MINISTRY OF HEALTH.

HC Deb 16 July 1936 vol 314 cc2326-91

Question again 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.

6.52 p.m.

Mr. E. SMITH

I was saying that the infantile mortality rate in England and Wales in the year 1930 was 59 per 1,000 births and that I believe in giving credit where it is due. There has been a great improvement in that respect. But I want to draw the Minister's attention to the particular area which I represent, and which, I think, needs his attention. The local medical officer, in his report, gives an analysis of the figures for 121 large towns. He finds that in those large towns, which are similar to the towns of which I am speaking, the infantile mortality per 1,000 births is 62; but, taking the area from which I come, the rate in Tunstall is 86, in Burslem 112, in Hanley 100, in Stoke itself 64, in Fenton 75, and in Longton 70. The medical officer goes on to state that great work is being done by the voluntary organisations. I admit that there is a great deal of voluntary effort in this country in connection with such work, but voluntary work, in the age in which we are living, is only like scratching the surface of the problem. Therefore, I appeal to the Minister to display the same spirit, energy and initiative that he displayed when he was at the Post Office, in tackling this problem. It is a legacy from the industrial revolution, which is responsible for conditions under which people ought not to be expected to live in the year 1936.

On page 80 of his report the medical officer deals with nutrition, and had there been time, had there not bee so many others who desire to speak, I should certainly have contrasted the national position as set out in the Minister's Report with the conditions in the area. of which I am speaking. The medical officer states in his report that: There can be no doubt that a marked degree of nutritional anaemia is present in too many expectant mothers. All the mothers suffering from anaemia have been treated with some iron preparation, and every endeavour has been made to improve their standard, but the following specimen diet illustrates how inadequataely some of the mothers are fed. He goes on to give typical cases of expectant mothers suffering from anaemia; and it must be remembered that, if the mother is suffering from anaemia, it is bound to reflect itself in the physical condition and health of the child. He states that many mothers have no milk, that they have eggs only occasionally, and fish only once a week; that they live on margarine, and have no fruit or vegetables; and he goes on to say: It would seem that a diet deficiency affecting maternal health is too prevalent and calls for further investigation. It is probably too much to say that this can be expected to be done by local treatment alone. Therefore, I want the Minister to pay special attention to these industrial areas, because the people living in the South have no idea of the conditions under which the people in the North are living. I have discussed this question with men and women who are just as sincere in their outlook on life as any of us on this side, and who, after having visited the North, have had to admit that they had no idea of the terrible conditions under which the people were living there. Therefore, I ask the Minister to consider during the next 12 months the possibility of a further survey by the local authorities, so that he can prepare a bold housing policy in the same way in which he handled the Post Office when he was responsible for that Department.

I also want to call attention to the commitments which the Minister made to the local authorities when the De-rating Act was passed. The general Exchequer grant which is now made was never intended to cover the discontinued grants. The grants have been discontinued as a result of de-rating, and now only a general Exchequer grant is made; and this reflects itself in the very serious financial position of the local authorities. If I may give one typical example, it is costing, for public assistance alone, in the area of which I am speaking, 6s. in the pound on the rates. This is having a serious effect on the rates, on the rents of the people, and on the production costs of local manufacturing firms. Since 1920, wages have been reduced by 50 per cent. in most cases, and I think it is time the Minister paid heed to the suggestion of the hon. Member for East Fulham (Mr. W. Astor) that it is time that the Rent Restrictions Act was again considered with a view to taking off the 40 per cent. increase. I appeal to the Minister to pay special attention to the area about which I have been speaking, because I believe the conditions there are relatively worse than in any other area. He has only to read the Report of the Unemployment Assistance Board. I believe that, after an examination of that report, he would be prepared to give his special attention to the matter.

7.0 p.m.

Major OSCAR GUEST

The hon. Gentleman in the earlier part of his speech drew a picture of conditions in some slum areas, and I was very much in sympathy with what he said. It was interesting to hear in the Minister's speech of the great advances which have been made in building throughout the country, but these new houses going up so quickly have created problems of their own. Great numbers of families have been moved into them from other districts. They have been put into better houses, and are living in better conditions than those from which they came; work has improved owing to the increased trade, and they have a better opportunity of finding work; but they are completely divorced from all the social life which they knew. They are brought into a new district where they know nobody, and they have no possibility of any social life. The result is a certain degree of discontent. This is a phase of the housing development which should be tackled. Compared with the cost of building these estates, the money which would be needed to assist some form of social life on them would be small. The authorities are already empowered to assist local settlement work, and there is a general desire among them that this work should be encouraged, but they need urging to carry it out, and some advice. On only one estate in this country is there anything of a social nature in operation, with proper premises. This is a new problem which is the result of great numbers of people being displaced from one district to another in a short time.

In parts of South London with which I am acquainted there are a number of block dwellings where up to 1,000 families have been moved during the last few years. The people do not know anybody in that locality, they hardly know each other, and they have a great desire to get together for social purposes. There are two things requisite before they can do so. They must have some building where they can meet; it need not be expensive or elaborate, and I would urge the Ministry to encourage local authorities to assist them in that way. The second thing required is a certain amount of supervision. On the larger estates there might be a full-time supervisor appointed by the local authority, and on the smaller ones it might be a part-time appointment. The National Council of Social Service have made a study of this question, and are working hard, but it needs some initial assistance from local authorities to get this social life started. The people on these estates would carry on once it had been started. This is not a sentimental cause to urge, because it is not enough to put people into better surroundings where they can be more healthy, or even to find them more work. There is such a thing as the time when you are not at work. In these new buildings the classes are being very much segregated, the working classes being put into large blocks of buildings together—rather a bad thing—and it is important to provide some sort of social life for them. Sometimes when I see these large block estates in South London I wonder whether it would not have been possible to build them more after the example of towns, accommodating different classes of people.

A great deal might be achieved if more effort was taken to help the social life of these new segregations of families. If it could be started by local authorities the movement would grow spontaneously, and we should mitigate to a large degree that feeling of isolation which exists in these new communities, who feel they are cut off from the rest of the town in which they live. They arc in newer houses; sometimes the rent is rather more, sometimes the distance to work is rather greater, which balances the more convenient accommodation; but they have no social life, and it is important to the nation that their social life should be wisely directed. People with a happy social life make the best community.

7.8 p.m.

Mr. QUIBELL

The hon. Member for Frome (Mrs. Tate) endeavoured to press on the Minister the necessity for a closer investigation of nursing homes and for a higher standard of equipment. I had an unfortunate experience a few years ago, when I was in a nursing home for nearly 20 weeks. The hon. Lady described in detail the room which I occupied and for which I paid very dearly—just an ordinary bedroom at the corner of a street, transformed into one of the rooms in that nursing home. I was unfortunate enough, after having five operations to the brain, to suffer from a septic condition in the head as a consequence of being in a room like that. I agree with the hon. Lady that if nursing homes are equipped in the same manner as that one was, the Ministry should give attention to a stricter supervision of them. The Minister in his speech, with which he seemed well satisfied, reported that 323,000 houses have been built last year, large numbers of them by private enterprise. I am inclined to think he is right. Many of them are of an inferior quality, and some of the people who have been so unfortunate as to put their little savings into a house, and are left with a building society mortgage which imposes on them the responsibility of finding each week interest and redemption charges amounting to 15s., plus rates, after borrowing £500 know very well what private enterprise has done for housing. Those who represent business in this House should realise that they are not serving the best interests of business by advocating a solution of the housing problem in this way. In the town in which I live they are building council houses now that are let at 8s. 6d. and 9s. per week inclusive. If we could supply the whole of the people in that district who want houses there would be in each family a balance of 6s. that they could spend in the shops of the town, and the tradesmen would benefit considerably because of that tremendous saving.

