Motion made, and Question proposed,
That a sum, not exceeding £1,651,592, 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, 1931, for the Salaries and Expenses of the Department of Health for Scotland, including Grants and other Expenses in connection with Housing, certain Grants to Local Authorities, etc., Grant-in-Aid of the Highlands and Islands Medical Service, Grants-in-Aid 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 Acts, and other Services.
§ The SECRETARY of STATE for SCOTLAND (Mr. William Adamson)
In submitting the Estimates of the Department of Health for Scotland it is not possible within the limited time available to review the whole field of that Department's activities, and I propose, therefore, to make a selection of those which may be regarded as being of the general interest. At the outset I shall refer to a few of the outstanding figures in the vital statistics for 1929. The birth rate was 19.02 per 1,000 of the population. Both the number of births and the birth rate were lower than in any year since compulsory registration was introduced in 1855. The death rate was 14.5 per 1,000 of the population, slightly higher than in the previous year, but this is largely if not entirely attributable to an epidemic of influenza which occurred in the first quarter of the year. Respiratory diseases during the epidemic of influenza also had an adverse effect on the infantile mortality rate, which was 86.8 per 1,000 births, but even this rate was lower than the rate for any year, excepting the years 1923, 1926 and 1928. As regards maternal mortality, Scotland, unfortunately, still stands in an un 946 enviable position. The maternal mortality rate for 1929 was 6.9 per 1,000 births, as compared with 7.0 for the preceding year. The rate has varied very little since the introduction of schemes of maternity and child welfare, and it shows no marked tendency to decline. The matter is one that is continually engaging the attention of the Department of Health, of the local authorities, and of offers engaged in medical administration.
Investigations are now being made into all deaths of married women during pregnancy or within four weeks of the termination of pregnancy. While the numbers so far investigated are not sufficient on which to base definite conclusions, there is throughout a quite definite indication of the need for providing more complete medical supervision and care of women during pregnancy and in the reorganisation of local health services under the Local Government (Scotland) Act, 1929, an effort will be made to secure an adequate ante-natal service. But in order that the best results may be obtained we must look to the mothers themselves to co-operate by making a fuller use of the services provided, and this will probably have to be secured by stimulating their interest in these services and educating them as to their value in protecting and preserving their health. When I come to tuberculosis I am able to present a more cheerful and encouraging picture. The death-rate from all forms of tuberculosis, which was 94 per 100,000 of the population, was the lowest yet recorded in Scotland. It was 3 per 100,000 less than the figure for 1928, which up to that time was the lowest recorded figure. Actually 4,579 persons died from tuberculosis in 1929. Ten years ago, in 1919, there were 6,326 deaths from tuberculosis. The 1929 figures show that 1,747 fewer persons died from this terrible disease in that year than in 1919. Although respiratory tuberculosis shared in the high mortality of the first quarter, the death-rate for the whole year is down and it is not improbable that, but for the abnormal weather conditions of the first quarter the decrease in the number of deaths from tuberculosis would have been more substantial. Although tuberculosis still accounts for many deaths, it is hoped that a continuance of the intensive cam 947 paign against the disease, aided by important methods of diagnosis, and greater facilities for institutional treatment, will, before long, secure that tuberculosis can be classed among the less deadly ailments of humanity.
I now come to Health Insurance—sickness and benefit. The amounts expended by approved societies in sickness and disablement benefits still keep abnormally high, the amount so expended in 1929 being £1,924,000 or an increase of £200,000 over the corresponding figure for 1928. As I have already indicated, there was a severe epidemic of influenza in the early months of last year which would account for some part of the increased expenditure. But, after making allowance for this and for a Slight increase in the number of insured persons at risk last year, there remains a considerable part of the increase for which no satisfactory explanation is available. The Department continues to give the matter their close attention, and they have been in conference regarding it with representatives of approved societies and with a special committee of the Insurance Acts Sub-committee of the British Medical Association. The Department have, in addition, had constantly before them the great importance of determining, if possible, the causes from which the demands on the sickness funds arise.
One defect of the Health Insurance scheme is that it has not hitherto been possible for various reasons to prepare and publish accurate statistical information regarding the nature and extent of incapacitating illness among the insured population. An attempt of that kind was made about 10 years ago by the Scottish Board of Health, but the data available were found to be inadequate and the attempt was abandoned. I am pleased to announce that the Department of Health now find themselves in a position to remedy that defect. They have put into operation on the 1st of July this year a scheme for the collecting of complete and trustworthy data from the approved societies from which may be compiled statistical records showing, inter alia (1) the incidence of the various incapacitating diseases and their duration not only for insured persons generally but for groups 948 of insured persons arranged according to area of residence, occupation, age, etc., and (2) the extent to which individual medical practitioners are granting certificates of incapacity for work. The scheme was considered recently at a conference between the department and representatives of the larger approved societies in Scotland. Those representatives approved of the principle of the scheme, and promised on behalf of their societies, to co-operate in making it as complete a success as possible. Incidentally, it is hoped that the morbidity statistics, when published, will be of great advantage to the local authorities in the administration of the health services within their areas.
I will now say a few words regarding a very much discussed subject in recent times, namely, Kilda. In May, 1930, we received a petition from the inhabitants of that island praying that they might be removed from the island before next winter. The petition was signed by all the householders on the island, numbering 36, exclusive of the missionary and his family and the nurse. Accordingly, the Under-Secretary of State for Scotland visited the island of St. Kilda early in June and made full inquiries on the spot. The Under-Secretary made a report on the subject and it was decided to accede to the prayer of the petitioners. Arrangements for carrying out the evacuation and for placing the inhabitants are now receiving attention. No definite decision has yet been arrived at as to where the inhabitants will be settled. The Forestry Commission have offered to employ the majority of the able-bodied members of the community on an estate at Ardtornish, Sound of Mull, but the Department of Health for Scotland are still in communication with the Inverness County Council, and any suggestions that may be made by that County Council will be considered along with the Forestry Commission's offer. The Department of Agriculture are dealing with one case in which one of the men desires to have a small holding.
I will now deal with the question of foods. Considerable improvement continues to be effected in the purity of the milk supply of Scotland. This is due 949 in large measure to the general effort on the part of producers to attain the standards set by the dairy by-laws, and to the increasing attention given by local authorities to the inspection of dairy cattle, and to the structure and sanitary conditions of dairy farms. Mention may be made here of the Lanarkshire Milk Investigation which was inaugurated in the early part of this year. That investigation was designed to ascertain the effect on the growth (height and weight) of school children by supplying them with an extra ration (¾ of a pint) of Grade "A" (T.T.) milk each school day. Children to the number of 10,000 received the milk, and another 10,000 "control" children were embraced in the investigation. Feeding was carried on until 20th June, 1930, when the final weighing and measuring of the children was completed. There were early signs of improvement in the children receiving milk, compared with the "controls." The preliminary work in the examination of the cards of record is now in progress. The cost of the investigation is being met by a grant from the Empire Marketing Board, supplemented by a contribution from the Miners' Relief Fund. Various firms and individuals interested in the milk industry have also been good enough to give subscriptions.
Then the Empire Marketing Board have also promised a grant—I cannot give the exact figures—to enable an investigation to be carried out into the tuberculous infection of milk, its object being to ascertain the incidence of such infection in the milk supplies of Scotland. The investigation will continue for a period of about two-years, and will be carried out by the Department of Health in co-operation with the health authorities of the four large cities of Scotland, namely, Aberdeen, Dundee, Edinburgh and Glasgow. The Hannah Dairy Research Institute will also participate in the investigation.
I will now deal briefly with the question of housing. When speaking on the Second Reading of the Housing Bill, I referred generally to the housing position in Scotland, and I do not know that I need repeat here in detail what I then said. I may, however, be permitted to give a few statistics showing what the 950 present position is. According to the latest returns, there had been completed up to 31st May, 1930, in Scotland, under all forms of State assistance, 110,136 houses. These probably accommodate about 495,000 people, or, perhaps, one-ninth of the working class population of Scotland. But while these figures are large, all are agreed that much yet remains to be done, and we are not exaggerating when we say that at least another 100,000 houses are required before the housing conditions in Scotland can be regarded as reasonably satisfactory. I am glad to report that prices continue to show a tendency to fall. During the last five years the average reduction in cost is estimated at approximately £75 per house.
As regards houses in rural areas, the local authorities of these areas, following on departmental communications, are causing housing surveys to be made, and I have caused a special letter to be sent to each of the new county councils in Scotland, urging them to seure that the utmost advantage will be taken by owners in rural areas of the provisions of the Housing (Rural Workers) Act, 1926. At 30th March of this year, the latest date for which information is available, there had been approved under the Act for improvement or reconstruction 4,184 houses, for which grant amounting to over £360,000 had been promised. The improvements had been effected on 2,406 of these houses, and grants amounting to £204,670 had been paid. The Government, as the Committee knows, are in course of carrying through special legislation dealing with slum clearance, and when the new Bill becomes law I trust that a great forward move will take place on the part of local authorities in tackling with the fullest energy this most necessitous problem. The Bill, I hope, will pass this House this week, and I would repeat my earnest appeal to local authorities that they should at once proceed with the completion of the details of their schemes, so that the work can be put in hand immediately the Bill is placed upon the Statute Book.
I will now turn to the Contributory Pensions Act, which was passed last year and is now in partial operation. On 2nd January last, certain of the anomalies resulting from the Act of 1925 were finally removed. The provisions of the amend 951 ing Act which came into operation on that date had the effect of bringing into the pension scheme over 3,000 wives of insured persons between the ages of 65 and 70 who had previously no title to pension. On the same date, over 1,800 widows whose pensions had expired under the 1925 Act had their pensions restored, and allowances or orphans' pensions at the full rates are now being paid in respect of approximately 2,400 children who previously were receiving reduced rates or nothing at all because of the payment of workmen's compensation. Apart from these minor changes, the first extension of the original pension scheme took place on the 1st instant, when the provisions of the 1929 Act conferring pensions on certain widows over the age of 60 became operative. The Department of Health for Scotland have, up to date, received over 26,000 applications from women in this category, and so far have awarded pensions in 19,700 cases. About 5,000 cases, many of which have only recently been received, are still under consideration.
While the Department's efforts have been concentrated on the foregoing part of the new scheme, certain steps have also been taken regarding the pensions which will become payable under the Act to widows over 55 years of age from January next. Already 5,500 claims have been received in this category, and up to date about 1,500 have been allowed. The total number of beneficiaries in Scotland under the Contributory Pensions Acts of 1925 and 1929 is now over 154,000. The Local Government (Scotland) Act, 1929, came into operation in May, 1930. Under its provisions the county councils and the town councils of larger burghs of over 20,000 population, have taken over the administration of education, the major health services and the whole field of public assistance and Poor Law. It would be premature to express any opinion on the effects of this enormous change, but I do not think that it is premature to recognise what an enormous amount of work it has thrown on these authorities and their officials, and to say that the way in which the majority of the authorities and their officials have faced their task is most praiseworthy. The ability and zeal of those responsible for local administration may well be recog 952 nised by this Committee, by the House and by the country. Having briefly reviewed some of the features of general interest in these Estimates, I hope that the Committee, after fully examining them, will see their way to pass our Estimates before the sitting concludes.
§ Sir JOHN GILMOUR
Anyone, of course, who speaks for a great Department of State with so wide a field of operations as that of the Department of Health for Scotland must, of necessity, deal only with certain aspects of the case. I do not doubt that before this debate closes to-day, there will be a number of problems dealt with by hon. Members in this Committee. I think that we may congratulate ourselves upon having an opportunity of reviewing some of the most important problems in the welfare of our country, and, at the outset, I should like, if I may be permitted to do so, to offer my congratulations to the Department of Health on their first report in their new position. Of course, in any changes which are made in the administrative machine, there are always bound to be differences of opinion as to whether these changes are likely to be more effective than in the past, but I am satisfied, from my knowledge of the personnel of the Department, that they have spared no effort on their part to do the best for the services which they have to conduct, and, from my knowledge and experience of my work with them, I think Scotland is to be congratulated upon that fact.
The right hon. Gentleman opened today, I think very properly, with a review of the progress which is being made in dealing with the well-being of our people, and particularly of women and children. He referred, in speaking of this matter, to the hope that the new schemes, which were being devised under the Local Government Act, and under the ægis of the newer and wider authorities, might be of material assistance. At a later stage in his speech, the right hon. Gentleman told us something of the progress which has been made in the development of these changes in local government. I should like to associate myself at once with the tribute which he paid to these new authorities in all parts of Scotland, and more particularly their officials, for the immense amount of work which they 953 have put in, in endeavouring to bring into operation this new system of local government. Although the right hon. Gentleman indicated that it was premature to go very deeply into this subject, I should like, and I think the Committee would like, and I am sure that the general public in Scotland would like, to know, if we can be told at a later stage, a little more as to how far the scheme, which the House discussed at considerable length, has been brought into operation in its initial stages of working, and if at any point there have been found insurmountable difficulties. So far as one can judge from the public Press and from the reports of the working of these schemes, there have come into operation fresh bodies with very wide duties, which call for an intensified interest in many of these problems, and one would hope that the very fact that the questions to which the right hon. Gentleman referred, dealing with the birth rate, with the care of mothers, and with the children, open out new opportunities for the development of health services, co-operation in hospital work, health visitors, and all those possibilities of further education which the right hon. Gentleman emphasised, will excite an increasing interest in these problems.
I have watched the development of these alterations with a peculiar interest, because of the measure of responsibility which I and my hon. and right hon. Friends have had in making these changes. I say at once, as I have said repeatedly, both in this House and in the country, that we have never claimed for these changes an unalterable system, nor have we said at any time that there might not be things which from time to time might be improved; but we base our hope in regard to these changes upon the fact that there is held out to these new bodies, whether they be the great cities or whether they be the enlarged local authorities in the counties, the hope of being able to give to the people of our country better service than they have been able to give-in the past. Above all, there is the opportunity now, which there was not in the past, of co-ordinating, particularly, these health services, and of linking up the health of the child from the very earliest age right through until it goes to school, and from the school on into the further stages of 954 life. There is nothing which it is of greater importance to note, in the report of the Department of Health, than the attention which it draws to the subject of the health of the children in the very earliest stages, before they go to school. If that alone were to be assisted and helped by this co-ordination of services, that Measure would be justified in a considerable degree.
I should very much have liked to hear from the Government, with their knowledge and information, how far these great new authorities have utilised the powers of organisation and of devolution of their duties which were given to them in the Measure; whether the district councils have in every case been set up; and whether they conform more or less to the old districts of the counties, or whether these authorities have in some cases, or in many cases, taken into account the new duties, and have been able to regroup and redistribute those duties. Of course, I realise that these are early days, and that the authorities themselves are merely feeling their way, but I should hope that, if there are some authorities which have been less ready to take into account the existing circumstances, the fact of their attention being drawn to these matters, either here or at a later stage through the Department, may lead to a better organisation throughout the country. Those of us who have knowledge of the Highland areas of Scotland, particularly, must welcome anything which will bring into the remoter parts better opportunities for the organisation of health services, and I should hope that, perhaps, at a later stage, we might hear something of the work which is being done in the outlying hospitals in the Lewis and in Orkney and Shetland, and as to whether these are developing on the lines on which we hope that they will develop, and whether the public are making greater use of the facilities which have been brought to them.
