HC Deb 14 July 1936 vol 314 cc1897-933

Motion made, and Question proposed, That a sum, not exceeding £2,207,766, 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, 1937, for the Salaries and Expenses of the Department of Health for Scotland; including Grants, a Grant in Aid 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 in respect of Benefits, etc., under the National Health Insurance Acts; certain Expenses in connection with the Widows', Orphans' and Old Age Contributory Pensions Acts, and other Services." [NOTE: £1,250,000 has been voted on account.]

3.49 p.m.

The SECRETARY of STATE for SCOTLAND (Sir Godfrey Collins)

The services indicated in the Vote which has been read from the Chair show the very wide view of health services in Scotland. They also represent the manifold activities of central and local government in endeavouring to make our people a fit nation. It may be for the convenience of the Committee if, instead of going into a mass of details at the outset, I remind the Committee of some of the larger aspects of health policy. It is said that truth is many-sided, and I suggest that health policy is many-sided also. During the last few years there has been in all parts of Britain a growing interest in health. We had an illustration of that last week in the Debate initiated by my right hon. Friend the Member for West Stirling (Mr. Johnston). As the standard of living has increased, the public have come to learn more and more of the value of health, and not only of the value of health but of the necessity for the wise use of leisure. The rise in the standard of environment throughout Great Britain also creates in the minds of our people a keener desire for health and all that it brings with it. Health knows no boundaries, health transcends and surpasses all party politics, and it is in that spirit that those of us who are associated with the Scottish Office endeavour to administer the sums of money which Parliament places at our disposal for the health of the people. It is also a truism to say that life without health has a very poor value.

Therefore, every effort that the local authorities and the central authorities can make must be judged by its effect upon the lives and well-being of our people. The Acts passed by former Parliaments are now translated into statutes, and unless those statutes, rules and regulations not only mitigate the diseases from which our people suffer, but also create a more fit nation, they fail in their object. Every Act must be tested in that light. Not only has there been a growing interest in health, but there is to-day a wider conception of health throughout the nation. Our people are to-day looking to the State and to the local authorities not only to take steps to improve their mental and physical activities and thereby to give them a keener zest in the race of life, but they are looking to all sorts of agencies to improve their standards. The health policy is not merely making provision for the treating of diseases, for the calling-in of doctors and nurses and attendance at hospitals and convalescent homes. The health policy goes beyond that, goes beyond, also, the Acts passed by Parliament in the past to protect the people against insanitary houses, certain types of disease, adulteration and all the other problems covered by the manifold activities of Parliament in former years.

To-day there is a change of emphasis in public opinion and on the part of local authorities. There has sprung up a demand not only for protection against these diseases, but for a positive policy to enable our country and our people to store up in themselves the power to resist diseases whenever they come along. There has been a change from a negative policy to a positive policy. It is now generally recognised that the best defence against disease is a fit nation, and in securing a fit nation I stress the value of a good and well-proportioned diet, proper housing, an adequate supply of water. Physical and mental training, for the provision of which this House has recently seen fit to entrust powers to the Government, and facilities for recreation and an improvement in the whole environment of living are of supreme importance. In view of the growing interest in health and the wider conception of health, where is the proper division between the efforts of the Government on the one hand and of the individual on the other? The Government, whether through the central authority or the local government bodies, must do all they can to strengthen that conception in the mind of the public, but unless individuals take full advantage of the different Acts of Parliament their lives will not come up to the full standard that this House desires. As environment improves, as standards of living increase, as the hours of labour are reduced Parliament will depend more and not less upon the individual to improve his own standard of health. Education is vital, we have to learn to live healthily and that is a slow process; but until that habit has been learned or, rather, absorbed by our people, their health will never come up to the standard we desire. No doubt we can do something for the middle-aged and the old, but the best raw material which exists to improve the health of our people lies with the young men and women scattered throughout the country.

Those are some general observations which I thought I might submit to the Committee before coming to the Vote under consideration. In this new and wider conception of health I have tried to place the individual in his relation to the local and central Government. Now I would remind the Committee of what has happened during the last 50 years. On some occasions such as this one dilates with emphasis, and sometimes with sadness, on the increase of certain diseases and the steps which have been taken to cope with them. I would remind the Committee of five broad facts which have emerged during the last 50 years. In tracing the rate of progress during that period I do so not with any sense of complacency, but to direct the minds of hon. Members to the broad facts of the situation. Since 1870, a short period in the life of a nation, the average expectation of life has risen from 41 years to 57 years.

Mr. MAXTON

Far too long.

Sir G. COLLINS

Our death rate in Scotland—these figures apply to Scotland—has fallen by as much as 50 per cent. during the last 60 years. Our infantile mortality has been reduced since 1900 by 33⅓ per cent. Tuberculosis now kills only one-fourth, in comparison with 1870. I am sure that hon. Members will agree that our children are taller and fitter than they were 25 years ago. This is amply borne out by the numerous reports made by school inspectors throughout the country. I have already said that I quote these figures in no spirit of complacency. I have made inquiries as to the progress made in other nations, and I am bound to say that a study of the health of other nations does not lead me to adopt any spirit of complacency when I study the health of our own people.

I have briefly sketched the progress of the last 50 years. What are we doing to-day? During the last year, entrusted by Parliament with large sums of money, I claim that we have made steady progress along the lines of efficiency in the health services. I will take first maternal mortality. I admit that our efforts to reduce that tragedy have not been successful. Maternal mortality in Scotland is some 50 per cent. higher than in England. I had hoped before now to have introduced a Bill dealing with this subject. During the last few months we have held inquiries and had consultations with the interests concerned, and I would remind the Committee that a Bill for dealing with maternal mortality in Scot. land will be introduced by 24th July, before the House rises, so that local authorities and the public will have ample time to consider the Measure in all its details.

I turn next to the subject of the sanitary services, water supplies, drainage and hospitals. I have been impressed with the simple fact that the best road of advance must be by enlisting the willing co-operation of local authorities adjacent to each other if these problems are to be solved. By all means let us retain in Scotland our present bodies in their present geographical areas, but if Scotland is to get the full advantage of these services there must be a more ready acceptance of a wider issue than the exact powers and responsibilities entrusted to those bodies in their own particular areas. I have been asked many questions in the last few months as to water supply. It was only last year that the Government passed an Act dealing with that problem. The Bill was criticised on the ground that it did not go far enough, that the sums of money available were not sufficient to deal with the needs. But some parts of Scotland, more especially the south-west, have found the Act a great advantage and a real benefit to the people living there. The subject is still under consideration and at the moment I cannot say anything more about it.

During the year there has been intense activity in building. In the past 12 months the local authorities have erected, with assistance from the State, a record number of houses, and private enterprise has built more houses—houses not exceeding five rooms—than in any previous year excepting one three years ago. No wonder that with that record of building by local authorities I desire to pay my tribute to the energy that they have displayed. The Committee will not be surprised to hear that there is a shortage of labour, especially bricklayers, in Scotland to-day. During the past month I have received a deputation on the subject from the master builders, and this morning I arranged to meet representatives of the operatives employed in the industry within the next 10 days, to consider the problem with them. These facts show that the local authorities have bent their energies to the problem.

Housing falls roughly into two spheres. First of all there are the slums. What has happened there? In February of last year I gave an undertaking in this House that by December, 1935, the local authorities would have contracted to build 60 per cent. of their needs to replace slum houses during the next five years. That undertaking the local authorities have amply secured, and already contracts have been placed to remove 60 per cent. of the slums well within the five years. The Committee will recollect that the Government started a five-years' plan, the aim being to demolish the slums in that time. Well within the five-years' period, if the present rate of progress continues—I see no reason why it should not—every one of the slums will have been destroyed. There have been more slums destroyed and more new houses erected for slum dwellers during the last three years than in the previous 30 years.

