HC Deb 16 July 1936 vol 314 cc2279-326

Motion made, and Question proposed, That a sum, not exceeding £15,628,150, 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 Ministry of Health; including Grants, a Grant in Aid, and other Expenses in connection with Housing, certain Grants to Local Authorities, etc., 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.—£6,000,000 has been voted on account.]

4.2 p.m.

The MINISTER of HEALTH (Sir Kingsley Wood)

The Estimates for my Department, which amount to some £21,000,000, show a net increase of some £1,200,000 over those of 1935. The increases arise mainly from increased provisions for housing, improved rural water supplies and health insurance, but the Committee will know that since the introduction of the block grant system the Estimate does not reflect the increase in Exchequer assistance for public health services generally. The additional money included in the block grant for the first period was £5,000,000 a year, and there was an increase of a further £350,000 a year for the second grant period. The growth of expenditure during the period which ends on 31st March next, will also involve a substantial increase in the grants for next year, much of which will be attributable to the development of the public health services.

I think I can say that no country is making such provisions for its social services. During the present year our expenditure on all such services, including the amount raised by local rates, will reach the considerable figure of £420,000,000. I am glad to think that at least some 30,000,000 men, women and children will benefit by one or more of these services. In addition to such expenditure we also have to note a further provision which is being made and which is also playing its part in our national efforts to promote good health and better conditions. There has recently been a considerable expansion in public works. Last year the total amount sanctioned rose from £26,000,000 to practically £36,000,000, a figure which has been exceeded only twice since the War, and then under exceptional conditions. These works include large sums for hospitals, improved drainage, street lighting, public baths, open spaces and water works, and so far as the last-named is concerned the figure is much higher than in any previous year.

Therefore, I can say that much money is being spent, and I believe the nation will not grudge it. But I think it right that we should emphasise the need for careful spending and good administration and the importance of obtaining adequate value for such a vast expenditure. We should not forget that the great purpose of all this expenditure, apart from securing healthier and happier lives for the people, is to increase the number of men and women who can stand on their own feet and shape their own lives with a minimum of dependence on others. I ask this question this afternoon: Is all this expenditure worth while? Are we getting a good return for the money that is being spent? Are our people benefiting? I think I can reply in this way: That better sanitation, better housing, our efforts to improve methods of prevention and methods of diagnosis and treatment of disease, and especially the diffusion of knowledge and a growing interest in the principles of health, have borne good fruit.

As I stated in the course of the Debate last week, the improvement in the health of the nation continne3 and it does not come by accident. There were two significant sign-posts last yeas. We measure length of life by death and we measure communal mortality by the death rate per 1,000 living. The first significant sign is contained in the latest figures furnished by the Registrar-General, which show a death rate for 1935 of 11.7 per thousand of the population. The expectation of life at birth has increased by seven years in the last 20 years. The second sign of the times is to be found in the facts relating to infantile mortality. Last year the figure per 1,000 live births was 57, the lowest on record in this country and one which is satisfactory when compared with even so recent a date as 1929, when it was 74. At last also the maternal mortality rate showed a slight decrease compared with previous years. I wish to remind the Committee that the significance in the decline of the death rate can be better appreciated if we analyse it in terms of persons living in each age group. Of persons living in each quinquennium, from five years of age upwards to 45, the number dying is less than half what it was 50 years ago, and in the age group under five it is less than one-third. There are other interesting figures. At all ages women have the advantage over men. An average woman can count on outliving an average man by between 12 months and four years. The mortality of widows is heavier than that of either single or married women, and at all ages from 25 to 60 the rates of mortality for married women are lighter than those of spinsters. It is not revealed whether a married man has a similar prospect in relation to a bachelor.

Last year the principal infectious diseases showed no unusual or disquieting features. Influenza gave rise to no anxiety; we were entirely free from smallpox. At the same time our knowledge of certain of these diseases has been widely extended. A great deal of light has been thrown on the causation of scarlet fever and its relationship to other infective conditions, such as tonsilitis and erysipelas; and even influenza, the most illusive and deadly of the infections, has been made to yield up some of its secrets, as is shown by the progress of the researches conducted by the Medical Research Council and the Ministry. Unlike scarlet fever, diphtheria has not shown a progressive loss of virulence, but against it we have the aid of anti-toxin and immunisation. Anti-toxin, given early enough and amply enough, has already saved many young lives, and it is now possible by the artificial immunisation of children of the pre-school age to reduce very considerably the danger of contracting the disease in the most susceptible years of life.

So far as enteric fever is concerned, it has been the experience of every sanitary district that the number of cases of this disease has fallen step by step with gratifying precision as the facilities for a proper water supply, proper sewerage and sewage disposal have been increased. But infectious disease is still the cause of many deaths and much disablement in early youth. It is responsible for over 60 per cent. of all deaths from the ages of one to 15 years. But at the same time there has been a remarkable decline in the mortality from infectious diseases during these age periods. Death rates at ages under 15 per 1,000,000 living have declined, in respect of measles from 750 in 1910 to 201 in 1933, in scarlet fever from 200 to 63, in diphtheria from 384 to 261, and in whooping-cough from 798 to 237.

It has been found even possible to turn an infectious disease to a beneficial purpose. Malaria, the greatest scourge of the tropical world, is now recognised as the most efficacious, and indeed the only treatment for general paralysis of the insane; and with a view of making this treatment generally available, the Ministry, in collaboration with the London County Council, maintain a laboratory where mosquitoes are bred and infected with pure strains of malaria for the practice of malaria therapy. During 1935 the laboratory complied with 318 requests for this material, which was received from 118 hospitals in England and Wales, three in Ireland, and one in Scotland. Certain other institutions were also supplied and mosquitoes with benign tertian malaria were sent by air mail to directors of clinics in Austria, Germany, and Rumania.

There is, of course, another side to the health balance sheet. Tuberculosis and cancer, for instance, still take their deadly toll. Nearly 30,000 persons were certified to have died from tuberculosis in England and Wales last year. There has been much advance here also. It is 11,000 fewer than 10 years ago. Cancer is, unfortunately, still one of the chief killing diseases. Deaths from this cause are over 60,000 every year—twice the number dying from tuberculosis. But cancer should not be regarded as a hopeless disease. Although its cause still remains obscure, there are to-day means of treating it such as there have never been before. Only a few years ago the word "tuberculosis" was taboo. People were afraid to mention it. They put off consulting their doctors long after they suspected that they had the disease, for they dreaded to have their convictions confirmed. That attitude to tuberculosis is almost entirely a thing of the past and in most cases it can be cured if advice is taken in time. The same in a large measure is true of cancer. We shall have made a great step towards solving the problem of early and timely diagnosis if we can banish unreasoning fear in the minds of our people. Here, I suggest, is a field in which the local authorities can render great assistance by judicious propaganda as part of their health educational work.

There is another disease which affects many, and which not so many years ago was treated more like a criminal offence than anything else. I should like to say a word or two about our mental deficiency service. In no branch of our public health service has there been such a striking change as has been effected in recent years, both with regard to national outlook and our methods of treatment. We all remember the question, "Can'st thou not minister to a mind diseased?" We can answer that question with more confidence and hope to-day. Much is now being done which has not only transformed the whole atmosphere and outlook of mental treatment but is designed to give better and healthier conditions of living to those who are mentally afflicted. There is the increasingly important part which occupational therapy and recreation are playing in the treatment of mental disorders. There is greater organisation of outdoor games and dancing, and we are told that, for an improving patient in particular, a good hair cut and shampoo have a real tonic value, particularly in the case of young women. The end of 1935 completed the first five years of the Mental Treatment Act which has produced one result so striking and far reaching that it deserves our special attention. It enabled voluntary patients to be received in any public mental asylum, which meant that for the first time rate-aided persons generally could be treated on a voluntary basis. These provisions have had remarkable results. In the first year of the operation of the Act, 1931, voluntary admissions represented 7.1 per cent. of the total admissions and certified admissions 91.1 per cent. The voluntary admissions have steadily increased and in 1935 they rose to 24 per cent. while certified admissions fell to 70.7 per cent. Nearly a quarter of the admissions to public mental hospitals are now on a voluntary basis. I am sometimes told that the mental deficiency service is a costly one, but, from the point of view of finance alone, if we did not provide proper and humane provisions for the defectives, we might well have to pay a bigger bill in all the social and other consequences which would ensue if we failed to undertake this work. I am glad to think that there are higher and better motives which animate us all and advance in this service is bringing control and self-respect to many sufferers.

We should not forget that the Cure and prevention of disease is, after all, a negative policy unless it is aided by schemes to promote health. Much also can be done by the self help of each individual citizen. The nation is undoubtedly becoming more health minded. We see it particularly in the younger generation in their growing appreciation of the importance of keeping fit, and in the increasing value that they place on physical recreation and the open-air life. But there is one aspect of health affairs which provokes some attention and cannot be regarded with the same satisfaction. Our unquenchable medicinal thirst still continues, and it is suggested with some truth that we are rapidly becoming a nation of confirmed medicine drinkers. In Scotland doctors generally have never adopted the custom of dispensing medicine for their patients, and the patients have not been induced to consider a bottle of medicine a necessary corollary of a visit to a doctor. In England, on the contrary, for generations past doctors have themselves, with few exceptions, dispensed medicines and their patients have come to regard a visit to a doctor as synonymous with the receipt of medicine. In the result the cost of providing medicine per head of the insured population in England regularly exceeds that in Scotland by approximately 50 per cent. There are no known facts connected with the incidence of disease in the two countries to account for this wide divergence in the cost of medicine, and no one will suggest that the standard of treatment of the Scottish practitioner is lower than that of his English colleague or that his results are less satisfactory. In fact—these are rather remarkable figures—there were no fewer than 57,000,000 prescriptions issued in 1934 under the Health Insurance Acts. Of course, drugs are necessary, but medication by drugs is not enough, or perhaps is too much.