Mr. MAITLAND

Is the hon. Member having no regard to the prices ruling when these houses were built, and conditions very different? Is it not within his knowledge that, in consequence of the improved conditions of to-day, houses are being built by private enterprise at a cost permitting them to be let at 9s. and sometimes less.

Mr. QDUIBELL

I am a builder and contractor, and I tell the hon. Member that houses are being sold by private enterprise at about £550 on which the purchaser has to pay £50 deposit. He has to borrow the remainder, £500, at not less than 5 per cent. in most cases, and the repayment of interest and capital is not less than 3s. per £100, which leaves them with a rental of 15s., plus rates. Many people who cannot afford such a house are allowed to go into it without even paying a deposit. So far from solving the housing difficulty, you are creating a difficulty, because as soon as the purchaser gets behind with his payments the society claims the house and he goes to the council to ask them to solve a difficulty that ought to have been solved before he accepted a liability that he cannot discharge.

The Minister was very proud that building trade employers were co-operating with his Department in order that specifications should be agreed upon and approved by some committee in order to safeguard the purchaser of houses and to secure some improvement in the condition of houses built and sold by private enterprise. I commend him for that, because some of the conditions that obtain will be within the knowledge of members who are not associated with the trade. It is commonly said that in 10 years the houses that are being built in some districts will have become slums. I suggest to the Ministry that, in places where this tremendous building spurt is taking place, the local authorities should be instructed to appoint officers to inspect the buildings in course of erection in order to protect those who purchase them. I would issue a standard by-law or specification and insist in some cases on more stringent application of the by-laws, and in others on a strengthening of the by-laws.

I know a town where they might as well put brown paper into the damp courses of the houses they have built as the stuff that is being put in. Some standard damp course ought to be incorporated in the by-laws, but the local authority has no power at present. There is not enough supervision and inspection in the matter of foundations. I know a street of 60 bungalows in which most of the internal partitions are lath and plaster, a thing that ought to be discouraged instead of encouraged. Like everything else that this Government have encouraged, these bungalows are not only cheap but they are very nasty. I have built council houses by contract, but I do not want to build any more. I was disgusted with the standard of cheapness insisted upon by the Ministry. There was not even a bit of plaster in the pantry. I had to paint the brickwork and limewash it. Some of these houses I consider a disgrace. I should be ashamed to have anything to do with them.

I hope the Minister will pay some attention to rural housing. In my division little has been done to remedy the grievances of the countryside, and I should like to know what the Department intends to do to solve some of the difficulties. It is certain that, if the only houses that can be built are houses to let at 9s. a week, you are not solving the agricultural labourer's difficulty. In my constituency nearly every house that the rural district council has built is occupied by a railwayman or someone engaged in another occupation. I do not know of one agricultural labourer living in a house in this so-called rural area. The reason is that they cannot afford it. There are special rates for drainage, water and street lighting, in addition to the general district rate. In some cases the rates are higher than in the town in which I live. This is not fiction but fact.

If you expect that you Are going to make any inroad into the difficulties of the countryside, you are only deceiving yourselves. You are not deceiving anyone in the countryside, They cannot afford the rent and the rates. The liability is too big for the agricultural labourer and nothing has been done to solve his difficulties. I am, however, pleased with the progress that has been made in solving the water difficulty in the countryside. I only wish the Ministry would make more speed. The faster they go the better we shall like them. But many people are going to have considerable difficulty in paying for the water supply. The problem of sewage disposal is also involved. There must be sewerage schemes to replace the present primitive arrangements, and that will need assistance from Parliament. The operation of the De-rating Act has left some local authorities without any rateable value at all, and some of these schemes will be a dead letter unless financial support is forthcoming from the Ministry.

An hon. Member below me referred to allotments. He went to my division and made a speech. He was induced to go there largely to meet the council and give them a good talking to and put them in their place because they had taken allotments for houses. But some authorities are in a difficulty. They have to choose between houses and the preservation of allotments. I have said to allotment authorities who have complained, "Tell us where to go and I will move Heaven and earth to preserve your allotments and also to secure a housing site." We did not know how to solve the difficulty. There are no means of transport. A local authority must have regard to the general convenience, and I considered housing infinitely more important than the preservation of a field of allotments.

The Minister stressed small houses. I do not know how many times I have known working men coming to look at a house and saying, "Plenty good enough for a working man." They have that complex. I am astonished at the number of times that remark has been made to me. As far as council houses are concerned, the policy of the Minister has been unfortunate. Take his policy in regard to the original houses. He allowed builders to put in concrete floors. I do not think that there is a man or woman in this House who for a moment thinks that it was appropriate to put down concrete floors in some of the rooms of those houses. They are most unhealthy. My own council have asked the Ministry to allow them to do away with the unhealthy conditions which obtain as a consequence of this sort of thing, but we have had great difficulty in getting them to consent so that we might remedy this grievance. There are scores of these rooms, which, owing to condensation and dampness, cannot be used at any time in the year. You have parlour houses with parlours which cannot be used, and this sort of thing happens in my own town of Scunthorpe.

Heaven knows that they ought to encourage a better type of house. The money that is allowed to be used for the purpose of repairs is almost entirely exhausted. If we were to carry out to the full replacements, improvements, and renewals in connection with the original houses, it would take nearly half the rents at present charged in order to put them into a proper condition. This must be a common experience of Members of this House. The rents that are charged for the original Addison houses are abominable. We have tried to induce the Ministry to allow us to reduce them, but "No." Why? Simply because if we reduce the rents the Ministry would have to make up the loss between the high rents that are now charged and the reduced rents. In order that we can continue the payment of interest on loans, borrowed at 6½ or 6¼ per cent., the Ministry insist upon the charging of high rents to a man living, say, in one street, as against a rent of 9s. to a man living in another street. If the Ministry want to help us in that respect they should consent to a revaluation as far as the rent is concerned, and fix it at the normal level of the rents which operate in the district, instead of penalising occupants who have been in these houses for 10 or 12 years. It would be an act of justice to them if either there could be a reduction in the rates of interest on loans to enable the rents to be reduced, or if the Ministry could consent to meet the loss consequent upon a reduction in rents.

7.33 p.m.

Sir E. GRAHAM-LITTLE

I suppose that this will be the last Debate to be conducted upon the present health legislation, because we are promised in the near future an Act to amend the Public Health Acts dating from 1839, the consolidation of which is long overdue. I propose to take the subjects which are discussed in the survey which precedes the current report of the Ministry of Health and which appears over the signature of the Minister himself. It is an extremely interesting survey, and no doubt the subjects dealt with are what the Minister himself considers to be the most important parts of public administration during the last 25 years. It is a survey produced in celebration of the Jubilee in July, 1935. Taking the survey in its sequence, it is highly satisfactory that the death rate from tuberculosis, both of the lung and other organs, has diminished by a little more than a third of what it was. It is a little unfortunate that there is no general scheme emanating from the Ministry itself for dealing with tuberculosis, and that the schemes which are in operation are the result of local invention and local control. Perhaps more might be done if there was a little more central control.

It is not altogether satisfactory that, in view of the figures of maternal mortality, which are stationary, if not increasing, provision for maternity homes is not increasing at a more rapid rate. According to the survey there were 7,513 beds in 1933 and only 7,909 in 1934, an increase of under 400. I would like to pay a very special tribute in respect of the provision of institutional treatment, and I do that the more cordially because I, as a hospital physician, was very doubtful of the possibility of really getting cooperation between the voluntary hospitals and the municipal hospitals. Much of the credit for that result is clue to the principal medical officer of the London County Council. The work which he has done in that respect is beyond praise. The number of institutions which he controls in that way would probably be a surprise to hon. Members who are not conversant with the position. There are 30,000 beds under the control of the London County Council, as compared with 56,000 beds over the whole country.