Mr. MACQUISTEN

At the same rent?

Sir G. COLLINS

In some cases at increased rents, for I have found from personal experience that many of the men and women who move into these new houses are willing to pay increased rents for the new accommodation. The other side of housing is overcrowding. The local authorities have been very prompt in making a survey of their needs to help Scotland. The need is enormous. To abolish overcrowding in Scotland some 150,000 houses are needed. From the programmes so far submitted the local authorities anticipate that during the next five years 37 per cent. of their needs will have been dealt with. The present programme covers only that 37 per cent., and I would remind the local authorities that the longer they delay in making their programmes, judging from the internal situation of the country, the greater will be the difficulties that will have to be faced in future. I am sure the Committee will be interested to know that in no single case will one-apartment or two-apartment houses be erected by local authorities to deal with the overcrowding problem.

There has been a distinct movement amongst local authorities to secure the services of outside architects for their housing estates. I wish indeed that the movement would go further. When this House decided some years ago to erect a Government building in Edinburgh and to employ a Government architect, there was an outcry in Scotland against the proposal. When the Government decided to build a new building in Edinburgh to accommodate the numerous departments of the Secretary of State, it was thought essential that the best brains of the country should be enlisted for the purpose and an outside architect was appointed. I regret, therefore, that during the last few months many local authorities in Scotland have not taken advantage of, or rather have refused to be associated with, outside architects and men and women who can help them in this matter. If I interpret the mind of the Committee correctly I am sure it would be their wish that the local authorities, which are spending large sums of public money in erecting houses, should not rest content until they have got the best architect, the best brains that money can buy, so that during the next five or ten years we may see built houses that are in keeping with the desire of the people.

Mr. BOOTHBY

What reason have the local authorities for refusing to do this?

Sir G. COLLINS

Although they have the power it is not an obligation on them to use it. Hon. Members no doubt have their own theories as to why they do not do it. We must rely on the pressure of public opinion and the real value which will accrue to the people of Scotland if these facts are known.

Voluntary agencies play a large part in the working of the health services. There is one voluntary movement which has sprung up very rapidly during the last few years and is deserving of every encouragement. Hon. Members know the value of the open air to health and happiness. The Scottish Youth Hostel Association, started only in 1931, now has 11,000 members, in comparison with 1,100 in 1931. It has 52 hostels compared with nine formerly. But we in Scotland are still a long way behind other countries in that movement. I appeal to local authorities and to all who can influence public opinion in any way to increase the number of open spaces and playing grounds. The more they do it the better and healthier people will they find.

I have referred to the activities of the Department during the past year. What about the future? Some years ago I appointed a committee to inquire into our health services in Scotland. That committee recently reported. What was in our minds in 1933 was the question, is the State in its health policy working on right lines? Was the State making full use of modern knowledge and all that that implied? Was also the State gaining full value for its money? If I endeavoured to interpret in one sentence the mind of that committee, to whose labours I am sure hon. Members in all parts of the House would desire me to pay a tribute—it sat continuously, sometimes day after day, for a period of between two and three years—it would be that the central fact of health policy should be the building up of a healthy race, and that the existing machinery of government, which had clone splendid work in the past, was not fully adapted to conditions to-day. The committee then went on to submit their proposals dealing with the matter.

It would be out of order now for me to deal with their proposals. Moreover, the committee sat for many weeks and went into the matter in great detail, and the Government could not yet make any pronouncement upon a report which only reached their hands a few weeks ago. This afternoon I have endeavoured to provide, in no controversial spirit—

Mr. KIRKWOOD

You are going to get some controversy.

Sir G. COLLINS

No doubt the Government will. I have endeavoured to trace the growing interest in health and the wider conception of health and progress during the past 50 years, as well as the progress made during the 19,st year, and to indicate the lines of advance in the future. We have endeavoured to administer the Acts of Parliament in no party spirit and with the sole aim of improving the health of our people. In doing so, we think we are interpreting aright the mind of Scotland. With these brief opening sentences on this wide subject, I commend these Estimates, largely composed as they are of a large sum for housing, representing a great step forward, although there is much still to be done. No-one taking a wide view of the interests of our people and of their health and happiness, can say that we administer the Acts in any spirit of complacency. Rather do we administer them feeling sure that we shall receive the support of the House of Commons.

4.19 p.m.

Mr. T. JOHNSTON

My first duty is to make a reference to the loss which this House has sustained since the last election by the death of the late Under-Secretary of State for Scotland, Mr. Skelton. I am sure that hon. Members in all parts of the Committee will join in the most sincere condolences to his relatives.

There is a general understanding among my hon. Friends, and, I believe, in other parts of the Committee, that each speaker shall endeavour not to exceed 15 minutes as a maximum this afternoon. I certainly hope to keep within my time. If we observe that self-denying ordinance, more Members who represent Scottish constituencies will be able to put their views before the Secretary of State and the Government than would be the case if a few Members spoke at inordinate length. I would especially commend the right hon. Gentleman for the self-abnegation and discipline of which he has given us an example by the very brief speech with which he has presented the Estimates.

The right hon. Gentleman opened his speech by stressing the improvements in health which have taken place in Scotland during the past half century. There is, of course, another side to those figures, and there are other figures to which he did not refer. Any complete conspectus of the position would undoubtedly show the black side as well as the bright side chosen by the right hon. Gentleman. Since the quinquennium which ended in 1875, the general death-rate in Scotland has fallen from 22 to 13 per thousand, as it was last year, but our death-rate is still higher than that of any northern country in Europe. It is higher than that of the Scandinavian countries and of Germany, and, so far as I know, it is exceeded only by that of the Latin countries, France and Italy. Our infantile mortality rate has fallen from 130 per thousand in 1900 to 76 per thousand in 1935.

The right hon. Gentleman did not tell us, as I think he ought to have done and ought to have stressed, the fact that Glasgow, the largest city in Scotland, still has a death-rate of 22 per thousand, which is worse than the average for all England. Glasgow has the worst figures of all our great cities. In Edinburgh, a child now has double the chance of life that it had in 1890, and in Dundee it has three times that chance. The improvement arises, in my view, from three main causes—public sanitation, a cleaner and more varied food and better housing. As the right hon. Gentleman said, there can be no complacency while our death-rate stands higher than the English death-rate and than that of any northern country in Europe. Most certainly there can be no complacency as long as in the burghs of Scotland there are still 300,000 houses, according to the report of the. Department of Health, where the families are minus a closet. What the figure would be if you added the houses that are minus a closet in the county areas I cannot estimate. That figure is an adequate reason why the Scottish Office and this Parlia- ment should not excuse the Government for complacency in regard to public health.

In going over the statistical tables in the report of the Department of Health, I came across a remarkable fact of which the Under-Secretary should give us an explanation when he speaks. On page 162, in the Appendix dealing with food supply, I see that of the milk supplied to Edinburgh during the year and examined by the sanitary inspectors, a tremendous proportion proved to be adulterated. Of 845 samples of milk examined, no fewer than 250 were proven to have been adulterated. In the whole of Scotland no fewer than one-eighth of the samples were found to be adulterated. That is an extraordinary state of affairs and those are the worst figures I have ever seen. We ought to have a statement on the subject from the Parliamentary Secretary as to what they mean. Do they mean that Edinburgh has a higher standard of analysis than other cities, that other cities are lax, or that a specially bad gang of milk adulterators is operating in the neighbourhood of Edinburgh? The Scottish Office should take urgent steps, in conjunction with the local authority in Edinburgh, to discover the cause or causes of those figures, and to see that they are stopped forthwith.