Everyone must have listened with interest to what the right hon. Gentleman said about the evacuation of St. Kilda. It was one of my regrets during the time of my administration that I failed to reach that rocky spot, and I congratulate the Under-Secretary of State on having been more fortunate. Of course, from a sentimental point of view, this evacuation 955 of St. Kilda may appear to some people to be unfortunate, but I am quite certain that, in view of the petition which has come from those who are chiefly concerned, and in view of the knowledge that we have of the extreme difficulties of communication and of bringing to these people that sustenance and support which we would desire them to have, we cannot but feel that this evacuation is a wise move; and, that being so, it only remains for us to express the hope that the Departments of the Government concerned may be able to provide suitable posts for these people When they come to the mainland.
I am interested indeed to hear what the right hon. Gentleman has had to say as to the food supplies of our country, and, more particularly, his remarks on the progress that is being made in improving the milk supply of the country. I trust that the new dairy school and research station at Auchincruive may be an improved centre for research in all these matters, and that the fullest opportunity will be taken of co-operation in connection with it. I am glad to hear from the right hon. Gentleman that co-operation is taking place between the Department of Health, the great cities of Scotland, and the Hannah Research Institution. The right hon. Gentleman spoke of the importance of the experiments which are being made in connection with the feeding of school children with milk in Lanarkshire. As to that I heartily agree. I would only remind him that, while, perhaps, this is a rather wider experiment, it is not a new experiment. Everyone who has followed such experiments as have been made in the past has been convinced that the education of our people as to the value of milk diet, and particularly as to the fact that it does not even require whole milk, but that skimmed milk in itself is often of great value as an extra constituent in the food of our children, is bound to be of great benefit to the whole community, and, if the work of the Government in that respect can be pushed forward, I am satisfied that it will have a good effect.
The right hon. Gentleman has, of course, not dealt at any great length with the problem of the inspection of meat, but I trust that the steps which are being taken by the local authorities to set up 956 improved abattoirs will conduce to greater facilities for inspection, and that, as the right hon. Gentleman indicated, in dealing with the problem of inspection of dairies and the improved construction of dairies, we shall gradually eliminate the serious scourge of tuberculosis among cattle. That is a problem which, of course, carries with it the difficulty of obtaining the good will and co-operation of those in the industry, because undoubtedly, if the matter is pushed too rapidly, it causes great expense to many of those concerned; but, at the same time, I would not for a moment say that that expense must not be met. All that I would urge is that, in dealing with this problem it is a matter of education and of demonstration, and the more we can induce the owners of stock and the producers of milk to go to such institutions as the Dairy Research Institution and to our research stations, whether in Aberdeen or in Edinburgh, and can convince them that the work which is being done there is in their interests as well as in the general interests of the public, the more we shall be able to get on to the right lines in these matters.
The right hon. Gentleman spoke of the problem of housing. I do not want at this stage to say anything on that matter, because it will be dealt with by others of my hon. Friends. All that I would like to say upon it is that we shall have an opportunity of debating in the House to-morrow the Bill to which the right hon. Gentleman has referred. Every one of us, from whatever party we may come or for whatever party we may speak, is anxious to see improved housing conditions in Scotland, and, for myself, I heartily approve of what the right hon. Gentleman has done in stimulating the interest of the county authorities in a survey of the conditions of housing in the country districts. We made every effort, when we were responsible in this matter, to stimulate interest in the improvement of housing in the country districts. Certain local authorities and certain proprietors have been more active than others, but some districts have failed to take the fullest advantage of the Act and of the easy opportunities of vastly improving many of the houses throughout the country districts. That is greatly to be regretted, and I hope that, through Parliament, the atten 957 tion of the local authorities, and particularly these new and enlarged authorities, may be stimulated and quickened in this matter, and they they will do everything that they can to assist. It is clear that, particularly in the country districts, we have many houses which could be improved by enlarging the windows and letting in fresh air. That in itself would be of material assistance.
The other problem before us is a more difficult and a more debatable one since, unless you can be quite certain of a proper supply of water and an adequate drainage system, you may do greater harm than good. But at the same time local authorities can do a great deal to encourage those in the country districts to improve the houses, particularly in connection with farms throughout the country. The right hon. Gentleman has spoken hopefully of the operations of his Department and of the improvement that is being made generally in the health of the people. Tuberculosis is being corn-bated, and we hope—here again it is largely a matter of education and of the co-operation of individuals with the authorities—that continued improvement will be made.
I hope, before the debate finishes, those who speak for the Department may be able to give us some further indication as to how far they think the local authorities have made improvements in co-ordinating the various services, and particularly whether there are any parts of Scotland which have more adequately than others made a proper use of the opportunities held out to them under the Local Government Act. I do not wish to introduce into the debate any kind of controversy as to whether that Act was good or bad. These things were thrashed out in the House and throughout the country. Some of us have been told we were poking sticks into the machinery of local government. Though I should hesitate to use that phrase myself, if I had poked a stick into the local government of Scotland for the purpose of better co-ordination and better service, I should not regret it.
§ Sir ROBERT HAMILTON
I can well understand the anxiety with which the right hon. Gentleman regards the working of the Local Government (Scotland) Act. Having regard to the amount of responsibility which he had for its in 958 troduction, I am sure he must watch very carefully to see that the objects that he hoped to achieve will be achieved. Many of us were strong opponents and critics of that Act when it was a Bill, but I can assure him that, if it does tend to the improvement of the health of Scotland generally, we shall welcome it. Whatever other criticism we may have made with regard to it, if that sole object is achieved, something will have been done for the benefit of the health of Scotland. Whether it will be entirely due to the insertion of that stick into local Government I am not prepared to say, but I should be rather inclined to think that inserting a stick into the wheels of Government is not the best way of making them turn round rapidly. Still, we shall all watch. As the right hon. Gentleman said, it is early days yet. We cannot tell. It is impossible to ask the Government to give an answer. The machine has hardly begun to function, but in a year's time we may have some very searching questions to put to whatever Government may be in power as to the way the Act has worked. I was particularly glad to hear the figures with regard to tuberculosis. That immense efforts that have been made of recent years to tackle that great disease have made it all the more courageous for the authorities who are tackling it to go on in the face of what were very disheartening results for some time, and it is very satisfactory to realise now that we believe we are making some inroads against the attacks of that disease, which in parts of Scotland is so very severe in its incidence.
The right hon. Gentleman referred to the work he did in the outlying parts of the Highlands and Islands. We have recently passed an Act to put the Highlands and Islands Medical Fund on a stable basis. I always speak of that fund with the greatest respect. There is, I believe, no fund of its size which is so well administered or which does so much good over so large an area. The people who are entrusted with applying the money in their hands—I am sure it is not as much as we should like to see—apply it in the most useful manner they can and spread it as far as they can. When you think of the multiplicity of objects and aims that they desire to achieve, the sum of some £72,000, 959 when it is split up into all these various departments, becomes very small in certain directions—much smaller than we should like to see it. Without the fund I really do not know what the Highlands and Islands would do. If anyone can go back half a century, as I am sorry to say, I can now, and remember what the conditions in those parts were, and compare them with what they are to-day, the change is enormous. Now we think we are not properly served if we have not medical officers in every district supplied with motor cars, district nurses, local hospitals and consulting surgeons in places where it was impossible to get, not only the attendance of a medical officer very often, but a nurse, and it was quite impossible to get any major operation carried out.
I said just now we hoped the fund had been put on a stable basis. In looking into the figures, I have been considerably surprised and disappointed. The Department in its report expresses great hopes of what may be done in the future. They say:The new Act provides that in addition to the annual grant of £42,000 hitherto paid, there shall be paid to the fund such sum as may be voted annually by Parliament for the purpose.That is the obligation now on Parliament year by year, to set aside whatever sum may be necessary for carrying out these health services in the North of Scotland in addition to the £42,000 under the 1913 Act. After having spoken of the advance that has been made under the Local Government Act with regard to the major health services, the report goes on to say:The Department hopes that full advantage will be taken of the opportunity thus opened up for securing a steady improvement in those conditions of highland life which are the Department's concern.When I turn to see what provision has been made for the forthcoming year, there is a total of £72,000 in the Estimates we are asked to vote to-night, but three years ago Sir James Leishman expressed the opinion that £25,000, in addition to the £42,000, was the very minimum that was necessary—that was £67,000. Last year there was available a sum of £74,800. This year provision is only made for £72,000 and, when we remember the way the services are being 960 extended in every direction as far as the money will go, I am very doubtful whether the provision that we are asked to make to-night will be sufficient to meet all the objects we have in view when you know that it is actually £3,000 less than was available last year. Instead of putting the fund on a more ample basis, it seems to me that its scope has been somewhat contracted. I hope the Government are not intending to contract the finances of this fund, but are rather looking forward to its expansion because, with all the work the Department is envisaging in the North, I am afraid this £72,000 will not be sufficient to meet what we desire to do.
Having said that, I should like to refer to the extension that has been made in the nursing services in the country districts in the North. They have been invaluable. There were places, no doubt, where doctors who have been living for a time by themselves objected to the introduction of a nurse, but those objections have all given way now and everyone realises what an enormous advantage it is to have a nurse in addition to a doctor. But the difficulty of the nurse getting about is very considerable and I am glad to see that the Department proposes that in future they shall be supplied with light cars. That will be a great advantage. A pedal bicycle against a steep brae, with a wind of 50 miles an hour against you, is not a way for a nurse to get to her work in a condition in which she can possibly carry it out, or even a motor cycle in bad weather, and I very much hope that some money will be found for the small cars that are available nowadays. Another direction in which very useful work has been done by the fund is in helping to build doctors' houses. At the same time, I know one or two cases where the question of the doctor's house has been hanging over for a very long time. I should like, particularly to call attention to the case of the island of Whalsay in the Orkneys, where the doctor's house is not built yet and the doctor on the island has been living in most uncomfortable conditions. I really wonder how he has kept on there so long. I hope that will be one of the first pieces of work that will be undertaken and put through.
Another piece of very useful work the Department has done in connection with 961 doctors' houses, almost as important as building the house, is putting the doctor on the telephone, They have gone to the extent of subscribing, and thus getting over the parsimony of the Post Office in the interests of humanity. I have often failed to understand why the Post Office asks for heavy guarantees. I can quote one instance in an island where they are absolutely unable to get the doctor put on to the service. The Post Office is asking for an £8 subscription from eight subscribers, who cannot be found. The lines of the existing telephone pass within a few yards of the doctor's house, and yet we cannot get the doctor in that parish on to the telephone. I hope that the Department mill keep their eyes very wide open for cases like that, and see if they cannot come to their assistance and help them if the Post Office is unable to come forward because of its rules and regulations with regard to its finances. This is a matter in which they should insist that every doctor in a country parish where there is a telephone service should be put upon the telephone. It is really ridiculous nowadays that you should have a medical officer in a country parish without the possibility of the people in the neighbourhood being able to call him up.
The right hon. Gentleman the Member for Pollok (Sir J. Gilmour) referred to the work that is being done by the hospitals in the North, and he asked the Government to give some information with regard to what had been done. I am happy to be able myself to give him a little information in that respect, because I am very closely interested in a hospital which is doing magnificent work in Lerwick. The history of that particular hospital is remarkable. It is very poorly endowed, in fact scarcely endowed at all. We make subscriptions all through the Islands and raise a very considerable sum annually, as much as the poverty of the people will allow, in order to enable the hospital, which is barely able to make ends meet, to keep going. But since flee Government Department have given the services of a consulting surgeon—we have a very excellent consulting surgeon there—the result has been that the hospital has become almost full of surgical cases, and there is practically no room for the ordinary medical cases. All the surgical cases which used to go south to Aberdeen 962 and Edinburgh and help to fill the already overfilled hospitals there are dealt with locally, with the peculiar result that they have taken up the places which would have been filled by the ordinary medical cases.
We are now faced with having to build a considerable extension of the hospital, and we have not the funds with which to do it. An estimate has been made that £12,000 is required at least for the building and another £3,000 for fitments—about £15,000 in all—and with our utmost endeavours so far we have been able to collect £2,200 towards this new extension work. I wish to ask the Secretary of State whether it is possible to make a call upon this fund for the extension of a local country hospital which is doing such magnificent work. If ever there was a case in which a hospital required to be extended, this is one, but what I am really concerned to know is whether this is a fund out of which aid can be given. In support of what I have said as regards the work of the hospital, I will quote one or two very remarkable statistics showing what has been done. The number of inpatients before the surgeon was appointed was between 140 and 170 per annum. After the surgeon was appointed the number rose to 281, and in 1927 it rose to 378. These are very remarkable figures showing how the work there has expanded. It has expanded to such an extent that they have had to cut down the rooms of the staff and turn the staff out of the hospital, and the staff are living apart from the hospital without any security of tenure. I have put the case before the Secretary of State for Scotland, and I should like him to say definitely to-night if it is possible for capital assistance to be given out of this fund, and if not, whether he will give his sympathetic attention to obtaining assistance from elsewhere.
I have referred particularly to the work of this hospital, because it is typical of the work which is being done by two or three similar hospitals in the North about which my hon. Friends here and others will, no doubt, be able to speak. I do not think that it is realised through the rest of Scotland how the work which is being done in these particular hospitals is relieving the hospitals in the South, or that that fact is 963 a very strong argument for very special assistance being given to them in these poor areas, where they make whatever endeavours they possibly can to get funds locally. We are now in the position of seeing these hospitals which have been going forward and doing excellent work definitely held up and scarcely able to exist for the want of means, which, if they had the means, they would expend to the very best possible advantage.
§ Mr. McGOVERN
I have listened with deep interest to the statement which was made by the right hon. Gentleman the Secretary of State for Scotland, and I have also listened to the discussion which has followed. But, while I am totally in agreement with the statements which have been made regarding hospital accommodation, the necessity for telephone communication between doctors and their patients, and many other things which have been mentioned, I suggest that there is a deeper problem even than the questions which have arisen to-day and which must be faced by the Department. The right hon. Gentleman should, at the earliest possible moment, convene a conference of all Public Assistance Committees in Scotland with a view to dealing with the totally inadequate scales of relief to the working-classes who are at present unemployed and in a state of depression. There are grave anomalies which ought to be rectified. I consider, to begin with, that the sum allocated for Scottish health is totally inadequate to meet the needs of the people of our country, and I want to see greater provision made in that direction.
I find in regard to relief in Scotland that under the headings of Poor Law, and of able-bodied relief there is a gulf that must be bridged if we are to deal with the health of the people, especially of the children. Under Poor Law relief in an industrial city like Glasgow, the Public Assistance Committee is paying, for the first child, a sum of 5s. a week, for the second child 4s., for the third child 3s., and if one of the children is under two years of age there is an extra provision for nourishment of 2s. per week. That brings the total for three children up to 14s., plus a rent allowance of 3s. on an ordinary rental of 6s. or 7s., making a grant of 17s. a week. In 964 respect of able-bodied relief, the same authority pay, in respect of three children, a sum of 2s. for each child, making a total of 6s. per week, with no rent allowances at all. The difference of 11s. per week between the sum paid in respect of three children on Poor Law relief, and the sum paid in respect of three children on able-bodied relief is an absolute scandal and ought to be rectified at the earliest possible moment.
These standards are laid down by the local authority in Glasgow, and they are a continuation of the standard which was laid down by the previous parish council. I know that my right hon. Friend has indicated to the local authorities that they are left free to raise the allowances to these children, even on the able-bodied side, and I am glad to hear that the right hon. Gentleman on the Opposition bench has been converted to the idea of looking after the health of the children of this country. He previously prohibited the parish council in Glasgow, of which I was a member, from raising the scale of relief of 2s. to the child of the able-bodied man. The present Department, since the Labour Government came into office, have taken off that restriction and have allowed the local authorities to add something to the grant. I find that local authorities are not taking advantage of the opportunity, and I want to see a form of stimulation adopted by the Scottish Office to ensure that the children shall be dealt with more adequately.