I should like to examine much more fully the subject of mental treatment. In the 15 pages of the survey, a whole page is given to that subject. This is one of the departments of medicine in which progress is not being made in anything like a measure commensurate with the progress in other branches, and the actual positions of the incidence of mental disorder in this country is one of grave disquiet. There are at the present time, according to authentic reports, over 1 per cent. of the whole population of this country affected with insanity or mental deficiency.

The DEPUTY-CHAIRMAN (Captain Bourne)

Surely this matter comes under the Board of Control?

Sir E. GRAHAM-LITTLE

It is in the Estimates of the Ministry.

The DEPUTY-CHAIRMAN

The Vote of the Board of Control is not before the Committee.

Sir E. GRAHAM-LITTLE

May I therefore continue with the suggestion that more attention should be paid to the provision of mental hospitals?

The DEPUTY-CHAIRMAN

I would point out to the hon. Gentleman that all questions concerned with mental deficiency come under the Vote of the Board of Control. That Vote is not before the Committee, and he cannot discuss it.

Sir E. GRAHAM-LITTLE

I am sorry to trespass upon the Rules of Order, but reference was made to that particular subject earlier in the Debate.

The DEPUTY-CHAIRMAN

I think the fact that this is a report signed by the Minister is not material to a consideration whether this matter is in order in Committee of Supply.

Mr. AMMON

Is it not the fact that the Minister dealt with it at some considerable length, and that the hon. Lady the Member for Frome (Mrs. Tate) devoted nearly the whole of her speech to dealing with that subject?

Mrs. TATE

No, half of it.

Mr. AMMON

It is putting other hon. Members in rather a difficult position.

The DEPUTY-CHAIRMAN

Of course, I was not fortunate enough to bear the speech of the Minister. I am only following the invariable rule in Committee of Supply that when there is a separate Estimate, you must discuss the appropriate subject upon that Estimate, and the Vote of the Board of Control is not before the Committee.

Sir E. GRAHAM-LITTLE

Perhaps I shall be in order in discussing another subject which is part of the survey of the Minister of Health, and that is the provision of medical education in this country. The Minister in his opening speech quite properly too well deserved credit for the improvement that has taken place in that education as a result of measures taken by the Ministry of Health. May I give a description of what has been, done in that respect? Possibly the Minister himself may not be aware of the extent to which that education is now available. In consequence of representations that postgraduate medical study should be improved, two schools were established upon the initiation of the Ministry of Health. They are both schools of the University of London. The first school that of tropical medicine and hygiene was opened in 1929 as a result of a grant from the Government and a large grant from the University of London. Two thousand students have passed through that school in the years since 1929, and it is very interesting to note the kind of students who come. One hundred and twenty-six were from Government services, 618 from Colonial services, 910 from the British Isles and foreign countries and 147 from missions. It is a very interesting fact that missions are taking advantage of the education given by the School of Tropical Medicine.

During the past week there has been a congress of the Universities of Empire meeting at Cambridge—they meet every five years—and the subject of postgraduate education by the universities in this country and in the Empire was discussed very thoroughly on the second day. It was at once agreed by all the representatives—there were over 200—that post-graduate study not only in medical matters, but in general matters, was a proper object of a university at the present time, and medical studies were insisted upon as being the most important of all. It was agreed that London must be the centre of those studies because of the provision of so many medical institutions in London. That is not surprising, because there are something like 30 institutions concerned with medical science in the University of London alone. The medical-student body of London University is nearly half of the whole of the medical population of the schools of this country.

A more recent and perhaps an even more important school was opened only at the beginning of this year—the postgraduate Medical School at Hammersmith. That school is under very interesting and curious management. It is under the control of the London County Council, the Ministry of Health, and the University of London. The London County Council have supplied the school with a very finely equipped hospital with over 500 beds, which was opened in 1934 by the King and Queen, and which began its active operations at the beginning of this year. In a very short time from the opening of the school, between January and June this year, 205 students have gone through the school. That number is particularly interesting because it has been largely British. The number of British students was 117, overseas and Dominion students 75, and foreign country students 14. It is obvious that while London must be the principal centre of that instruction, it is useful and desirable that we should have some provincial centres, and during the congress at Cambridge the interesting announcement was made that Cambridge University for the first time is proposing to have a department of clinical medicine, which will be opened in the coming session and will give admission to all post-graduate students in other universities. It is unfortunate that while so much money is being spent in meeting the demand for an improvement in medical education there should be such a multiplication of irregular schools, founded by irregular practitioners who pretend to give an adequate medical tuition, but who are, perfectly obviously, unable to do so. I received a letter this morning containing a prospectus in which a certain grandiloquent association pretends to give a complete education in medicine and surgery by postal tuition in the short period of nine months. It is that type of school which is well worth the attention of the Ministry of Health, because it is difficult to distinguish the product of those schools from the product of properly constituted medical schools, and the public undoubtedly finds a difficulty in distinguishing that counterfeit coin from the currency minted officially, which is safer to employ.

Sir FRANCIS FREMANTLE

Surely my hon. Friend must recognise that a distinction is made in the examination. There is every difference between the product of such a school and the production of decent schools, such as those which have had instruction from my hon. Friend.

Sir E. GRAHAM-LITTLE

The difficulty is that diplomas are issued as a result of that education, and the successful candidates are declared entitled to put a large number of letters of the alphabet after their names.

Sir F. FREMANTLE

But they are not registered diplomas.

Sir E. GRAHAM-LITTLE

There is one other question to which I should like to refer. Every hon. Member has been disturbed by the real evidence of malnutrition existing in our midst. I do not think there is any doubt that malnutrition does very largely exist, but very much more might be done towards remedying that condition by the proper instruction of people in the relative values of food. On that subject there has been a recent advance in medicine, and it is a very important one. It would be very useful if instruction could be given to those persons who are mostly in need of it, persons for example who are in receipt of unemployment assistance, where there is a very meagre sum given to them for subsistence, much of which is woefully wasted by ignorance on the part of those who have to pay the weekly bill. That sort of ignorance is, unfortunately, much more common in our country than in some other countries. One who has lived a good deal abroad knows the way in which, for instance, French peasants can make an appetising meal out of practically nothing. That is an illustration of what might be done here, and. I think more instruction might be given on that subject. I am pleased to note that lately a very important committee has been founded for the study of the subject of nutrition, but much more could be and should be done. The principles of dietetics are very easy to apprehend.

Those of us who have been in charge of hospital departments will be familiar with the very admirable series of leaflets issued by the Ministry of Health on the subject of venereal disease and its prevention. Those leaflets were a very important cause in reducing the incidence of and the mortality from that disease. Certain figures have been given which show that the incidence of syphilis and the nervous diseases which follow from it has been reduced to something like one-fourth of what it was in 1910. The figures for 1936 are about one-fourth of those for 1910. A great deal might be done by the issue of leaflets of that kind in regard to nutrition. I think also that the B.B.C. might be very properly used in broadcasting information and instruction of that nature. It is in these simple ways that the record of the Ministry of Health might be very greatly improved.

I do not wish to sit down without paying a very sincere tribute to the present Minister of Health. Comments have been made about the ability that he showed at the Post Office, very high compliments, and I hope that he will show something of the same methods in spreading the knowledge of medical science which is at his disposal, the value of which I am sure he appreciates. I do not know of any Minister in my memory who has been so successful or a Minister so much appreciated by the medical profession as the present Minister of Health.

7.53 p.m.