I will now turn to the housing situation. There is a remarkable table on page 387 of the report of the Scottish Health Services. I beg hon. Members to look at that table, which shows that in Glasgow, the Department compared the houses with four apartments and over with houses of a single apartment, and have discovered that boys living in four-apartment houses are more than two inches taller and 7½ lbs. heavier than boys living in single-apartment dwellings. Girls are 2½ inches higher in the four-apartment houses and 9 lbs. heavier than in the single-apartment houses. Those are extraordinary figures; they are appalling figures. I suggest to the right hon. Gentleman and to the Scottish Office that it is in respect of housing and food that we have the reasons why our death-rate is higher than in England, or in the northern countries of Europe.

We have dealt with about one-fifth of our houses in Scotland since 1919. The right hon. Gentleman said last year that we had done extraordinarily well. We had in regard to slum clearance, but there has been an appalling reduction in the number of houses built by local authorities for what I might call the general population. There is an appalling shortage now, in many areas, of houses for young couples. There are many areas where the only way in which a young couple who want to get married can get a house is by deliberately overcrowding a house occupied by their relatives, in order to get the relatives' house scheduled and a fighting chance of getting a new home. I have asked questions in the House as to what provision the right hon. Gentleman is making. There used to be provision for a subsidy in aid of the building of houses for young couples, but there is not now. At the present time a subsidy is given for dealing with overcrowding, and a subsidy is given, quite properly, for dealing with slum clearance, but there is a third channel of attack which used to be on the Statute Book of this country, but which the right hon. Gentleman and the present Government have abandoned, namely, the provision of houses for persons who are not living under overcrowded conditions or in slums. I seriously urge the right hon. Gentleman to take up this matter before it is too late, and to pay attention to the representations that have been made to him by the Convention of Royal Burghs and all sorts of local authorities in Scotland demanding that assistance should be given to provide housing accommodation for such classes of people as young couples who are about to get married.

Then I am utterly at a loss to understand why the right hon. Gentleman seems to have damped down the effort in the direction of the provision of hostels. One of the most valuable provisions of the Act of 1930 was a subsidy approved by the Treasury for providing decent accommodation for spinsters and old men, who have never had any housing facilities afforded them by any other Act of Parliament. I will not trouble the Committee with the table, on page 158 of the report, showing the number of hostels, but only two, for 12 people, were provided last year in Scotland. I know that local authorities are pleading, and begging, and struggling, and urging, particularly in places where those who agree with me politically are in the majority or in a large minority, that something shall be done in this matter. We do nothing for the single man or the single woman. I would beg the right hon. Gentleman to pay some attention to the very valuable report which he had this year from the Secretary to the Department of Health, who wandered all over Europe and came hack with a most magnificent set of photographs and most valuable information about what has been done in other countries. There is no excuse now for doing nothing for spinsters or old men, and still less is there any excuse for continuing the dull, monotonous, barrack-like system of housing that is unfortunately springing up all over Scotland. As a last word, I beg the right hon. Gentleman to give facilities for the introduction of refrigerators into households, particularly where there is an electricity supply. Let us begin gradually, It takes 10 years for an idea to be used; it is laughed at at first; but let us begin gradually to give the working classes of our country facilities for keeping their food supplies in decent, eatable condition.

4.36 p.m.

Sir ARCHIBALD SINCLAIR

Let me in the first place associate myself with the right hon. Gentleman the Member for West Stirling (Mr. Johnston) in the tribute which he paid to the memory of Mr. Skelton. It was only a year ago that, in opening the discussion on these Estimates, I welcomed Mr. Skelton back to the House after an illness through which he had been passing, and expressed the hope that he was completely restored to health. That hope, unhappily, has not been fulfilled, but Mr. 'Skelton leaves behind him the memory of a great public servant, who inspired his colleagues in all parts of the House with admiration and affection and has left the stamp of his vigorous personality on the public administration of Scotland.

The report of the Committee on Health Services, to which the Secretary of State and the right hon. Gentleman the Member for West Stirling have already made reference, seems to me to be a masterly review of the present situation of the health services in Scotland, and to make a series of imaginative, constructive and most valuable suggestions for a national health policy. I hope that everyone will read it. I do not much care for reading blue-books myself, but I confess that I found this one to be of fascinating interest, and I hope it will find its way into the hands of all local administrators. I only wish that the Secretary of State could reduce its price from 6s., so as to put it within the compass of people of very moderate means. The book shows clearly the soundness of the foundations which were laid before the War. In those days, when these social services and health services were started, there was a great deal of controversy, and many people said, "You are coddling the people; you are undermining the responsibility of parents." The report shows clearly, to quote its own words, that: Parental responsibility is developed, and not suppressed, by civic organisation. In short, the foundations on which we are building are economically and morally sound, and we should go forward confidently to erect the structure of a national health policy with the aim of promoting the physical well-being and fitness of the people. How much there is to be done is shown clearly by some passages in the report in which it is mentioned that the mortality rates in Scotland at different ages are higher than the corresponding figures in England and Wales. The committee note that our national health in Scotland falls far short of what it ought to be, and that: The vital statistics in Scotland are disquietingly less favourable than those of England and Wales and other European countries. To some of these European countries the right hon. Gentleman the Member for West Stirling has already made reference. We cannot discuss these recommendations at length to-day, because they would involve legislation, but I should like to deal with four main topics which arise out of them.

The first is that of hospitals. Last year I drew attention to the inadequacy of the Scottish hospital services, and the Government, in reply to the Debate, said that it was a matter for the local authorities and that they could not interfere with them. The report which we are discussing makes it clear that that answer is not good enough. It is stated that in the case of some hospitals the number of persons waiting for admission greatly exceeds the total number of beds in the hospital, and the Committee find that the central problem is the one to which I ventured to draw attention last year—the inadequacy of hospital facilities. Since the recommendations of the committee on this subject, as on others, would involve legislation, we cannot discuss them this afternoon, but I should like the Secretary of State, if possible, to give some indication, before the Debate closes, of the way in which he regards this problem. If he can give such an indication, I am sure the whole Committee will hear it with interest.

In the second place, it seems to me that there is profound truth in the observation of two medical witnesses who appeared before the committee, Dr. McKendrick and Dr. Kermack, that the health of the child is determined by the environmental conditions existing during the years up to 15, and that the health of the man is determined preponderantly by the physical constitution which the child has built up. This points to and emphasises the importance of a vast range of subjects, including maternity services, the ante-natal and post-natal care and nutrition of mothers, nursery schools, the nutrition of, and especially the supply of milk for, school children, dental and medical inspection and care of school children, and recreation and physical training. Of these subjects, it is only the last with which I want to deal this afternoon.

The committee pay a generous tribute to the work of the National Playing Fields Association, in co-operation with the Carnegie Trustees and other voluntary organisations, but they declare that the need and the demand have developed to the point where the State must now take an active part in providing facilities for physical education and recreation. They recommend that this duty should be made a function of the Department of Health, and that funds for carrying it out should be provided. Among the many people I have met who have been to Germany recently, and who are filled with disgust and dislike for many things that they found there, there is an almost universal admiration for the great work that is being done in connection with the physical training and recreation of the children and young people of that country. I do not believe that we ought to work on those German lines; I do not believe that the German lines of rigid discipline are the ones best adapted for the people of this country to follow. There are many other examples from which we might learn, such as the Sokols of Czechoslovakia, which are run on a system of far greater freedom than the organisations in Germany. But I believe that we are developing in this country a system of our own which is very much better adapted to our circumstances than any of these foreign systems would be. The National Playing Fields Association has been working at the provision of playing fields and at the problem of play-leadership, so that the best use can be made of fields when they are provided.