I have spoken of our health efforts. Let me now speak of what we are doing in co-operation with other nations. Those who may have doubts about certain aspects of the League of Nations should have none with reference to the value and importance of the League's medical work. Our own representatives there have played a considerable and distinguished part not only in the periodic statistical reports on international hygienic co-operation but in the cordial co-operation between the medical men of the different nations of the world in which good work has been and is being done. One of our leading medical journals put it like this: It is in the habit of quiet serious cooperation of men and women of different nations, having in common a medical training and a desire to solve some scientific problem, that the Health Organisation has carried out its best work. Good health is bound up with good housing and I want to say a word about that. There has been an unprecedented output of houses since the War. It has played an important part in the national recovery and in the increased employment that it has provided. Last week I made a quotation from the right hon. Gentleman the Member for West Stirling (Mr. Johnston). I will make another, because it is equally satisfactory to me. He said a few weeks ago: I should say our generation has made its big contribution to housing reform. We have certainly done more in the last 15 years to provide decent homes for the people than any previous generation ever did. The slums are going. Ten years more and the foul, sanitationless human death traps from which capitalist investments reaped profit will have gone. I think that is a very fair statement so far as the health aspect is concerned. Well over 3,000,000 houses have been erected since the Armistice, and a gratifying feature in recent building activity has been the increasing proportion of houses built for people of moderate means. Out of 323,926 houses built last year, 271,389 were built by private enterprise without assistance, and 90 per cent. of that total were houses up to £26 rateable value. It is remarkable how these figures have risen, because in 1926 the proportion was 70 per cent., in 1930 it had risen to 74 per cent., and it is now 90 per cent. Only in the last two years have statistics been obtained by my Department which enable us to distinguish houses built for letting and houses of a rateable value not exceeding £13. During that two years unassisted private enterprise has been building small houses not exceeding £13 rateable value at the rate of 100,000 a year, and a third of these have been built to let. The returns so far as local authority building is concerned are equally satisfactory. I want to encourage both. The last half year was the best building half year that we have ever had, no fewer than 174,000 houses having been built for the half year ending 31st March, 1936, the best previous one being 168,000 in the half year ended 31st March, 1935. The output of houses by all agencies shows how substantial has been the addition to the supply of working-class accommodation in this country. I will refer to three records because they are most remarkable and encouraging. The real and greatest housing needs at the present time are small houses and houses to let, and for the half year ended March, 1936, local authorities and private enterprise—this is for six months only—provided no fewer than 80,000 small houses, easily a record for the country. As far as houses to let are concerned they are now being built, I am glad to say, at the rate of 100,000 a year, which is another record.


What about the rents?


I find that at the Department there is no record of rents, but I have thought that it would be advisable for the Departments to have some information about rents and I am asking local authorities to supply it to me.


For the purposes of having a correct comparison, is the right hon. Gentleman able to say exactly how many of these houses have been built by local authorities and how many by private enterprise?


I will ascertain the exact proportion and let the hon. Member know during the Debate, but it is one of the most encouraging signs of the times—and I am sure that the hon. Gentleman will agree with me—that private enterprise is now beginning to build small houses and also houses to let.


Very few.


My hon. Friend the Parliamentary Secretary thinks that it is about half and half, about 50 per cent., but I will find out the exact figure. I am glad to say that slums are going. Successful progress is being made and already some 400,000 slum dwellers have obtained new and better housing accommodation and at this period slum dwellers are going to new and better homes at the rate of about 6,000 every week. There is every reason to believe that, except for a few large towns, the programmes of local authorities will be well completed within the five-year period. For the benefit of the right hon. Gentleman the Member for Wakefield (Mr. Greenwood), because he will be interested in these figures, I should like to make an addition to what I said about housing in my observations last week. In my speech in this House last week I gave some interesting figures from Manchester to dispel the suggestion which is sometimes made that health has not improved by transference from the slum to a new housing estate.

I said that I was obtaining similar figures from other towns. I wanted to have something for the right hon. Gentleman this afternoon with special interest to him, and I have now the figures from Wakefield. They cover a smaller population than the Manchester figures, but they are no less striking. The figures which I will give for Wakefield relate to two slum areas with a population of about 1,150, and a new estate with a population of 2,500. I will give the death rates for the whole city, the two slum areas and the new estate. The crude death rate for the whole city is 13.3, but in the slums it is 17.3, and on the new estate 8.8. The infantile mortality rate in the city is 64, in the slums 147, and on the new estate 43. I could give a number of other figures of the same character, but Wakefield—and I know that the right hon. Gentleman will agree with me for he has never supported any other suggestion—certainly confirms the view that slum clearance is worth while.

I want to say a few words about overcrowding. It is now possible to say that the great proportion of local authorities will soon be proceeding with the actual abatement of overcrowding itself. The Housing Act of 1935 set up a statutory universal standard by which overcrowding was to be measured, and machinery to ensure that at the earliest possible date no family in this country should have less than the minimum accommodation provided in accordance with the statutory standard. The standard adopted, in my judgment, is a beginning. It represents the minimum amount of accommodation capable of early enforcement, and I hope and believe that the standard will no doubt be improved as progress is made in our present housing efforts. It should not be forgotten that in the meantime overcrowded families who are rehoused by the local authorities will be rehoused on the basis of standards laid down in Section 37 of the 1930 Act as appropriate to the rehousing operations of local authorities. I am glad to say that the appropriate surveys have, for the most part, been made.


The right hon. Gentleman says that the local authorities must rehouse on the basis of the standard in Section 37 of the 1930 Act. Have private owners to do the same?


No. I was telling the Committee that the appropriate surveys have for the most part been made, and that for at least three-quarters of the authorities in the country and for at least three-quarters of the area, 1st January will be the appointed day for bringing the overcrowding code into operation in this country. I have fixed 1st August as the date by which all local authorities are to submit their general proposals for the provision of rehousing shown to be necessary by the overcrowding survey. I will say—again I think with general agreement—that the execution of these two programmes, slum clearance and overcrowding, will provide a substantial building programme for local authorities, but it is a programme which, in my judgment, is well within their powers, and it is not outside their capacity, and I do not think that it competes with the maintenance of activity by the building industry itself.

I would now like to refer to one or two what may be called subsidiary matters in connection with housing, although I would not like so to describe these matters. Undoubtedly many problems arise from the great exodus which is taking place, and to many people who go to the new estates it is not a small matter to uproot the family and transplant them in strange surroundings, often removed from former neighbours and friends. I am glad to think that there has been a great response by large numbers to the better conditions in which they now find themselves, and that there is a real pride taken in their new homes. But many miss the old stir and the scenes and attractions of the city and the town, and I believe that there is a great need for providing for their social interest, clubs and institutions. Leisure for many is increasing, and I attach great importance—and I have myself called the attention of local authorities to it—to the need for community centres and matters of that kind. The local authorities possess the necessary statutory powers, and many are already doing something in this connection. In all these cases, or, at any rate, in the great majority of cases of large aggregations of people, some provision of this kind is very necessary and right. I hope and believe that it will be forthcoming. What is, perhaps, almost as necessary as these community centres is that we should secure the right type of leaders and organisers among men and women who can make these things thoroughly successful. I believe that a great deal can be done in that particular connection.

I would also say that in housing—and the Committee, again, will agree with me—quality as well as quantity is important. It is useless for us to replace old and unfit houses with houses which fail to provide conditions conducive to health, amenity and comfort. It is not only important that our standards of construction should be high, but that the type of house built should be suitable both to the needs of those to be housed and for the character of the district. I have recently communicated a number of suggestions to the local authorities as to the type of house to be built under the 1935 Act, emphasising that the execution of their schemes should be entrusted to persons of experience capable not only of producing well-built houses but houses of architectural merit. It is possible for a new house to be healthy and comfortable, and at the same time unpleasing to the eye of the beholder, and it is also possible for an old cottage to be picturesque to the eye and a source of discomfort and ill-health to the occupant. I suggest that in our new houses there is no reason why we should not combine the virtues and avoid the vices.

The enforcement of local by-laws play an important part in the control of building standards, but they deal only with a certain part of the building structure, and the administration of by-laws cannot take the place of full specifications and proper and continuous technical supervision. I was very glad indeed to note the assurance, as I daresay did the right hon. Gentleman, recently given by Sir Harold Bellman on behalf of the building societies, that they would do all they could to co-operate in this matter, and I believe that they can do a great deal. Many private purchasers of small houses have to buy their houses ready built. They are often not in a position to employ an architect and to have the building carried out to specification, and a number of complaints have been made in this connection that houses have proved to be defective. I am very glad to bring to the attention of the Committee this afternoon the fact that in order to meet the needs of these people the National Federation of Building Trades Employers have advanced a scheme for the future establishment of good house building standards, and the essential of the scheme is that builders should undertake to conform to a full specification and give a guarantee to that effect to the purchaser. The house itself would be certified by a central body set up by the federation. I have referred the matter to the Central Housing Advisory Committee to consider and report. Certain difficulties undoubtedly may yet have to be overcome and certain adjustments may be necessary, but I welcome the proposal as an earnest endeavour on the part of the building industry to help to eliminate the jerrybuilder from our midst.

