can profess to know. He was a member of the committee. Why is a member of the committee suffering from a misapprehension? What is his language about the right hon. Gentleman's conduct in regard to the Report? He says: He regarded it as most unfortunate that, in the first place, the Government Departments concerned should have required the Report to be divided into two sections dealing with children and adults respectively, and that the part dealing with adults should not have been published. Considering the answers given in the House of Commons regarding this matter, they could not help feeling that some mysterious influences were at work in some place or other to delay, or even prevent, its publication. If this were so, it was a grave matter. Quite apart from the time and labour which had been devoted to the subject by the committee, as well as the not inconsiderable public expense which had been incurred, it seemed to him a most extraordinary thing that it should be possible to hide the carefully considered opinions and recommendations of an independent committee on such a subject from the country. He very much doubted whether the public authorities who were charged with the duty of providing for these defectives, whether Parliament, and whether the country would tolerate such an autocratic procedure"— —very strong language from an eminent member of the committee about the action of the right hon. Gentleman— which was so totally at variance with our national ideals and reputation for integrity. If an eminent gentleman such as Dr. Tredgold, a member of the committee is suffering from this misapprehension, why does not the right hon. Gentleman explain how it is that the Report has not been published? Why should he appoint a committee of such distinction, why should he spend public money and why should the committee devote their time to investigations, and then when the information has been accumulated it is not to be placed at the disposal of the country? The right hon. Gentleman said this afternoon that the figures and the investigations of Dr. Lewis had been published. If so, why cannot the whole of the findings of the committee be published? What are the views of the "British Medical Journal?" That is not a partisan paper. It cannot be accused of any political opposition to the right hon. Gentleman or of any political bias. It says: The portion of the Report which deals with adult defectives is still mysteriously withheld. Neither delay nor withholding is the fault of the joint committees themselves. In the public interest it is necessary to press for, even insist upon, the early publication of the missing Part 3. The only answer that the right hon. Gentleman gives is that there is misapprehension. Clearly, there is a mystery, and clearly no one is more mystified than the people primarily concerned in the investigation. Why will the right hon. Gentleman not tell us the real reason for the non-publication of the Report? It cannot be that he has been pressed for time from January down to the present day. I would ask him or the Parliamentary Secretary to tell us a great deal more about the Report than has been vouchsafed to the Committee and the country in the speech which the right hon. Gentleman has given to-day. I hope that the Parliamentary Secretary will be in a position to say that the Report will be published and that he will take up the same attitude towards it that his colleague the President of the Board of Education took in regard to the other part of the Report.

Dr. VERNON DAVIES

We have had a lucid and interesting address from the Minister of Health, and we have had an interesting speech from the hon. Member for Nelson and Colne (Mr. Greenwood), who led the House to believe that it was to be his swan song. If we have not the pleasure of welcoming the hon. Member to the next Parliament, we shall look back with great happiness to the speech which he has made to-day. He assured us that if he bad had the choice of the subject, nothing would have given him more pleasure than to have dealt with the housing record of the present Government. If we of the Conservative party had had any preference in regard to the way in which the subject should be handled by a Member of the Opposition, we should have chosen the hon. Member for Nelson and Colne. We shall go to the country fortified by his speech, in which he showed what the Conservative Government have really done.

In spite of all his dexterity, wit and happiness, there are certain fundamental facts which the hon. Member has not been able to upset. Some 800,000 houses have been built. It does not matter whether they are occupied or unoccupied; the fact remains that they have been built during the administration of the present Government. Another point to remember is that the price of houses has come down. The hon. Member seems to object that houses should have come down in price. He said, or he led us to imagine, that the very fact that houses are coming cheaper would be a sufficient reason for people not to build houses. Therefore, the hope and desire of the hon. Member are that the subsidy should be put on again, that the price of houses should be increased, and then the public will rush in and either buy or rent the houses. I do not think that the evidence of the past points to that. I have a dim recollection of a very important speech made by my right hon. Friend the Minister of Health before he took off the subsidy. If I remember rightly, he said that he had had a very careful analysis made of the cost of housing under the Wheatley Act and the Chamberlain Act, and the effect of the subsidy. He found that any increase or decrease of the subsidy had not been reflected in any shape or form in the rent, that the subsidy was going into the hands of the contractors and that it did not even go into the pockets of the bricklayers or other workpeople.

Therefore, he said: "As an experiment, I will reduce the subsidy because the people who rent the houses are getting no benefit, the workpeople who build the houses are getting no benefit, and I will see what happens." When he made the first reduction of the subsidy, he found that the price of houses came down, as he had prophesied. When the next reduction of subsidy took place, the price still further came down. We can go to the country with every confidence and say that under the administration of my right hon. Friend the number of houses built is a record for this country or any country in the world, that it has not been approached by any other nation and that the houses are cheaper. Having built such a large number of houses, it stands to reason and common-sense that the congestion and pressure on other houses has been relieved, and that there cannot possibly be as much overcrowding as there was before the houses were built. Now, the path has been cleared for making even greater progress for building cheaper houses and for dealing with slum clearance. I thank the hon. Member for Nelson and Colne for the excellent ammunition that he has given us for our campaign during the next few weeks. I was rather amused at his attitude towards rural housing. In regard to ordinary houses in urban areas he advocates subsidies, but when he spoke of rural housing he objected, if I understood him correctly, to rural houses having a subsidy from public funds. I do not know why he should take that attitude, seeing that he is asking for an increased subsidy for the ordinary houses of the country.

The speech of my right hon. Friend was divided into various parts. The part with which I wish to deal more particularly is that relating to health services. Probably owing to stress of time, the right hon. Gentleman has not been able to deal fully with this subject. I have heard all the speeches that have been delivered in connection with the Health Estimates during this Parliament, and while bearing in mind all that has been done during the past 4½ years I am appalled by the amount of work remaining to be done. We have made marked progress in housing, pensions and national health insurance, but there still remains a great deal to be done in connection with our health services. The hon. Member for Cardigan (Mr. Morris) referred to the Report on mental deficiency, and the right hon. Gentleman spoke of the large number of mental defectives. It cannot be denied that there is a certain amount of apprehension or anxiety as to the non-publication of the adult part of the Report. It is only natural that when people begin to imagine certain things they put the worst construction upon certain facts. Although I am convinced that the Minister must have good reasons for his action with regard to the Report, I do hope that he will give the matter immediate attention and remove apprehension which I feel quite certain will prove to be unnecessary when the position has been made clear.

The right hon. Gentleman referred to the large number of lunatics in the country and carefully and accurately stressed the point that in lunacy you have a curable disease; in mental defectiveness you have not. One important point to bear in mind is that there is a large number of people on the border line who, by proper treatment in mental hospitals or in suitable hospitals, could be prevented from going over the line or could be brought back to normal. That is one of the urgent and vital works in front of the Ministry of Health. The main essential is that you may have a class of patient who can be treated mentally without certification. For years in this country there has been a sort of feeling that any poor individual who suffers mentally is suffering from an affliction inherited from the parents or that the affliction is from God. If a patient suffers from the heart, chest or the lungs he is regarded as suffering from one of the ordinary afflictions of human life and there is no discredit attached to it. Why should people try to attach discredit to a poor person who happens to be suffering from mental illness, which may be temporary or permanent? Until the Ministry of Health take their courage in both hands and deal with the Report of the Royal Commission on Lunacy and bring in legislation to deal with it, we shall have this awful feeling amongst the people of this country towards people who are suffering from mental affliction. A great work lies before us in that respect.