There is another organisation the Council for Physical and Recreational Training, with great resources and a different type of organisation, which draws its strength from the physical training instructors and local enthusiasts who have taken an interest in this subject all over the country, and which is working at physical recreation and training, indoor gymnasia, and activities of that kind. These two organisations have come together. They have a joint committee, and they are working out a joint policy. I believe that this opens up the possibility of a greater advance in the development and use of playing fields under competent leadership and in physical training indoors and outdoors than we have had before. I venture to commend this movement to the Secretary of State, and I hope it will have his active sympathy and support as it gets going in Scotland, because the work will be very much in accordance with the recommendations of this very valuable report.

This brings me to my third point, which is the importance of town and country planning, for the committee recommend that it should be made obligatory on local authorities to make ample provision in town and country planning for schemes for playing fields and other facilities for healthy recreation. Land is now being eaten up by the builder all round our big towns and cities. Only last year I had to draw attention to the fact that very little progress was being made in town and country planning under the Act of 1932, and that very little was being done to preserve the fields which are vital for the open-air recreation of our people. The Department of Health in its annual report this year declares that up to the present progress in planning has been very disappointing. I would, therefore, ask the Secretary of State what action he is taking to remove this reproach to our administration, what action the Government propose to take on the report of the Garden Cities and Satellite Towns Committee which reported a year ago, and whether they propose to adopt the recommendations of the committee on Scottish health services in regard to the position of playing fields and other facilities for healthy recreation in town and country planning schemes.

Lastly, I come to the committee's references to the Highlands and Islands Medical Service. None of us who know the Highlands will be surprised at the tribute paid in the report to the Highlands and Islands Medical Service. It has amply fulfilled the intention and justified the policy of those who designed it in 1912, and now it is taken by the committee as a model on which the whole medical service of Scotland should be developed in the future. No praise is sufficient for the admirable work of the doctors and nurses, and more recently the surgeons. Their self-sacrificing and devoted work has established the reputation of this service. I am particularly glad that the committee has a special word of praise for the nurses, for their services in conditions of real hardship in the worst of weathers and on the worst of roads are beyond all praise, and I hope the Government will lend an attentive ear to the committee's recommendations for an improvement of the conditions in which they render them.

There are three points to which I wish to allude. The first is housing, particularly that of smallholders, crofters and farm servants. We all agreed, when we discussed the 1935 Act, that it had very little relation to the problem of housing in the rural districts, and particularly in the Highlands, so the Housing Advisory Committee was set up and the Secretary of State, at the instance of some of my hon. Friends, agreed that rural housing should be one of the first, subjects to be tackled. I am informed that some of the arrangements for enabling local authorities to give evidence to the committee have not proved satisfactory. One local authority with which I am in close touch was asked by the Scottish Landowners' Federation to supply information before the authority itself had been invited to give evidence. Now, after a protest, I understand that they are to be given facilities for sending representatives to the committee and tendering their evidence. I believe no invitation has been given to the county of Sutherland, where the housing position is at least as difficult as and in many respects different from, that of any of the neighbouring counties. l hope all these local authorities will be given an opportunity of tendering evidence, for the importance of their work is immense. It is not merely dealing with a detail here and there. All our hopes of housing progress in the Highlands depend on this committee being able to make effective and constructive recommendations.

The Secretary of State said that the matter of water supplies was one for cooperation between local authorities. I believe that is true in a great many parts of the country, but it is not true in the Highlands. It is not a matter of cooperation. It is a matter of giving help to a number of localities to enable them to supply themselves with what the Department of Health calls a cardinal necessity of public health. I hope the Secretary of State will give us an indication that he is going to proceed on those lines. The yield of a penny rate in some of these water districts is very small—in one that I know it is only 19s. 5d. Over the whole county of Sutherland it is only £291, and over the whole of Caithness, including the towns of Wick and Thursoe, it is only £364. This committee reports that additional grants are required for local authority health services, housing and water. The most prosperous counties can get 75 per cent. grants for their roads. These impoverished counties cannot any longer get even a 25 per cent. grant for the provision of a supply of pure water. Consequently I find myself in agreement with the recommendations of the committee so far as the Highland area is concerned. I realise that the housing question is to some extent sub judice, being under the consideration of the Housing Advisory Committee, but I hope the Secretary of State will tell us what he proposes to do to help the Highland counties to improve their water supplies and their statutory health services. I associate myself with the tribute that the right hon. Gentleman paid to this authoritative committee. We ought to be deeply grateful to them. We shall await with eagerness, perhaps not to-day but on some future occasion, a declaration of policy from the Government on their recommendations.

4.52 p.m.

Mr. CASSELLS

I am sure everyone listened with rapt attention to the Minister's speech. During the last few months I have been engaged in two electioneering campaigns, the first in November last year and a by-election in March. In both I was faced by a candidate of what is termed the Scottish Nationalist party. I believe it is rather important that we should have some little regard to the complaint that that party makes. It is that our native land, being so far removed from Westminster, is practically in a state of isolation, and that Scottish demands have not been met as they ought to have been. Whether these complaints are justified or not is not a matter for consideration at the moment. It is sufficient to say that there is a body of public opinion expressing that view, and I trust that the Minister in his wisdom will have due regard to it and will do all in his power to protect the rights, interests and privileges of the people. It is all very well to make pretty speeches and to be optimistic, but I hope that his speech today will be definitely consistent with his action in the future. There was a question on the Paper to-day with regard to supplying milk to children in schools during the holiday period, and we learnt the astonishing fact that the duty and responsibility of the public authority, which is the health authority, is taken completely away from it and vested in the Milk Marketing Board. These two things are entirely inconsistent with the right hon. Gentleman's speech.

My right hon. Friend the Member for West Stirling (Mr. Johnston) drew a comparison between Scottish statistics and those applicable to other countries. I have here an article in the "Glasgow Evening News" of the 6th instant which is of vital interest. It says: Scotland is one of the healthiest countries on the earth's surface. The soil is clean and does not breed poison conveying insects. The climate is singularly equable. The air never stagnates and the whole coon- try is refreshed by ocean winds which in their passage over mountains, have acquired tonic sweetness and get rid of their excess moisture. The greater part of the land surface is several hundred feet above sea level. Such a country, other things being equal, ought to be the healthiest country in the world. Our death rate should be lower than that of England, but it is 1.1 higher. It is higher even than that of Belgium. England itself suffers by comparison with Sweden, for which the rate is 11.2. Germany is still better with 10.9, but the figure which chiefly puts Scotland to shame is Norway's 9.8. These statistics speak for themselves, and they are of the utmost importance. My right hon. Friend indicated that Members would in all probability place any particular complaints that they have before the Committee, and I accept that privilege. The county that I represent, Dmbarton, is in my own personal experiece, very adversely affected so far as housing conditions are concerned. In Arrochar, situated right at the top of the Loch, and blessed with Conservative rule, there is not a single new house under any Housing Act of Parliament, and there is no power, water supply or drainage supply. In other words further down the Loch it is precisely the same. The local authority of Alexandria has undoubtedly done something to ameliorate the conditions, but there within the last three or four months we have had a case of a family of five persons living in a single room. The youngest child died and the coffin with the body in it was left lying on the table and, when the parents desired to take food, the coffin was removed from the table and placed on the bed. I am perfectly satisfied—and there are incontrovertible facts—that, of you take my constituency from East to West and from North to South, you will find more or less precisely similar circumstances arising. I trust that, as a result of the discussion to-day, the Secretary of State will arise like a giant refreshed, and that as far as the future is concerned, he will be a modern Wallace wielding his two-handed sword, cleaving his particular opinion into the minds of the Anglified Government Front Bench with which this House is faced at the present time.