After the restriction was taken off by the present Secretary of State for Scotland, Govan Parish Council raised the grant to the children of the unemployed from 2s. to 3s. 6d. per week, an addition of 1s. 6d. per week, and we were told that the general welfare of the families was steadily improving. Even factors and landlords were in agreement that rents were being met better in that area during the period that the increased amount was being given to the children. But, upon Govan coming under the new administration and under the wing of Glasgow Corporation, the additional 1s. 6d. per week was stolen from the children, and they were again reduced to the 2s. standard of life. I am satisfied that, while the Department can state that there is a decrease in the cases of tuberculosis, the advantage is not being felt which might be felt as the result of that decrease owing to the fact that the 965 children are suffering a worse fate than that which they formerly suffered in better days. To put it bluntly, instead of developing the child into a state when it becomes an inmate of a sanatorium, we are simply crushing the life out of the child at an earlier age and we are pushing it into the grave, by depriving it of the ordinary decencies and essentials of life.
If we take a family of five, including father and mother, on Poor Law relief, we find that there is a total of 37s., plus 9s. relief on rent, which gives an income of 46s., but in regard to a family of five across the landing, where the father may be ill or in prison, the allowance is 32s. with no rent relief. There is a difference of 14s. a week between two families on the same stairs under the respective headings of able-bodied and Poor Law relief. Medical men on the Glasgow Parish Council have laid it down that the minimum under the Poor Law heading is the absolute minimum for children under 14 years. If this is the minimum in the interests of the health of these children, I want to know what the Department are going to do to ensure that that minimum shall be paid, not only in respect of Poor Law but able-bodied relief? If we take, for example, a child which is boarded out under the Glasgow Corporation or Parish Council, a child who may have been taken from parents who have probably been running an immoral house or may have been drunken and neglected their duties as father and mother, and if we board out that child in the Highlands it costs 14s. 9d. a week to keep it. We spend 14s. 9d. per week, we give the best medical attention, we give clothing, and we even give cycles to enable the child to go to and from school, and we provide education right up to the university if a child is fitted for it. We give the children of the bad parents every opportunity to develop, but we penalise the child of the good parents in every shape and form. We give to the good father and mother 2s. a week for the child, and we pay to the bad father and mother 14s. 9d. in respect of their child. I suggest that there is something radically wrong there which ought to be met and which could be met by the Department 966 convening a conference of the kind I have suggested to the right hon. Gentleman. Take the case of the parish councils and the amount of relief that is given for a family of five, 32s. If the family is to meet the ordinary obligations of a rental of 7s. or 8s. a week, there is nothing left in the home for five persons to meet the needs of ordinary human beings when you have provided for seven days 105 meals at 2¾d. per meal. The essential needs cannot be met on such a totally inadequate sum. I have had experience of the upbringing of children in my home. The latest recruit to our home came two years ago, and I have taken account of the cost of the upbringing of that child. From the co-operative creamery in our area it requires over 2½ pints of milk per day for that child, which means 5s. 2¾d. a week. If it costs 5s. 2¾d. to keep my child in milk, and the working class mother and father is only given an allowance of 2s. per week for a child they are not getting justice, and the system ought to be ended at the earliest possible moment.
It will be suggested that it is not the function of the Department to implement the scales that ought to be granted by another Department. We are told that the Ministry of Labour is responsible for the scales of relief that are laid down. When we were arguing the case for added nourishment for children in the Glasgow Corporation we were met at every turn by the statement that these were the scales laid down by the Labour Government and that they could not be added to in any form. I know the effect of these scales on child life. For the past two years I have been meeting every week 80 or 90 mothers, who have been seeking some form of assistance, parochial relief or otherwise. I have seen children with legs no thicker than my two fingers. These children are simply being crushed to death by the scales of relief given by the public authorities. I know of homes entirely without the ordinary decencies of life, without a sheet or a blanket, and without the ordinary civilised decencies that we might expect. That is not due to any crime on the part of the parents, but to the fact that the fathers and 967 mothers are unemployed, and that they have been brought to that very low subsistence level.
Take the question of tuberculosis. We have provided in connection with the Glasgow Corporation a sanatorium, and it is going to cost, according to the medical officer of health, three guineas a week to keep a child in that sanatorium. The two shillings a week maintenance that is being offered for a child is so reducing the physical powers of the children that we are faced with the tragedy of having to pour out money at the rate of three guineas a week in a sanatorium to try to build up the frame that has been destroyed by the present scales that are being paid. We want to see a different outlook. I suggest that the Lord Advocate might have a job here. He might prosecute the public bodies that are responsible for the murdering of children of the working class in Scotland. If it is wrong for a human being to take life, surely it cannot be right for a public authority, by the scales of relief that are offered, to murder the children of the working class in large numbers throughout our area. If we are going to deal with these people in the lenient fashion that we have dealt with them in the past, we can only expect a continuation of these low scales that are paid by the local authorities.
In another form we have sad cases that come into the Robroyson Sanatorium. I have seen in the Glasgow area young men and young women, who ought to have been the joy and comfort of their parents, gasping for breath, black in the face, with machines pumping air into their lungs in order that they might retain their hold on life. The tragedy is that you know that they are struggling there, and every medical man who is worthy of his noble calling will tell you that they are there, because of lack of nourishment in their infancy. They are there because of slumdom, because they were deprived of pure air. So the tragedy goes on, and it can be multiplied in every large area in Great Britain, and yet nothing of a logical nature is being done to alter this state of affairs. We talk of the provision of houses for the working classes. I do not care what kind of house you provide for the 968 worker, or how low the rental may be, the man or woman who is unemployed and has a family, having regard to the low scale of relief that is paid to-day, cannot afford to pay any rent. If you are going to build houses, even from the point of view of health, you will have to let the houses rent free. What do we find in Glasgow, according to an answer which was given last week? We have cited for the Land Courts 14,305 persons who are unable to pay their rent. Go there any week and you can see a great number of women, degraded and demoralised women, trembling at being compelled to go there week after week and month after month because they cannot afford to pay rent. If they pay rent it has to be taken out of the bodies of their children.
We are putting these children into a process of martyrdom; we are crushing the very life's blood out of them. If in this Assembly there was a child and I dashed out its brains against the table, there would not be a man or woman who would not be prepared to have vengeance upon me for an atrocious act of that nature. Yet we are going on, callously and coldly, allowing tens of thousands of children to be put to death in a more tragic and more immoral manner even than the committing of the atrocious crime which I have just suggested. If the Department is going to tackle this problem it must get down to the root causes, and deal with them. There is no use in trying merely to deal with the child when it has contracted a foul disease. It is far better to pour the nourishment into the body of the child and to stimulate its life, rather than attempt to perform miracles after the child has contracted a foul disease. Therefore, I suggest, quite honestly, that something should be done in the way I have proposed by the convening of a conference and by the Department saying that it is determined that a higher standard of life must be given to the children of the working class.
It is all very well to say that the public authorities will not pay heed, but I suggest to the Department, who are responsible for the health of the children, that they have a right to see that they carry out their duties in a better manner than in the past. Instead of being called a Ministry of Labour or a Ministry of 969 Health, if the process of which I have complained goes on it will be called a Ministry of Death. I do not want to be associated in any way with any action of that kind. The Under-Secretary has met us in some respects in Glasgow. Within the past 12 months he has stopped the sending into the workhouse of able-bodied men whose only crime was that they had not been able to secure employment. He has taken off the prohibition that the Tory Government enforced to prevent the raising of the scales for children. I suggest that he might go forward and convene the conference and say to the conference: "You are responsible for the health of the children. You must face up to your responsibility. I will do all I can to encourage the Government to face up to their responsibility, and not allow the present state of affairs to continue."
§ Mr. MACQUISTEN
I should like to congratulate the hon. Member for Shettleston (Mr. McGovern) on the eloquent and forceful way that he has presented his view to the Committee, and to assure him that while we on this side do not agree with him on many aspects of things, we shall be glad every time that he makes a contribution to our debates, because his speeches are characterised by power and lucidity. He has opened a very vast subject. He has told us the story of the poverty that prevails in our industrial towns. It makes one realise the truth of what was said long ago, that God made the country and the devil made the towns. We have people living in the towns in what always seems to me unnatural and unhealthy conditions. When the particular work to which they have been trained fails, then they have nothing to fall back upon like the people who have been brought up under more natural conditions, who have all the supplies of nature round about them. We have to consider the logical outcome of the proposal as to the responsibility for offspring, which are the natural burden of the parents, falling upon other parents, other people in the community. No doubt the time will come when we shall have to take seriously into consideration whether the right to have families, which certain people are not able, through economic circumstances or other reasons, themselves to bring up, shall be a concession that is to be made to everybody. 970 We have had effective speeches made in this House from time to time as to whether there should not be some method of dealing with the increase of mental defectives.
We have a serious problem before us. It is quite true that the children of parents who are utterly worthless are often better treated than the children of those who struggle along and do the best they can. I have seen these children in the Highlands. I have known many cases of little children taken from the poorest of parents and under the worst surroundings, who are now occupying positions of credit and honour in many parts of Great Britain. I came across a striking case of that sort the other day, of two young women who said they had come from a part of my constituency. They had been taken there in their tender years, and they are now occupying very creditable positions in the South of England. How far one can go in these matters it is difficult to say. It is easy to rend the hearts of the people with pity, but the heart of mankind is not wide enough to take in all his fellows. You can test the matter very simply. We have, first of all, the instinct of self preservation, and then comes one's own family and one's own household, which come practically before everything else. That is what makes the appeal to the patriotic instinct when it is said that a man is defending his own hearth and home. We can test whether the sympathy of humanity is world wide, by a very simple illustration. We know of the great crowded populations out in the East, and we sometimes hear of an earthquake in Japan or a river flooding in China, where perhaps a million people are annihilated, and yet our hearts are not wrung by the news of an earthquake in Japan or China where so many people are killed so much as by news of a much smaller tragedy which comes closer to us. Not even the hon. Member for Shettleston (Mr. McGovern) would be so much put about by such an awful tragedy in the Far East as he would be by the loss of his own umbrella.
§ Mr. MACQUISTEN
True. Of course, if he thought that by sacrificing an umbrella he might save a million lives he would do so. The fact remains that great 971 tragedies occur all over the world, but unless they come close to us, unless, as the hon. Member for Shettleston mentioned, one can stand before a bed and see the terrible effects upon tuberculosis cases, one never fully realises the horror of it. I recollect the time of the air raid on London. I heard one going on some miles away and it did not perturb me particularly, but the next night, when a bomb dropped on the building in which I was staying, I immediately realised what it meant. It came home to me. In the same way these tragedies come home to the hon. Member because they happen in his particular constituency, and whilst we all sympathise with his view we must realise that an excellent beginning has been made in these services. I am a much older man than the hon. Member. In my young days we had a healthy, strong and vigorous population, subject, no doubt, to many complaints, but still sturdy and vigorous and we had none of this eleemosynary assistance at all. All contractors will tell you that the navvies they get to-day are poor creatures compared with the great hefty fellows of 30 or 41 years ago.
We are doing something very useful in maintaining the people in the Highlands of Scotland, and I was very interested in reading the observations concerning the medical services in the Highlands. It is a wonderful service and a remarkable monument to the memory of the late Lord Forteviot, who instituted it. When I was a boy in Argyll I recollect that a man whose leg was broken had to remain 25 years in his bed because there was no medical man within reach and no way of bringing in a medical man to perform the comparatively simple operation of setting his leg. Those evil days have gone. A great advance has been made, and with a comparatively small sum of money. To the honour of the noble profession of medical science it has been found possible to get men, and still more women, who love the solitudes and lone spaces, to go into these parts and conduct their great calling. And the nurses too. There is nothing that does more honour to that noble profession than the work that is done by them in the Highlands and Islands.
972 I want to make a suggestion to the Scottish Office which I think will make this small sum of money go still further. We might follow the precedent of the medical missionary in Africa. We have in the Highlands a great many manses. In these days it is very difficult to get the lad of parts to go in for the Church, because the teaching profession attracts him more. The carnal emoluments are much better than those in the church and there is, moreover, the prospect of a satisfactory pension at a comparatively early age on which he is able to retire. Some of these manses are of considerable extent, and it occurs to me that there might be a combination in many of the districts in the Highlands of the clergyman and the doctor. In this way much of the difficulty would be solved. You would have the doctor's house at the manse, and, generally, it is a much larger house than the salary ever justified. If we combine the stipend with the assistance which is given by the Department of Health, and the other small emoluments which attach to the position of medical officer, you would solve a great difficulty. When a man has taken his medical degree he might, with the assistance of the church, spend 12 months, in a theological college—
§ Mr. MACQUISTEN
He probably will not have the rhetorical faculty of preaching like the hon. Member for Bridgeton (Mr. Maxton).
§ Mr. MACQUISTEN
No; I should have been quite ready to take charge on Sundays; it was the difficulty of setting an example throughout the week; that always stopped me. But that is a scheme which, I think, would modify our difficulty. It would meet the difficulty of trying to keep the cure of souls; and there is no reason why a man should not have the cure of souls as well as of bodies. Why should they not be combined? It would enable the fund to be spread, and many places could have a medical man which at present cannot afford to provide a suitable house. It might also mean a little hospital accommodation in some cases. It would enable the medical services to be spread to a much greater extent over the Highlands than is the case at present.
§ Mr. MACPHERSON
I have on more than one occasion dealt in this House with the reports from the old Board of Health, and very rarely has the House of Commons had documents so admirably presented as the reports from that particular Department. I am glad that the report which we are discussing to-day is as comprehensive and as full in its information as any of the reports which have been presented in the past. The Secretary of State gave us a resumé of part of the work of this Department, but he quite frankly said that he could not cover the whole of the work. We are grateful for the information he gave. I was particularly interested in the statistics he presented, and if the Department continues on the lines he outlined, the Scottish nation will owe it a deep debt of gratitude. The right hon. Gentleman was particularly anxious about his own reorganisation scheme. I am not surprised, because by that scheme he put out of existence no fewer than 1,000 public bodies. I associate myself with his appreciation of the work of the defunct bodies and the work that is now being done by the reconstituted bodies. I have been astonished how admirably they have started their new work in my own constituency, and I am hopeful that the doubts and misgivings which so many of us expressed may be belied, and that the newly constituted authorities, after they have been in existence for a little while, will prove that they are a real blessing and will carry on their excellent work in the future.
I am not going to deal with all the points raised by the Secretary of State but I should like to refer to his remarks about St. Kilda. I was glad to hear that the Under-Secretary of State had paid a visit to the island, but he might have mentioned that on the same date the hon. Member for the island also arrived on that rocky coast. The island of St. Kilda has always been a problem. It appears now to have been solved; and we all hope for the best. Nobody likes to think of anybody being forcibly or compulsorily taken from the land of their fathers, however poor and rocky it may be, and I am glad that the inhabitants of that island are leaving it not because of any force of compulsion but of their own free will. With regard to their settlement. They are a hardy and 974 good-looking race. They are brave, as you would expect from their livelihood. They have to get their living in a most dangerous way. I have seen it stated that if you take inhabitants from a particular sort of environment and surrounding and place them in large cities, very unlike the surroundings of their native land, that they immediately succumb. I want to impress upon the Secretary of State that when he is considering the question of settling the inhabitants of this island upon the mainland or upon another island that he will allocate portions of land which are near the sea for them or, alternately, give them occupation in afforestation or fishing, which would be consistent with their habits in the past.