Another important question is that of small-pox. This country, the home of Jenner, the country which first discovered the principle of vaccination, the country which first dealt with small-pox, is held up to the ridicule and horror of the world. A neighbourly and friendly country, France, acting in a moment of panic or irresponsibility, issued a very drastic order against this country in regard to small-pox. At the other end of the world Brazil is taking the same action and objecting to the importation of people from Great Britain unless they have been vaccinated. I believe I read a publication of the International Labour Office or the Health Commission in which it was said that we were the worst vaccinated country in the world—the country of Jenner. The Minister has powers to enforce the administration of the law. The Rolleston Committee suggested various alterations in regard to vaccination, and I hope the right hon. Gentleman will take this matter in hand and see that we really do get efficient administration in order to get rid of the curse of small-pox.

The Minister of Health also referred to the question of cancer and the Radium Fund. I understand that we shall probably have an opportunity of discussing this question on the Supplementary Vote for Radium, but I should like to draw the attention of the Committee and also of the country to the fact that although in radium we have a substance which has proved, and is proving, of enormous value in the treatment of certain forms of cancer, it must not be forgotten that we are dealing with an extremely dangerous clement which ought only to be handled by experts. In the hands of people who do not know how to use it, it is much more likely to do more harm than good. The essential thing, having obtained radium, is to see that it is used only by people who thoroughly understand it; by medical men who are thoroughly expert in its use. What I am afraid of in this country is not that we shall not get a sufficiency of radium, but that for some little time we shall not have a sufficient number of experts to deal with it.

The right hon. Gentleman, as we all know, takes a great interest in the question of maternal health and maternal mortality, and we appreciate the fact that these committees have been set up. We have great hopes that they will lead to a diminution in the maternal death rate, but I am convinced that the secret of the matter is efficient midwives, properly trained, and, above all, that babies should be born in satisfactory surroundings. It is extremely difficult to say that there is no risk to a mother or baby born in a slum area, but there is a possibility that there is a certain amount, or there has been a certain amount, of carelessness, because, if I understood the Minister of Health, he said that the fact that he had made inquiries from medical men in the country as to the causes of death had already led to an improvement. That can only be the result of a little extra care taken by the doctor, or nurse, or the attendants, and a little more cleanliness. If this extra care and attention is going to add to the number of lives that are saved, that alone will more than justify the right hon. Gentleman for the work he has done.

Very little was said by the right hon. Gentleman about tuberculosis. Unfortunately we have not had the Report for last year. As my right hon. Friend knows, this is a subject in which I take the greatest possible interest, and I should like to know whether there has been any improvement in the compulsory notification of phthisis? Are you getting better results? Is your dispensary system functioning properly? Are you co-operating with the medical men, with the sanatorium and with the hospitals? Are they all working like one efficient unit? Will the right hon. Gentleman take care to see that under the Local Government Act the tuberculosis service is worked as a complete unit? If it is necessary to have a full-time medical officer for health services, it is 10 times more important to have a full-time tuberculosis officer. The one essential thing in tuberculosis is early diagnosis, and that is a matter for the expert. You cannot expect the ordinary general medical practitioner, who has not the latest means at his disposal, such as X-rays, to diagnose the early case. I am pleased to know that there has been an increase in co-operation as between the general medical practitioner and the tuberculosis expert. It is no use getting the middle or the final cases; it is the early cases we want to get, and we cannot get them unless a full-time tuberculosis officer is appointed. Then there is the question of venereal disease, about which the right hon. Gentleman said very little. He referred to the diminution in the number of cases of ophthalmia neonatorum, but that is simply an example of the extra care that is being taken. He did not mention how many of the 5,000 were blind, but I can safely say that with ordinary care and attention there should not be a single case of ophthalmia neonatorum. It is easily Preventable by proper care and attention, and I hope the right hon. Gentleman will exercise all the moral and administrative pressure he can in regard to this particular disease.

My right hon. Friend can lock back on a very successful 4½ years' administration. The work of the Ministry of Health during that time has advanced by leaps and bounds. The health of the country has improved; the social services have advanced, and by now my right hon. Friend must be tired of the congratulations and good things which have been said about him and his administration. Not the least remarkable result is the great admiration and respect shown to the right hon. Gentleman and his colleague the Parliamentary Secretary by members of my own profession. Although the Minister is not a medical man, he has an uncanny knack of spotting a case, and I have no doubt that if he had been fortunate enough to have been a member of my profession he would have risen to great heights. Let me conclude with just a little criticism on the Vote itself. On page 15, under the heading "Medical Staff (including Government Lymph Establishment)," I find that there are 40 medical officers, and on referring to paragraph (c) I find that of these officers two are in receipt of pensions of £400 and £460 respectively per annum from Indian funds; one of a pension from Nigeria and Gold Coast funds to bring his total emoluments up to £1,305, and two of Army retired pay of £365 and £510 per annum respectively. I would ask whether there are no medical men in this country fit for these offices without taking retired officers from the Indian medical service? It is very essential, particularly in our national health insurance service, that a man who has a chance of working up from general practitioner to a higher administrative office should not be pushed on one side and the job given to another man from another service. There is probably good reason for these appointments. I do not know what the reason is, but I shall be glad to know it. In conclusion, let me as a medical man express my deep appreciation of what the right hon. Gentleman has done for the country and its health services and for the medical profession, and at the same time point out that so far only half the work has yet been done.

Miss LAWRENCE

I do not propose to go into such details as have been covered by the hon. Member for Royton (Dr. Davies). The hon. Member took the speech of the Minister of Health point by point and then proceeded to elaborate it. He reminded me rather of the old-fashioned commentator of the inspired Book. He takes each sentence of the Minister of Health, develops it a little, adds to it and then there is the pious ejaculation: "In all his works, how wonderful!" I want to devote myself to the Minister and to a subject hardly dealt with in his speech and that is the question of the Poor Law. The right hon. Gentleman did not touch upon that matter because his administration of Poor Law relief has been the most remarkable thing in his career. It is marked by two things. He has arrogated to himself powers greater than those which any Minister has ever enjoyed before, powers which, I think, are wholly illegitimate. In the second place, he has reversed the policy not only of his immediate predecessor, but of a long line of predecessors, from 1920 downwards. I am not going to labour the point that the right hon. Gentleman is in possession of greater powers than any Minister has ever obtained. The House has over and over again debated Acts increasing his powers; the Guardians (Default) Act, the Auditors Act, the Emergency Provisions Act, and that amazing Clause in the Local Government Act which allows him to withhold the income paid in lieu of compensation for de-rating from any authority who may spend more than he thinks proper. These are enormous powers, and some of them are wholly illegitimate. It is wrong that there should be civil servants appointed by the Minister of Health, promoted by him, their salaries paid by him, for whom he is not answerable in Parliament—I mean the auditors and the appointed guardians. The auditor is supposed to be in a position of impartiality, but the Report of the inspectors does not pretend to keep up that disguise. The inspectors in their Report, and the Minister in his, treats them as servants of the Department. I have here an abstract from the Report, They are speaking of the difficulty they have in inducing boards of guardians to adopt a restrictive policy, and they say: It is hoped to make considerable further progress by means of investigations and correspondence and conferences, reinforced, if necessary, by the Minister's power to withhold approval of relief, with a resulting disallowance and surcharge by the district auditor. There is no mystery about it. The auditor is treated in the Report as the executioner of the Minister of Health. Whether these powers are right or not, and whether Parliament approves of the policy or not, I say that in these Estimates we have civil servants appointed by the Minister, who are under the approval of the Minister, whose whole being depends on the Minister, and in regard to whom the right hon. Gentleman is not responsible to Parliament. That is a thing unheard of in England since 1660. It is repugnant to the whole principle of our Constitution.