It has been conveyed to me that the hon. Gentleman opposite would like me to say a few words about planning. It is in the nature of planning that the results are for the most part in the future, but here also I am glad to know that much progress has been made. At the close of August, 1931, over 7,000,000 acres of land were under planning control. County councils were only just beginning to interest themselves in the work and few effective measures had been taken for the preservation of the countryside, but I am glad to say that there was much agreement among all parties on the importance of planning and even of the methods by which it should be carried out. The National Government took over from their political opponents the Bill which became the Town and Country Planning Act, 1932. I will give a few of the results that have come about as a result of that Act. There are two main matters of note, speaking generally in connection with planning, to which I should like to refer. What has been very necessary has certainly come about, and that is the co-operation which landlords, both great and small, have willingly extended to the planning authorities, which has shown that there is genuine support for planning in all classes of the community.

In the second place, in regional planning local authorities are, for the most part, co-operating well, and much is owed to the county councils who have availed themselves of the Act of 1932 with enthusiasm and determination, for which no praise can be too high. The result has been that on 31st March, 1933, there were over 9,000,000 acres of land being planned. In the past three and a-quarter years the figure has more than doubled, and is now nearly 20,000,000 acres, or more than half the total acreage of the country. The half of the country under control is the half where building development is going on, or where some particularly fine stretch was threatened with spoliation.

As far as regional planning is concerned, there are 122 executive joint committees in existence, many of them operating over wide areas. Much, I am glad to say, has also been done by way of interim development control. I would suggest that the results of planning are already manifest in many parts of the country. For instance, by the efforts of the two Sussex county councils and the help of landowners the South Downs have been saved from sporadic building. Surrey is doing the same for the North Downs, and schemes for preservation are making good progress in the Lake District, on the Norfolk Broads, in the Peak District and Dovedale, and large areas are annually being reserved by planning authorities for public open spaces. So far as housing is concerned I am under a considerable debt to the Housing Advisory Committee, which I had the honour of setting up some time ago, and upon which several hon. Members of this House have been most helpful in all their work. I can report to the Committee that the Housing Advisory Committee is doing good and useful work and is a very valuable adjunct to the Ministry.

As to maternity and child welfare work, I do not think there is much need for me to refer to it in detail, because on the introduction of the Midwives Bill I gave a report of the continued progress that is being made in the provisions generally for the mother and the Child. I should, however, like to say that further steps have recently been formulated through local authorities with a view to securing systematic and periodical health visiting for all children under the age of five who do not attend school, as part of our policy of making provision for those gaps which at present exist in the services.


Is that to be compulsory?


It is a matter for the local authorities, but I have communicated with them and I have no reason to suppose for a moment that they will not do all they can in connection with this matter. I have also endeavoured to give every encouragement to day nurseries for young children whose mothers go out to work or whose conditions are such that their health would benefit by the daily supervision that can be obtained through a day nursery.

Let me say a few words about water supply, in case the right hon. Gentleman the Member for Wakefield may say that I have forgotten it. The authority for water supplies is my hon. Friend the Parliamentary Secretary, who is a water diviner. In the urban areas the position generally is satisfactory in that supplies are adequate to meet present needs and any demands likely to arise in the near future. As far as rural areas are concerned, with the aid of the £1,000,000 grant there is no doubt that the back of the rural water problem has been broken. Schemes, with the aid of the grant, have been undertaken in 2,350 parishes, at a total estimated cost of £7,000,000. In addition, since March, 1934, loans have been sanctioned totalling £1,340,000 for schemes in 400 parishes. Regional advisory water committees have been established in eight areas for a population of 14,000,000. I am now awaiting the report of the Joint Select Committee of the two Houses who are considering the better conservation and organisation of the water supplies and resources of the country. When I receive their report I hope that it may be possible for me to take further action in regard to it.

I am much indebted to the Committee for listening to me so long and patiently. I hope they will not think that I have unduly trespassed on their time, but we do not have many opportunities of going into these matters, which are of considerable moment to millions of our people. While we spend, of necessity, much time on other matters, I do think it is well for us to spend, at any rate, one day in considering matters so vital to our fellow-men and women. I hope the Committee will feel that so far as my colleague and I are concerned, although we of necessity have had to recount progress that has been made during the year, I have indicated sufficient to assure them that complacency and self-satisfaction can play no real part in our work, because there is still very much to be done.

I think the claim can be legitimately made that steady and continuous progress is being made in the building up of the health of the nation. That is in the main due to those vast numbers of men and women, for the most part unknown, who serve on our local authorities or in connection with our fine voluntary organisations. It is also due to our general practitioners and other doctors, to the nurses and the men who spend long days and nights in laborious research, and not least to the devoted officers and servants of the State and the municipalities. It is through these agencies, aided by an enlightened public opinion and generous public aid, that we are surely securing the purpose for which the Ministry of Health was instituted, namely, to improve the health and happiness of our people throughout the land.

4.55 p.m.


I cannot understand the unusual modesty of the right hon. Gentleman. I have never regarded modesty as one of his major qualities, and I see no reason why he should have apologised for keeping the Committee in the performance of his duty and informing them of the activities of his Department. I have learned a new phrase this afternoon. I have learned a description of the right hon. Gentleman for which I have been searching for years. When I sat on the Front Government Bench and the right hon. Gentleman sat over here I wondered how to describe him. Now, I have got the proper description—"a benign mosquito." I thank the right hon. Gentleman for his perfect self-description.


It is excellent for the treatment of the insane.


I am drawing no conclusions from the right hon. Gentleman's description. Now that he sits there he is no longer a benign mosquito. He is a sort of benevolent uncle. I think there must have been some transmigration of soul. Perhaps at some future time, when political fortunes change, the right hon. Gentleman may really become a benevolent uncle announcing the Children's Hour at the B.B.C. He has made a speech which one anticipated in which, by implication, he attributed the whole of the nation's progress for the last 50 or 60 years to the actions of the National Government. But I am glad to think that, also by implication, he at least paid some tribute to Acts of Parliament which were put on the Statute Book when we occupied opposite places in this House His references to the operations of the Mental Treatment Act and the Housing Act, 1930, are to be welcomed on this side of the Committee.

The right hon. Gentleman occupies a post of very great importance, and I am certain that he feels proud of the position, because he realises individually, if not collectively, that it is far better to heal the sores of an imperfect social system than to pave the way to war, that clinics are far better than bombing aeroplanes and that maternity centres and hospitals are infinitely superior to casualty clearing stations. I hope the right hon. Gentleman is going to look very closely to the interests of the social services which he administers and supervises, and which it is part of his duty to inspire. I regard our social services, which have been built up by all political parties in the State for three or four generations, as one of our greatest national achievements. They have been built up clumsily, it is true. They have not been conceived as a perfectly coordinated system. They have, in the curious British fashion, been moulded to meet insistent social evils as they have imprinted themselves on the public mind, but without our social services this country would be infinitely weaker and poorer than it is to-day.

One of my chief criticisms of the last five years is that the National Government thought it necessary in what they regarded as the national interest—I am trying to be as unprovocative as possible to-day, which is rather a new role for me to play in this House—and in their wisdom, to put a break on the big social services and to damp down the greater progress that might have been made. I cannot believe that even in a financial crisis that was wise national policy. Money can be saved, but health, life, vigour and vitality once they have gone can very rarely be restored. We look forward to the right hon. Gentleman taking off the brake and giving the signal for full-speed ahead. I should like to ask him to try to persuade the Chancellor of the Exchequer, who has also occupied the office of Minister of Health on more than one occasion, to loosen his purse-strings for the constructive social services, and to show the same generosity there that he has shown to the rearmament programme of the Government. Again, I am not trying to be provocative; I am restraining myself, but it is unfortunate that while the Chancellor of the Exchequer has declared how sorry he is that he can find no money for the social services, the three fighting Services find in him an openhearted friend. In the view of the Labour party the social services of this country are absolutely fundamental to national well-being, and we look to the right hon. Gentleman the Minister of Health, as the standard-bearer of our cause, going out to do battle with the Chancellor of the Exchequer.

I have had some little experience of Chancellors of the Exchequer and they all seem to be equally parsimonious. No Chancellor of the Exchequer has ever rushed into another Department offering promissory notes. To get money out of the Chancellor of the Exchequer is like getting butter out of a dog's mouth. But the Minister of Health has this advantage, that the Chancellor of the Exchequer is an ex-Minister of Health and has boasted on many occasions that as a result of his mighty efforts as Chancellor of the Exchequer in successive Budgets, he has rescued the country from national ruin and put it on a basis of prosperity. If that be true, the social services should share in the prosperity. The right hon. Gentleman's Estimates do not show that this is happening. His Estimates this year are increased because of perfectly automatic increases, which would have taken place altogether apart from any alterations in legislation. I would do everything I could to help the right hon. Gentleman to carry on his work. There is one suggestion I want to make. I could not carry it out myself, because I do not possess the art of advertisement, which is one of the qualities of the right hon. Gentleman.


Perhaps you have nothing to advertise.