§ The UNDER-SECRETARY of STATE for SCOTLAND (Mr. T. Johnston)
They do not fish.
§ Mr. MACPHERSON
I understand that a good many of them fish, and go in for bird nesting. In any case I mention these sea pursuits as those which would be more appropriate for these men and women who are now the responsibility of His Majesty's Government. The Secretary of State gave us a few statistics about housing which I have no doubt will be discussed later on by the hon. and gallant Member for Kelvingrove (Major Elliot). I listened with interest to-day to the two answers which the hon. and gallant Member received, and while I will leave him to deal with those replies I should like to draw the serious attention of the Secretary of State to the fact that there is now a shortage of 100,000 houses in Scotland and that the number which was erected last year was much less than the number erected a year ago. Not only that, the number employed was 2,000 less than in the previous year. I do not agree with the statement of the Under-Secretary that that was due to the fact that local authorities were Unionist in principles. There is no justification of any sort or kind for that statement. What is happening in Glasgow? What is the party complexion there? Has the number of houses increased there to any great extent? No, the Under-Secretary cannot say that it has. The answer which the hon. Gentleman gave this afternoon is, not an answer which this Committee can tolerate or believe.
§ Mr. JOHNSTON
What I said was that one of the reasons why house building in certain parts of Scotland was in arrears was the complexion of the councils. There are areas where no building at all has been done.
§ Mr. JOHNSTON
The people who are responsible for the fact I have stated are not representative of this side of the Committee, but of the other side.
§ Mr. MACPHERSON
The hon. Gentleman may be accurate in citing one instance where the local authority has been dilatory, but to say that local authorities are dilatory because of their political complexion is quite absurd. What were they going to gain by it? If they did not build they would have 2,000 or 3,000 more out of employment, and they would have the privilege of giving these men a dole for doing nothing. The whole logic of the statement is ridiculous. I was glad to hear that the Secretary of State intended to press upon the rural local authorities by letter or some other means—
§ Mr. MACPHERSON
I am glad it has been done, and that there has been impressed on the local authorities the dire need of improvement in housing in rural districts. The late Secretary for Scotland pointed out how difficult it might be to get all the authorities to introduce the latest improvements, so far as smaller houses in rural districts are concerned. I think that the Act to-morrow will do something to compel the recalcitrant local authorities to act, and in any case to stimulate action by them. There is nothing so dreadful as to think that you may have a slum condition in a small house in the country just as iniquitous as in one of the large slum areas of a town. Whatever action the Under-Secretary may take in inspiring a new interest among these recalcitrant local authorities in the country districts, I am sure, will have the unanimous support of every Member of the House.
My hon. Friend the Member for Orkney and Shetland (Sir R. Hamilton) quite appropriately introduced the important subject of the administration of the Highlands and Islands grant. It was his predecessor as Member for those islands, 976 along with myself, if I may say so, who moved the Amendment introducing this peculiar grant—a grant that was peculiar because of the conditions in the area—under the Insurance Act of 1911. Afterwards Lord Forteviot and his Commission did an enormous amount of excellent work in bringing great advantages, aided by this grant, to this Highlands and Islands. In the past it was found that £42,000 a year was quite inadequate to meet the multifarious needs of the very diversified communities which you have in these great open spaces of the North, and if this Government has done nothing else it has done one good thing in having promised to increase the grant from £42,000 to £72,000. It is a variable grant, and so long as the present Government are in office they are more or less pledged to keep the grant art a figure at least high enough to meet the various needs of the community.
I know the life of the Highland doctor of the old days. If ever there was a hero in the world it was the Highland doctor. Many a stormy night in winter he would go miles up hill and down dale, and very often at the end of it all, after six or seven hours, he would get half a crown or nothing at all for his work. There were no motors in those days; the doctor had to use his Highland pony, and he did his work ungrudgingly and remarkably well. It was a great joy to those of us who are interested in the Highlands to find that men of that calibre could now, under the Highlands and Islands Act, be guaranteed a livelihood in any case. The grant which was introduced in 1911 has justified itself, as was proved by an hon. Friend in the case which he adduced. I could adduce many other cases and describe similar circumstances, but it is not necessary for me to do so. All that I would impress upon the Under-Secretary is this: The details in the report, such as telephones in doctors' houses, houses, doctors' housing itself, and assistance to nursing associations—these should be further developed because they have proved of enormous value to the communities in the north. I would draw attention particularly to the nursing associations. I remember the time when there was not a single professional nurse in any parish in the Highlands. Now it is the rarest thing to see a parish without a nurse, and some parishes have two 977 nurses. They have gat them because of the willingness of the voluntary workers and of the local inhabitants, who help themselves by subscriptions and otherwise to acquire gradually a nurse here and a nurse there. As I understand it, these voluntary associations do not desire in any way to be dependent upon State grant entirely. All that they want is that in certain cases of necessitous areas the State should stand by, and that where the need is greatest the State should come forward and assist.
The report states that the Department is taking a great interest in the various hospitals which are in these areas. Reference has already been made to some hospitals. I have no doubt that my hon. Friend the Member for the Western Isles (Mr. Ramsay), when he catches the Chairman's eye, will speak about the hospital in Lewis. I would like to say a few words about the Invergordon Hospital. I am not pleading for this particular hospital, but for this class of hospital, the sanatorium hospital. I am very anxious that the good work started locally by the local authorities should be watched with the tenderest care by the Government, and if when the local authority has done its level best it should be necessary, in the public interest, that an additional sum should be given, whether through this grant or otherwise, I hope that the State will look with sympathy on any request that might be made.
The hospital at Invergordon is exceedingly well managed. I can say the same about every other hospital of this class. There are the Ross Memorial Hospital at Dingwall and the Northern Infirmary at Inverness. It is a wonderful achievement by voluntary subscription to raise no less than £100,000 for the local hospital in Inverness. They have established, under the wgis of the Department of Health, a specialised service of highly skilled consultants and surgeons. As has been pointed out, when you are developing a hospital system in the north you are easing the burden of the hospitals in the south and benefiting not only the local community but the community in the south. I hope that when the Under-Secretary replies he will give a guarantee, so far as he can, that all these things are under the special supervision of his Department, and that he will persuade 978 the Chancellor of the Exchequer not only to keep this grant of £72,000 in existence, but that if need should arise he will do his level best to add to the guarantee so that needs may be adequately met.
§ Mr. HARDIE
I regret that the hon. and learned Member for Argyllshire (Mr. Macquisten) has left the Committee. He is always extremely interesting in his comments, but in his speech he got down to what I call the rice basis, and about that I want to say something. Whenever a speaker gets down to the coolie basis, in the multiplication of the professions of one individual, it generally means getting down to the least efficient. So far as missionary societies are concerned, they have sent missionaries to China, but none of them would claim to have the fullest qualifications of the medical profession. To say that we are too poor to provide in the remotest part of these islands not only medical proficiency but everything else that is required, is simply to ignore the wealth of the nation. We have not only the wealth but the people who can do this kind of work. What we still lack is the will to apply. There are idle medical men, idle nurses and idle teachers. There is no lack of ability. I regret that any Scotsman should have been reduced to the argument of the split service idea. If a man is to be fit for medical work he must concentrate upon medical science alone. If he is to be fit as a spiritual advisor, he must concentrate on spiritual subjects alone.
The first thing in the report to which I wish to draw attention is the question of the able-bodied unemployed. This has always been a vexed question, and it is not so long ago since the able-bodied person in Scotland had no recourse in the matter of relief unless he became a criminal. That condition has been removed. We are now going a step further, and I observe in the report there is the suggestion that a conference of local authorities should be held to consider what can be done in reference to this question. Something will have to be done. It is no longer a question of the Poor Law authority acting as a Poor Law authority. The Poor Law authority used to deal with cases of poverty arising out of conditions other than that of being unable to obtain 979 employment, but now we have a duplication of governmental departments in dealing with this matter. The Employment Exchange deals with the man who is termed an unemployed insured man, but after a long period of unemployment that man becomes an uninsured person and comes on to Poor Law relief.
What we want to deal with in connection with this matter is the status of the man himself and whether any difference should be made in the case of the man who, as a result of a long period of unemployment, is prevented from receiving the benefits enjoyed by the more fortunate men who are still treated as insured persons and are drawing benefit from the Exchange. I hope that the Under-Secretary will consider the question of having a conference of local authorities. I do not see any other way out of the difficulty unless Parliament takes direct action and overrides the findings of the local authorities, which is a bad thing to do. If we are to have local government, the local authorities ought to have their own responsibilities. But if we are going to deal, by means of local government, with something quite outside the Act which brought the Poor Law authorities into being, then some legislative change is necessary in order to meet cases of the kind I have indicated.
I was rather surprised at the speech of the right hon. Gentleman the Member for Pollok (Sir J. Gilmour), who is usually very well-informed on these matters, but to-day, particularly on the question of housing, he was far from being well-informed. I thought he was trying a joke on us, but he assures me that he is serious. If he is serious, I would point out to him that the factors and owners of property are doing everything possible on the town councils and other public bodies to put a stop to the building of houses, because the increase in the number of houses is reducing the rental and the selling value of their property. As the number of houses increases, the value is bound to come down from the present enhanced value—a value which ought not to be there at all. Anybody who watches the doings of public bodies must realise the kind of influences that are being used to keep lap the demand for houses by keeping down the 980 building of new houses—to do that, on the one hand, in the interests of the property-owners themselves and, on the other hand, to do all that is possible to create difficulties for the present Government. Those are the two things that we find going on in the councils in Scotland.
Take the case of my own city. One does not need spectacles in order to see what is happening in Glasgow. If the property-owner himself cannot get into the town council to do this kind of work, he gets the factor or the house agent into the council. One has only to read the reports of the town council to see what is going on there. It is not so long ago since I had to raise in this House a question about the action of certain factors in placing a slip of paper inside each rent book stating that the Rent Acts did not apply to what was being paid. The men who would stoop to do that dirty, illegal thing on people who are uneducated, as far as the law is concerned—well, you cannot question what they would stoop to in other directions! I can understand a man who is mentally well-equipped meeting another man who is mentally well-equipped on equal terms, but when a man who is mentally well-equipped tries to take advantage of the mentally unequipped, it brings us down to a very low stage, as far as public business is concerned. In the City of Glasgow though the opinions which are held on these benches have a certain dominance, there is still a minority, and the same thing applies all through Scotland. In regard to housing it is showing itself in the way I have described. We are seeing now in Glasgow what has not been seen for many years, namely, "to let" boards on the houses, and just as the number of those boards increases, the property-owner and his representatives in the town councils throughout Scotland become more active against the building of houses because they know that as more houses are built the people will leave the tenements and the value of property will fall.
It is absurd for anyone, and especially for anyone on the Front Opposition Bench, to suggest that it is because of something done by this Government that more houses are not being built. I challenge anyone to point to any single thing done by this Government which has interfered with grants or materials, or, in 981 any way at all, hindered the provision of more houses. The basis of this matter rests with the local authorities, and that is why, on Friday last, this House was asked to pass a Measure the object of which was to get these authorities to act more quickly if possible. That proves that the statements made from the Front Opposition Bench on this matter are entirely wrong. Were those statements right, the local authorities would have been telling the country that they were being prevented by the Government from doing these things. They cannot say so, because this Government ever since coming into office have been probing the local authorities and urging them to get on with the work.
The next point which I wish to raise is in relation to the question of allowances for children, and particularly to the disparity between the 2s. a week and the 14s. 9d. a week for boarded-out children. I quite understand all the costs that are included in the 14s. 9d., but, even taking into account the cost of inspectors and the overhead costs of keeping records in the offices and getting reports and all these other things, still the difference between the 14s. 9d. and 2s. calls for some explanation, and some new light ought to be thrown upon it. I have the feeling that 2s. is entirely inadequate, and it is certainly out of all proportion to the 14s. 9d. in respect of the boarded-out child. I hope that something will be done in reference to this matter. It is not a very large sum which would be required to deal with the matter, if we take the returns for the whole of Scotland, and as regards the question of the boarded-out child in Scotland, we ought to try to bring about the greatest possible amount of progress. This is not a party matter, and I think everbody wants to reduce the number of boarded-out Children. To me it is always heartbreaking to see a boarded-out child. I do not like the idea at all, but I know that there are cases in which the only home influences are bad influences where boarding-out is unavoidable.
We want to give such a child the best possible chance, but we must not forget the child in the good home. If the child of the bad home is going to cost the nation 14s. 9d., why should the parents of the child in the good home be penalised? It seems to me a penalty that, because 982 the parents happen to be good parents, they should only get an allowance of 2s. whereas if the parents are bad parents a much increased cost is incurred. I hope that something will be done to secure a better relation, on the cost of living basis, between the case of the good parent and the case of the bad parent. The cost of the child's living ought to be the basis of calculation, and 2s. a week is a very inadequate sum to provide a healthy child with all it requires. As I have said, this nation is so rich that we need have no fear about anyone being against doing something for the child in the small way which I have suggested.
To return to the question of the able-bodied unemployed, that problem becomes more serious every week and every month. We have to realise the position of the able-bodied unemployed man who is outside unemployment insurance. One of the alternatives before the Government is to bring in legislation which will include every unemployed individual. I believe in a system whereby we should have no insurance at all but a form of State relief. It would be cheaper and it would be better. An all-over system of State relief for the able-bodied unemployed would mean that there would be no question at all of whether a man was insured or not. At present if a man applies at the Exchange and it is found that he does not come within the scope of the Arts he is flung back on the parish council or the board of guardians. The State has to meet that man's claim in any case. Why have two sets of officials for doing it? Why not have your able-bodied unemployed all going through one door? If at the Exchanges all the able-bodied unemployed were dealt with, then in Glasgow and Dundee and other cities there would be no need for the double queues—one queue at the Exchange and one at the parish council. The unemployed man should not, in any circumstances, be placed in the position of a pauper because the word "pauper" in relation to our Poor Law system denotes an individual who through illness of some kind is unable to work. To treat the able-bodied unemployed man of today as a pauper is most unfair. I hope the points which I have raised will receive some consideration and particularly 983 this question of the able-bodied unemployed man. There is no greater tragedy than to see that able-bodied man standing at the parish council door. He should be with his fellows who are fit going through the door of the Employment Exchange and there dealt with as an unemployed man.
§ 6.0 p.m.
Mr. R. W. SMITH
The Secretary of State for Scotland referred in passing to the figures given in the Ministry of Health report with regard to infant and maternal mortality. These figures are most distressing, and I was extremely sorry that the right hon. Gentleman did not seem to take a more serious view of them, because if one looks at the column for maternal mortality, on page 71, he will find that there is practically no improvement in that case over a large number of years. I hope the Government will seriously consider this question of the children and their mothers. I speak only as a layman, but I have studied this report very carefully, and it seems to me that it is very clearly shown that greater care must be taken of the expectant mother and also of the child just after birth. There is no good our expecting to have a healthy nation if the children come into the world in unhealthy circumstances. I have referred to these tables, but they do not give the whole case, and I am sure it is true that there are many children in this country who suffer from weakness all their lives owing to the conditions under which they came into the world. Therefore, I press upon the Government very strongly that they should try to do something for these mothers and children.
It seems to me quite clear, though the Secretary of State for Scotland did not refer to it, that what is wanted is the better education of the expectant mother, which can be done in various ways. We have, I notice from the report, about 87 pre-natal centres in Scotland, and I hope it will be possible to increase these places. The report says that experience indicates the need for the establishment of the pre-natal service on a more adequate basis. I would press that on the Government, but there is as well the maternity and child welfare centre, which also gives very valuable informa 984 tion to the expectant mother, and I am sorry to see that in the Estimates for this year we find, on page 85, that the grants for the training of midwives and health visitors are down by over £1,000. I do not say that the amount is very large, but it seems to be going the wrong way, especially when we see that the administrative expenses of this Department are up by over £39,000.