6.0 p.m.

I pass from that to the question of out-relief. In 1921, unemployment first reached the figure of 1,000,000 and, roughly speaking, it has stopped about that figure ever since. The Government of the day considered the probable effect upon the country and upon the individual if such a great mass of persons were deprived of their ordinary means of subsistence. Either moved by pity for the unemployed or by fear, either moved by pity for the men who certainly were not guilty of the depression in trade, or else by the political consideration that a mass of hungry people might be very dangerous, the policy was adopted of suspending the Poor Law Relief Order of 1911. The Minister then in charge was undoubtedly an exceedingly intelligent man, and I believe him to have been a very humane man. That policy of suspending the Order of 1911 and allowing guardians at their own discretion to give out-relief worthy of the claim, became the policy of the country. The guardians were not all Labour guardians. There were most respectable guardians, in Manchester and in London, who felt, as the Government then felt, that the unemployed should be relieved. During all these years, though unemployment still stood at a high figure, we never had any complaint of acute physical distress on a large scale in the whole of England and Wales. It was only about 18 months ago that the distress in the depressed districts forced itself so much on the attention of the House and the country that we had Lord Mayors appealing for money, and we had the Heir to the Throne speaking natural, simple and manly language of disgust—and no man ever spoke more to the conscience of the people.

Why was it that for all the years from 1920 to 1927 there was no complaint of actual physical privation affecting large masses of people? Why is it that last winter and last summer the cry of distress was so great that charitable people were asked to help? The distress and the suffering and the misery are entirely due to the policy of the Minister of Health. That is so serious a matter and so enormous an accusation to bring against anyone that I desire as quietly and as soberly as possible to state the facts and figures which are on record. The Minister of Health has said in this House that his policy is to return to the 1911 Order as quickly as possible. That Order provides that no out-relief shall be given to any male person except with the expressed approval of the Minister, or in a case where test work was provided under certain conditions. It was obviously nonsense to say that boards could give test work or any work to one million unemployed. I do not think that any hon. Member opposite who pours such contempt on the unemployment scheme put forward by us and supported by hon. Members of the Liberal party, would pretend that the board of guardians alone, out of the rates, can give test work or any other sort of work to so great a number of people. A return to the principle of the 1911 Order means, therefore, that male persons will not be relieved save in exceptional cases.

The officials of the Minister set to work to put his decision into operation. They set to work immediately after the failure of the miners' lock-out. As the clerk of one board of guardians said to me: "The Minister's push began two years ago." Circumstances have altered since then. The enemy have been beaten. There was no danger of any response on the part of those who have been so cruelly reduced. When the general strike and the miners' lock-out were safely over, there began the putting into force of the policy of reducing. The Minister pointed with great pride to the reduction of pauperism in the year ended March, 1928. It was wholly due to out-relief reduction and not due, as the Minister seemed to think, to a reduction in the number of widows who depended on the Poor Law. The reduction in the number of widows in that year was only 2,000. In the case of the people ordinarily unemployed the figures fell from 545,685 persons, who were in receipt of relief, to 481,128, and the Minister has given figures to the House to show that in January 1929, the numbers were further reduced to 314,963. That is to say that, although unemployment was very much worse in January, 1929, than it had been before, though we were passing through a time of almost unexampled unemployment and there was very bitter weather, and though the hoardings were covered with appeals on behalf of the distressed miners and their families, the Minister and his officials went on with the good work and pushed off the relief list over 180,000 persons.

That is what they have done in bulk, and that is what they are continuing to do. If one examines individual histories one finds that they have been most active in some of the places where the depression has been worst. Merthyr Tydvil had 22,000 in receipt of relief in 1925, but there are only 14,000 to-day. Bridgend and Cowbridge had 9,000 in receipt of relief in 1925 and has 4,000 now. Pontypridd had 30,000 in 1925 and has only 20,000 now. Man by man and family by family are being dealt with. The inspectors of the board are going down to the guardians and exhorting them. I have here the reports from Manchester, where there is a thoroughly good and respectable board of guardians. I have the lists of individual cases in which the inspectors have almost directed the guardians to cut down relief. What hypocrisy it is! If we come to this House and ask the Minister a question about relief which is inadequate, he gives a stock phrase reply that by Statute he is forbidden to interfere in any individual cases. But his officials who represent him go down to the boards of guardians, look through all the cases, and with all the machinery of the Department behind them exhort the guardians, in thousands of individual cases, to cut down the relief.

It is not only that. What sort of relief do the recipients get? I have here a document which has had considerable publicity. It was, I believe, the origin of the Lord Mayor's Fund. It is a report of the investigation of Poor Law cases in the Bedwellty union. It is signed by the treasurer of the South Wales Miners' Federation, and is the report of an inquiry which he made, together with persons sent down by the Minister. I will give one or two cases taken from it. In the case of a husband and wife and four children the relief granted was 23s. 6d., and after rent was paid there was 14s. 6d. left, or an average of 2s. 5d. per person. Another case is that of a husband, wife and eight children under 14, the husband being an ex-service man. The relief granted was 35s., and the rent 9s., and the balance had to maintain 10 persons. In Bedwellty, where the Minister's appointed guardians are, the average net income per person was 2s. 3d. a week, including the Poor Law relief granted and any other income. That is the treatment that is being meted out to the poor.

The Minister has stated in the House that single able-bodied young men should not have out-relief. Thanks to the pressure of the inspectors, backed by the obedient auditors, that decision has been put into force in many unions. Young men are left without work, without Poor Law relief, without anything to live upon except a share of the 2s. 9d. per head which is given to their family. No man with any human feelings would dare to stay at home and eat the babies' bread. So these young men break out and go travelling along the roads. Then officials of the Minister speak of the extraordinary flood of new vagrants, and young vagrants. To do the inspectors justice, they speak of these young men as in a very large percentage of cases genuinely searching for work. How has the Minister met this growth in vagrancy? He has tightened up the relief to casuals by exhorting the guardians to give a man two nights in a watch house, and a day's physical work for every day that he spends along the road. It is a cruel thing, and is hard on these young men. But that is not all. In these casual wards, as Members know, there are some of the most hardened rogues in the world. When you put a young man there you put him in close contact with some of the worst characters in the country. Nearly everything that was said in former times about the evils of mixed prisons is true of the casual wards to-day. These hardened old rogues look out for innocent young men to be their accomplices.