I am not sure that the right hon. Gentleman has very much to advertise. I do not want to be drawn into making a provocative speech. I am only saying that the right hon. Gentleman when he was Postmaster-General did put the Post Office on the map. He did that by advertising. Why should he not advertise health? He was made the chief propaganda officer of the National Government because of his great capacity for advertisement, which I acknowledged fully, and entrusted with the enormous responsibility of trying to advertise a decaying National Government, a task which he did with a certain amount of success—I admit that, too. Having these great qualities, which I do not possess myself, I hope he will use them to the advantage of the public health services of the country and, in an American phrase, advise the people to buy health. I am sure he could do it admirably, because his experience as Postmaster-General has proved it. We all desire to see a development of the health services, and now that there is a return to prosperity I hope the right hon. Gentleman will do something actively and vigorously to promote the health services.

I am not going to discuss the question of malnutrition as it affects the right hon. Gentleman's Department. He wound up his speech by saying that neither he nor the Parliamentary Secretary found any reasons for complacency. I agree. There is no reason why anybody should be complacent about the situation in the country in regard to the health of the people, but I think the right hon. Gentleman was inclined to be a little complacent as to the question of malnutrition. He has it in his power by moral pressure and lofty appeals to do something in the matter of the nutrition of our people, by means of the provision of milk and meals for expectant and nursing mothers, and for infants and young people under school age. A considerable number of local authorities do provide for expectant mothers, and many of them for nursing mothers, milk or meals. I should like the right hon. Gentleman to carry out a great advertising campaign, because he is par excellence the real advertiser of the Government, and do something to get local authorities to do rather more than they are doing now in the way of the provision of nutrition for expectant and nursing mothers. I am not denying that a good deal has been done, and what information is available goes to show that the provision is of great social value. I am sure that the right hon. Gentleman will agree that if all mothers could be assured of proper nutrition we might make some impression on the problem of maternal mortality, and we should certainly make a considerable impression on the standard of physique among our people.

I was glad to hear the right hon. Gentleman say that he intends to do something for the toddlers between one year and five years. It is unfortunate that the drive which took place up to 1931 for better provision for children under school age was stopped, and that the progress which has taken place since, compared with the previous development, has been negligible, but I am glad that the right hon. Gentleman is now taking this question into his consideration. He has put on the Statute Book this Session a Midwives Act. I told him my views of the Measure on the Second Reading. It is a good Measure as far as it goes, but it does not go very far. I hope the right hon. Gentleman who has made this contribution to the solution of the problem of maternal mortality, in which Members on all sides are interested, will back up the Act by a co-ordinated campaign to bring pressure on local authorities to develop other powers which already exist to deal with this problem, the development of ante-natal services, increasing the provision of maternity homes and hospitals, and urging upon the people the tremendous importance of the provision of home helps. He has the power not to command but to charm, the influence to attract local authorities to extend their activities in these directions.

The right hon. Gentleman spoke about the progress of town and country planning, and I am glad to think that the Town and Country Planning Act is making progress. I realise the difficulties and delays which are inherent in a problem of this character, but I hope the right hon. Gentleman will leave no stone unturned and will press on as rapidly as possible. It is true that certain progressive and far-sighted local authorities in the country, as well as other bodies and also large landowners, have cooperated with a view of saving some of the finest stretches of our country. I hope this will continue, but it is, nevertheless, also true that London and the great provincial towns still go sprawling out into the country in a most disorderly, untidy and irregular way. Every week on every road outside every big town in this country you will find this nasty bungaloid growth extending into the heart of the countryside. I hope the right hon. Gentleman will see his friend the Minister of Transport about this. It was a little unfortunate that the right hon. Gentleman's predecessor allowed another Minister to steal his thunder.

I am not concerned with ribbon development merely from the point of view of speeding on the roads, but as a problem of social organisation. All that kind of growth is socially inefficient. All the provisions that have to be made, whether it is water, gas, electricity or other social services, are infinitely more costly if they have to be provided for these long ribbons of houses than if they had to be provided for properly organised houses set back from the main roads. Even now this thing, which is offending the conscience of all intelligent people, is being permitted in spite of the legislation in the Town and Country Planning Act and the legislation passed by the Minister of Transport. The London-Cambridge arterial road is a case in point. Day after day the dreadful stretch of new buildings continues. The right hon. Gentleman really ought to do something about it in conjunction with his colleague the Minister of Transport, now that they have a joint responsibility in the matter. It is important that every atom of intelligent public opinion and public spirit in the country should be mobilised behind a movement to save what is left. I hope the right hon. Gentleman will do all he can to prevent this untidy, unscientific and ugly development on the outskirts of our great towns.

The right hon. Gentleman referred to the housing position and drew what comfort he could from the building of houses. We must not close our eyes to the hard facts of the situation. The truth is that the overwhelming majority of houses which are being built to-day are houses built for sale. That is a fact which cannot be denied. Moreover, I grieve to say that a very large number of those houses are of a quality of which the right hon. Gentleman could not possibly approve. That is the case on the outskirts of our towns, and on the outskirts of London I have seen many hundreds of houses which violate any decent standard of building regulations. They are being built purely for profit by people who are exploiting, as it were, the needs of a very large number of people for housing accommodation. People are being driven to purchase houses, and unfortunately they will very shortly find themselves compelled to make considerable expenditure because of the bad quality of the houses that are being built. But the building of houses for the middle classes is not the real problem although, as long as we have the middle classes, I admit that they are entitled to housing accommodation like everybody else. The real problem has never been the housing of the middle classes, because private enterprise has always been prepared to satisfy that need.

The problem which faces us to-day is the building of houses to let to working class families at a rent within the compass of the ordinary working-class in- come. That problem has been stated from every bench in the House for years past. What is disappointing in recent figures is the number of houses built to let. The greatest contribution made since the War to the building of working-class houses was the Labour Government's Act of 1924. No one before or since has made anything like as large a contribution to the solution of this problem as was made in the Wheatley Act of 1924. Unfortunately, that Act has gone; it was massacred in the great massacre of 1931. At that time I also was one of the massacred. In place of that Act, we had the Housing (Financial Provisions) Act, 1933, which was passed during the period of office of the late Minister of Health. That Act has been a dismal failure. In place of the Wheatley Act, under which it was possible to build thousands of houses per year, we had the Housing (Financial Provisions) Act, 1933, by which local authorities were, in fact, discouraged from carrying on this work and private enterprise was to be encouraged to carry it on by means of guarantees. We were assured from that Box that that was the way in which to solve the problem of working-class housing. Up to 31st March of this year—nearly three years after the coming into operation of the Act—the total number of houses for which guarantees were given was 10,000. That is what was brought forward to fill the gap caused by the destruction of the Wheatley Act of 1924. The right hon. Gentleman did not refer to that Act, and I am not surprised, for it was not to his interest or credit to do so.

The only Housing Act which is effectively operating at the present time is the Act of 1930, with which I had a little to do, although I have noticed that it is never admitted on the other side of the House. There, of course, progress has been made, although it has not been nearly as rapid as one would wish. Let me analyse the figures. I hope my figures and those of the right hon. Gentleman will tally, because I did not understand some of the figures he quoted this afternoon; I do not say they were wrong, because obviously they were right. I would like to refer to the number of houses built by private enterprise, and let hon. Members remember that it is private enterprise which is to-day left in control of the field, apart from the problem of slum clearance and something which is called overcrowding, which I fail to understand as a special problem. During the half year ended 31st March, 1936, in the case of houses having a rateable value not exceeding £13, or £20 in London, the total number built by private enterprise was 52,735. Of those houses, the number occupied by persons other than the owners—that is to say, those which were let—was 18,793; in other words, only one-quarter of the smallest type of houses were built to let.

If one takes houses having a rateable value exceeding £13 but not exceeding £26, or in London £21 to £35, 74,299 houses were built during the same half-year, but of that number only 14,753 were occupied by people other than the owners, which means that only one-fifth of them were built to let. The whole problem is the building of houses to let, and in that respect private enterprise is clearly not filling the bill. Under the restrictive legislation, which I cannot argue this afternoon, the local authorities are building far less than they could build and far less than they used to build, and they are building on a scale which is not commensurate with the need of the working classes for houses. The time will very shortly come when this boom in speculative building will come to an end. The market is slowly but fairly definitely becoming saturated. We shall then be left with a vast building trade in this country hungering for something to do.

There is still left the problem which has been attacked by Government after Government and which has only been partially solved, and that is the provision of an adequate supply of modern, well-equipped houses, capable of standing for two generations, for the masses of the peope of this country. I hope the right hon. Gentleman will realise his responsibilities and I hope that if he lives long enough—I mean politically until next Session—he will find it in his heart to do something more in the matter of housing legislation than was done by the right hon. Gentleman who preceded him. The Overcrowding Act is only at its beginning, and I wish the right hon. Gentleman well in the administration of that Act, although in its case I am bound to make the same prophecy that I made with regard to the Act of 1933—which has been proved right three years afterwards—and to say that the Overcrowding Act will not be a staggering success. I think that, like the Act of 1933, it is likely to prove a failure. If the right hon. Gentleman the Minister of Health will brave the anger of the Chancellor of the Exchequer, if he will go out—as he suggested this afternoon he wished to do—as a bold crusader, nobody will like it more than hon. Members on these benches. We are glad to think that the right hon. Gentleman takes a joy in the improvement of the health of the people in my constituency, but let me say that that does not disprove the case made on these benches. I noticed that the right hon. Gentleman did not quote the case of Manchester, although he said he had the figures; but perhaps that is only because we are both going there next week, and he is saving his speech for that time. We rejoice to think that the right hon. Gentleman takes pleasure in these achievements. We wish any Minister of Health well in his work. No Department of State has better friends than my hon. Friends on these benches when the Ministry is doing the work for which it exists.