Mr. WHITELEY

In the review which the Minister of Health gave us of the work of his Department, housing occupied a very large part, and necessarily so because it is so important a matter in connection with the lives of the people of this country. On looking through the Estimates I find that there has been a very small increase of money devoted to housing, namely, £422,000. On such an important matter that is an infinitesimal increase, when one realises what the effects of a real housing policy have been in the past and its value for the future. It is no use trying to convince ourselves that we are making good progress when we are still receiving letters—I receive letters constantly—complaining that people cannot get decent accommodation in their particular locality. One of the things that is responsible for housing having gone back, as it were, is the fact that the Government in their quest for economy have discarded the subsidising of local authorities, who were making excellent progress with housing when the subsidies were in operation. Instead of the local authorities receiving the subsidies which they had in the past for the purpose of building working-class homes, subsidies are now granted for beet sugar the wheat quota, the cattle industry, the shipping industry and so on. Millions of pounds of the taxpayers' money are being devoted to all these special interests, but not one penny is being granted at present for the erection of working-class houses, so that there might be the necessary accommodation provided.

The PARLIAMENTARY SECRETARY to the MINISTRY of HEALTH (Mr. Shakespeare)

indicated dissent.

Mr. WHITELEY

The Parliamentary Secretary disagrees with that statement. The Government are granting subsidies for aged workers' homes, for slum clearance schemes and for schemes in connection with overcrowding, but for the actual building of houses to meet the requirements of people who are to-day living under overcrowded conditions, where the local authorities have nowhere to put them, there is no subsidy of any kind.

I want to turn to the Special Areas, one of the divisions of which in the north-east I have the honour to represent. One of the difficulties we have is that the waiting lists for houses is so long that there is no possibility of saying to the people with any certainty that they can have a house at any particular time. All that is being done or that can be done is to replace those people who are removed from the slums and to make provision for those people who are living with other people under overcrowded conditions, but for the additional population that is growing up all the time no proper provision is being made or can be made by the local authorities. I am particularly referring to the cases where you have local authorities in areas like ours on the north-east coast who have no available resources. The Government have taken away the great incentive from local councillors in our areas to put their real energies into housing programmes. The Minister will be able to say that a Housing Association has been established on the northeast coast for the purpose of giving rate relief to the local authorities in those areas that are penalised because they have not the resources, but what is the effect of a scheme of that kind on those local authorities which are composed of councillors who were full of enthusiasm for their housing schemes in the past, because when they were completed they could see something that was their own?

The Government are saying to those local councillors: "Your work in the future is to see to it that you prepare plans and arrange schemes, in order that some outside authority may have an opportunity of building those schemes, and when the houses are completed they will be the property of that outside authority and not the property of the local authority." How can you expect to have enthusiasm for housing if you are to develop a situation of that kind? Therefore, I say to the Minister that in the Special Areas, in the colliery districts, there ought to be more power given to the local authorities. What has been happening in the areas populated by miners in past days? They have lived in the dismal, drab, colliery cottages, with no outlook for those who occupy them, and when the local authority is asked to put the Streets Act into operation or to provide sewerage and a proper water system, they have been told by the colliery owner or manager that if such expense was forced on them the colliery would close down. That is why in colliery districts there has been so little progress made in the past. There ought to be better housing provisions.

The Minister of Health said to-day that tuberculosis had not been reduced to the extent that he would have liked to see. Take our area, Durham County. In 1920 we spent £42,000 on the treatment of tuberculosis. Five years later it had risen to £62,000, and five years later again, in 1930, to £77,000. In 1935 we spent £82,000. The Minister of Health said that there were 30,000 deaths from tuberculosis last year. That is a monstrous state of things, but in the County of Durham, where we spent £82,000 last year on the treatment of tuberculosis, the only thing we can do after we had got the people into something like a fit condition is to bring them back to the place where they contracted the complaint. That is not a good thing; and that is where the value of housing comes in. Local authorities should be assisted to build houses that will meet the requirements not of slum clearance or of overcrowding, but of these people. It would help tremendously in the treatment of tuberculosis.

The right hon. Gentleman also referred to the importance of some communal efforts for recreation and sport. In the mining areas the finest things are the miners' welfare centres and the aged miners' cottages, built by the aged Miners' Association. This week we have had three Supply days for the Scottish Department, the Board of Trade and the Ministry of Health. The three Ministers have made excellent speeches congratulating themselves on the excellent work they have done during the year. I rather suspect that they made these speeches in order to relieve the depression of their supporters. But, quite frankly, it is not well for us to congratulate ourselves. My hon. Friend has referred to the speech made by Sir Benjamin Dawson, who, after pointing out that he lives in the best country in the world, went on to say: The other day I saw the following advertisement in the 'Yorkshire Post': 'Coals for the poor and aged.—In hundreds of homes of the poor in the slums of Leeds there are little children and sick and aged people suffering from cold and hunger. We are very grateful to readers who help us to minister to the most needy of these, and further gifts of money, clothing, bedding, coals, etc., will be thankfully acknowledged.' I made an appointment with one of the staff of the society responsible for the advertisement, a society which is doing a wonderful work amongst the poor, and I spent half a day visiting numerous dwellings. When I had finished my tour I felt thoroughly ashamed of my country, thoroughly ashamed of the National Government, and thoroughly ashamed of the Conservative party. The pigs on my farm are better housed and fed than most of the people I saw that day. That is one of the things upon which the Minister of Health must concentrate and see that in the future there is an opportunity for local authorities to build extra accommodation, not only for slum clearance and overcrowding, but accommodation which will enable a full development of the people.

8.7 p.m.

Sir F. FREMANTLE

I want to deal with a few special points on the subject of housing and health, although there are many other questions upon which, however, we can feel that great progress is being made by the Government. We had a good example set up in the Scottish Debate two days ago, when they imposed a self-denying ordinance and limited their speeches to 10 minutes. I will try to see how near I can get to that ideal. There are one or two points I want to add with regard to housing. It is interesting to recognise the reaction between private enterprise and municipal efforts in this matte. The future of private enterprise in the larger towns is coming to be more closely connected with the necessary work of erecting houses for the lower middle class, the artisan population and the black-coated worker, who are able to provide houses for themselves and, therefore, are not fit subjects for the public relief works of housing authorities. Housing authorities are going ahead, especially under the overcrowding Act, and they will find that a number of persons will have to be combed out of municipal houses, because they are able to afford a higher rental, and ought to be asked to provide houses for themselves. That is the case for private enterprise, and I hope that those who take too rigid a line against private enterprise will recognise that there is a need for every help on every side of this problem, for private enterprise as well as for municipal schemes.

Reference has been made to bad housing. It is not only private enterprise that is responsible. Bad houses have been put up by local authorities, and in many cases local authorities get the work clone by the same contractors as private enterprise. But there is no doubt that there is a great deal of jerry-building going on at the present time. Of course, the reply is that it is in the hands of local authorities who have their own bylaws, but I cannot understand how it is that this bad housing is allowed to go on. It means that local authorities must vary a good deal in the supervision they exercise over the work, or over their officers. If anyone goes about new housing estates after the tremendous rainy seasons we have had they will hear of leakages, windows not fitting, wood warping, and doors not shutting, which will all mean great expense later. I wish there was some means of getting the more backward local authorities to see that every house that is being put up is properly supervised.

We have heard about the efflux from the big towns into the country, but yesterday I had evidence of the contrary, and there is no doubt a considerable movement, a reflux, of people back to the towns. When people get into the country on big suburban estates they find that they have to spend an hour, or an hour and a-half, every day travelling; and in the case of London they are coming back because it is not so bad, they say, being in London. I do not know what the future will bring, but it only emphasises the plea that has been made that the _Minister of Transport should be brought in when dealing with housing. There has been a considerable correspondence lately in the "Times" on the subject of satellite towns. That is the ideal towards which we must work, and I do not think we are doing so at the moment. The mistake which has been made in the garden city movement is that they emphasised too much the idea that they were aiming at a new complete town, like Letchworth and Welwyn, but they have not applied their principle to the actual moods and necessities of the times.