What of the future? Nobody supposes that trade is going to revive by itself, so as to take in the unemployed suddenly. It will be a gradual process. If the Minister's policy goes on it means that the unemployed will be deprived of Poor Law relief altogether. If the Regulations of 1911 are put into force no male person will be relieved, save as an exception. Unemployment benefit was never intended for a man and his wife and children to live on; it is not supposed to be maintenance, but only assistance to carry people over a temporary period. Thousands of people have exhausted their unemployment benefit. They have exhausted everything else. They have exhausted their credit; they cannot pawn any more; they have exhausted the help of their friends. They will be left with the Poor Law as the only resource, and the Minister's declared policy is to go back fully, as he has gone back partially, to the Regulation of 1911, under which relief is forbidden to all male persons.

Human misery, which it is almost impossible to contemplate, has resulted from that policy and that is what will continue to happen to the unemployed if, by any misfortune, the present Minister of Health and the present Government are allowed to remain in control. But if we come back we will end the misery, the hunger and the starvation. I know that to bring in a proper Unemployment Insurance Measure would take months, and to start everybody who is unemployed on schemes of work would also take months. We will do these things, but we will not only look to the curing of unemployment; we will deal with the people who are suffering from hunger and cold, from want of boots, from want of milk and want of clothes. These are things which a Labour Government can cure within three weeks of coming into office. They are things which we can cure without Acts of Parliament. They are things which can be cured by administration just as was done in 1920. We shall cure them by administration, just as the evils themselves have been caused by administration. There is no Act of Parliament needed to enable the Minister to reaffirm the Order of 1911 and no Act of Parliament will be necessary to revoke that Order again. These things, as I say, can be done in three weeks. [Interruption.] I am not saying to the Liberal Members that the unemployed can all be put on to useful work in three weeks. Who says that?

Mr. PALING

The right hon. Gentleman the Member for West Woolwich (Sir K. Wood) laughs.

Miss LAWRENCE

The right hon. Gentleman the Member for West Woolwich laughs and jeers, but, if I am right in my view, his place will know him no more. The Minister of Health will probably come back, but as to the right hon. Gentleman the Member for West Woolwich, I very much doubt if this House will see him again. To put the unem- ployed to work—that can be done. To pass a new Unemployment Insurance Act—that can be done. But these are things which any Parliamentarian knows must take some little time. I repeat, however, that to stop hunger is a thing which can be done in three weeks. It is a mere question of the Minister of Health issuing a new Circular to local authorities, and, under his existing powers, making funds available for the purpose just as Lord Melchett did in 1920. There is no mystery about it, and when we come into power we will end the hunger, the want of milk, the condition of "no boots for bairns." We will take it as our first and most sacred duty to see that the harmless and the innocent shall not suffer actual physical privation. If we were going to do no more than that, it would be well worth winning the Election and it would be well worth while for everybody with an ounce of humanity in their hearts to put every scrap of their courage, their strength and their intelligence, into bringing about that victory and sweeping the present Ministers away from the Departments of State.

Captain FRASER

The hon. Lady the Member for East Ham North (Miss Lawrence) apparently feels so sincerely about these matters that one must sympathise with her plea for people who are in these difficulties, but I think that she misleads people a little—if she will allow me to say so—by suggesting that these things can be cured quite as easily as she has indicated. I think the present Minister of Health has done the first thing first, which was to set in order the finances of these local authorities. If instead of financial order, you have financial chaos and if debts accumulate until they cannot be paid, you cannot hope for normal relief, let alone abnormal relief. With all respect to the hon. Lady, I think it a little unkind to these in need, to suggest to them that by a wave of the wand you can in three weeks remove all their needs and difficulties, when her leaders must know perfectly well that such a policy is not one which they can put into a formal statement of their programme.

Miss LAWRENCE

I did not say all their needs and difficulties. I said hunger and physical privation.

Captain FRASER

I do not think that it is true to say that there is a large measure, or any measure at all of physical privation. There is need, as everybody knows, but I think the hon. Lady does less than justice to the people whom she tries so sincerely to represent, by exaggerating their case in this way.

I wish to say something about the blind community which is one of the charges of the Ministry of Health. Before I ask the Minister if he can do something to help them, may I have the indulgence of the Committee while I explain the situation of the blind community, and show how we in this country look after them, because I do not think that there is enough general information on the subject. There are about 48,000 blind persons in this country of whom about 11,000 are under the age of 40 and the balance are over that age. One can analyse the figures in another way and say that there are about 10,000 blind persons employed and about 33,000, or the greater part of the balance, characterised as unemployable. It is curious that these two sets of figures should be so similar in their division. The number of blind persons has apparently increased, but that is not due to a real increase in blindness. Owing to various causes such as those mentioned by the Minister when he referred to the notification and early treatment of ophthalmia neonatorum and better methods of preventing blindness in factories, the amount of blindness has in fact decreased. But there has been an increase in the number of those who are registered. That is partly because the Ministry and the local authorities seek out hitherto unknown cases and get them on to the register in order that they may be cared for. It is also partly due, curiously enough, to the Act of Parliament passed in 1926 for the purpose of giving blind persons free wireless licences. That has led to an extraordinary increase in the number on the register and in London alone no fewer than 900 blind persons hitherto unknown or unregistered, have been discovered as an indirect result of that Act.

There are three ways in which public funds are used in this country to help the blind. First there are the pensions given to them under the same conditions as the original old age pensions, but at the age of 50 instead of 70. In 1924, 11,000 persons were receiving those pensions, costing approximately £280,000. In the last year there were 17,000 persons receiving these pensions at a cost which would work out at about £450,000. Then, a considerable sum is spent by the Ministry in aiding local authorities and workshops for the blind, subsidising the employment of blind persons in factories and in their homes, and in various other ways contributing to the well-being of individual blind people. These grants in 1924 amounted to £95,000, and in the last year the expenditure had risen to £126,000. Thirdly, there is the expenditure of the local authorities themselves. Under the Blind Persons Act they are charged to carry out schemes for the well-being of the blind in their areas in a variety of ways which I have not time to mention. In 1924 the local authorities expended £102,000 on these services and judging by the rate of increase during the last two or three years, I calculate that in the year just ended they must have spent about £225,000. If these figures are correct, it will be found that in 1924 the amount spent on the blind from public funds was about £477,000, and in the last year there has been spent under the same headings no less than £801,000, or an increase of about 68 per cent.

I suggest that that is real progress, and that we can congratulate my right hon. Friend upon having done his best to push forward these services, to see that more blind people were registered and consequently made eligible for these services and to increase the general provision made by the State and the municipalities for the welfare of the blind. I say unhesitatingly that in this country we have a more carefully worked out, more widespread systematic and generous method of helping the blind people than any other country in the world. Curiously enough, blind people were the first to be partially removed from the Poor Law. In 1920 it became possible for blind people to be assisted by local authorities instead of by the Poor Law. I hope that local authorities using the experience which they have gained in relieving the necessitous blind may, as quickly as possible, make use of the permissive powers given under the recent Act which would make it possible for them to look after, not only the blind people, but also their relations and, indeed, all poor persons, without resort to the Poor Law.