We have never taken part in Debates such as this in any bitter partisan spirit, although if ever I open my mouth at this Box somebody on the opposite side is sure to interrupt me within three minutes, even if I try to coo like a dove, which I admit is difficult for me. On these benches we have never been bitterly hostile to any Minister of Health who tried to carry out his responsibility in a generous spirit. We are hoping that the right hon. Gentleman will do that, and will live up to our views about him. I can say in his presence that he is the best Minister of Health I have known since 1931, and so long as this Government continues, I hope he will continue to hold his office. It is one which he understands, one with which he is familiar, one which he adorns now, one with which he has been associated in the past and one in which I am perfectly sure he finds his deepest interests. I wish him well in his work, and I hope he will do better in the future than he has done in the past. I hope he will be the bold dragon who will frighten the old lady, the Treasury, who is so diffident about providing him with the resources which he needs to carry on his work.

5.28 p.m.


I would like to refer to some of the matters with which the Minister dealt in his very interesting speech, and perhaps to one or two other matters as well. I will begin by saying a few words about housing. I think it will be generally agreed that the progress which has been made, whether under Acts passed by one side or the other, in the great task which amounts almost to the rehousing of the nation, is very remarkable indeed. I think all hon. Members were glad to hear the figures which the Minister was able to give this afternoon, and I would like to join in congratulating the Minister, the Under-Secretary and the very over-worked civil servants in the Department who deal with housing matters. They are undoubtedly now trying to press forward as much as they can to get local authorities actively to work in this very important matter.

I will not repeat the point made by the right hon. Gentleman the Member for Wakefield (Mr. Greenwood)—although I entirely agree with him—about the lack of small houses to let. In his dovelike speech, the right hon. Gentleman truly said that that matter had been sufficiently dealt with, and I will pass on to something which I think is also important. We know that the Ministry will concentrate, as far as new work is concerned, for some years to come largely on seeing that the overcrowding which is now being reported by local authorities is thoroughly tackled and new houses provided to replace those which are overcrowded. But there is one point which ought not to be forgotten and which relates particularly to the rural districts. It is that the standard of an overcrowded building was put so high in the recent Act, on which the authorities are now working, that it leaves the normal village practically untouched. That had to be done in order to present a task which would be within the competence of authorities in places like London where there are still terrible conditions of families living in one or two rooms.

That being so, I was glad to hear the Minister use such words as "minimum" and "beginning" in connection with this work. The standard of reasonable floor space which was set up in that Act, allowing two adults and four children under 10 for each room, means that the normal five-roomed country cottage may contain not one but two families of father, mother, and six children, without being declared to be overcrowded. Thank goodness, people do not live in that way in the villages and though the Minister will find from the reports which, no doubt, have been coming in during the last few months, that there is a sprinkling of cases of overcrowding in some of the rural district council areas, I think on analysis it will be found that most of them come from the back courts of the old-fashioned country towns, rather than from the rural villages. Yet though we have not technical overcrowding there, those of us who know our villages could give the Minister cases of young men and women of the best country stock, who are waiting to get married but who cannot do so because they are unable to find decent cottages in which to live. As a result, they tend to drift to the towns where the prospects of permanent employment are not so good and those are just the people who ought to be staying in the country.

We have not really got to grips with this problem. The cure depends partly on matters beyond the range of our discussion to-day but a certain amount could be done by administration. I believe that one way is the more active administration of the Housing (Rural Workers) Act. That Act does not normally produce fresh houses but buildings which have not previously been used as dwelling houses can be converted into dwelling houses in some cases, and houses which are dark, damp, leaky, and insanitary and likely to become unfit for human habitation if left alone can be made into houses which the younger people are glad to live in, as the older people pass away. That is one of the things which we want to see.

I have not seen the recent figures, and I should be glad if we could get some of them in the course of the Debate, but I believe that the county of Devon still keeps very well ahead of others in this respect, and that one of the divisions of Suffolk has done very good work. I could wish that the county from which I come was not so easily ahead, and that other counties were finding the benefits of active administration of that Act while it is still on the Statute Book. There is one other point concerning housing, on which the Minister touched. It is that the new houses which we hope are to be built by local authorities should be built to plans properly drawn by architects. The Minister referred to persons of experience but did not specify their qualifications. I am not sure whether the Ministry are aware of how many authorities are in the habit of employing architects and how many leave it to their sanitary inspectors to design these houses, which is generally a most vicious, and, in the long run, uneconomical and wasteful thing to do. I hope the Minister will do all he can to see that the new houses are seemly, and that they fit in with the rural surroundings in which they are so often built.

Another point arises out of the very interesting facts and figures given by the Minister in connection with the state of public health. It has become almost a commonplace in these Debates that we should congratulate ourselves as a nation on the great advance which has been made in the last generation in public health. It is remarkable how we have been learning the art of right living and, as the Minister said, steadily becoming more health-minded. The right hon. Gentleman mentioned an added expectation of life of seven years in the last 20 years, and an added expectation of something like nine years in the last generation. I believe that a male child born now can expect to live almost to the age of 60 which is very remarkable. I do not wish to depreciate the wonderful work which has been and is still being done, but I would draw attention to something which seems to me to be very important. I think that the science of sanitation and practical methods of preventive medicine have been developing faster than our mastery of the principles on which disease can be cured, but there are some definite and positive advances in the curing of disease. The Minister referred to one or two of them. There is the treatment of diphtheria by therapeutic immunisation which is a very remarkable development. That method has not been extended as widely as it might have been. In the case of heart disease we find that the deaths in 1926 were 69,000 and had increased in 1933, the last year for which I have the figures, to 120,000. I think it was Sir George Newman who once stated that a large proportion of these deaths were of people under the age of 25.

When one considers things of that kind, one realises that while doctors may be taught, and undoubtedly are taught, a great deal about anatomy and pathology and the mechanism of circulation yet they know very little about how to cure heart disease. Though a layman I have some ground for saying that if more study were given, in training and in practice, by the medical profession to the method of therapeutic immunisation, that sort of thing could be improved. I do not want to dilate on this subject, but I have reached the conclusion that the time has come when the Minister might, in Conjunction with the Privy Council Office, cause the question of the medical curriculum to be reconsidered? If that is to be done, it is not much use having it done mainly by persons who have themselves been trained on a particular curriculum 40 years ago and have been training other people most of the time since then, on nearly the same curriculum, and who are pretty well wedded to the present system. I believe that an intelligent layman who was willing to keep an open mind might be of real use to the Minister in examining that matter—quite as useful as some of the heads of the medical profession whose minds in my experience are apt to be as inelastic as the arteries of their elderly patients.


Is the right hon. Gentleman aware that the medical curriculum has been recast at least 10 times in the last 20 years, and that a special committee of the Medical Council has been considering it for the last six or eight months?


Yes, I am in close touch with all that and I know that modifications have been made in the last 20 years but the general impression produced on my mind is that the more it changes the more it tends to remain the same thing.

I would next refer to the subject of water supplies. I understand that the sum of £1,000,000 set apart for rural water supplies has been expended but, in spite of that fact, I hope there will not be any slacking off in the work of developing these rural water supplies. I hope we shall not find our local authorities acting in the same way as the legendary persons who lived on opposite sides of a stream which at times became a torrent, and who desired some permanent means of communicating with each other. When the torrent was rushing down they said they could not build a bridge, and when the torrent dried up they said there was no need for a bridge. I have heard that some local authorities are suggesting that as we have been through a few years of drought, we are not now likely to have any more drought, because of some sun spots or something of the kind. I think that is a mistake and that there is as much need to proceed with this work now, although there has been plenty of water during the past winter, and indeed during this summer, as there was some time ago when water was scarce. In the work of administering the Housing (Rural Workers) Act we are constantly having cases in which we are not able to make grants for putting houses in proper order, because there is no water supply within a reasonable distance and there cannot be such a supply until some district scheme has been carried into operation. Therefore, we have to suspend the payment of grants until a district scheme comes along. These district schemes are rather slow in coming and I wish there were more of them.

I am afraid I am skidding about rather a lot, but I wish to refer to the administration of the Dentists Act. As chairman of the Dental Board I have tried to do what I could to develop what has been called dental health propaganda. It takes the form of bringing the importance of better dental health to the notice of the children in the schools and their teachers. This is done by means of travelling exhibits, by good advice to those who are leaving school, by the distribution of books, and other things which are outside the range of this Debate. There has been a definite and steady improvement in the provision of school dentists but that again is a matter which we cannot discuss on this occasion. It is after the children leave school—and more and more of them are leaving school now with their teeth in fairly good condition—that the bad period comes. It is true that they get into dental benefit under national health insurance later on and I know that over £20,000,000 has been spent on dental benefit alone, which is a very good thing but what has been borne in upon me in the course of 10 years' experience is that there is a sufficient lapse of time between the school-leaving period and the realisation of the desirability of getting proper dental treatment, to allow nearly all the advantages of the school dental service to pass away.

If a boy or girl leaves school at the age of 14 and goes into industry, the earliest age for joining an approved society is 16 and it will not be until the age of 18½ that he or she will be able to get any dental benefit. There are 4½ years during which they do not come across any of the propaganda of the Dental Board; neither can they get any help as regards having their teeth kept in order. That is too long. The work done in the schools is undone, and yet two things are certain, first, that those particular years of adolescence are extraordinarily important in building up a permanent basis of health, which depends a great deal on the soundness of the mouth, and, secondly, that if a young man or a young woman gets accustomed to neglect of the teeth and waits until the time when they get so bad that they can all come out and he or she can have artificial dentures substituted, it is a bad thing for the general health. In the report of the Chief Medical Officer of the Ministry of Health two years ago, he said that diseases of the teeth and the surrounding tissues in the adolescent were an important factor in causing several diseases, and it is, I think, very largely because of disease which enters through a defect of the teeth that we find, as we all do as we go about the country, so many people saying they enjoy bad health, as if they really did, and making very little real attempt to get it benefited. This gap after the school age is a thing which we should be glad to have tackled if we could.