The training of a mother is of vital importance, but my candid opinion is that the training should begin long before the woman ever becomes a mother. It seems to me that in order that the expectant mothers may gain the full benefit of these pre-natal centres, and also of the maternity and child welfare centres, they must really learn ordinary physical hygiene at school, and that is why I would like to refer especially to the part of the report which deals with the health of the school children. In my opinion, the way in which the children are allowed to go about at school in our country is simply shocking. They are not taught there how to look after their health properly, and my opinion is that we want to start with the children at school and teach them how to keep themselves healthy. If you once manage to inculcate that at school, you will not find it so difficult to get the women to come for advice on health matters when they come to be expectant mothers. I should like to refer especially to what is said on page 92 of the report:The school child should not only he taught the golden rules of health, but should also be trained in the practice of them.If I may give a personal experience, I would like to refer to what happened in my own case. I visited a school in my part of the world and found a class meeting. There was one child who was reading whom I asked to clean its nose before it went further, but it said it had not got a handkerchief. I asked all the children in the class what hankerchiefs they had, and there was not 50 per cent. of the class with handkerchiefs, and there was not 50 per cent. in the school that had them either. One of the first things necessary is that these children should have handkerchiefs and learn how to use them. I do not think I am the only person who has observed this lack of handkerchiefs among school children, 985 because, on page 91 of the report, I find that the school medical officer of Banff states that the common coldshould be regarded as an infectious fever, and much can be done to prevent it and to check its spread by teaching the children ordinary hygienic hbaits and the proper use of the handkerchief.Evidently he found exactly the same as I did, that there was a sad lack there. There is another thing, and that is with regard to the cleanliness of the hands and faces of the children in our schools. Far be it front me to say that all the teachers do not look after the children in that way, because many of them do so most carefully, but there are many places in which the children are not properly washed during school hours. In the schools there is a supply of soap and water and towels, and therefore there is no reason why the children should not be clean. I raised this very question on the school management committee of which I was a member, and the reply that was made to me was, "You cannot expect the school teacher to do that sort of work." I hope the Government will see that the school teachers do consider that it is part of their duty to see that the children are clean and tidy, and if hon. Members will study this report, they will find that that suggestion is made. It must not be left to the nurses and the medical men, but it ought to be done by the teachers in the ordinary routine. The doctors and the nurses come round at certain times, but the teacher is there every day, and I want to see that we teach the children properly to be clean and tidy in the schools. It says, on page 91 of the report, that all officers of the local authorities:the medical officer, the school nurse, the physical training specialists, and the school teachers,should take part in the hyigenic training of the children. If we were to get the children into the way of keeping themselves clean at school and learning the advantages of health, I think we should find, when it came to a question of mothers and children, that they would be much more willing to visit the maternity and welfare centres for advice and that, having got the advice, they would be better able to benefit by it. I believe that if we started in that way and took some trouble on those lines, we should 986 find that the figures of maternal and infant mortality would very soon begin to drop.
§ Mr. RAMSAY
The question of Saint Kilda was introduced, and until then I had no intention of intervening, but, to my very great surprise, not only tilt Secretary of State for Scotland, but the late Secretary of State, gave a blessing to the action that is being taken in that connection. I happen to differ from both these right hon. Gentlemen in regard to the policy adopted, and unlike the previous Secretary of State but like the present Under-Secretary of State, I have had the privilege and honour of visiting that far-flung part of the United Kingdom. It was stated by the Secretary of State that he had received a petition, dated the 10th May last, as a result of which, and of the visit of the Under-Secretary of State, it had been determined to vacate the island. It is quite easy to understand why that petition was drafted. When you get a set of circumstances in which no letters reached the islanders from the middle of October, 1923, till the middle of February, 1930, and no newspapers or any communications whatsoever, you can understand why, in their desperation, they signed a petition asking to be removed out of such conditions.
I hold that all this is a tragedy of neglect. It is a thousand pities that something was not done to help the communications. We know that during the months of May, June, July, and August communications have reached these people by the ordinary touring vessels, but for the remainder of the year, from the middle of September to the return of May in the following year, these people are dependant on spasmodic visits from trawlers for the delivery of letters. I cannot understand why, in these days of the advance of science, when we have aeroplanes, seaplanes, and submarines, and many ways of getting at people that we did not have formerly, we should not have thought out some better method of reaching these people. It is very easy to remove the people themselves—much easier than stepping forward and fulfilling one's duty in another way.
If the Government had only gone into this problem seriously from the point of view of helping the people by adopting 987 better means of communication by aeroplane, seaplane, or submarine, it would have been far better. What is the use of keeping these vessels for merely ornamental purposes? We want to use these things to help the people. I understand that the sheep on the Island of Boreray were never shorn for three years. Something might have been done there. At the present moment the people have only—[Interruption]. I hope I shall be allowed to continue. There was a scene when St. Kilda was debated before, but I hope that I shall have an opportunity of voicing my opinions and letting the Committee know things as I found them. After all, the Saint Kildans are my own constituents. At the present moment we have nothing but small boats in which these poor islanders have to go to the neighbouring island of Boreray for shearing machines, and with the cross currents in the sea that is almost impossible. If a motor boat supplied with a winch for hauling it up in rough weather—
The CHAIRMAN (Mr. Robert Young)
I am trying to find out where in the Estimates of the Department of Health for Scotland the shearing of sheep comes in.
§ Mr. MACPHERSON
The Secretary of State for Scotland expressly introduced this subject, and enlarged upon the conditions of the island and of the islanders.
§ Mr. JOHNSTON
May I suggest that as this question is bound up with public health and medical services, and as this is possibly the only opportunity which the hon. Gentleman may have of raising the question of the evacuation of the island, which is bound up with medical costs in the island, it might be possible, if the hon. Gentleman could forget the word "shearing," to state his point of view?
§ Major ELLIOT
There is a definite reference in the report which we are discussing to a Poor Law allowance which has had to be paid for the first time to a resident of St. Kilda.
§ The CHAIRMAN
The hon. Member was talking about sheep, and he must show me how he can talk about public health in connection with sheep.
§ Mr. RAMSAY
I was using the illustration as a reason why the island should not be evacuated, and I was coming to the reason which the Government give for the evacuation, namely, health. I should have liked to go into the other point, because it was the foundation of the petition which the islanders presented, and there is definite mention of it in the report. We know that a number of people have been removed from the island of St. Kilda during the year, and considerable expense has been incurred in removing them. I understand that something in the neighbourhood of £500 has been spent, and that is largely the reason which has determined the Government—
§ The CHAIRMAN
Where is the £500 in these Estimates? The hon. Member has access to these Estimates as I have, and he ought to show me where it is.
§ Mr. MACPHERSON
It has been stated in the House that the doctors of the Department of Health attempted to visit the island and were unable to land. That was stated recently in the House, and it is in connection with the visit of these doctors to see the condition of the health of the people that my hon. Friend is now raising this point.
§ The CHAIRMAN
I have no objection to that, but the hon. Gentleman has been round about it a long way and talking about the shearing of sheep.
§ Mr. MACPHERSON
I think that he was introducing that as an example of the difficulty of approaching the island, and of getting off the island.
§ Mr. RAMSAY
It is a well-known fact that there have been two cases of serious illness where medical officers belonging to the Department of Health have sent to have patients removed, and largely as a result of the costs incurred in visiting the island to get these people off, the policy of the Government is to evacuate it, and surely I am entitled to bring that forward. If it is a point which is full 989 of dangers and pitfalls, I have no desire to thrash it out in the way that I would otherwise have done.
Another point which is of interest to my constituency is the question of the delegation of health services to the island of Lewis. This question has caused something in the nature of a deadlock for a considerable time, and we have been in communication with the Scottish Office about it. We are anxious to get the views of the Under-Secretary upon this point, because it is a serious matter. The county councils of Inverness and Argyll have delegated the health services to a specific committee belonging more or less to the islands of these two counties, but, unfortunately, the people of Lewis, although they have asked for a similar delegation, have not received it. I hope that the Under-Secretary will give us an assurance that something will be done in this respect, because it is a serious thing from the health point of view of the island of Lewis that they should have people who understand the local conditions on the sub-committees or district committees which are dealing with these health problems. At the present moment those members who have to go to the mainland waste about three days in going there, attending the meetings and returning, and if the hon. Gentleman would only give us an assurance that he is sympathetic and will support the claim of the people of Lewis to have a delegation to look after their own health services, it would be a great thing for the island. I have not, the same complaint to make about the other islands, because the county councils have given this delegation.
With regard to the nurses, no one has a greater respect for them than I have. In all these islands I have seen them on their bicycles pushing themselves along the very bad roads, and when they come to the townships they have to get off their bicycles and walk long distances. It has been suggested that light cars should be provided for them. I would be the last to deny fiat they should have light cars, and I hope that they will be provided, but a difficulty would arise with regard to the township roads, which are four or five miles from the main roads. That is a question which, I hope, the Under-Secretary will keep in view. Doctors' houses have been mentioned, 990 and I would like the views of the Under-Secretary with regard to the provision of telephones for these houses. I have advocated telephones for a long time, and I did it on the Committee stage of the Act dealing with the Highlands and Islands medical services. I should like to emphasise the desirability of having telephones not only in every doctor's house, but in every schoolhouse or other convenient centre in each parish in the Highlands and Islands of Scotland. The hon. Gentleman might get into communication with the Post Office and ask them to help in that respect. We are making a great fight with the Post Office for the provision of telephones, but it is difficut for us to get them unless the Secretary of State will support us and see that some of the great profits which the Post Office are making are used to help the outlying parts of the United Kingdom.
We were grateful for the statement which was made by the hon. Member for Orkney and Shetland (Sir R. Hamilton) with regard to hospitals, and I want to thank the Government and the late Government for the encouragement which they have given to Lewis Hospital. This Government and the last Government have done splendid work for the island of Lewis in establishing that hospital. I can assure the Government that it is very much appreciated. I wish, however, that provision were made for more ambulances and stretchers. During a recent tour a case was brought to my notice of a man suffering from peritonitis; he expired largely because no near ambulance on which to take him to hospital was available. There was no stretcher, and he had to be put on part of a bed, and when he got to the end of the narrow footpaths which are so abundant in the Western Islands, he had to be put into an ordinary motor car, with the result that he doubled up and expired. The provision of ambulances would go a long way to help the situation. I thank the Government also for the provision of a road at Bernera. The people there have been in a bad position for a long time because of the want of a medical service. Formerly there was one doctor; in recent years there have been two doctors, but the island was more badly served with two doctors than with one, and I am glad that provision 991 has been made for a road, which will enable the islanders to get over the narrow neck of land and to reach the doctors more expeditiously.
I do not know how far I shall be allowed to raise the question of unemployment, but it was mentioned freely on the benches opposite. When men in the mercantile service in the Western Islands are out of employment they naturally want to go back to the islands because they do not want to be separated from their families; and places like Oban and Dumbarton, where they might search for work, are too far away. This is a serious position from the point of view of health, because these men cannot stay in Dumbarton or Oban or other places and leave their wives and families in the islands.
§ The CHAIRMAN
I am afraid that that question cannot be introduced. I do not see how the hon. Member can suggest that the Department of Health are responsible for the fact that men have to live apart from their families.
§ The CHAIRMAN
I cannot help that report; I am confined to the Estimates. The hon. Member must show me that anything he refers to in that report has any relation to the Estimates before us.
§ Mr. MACPHERSON
The point in the report is that in these districts unemployment affects the health of the people, and it is because of that that this particular paragraph on page 171 is inserted.
§ The CHAIRMAN
I can hardly see how that has any relation to the point which the hon. Member for the Western Isles (Mr. Ramsay) is making.
§ Mr. RAMSAY
A similar subject was introduced from the benches opposite, and I thought that I had an equal right to speak about it. I suggest that the health of the children is affected if the families are forced to live apart.
§ The CHAIRMAN
Surely that is something that is occurring all over the country. The question of unemployment does not arise.
§ Mr. LOVAT-FRASER
I do not rise with the intention of making a speech. 992 As an English Member I am in danger of being an intruder in a discussion of this kind, but I wish to ask one or two questions suggested by the report. After your remarks, Mr. Young, to the hon. Member for the Western Isles (Mr. Ramsay) I am a little nervous of referring to the report, but I will go on until you stop me.
§ The CHAIRMAN
The hon. Member must make himself conversant with the details of the Estimate before the House. It is not for me to tell him what the details are, and if the hon. Gentleman wishes to raise matters of that kind he must do so on the Scottish Office Vote. Unless they are in this Estimate, they are out of order.
§ Mr. LOVAT-FRASER
I will submit to any correction or rebuke that you may think proper to give me if I go beyond the scope of what is permissible to-day. The first question I wish to ask arises out of the Poor Law relief statistics on page 206. It is stated there that 790 Poor Law children are in poor houses. I wish to know how that number of 790 is made up. Modern, enlightened opinion is hostile to the retention of children in poor houses and workhouses. The last place in the world for young children, whose eyes ought to be opening on the world with hope and happiness, is among the wreckages and failures of the poor house. In England the Ministry of Health take a strong view about the undesirability of children living in workhouses, and there is an Order which forbids children over the age of three remaining in workhouses for more than six weeks. I would like an assurance from those who represent the Scottish Office that everything is done to keep the number of children in poor houses as low as possible, because 790 is 10 per cent. of the total number of Poor Law children. The best method of dealing with them is to board them out, and I hope the Scottish Office will follow that policy with vigour and persistence.
The next matter to which I wish to refer concerns the dental service in the Highlands and Islands. Having some little knowledge of the Highlands and Islands, I attach great importance to it. We who live in towns and cities think of toothache as a small thing, but to people in remote islands, where the nearest dentist is 50 miles away, it is a very 993 serious matter. I need hardly remind this Scottish gathering of Robert Burns' description of toothache:Thou hell o' a' diseases…Aye mocks our groan.The hell of all diseases is a very real thing to the people in the Highlands and Islands. When I go up to those remote islands I take a supply of genaspirin with me, and I have been able on more than one occasion to bring much-needed relief to sufferers there, on one occasion with the happy result of reducing my hotel bill. I was glad to read in the report that the regional and town-planning movement is being pushed forward in Scotland. There was an inquiry last, year into a town-planning scheme for a part of Edinburgh, including Charlotte Square, and I would like to know what was the result of the inquiry. It is referred to in the report, but the result is not given. On page 52 of the report there is a reference to canned horse flesh. It says that the Scottish Office saw an advertisement by an American firm who wished to obtain carcases of horses for importation into other countries in the form of canned meat. The report says:In view of the possibility that canned horse flesh might reach this country for home consumtion either under its own name or labelled as beef the attention of the medical officers of health of the principal ports was drawn to the matter.I only want to ask the Scottish Office whether there is the slightest suspicion that people in this country consume canned horse flesh.