As I have said, considerable progress has been made and this country cannot fairly be charged with being behindhand in the care of the blind, but I hope that the Minister will think that the time has come to go a little further. I would remind him that in recent years inquiry has been made by his advisory committee to find out the situation from every point of view as regards all the unemployable blind persons in the country. That inquiry must be nearing completion, and there should be available very soon, information which might make it possible for him to go forward and suggest further State assistance. It would be out of order for me to suggest any method which would require legislation, but I may be allowed to say that I feel that it is in the direction of pensions for a larger section of the blind community that the Minister's efforts should be directed. Some hon. Members above the Gangway are critical of any voluntary effort to help blind people, and since it happens to be the Ministry's policy, rigidly observed for 10 years, to encourage voluntary agencies, I may be in order in saying something upon that method which I believe I can justify. The feeling of hon. Members apparently is that the State or the municipality should do all that is required. Everyone will agree that in a matter like this the State and the municipality should do all that public opinion will permit them to do. That does not mean that there are not other needs which can be met by voluntary assistance.

The triple partnership of the State, the municipality and the voluntary agency, brings to bear on the needs of our blind people a very powerful method of helping them in their distress and those who advocate a diminution of voluntary effort, and even its abandonment, are, though they may not know it, the worst friends of the blind. If they realised what a loss it would mean to the blind community to be without the assistance that is given voluntarily, if they realised the harm they did by frequent and repeated criticism of voluntary agencies, they would, I think, cease to do it, out of the kindness of their hearts. A mistaken idea, and perhaps the feelings of the blind people who are in distress and who turn to anyone who will offer them something, however impracticable it may be, make them go on repeating these statements, which I do not believe are in the best interests of our blind people. Fortunately you cannot by legislation change the hearts of men nor suppress generous impulses, and if you could, I wonder how many people there are who would really wish to do it. I think that we can genuinely and safety say that we have made enormous progress during the past five years—more than in any other five years in our history—and if the Minister will go a step further, or will leave behind him such arrangements as will make it possible for his successor to go a step further, then we may be satisfied that the period of the last five years, in the development of care for the blind, has been a useful one.

Before I conclude, may I say one very brief word about cancer? What I believe we need in this country is a central institution where a sufficient number of cases can be gathered together, in order that the medical men concerned may get adequate statistics about experiments and the treatments which they give. An ordinary general hospital has the primary function of caring for the cases which come from its immediate neighbourhood, and the majority of them are not cancer cases. In any plans which the Minister is formulating to aid this work and cause progress to be made, and in any plans which he or his Department may have in mind for the use of radium, I hope he will consider the advisability of lending his powerful aid and that of his Department towards the establishment of some institution comparable to that in France, to that in Sweden, and to that in Berlin, in order that England may do a work similar in its value to that which has been done hitherto more especially on the Continent.

Mr. LANSBURY

I would like to say one word about charity and the attitude of mind of myself and certain of my colleagues. Our contention is that private charity utterly fails to deal with the social evils of our time, and that even the question of dealing with blindness had to come at last, after very great opposition and after much agitation by Members on these benches, into this House and be legislated about.

Captain FRASER

Not only on those benches.

Mr. LANSBURY

The hon. and gallant Member for North St. Pancras (Captain Fraser) will allow me to say that the whole question of legislation for the blind started in the Trade Union Congress of this country, and for many years we appealed to this House to deal with that problem, but this House refused to do so until quite recently, and the condition of the blind was a disgrace to Christendom until we took legislative action here in this House of Commons. The fact that the hon. and gallant Member is now appealing for further State action in dealing with cancer and other diseases proves conclusively that in the end the only powerful society that can deal with social evils is society as a whole, and not the private charity of individuals. Further, we deny the right of any section of the community to patronise and give something to those who are in need. [HON. MEMBERS: "Oh!"] There is nobody in this House who would care to live on the charity of anybody else. I, myself, do not intend if I can help it, however long or short my life may be, to live on the charity of anybody. If I were sick, I should not care to receive attention from the rich and the well-to-do, and if I were a poor person who had worked all my life for my bread, and then, because of my inability to help make profits and dividends and rents for other people. I was helpless. I would demand from my fellow men and women the assistance I needed rather than receive it from the dividend and rent-takers.

I want also to call attention to the speech of the hon. Member for Royton (Dr. Davies), who told us that we apparently were getting no further ahead. That is perfectly true. The right hon. Gentleman the Parliamentary Secretary will probably tell us, when he comes to reply, that we have made the same speeches as before, and we can tell him beforehand that he will make the same speech as before. The fact is that it is quite impossible to rise in this House and speak on anything connected with local government, with the prevention of destitution, and with public health, without repeating the statements that have been made again and again and again for the last 25 years. There is a perfectly simple reason for that. Up to the present no House of Commons has tackled the causes of these things, and the reason people are sick and need help from the community, the reason people cannot get decent houses to live in, the reason people cannot get work, is not the fault of the individual at all, but the fault of the system under which we live. Poverty causes people to be sick; poverty murders the mothers at times of maternity; poverty causes consumption. If the hon. and gallant Member for St. Albans (Lieut.-Colonel Fremantle) stood up and made the speech that he could make on this subject, he would be obliged to say that after the right hon. Gentleman and his Department and the local authorities have done everything possible for the phthisical cases, when they have dealt with them in sanatoria, they send them back to the same wretched slums and poverty-stricken conditions, again to fall victims to the disease. Why is it that men like myself never suffer from that disease? Why is it that my children have not suffered from it? It is because they have had enough food and have slept in rooms big enough to breathe in. The reason consumption increases and people suffer from these diseases is, I repeat, poverty, imposed upon them by social conditions.

Dr. DAVIES

Not always.

Mr. LANSBURY

I would like to offer this piece of advice to the hon. Member for Royton, that he should learn one thing, and that is to make his own speech and then to let other people make theirs. The doctors of this country, especially those who have had anything to do with the public health, know very well that the diseases dealt with through the public health authorities are attributable in the main to bad housing, low wages, unemployment, casual labour, and everything that goes to produce poverty, and, therefore, until you remove the causes of poverty, you will not get rid of the things that you are complaining about to-day. You may go on spending money, you may go on pouring out money on experts here and experts there, you may go on putting a patch on here and a patch on there, but the diseases will remain and will still cause these speeches and all this discussion as to how to deal with them. Everybody knows that the people who suffer most from these diseases are those whom I have just mentioned. I wanted to say that first of all. I know I must not pursue it and state what the remedies are, because they would need legislation, but now that this spirit of repression has taken hold of the Ministry of Health and the whole tendency of the Ministry is to depress the poor, it is just as well that those of us who believe that poverty is at the root of these things should tell the House of Commons that the time has come when we ought to tackle the problem of poverty and get rid of it and of the evils of which we are complaining.

I want also to say a word about the mentally deficient. It amuses me very much to read the newspaper articles and to listen to experts in this House on the question of the mentally deficient; and I say here again that there is no medical officer of health and no doctor who attends Poor Law people who will not tell you, what is perfectly true, that the children who are mentally deficient are not all the children in one family, but that you will get perhaps one child in a family suffering in that way. I want to know where you will start to sterilise. I have never heard such utter rubbish and nonsense talked and written as I have heard and seen on this particular subject of the mentally deficient. I am not a medical man, and, thank God, I am not an expert either, but I know perfectly well that where I live most of the children who have to attend this kind of school come from the same kind of homes that the phthisical cases come from and the others who suffer from poverty disease. I believe that often it is the worry, the struggle to live, the being pressed down because they have not the means to get their daily bread, that creates in a woman, when she is carrying a baby, the sort of things that bring about mental deficiency in the child when it is born, and then the child is born into conditions that never give it a chance at all. I say that, before you start telling the multitudes you are going to pick out—you doctors—those whom you will sterilise, take good care that we do not sterilise the lot of you first!