I want to bring next to the attention of the Minister the present position in the matter of the voluntary sterilisation of the unfit. We shall all agree, I think, as was pointed out in the Brock report which was published more than four years ago, first, that the incidence of over 250,000 mental defectives and a far larger number of persons who without being certifiably defective, are mentally subnormal causes, to use their own words, "a dead weight of social inefficiency and individual misery" which we should all be glad to deal with. Secondly, we have to realise that fully to carry out the recommendations of the Brock report would involve legislation, which we cannot go into now, but I think I may draw attention to the extent to which the reasonable requirements of the Minister of Health's predecessor have been met. When a deputation went to him last year to represent the matter to him, he congratulated them and attached great weight to the unanimity of view which had been expressed on behalf of the bodies which composed that deputation, like the County Councils' Association, the Association of Municipal Corporations, and the Mental Hospitals Association, and he said that the people interested ought to go on with the good work of getting more public support, which was perfectly reasonable, for it is rather a prickly subject to tackle.

That has been done, and the position may now, I think, fairly be stated like this, that whereas when we began it was difficult to find public bodies which were in favour of the projected changes, now the difficulty is to find any public or representative bodies which are in any way opposed to the recommendations in that report. I hope that my hon. and gallant Friend the Member for Wellingborough (Wing-Commander James) may be making a fuller statement about that later, but I would only now urge on the Minister the importance of giving his practical attention to it, and I can assure him at any rate of this, that when he said last year in winding up the Debate in the House on a similar occasion, that he wanted the guidance of public opinion on the matter, that has been steadily worked at and public opinion is now much more active and much more ready and willing to back up any effort that he or the Government might make.

I am coming now to my last subject, and that is the question of allotments, which, to some extent, fall into the work which the Ministry does, though there are naturally many public Departments concerned. One thing has been happening lately to which I hope the Minister might be willing to give some attention, and that is the continued loss by the allotment holders when land has to be taken away for building purposes. It is almost a rule that when anybody says he wants a bit of land for building, it is the allotments which are first taken, and it makes the hearts of the allotment holders sick within them. It is extraordinarily difficult to get men to take up allotment land, although, as we know, allotment cultivation is the best occupation for a man in employment and the best relief for a man who is out of employment that can be found anywhere; and things are getting worse in that matter rather than better, because the discouragement is so great.

In the National Allotment movement we have been trying to get attention paid to the amenities. We have been trying to get proper fencing substituted for the old bedsteads which are almost the standard fencing for allotments in some places. We are trying to get proper, tidy, community huts, with creepers and roses over them, instead of the ramshackle tool-sheds all over the place which we too often see. We are in a vicious circle. The allotments are untidy, and that means that the local authority does not take much trouble about them and does not use much effort to get their tenure better. The tenants naturally say, "What is the good of trying to make them more tidy, while our tenure is so insecure and when we may be losing them within the next 18 months or the next year?" So we go on for the want of a little more attention to the importance of this allotment movement in the country. Town planning, which has been suggested, is a broken reed. Land gets earmarked for allotments, and allotment holders depend on that. They see it nicely marked on a plan hung up at the town hall, and in nine cases out of 10 when the time comes that gets blocked up with something else, and the allotment holders lose their holdings. I do not want to go into that more fully, because if I did, I should take much too long. I have, I am afraid, touched upon at least five subjects, but I have tried to do so without controversy and certainly without political bias, and I hope the Minister at a later stage may be able to give us good news on some, at any rate, of the matters which I have ventured to bring forward.

5.53 p.m.


The Minister took credit for the progress of slum clearance, and I do not suppose anybody, inside this House or outside it, wishes slum clearance well more than I do, seeing that I have been for a great many years the representative of a densely populated and very big industrial constituency. But these slum clearance schemes can have certain repercussions which are very hard indeed upon individual people. Perhaps I should not say "repercussions," because there are quite direct results, and I suppose that "repercussions" mean something indirect and probably unexpected. I want to illustrate for a very few minutes these results from a slum clearance scheme which is in operation now in Ipswich and about which an order was made by the Ministry in November last. As proposed by the county borough council is originally affected some 900 houses and shops. Objections were taken, and the Ministry sent their inspector down to hold a local public inquiry. I should like to say at once, and most emphatically, that the inspection appeared to be very thorough, very painstaking, and most genuine in every respect. We were told beforehand that the inspector would visit every single one of the premises affected, and it appears that he actually did so, and not one of the victims of this scheme, with one single exception, has a word to say against the inspector or his methods. They were treated with every consideration. The matter was gone into deeply, but nevertheless the most unfortunate results have occurred.

It will be present to the minds of the Committee that there are various classes of houses affected by these schemes under the Acts of 1930 and 1935. There was a slight improvement for the owner and occupier given by the National Government Act of 1935, but it is still possible for very considerable hardship to be suffered. I take it that all slum clearance schemes have two objects, one being obviously to clear what is definitely decided after inquiry to be a slum and to re-house the population in fresh, suitable, and healthy surroundings, and the other and equally worthy object is to put an end, once and for all, if possible, to the class of person who buys up large quantities of property at even worse than a knock-out price—groups of houses of fifties or hundreds, at £20, £50, and less—lets them at rack rents to the unfortunate people who must live near their work and who cannot choose where they will live, and then lets those houses get worse and worse, partly perhaps from sheer unwillingness to improve them, partly, in the case of the smaller owners, from inability, and partly also, of course, because they always have hanging over them the probability, if not the certainty, that they will be condemned and demolished under some Act or other, and, therefore, they very naturally are not going to spend anything more than they can possibly help upon keeping them in good order.

As far as I know, that class of owner, who is to be found elsewhere, is entirely unknown in Ipswich, and of course, if he does exist, he would be the last person to have approached or written to me or attracted attention to himself in public at protest meetings held in the borough; but the class of owner and occupier of whom I am speaking is the small man who has bought either a house or a house and shop to live in and carry on the shop, or who has bought, I would say at the most, two or three of these small cottages in the area out of his life savings, generally a man of 60 years of age or onwards, often an ex-Service man, wounded, and in many cases the original purchaser or mortgagor has died and his widow owns the property. It is their only source of income, and they now find, under slum clearance schemes, that the houses for which they have paid a substantial sum, and in the case of Ipswich very recently, are now being demolished under an order, and they are only being awarded the site value under the Act.

I have here a sheet covered with individual cases following the description that I have just given to the Committee, and the remarkable thing about them is that, with exceptions, they are all houses that have been purchased in 1931 or 1932. It is not a ease of people who have bought old property 30 years ago and let things get worse and worse; they are houses that have been quite recently purchased, for sums varying from about £200 for each of these cottages up to £470. I will give only one individual case, because bad cases do not make good law. It is the case of the wife of a Mr. Harry Smith, who is himself an unemployed man, unable to work, and whose source of income is 5s. from a benefit society pension. His wife has a small amount of property of this kind. In this case I have not got a note of the purchase price, but the purchase of this house, 28, Rope Walk, was in 1931, and that is the point about it. When he bought it in 1931 the net assessment was £8 5s. The gross was, I believe, £11. It remained at that, and last year, the year that the council promoted their scheme, he received a notice that his house was included in the area, that it must be demolished, and that he would get site value for it.

He went to the town hall full of indignation to try and see someone personally on the subject. When he got back to his house in the evening, he found a notice from the Income Tax authorities that his assessment for 1936–37 would be raised to £18 net and £25 10s. gross. It was such a good house that it was raised well over 100 per cent., but it was such a bad house that it must be demolished forthwith as being unfit for human habitation, and only bare site value was to be awarded. That is an extraordinary case, and is the only one I have troubled to bring forward on the grounds of assessment, but a large number of the cases of which I have records in my hand had the assessments raised by £1 per house in 1934. These are houses that have been marked for demolition with only payment for bare site value. Obviously, the Ministry does not wish that, and Parliament did not intend it when they passed either Act, but these results have flowed directly from these two Acts. I understand that there is to be another slum clearance inquiry in Ipswich on the 22nd of this month, and, as there may be other schemes in other parts of the country which come more closely home to other hon. Members, I am taking the opportunity on this Vote to bring the matter up.


I think that the hon. Gentleman is a little mistaken. The Income Tax authorities have nothing to do with assessment. That is set by the local rating authority merely on the rent which the property could command, whether it is a slum house or any other kind of house. Slum houses do sometimes command a higher rent because of the crowded conditions.


That coincides very closely with the reply given to me by the Parliamentary Secretary in March.

It is true, and I have not gainsaid it for a moment. I have not pursued the point any further, but I mention it to-day as an anomalous thing which it is impossible to explain away to an unfortunate owner. Naturally there remains a sense of grievance. The Ipswich Council are doing what they can and have appointed an ad hoc committee to inquire into cases of hardship, by which they mean cases where the people affected by the slum clearance scheme are thereby placed in straitened circumstances or made destitute. This committee issued an advertisement for people who considered that they were suffering hardship to apply to them, and they received only 117 applications. They decided not to take action in 39 of these cases owing to the applicants' circumstances, as they had other sources of income, although that does not affect the justice of the case. Thirty-eight of the cases were obviously cases where what the people wanted was compensation for disturbance, which they will now get. That left 40 further cases which the committee are referring to the public health committee of the council to see what can be done after the compensation payable under the Act is definitely ascertained. No matter how good the intentions of the council are, they cannot, out of the rates or out of the loan raised for the purpose of slum clearance, pay additional compensation beyond what the Act provides to any of these people.