5.1 p.m.

Mr. BOOTHBY

I shall detain the Committee for as short a time as possible in a speech of a kind of verbal shorthand. There are one or two questions which I want to raise. First of all, I agree with the right hon. Gentleman the Member for Caithness and Sutherland (Sir A. Sinclair) in his statement about the Highlands and Islands and the lack of provision which we make for them, and the lack of assistance which we give to their impoverished local authorities in carrying out essential health services. I always have an uneasy feeling that we do more for our Crown Colonies in this connection than we do for the outlying portions of our country. It may or may not be true, but I should like to see the figures of the money spent in this way on the Crown Colonies and compare them with what is spent on the Highlands and Islands rind the really poor districts of our own country.

I want to raise three topics. First of all, I want to suggest to the Secretary of State for Scotland that one of the great problems we have, after the Highlands and Islands, is the derelict appearance of the central industrial belt of Scotland. I want to draw his attention to the psychological effect that it must have upon the people who live in the central industrial belt and have to look out every morning at those God-forsaken slag heaps and hideous Bings, which ought to be cleared out. Has lie in mind any steps that the Government will take to help to clear up this central industrial belt and make it more habitable and fitted to conduct what are, after all, our best heavy industries? I want to ask him whether he thinks that some body or councili—t might be a sub-committee of the Scottish Development Council, which is rather an unwieldy council in itself—might not be the instrument, coupled perhaps with a trading estate, for making the central industrial belt more sightly and habitable? It is false economy to build up new industrial centres as they have done in England and to move about our industrial population, when the existing areas can be transformed, with a little wise expenditure, at about half the expense of building up new ones. We do not want Scotland to follow the example of England and move our industrial areas and populations about by developing new industries in areas for which no facilities at present exist for their conduct. We should devote our main attention to improving our present industrial areas.

The right hon. Gentleman the Secretary of State indicated that in his Housing Bill he hoped to get the slums cleared away within the next five years. His Housing Bill involves rebuilding operations upon a very large scale in the present built-up areas. I suggest to him that it is very important that this rebuilding in Scotland should be better done in the future than it has been done since the War. Hon. Members on both sides of the Committee know of the hideous, unedifying and drab ugliness of most of our housing schemes in Scotland. There are one or two brilliant exceptions, and perhaps the housing scheme at Johnstone is one. Take my native city of Edinburgh. It would be difficult to imagine anything more uniformly ugly than the housing schemes on the south side, and at Lochend and Pilton.

Why should we build ugly cities f Compare the imagination, the enterprise and courage of the Town Council of Edinburgh when it had to build the new town and had no hesitation in hiring the Adam Brothers to lay the whole of it out. Now we have in Edinburgh, in the new town, a city of which we can well be proud. It is the admiration of the world. Compare that with the present housing schemes in Scotland. These are a disgrace, and this House and the Secretary of State ought certainly to do nothing to encourage the local authorities in Scotland to go on with their self-imposed task of turning one of the most beautiful countries in the world into one of the ugliest, which is what they have done for the last ten years.

I would like to draw the attention of the Committee and of the Secretary of State—although I do not think he requires his attention to be called to it because it is a subject in which he has taken a very personal interest—to the admirable report of the Department of Health on working-class houses on the Continent of Europe, which I strongly recommend to the attention of hon. Members on both sides of the Committee. I have often wondered why so many of these Continental housing schemes should be so superior to our own. This report gives the answer to the question, and points out that on the Continent housing schemes are given into the hands of a competent (and often a brilliant) architect, who proceeds to fit the details into a general architectural conception. It says: So far as housing is concerned, much of the architectural talent which exists in Scotland is hardly being used. This appeared to be what the right hon. Gentleman thought when he seemed rather inclined to ask what was going to be done. The report continues: Young men, largely unoccupied, who have been trained in the newest schools of architectural technique are anxious to express their ideas, but get little chance to do so; while overworked officials cover acre after acre with drab monotonies, because pressure of other duties prevents them devoting any time to creative thought. The report reaches the conclusion that more imaginative architecture and more imaginative planning, a brighter and more colourful layout, and the provision, in immediate proximity to the houses, of improved facilities for rest, recreation and social intercourse could be achieved at no great cost. The right hon. Gentleman the Member for West Stirlingshire (Mr. Johnston) referred to barracks. Modern tenement schemes need not be barracks. They are barracks because we make them barracks. They are not barracks on the Continent. [An Hon. MEMBER "Some of them!"] Some of them are, but the best are not. Many of the amenities which we would all like to see, such as central heating, electric light, refrigerators, central laundries and central playgrounds, could be achieved in these new modern tenement schemes at much lower cost than by the building of single houses. With the solitary exception of Johnstone, we have not really made a serious effort to design and lay out modern tenement schemes in Scotland.

I wish that the right hon. Gentleman the Secretary of State would devote more of his energy in trying to get the local authorities to use a little imagination and courage in this matter. I ask him whether he does not think that it would be worth while calling a conference of local authorities to discuss whether they have adequate powers to carry out schemes of this character, and whether it would not be worth his while perhaps to give greater powers to his Central Advisory Committee with regard both to the advice that they should give to local authorities and even to the centralisation of the supply of raw materials for building houses? This housing question is one of the greatest importance. Sir Andrew Grierson, in the report of the Health Committee, says in another connection, but it also applies to housing: If there is to be co-ordination and unification among health services, the chief requisite is that there should be an effective unifying authority. This essential of any unified health service does not exist at present. This to my mind is in no small measure due to the fact that there is a singular want of control on the part of the central authorities over local health administration in Scotland, particularly as regards matters which are not purely local but are national in character. I think that this applies just as much to housing as to the health services themselves. The right hon. Gentleman ought to give very close attention and consideration to the question of administration and the machinery of Government, with a view to deciding whether there is any central authority with sufficient power to give a lead in this matter.

The second point with which I want to deal is the question of vital statistics, which was referred to by the hon. Gentleman the Member for Dumbartonshire (Mr. Cassells). It is a scandal that our death rate should be so high in Scotland, which is not an unhealthy country, and that our maternal mortality rate should be as high as it is, and far in excess of that of Scandinavia. I do not see any reason why it should be so. The report of the Committee on Health Services points out that the central Government should be equipped in all necessary ways to advise local authorities on questions relating to numbers and distribution of population, and that they are not in a position to do so. It also raises the question of heredity in a very interesting passage. I agree with the right hon. Gentleman that the report reads like a very interesting novel, and I am sure that hon. Members would be well repaid by studying it with great care.