The doctors, with their usual "authoritarian" sort of speech, talk about ophthalmia neonatorum. The hon. and gallant Member for St. Albans and the hon. Member for Royton know as well as I do where you get those cases from. Out of the big houses, out of the places where the people have the means of employing nurses and doctors, and where the mother has all the pleasure of a comfortable bed and a nice, big, airy room? Of course not. You get them out of the slums, and you cannot get rid of that disease until you get rid of the conditions that drive people to live in the slums. Therefore, you come back, with that disease again, to the question of poverty. I know what I am talking about, because I have seen hundreds and hundreds of cases, and I know where they all come from. They come from the very poor.

Captain FRASER

Will the hon. Gentleman allow me?

Mr. LANSBURY

No, I cannot. I notice a good deal of hilarity and jocularity among Members when one is talking about these kind of people, but when they get face to face with them, they do not snigger at them in this fashion. I am saying that these cases of ophthalmia neonatorum come from poverty-stricken areas.

Captain FRASER

The hon. Gentleman does not know what causes it, or he would not say that.

Mr. LANSBURY

I am very sorry that the hon. Member for North St. Pancras interrupts me. It happens that I was one of those who helped very materially to get this disease notifiable, and I took a great deal of trouble to try and understand it.

Captain FRASER

I apologise.

Mr. LANSBURY

Thank you. I want to deal with the right hon. Gentleman's administration of the Poor Law. His well-fed, well-housed, well-clothed Department have brought the Poor Law of this country back to the most inhuman, most callous and most brutal position in which it has ever been in all the years that I have had anything to do with it. They have brought it into the position when they are breaking the law every day. Poor, honest, decent people, widows, orphans and aged people, are being driven down to the depths of destitution by the right hon. Gentleman and his chief, aided and abetted by the auditors and the Minister's inspectors. I am going to prove that. A law on the Statute Book says that boards of guardians should not take into account the first 7s. 6d. of friendly society benefit or of benefit derived under national health insurance in assessing a person's need. What have these people done? When I think of the cant and noxious humbug that is talked to ex-service men these days, I could vomit. You talk of your love for them and your respect for them, and yet you allow these Ministers to say to an ex-service man who gets 7s. 6d. under the Health Insurance Act, that it shall be taken into consideration. The law, however, says that it shall not be taken into account in assessing a man's need, but the Minister says to the boards of guardians: "If you do not take that into account when assessing the need, I shall surcharge you, bankrupt you, and put you out of public life for five years."

The right hon. Gentleman has made new laws, and he is overriding the law through the power that the auditor has. I challenge him to deny what I am saying. An auditor told me that no one could do anything with him because he has the power. This House has given him the power of carrying out what he determines by saying that if we do not obey, we must be surcharged, bankrupted and driven out of public life. That is what the constitutionalists have done for the poor. I would not mind if it were not for the fact that it brings about what the hon. Member for North St. Pancras said did not exist. It brings a life of hardship and semi-destitution, and it is a crime which this House ought not to allow to go on.

With regard to the unemployed, I have heard Members from Middlesbrough, Sheffield and the Midlands stand up and Bay that unemployment is a question that ought to be dealt with, not by the localities, for it is too big a problem, but by the nation. What have these two right hon. Gentlemen in their callous, brutal administration of the Poor Law done? This is what they have done. Young women who earn £2 a week are compelled to keep one other person out of that £2. I ask any hon. Member opposite if he would like a daughter 30 years of age, working nine hours a day to earn £2 a week, to have to keep another adult? That is not putting the burden of unemployment on the nation; it is putting on individuals the burden of the unemployment of their friends and relations.

The right hon. Gentleman has also said that children shall keep able-bodied parents and the younger children. He says to his auditors, his inspectors and his officials that where there is a family income of so much, that must be used to keep the whole family. I challenge the right hon. Gentleman to tell me under what law he is able to do that. The Statute says quite clearly that a grandfather shall keep, as far as he is able, a grandchild, or that if parents are unable to work, the children shall help to maintain them. That is quite right, but there is no law which says that a child going out to work shall be obliged to keep an able-bodied father and mother and children besides. The right hon. Gentleman will say that he has lowered the figures of Poplar, Durham and elsewhere, but he has lowered them at the cost of the necessities of life of the rest of the families. He is bringing down the standard of life of the whole of the people. He wants to get back to the good old days of no outdoor relief for able-bodied men. In those days it produced what was known during the War as a C.3 population. To-day we have that population rapidly growing up again. The figures of rejection for men who want to enlist prove that that is true.

The right hon. Gentleman will say that the mortality figures have gone down—I heard his speech on the wireless—but he knows that those figures went down only in those districts where they were formerly high, where poor people lived, and where Labour came into the control of the local authorities. We in Poplar reduced the death rate among babies—and that is why I am proud of Poplarism—from 160 to 80. I charge the right hon. Gentleman and all his Department deliberately and without reservation with pursuing a policy towards West Ham and Poplar which will increase the death rate again; and every child that dies under those conditions will be foully murdered by the right hon. Gentleman and his friends. When the guardians were allowed to give out-relief, when they were allowed to take care of the women at times of childbirth, what happened? The London County Council officials came to examine the schools, and I recommend the right hon. Gentleman to read their Report. When we were taking care of the children, the Report said that the children of Poplar were the best fed best clothed and the most healthy in the whole of London. I am proud of Poplarism which produced those results. The right hon. Gentleman boasts about his care for public health, and he makes speeches where rich people meet together deploring the fact that mothers die at the time of childbirth, and all the time his policy-is to forbid boards of guardians doing what nobody else at present has the power to do, that is, to take care of those who are in so much need.

7.0 p.m.