I think that I have said enough to make it clear that, although the council were right in originally asking that a considerable proportion of these houses should be demolished, although the inquiry was held with the greatest care, very great injustice has been done. If I worried the Committee with the cases of which I have records I should reveal case after case of elderly people, ex-service men who cannot work on account of their wounds, crippled women, widows and others who bought houses within the last 11 years and who have done their best to keep them up. They have in many cases paid only a small deposit down and are now in the middle of paying off the capital and interest to building societies. One case has only paid 1½ years and has 12 years to run. Other cases have paid six years and have five years to run, and are now in the position of having their security taken away while keeping the legal liability for the debt. In many cases they have nothing out of which they can meet the liabilities, and the loss will probably fall on two local building societies and, to a lesser extent, on one or two of the larger building societies outside, whose operations on the whole are entirely to the benefit of the people who wish to buy small property. I do not think that anything more that I could say would make the point clearer or give any more emphasis to it. I am glad that I have had the opportunity on this Vote to call attention to some of the dangers that may flow directly from slum clearance schemes as they have to be administered by the Ministry of Health, and as they have to be first conceived and finally carried out by the local authorities.

6.8 p.m.


I think that every one who listened to the Minister's speech must have been grateful to him for the very wide range which it covered, and that we must all feel that the Ministry of Health is a terribly overloaded Ministry. It has to deal with housing, water, ribbon development, allotments and drought, and for that reason I do not think that it has been in the past sufficiently a Ministry which is equipped to fight and prevent disease. I believe that under the present Minister we may really have something done to raise the standard of health of the nation. The Minister gave a picture which led us to believe that the health of the nation had improved, as it undoubtedly has, but as the right hon. Gentleman the Member for North Cornwall (Sir F. Acland) pointed out, that improvement in health has been far more due to better sanitation and to better education with regard to housing and cleanliness than to constructive medical work. I do not think that there has been anything like the improvement in public health that we have a right to expect if all the knowledge available to the medical profession, but not, unfortunately, used by them, had been employed. I feel that there ought to be an extra Under-Secretary to the Ministry of Health or an extra Department, which could co-relate all the information available in order that the medical profession might be able to do more than they have done for the improvement of the health of the people. There is no question that a very large part of the improvement in the health of the people is not due to medical men. In fact, our greatest debt is undoubtedly due to Louis Pasteur, about whom there is a film being shown in London now. It is a magnificent film, and it happens to be a true film. It does not inspire one with any great confidence that forward steps in the eradication of disease are always likely to be backed by the medical profession.

There is one department of health in particular in which I could riot quite join with the Minister in his satisfaction. I feel that it is because, with the enormous number of subjects over which he has to preside, it has not been possible for him to give to that subject the attention it deserves. I refer to mental illness. I agree that the improvement in the care of mental defectives is extraordinary, but I do not think the same thing applies to the care of the insane, who are an entirely different problem. The insane, as far as any curative treatment is concerned, are very much where they were many years ago. Comparatively speaking, nothing is being done to find out the causes of insanity. The under-staffing of mental hospitals is one of the scandals of the age. I read the other day that at the eighteenth annual meeting of the Mental Hospitals Association, Sir Laurence Brock, Chairman of the Board of Control, said that the number of patients under care on 1st January, 1936, was 127,813, an increase on the previous year of 1,711. He went on to say that that increase was quite normal and need cause no alarm, and that an increase must be expected for a good many years because the admission rate was related to the birth rate.

Are we really going to be satisfied, as apparently the Chairman of the Board of Control is, because the mental trouble of the country increases when there is an increase in the population? Are we to expect no improvement? I venture to suggest that there will be no improvement in regard to insanity unless a great deal more than is being done at the present time is done to find out the cause.

Wing-Commander JAMES

If the hon. Lady will permit me, I think she is most unfair to Sir Laurence Brock. Nobody who knows him would suggest for a moment that he is complacent. Did he not, as Chairman of the Committee that bears his name, make a very practical suggestion directed towards reducing the incidence of mental troubles?


I agree that the recommendations of the Brock Committee might have been given closer study, but I do not think that it is certain that sterilisation is satisfactory in countries where it has been put into practice. I emphatically say that sterilisation is not a cure. Even if we admit that it is right, which I do not think has yet been proved, it is not a cure. It may be a method of prevention of spreading mental disease, but it is not in any way a prevention of the cause of the disease. We shall never find out the cause of the disease unless there is far greater research into the glands of the human body. Anyone who has had anything to do with certifying the insane, as I have as a magistrate, must be struck by the enormous amount of insanity which occurs in both sexes at adolescence and again in later age. I think that that points to insanity being closely connected with the glandular system of the body. That is where greater research is needed. How can there be research when we have in our mental hospitals sometimes 700 or 800 patients with only two doctors? I know that we are very proud of the research which is being done in Maudsley Hospital. How much money is being spent on research there to-day? It is about £4,000 a year, of which £3,000 is provided by the Rockefeller Institute of America. That money is largely spent on investigation into past family history. That is very valuable and ncessary, but it is not investigating the medical cause of the disease. It is making no effective research into the cause.

The Minister said how splendid it was that we had so much improved occupational and recreational centres in these hospitals. I cannot agree that in that respect we are advancing as we should. I went over the Maudsley Hospital the other day and with immense pride I was shown the room for occupational and recreational pastimes. I said, "What a miserable little room." The doctor replied, "Mrs. Tate, don't you know it is the largest in the whole country." There are a great many mental hospitals which have been completed in the last five years and have not had a room built in them which was designed for occupational or recreational work, although it has been proved in America to be one of the most curative treatments. In this country we still have the padded cell. Do you mean to tell me that the padded cell is a method of cure? It is wholly out of date; it is not allowed in Scotland; it is not allowed any longer on the Continent. While there are 300 to 400 insane people under the care of one doctor, of course some of them have to be put in a padded cell, but that is not the right way to treat them. It is hiding them away and preventing their being a nuisance and in a manner, salving our conscience, but it is not doing anything to find out the causes of the disease or how to cure them. I think it is time we insisted that money was spent on. research and that proper salaries were paid to those engaged in research work.

I turn to another subject. It is under the Ministry of Health that inspection of nursing homes is compulsory. I do not think there is a medical man in this House who will not say that conditions in many private nursing homes in London and throughout the country are an absolute scandal. Louis Pasteur taught us the reality of the spread of disease by germs. If you believe in that you must believe that in a great many instances disease is being spread by the London nursing homes. You can walk into London nursing homes and in many of them you will find carpets far from clean on the floor, curtains at the windows, covers on the sofas which are never sterilised. The right hon. Gentleman mentioned that cancer was still increasing. There are engaged in cancer research to-day a large number of people who are beginning to hold the view that cancer is due to a germ, and that possibly it is contagious. I know that is the view of one school of thought only, but there is that school of thought, and it may prove to be right. If that is so, one can only come to the conclusion that in many cases it is not very safe to enter a London nursing home. There is no regulation which ensures that rooms are sterilised after each patient has occupied them. The carpets and the curtains are still there, full of the germs of the last patient.

That kind of thing should not be allowed to continue. At the Pasteur Institute as long ago as 1890 rooms were built which are a model of what rooms in a nursing home should be. Before a nurse goes in to see a patient she has to put on the overall which she wears for that patient. In those rooms you have curved corners, you have everything for the prevention of the spread of disease, but in this country many of the London nursing homes must be a cause of the spread of disease. I should like to know who inspects those nursing homes and what they are asked to look for when they do inspect them. And why do we allow this state of affairs to continue after what Pasteur taught us?

There is only one other matter on which I wish to touch, and that is the subject of vaccination. The Minister said to-day there had not been a single case of smallpox in this country in the last year. As hon. Members know, in this country vaccination is still legally compulsory, but that compulsion is an absolute farce. I am thankful to say that at the present time not more than 40 per cent. of the children born are vaccinated against smallpox. I say that I am thankful for this reason. I am a believer in vaccination, and I do not think there is any question whatever that smallpox was stamped out originally by vaccination, but I do not think that hon. Members or the country are aware that the vaccine lymph used in this country today has very little if any relation to the lymph which stamped out smallpox, and I believe that it is a cause of very grave danger to the community. Any bacteriologist—I have worked in a laboratory—will admit if he is honest that if you change a lymph from one animal to a completely different animal you entirely change its character. Calf lymph is the lymph with which children have to be vaccinated according to the law, but they are not being vaccinated with calf lymph, although people do not know it. What they are being vaccinated with is rabbit lymph.

It is only since 1902 that the Government began to make experiments with rabbit lymph, and I think it was in 1905 that that lymph began to be used for the public. It was in 1912 that the first case of encephalitis, following vaccination, was notified in this country, and it was treated at the London Hospital. It is known that there have been over 1,000 cases of deaths from encephalitis following vaccination, and I believe that the actual number is enormously in excess of that, and I speak from what I know, because I had charge of a child who had encephalitis following vaccination. I called in. four very expert medical men to treat that child in the early stages of the illness. The case was diagnosed first as typhoid, then as paratyphoid, then as influenza and then as gastric chill. It was not until the patient was brought to London, and when the symptoms of almost complete paralysis were present, that the case was diagnosed as what it was, one of poliomyelitis and following vaccination. [An HON. MEMBER: "Caused by vaccination?"]