§ Mr. TRAIN
In the interesting speech of the Secertary of State the most interesting item to me was the announcement that one-ninth of the working class population of Scotland are housed in sanitary houses, but reading through this report one sees that something more than the mere building of houses is required in order to secure the health of the people. We have had many suggestions from hon. and right hon. Members opposite as to the assistance to be given in order to help public health work all over Scotland. One suggestion was that we should give free houses to some of the people, and now that we have given free education, perhaps there is some 994 thing in the argument in favour of free houses; but I wish to draw attention to the fact that something in connection with house building we have neglected is sewage purification and the provision of a good water supply. I see from page 38 of the report that the work of the Local Government (Scotland) Act, 1929, is beginning to make itself felt, in that local authorities are thinking about introducing sewage purification. In the case of the larger areas there is not the difficulty over the contour of the land that arises in other cases. Where one area is abutting on to another and the ground happens to fall the wrong way for outlets for sewers, the authorities of the two areas can get together and have a joint scheme, as they are doing in East Stirling. The great difficulty there was money. The rate in Slamannan and Maddiston was something like 20s. in the £, and they were not able to proceed with the scheme, because they were offered only 75 per cent. of the cost, but I see by a footnote that they are now getting the full grant and are going on with sewage purification. Kilmarnock is in difficulty over its sewage purification. It is still running crude sewage into the River Irvine. Further on we find the Vale of Leven in the same position. Then we come to the premier county of Scotland, the county of Lanark, and we find that the Board of Health have been supporting the county authorities in a prosecution against a colliery owner and a creamery, the colliery owner for polluting the river by washings from coal dust and the creamery for putting what is known as whey into the stream. It is a matter of great surprise to me that two small items like that should occupy about half a page of the report, when one knows that the great town of Hamilton has no sewage purification and is putting its crude sewage into the river. The town of Paisley is polluting the Cart and causing a nuisance. The effluvia from these rivers and streams is not good for the public health. We are to have more housing schemes, but we shall be putting the cart before the horse in proceeding with them without doing something to purify the streams and rivers that are at present a menace to the public health.
§ Major Sir ARCHIBALD SINCLAIR
Most of the matters in which I am specially interested have been referred 995 to already, but there are one or two small points to which I wish to draw attention. The Secretary of State estimated the need for houses in Scotland at 100,000, and the report of the Department of Health says that even more than 100,000 are required, and at a time when there is immense unemployment, especially in the building industry, it is a tragedy that greater strides are not being made to cope with the housing shortage. To-morrow we shall have a discussion on slum clearance, and I will not now take up time with discussing those aspects of the housing question which will be dealt with under that Bill, but there are two aspects which are of particular interest to my own constituency and to the countryside of Scotland generally. Very slow progress is being made with housing in the rural districts. It is stated in the report that continual pressure has been applied during the year to landward local authorities in the Highlands and Islands to frame schemes, and more schemes have been approved, and that almost one-half of the local authorities now have schemes in operation. The position is that three or four years after the legislation was passed less than half the local authorities actually have schemes in operation. One of the local authorities in my own constituency had not then got a scheme, but I am glad to think that they are now undertaking a scheme under the Act.
I hope that the Under-Secretary of State when he replies will tell us a little more of what use is being made of this Act and whether other authorities are coming forward. Can the right hon. Gentleman say whether more than half of these authorities are working the Act, and what steps the Government propose to take in those areas where the local authorities are refusing to work the Act? This is a Measure to which the Government ought to attach much importance, and I know that they have been circularising some of the local authorities. I want to know what steps the Government propose to take in those areas where the Act is not being worked, and where there is no immediate prospect of the Act being brought into operation.
Another point I wish to raise is that of housing in the small burghs of Scot 996 land. I will not go into that subject in detail, because we shall have an opportunity to-morrow of doing so when we are considering legislation which will then be under discussion. I hope that the Under-Secretary of State for Scotland will consider between now and to-morrow how serious the situation is in the small burghs, and that he will take into account the fact that in some parts of the small burghs there are whole streets where the housing is worse than it is in the country districts. It is particularly unfortunate that, the small burghs should not be able to get the same assistance by way of subsidies as is granted to the rural parishes. I hope these facts will be taken note of by the Government when they are considering housing in the Scottish countryside.
I was very much interested in the remarks made by the hon. Member for Orkney and Shetland (Sir B. Hamilton), particularly with regard to the experience of the people of Lerwick with regard to their hospitals. He told us that when a residential surgeon was appointed, the number of cases rose from 170 in the first year to 281, and in the next year to 378. We have that kind of situation in Caithness. There is a scheme before the Scottish Department of Health for the appointment of a residential surgeon for a district in my constituency, and I should be very grateful to the Under-Secretary if it is possible for him to give any indication of the attitude of the Department now that that scheme is before them.
I listened with pleasure to the important and interesting observations made by the Secretary of State about the Lanarkshire experiment for the feeding of school children. He said that that investigation was completed on 20th June, and I should like the Under-Secretary to tell us when he replies when the result will be published. This is a matter of immense importance. I gather that the indications so far are that the result of the experiments will bear out the results of previous experiments and show the immense importance of that extra ration of milk to school children under those particular circumstances. If that is so, it will undoubtedly have an immense influence upon education authorities all over Scotland when they 997 come to consider, as they must soon consider, the powers which they have just received under the Bill which this House passed earlier in the Session and which was introduced by the hon. and gallant Member for Kelvingrove (Major Elliot) to enable education committees to supply milk for school children. I hope that the Under-Secretary will be able to tell us that these results will be published as early as possible.
The Secretary of State also referred to other interesting experiments being made by the Empire Marketing Board with regard to tuberculosis and the way in which that disease may be communicated to children by different kinds of milk. I understand that every single consignment of milk is being tested, including the best kind, and what is considered to be the absolutely gilt-edged safe kind of milk, in case there is a possibility of infection at the different stages of the production and distribution of milk. The results of these experiments will be of the greatest assistance to those who take an interest in the health and education of our children. The late Secretary of State for Scotland, in referring to this subject of eliminating this disease from our herds, said that we must not push on too fast. That is quite true, but I think the industry is prepared to go further than it has gone up to the present time. Various plans have been discussed with the industry for instituting schemes which would result in the elimination of this scourge from our Scottish herds. It has been done in other countries, and I believe it can be done in Scotland. I ask the Under-Secretary if he can give any indication as to whether he considers any advance is possible at this time in connection with the elimination of this scourge from our Scottish herds.
§ Mr. DUNCAN MILLAR
I should like to call the attention of the Under-Secretary of State for Scotland to the question of river pollution prevention. The Scottish Advisory Committee has been at work dealing with this question for a considerable period of time, and we are definitely concerned to know the nature of the report of their investigations which have been recently carried out. We are awaiting reports on the River Tweed and the River Esk, Midlothian. The Secretary of State for Scotland has under- 998 taken that the attention of this Committee should next be drawn to the River Leven in Fife. I should like to urge upon the Government that this question of pollution is a matter which calls for their immediate consideration, and that schemes should be framed to carry out the measures which are necessary to deal with the pollution of the rivers in various areas in Scotland.
I would like specially to refer to the serious pollution of the River Leven in Fife, and urge that steps should be taken at the earliest possible moment to secure the carrying out of a scheme through the united action of the local authorities. The necessity for such action has been admitted over a considerable period, and I suggest to the Under-Secretary of State that he should arrange to deal with this matter at the earliest possible moment. Some of the local authorities, who are greatly interested in this matter, are desirous of putting their views before the Scottish Advisory Committee, and I think it is very desirable that he should afford an opportunity for a discussion of this question with those immediately concerned. I ask the Under-Secretary whether it would be possible for him to arrange for a meeting at which the town council of Leven and representatives of the other local authorities would have an opportunity of discussing this important matter with the Committee, and putting their views before them. The necessity for action is very urgent to-day, particularly in view of the quantity of effluents from the industrial undertakings which are creating pollution and which are now capable of being treated so as to remove all danger in future. The local authorities in some cases are responsible for a considerable amount of sewage going into the rivers, and steps should be taken to diminish that pollution by formulating an agreed scheme which would meet local needs. I suggest to the Under-Secretary also that at a time when the local authorities are very much concerned about the progress which ought to be made in connection with their unemployment relief schemes, such purification schemes would afford a large measure of employment.
§ Mr. MILLAR
I am discussing administration, and I am dealing with the question of health and the schemes 999 necessary to promote public health, which the local authorities and the Department are charged with administering.
§ The CHAIRMAN
That is not in order unless the hon. Member can show me that money is being voted in this Vote for that purpose.
§ 7.0 p.m.
§ Mr. MILLAR
I understand that money is involved in this Vote for the payment of officials and inspectors of schemes whose salaries are down on this Vote. The only point I wish to put is in connection with that work. The work I allude to is carried out under the supervision of the Department and of the Secretary of State for Scotland, and I am dealing with the acceleration of such work by the officials, who are directly concerned, and whose salaries come under this particular Vote. I am aware that we have at the head of this Department a gentleman who is extremely sympathetic towards these schemes, but I want to emphasise that something further should be done in regard to the acceleration of relief schemes and of schemes relating to pollution, or the diminution of pollution, which is work that conies within the scope of the local authorities themselves in co-operation with the Department. I hope that the right hon. Gentleman will be able to give us an under-taking that an effort will be made to deal with the case I have mentioned and with similar cases at the earliest possible moment. I associate myself with what has been said by my two hon. Friends who spoke on the subject of rural housing, and I would urge very strongly that some further efforts should be made to complete the surveys which are being carried out in all parts of Scotland, and to ensure that effect is given to the recommendations of various bodies interested in the farm servants and agricultural workers. There is urgent need for this work to be carried out, and I am sure that the officials of the Department of Health are prepared, if further assistance is afforded them by way of staff or otherwise, to have this work completed at an early date. I am glad to recognise from the report the work done by the Department, and that an effort has been 1000 made to cope with the very serious situation which has arisen all over Scotland. The time has come when definite schemes submitted to the Department ought to receive the earliest possible sanction, and no obstacles should be placed in their way either by reduction of grants through the deduction of Income Tax or otherwise to the carrying through of these schemes.
The local authorities are very keen to get on with their work. They have often been held up by delays and by the conditions imposed. I know that, at a conference held in Edinburgh the other day, there was a very strong feeling, to which I desire to give expression here, that much further progress could be made by closer co-operation between the various local authorities concerned and the Department. The suggestion made there to establish an advisory committee to deal with all the particular aspects connected with unemployment relief schemes, on which officials representing the different local authorities should act, would be a very good suggestion to carry out. I hope that the Under-Secretary will be able to make an answer now with regard to some of the questions put to him on that occasion of the conference referred to, and particularly with regard to the very unfair demand which has been made upon local authorities through the deduction of Income Tax on grants towards revenue producing schemes.
§ The CHAIRMAN
I have no intention of allowing the Minister to reply to questions of that kind. We must keep to the Vote before us. If hon. Members wish to raise anything, they must select that Vote. When we come to a Vote of this kind we must discuss what is contained in it, and if the Minister went beyond its border, that is no reason why I should allow it to develop.
§ Mr. MILLAR
I am only referring to the undertaking the Under-Secretary gave to the conference in Edinburgh that he would meet some of the points of local authorities, particularly in reference to this question of unemployment.
§ The CHAIRMAN
If we are to deal with unemployment we must deal with it as far as it goes within this Estimate, and not outside.
§ Major ELLIOT
I am sure that the Under-Secretary will have listened with 1001 some relief to the efforts to limit some of the questions he will have to answer. I have sat in his place, and towards the end of a debate, either on the Board of Health for Scotland or on the Scottish Office, have begun to wonder whether there was anything on earth not ancillary to the activities of the Secretary of State for Scotland or the Scottish Board of Health. I have no doubt whatever that the Under-Secretary will do his utmost to reply to some of the questions asked, but, when it comes to the hon. and learned Member for Argyllshire (Mr. Macquisten) expressing a wish to have been made a minister in his youth, I am not sure that he feels that his power would reach to such extreme limits.
The course of the debate this afternoon has been most gratifying to us on this side of the Committee, because it has shown that there is no grievance arising out of the great Act of 1929, the Local Government Act, of such a nature as to call for redress in this House. There are no administrative difficulties arising out of it which are insuperable. Many hon. Members who have spoken have borne testimony to the fact that the Act gives every prospect of operating in a smooth and efficient manner. Indeed, the right hon. Member for Ross and Cromarty (Mr. Macpherson) went so far as to say that in his own county he found there were considerable advances being made by it on the health side. The hon. Member for Caithness and Sutherland (Sir A. Sinclair) also intimated that since its coming into force his local authority had attempted a housing scheme. Whether post hoc or propter hoc, I am not quite certain, but, at any rate, it does not injure the prospects of housing in his constituency.
The review which we have before us to-day is a review, apart from the examination of legislative changes and the working out of the Local Government Act, of the public health activity, and the housing activities of the Department of Health for Scotland. The Acts are all very well, butWhate'er is best administered is best.The genius of our people will allow us to adminster almost any Act if there is good will behind it and a fair amount of assistance from the Chancellor of the Ex 1002 chequer.I have no doubt whatever that we can adminster the 1929 Act, and, indeed, we have made progress under the Acts which stood previously on the Statute Book. There are provisions of that Act which I should like to see pressed forward more vigorously. There are provisions with regard to district councils which make me believe that a great deal more work could be taken off the central authority by a greater devolution. Greater use might be made of that provision. There are Clauses also with regard to what is known as the break-up of the Poor Law, and the reorganisation of the hospital services. Good will has been secured for the voluntary hospitals, and the Department states in its report that there are already signs that certain of these schemes for reorganisation will be brought forward at an early date. All these things are for the future; we are dealing with the present.
Statistics show that the public health of Scotland improves, that the attack which the local authorities and voluntary societies have for so long conducted on tuberculosis continues to give an increasing yield. It took us 40 years from 1870 onwards to halve the death rate from tuberculosis; it took us 20 years to halve it again. If it took us 40 years to cut it in half the first time, and took us only 20 years the second time, let us see if we can cut it in half the third time in 10 years. As to the work in regard to non-pulmonary tuberculosis and food infections, there is no doubt whatever that the fall in these figures is of a most encouraging nature, and seems to indicate that the administration of the Acts with regard to the slaughtering of tuberculous cattle and the cleansing of the dairies and the administrative pressure which is being kept up towards getting a clean supply of milk, are doing much to diminish the non-pulmonary infections, which do so much for the killing and crippling of young children in Scotland. That demands a reasonable outlook by the people. They themselves must respond. All this effort by the administration is of no use unless it meets a corresponding will among the people to look for clean milk, to purchase and pay for clean miuk. It is a common complaint among the producers of milk, that, with all the work they do to secure 1003 cleanliness in the production of milk, they find it very difficult to get any recognition from the public by paying a penny extra for clean milk, whereas they will cheerfully pay from 1s. to 5s. to get a better seat at the cinema. That requires a better health consciousness among the people. Though there are signs of it growing, yet it has to be fostered. Work, such as the Under-Secretary has sketched out in regard to the milk experiment in Lanarkshire, will undoubtedly help to foster that health consciousness among the people. We laid the foundations in the experiments under control conditions. Both for that and the present experiment we owe much to the Empire Marketing Board for the ready support it gave us in the way of funds, treating the experiments in Scotland as a real Empire experiment, of value not only to us in Scotland but to the United Kingdom, not only to the United Kingdom but to any areas wherever milk is given to school children, which is wherever there is a white community.