I want to finish by reading a letter which came to me to-day, and which I hope every Member will hear, mark and inwardly digest, because it is typical of what is happening under the benign rule of the gentlemen whom the Minister has appointed to devastate the poor of West Ham. The letter reads: I take the liberty to write to you to ask if you will be able to soften the hearts of the Department responsible for parish relief in West Ham. I am married, without a family, strong, active, willing to do anything of work and go to any part of the country for it. For eight months I have been out of employment. For two months my wife and I managed to live on our small savings. I then applied for relief. A 10s. food ticket was granted for seven weeks, but no rent. We were then seven weeks in arrears. Afterwards we received 10s. in food and 13s. in cash. That was granted for four weeks. On the expiration of the time, we were granted another four weeks which continued until the 19th, when I was told by Sir Alfred Woodgate's representative that he could not assist us further. I wrote to Sir Alfred Woodgate at Leytonstone appealing for assistance and begging for work, stating that I served my country faithfully for 30 years as a sergeant in the 19th Hussars, and fought in South Africa. Not receiving a reply, I saw the relieving officer on Saturday, and from him I received a 10s. voucher for food and was told we would have to go to the workhouse. That is what the right hon. Gentleman is compelling ordinary boards of guardians to do through the action of his auditors and inspectors. Sir Alfred Woodgate does it because that is what he is appointed to do. To my mind, that is not a fit place for able-bodied, conscientious people. We have been married 30 years and will not be parted. Apparently, as we have not been able to pay our rent this will cause the bailiffs to take possession and force us into the street. Mr. Watts, the Relieving Officer, during my absence called and inspected my home. So he expects that his home will be taken and sold up. Trusting that something will be done to rectify this terrible treatment, I am Yours, and he signs his name. I read that letter, because I can multiply it by thousands and tens of thousands throughout the country. [Interruption.] I have read exactly what he wrote to me, and, even if he does have a small trumpery pension, which comes to him quarterly, everyone knows that that would be needed for the debts he would accumulate. Whether he has a pension or not, he is a man who is told by the guardians exactly what the Minister wants them to tell him, namely, that he is to go into the workhouse. The Minister's reason is to push the people off relief. The credit that the right hon. Gentleman can take for their 4½ years of administion or rather maladministration at the Ministry is that they have brought us back again to the penal conditions of the Poor Law, brought back that state of things which treats poverty as a crime. We have heard the right hon. Gentleman say very often of this or that man that he has been on relief for eight months or a year. That is not the point. If the man is unable to get work, if Society will not allow him to earn his bread, then he has a right to go to Society, and say, "Give me the means to maintain myself." When the right hon. Gentleman talks about his ridiculous scheme for training these men and says that Poplar is going to engage in it, I reply that we are only engaging in it because here again we have the iron heel of repression. The Poplar Board is only accepting this wretched scheme because they are told that they must not under any circumstances give relief to able-bodied married men with wives and children unless they make them drill part of the day, swim part of the day, add up figures part of the day, and do other tomfoolery of that kind.

What the two right hon. Gentlemen can go to the country and boast of is that they have treated tens and hundreds of thousands of decent able-bodied men better men many of them than many of us, as if they were mere criminals and have treated their wives and children as if they were people of no account whatever. Instead of the right hon. Gentleman defending the health and standing up for the well-being of the people, he has done his utmost to grind down the face of the poor, to depress and repress the widow and the orphan. As for the able-bodied men and their wives and children, he has done his best to break their spirit and not to give them a scrap of that public assistance which they not only deserve but which is their right. When this House can vote, as it does yearly, tens of thousands of pounds in pensions to rich and well-to-do people, I say that we can afford, if we have only the will to do it, to give to all decent persons in need the things they need not in a grudging spirit but in full measure pressed down and running over.

The PARLIAMENTARY SECRETARY to the MINISTRY of HEALTH (Sir Kingsley Wood)

It is now my duty to reply to some of the questions which have been put in the course of the Debate and to make some observations on the more important criticisms of these Estimates. There was one point raised by my hon. Friend the Member for Royton (Dr. Davies) which I shall reply to privately, because I do not think it is a matter of general interest. It concerns the appointment of some of the medical men, particulars of whom appear on page 15 of the Estimates. In all those cases, I shall be able to satisfy him that these particular men have had special knowledge of particular sides of the Ministry's work. The first name, for instance, is that of a doctor of the Indian Medical Service with special knowledge of malaria and other kindred diseases and who is specially qualified for that particular matter. I shall endeavour to show the hon. Member the reasons why these appointments were made.

The hon. Member for North St. Pancras (Captain Fraser) raised, as he So constantly does, the question of the welfare of the blind. Everybody shares with him the desire to assist in every possible way those so circumstanced. I will not deal with the question which he raised, which is really one of legislation, further to-night than by saying that it shall receive my right hon. Friend's consideration. I believe, however, that, in the administration of the fund during the last 4½ years, considerable progress has been made, at any rate in one or two directions which will commend themselves to all quarters of the House. There are 50,771 blind persons in this country, of whom unhappily 36,485 are unemployed. The most important development to a considerable extent which has taken place during the last few years has been the scheme for workshops for the blind. Nothing can help the blind people more than the particular schemes which have been put into operation by the Department during the last few years. It is interesting to see that the amount of money which the State has given to help the Wind people has considerably increased year by year. In 1923–4, the amount of the grants was £83,470; in 1927–28, the sum had increased to £120,550.

A good many people would like more money to be spent, of course, but at any rate a considerably larger sum of money has been spent during those last four years. It is very interesting to observe that that money has been spent in a variety of ways. The largest part of it has been spent on workshops for the blind. Last year, of the £120,000 which was expended in grants, over £44,000 was spent on workshops for the blind. Another very valuable advance which has been made has been in the amount spent on book production. While in 1924–25 some £4,600 was spent on book production, in 1927–28 no less than £8,327 was spent in that direction. Therefore, apart from the question, which we are not able to discuss on this occasion, as to whether anything further should be done by legislation, the Committee will agree that endeavouring to get blind people into employment and spending the money for grants in this way is the most useful, most humane, and kindest way in which we can assist them at the present time. Whatever strictures hon. Gentlemen may care to pass on the Ministry in other directions, they must say that during the past four years there has been considerable progress in this matter, which is not a question of party politics but on which we have the support of the whole Committee.

The major part of the criticisms to which I desire to address myself this afternoon is naturally the speech of the hon. Member for Nelson and Colne (Mr. A. Greenwood). It has been my constant duty in this Parliament, though a happy one, to reply on every occasion to the observations of the hon. Gentleman. I am perfectly familiar by this time with his views on the world in general and on the Ministry of Health in particular. It has been a great pleasure to me to know the progress which he has made in the criticisms which he has directed against the Department. Certainly no man has been entrusted with more difficult and disagreeable jobs in opposition than has the hon. Member. He is put up on every occasion to criticise the work of the Ministry of Health, though I know that in his heart he would like to commend it. He has been deputed to move the rejection of all the beneficent Bills we have brought in. When he goes to face the electorate, he will be able to tell them that he moved the rejection of the Widows' and Orphans' Pensions Act. He will be able to commend himself by saying that he was the man who moved the rejection of the Housing Acts. His constituency will look on him with considerable confidence. Now he has taken on a bigger job than previously. I sup-pose it is the culminating effort of his career as far as this Parliament is concerned. No one would desire to cut him off entirely from Parliamentary work, and no doubt facilities may be made available for him in another place. He actually said this afternoon that the strongest indictment against the Ministry of Health was in relation to its housing record. He appeared to base this statement upon two leaflets which he has kindly handed to me. He complains of two paragraphs in a leaflet, which is really a very admirable one, entitled "More and More Homes." The first part of this leaflet, which is a very accurate one, as we should expect, issued as it is by the Conservative party, states the number of houses that have been built, and then there is the paragraph, to which he took exception, which said: Unless Socialists stir up trouble in the building trade and so hold up housing, the number of houses built in the 12 months to 30th September, 1927, should be over 200,000. The first point to which he took exception was the indication that the Socialists might stir up trouble in the building trade. Of course, I cannot pat myself in the place of the writer, but I should rather think that he had in mind the statement of a respected and honoured Member of the Socialist party who, when he spoke in this House of the efforts which he had made in connection with housing, said: I have had no help from organised labour in this matter from start to finish. The organised Labour party in the House has never given me any help. That was said by Dr. Addison, and very likely the writer of the leaflet was thinking of that particular matter. The complaint was made that, in spite of promises, the number of houses built in the 12 months which would end 30th September, 1927, would be only 200,000. We have fulfilled the promise in that particular connection, because we built over 273,000 houses in that period, so I do not think the hon. Member has much to complain about. Then he made another curious attack upon a poster which I hope everyone will read every day and ponder over during the next few weeks, and that is the one which asserts that, thanks to the help of the Conservative party, 800,000 houses have been built during the past four and a-half years. Though I do not think anyone would credit it, the particular complaint of the hon. Gentleman was that from that 800,000 houses—which, I may say, is a world's record—we ought to deduct 300,000 built by private enterprise without subsidy. Why is such a suggestion made? If I may be permitted to say so, I should say that one of the greatest achievements which my right hon. Friend has accomplished during his present administration as Minister of Health, and his previous administration, was the restoration of private enterprise in connection with the building trade.