How can we correct and deal with these matters, and with the important question of the vital statistics of Scotland? Undoubtedly, as the right hon. Gentleman said, the root of the whole problem is the provision of hospitals and better hospital facilities. We should like a few words from the Under-Secretary of State upon that point when he comes to reply. Another vital point is the need for a better midwifery service. The whole status of midwives is not sufficiently high to attract the best possible persons into the profession, and that is another point to which I would direct the attention of the right hon. Gentleman. It is pointed out in the report of the Committee on Health Services that Professor Crew, of Edinburgh University, is: inclined to the view that under the social system which now exists in Scotland the social position, the wealth and the culture of the individual can be regarded on the whole as being a measure of his genetical worth, and that efforts should be made to control the differential birth rate. Professor Call. Saunders is also quoted as stating, the whole mechanism of scholarships, examinations, tests and so on, ensures that those who move upwards are above the average level in respect of certain mental qualities. The result must be a somewhat higher level of intelligence in the upper classes, and measurements of intelligence do in fact show a slight average superiority in the higher classes. It follows that a failure of these classes to contribute to the next generation in proportion to their numbers must involve some lowering of the intellectual quality of the population. The report goes on to say that there is undoubtedly a tendency for the lowest class of population to be more fertile than the higher classes, at any rate to produce to a greater extent. I suggest, at the risk of shocking hon. Members, that until this House and the Secretary of State are really prepared to face up to the two questions, first of all, of the sterilisation of mental defectives, and, secondly, to the question of contraception, we shall never be able to come to serious grips with this particular question. As long as you allow your professional classes or your so-called upper classes, who, apparently, according to the report, are inclined to be of a slightly higher average of intellect, to practise free contraception, as you do, and give no facilities as a Government to the industrial masses of this country to practise contraception, we are bound to get a lack of balance and of proportion. One of the difficulties of a democratic Government is that no Government dares to tackle the question for fear of getting u[...] against the Roman Catholic vote. It does not matter what your politics are, for when it comes to facing purely social questions that are not questions of economics or politics, no Government have dared to tackle them, because they feel that they are more inclined to lose votes than to get them.

Mr. McKIE

How does the hon. Gentleman suggest that we should tackle this important subject?

Mr. BOOTHBY

By being brave and not minding the electoral consequences. I understand why the right hon. Gentleman is afraid to tackle it, but there is need for further research into these matters and into the whole question of human genetics. As the report points cut, the Government supports the Rowett Institute in carrying out the most meticulous and careful research into the question of animal genetics. Surely human genetics are more important than animal genetics. The question of mental defectives, the whole question of genetics and allied subjects deserve the closest attention, and the Government might make a start by carrying out research on a comprehensive and intensive scale. It would not cost much, because the facilities are there in the universities and the hospitals.

I should like to say a few words on the subject of nutrition. We do not yet know enough about the facts in connection with nutrition. We had a great Debate on that subject the other day and there has been much writing in the Press about it. We hear from Sir John Orr, from Dr. McGonigle and every kind of authority on the subject of nutrition, and yet we are not in a position to know the true facts. The report on Scottish Health Services says: While there is no evidence of wholesale and widespread malnutrition there is a good deal of underfeeding and wrong feeding. I do not think that anyone would dissent from that view. What we want to know is the extent to which there is underfeeding and wrong feeding, and what are the reasons for it. A prima facie case for the investigation into the question of malnutrition in the distressed areas has been completely made out. My right hon. Friend might give a lead on this question and carry out some investigations into the subject of nutrition generally in the industrial centres of Scotland, and find out how we compare with other countries. There can be no doubt that the nutrition of the population, especially among the children, has improved during the last 10 years, but just as we do not judge our aeroplane strength by comparing it with what it was 10 years ago so we do not want to judge our present standards of nutrition, any more than we want to judge our expectations of life from what prevailed a number of years ago. It is very useful to try and compare these figures in our own country with those that exist in up-to-date modern countries. Scandinavia is a good example, because we are behind Scandinavia in many respects in regard to these matters.

The report points out that we are spending now practically £20,000,000 a year on disease in Scotland. How much of that £20,000,000 has to be spent because of under-feeding or wrong feeding? I would remind hon. Members that we are spending a great deal in subsidising agriculture. I wonder whether all the money that is being spent on disease is necessarily being spent in the right way, whether the money spent on agriculture is necessarily being spent in the best way, and whether this problem is not a dual one and that health and agriculture are two parts of the same problem, and that if the money spent on both were pooled we could probably spend less in the long run and do a great deal more good than we are doing to-day for the health of the population and for the agricultural industry.

Let me deal briefly with the subject of milk. I wish the Under-Secretary would say whether in his opinion the consumption of milk per head of the population in Scotland to-day is satisfactory. I think it is entirely unsatisfactory, that it is deplorable. We know the nutritive value of milk from the White Paper that has been issued by the Government. The average consumption of milk ought to be one pint per head per day, as it is in Scandinavia and the United States of America. Growing children should have one and a-half pints of liquid milk per day. Our consumption is only one-third of a pint per head per day. How much of the money that we spend every year on disease is due to the fact that in their early years children do not consume enough fresh milk. If we consumed enough fresh milk we ought to double the production of milk instead of restricting it.

We have seen what the milk scheme is doing. It has raised the price and reduced the consumption. It is no use blinking these facts. I suggest to my right hon. Friend that he ought to extend as quickly as possible the milk scheme for the provision of free milk to school children and milk at reduced prices for children under school age, and for nursing mothers. If we did that I believe that in a very short time we should reap benefits tenfold from the small extra expenditure that would be involved. Health is the foundation of everything. Upon it the future of the race depends. To relate food production and purchasing power to health is no mean objective for contemporary statesmanship. I hope that the Minister will have something to say on this topic when he replies.

5.20 p.m.

Mr. LEONARD

I do not wish to detract from anything that has been said in regard to the Special Report on Health Services but we also must give regard to the admirable manner in which the Health Department presents its story to us. The hon. Member for East Aberdeen (Mr. Boothby) has referred to the question of milk. I agree with everything that lie said on that subject, but I am concerned whether those who are supplying the milk are doing all that we are entitled to expect them to do. For the purpose of putting the matter before the Secretary of State for Scotland I should like to refer to the report of the Department on the question of the registration of dairies, and to express the hope that the provisional registration will not be allowed to run to what the report seems to indicate is the tendency at the present time. On page 52 the report states, in regard to a complaint which the Department received: The Department consulted with the local authorities' officers in regard to the administration of the Act generally and the enforcement of the dairy by-laws in particular. It was found that considering the period that had elapsed since the passing of this Act too many dairies were still registered only provisionally, in respect that they have not been brought up to the standards required by the by-laws. That is a matter which certainly needs attention. The report proceeds: The sanitary staff was insufficient to secure proper administration of the bylaws. The local authorities ought to be communicated with so that the regulations which are supposed to apply shall not be allowed any longer to present the picture suggested by this paragraph. The report also states, referring to a certain county: As this county is one that has benefited from the operation of organised milk marketing, the Department have urged the county council to intensify their efforts to obtain improvement. That remark might apply to more than the county referred to specifically, and I hope that the Department will see that this matter receives attention. I have the same feeling with regard to the question of the diseases of cows. There is still great diversity of opinion as to the extent to which local authorities carry out their obligations. The report says with regard to diseases of cows which may be suspected to be in a condition to infect or contaminate milk: It seems clear that in many cases failure to report is not due to the dairyman's inability to recognise diseased conditions. If that statement can be put into black and white in a report it certainly indicates a state of things which requires attention, and I trust that such references will not require to be made in regard to any further observations on the dairymen of Scotland.