§ Major ELLIOT
In all these ways the help of the Empire Marketing Board was of great value to the Scottish administration, and we should pay a tribute to the enlightened view which both the home and overseas representatives took of the possibilities of this experiment. It is clear, in looking at the health side of the report, that many of the water-borne diseases have practically been conquered, that food diseases are in the way of being conquered, but that the air-borne diseases, if one may call them so, are still completely unsubdued. You have the great epidemics which range among the crowded tenement populations of our great cities, measles, bronchial pneumonia, whooping cough. If one takes pre-school children, one finds on looking at the deaths of children between one and five years of age, in 1928, numbering 4,247, that of those, bronchial pneumonia, measles, whooping cough and tuberculosis accounted for 57 per cent. of the deaths. Of those deaths, then, 57 per cent. were caused almost entirely by the respiratory diseases and the complications arising from those diseases. 1004 That seems to point not to an attempt to clean up the air, which is a very big business, and although it is necessary in our great cities may take us a long time, but to point to the fact that the resistance of the individual is the next line to go upon. We have to bring up the resistance of the individual to the diseases which affect their health. The lung diseases especially are a sign of lowered resistance in the individual child.
All these points, the experiments in the feeding of the school children, the high rate of measles and bronchial pneumonia, the figures for the health of the school population all seem to point to the fact that we are still trying to build the health of our population on a marsh. We have not got the pile-driving done which is necessary to get a sound foundation. With 73 per cent. of the children with decayed teeth, with 2 per cent. with primary anæmia, with the bronchitis figures, with the rickets and with the other figures I have mentioned, all these point strongly to the fact that the fundamental resistance of the race is not being safeguarded at the point where it will give the best results and where, if it is not safeguarded, it will sooner or later lead to that breakdown in adolescence or adult life which is so painful a feature of our modern life, whether you take it from the point of view of the unemployed who go out to Canada, the recruits we cannot get for the Army, the people who go on the health insurance funds for one reason or another, or those who fall through all these provisions and end up as cripples or bedridden persons in one or other of the hospitals which alone remain for them to drag out their lives in.
I do not wish to raise a controversial note in the debate, but, surely, under such conditions, it seems urgent that, until the child is safe up to the age of 14, the child between the ages of 14 and 15 should take a secondary place. If you have not a sound child between the ages of one and five, it is useless to try to pump education into children between the ages of 14 and 15. Looking at the report, I find it stated that defective vision is the greatest difficulty from the point of view of the school child. I beg to differ from that. I myself suffer from defective vision, but I am sure that if I had acute rheumatism, or tooth 1005 ache, or rickets, or anaemia, it would be a much greater prejudice to the absorption of knowledge than the fact that I had to sit a little closer to the blackboard. I am not at all afraid of defective vision as compared with some of these other complaints from the educational point of view. That was precisely one of the reasons for which we found it necessary to move against the ad hoc authority, and towards the ad omnia authority. The report states, at page 81, that:Education authorities have recognised that the presence of defective vision, more than any other defective condition, is the most immediately serious handicap to the education of the child.I say that, when you find such a passage in an official report, it is very reasonable for us to say that that view is not one which would commend itself to most of us as common-sense citizens looking at the upbringing of the child from a common-sense point of view. We have turned very largely towards preserved foods, extracted foods, refined foods of one kind and another, and the necessity for studying these things scientifically stands out in almost every sentence of the report. The Poor Law authorities, since 1920, have spent £10,000,000 on the purchase of food for the Poor Law population of Scotland, without, as far as I know, any examination into the principles which should govern dietetics in the modern State. The difficulties before us are very great. There is no reason to suppose that scientific examination into the feeding of both the younger and the older people would not give us most valuable results, because it becomes clearer and clearer that, in moving away from the generally rough food on which our ancestors used to live, with a considerable amount of "roughage" of one kind and another, even including that peck of dirt which it was assumed everyone had to eat before he reached the age of 40, we do run the risk of over-refinement, of over-elaboration, and of a diet which eventually causes, to a considerable extent, the lack of that stamina which we all should desire.
The physical condition of our people is one of the chief concerns of the Department of Health, and the advance in that respect is going steadily forward, 1006 but there is another field of advance which is more particularly the field of the Department just now, namely, the field of housing, and in that field we cannot say that the advance is going steadily forward. Accusations and discussions have gone on to a certain extent this afternoon as to what it is that is responsible for the fall in housing which has undoubtedly taken place. We need go no further than the answers which have been given this afternoon by the Under-Secretary of State for Scotland on behalf of the Department. He stated that on the 31st May, 1930, there were 6,300 men employed on local authorities' housing schemes in Scotland, while last year there were 8,900. That shows a drop of 3,600 in the number of men engaged in the building of houses in Scotland as compared with a year ago. We find the same thing in the case of the figures for houses under construction. On the 31st May of this year there were 10,500 houses under construction, while on the corresponding date last year there were 14,700. That shows a drop of 4,200 houses under construction, or very nearly 33⅓ per cent. The figures for houses completed are even more strikng. In the first five months of 1930, 2,807 houses were completed by local authorities in Scotland under all the State-assisted schemes, while the number completed in the corresponding period of 1929 was 5,700. That shows a drop of just in the region of 3,000.
This matter was under review a, few days ago in the case of the English Ministry of Health, when several points of considerable interest were brought out. First of all, the discontinuance of the subsidy to private builders did mean that, in the case of a certain number of houses, the label had simply been taken off. Houses were still being built, but, while they were previously labelled as State-assisted houses, they were not now so labelled. I should like very much to know whether in Scotland the Under-Secretary of State considers that that is the case in Scotland. Undoubtedly, a certain number of houses fewer are being built, but it looks as though the number may be fewer simply because the label has been taken off them. Does not the hon. Gentleman, however, consider that there has been a real drop in the number of houses con 1007 structed in Scotland? I think that none of us could deny that there has been a real and a serious drop, and we have to look for the reason for it. Two of the reasons are given in the current Report of the Department of Health, I notice with some interest, in a journal to which I have always devoted great attenion, namely, "Forward," an article by Councillor Dollan, to whose work I have always paid great attention, because you nearly always find that there is a "catch" in it somewhere. In this article the "catch" is clear to see. The Report says:Two factors militated against an improved output for the year. In December, 1928, it was decided to reduce the rates of subsidy under the Acts of 1923 and 1924 as from the end of the following September. The rates under the latter Act were restored by Act of Parliament in July, so that actually the reduction under that Act never came into operation, but the prospect of the reduction doubtless deterred some local authorities from building. From July onwards better results might have ensued, but by that time there was a prospect of new legislation which it was hoped by local authorities might offer more attractive terms than those existing, and this consideration operated to retard building activity right to the close of the year. The year, therefore, was one of doubt and hesitancy, and to this may be attributed the fact that, the output of houses did not reach the 20,000 mark.It will surprise none who are familiar with the methods of controversy of the correspondent in question to be told that he left out altogether the second factor which militated against the construction of houses in the year, and the passage, printed all in black type, looked as if it were entirely due to the proposed reduction of subsidy. The fact that half of it, according to the opinion expressed in the official report itself, was due to the prospect of more favourable legislative terms, was entirely omitted from the powerful article in question. The correspondent went on to say that he expected an apology. I am not disposed to tender any apology whatsoever, and I think that perhaps the demand for an apology might reasonably come from myself instead of from the eminent author. The report states that:the prospect of the reduction doubtless deterred some local authorities from building.1008 Yes, but that was over a year ago, and the restoration of the subsidy might reasonably have been expected to show itself in the number of houses under construction, if not in the number actually completed. But the number under construction has fallen by over 4,000 even with the prospect of an increased subsidy as compared with what it was when there was a prospect of a decreased subsidy. I think we must look further for the cause of the decline in house-building. I look to the figures given by the Parliamentary Secretary to the English Ministry of Health, who is always very interesting, because she is so extremely frank in reading out anything given to her by the Department. She said that, although it was quite true that municipal housing had collapsed, the country was being saved by private enterprise. She said:That programme has been kept up quite satisfactorily, and though it is true that the private enterprise houses are not much good to the poorer workers, they are just as much good to the bricklayers and workers in the building trade as any other houses."—[OFFICIAL REPORT, 30th June, 1930; col. 1,677, Vol. 240.]Is that what we are to look for in Scotland? If it is, I do not think that there is anything like the same revival of private enterprise in Scotland as there is in England, although that was the official explanation of the Ministry in England with regard to the saving of the housing situation. The hon. Lady went even further, and I wish that the hon. Member for Springburn (Mr. Hardie) were in his place, because she dealt very directly with the accusation that the Government were in some way responsible for the drop in housing during recent months. She went so far as not only to say, but to glory in the fact, that it was due to the action of the Government. These were her words:As a matter of administration, I can say that we have advised local authorities to hold their hands for slum clearance until the new Housing Bill goes through the House."—[OFFICIAL REPORT, 30th June, 1930; col. 1,679, Vol. 240.]I have no doubt—[Interruption.] I am glad to hear that interjection from the Under-Secretary. More will be heard, no doubt, of the extreme but unblushing lucidity of the hon. Lady who is his opposite number in the English Ministry of Health, but I am glad that the repre 1009 sentative of the Scottish Department has not said anything of the kind, and I am sure that in vain is the net spread in the sight of the bird, and that he will refuse to say anything of the kind.
What is it due to? I think we shall all agree that it is due to a consideraable extent to the fear on the part of local authorities of the increasing burden of local taxation which it is piling up on their shoulders. It is quite true, as the Under-Secretary has said, that a great many members of local authorities are not of his political way of thinking; but they have not changed their way of thinking since a year ago. When we lost the General Election, we did not simultaneously win all the local authorities of Scotland. My right hon. Friend and myself had to deal with exactly the same local authorities, of exactly the same composition. We had to fight exactly the same opposition and to dispel exactly the same doubts as the hon. Gentleman. That explanation, really, if he will excuse my saying so, will not hold water. There is no vital change in the political complexion of local authorities since a year ago, and we must look further for the difficulties in which they find themselves, and in which the hon. Gentleman finds himself just now.
The difficulty is one of finance, and the danger of piling burdens upon the local authorities is the danger that it slows up their progress in every branch. In such a case, with the slowing up of housing, with the fearful conditions under which the people are living and moving, with the slum sections of his own report, with the records by the Commissioners of children unable to sleep at night because of vermin, of dark houses, where a shilling a day is demanded for artificial light, burning up the air and ruining the health of the people as well as adding to their expense, what folly to ask Glasgow to find £400,000 for additional school buildings which may or may not be wanted when the present excessive number of school children pass from the schools! This is a moment to concentrate upon essentials, and, when you have a grievous housing situation and a slackening in the rate of progress in the Department, which all of us would desire to see accelerated rather than slowed down, such is surely a moment to save 1010 rather than increase the burden on local authorities. First things first. Let us deal with these tremendous and urgent problems before we go on to other problems which, no doubt, require attention, but do not require it in anything like the same degree as the problems immediately under review. No doubt, considerable advances have been made. Health has improved and housing has now improved, but we have a long way to go, and we do not know what the condition of the finances of the local authorities will be in the near future. Let us concentrate upon essentials. If anything is essential, the health of the young child and the housing of the population are. When we have cleaned these things up, we can pass on to other fields of activity, but let us, for God's sake, deal with these urgent problems first.
§ Mr. JOHNSTON
I despair of meeting in detail the enormous number of questions that have been raised in every part of the Committee, but, as on a previous occasion, if I undertake to send hon. Members written answers to points of local interest, that may meet the convenience of the Committee and enable me to concentrate my attention a little more upon general questions. The right hon. Gentleman who opened the debate asked how the new Local Government Act was being fitted into the machinery of local government. It is far too early to say. The machinery creaks a little here and there. It creaks rather badly in Lewis, and we have considerable difficulty in fitting in the desire of the people for local government and financial autonomy, with considerable State subventions, with the control which is being exercised by the county council of which it forms a part. But since 15th May, when the new Act came into full operation, it is fair to say that it is working with considerable facility and smoothness, taking the country as a whole. While I am not able to give the right hon. Gentleman any considered opinion as to what the ultimate facts may be, he will recognise that we have only had two months experience to go on, and it is really impossible to answer his question.
He and others raised the question of St. Kilda. He supported our attitude, while the hon. Member who represents the Western Isles rather criticized it. 1011 He took the view that our sole reason for assisting the evacuation of the population was one of saving cost, that it was only because it was costing us something like £500 a year to keep the people on the island that we were desirous of assisting evacuation. I assure him that it not so. Cost was, of course, a factor. It had to be considered. Any Government in its senses would consider whether it ought not to do something to stop a drain like that upon its finances. I went into every house and asked all the islanders separately what their views were, and I was assured in every case that it was their earnest desire not to spend another winter on the island. They implored me not to let the question of sheep stock stand between them and evacuation. We will take every step possible to see that these people are accommodated in future in surroundings which will be a very considerable improvement upon those under which they were living. The poverty under which they have lived is almost indescribable. They were faced with famine—actual shortage of food. Had it not been for the Queen's nurse, to whose devoted labour and service I should like to pay a tribute, who stayed there these two winters, Heaven only knows what tragedies would have occurred. We are taking every step, and I believe now with success, to find suitable employment, and we are making provision for those who are unable to fend for themselves.
§ Mr. RAMSAY
Whatever provision the hon. Gentleman makes, will he see that these people are kept as near the sea as possible, so that the old conditions under which they were reared will be available for them, and that in any case they shall be kept away from town life?
§ Mr. JOHNSTON
That is the desire of the majority, but there are at least two who do not want the particular conditions that the hon. Member specifies. Their desires are being met so far as they can be met, and I have reason to believe that the offers made to them have been heartily welcomed.
The right hon. Gentleman also raised the question of the Lanarkshire milk experiment. I agree with the late Under-Secretary that we are exceedingly indebted to the members of the Empire 1012 Marketing Board for the generosity with which they put at our disposal some £5,000 to give us the basis of our experiment. We have had to raise the balance from other sources, sometimes not without difficulty, but I think we have got it all, and I believe the experiment we have conducted with these 10,000 children in Lanarkshire will be one of interest to the people, not only of Scotland but of all the world. If we can prove beyond all doubt that a ration of milk given to the school child will raise its weight and its height and will benefit its health in every way, and that by organising the milk supply properly through the local authorities we shall save untold millions later on in public health expenditure, we may get a well organised demand for milk rations to school children. Then there is the question of bovine tuberculosis. That ought to be wiped out. It is a scandal that anyone should suffer now as the result of bovine tubercle.
The hon. Member for Orkney and Shetland (Sir R Hamilton) raised the question of the Highlands and Islands Medical Fund. I propose to send him a considered answer to his question. In general, I can assure him that we have every sympathy with the point of view that he expressed, and we are not at all desirous of cutting down the expenditure. We recognise the very valuable service it has given, and my right hon. Friend proposes to extend its operation. We propose to assist telephones, and all the rest of it, in the rural areas. Without going further in detail into these matters, I assure him that the questions he raised will have our sympathy.
The hon. Member for Shettleston (Mr. McGovern), who delivered a very forcible maiden speech, asked whether the Secretary of State would agree to calling a conference of public assistance committees to discuss the equalisation of the present scales of relief, particularly in so far as they apply to children. My right hon. Friend and I have been giving the matter very serious consideration. Take two authorities adjacent to one another, Wishaw and Hamilton. In Wishaw a man and his wife on poor relief have a scale of 20s., and 2s. for each child under 16. In Hamilton it is 4s. better. That is only over an imaginary line where, presumably, the cost of living and so on is the same, and obviously 1013 it is wrong. If it is right that poor relief should be a certain sum in Hamilton—that was on advice from the medical officer—it is time we had some examination of the lower scales of relief in the immediate neighbourhood. There are remarkable differences all over Scotland. Some areas pay 3s. 6d. per child, and other areas pay 2s. per child. I want to say no more about the 2s. areas, but I, do not think that any child can be maintained for a week for 2s. I do not know how it can be done; seven days a week, 3½d. per day. It cannot be done. No matter how thrifty or how economically a mother may spend the money, a child cannot be maintained in physical efficiency to-day at 3½. per day. My right hon. Friend authorises me to say that he proposes at an early date, after the Public Assistance Committees have found their feet, after the new Committees under the Act have visualised the problem which is in front of them, to have a friendly discussion at least with some of these authorities to see how far we may secure the adoption of a more reasonable scale as far as the children are concerned.