The rabbit is known to have encephalitis. I know that the Minister will be told by his Department that the encephalitis of the rabbit has no relation to the encephalitis of the human being. How do they know? Another thing. I do not think it is generally known that other diseases can be super-imposed. It was because a child of five died from syphilis after being vaccinated with human lymph from a grown man that human-being-to-human-being vaccination was forbidden in this country. It was because lymph which was taken to America caused the outbreak of foot-and-mouth disease in America in 1908 that America passed a law forbidding the importation. of foreign lymph. We are to-day using rabbit lymph, though the Ministry have tried to assert that that is not the case. In December, 1922, in answer to a question asked in this House, the then Minister of Health said: The lymph at present used at the Government lymph establishment is a strain of lymph obtained many years ago which has been carried on by repeated transference from calf to calf."—{OFFICIAL REPORT, 13th December, 1922, col. 2968. Vol. 159.] That may be a very satisfactory answer, but does not happen to be the truth. If hon. Members will turn to the Ministry of Health Vaccination Report published in 1928, they will find, on page 15, under the heading of "Procedure at Government Lymph Establishments," the statement: The seed lymph used is derived from calf lymph received from Cologne in 1907. Its quality has been maintained by cutaneous passage through the rabbit. It is obtained by cutaneous passage through the rabbit, it is not lymph obtained by passage from calf to calf. I do not know whether the House is aware that glycerinated calf lymph, the only calf lymph which should be used, will not pass the Ministry's test to-day because the lymph submitted is diluted by one in a thousand and tried on a rabbit, and glycerinated calf lymph, if diluted by one in a thousand and tried on a rabbit, will bring forth no reaction and cannot pass the test. The only stuff that will pass the test is the very dangerous lymph from the rabbit, which works with rapidity because it is obtained from the rabbit. I hope that the Minister will now either see that we have glycerinated calf lymph or wipe away the nonsensical provision that people shall be compulsorily vaccinated, in view of the fact that smallpox is not prevalent and no one has proved whether the extraordinary lymph used to-day is really a safeguard against smallpox.

I know that smallpox was stamped out in the 1924 epidemic in Edinburgh by vaccination, but the lymph used there was not the Government lymph. The Ministry of Health was written to urgently for supplies and sent supplies sufficient for three days, with a letter saying that to send further supplies would unduly deplete their resources. The Edinburgh authorities then wrote to a doctor in London and got a million doses of glycerinated calf lymph, which proved entirely satisfactory. Since then glycerinated calf lymph has not been used in this country, because it will not pass the Ministry's test. I believe that in the present Minister of Health we have a man who really will do something to see that use is made of the existing medical knowledge. I believe that under him we may have something really original done to get a move on to the medical profession. I congratulate him on his speech to-day and would like to renew my expressions of confidence in him. I think we could have no better proof of the work which the Ministry of Health has done than the curiously weak speech of the spokesman for the Opposition.

6.28 p.m.


The Minister, when introducing the report which we have before us, painted a beautiful picture of his administration. In this report are figures which certainly indicate a great improvement during the past few years, but in the picture which he has painted there are some very dark spots. It is true that in the south in particular, and in places like Eastbourne, Bournemouth and Harrogate, the picture is beautiful and that ideal conditions exist, but I wish to draw attention to the darker part of the picture represented in particular by the industrial north, and parts of it like North Staffordshire and Lancashire. His report certainly indicates an improvement, but had there been time one could have shown by an analysis of this report that the improvement is not proportionately such as we should have a right to expect in the year 1936.

I want to deal with an area which is experiencing the results of a legacy and an endowment from the industrial revolution. In this area you will find fine women, as good as any women living in the country, and as good as the so-called ladies that we see hanging around such a centre as this, when we are assembling here. [Laughter.] These women are having to struggle week after week in order to make ends meet. They are living in a terrible environment which is disgraceful to this House. Although hon. Members sitting over there may laugh, if they were living in similar conditions they would not be so pleased, or so ready to laugh at someone who is attempting to represent people who have not been represented to the extent to which they will be represented in the very near future. These conditions have been handed down; jerrybuilt houses, slum conditions, poor environment, and disgraceful conditions. The hon. Member who sits over there, and who was laughing, has a beautiful flower in his coat. Probably that rose has been grown in ideal conditions, in an environment that lends itself to bringing the best out of rose trees, but if that rose tree had been growing in the part of the country for which I am speaking, not among the class represented on that side of the Committee, but the class to which we are proud to belong, you would not have got a beautiful rose like that which the hon. Member is now wearing in his coat.


It depends upon the soil.


Quite true, but the soil that is in the South is not the same soil as in the North, for which I am speaking. What applies to vegetables and to roses applies equally to men, women and children. It is for those people that I am speaking. It states in the report that there has been a great improvement in housing. I want to draw the attention of the Minister to the fact that, in the area for which I am speaking, 59,424 houses were inspected, out of a total of 64,200, and that the result of that inspection shows that 1,267 new houses are required. The medical officer says—I have his report here—that the standard that has been laid down by the Ministry is altogether too low. He states in his report: The census of overcrowding in the city is given in the body of the report, but in my opinion gives no idea of the true picture, and the houses to be provided are quite inadequate to abate the overcrowding of the city. Then he goes on to say: Owing to the Minister's standard being so low, instead of only 1,227 houses being required at least 5,000 houses are required in this city. He states that the survey standard is altogether too low, and that there are at least 8,637 houses overcrowded, not included in the survey under the Act. In 737 cases there were three, four, five, six, or seven families living in one small house, not included as overcrowded under the Act. I wonder how hon. Members, and particularly the hon. Member wearing the rose, would like to live under conditions like that.


I do not complain of the hon. Member for attacking me, but why should he attack my poor, innocent little rose?


It is in bad company.


I am not attacking the rose, but I am certainly attacking the individual that is wearing it, and who laughed when I was speaking about the conditions in my part of the country. If he were living under those conditions, he would not be so ready to laugh.


We must have a sense of humour.


It is all right having a sense of humour when you are well-fed, well-clothed and living in ideal conditions, but do not let us forget that there are thousands of people in this country on whose backs you are living and who are not laughing, under the conditions in which they live. According to the report, 12 per cent. of the families require additional accommodation and at least 5,000 houses, owing to the 8,637 houses not being included, under the low standard of the Act. If houses are built, no subsidies are allowed, and that would mean the fixing of a high rent. The local authority will not be able, therefore, to build their own houses. I want to ask the Minister whether he has read the latest report of the Unemployment Assistance Board, in which it states that, in the area which I am proud to represent, there are houses where it is common for from 15 to 30 rats to be found. I am not saying that, but the Unemployment Assistance Board. I have here a statement from the "Daily Express" of 8th July, in which it appears that they sent a special correspondent to the houses. It is an indication of the terrible conditions about. which I am speaking. The "Times" of 1st July, in an article entitled "Hidden Needs," states: In the Hanley area, cases have been found deserving attention of 32 people living in a two-bedroomed house and of 17 people living in one room. Many houses are infested with vermin, rats and crickets. The "Times," the most authoritative journal published daily in this country, described the conditions which I am attempting to reflect in this Committee. It is not a Socialist saying that, but the orthodox "Times." I am trying to refrain from speaking with political bias and am attempting only to reflect those conditions, in order that the Minister may give his personal attention to them, as he did when he was at the Post Office. He then showed, by his energy, his spirit and his initiative, that, having taken over that great Post Office service, how he had improved it. It is now a credit to this nation. I am only trying to represent, without political bias, these poor women, men and children who are living under those conditions, in order that the same energy and spirit may be devoted to remedying those conditions.

Now perhaps the hon. Gentleman with the rose will listen. The right hon. Gentleman the Member for West Birmingham (Sir A. Chamberlain), speaking on 15th December, 1932, made a remarkable statement. He is always to be found in his place when some question of defence, or some international question, is being discussed, but I have watched those benches carefully these last few days, arid the right hon. Gentleman and other right hon. Gentlemen are not in their places when questions such as we are debating to-day are being considered.


Their hearts may be in the right place.


I readily accept that, but I want to see that feeling reflected in legislation, in order that the conditions which I am describing may be changed.


So do the right hon. Gentlemen.


The right hon. Gentleman the Member for West Birmingham used on that occasion these words: Why should anybody who lives in the conditions which I see there vote for me or the causes for which I stand? … If I lived in such conditions … I should feel that the circumstances to which I was condemned were intolerable, that there was something rotten in a State which had permitted them to exist so long… You cannot see those conditions and not feel your blood boil."—[OFFICIAL REPORT, 15th December, 1932; col. 577, Vol. 273.] We heartily agree with what the right hon. Gentleman said on that occasion. I would go further, and point out that his attitude was supported by Sir Benjamin Dawson, chairman of the Bradford Central Divisional Conservative Association, a few months ago, who spoke in exactly the same way.

I have been analysing the Ministry's report, and on page 113 I find the infantile mortality rate in England and Wales, showing that the number of deaths of infants under one year of age per thousand births fell to a record low figure of 59 in 1934. I believe in giving credit where it is due. There have certainly been improvements nationally, but I want to draw the attention of the Minister to the area which I represent. I have here the report of the medical officer for Stoke-on-Trent, and he has analysed—

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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