I feel that the basis of a satisfactory disposal of the population is the factory. People do not want to live round a factory, but the basis of any large movement of population must be the factory, or a series of factories like you have along the Great West Road. But it is most important that in the very early stages you should apply your principle to the disposal of residences and shops. This must be done in the early stages. Each of the garden cities 1 have mentioned was started with a clean slate. They began with residences. They wanted to get the people there at any cost, and then after the population had been brought together they wanted to bring the factories there. Naturally the factories did not want to come; they wanted to go where they were certain of a large labour population. That has been the real difficulty of Letchworth and Welwyn; the difficulty of getting factories on a large scale to come in.

I maintain that there is a real danger here, which arises from that fact that we have not visualised the essential connection between the decentralisation of residence and the decentralisation of industry. Both are going on to a considerable extent, but the decentralisation of industry should be the nucleus of the scheme, combined with the development of transport. You have three Departments interested—the Board of Trade, the Ministry of Transport and the Ministry of Health—and unless you have these three Departments working under a combined scheme you are not going to get any solution of the question of decentralisation. All the good work that has been done by each of those Departments for years and years will be ruined if this decentralisation continues in different directions. It is scandalous the way in which we are getting all these square miles of small houses and mean streets—even though they arc very much better than they used to be, they are nevertheless mean streets—quite independent of the amenities and work of the people.

I would like now to refer to the question of cancer, which has been dealt with to a certain extent during this Debate. I wish to endorse the real hopefulness of the present situation. Only within the last month I was reading the farewell lecture delivered by Sir Charles Gordon-Watson, the senior surgeon of St. Bartholomew's Hospital, in which he gave a review of the position with regard to cancer. I have worked with Sir Charles in the British Empire Cancer Campaign during the last 14 years. He quoted Dr. McKillip's statement that: The idea is rapidly gaining ground that the cause of cancer is no mystery at all, as the disease is, in all probability, the biological penalty to be paid by a tissue for being deviated from its normal physiological duty by one or more influences. The vicious circle of fatalism regarding the disease, which is shared alike by rich and poor, by the educated and by the ignorant, is based upon a false assumption that cancer is an incurable disease. He went on to say: Because of this belief a large proportion of sufferers fail to seek advice early, and because they dread a mutilating operation which they are convinced cannot cure. So the vicious circle grows. Then he made this statement: There is only one way to break this vicious circle. Let the public know with no uncertain voice that localised cancer is easily curable by the means which we have at our command, and that thousands of cured cases are living healthy lives, and let them know that only if cancer is neglected does it spread beyond the reach of cure. That is a hopeful message. But what does it mean? It means that we have to spread knowledge of the position among the people through the health authorities, the education authorities, the insurance committees and all the voluntary associations. We have to spread among the people the knowledge that they must not be afraid of the disease, and that when they know that there is a chance of something which they have developing into that dreaded disease, they must at the earliest possible stage have it examined and dealt with, and that if that is done, they can be cured; but that if they leave it and hush it up, as many do when they are foolish women or still more foolish men, as is often the case, there is the danger that it will have gone too far, and there will be disaster. We must drive that knowledge home, and in that connection I would point out the necessity, especially after middle age, of having occasional medical overhauls. An occasional overhaul, not necessarily every year, but every now and again, is one of the best ways of perserving one's life, especially so far as malignant disease or heart disease is concerned.

There is one other point with which I would like to deal. We have heard a good deal lately about maternal mortality, and I wish again to press upon the Committee the lesson of what is known as the Rochdale experiment. The medical officer of health at Rochdale and three medical men from London, independent of him, asked themselves what could be hone to lessen the terrible maternal mortality in Rochdale by making the most of the means at their disposal at the present time. The three medical men from London, one of them a general practitioner in the East End and the other two consultants, said, "The town which would be the best to take for an experiment would be one with a sufficiently large, but not too large population, where it is possible to get the actual facts and where the people can be persuaded to fall in with the experiment."

They got into touch with the medical officer of health of Rochdale, Dr. Topping, now on the staff of the London County Council, and the local authority of Rochdale agreed that there should be a big campaign to see what could be done. There was a maternal mortality in Rochdale, not of four, five or six per 1,000, but 10 per 1,000. What could he done by getting everybody to help, by making the utmost use of the facilities existing, by getting the medical men to help, and the medical officer of health particularly, by getting the school teachers and all the local private voluntary associations to help? First of all, they took the records of the previous three years for comparison. Then they started a tremendous campaign, helped by the local authorities. I will give the Committee the striking results for the next three years: The deaths due to pregnancy and childbirth in the three years preceding the experiment were 37; in the three years during the experiment, they were down to 13. The deathrate was cut down from 10 to below 4 per 1,000. The deaths due to intercurrent disease fell from six to three. That is not simply a total figure, but if one takes each set of causes in turn, one finds that the reduction is the same with puerperal causes, nutrition causes and heart causes, and the different conditions into which maternal mortality is divided up.

That is a lesson which needs to be driven home throughout the whole of our public health administration. A very large amount of improvement can be brought about if only one gets keenness and enthusiasm in the carrying out of things under present conditions. By all means go ahead and improve things where that is possible, but there is far too great a tendency for it to be said that it is a matter of pouring out more money and of getting extra help from outside. That is one of the dangers. In our personal lives, if we can get help or money from outside, it tends to sap away our independence and initiative; and the same applies in matters of public health. Medical officers of health tell us again and again that if people are enthusiastic and keen in carrying out what we have already, we can bring about an enormous advance. I hope that on all sides of the House, as well as in the Ministry itself, everything possible will be done to get both the voluntary associations and the local authorities, which, after all, also represent voluntary work to a large extent, to do all they can in the way I have suggested, and if they do that I believe that more than half the battle will be won. At the same time we must try to get fresh powers for further improvement from the point of view of administration by that most admirable Department, the Ministry of Health, under its present most admirable Minister.

8.25 p.m.

Mr. SILKIN

I propose to discuss the question of housing mainly from the administrative point of view. It is generally recognised that the Minister of Health is really anxious that the work of housing, of rehousing the people displaced from the slums and of dealing with overcrowding should be proceeded with as rapidly and as energetically as possible. It will also be agreed that the figures quoted by the Minister, showing the results so far achieved, represent the efforts of a large number of individual local authorities and that a large measure of the credit for that achievement is due to those local authorities. The Minister has it in his power to help or to impede the progress of local authorities, and I suggest that he could improve the progress of housing work in certain directions by the appointment of additional staff.

I have a certain amount of experience in the administration of a department of a, large local authority, and I have asked officials of that department to inform me of the average time taken by the Ministry in dealing with local inquiries. I find that, on the average, a period of about three months elapses from the date when a, slum clearance proposal is put before the Minister and the date of the official inquiry, while from the date of the inquiry to the date of the confirma- tion of the order, a further period of between three and four months elapses. Thus there is a period, roughly, of seven months, on the average, from the date when a scheme is put before the Minister to the date when the local authority is finally informed of the Minister's approval. In one case which the Minister probably knows about, the official inquiry was held on 1st October last and the Minister's final decision has not yet been notified to the authority. That is a period of nine and a-half months. That case may be a special one, and I appreciate the possibility that the Minister may have found certain difficulties in it.

I am content, however, to rest my contention on the average normal amount of delay, and I think the Minister will agree that seven months is far too long a period for the formalities of an inquiry. I suggest that he might consider increasing the inspectorial and other staffs with a view to expediting the consideration of these schemes. The delay is a great inconvenience to local authorities because it is impossible for a local authority to time its activities properly unless it is pretty certain that the procedure will be conducted rapidly. I have given seven months as an average period, but in a large number of cases the period is considerably longer. Moreover, it is an inconvenience to the owner who is uncertain of what is going to happen to his property, and while I do not express too much sympathy with the owner of slum property, he is often faced with the position that once the tenants realise that clearance schemes are about to be put into operation on the property, they refuse to pay their rent and the owner has considerable difficulty in recovering it. In some cases real hardship may be inflicted on the owner.