I should like to say a few words further in regard to the special report. As we are trying to save time for each other in this Debate I will allow some of the comments that have been made to suffice so far as I am concerned. I should, however, like to express my confirmation as to the improved tendencies in regard to health in general. There has been considerable improvement, but it is disturbing to learn in regard to this country and especially Scotland that there are other countries in Europe that can show a better state of health than we can. I should like to touch on one aspect of this matter, and that is the epidemic disease of measles. This subject receives special attention. The report says: The death rate from measles has declined less than that of any other infectious disease—from 36 to 20 per 100,000 between the periods (1871–80 and 1921–30). I am dealing with this subject more particularly as it affects the City of Glasgow: In 1931 measles caused 641 deaths, in 1932 892 deaths, and in 1933 there was no measles epidemic. A little later the report says: The number of cases that occur annually throughout the country is not accurately known, but the case mortality of measles would appear to be about 3 to 4 per cent. That it is much higher in young children, the experience of Glasgow shows. For instance, in the successive epidemics between 1921–22 and 1931–32 totalling 118,265 cases, 16.9 per cent. of children attacked under one year died, and 13.8 per cent, of those between one and two years. That condition of things requires special attention. I should like to refer to the monthly report issued covering 16 towns in Scotland. The reason why I have mentioned the question of measles is because I see from the tabular statement that there are the details of deaths from measles for 10 years going back to 1926. There is great variation. In 1926 the deaths from measles were 158; in 1927, 22; in 1928, 138; in 1929, 3; in 1930, 127; in 1931, 5; in 1932, 147; in 1933, 6; in 1934, 63; in 1935, 4; and in March of this year it had gone up to 56. Therefore, although I am speaking purely as a layman I think that when one sees this disease persisting from year to year in this way, with such pronounced regular variation, special attention might be given to the question of measles. I express that view more particularly having regard to the incidence of the disease in the City of Glasgow.

I should like to refer to health and school buildings. They are referred to in the report. I notice that 16 per cent. of school children suffer from ailments that could not be classified as minor. That is a very disturbing statement: The principal abnormal conditions are dental caries, enlarged tonsils, … nasal catarrh, skin diseases and lung affections. This is considerably affected by the condition in the schools. I see that on page 115 in the report they say in their third recommendation: All new schools should have sufficient indoor accommodation to permit of the proper development of schemes of physical education, and steps should be taken, where practicable, to make good this deficiency in the older schools. An hon. Member has stated that sometimes it is necessary to conduct propaganda for many years before a matter receives any recognition. May I suggest that this question of indoor accommodation for physical instruction in the future should be considered, because it might create a change in our attitude in regard to ventilation. In large offices, in theatres, and in picture-houses special attention is already paid to what is called air conditioning, and there is no reason why air conditions in our schools should not also receive attention so that the children may benefit. There is at the present time an establishment in this country where they have not only got air conditions but they have installed an apparatus for dealing with bacteria free air, and when one considers the conditions in the centre of Glasgow, where there is no fresh air at all, one wonders how on earth the children can get any fresh air by opening the windows. They could get bacteria free air if proper installations were provided, as is the case in Germany and other Continental countries. Hon. Members will, no doubt, also bear in mind that this would react to the advantage of the school work.

An hon. Member gave the weights and height of children in relation to air space in the home, let me give the Committee what this means in the case of the school and the work which is done by the school children. In a special report prepared from three typical schools for presentation to the British Medical Association, it was found that of the boys from one-room houses who sat for the examination 6 per cent. received the mark "excellent." By the addition of another room 16.6 per cent. received "excellent," and by the addition of a third room 17.5 received "excellent." With regard to those who only obtained "good" as the result of the examination, 26.6 were from one-apartment houses, but from two-apartment houses the number jumped to 45.4 per cent., and with the addition of another room to 49.1 per cent. These were boys who were living the same type of life and, therefore, the matter I am putting forward, even if it entails a ten year's propaganda of the advantages of air conditions in schools, is a practical proposition and one which should be taken up as quickly as possible, especially in view of the fact that the report makes it clear that alterations can be made in schools already built. I think this is a matter which should be considered especially in relation to densely populated districts, and that proper plant for supplying good air conditions should be provided in our schools in order to give our students an advantage which is given to students in other lands.

5.37 p.m.

Lieut.-Colonel MOORE

I intend most heartily and gladly to obey the self-imposed ordinance of short speeches this afternoon. I am reminded of an Irish witness, Mr. O'Duffy, who was giving evidence before the court. He came in laden with a large number of documents. The judge was horrified, and said "Could we not, while realising the value of the evidence, have the gist of all this, Mr. O'Duffy?" Mr. O'Duffy replied: "Your Honour, it is all gist." My remarks this afternoon will be all gist. I was touched by the tributes which have been paid to our late friend Mr. Noel Skelton, but I thought how stupid we are to keep all these nice things until people are dead instead of saying something like this when we have the opportunity and when they are so well deserved. I could use the few minutes at my disposal in paying a tribute to the Secretary of State and the Under-Secretary of State. To my mind they are an ideal combination to be in charge of the affairs of Scotland. They have broadminded ideas on Socialism, which so many Socialists do not possess, and they have a wide and enlightened Liberal outlook, which the Liberal party seem to have forgotten. They have a Conservative stability, coupled with imaginative and sane progress. These, of course, are qualities which are commonly associated with the Conservative party.

Only a short time ago I had the honour of accompanying the Secretary of State round some of the slums in my constituency, and possibly on that occasion he opened his heart to me. found him a man of deep human sympathy, a quality which he is bringing to bear on the problem of slum clearance and rehousing. I was particularly struck with his reference to-day to the lack of trained and skilled architects. We are remodelling Scotland to-day, and surely we ought not to fail to employ the best architects to get rid of the dreariness which we find in our mining villages. Architects in Scotland are particularly well qualified for this work by reason of the Registration Bill which was passed some years ago, yet they are allowed to run waste. Whilst new towns are springing up we are failing to take advantage of the skill and ability at our disposal. But it is no good having wholesome houses if you do not have wholesome bodies to put into them. The converse, of course, is true.

There are three points to which I want to draw the attention of hon. Members. First of all—the question of milk. Is it beyond human intelligence to include in the National Health Insurance scheme the right of panel doctors to prescribe milk as well as medicine? I have submitted this to my right hon. Friend before. Medicine is for the elderly. They like it, and live by it. But children live by fats, and we want to prescribe for them those foods which will build up the constitution. Let the elderly go on taking those things which they think will cure their imaginary ills. The hon. Member for East Aberdeen (Mr. Boothby) said that there should be at least one pint of good pure milk a day for every child. I entirely agree. To suppose that one-third of a pint is enough is really ridiculous. Local authorities should receive some encouragement from the Secretary of State in regard to their obligations in this matter. We are expanding and increasing our defence forces and, no matter what hon. Members opposite may say, while it is a great and noble ideal to fight and die for your country, it is much better to live for it. I want to give an opportunity to the people of Scotland to live for their country. They will live better if given plenty of milk and good houses, and if they are provided with adequate arms by which they can overawe any peace-breaker. About 50,000 recruits for the Army were rejected last year. Would they have been rejected if they had been given more of this satisfying food? I suggest that if the Government accept the advice which has been given to-day there will be no complaint 50 years hence that 50,030 recruits have had to be rejected.

Why should we not advertise the benefits of milk? Why do not the Government set up milk bars throughout the country? I do not say that they should be set up in competition with private enterprise. There is one in the City of London already, and I have never seen it empty. Why should not milk bars be set up so that people in stead of going into a public-house for a pint of beer—I am not against it, because I do it myself—should be able to go into a milk bar and get a pint of milk? Then there is the question of fish. We have heard to-day the tragic story of fish being thrown away when so many of our poor people are near starvation point. I agree; but the trouble is that fish are like women. They are "uncertain, coy, and hard to please." You can never tell when you catch fish how you are going to keep it fresh until it is distributed. The difficulty is distribution; to get the fish where they are wanted. I cannot believe that it is beyond the intelligence of the Scottish Office to provide depots around the coast so that the fish might be collected when they come in large quantities, and by some form of freezing or salting kept fresh until they can be taken to those centres of population where they are so urgently required.