Mr. MONTAGUE

Due to the building trade unions.

Sir K. WOOD

When I recollect that for the four years ended in 1922 the average number of houses built in this country without assistance was only 7,500 per year, and when we look round to-day and see that private enterprise has averaged over 60,000 subsidy houses a year during the last five years, and that the number of houses provided without a subsidy by private enterprise during the same period has averaged about 65,000, I think my right hon. Friend is entitled, as are the Conservative party, to say that the great record they have achieved includes the fact that they have helped very considerably to restore the private builder back to his own work again. Another argument of the hon. Gentleman was that not only must we eliminate from that figure of 800,000, which upsets him so much every morning, the 300,000 houses built by unsubsidised private enterprise, but eliminate also the 300,000 odd built by private enterprise under the Chamberlain Act. His reason for that—and it shows a very interesting mentality—was that all those houses are only houses for sale. If that is to be the argument adopted, let us apply it to the time when the Labour Government were on these benches and were responsible for housing. In that period, the Labour Government built, I think, some 125,000 houses, but, if we take away the houses built by private enterprise and the houses built under the Chamberlain Act, the sole achievement of the Labour Government, according to the doctrine of the hon. Member for Nelson and Colne, was an output of 537 houses. I think we are certainly entitled to include in the figures the number of houses built under what we call the Chamberlain Act. It is quite true that there are a very large number of people who desire houses to let, and I will say a word about that in a moment, but, undoubtedly, anybody who is associated with building society work must know full well that many desire to purchase houses, and that one of the best methods of doing so for a man with a limited income is to pay so much a week. I can well understand hon. Gentlemen opposite objecting to this proposal—

Mr. MONTAGUE

You do not understand the point.

Sir K. WOOD

—because it was the late Socialist Minister of Health who said that his party were determined to see that the owning of houses by private individuals was put absolutely out of court. That, I think, was their particular policy. Then I am told that my right hon. Friend has failed in his policy, because there has not been a sufficient number of houses to let. We are told that if the Socialist party again have to administer the housing scheme—which Heaven forbid!—they will continue the Wheatley Act and increase the subsidy. If ever there was a failure from the point of view of erecting houses at a rent which tenants can afford to pay, it is the Wheatley Act. We heard a great deal from hon. Members this afternoon, and we also read in the newspapers, of what a fine thing the Wheatley Act is. They say the Wheatley Act brought about the provision of houses to let; and they stop there. They forget a matter which I shall never forget, the statements which were made by the right hon. Gentleman the Member for Aberavon (Mr. MacDonald) and by the right hon. Gentleman the Socialist Minister of Health that he was going not to have houses to let but houses to let for the lower paid workers of the country. He said at this Box that the reason he was asking for such a large sum of money from the State was to enable them to do it. What happened?

Miss LAWRENCE

But you fixed the rents.

Sir K. WOOD

Immediately that Act was brought in, with its increased subsidy—almost before it could be put into operation—the whole value of that subsidy had disappeared so far as the tenant was concerned. When the local authorities started to work what we call the Wheatley Act, the entire value of the increased subsidy had gone.

Mr. MONTAGUE

To whom? Your pals.

Sir K. WOOD

The local authority said, "Here we have the Chamberlain Act, and here we have the Wheatley Act. We are getting about double the amount under the Wheatley Act that we were getting from the Chamberlain Act, therefore, we will cross over to the Wheatley Act." Then the hon. Gentleman says what a success the Wheatley Act has been! It was one of the biggest failures from the point of view of producing houses to let at reasonable rents that has ever appeared on the Statute Book. Another thing that the hon. Gentleman said was that there were 12 reasons why, when the subsidy was cut down, the cost of houses increased. What an extraordinary statement! One of the most curious things about the cutting of the subsidy was that directly the announcement—even the announcement—of the first cut in the subsidy was made housing prices began to fall. There are two things perfectly certain so far as subsidies on houses are concerned. The first one is this: The higher the subsidy the higher the cost of the house. The Lloyd George-Addison house cost £1,000, and that was when the subsidy was highest.

Mr. MONTAGUE

That was in 1921.

Sir K. WOOD

And since the subsidy has been cut down the cost of housing has been lowest. It is perfectly ridiculous—

Mr. MONTAGUE

It is.

Sir K. WOOD

—for hon. Gentlemen to say that there are 12 reasons why the cost of housing has gone down. The fact remains—it is a very curious coincidence, at any rate—that directly you cut down the subsidy you found the cost of housing rapidly decreasing. In the last minute or two which is left to me, I do not hesitate to say that the best hope for houses at lower rents in this country is to decrease the cost of building. If you want to get houses at lower rents, if you want to give facilities for lower paid workers to rent houses, you have to get your cost of housing down, and I do not hesitate to say that it is far better for us to be building new houses at the rate of 165,000 a year at an average cost of some £350 each than to build double the number at £1,000 each. Much as I would like to deal further with this matter, I will conclude by saying that on every ground my right hon. Friend has been justified in his housing policy, and highest among his achievements is that not only has he obtained a very large number of houses, the building of which has been helped by his inspiration and his administration, but that he has brought the cost of housing down, and by that means has given the best promise of houses to the lower-paid workers.

Mr. MONTAGUE

I always admire the smug satisfaction of the Parliamentary Secretary of the Ministry of Health when he is dealing with a question of housing for the poor, or anything else for the poor. It is a fact that the present Government have not put the Wheatley proposals into operation at all. He talks about the reduction of the subsidy and the number of houses being built, and infers that by reducing the subsidy you reduce the amount that goes into the pockets of profiteers in building materials. But he forgets the fact that part of the Labour plan for dealing with the housing problem involves the control of those profiteers and the prevention of the forcing up of the price of building materials by rings and combinations. I would remind the House that the Labour Government had an agreement with the whole of the building industry under which new entrants into that industry were increased from a ratio of 1 in 10 to a ratio of 3 in 10. That has been repudiated by the Government which succeeded the Labour Government, in spite of what has been persistently said upon the subject of repudiation, with the result that to-day there are approaching 250,000 building trade workers out of work. Those building trade workers came into the industry upon the guarantee of a British Government that there would be a housing plan extending over a period of 15 years. In spite of the demand for houses to-day—and it is idle to pretend that there is any approach to a solution of the housing problem—we have over 200,000 building trade workers walking the streets unemployed. They were brought into the industry on this new ratio and have been let down by the Tory Government.

It being half-past Seven of the Clock and there being Private Business set down by direction of the CHAIRMAN OF WAYS AND MEANS under Standing Order No. 8, further Proceeding was postponed without Question put.

PRIVATE BUSINESS.