One consequence of the 1935 Housing Act has been that the preparatory period for local authorities has of necessity been extended, because they are now under an obligation which they were not under before, to give the owner of the property affected considerable details as to the respects in which his property is alleged to be defective. That all takes time, and when an authority is dealing with an area comprising 100 or 200 houses it will be realised that that factor alone is bound to cause delay. But that delay is inevitable, whereas the delay in connection with the official inquiries is, in my submission, capable of being remedied. Since the passing of the 1935 Act local authorities have been involved in considerably increased expense in the acquisition of property which has been declared to be slum property. The Minister may be interested to know the extent of that increase. The abolition of the reduction factor has had a serious effect in many cases in increasing the price of land. In one case where the London County Council had agreed to acquire land for—10,000 prior to the passing of the 1935 Act, the agreement was suspended in view of the passing of the Act, and eventually the council had to pay £19,000 or an increase of nearly 100 per cent.

In many cases the effect of the abolition of reduction factor has been that the owner of slum property is actually receiving more for his property than it would fetch if it were sold in the open market, because he is treated as the owner of a cleared site—with the local authority taking the financial responsibility for the clearance of the site. There are instances all over London where fortunate people are being compensated for being owners of slum property. The hon. Member for Ipswich (Sir J. Ganzoni) spoke of the hardships of owners of slum property. I would refer him to the large number of cases in which people are actually getting premiums for owning such property. Under the 1935 Act the class of person who is described as an owner-occupier had his compensation specially increased. In my view the increased compensation adequately meets the case.

Reference was made by the Minister and by the hon. and gallant Member for North-West Camberwell (Major Guest) to the question of community centres. I agree that there is a great need for community centres where large masses of population have been transferred from cities into what are practically new towns in which all social services and social amenities have to be created. But I think the hon. and gallant Member for North-West Camberwell would go further and have community centres established on all estates provided by local authorities even inside the cities. I have some doubt as to the wisdom of isolating a section of the working-class community inside our towns and in the provision of special community centres for local authority tenants there is danger of such isolation. I feel that tenants of local authorities, inside the cities, ought to have the advantage of all the amenities of those cities. There should be no distinction between municipal tenants and other tenants. The amenities of the cities should be made available to all and municipal tenants should not be encouraged to regard themselves as belonging to a separate class. In places like Becontree it may be necessary to encourage the establishment of community centres. If the Minister is anxious that local authorities should add to their burdens by the provision of these centres, he might perhaps consider the possibility of giving them some further assistance in that connection.

The 1935 Housing Act has now been in operation for nearly a year, and it is possible to arrive at certain conclusions in regard to its working. Under it there is a separation made between the sheep and the goats. There is a, favoured class of tenements set up, namely, the flat dwelling, which receives in certain cases a large contribution from the Exchequer, and there is the cottage, which as a general rule, particularly in the case of large cities, will attract no subsidy. The Minister shakes his head, and I hope he really believes that a subsidy will be attracted for cottages, but on the wording of the 1935 Act, much as I would desire that a subsidy should be attracted to cottages—and, indeed, I am not giving up the battle, and T. am perhaps going to make application to the Minister in due course—I think he will find himself in some difficulty in giving that subsidy in the case of large towns with a large rateable value and so on. To any case, the subsidy for cottages is quite small in comparison with the subsidy for flats, but the result is that the local authorities have a financial inducement to build flats as against cottages, and I submit that this question of building flats as against cottages ought to be considered entirely on the merits of each particular case.

I do not think it is right that local authorities should have a financial inducement to build a class of dwellings which they might, if there were no question of finance, consider to be entirely wrong. Local authorities are only human; they have to have regard to rates and to take into account such considerations as State subsidies, and one of the consequences is bound to be that there will be a bias, in the case of a large number of cities and towns, in the direction of flats, where flats might, on the merits of the case, be entirely wrong. Moreover, there is a direct incentive given to the erection of high buildings of flats—four and five storeys or even more—because the subsidy under the 1935 Act is given in respect of the cost of the land, and the more flats you can put on a particular piece of land, the better off the local authority is. There is, therefore, a direct inducement to build high dwellings on land, irrespective of the merits of the case, because of the way in which the Exchequer subsidy is being provided.

Then there is the further point that there are two different subsidies being provided, one under the 1930 Act and one under the 1935 Act, and, if I may let the Minister into some of the secrets of a local authority, in the case of every scheme inevitably consideration is given as to which particular Act it pays the authority to build under. In certain cases it pays them to treat a scheme as a slum clearance scheme, and in other cases it pays them financially to treat it as an overcrowding scheme. I submit that that is all wrong and that there should be no financial inducement of that sort. Every scheme should be permitted to be treated entirely on its merits, and one way of doing that would be that there should be one subsidy only for all types of houses. I hope the Minister may find it possible to give consideration to that suggestion.

In some of the large cities probably the only way of dealing with the overcrowding problem is by utilising Section 13 of the 1935 Housing Act, which deals with re-development. All progressively minded local authorities would, I am sure, wish to take the fullest advantage of the redevelopment portion of the 1935 Act, and indeed I, personally, regard that section as perhaps the most valuable in the Act, because it does enable a large local authority to re-develop large portions of its area which could not be dealt with except by way of a large re-development. Unfortunately, the procedure laid down under the 1935 Act for dealing with redevelopment is long, cumbersome, and difficult, and already many problems have arisen which may have to be settled by reference to the courts. At the best, the procedure will take something like two years, and during the whole of that period it is open to owners inside a re-development area to deal with their property, to develop it in any way they please, subject, of course, to town planning, and, consequently to force up the price of that property against the local authority. I would have hoped that some much more expeditious method would have been found for dealing with redevelopment, which would have prevented what may very well become an abuse and may indeed make this particular provision very difficult to carry into effect.

Moreover, there is a further difficulty in connection with re-development. Under the Act it is necessary for the local authority to make a map of the area with which it proposes to deal. It, so to speak, puts a ring round that area, and then, under the Act, the local authority may be forced to acquire the whole of the property within that area, whether it wishes to do so or not. I do not want to weary the Committee by drawing particular attention to that Section, but I think the Minister will agree on reading it—and indeed that is the advice of his own officials—that the local authority may be compelled to acquire the whole of the land within that area, whether it is necessary to do so or not for the purpose of re-development. Some of that land may be very expensive indeed, and no doubt it will be the more expensive portions of the land which owners will force the local authority to acquire, and in that way these particular Sections may very well become nugatory, and not only may re-development become inordinately expensive, but local authorities may be faced with very large and unknown expenditure at the time of making a redevelopment order, and only the most courageous and the most wealthy of them will be prepared to face up to it.

There is one other point in connection with the 1935 Act to which I would like to refer, and that is that the definition of an unfit house in a re-development area is different from the definition of an unfit house in the 1930 Act. That gives rise to considerable confusion, not only in the minds of local authorities, but also in the minds of the public. In one case a house has to be unfit for human habitation and injurious to health —and local authorities have become accustomed to the working of Section 1 of the 1930 Housing Act and know exactly where they are—but in the redevelopment Sections, in order to get your third, you have to find houses which are unfit for human habitation and not capable of being rendered fit at a reasonable expense. That gives rise to a tremendous amount of controversy as to what is a reasonable expense in dealing with a re-development area, and it seems to me a pity that the same definition should not apply to the re-development Sections as applies to Section 1 of the 1930 Housing Act.