A few years ago the Chief Commissioner of the Dublin Constabulary told me that he got the best recruits for his force from Tipperary, where they were brought up on porridge, milk and potatoes. Let me deal with the question of oats and potatoes. We have a surplus of oats in Scotland, which should be properly utilised. Yet we allow foreign oats to enter the country and I think our oats should be turned into porridge, and I should be happy if my right hon. Friend could find a way by which these two staple commodities, potatoes and porridge, could be placed within the means of the poorest of the poor. There are many other suggestions that I might make, but I know that every hon. Member who represents a Scottish constituency has equally constructive and helpful suggestions to make, and I will leave the field to them.

5.46 p.m.

Mr. JAMES BROWN

The hon. and gallant Gentleman who has just spoken represents the burgh which is my native burgh. I agree with him in many ways, but I cannot agree with some of the things he has been saying to-day. I am not going to argue against anything which he or any other hon. Member has been saying, because the health of Scotland is a big enough subject without diverting one's thoughts into argumentative channels, getting out of order or doing anything which would impede the discussion of the health of Scotland to-day. I would have liked the hon. Member for East Aberdeen (Mr. Boothby) to have been in his place, but he can read my remarks in the OFFICIAL REPORT if he wishes to do so. Although I consider that some of the suggestions he made are very helpful, there are some of them with which I do not agree. The hon. Member talked about contraception being a gift from God. I have read the old Book and I rather think the old Book does not agree with men doing anything of the kind. [An HON. MEMBER: "Which old Book?"] There is only one old Book in Scotland—[An HON. MEMBER: "Burns!"]—Burns is the second. The Bible belongs to the world and so does Robert Burns. I do not wish to be jocular on this question. I think that if we believe the Bible, we should know that contraception is not hygienic at any rate, and it is health we are talking about to-day. I do not know why anybody should introduce a topic of that sort into a health controversy.

I am sure there are hon. Members present here, especially those from the rural districts, who are grieved every day of their lives by the rubbish heaps that lie at their very doors, destroying what was called one of the most beautiful countries in the world, all for the sake of saving a few pence for the coal owners or the shale owners, or whoever they may be. There are many hon. Members who, as they go through their constituencies, are grieved to the heart to see that their country and the House of Commons should for a moment tolerate anybody making these rubbish heaps. I am speaking as a practical coal-miner and so far as coal-mining is concerned, I know, as does the Under-Secretary, that there is a very simple cure and that the whole of these rubbish heaps could be kept down, thus improving the landscape and preventing subsidences. They are not conducive to health, because the heaps catch fire and it is no exaggeration to say that the sulphur floats for a mile or more. I have been awakened from my sleep wondering whether the house was on fire or not, and that was a good mile from the rubbish heap.

I would like now to deal with the housing of our people. I think there is one class in Scotland which has been neglected so far as housing is concerned. I am not sure whether this applies in the North and the North-East, but in the South-West it does apply. I am referring to the fishermen. They have been more neglected in matters of housing than any other class of which I know. It is true that if one goes to some of the coal-mining districts one sees that there has been some improvement. The reason is that the public conscience was awakened, and I want to tell hon. Gentlemen opposite that it was not they who awakened the public conscience. We had been crying in the wilderness for many years before we could get Church or State to believe that housing was a real necessity. But now we have to remember that in many districts they have been utterly neglected. The fishermen are sadly in need of better housing at the fishing stations at Girvan, Maidens, Ballantrae and Dunure. Every Monday when I am leaving Ayr Station, some fisherman comes up to me and says, "In God's name when is something going to be done for us? When are houses going to be built? They know we need those houses, so why should there be delay in getting them?"

I may be wrong, but in my opinion the reason for the neglect of Scotland— and it is a very strange thing to say of Scotsmen—is that we have been far too quiescent. I remember that years ago we had only half a day for the Scottish Estimates; we quarrelled about that and we now have two days, and they are little enough; but we have not claimed our rightful place, or our rightful share of finance, in our Scottish affairs. That is one of the reasons we have done little or nothing for Scotland in comparison with what might have been done. I do not for a moment want the Committee to believe that I am not aware that great progress has been made. A man of my age knows the real progress that has been made if he compares the position 50 years ago with the position to-day. But Scotland has not made the progress which she might have made, and if my hon. and gallant Friend the Member for Ayr Burghs (Lieut.-Colonel Moore) wants the mens sana in corpore sano, he must agree with me that we must have more attention paid to Scottish affairs and not have the finances dealt out in such a niggardly way as they are dealt out to us to-day. In my opinion, it is most disgraceful that Scotsmen in Scottish affairs should hang on the tail of the Sassenach. I have referred to housing. I think that housing is one of the paramount needs of Scotland. Unless we have good housing we cannot get anything like the people that we desire, even though the idea is to train them for war. I would rather train them to be strong men and women, to he ready to play their part if necessary, but not train them with the idea that they are going to be made into soldiers. While. I am a Scotsman, I am more or less of a peaceable nature.

I have no objection to milk bars, although I would like another name for them. If one asks a friend to come and have a pint, what is the natural conclusion? He might be greatly disappointed. Moreover, milk must be cheaper. From time to time there is a great outcry in Scotland, but the last person to be considered is the consumer; the fight is between the producer and the distributor. Why should that be so? Surely the consumers have as big an interest as anybody. Surely they have a health interest, and if milk is so good and powerful in building up the physique of our children, as I believe it is, why should it not be available at a cheaper rate than it is to-day? No matter how much milk we may be able to produce, if people are not able to buy it, then it is of very little use to them. What we want in Scotland to-day is milk at a cheaper rate than the present one.

In conclusion, may I ask the Lord Advocate, the Secretary of State for Scotland and the Under-Secretary of State not to treat this Debate simply as a high holiday on which Scottish Members air their opinions? I want them to do something so that these things will not recur year after year. I want them to take a real step forward. As I have already said, some progress has been made, but in many directions progress must still be made, and I would implore the right hon. Gentlemen to give us the lead. I believe that at heart, as Scottish Tories, they are patriotic and think only of their country's good. They want to see Scotland flourish and stay on the road of progress. They wart to be able to say with great pride wherever they may be, "I am a Scotsman and Scotland is being attended to because we have Scotsmen at the head of affairs."

6.0. p.m.

Captain McEWEN

I regret that the hon. Member for East Aberdeen (Mr. Boothby) is no longer in his place. His bold and challenging statements I always listen to with interest and they never fail to impress me, but on this occasion should like to direct his attention to page 64 of the Annual Report of the Department of Health for Scotland, where there is a statement on the subject of the birth rate in Scotland. If he examines that paragraph of the report he will see that since 1876 the birth rate has gone down by one-half and I suggest to him that such a thing would distress even Mr. Stalin himself if he saw it. The chief point to which I wish to refer this afternoon, however, is connected with the maternity service in Scotland. On page 63 of the same report the Committee will see the following statement: In a circular to local authorities the Department urged them to consider in the light of the conclusions and recommendations contained in the report, in what direction the maternity services of their area may be Unproved. As a first step it was suggested that they should put in hand a survey of local maternity services. I do not know how far such a survey has yet gone, but I wish to raise the question of the expenses which are incurred when a woman goes to hospital—the expenses of her maintenance in hospital and of her transference there and back. Two cases have been brought to my notice in my own county.

Whereupon the Gentleman Usher of the Black Rod being come with a Message,The CHAIRMAN left the Chair.

Mr. SPEAKER resumed the Chair.

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