Several hon. Gentlemen raised the question of rivers pollution, including the hon. Member for Cathcart (Mr. Train) and the hon. and learned Member for East Fife (Mr. Millar). I can assure hon. Members that the Rivers Pollution Committee are very actively engaged at this moment. The report on the Tweed has been finished, and it will be published shortly; at least, I hope it will be published shortly, and I understand that we propose to go on with the Leven as has been suggested. The hon. Member for Cathcart may rest assured that everything that the Committee can do to secure a more comprehensive attack upon rivers pollution will be undertaken.
§ Mr. MILLAR
Can the hon. Gentleman say whether it will be possible to arrange that the Committee should meet the Town Council of Leven who are closely affected?
§ Mr. JOHNSTON
I should hardly think it would be necessary for me to suggest that they should meet any particular body. I am certain that if the town of Leven made any representation with regard to being seen by the Rivers Pollution Committee, the Committee 1014 would be prepared to meet them, but I should not like to give any promise that they would meet any particular body. I will not seek to follow the hon. and learned Member for Argyllshire (Mr. Macquisten) in his irrelevant but rather humorous dissertation upon medical missionaries among the aborigines of the West Highlands. I should be hopelessly out of order if I sought to follow him. The hon. Member for Central Aberdeen (Mr. R. W. Smith) raised questions about the necessity of paying more attention to pre-natal trouble, and, as will be seen from the report, that matter is engaging the attention of the medical officers of the Department, and we certainly intend to speed up that matter in every way that we can.
The hon. and gallant Member for Caithness and Sutherland (Sir A. Sinclair) asked if we could speed up rural housing. I think that it will he more appropriate if we discuss that matter to-morrow on the new Bill, but I can assure him that my right hon. Friend has sent out circulars to the local authorities, he has met the local authorities, or some of them, and we are sending inspectors to local authorities and doing everything in our power to induce the local authorities, as far as they financially can, to make the maximum effort possible in dealing with the improvement of housing in the rural areas in Scotland. Up till March there were 2,406 housing schemes under the Housing (Rural Workers) Act, 1926, and there are at present 1,637 under construction so that there are nearly as many houses under construction as had been constructed previously, thus proving that we are not slackening in pressure but are hacking up local authorities in the matter.
My hon. Friend the Member for Lichfield (Mr. Lovat-Fraser) asked about the number of children whom he saw from the report were in Poor houses in Scotland. I am informed that these include newly-born children and also what are called temporary cases, and that they include cases where the local authorities have so far not been able to make arrangements for boarding out. There are very few of them all told. At any rate, it is the desire of the Department that no children whatever should be brought up in the poor houses in Scot 1015 land. We ought to get the children out of the poor houses, and as far as we do so we are exerting pressure in that sense.
§ Mr. JOHNSTON
I have only been able to refer to the Tweed. I come to the speech of the hon. and gallant Gentleman the Member for Kelvingrove (Major Elliot), who wound up the debate on the other side. With the opening statement of that speech, I am in whole-hearted agreement. If the hon. and gallant Gentleman does not mind my saying so, I think that he made a most statesmanlike summary of the health position in Scotland and I recommend every hon. Member who did not hear his statement to read it in the OFFICIAL REPORT to-morrow. I also agree with him that we are making very considerable progress not only in regard to tuberculosis, but along other lines. We are making some progress in regard to nutrition, and, if our milk experiment succeeds, we shall make a great advance in nutrition. We are making great advances in regard to fresh air. We see the younger generation with their rucksacks and their staffs marching out from the cities to camp out on the hillsides. And the omnibus is having an effect upon the health of this generation. I can see a generation demanding fresh air and sunlight: a generation which will never again go back to the damp closed-in beds and the unhealthy conditions which past generations have tolerated.
I am not sure that I agree with the hon. and gallant Gentleman in his summary of the causes of the diminution in house building during recent months. It is not only during the past 12 months that there has been a diminution in the rate of house building in Scotland; it is not only since this Government came into office that there has been a diminution. But I welcome whole-heartedly the desire now evinced on all sides of the Committee for a greater speeding up in public ownership of dwelling-houses for the people of Scotland. I remember the day when you could not get a majority in any city or village in Scotland to agree with the principle of municipal housing. To-day it is accepted on all hands that 1016 the future dwelling-house to let must be publicly-owned. [Interruption.] At any rate, I should say that the overwhelming voice of the people of Scotland is now in favour of the public ownership of dwelling-houses to let and that, as far as houses built to be let are concerned, they should be publicly and not privately-owned. I welcome that fact. Have we left anything undone during the last 12 months which we ought to have done to speed up housing? I know of nothing. If there be anything that we have left undone, will the hon. and gallant Gentleman tell me what we have left undone?
§ Major ELLIOT
If the hon. Gentleman and his party continue to pile financial burdens upon the backs of the authorities, housing will diminish. I should like the hon. Gentleman to leave undone exactly the sort of thing which we are going to debate in a very few minutes, and in which the right hon. Gentleman the Secretary of State for Scotland and the Noble Lady the Member for Kinross and Western (Duchess of Atholl) will take part.
§ Mr. JOHNSTON
The question of whether or not we should extend the school age is a matter that we cannot discuss at the moment.
§ Major ELLIOT
It is administratively possible for Tie Secretary of State by a stroke of the pen to extend the school age, and therefore is it not in order to discuss the matter?
§ Mr. JOHNSTON
I agree that it is within the power of the Secretary of State to do that. I was asking: Is there anything which we have left undone during the past I2 months that we could have done to induce the local authorities to build more houses? [An. HON. MEMBER: "You have increased the subsidy!"] I will come to that in a moment. Has anything been left undone during the past 12 months which would have induced local authorities to build more houses? I do not know of anything. We have met them in conference, we have written to them, we have pleaded with them, and 1017 we have sent our inspectors. I know of nothing more that could have been done to induce the production of a greater number of houses in the country. What has happened—and it is very important that the Committee should know it—to cause a diminution in the rate of house building in Scotland? The Committee must cast back their minds to the fact that the review period under the Wheatley Act ended on the 1st October, or at the end of September, 1928, and that the then Government—not our Government—in December of that year decided to cut the subsidy, to lower the subsidy. I would ask the attention of the hon. and gallant Gentleman to this fact, that between the period September, 1928, and the period when we took office there was a steady reduction month by month of the houses under construction in Scotland, and the reduction was at the rate of 5,000 per month when we took office. There were 14,000 houses being built per month when we took office, and there were 19,000 houses being built before the subsidy was cut, so that under the regime of our predecessors house building fell at the rate of 5,000 Der month. It is true that building construction has still fallen, but building construction under this Government has fallen at a slightly lower rate. It has fallen to the extent of 3,600 up to the end of May. I have not the June figures. Up to the end of May, 10,580 houses were under construction, and when we took office there were 3,600 more than that. Therefore, the rate of fall has been somewhat smaller under our regime than under the regime of our predecessors. I would like to carry the matter further. I have here a very interesting extract, which I have been waiting to quote on a favouable opportunity. It is a- quotation from a speech made by the hon. and gallant Member for Kelvingrove in this House on the 12th December, 1928, when he was justifying the cut in the subsidy. He sad:I say that in the near future no look for an increase and not for a decrease in housing as a result of this Order."—[OFFICIAL REPORT, 12th December, 1928; col. 2204, Vol. 223.]He expected to get an increase in the number.
§ 8.0 p.m.
§ Major ELLIOT
Will the Under-Secretary compare that quotation with page 2 or the current report, which says: 1018The number of houses completed during the year, although greater than in 1928, did not fulfil all expectations."Greater than in 1928." So that the increase which I expected actually occurred.
§ Mr. JOHNSTON
The number of houses for which the hon. and gallant Member took credit in 1928 were almost entirely started before he got the cut in the subsidy. When he intimated the cut in the subsidy, the local authorities rushed forward to have their schemes completed in order to secure the larger subsidy. As a matter of fact, the number of houses under construction fell steadily from September, 1928, when the Wheatley review period had to be undertaken.
§ Major ELLIOT
The Under-Secretary will agree that they were falling before then, when there was no suggestion of a cut in the subsidy.
§ Mr. JOHNSTON
I am dealing with the year 1928. In 1928 the figures ran 18,000, 17,000, 18,000, 19,000, and so on until October, when the figure was 17,000; then November, 16,000; December, 16,000; January, 1929, 15,000; February, 15,000; March, 14,000—a steady diminution—12,000; 10,000; 9,000. Instead of getting an increase of houses as a result of his cut in the subsidy, the hon. and gallant Member actually got a steady decrease. I am not blaming the hon. and gallant Member any more than we can be blamed. I know that he exercised every possible pressure that he could to get houses built in Scotland, and so did his right hon. Friend. They sent out circulars, they threatened and did everything possible, but there are local authorities in Scotland to-day, county councils, who have built no State-aided houses at all. I was in a housing scheme yesterday, in Smithston in Dumbartonshire. Up to the 15th May this year there was not a solitary representative of my political persuasion on the county council there. They were all supporters of the right hon. and the hon. and gallant Gentleman opposite. In the village of Smithston there are 70 houses and there are eight dry privies, 1019 14 feet from the windows of the houses. There is not a door in one of those privies. There is not a spar or a seat in one of these privies. There is an open sewer 1½ yards broad which runs down the whole length of the village. There is a stench that cries to heaven, yet I cannot get and the hon. and gallant Member could not get that county council to build a solitary house in that area. The houses are not owned by a widow, but they are owned by William Baird and Company.
We cannot be blamed nor can any other Government be blamed unless it can be proved that the Government are not using all their powers and energies to see that Acts that are passed by the House of Commons are put into operation. Therefore, I regret that the hon. and gallant Member and his friends have put down an Amendment to the Bill which comes up for discussion to-morrow, to limit our powers in dealing with these recalcitrant local authorities. We are asking for powers so that where a local authority will not build we can have power to go in and build on health grounds, and charge them. Hon. Members opposite have put down an Amendment to provide that, before we are able to exercise that power, we are to lay the Order on the Table of this House and the other House for 30 days. If there are local authorities that will not move, if there are local authorities that defy the elementary laws of decency and human existence, then instead of blaming the Government as being responsible let us take all the powers that we can to compel the local authorities to act. When we get the powers, then let whatever Government is in office exercise those powers. My right hon. Friend and I, if we have anything to do with the administration of that Act, propose to exercise to the maximum our powers of compulsion upon the recalcitrant local authorities who have defied us, who have defied civilisation, who have defied Christianity and, to my knowledge, have allowed to remain in this old Scotland of ours stinking hovels the like of which cannot be described in a public assembly. There is nothing that my right hon. Friend and I are conscious of having left undone to wipe away the slums in Scotland and to 1020 secure a healthier environment and better conditions for the generation which is to come after us.
§ Mr. SCRYMGEOUR
The situation with regard to the smaller house is one of very great importance, and I am asked to make a further representation on that point and to appeal to the Government to enable a local authority in any given quarter where it is found essential to provide the smaller houses, and that the 25 per cent. should be increased to meet the urgent necessities of the case. The report that we have before us to-day shows that the Government have shown appreciation of the magnificent gift to our city of 500 houses at a cost of £155,000. These houses range from houses of one, two and three rooms, and the report expresses due appreciation of that munificent gift. So far as our city is concerned, however, we do appeal to the Government to concede the urgent call for an extension of the 25 per cent. with respect to two-roomed houses. We know that that matter will be under consideration tomorrow, but we may have some difficulty in raising the matter then. There is reference in the report to the proposed provision in Scotland of hostel accommodation, and the Corporation of Dundee wish again to call attention to the anomalous situation that whereas the English Housing Bill provides for the smaller houses and not for hostel accommodation—
The hon. Member is now discussing a matter which involves legislation. On this Vote he must deal only with questions of administration for which the Department is responsible.
§ Mr. SCRYMGEOUR
I was referring to the fact that the report states that hostel accommodation is to be provided, and I was merely pointing out that that matter will be dealt with in the Bill which is to be discussed to-morrow. I am not proceeding to discuss legislation, but I do suggest that it is vital to meet the call of the corporation of Dundee and other parts of Scotland where they may wish to provide smaller houses, as can be done in England. Reference was made in the Committee on the Scottish Housing Bill to the cubicle system in the hostel accommodation, and the Under-Secretary took exception to it, vet I find in the re 1021 port now under discussion that, with regard to the Edinburgh scheme, it distinctly points out that there is the provision of cubicles. Therefore, there is strong warrant for the application of the term that I used in Committee, and it is a very effective answer to the statement of the Under-Secretary.
§ Mr. JOHNSTON
On a point of Order. It will be grossly unfair if no opportunity is to be given to reply to these statements by the hon. Member. I distinctly deny that anything in our Bill which deals with hostels has anything to do with cubicles.
That is my difficulty. The hon. Member is referring to matters which imply legislation, and that is distinctly out of order on this Vote. The only matters that can be discussed on this Vote are matters for which the Department is administratively responsible. The hon. Member must not anticipate future legislation.
§ Mr. SCRYMGEOUR
I am not discussing future legislation. I did not say that that term is used in the Bill. I said that in the report of the Department which is now under review in connection with this Vote reference is made to the term "cubicle," and I submit that as an effective endorsement of the term which was resented by the Under-Secretary when I used it. I urge that the Government should give consideration to the advisability of meeting the needs of the community where industrial conditions are such, as admitted by the report, that people are not able to find the requisite rental for a larger house. The corporation of Dundee say, "We accept your condition as to the number of people who are to occupy houses"—that is to prevent overcrowding—"but we as a corporation ask, and the women workers in Dundee ask and insist upon it, that we should be allowed to provide smaller houses, and we maintain that Scotland is rightly entitled to do what England is entitled to do." If hostels are not good enough for England, they are not good enough for Scotland.
§ Mr. SULLIVAN
I must enter my protest against the Government giving way to the appeal which has just been made. Scotland has been suffering for years from one and two roomed houses, 1022 and it is only in recent times that we have begun to raise the standard of living. Even at the moment 48 per cent. of our people are living in one and two roomed houses, and that is only a reduction from the 62 per cent. a few years ago. Some public authorities, and sometimes Members of Parliament, desire to keep up the conditions which have been killing off our people before their time. Our object should be to raise the standard of living in Scotland. For years yet, with all the work which the Scottish Department of Health is doing, there will still be far too many of these small houses. I admire the public work of the hon. Member for Dundee (Mr. Scrymgeour) and the stand he has taken on certain questions, but bad housing and insanitary conditions have destroyed more of our people than anything else, and we shall never raise the standard of living or take away the curse of strong drink so long as they are housed worse than pigs. I sincerely hope that the Scottish Office will not listen to the voice of the pleader as far as housing is concerned.
§ Mr. SCRYMGEOUR
May I point out to the hon. Member for Bothwell (Mr. Sullivan) that the Parliamentary Secretary to the Ministry of Health gave a very effective reply when she said that she had occupied one room. She has risen to a position of eminence to which my hon. Friend has not risen. Then again, the right hon. Member for South Ayrshire (Mr. J. Brown) still takes great credit that his beloved wife and himself occupy a "butt and ben," and the right hon. Gentleman is Lord High Commissioner to the General Assembly of the Church of Scotland. That is a position to which one may rise from two rooms.
§ Question put, and agreed to.