A further subject on which I should like to touch is the overcrowding survey. In some parts of the country the survey has been completed. The results are in the hands of the Minister and most local authorities are proceeding to investigate the total number of dwellings that will be required to alleviate overcrowding. In London these figures are ready. Prior to making the survey, a preliminary estimate was obtained as to the number of dwellings that would be required in London to deal with overcrowding, and the figure was found to be 39,000. The actual result, however, shows that only 23,000 will be required. I suggest that it is a great pity in these circumstances that the standard of overcrowding was fixed so low. It would have been possible to deal expeditiously—and I think the same applies to most places in the country—with a somewhat higher standard. Indeed, in the case of the London survey there are almost as many families living on the verge of overcrowding, but not officially overcrowded. as were found to be actually overcrowded. The fact that 80 per cent. of the local authorities have found it possible to fix the appointed day under the 1935 Act 1st January next indicates that they would have been prepared to deal with an even bigger problem than that with which they appear to be faced as a result of the overcrowding standard which was fixed. I suggest, therefore, that it might be possible at an early date to fix a somewhat higher standard, because I am sure that neither the Minister nor any hon. Member really regards the standard as at present fixed as an entirely satisfactory one. I have attempted to deal with some of the difficulties which arise in actual practice, and I hope that I may be forgiven if I have kept the Committee too long.

8.48 p.m.

Sir RICHARD MELLER

I would like to endorse the appeal that has been made by the hon. and gallant Member for North West Camberwell (Major Guest) and the hon. Member for St. Albans (Sir F. Fremantle) with regard to the large housing estates. We have had to gain our experience as we have gone along and I think that one of the points which have come out of the large housing estates is the fact that regard has not been had for the amenities of the people. In my constituency there is the large estate of St. Helier, which has been placed there by the London County Council. From the point of view of the estate there can be no complaint about the layout, but the people have been brought from crowded areas, from shopping centres much cheaper than the shopping centre in which they find themselves; and they were much closer to their work, and the young people were within easy reach of places of entertainment. There are these vast areas of wide streets and well spread houses, with some communication, it is true, with a main road, but in the centre of them there is no place of meeting except one or two church halls, and the people feel that there is a sort of penalty placed upon them because they have been brought outside. It will take a good many years for these people to get used to the, new position, but many years will have to go by before the young, people can appreciate that they must walk a mile, or two, or three miles for that innocent entertainment which they used to obtain on their doorsteps.

I want to turn to a subject which forms an important part of the Minister's Department, namely, National Health Insurance. Just over a year ago we were dealing with a Measure which had been introduced by the Minister to try and overcome some of the real difficulties that had arisen for the insured person by reason of long periods of unemployment, and to meet what was a real fear that many of them would pass out of insurance and be deprived of its benefits. The Minister introduced a scheme which provided for a prolongation of insurance, but that prolongation necessitated very complex regulations to be administered by the societies. The administration of National Health Insurance has never been an easy matter, but when you have to deal with the complexities of the arrears regulations, you will find the complexities greater than are experienced in any other form of clerical work. It has been suggested to me that the Act has very much complicated the work of officials of societies, and I should like to ask the Minister whether the societies have expressed any views, not so much upon the principles—because the principles embodied in the 1935 Act are highly appreciated by them—but whether any real objection has been raised or any complaint made with regard to the complexity of the arrears regulations.

There is another point about which I should like to ask the Minister, because it affects very largely the question of distributable surpluses. Hon. Members have spoken to-day of the advantages to be obtained from dental treatment, ophthalmic treatment and other treatments and special benefits, which are obtained by the possession of large distributable surpluses accruing at the end of the period of valuation. The arrears regulations which were made under the Act of 1935 will have some effect upon the financial results of the approved societies, and I would like to ask whether, in fact, the regulations, and the extent to which they are applied to those persons who have suffered long periods of unemployment, have had a material effect upon the possible disposable surpluses or the finances of approved societies generally. I was glad to find that, as a result of the 1935 Act, large numbers of unemployed persons have been reinstated in benefit. Can the Minister give any idea of the proportion of the persons who under the former conditions would have had to suffer termination of insurance but have benefited under the provisions of the Act of 1935?

Cases were brought to my notice of unemployed persons who, fearing the loss of benefits through long unemployment, have been persuaded to pay contributions as voluntary contributors. The number of cases brought forward at the time rather startled the Minister and the House, but the right hon. Gentleman was good enough to say that provision would be made for those persons who had continued their insurance as voluntary contributors to go back into the employed class. Will the right hon. Gentleman be good enough to say whether the undertaking which he gave in respect of those persons has been kept? Then there is the question, which I believe is of interest to Members of the Opposition and to insured persons generally, of the effect of the Act upon the persons whose insurance would have terminated but for the Act of 1935. Further, if there are persons whose insurance was terminated during the course of the year, are they being provided with full information as to their rights to continue as voluntary contributors? Not only should the information be supplied in a simple form, but every person entitled to that information ought to have it. I hope the Minister will make arrangements so that no person can hereafter complain that he lost the valuable benefits under the National Health Insurance, including his right to pension, through not having been informed of his rights uder the various Acts.

The only other question I wish to put to the Minister concerns the report which was presented to him by the joint committee which has been considering optical benefits. That committee was formed of representatives of the approved societies and of the opticians. It was appointed to deal more particularly with ophthalmic benefits—providing ophthalmic treatment at a reasonable rate, seeing that the provision of glasses was not too costly, and that, generally, the most experienced opticians were brought into the field of National Health Insurance. There has been a great deal of co-operation between the two bodies, and there has been a preliminary, an interim and a final report. The final report has now been in the hands of the Minister for some months, and those who have been engaged on this work for three years are rather anxious to know what is to happen as an outcome of that report. Some observations were made by a member of the right hon. Gentleman's Department at a conference, but I think that we in this House are entitled to know the Minister's view of the subject and what he proposes to do on that report. I do not wish to say anything more, but I have put forward these points because they deal with matters which very much disturbed some Members of the House when the 1935 Act was under consideration.

8.58 p.m.

Mr. G. GRIFFITHS

I shall not throw any bouquets to the Minister, because he has been almost smothered with them since four o'clock this afternoon. I should like to offer a reply to the speech of the hon. Member for London University (Sir E. Graham-Little), though not to deal in any sense with what he said when he was giving us a lecture on medical science. I want to cross swords with him on his malnutrition theory. He said, when dealing with malnutrition, that a lot more instruction should be given to people. I want to tell him that in the industrial areas, in the depressed areas, and in the semi-depressed areas, it is not instruction they want but money to enable them to buy food, so that they can cook it. If they can get hold of the money it is not much instruction they will require. We have some of the best cooks in the world in those distressed areas. The hon. Member also said there was a lot of food wilfully wasted. I want to refute that statement entirely.

Sir E. GRAHAM-LITTLE

I said that in the choice of foods money was often not wisely spent.

Mr. GRIFFITHS

If the hon. Member, before he eats his breakfast tomorrow morning, will read what he said he will find that he did make the statement that there was a lot of food wilfully wasted. There may be a lot of food wilfully wasted by the class among whom he lives, but there is not a lot of food wilfully wasted so far as we are concerned.

Wing-Commander JAMES

May I ask whether it is in order to discuss nutrition on this Vote?

The TEMPORARY CHAIRMAN (Sir Robert Young)

I understand that the hon. Member for London University (Sir E. Graham-Little) has raised the question, and I cannot stand in the way of the hon. Member giving an answer.

Mr. KELLY

There is an item in the Estimate dealing with nutrition.

Mr. GRIFFITHS

If the hon. and gallant Member had not risen to a point of Order he would have found that I was coming to the effect of nutrition on tuberculosis. I will leave the speech of the hon. Member for London University, but nobody on these benches could allow the statement which he made to pass. Another point I wish to raise is that on this 16th July, 1936, we are still waiting for the annual report of the Medical Officer of Health of the Ministry of Health for 1935. 1 hope that in future when we are discussing the Ministry of Health Vote we shall be able to have that report for the preceding year. The Minister of Health stated—and he skipped over this pretty freely—that 30,000 people died of tuberculosis last year, and that in the previous year the total was 33,255. A figure like that does not seem high, seeing that in this House we are talking in millions every day, but it means that something like 95 men and women, boys and girls, die in this country every day from tuberculosis; and the most alarming feature is that 54 per cent. of them are under the age of 35. They are the young life, the life that we require. Another statement was that 34 per cent. of those who die of tuberculosis in England and Wales, leaving out Scotland, are between the ages of 15 and 25. The Minister spent only about two and a-half minutes to-day on this most vital subject. I know that we are doing better than we did 25 years ago, when some 50,000 a year were dying, but the Minister did not tell us that last year there were 66,000 new cases of tuberulosis reported in this country.

Although the Ministry have given a certain amount of consideration to this question I must ask them to give further consideration. I make bold to say—although I know my view has been refuted I have a few figures here which I shall quote—that this disease is largely a disease of poverty, of overcrowding and of bad housing. During two years Dr. Bradbury conducted an investigation in Jarrow and in Blaydon. He was in that area for two full years and he traced tuberculosis all over the town. He has published his report, which is a most enlightening one. The Minister may have read it, but if he has not I suggest that it would be a good thing for his education on this question of tuberculosis to read it. Dr. Bradbury distinctly states that the chief cause of tuberculosis is bad housing and overcrowding—forcible overcrowding in some cases, because of low wages. There were two and in some cases three families living in one house because one family could not afford to pay the rent of the whole house. They had to join in payment of the rent. In this house, they found that tuberculosis was very prevalent.

I know that some people say that tuberculosis is not largely due to poverty, but I have a set of figures from which I want to quote. They are not from the Labour Research Department and not from Mary Sutherland's Nutrition Department, but from Mrs. Baldwin's own committee—the committee of the Prime Minister's wife. Hon. Members will not say that the figures are biased from the Socialist side of the case. I am very pleased that the Prime Minister's wife is so active and so interested in the question of infantile and maternal mortality. She, and other women, have set up different committees, and these are the comparison figures that they have found out between the North of England depressed areas and London and Middlesex. The figures of infant deaths are for the seven years 1927 to 1933, and the maternal deaths are for the seven years 1928 to 1934. They comprise a population of 6,148,000, and include five coal-mine counties, Durham, Glamorgan, Monmouth, Northumberland and Yorkshire—the West Riding—and seven ports representing depressed areas, namely, Birkenhead, Cardiff, Hull, Liverpool, Newcastle, Sunderland and Swansea. In those areas the infantile deaths were 64,052. The population in London and Middlesex was the same, to within one or two thousands, and the deaths there were 38,629; or, there were 25,423 more infant deaths in the seven years in the northern areas than there were in the latter two areas which had the same population.

Take the maternity deaths. In the seven depressed areas which I have cited they were 3,965, but in London and Middlesex they were 2,206. That is to say, although the population in the depressed and semi-depressed areas was the same as in London and Middlesex, there were 1,795 more deaths, proving that if the people in the North, in Wales and in the ports had the same facilities arid were fed exactly similarly, there would have been a lower maternal death rate by 1,795. Yet people get up and tell us that it is not a matter of poverty, arid that you have to give people instruction. so that they know how to cook, etc. What we say is: It is not instruction they want, but food to eat.

During the General Election, I was delivering pamphlets from door to door in my own constituency. I knocked at a door. In our constituency you generally say "Hallo," and walk in. I walked in, and in that room downstairs there was a young lady lying in bed. She was as thin as a lath. She was not as fat as an envelope edgeways on. I said to the mother, "What is the matter with this young lady?" She told me what had happened. Anybody could see that the young lady was dying. The mother said that the girl had given birth to her first baby a fortnight ago. I said, "Why don't you seek some help?" She said: "Because her husband has worked two days a week, he cannot get any help at all." I said: "You have to have some help as quickly as possible." They gave that young woman 5s. to help her. The mother said to me: "The cause of this, Mr. Griffiths, is that this girl came from Durham. Her father had not been working for six years before we came down here." She was starved to death before she was married. She had not had sufficient strength for years. and when she had to face the throes of death she had not the strength to go through with it. That is a case of malnutrition, and not the effect of not knowing how to cook. That is the case with a lot of people. I mean that.

I want to touch on a point that I know something about. I shall ask the Under-Secretary to reply to one or two questions affecting 200,000 people in our population who are smitten with the disease of diabetes. One out of every 250 people suffers from diabetes, and yet the Ministry of Health never says one word about it. In 1924, when the late Mr. John Wheatley was Minister of Health, there was an Order in Council that every State-insured person in this country should have insulin free. The statement was also made that anybody who could not afford insulin should be enabled to get it through the public assistance committee—the guardians, as they then were. I appeal for this population of 200,000. I ask the Minister of Health to give the matter further and better consideration than has been given to it for the last three years. He has stated that if the people were not National Health Insurance persons suffering from diabetes, they would be unable to get insulin treatment. Although insulin treatment is not a perfect cure for diabetes, it is the greatest palliative that has ever been discovered. It helps to put life and vigour into the man who has diabetes. I ask the Parliamentary Secretary, or the Minister, when replying to-night to state that anybody who has diabetes in this country, including working-class people and their wives, shall be enabled to get insulin.

I want to give him three cases, although I could talk about this matter all night. Before I give those three cases, I would just mention, to show how prevalent diabetes is to-day, that 2,000 diabetics attend King's College Hospital, and that 800 diabetic patients are attending the London Hospital, in the East End They are not all getting insulin. During the last 12 months, since the Minister gave the reply, I have been finding cases, and I have three to put across the Floor of this Committee. One case is that of an old lady who has gone blind. She has to have two injections of insulin every day, 40 units daily. She is living with her son-in-law. Her husband was living with them and was past work, but because the woman was living with her son-in-law and the son-in-law was in regular work, she could not get her insulin free. Those 40 units a day, multiplied by seven, mean that she has to have 280 units a week. If she gets the best insulin, at 1s. 10½d.—I am not speaking about the shilling bottle now but about the best insulin—she must have three bottles, costing 5s. 7½d. per week. Because she was living with her son-in-law, she could not get insulin, as was the intention when the Order in Council was issued.

I will give another case. I visited last Saturday afternoon, when I was in my division, a young woman 38 years of age. Her husband is working regularly, and is getting about £2 15s. a week. This woman has to have 45 units a day, and she is suffering at the moment also from running gangrene. I said to her, "Cannot you get your insulin?" and she replied, "No, I cannot. It costs me 6s. a week. I had to pay 6d. for a needle yesterday, and I have to find my own iodine, methylated spirit and wadding." It costs altogether no less than 6s. 9½d. a week. Moreover, she said, "I have to have a special diet, besides our Jack having his." He has his own diet, and she has to have a special diet; and yet they cannot get any insulin. I want the Minister to stir these folks up and let them know, perhaps by circular, that they can get it.

I have one other case, and I am not sure that it is not even more distressing than the other two. It is a case where a woman is living with her husband in one of our old-age cottages in my own township in Yorkshire. Her husband has a pension of 10s. She is not old enough for a pension, but they are getting 15s. a week from the public assistance committee, which makes a total for them both together of 25s. a week, and they pay 5s. 6d. a week rent. This woman has to have insulin, but the price of the insulin has to be taken out of the 15s. that they get from the public assistance committee. My contention is that, if that circular is properly applied, she should, on the top of that 15s. from the public assistance committee, have her insulin and all the incidental necessities, so that she may have a chance to live.

Mr. FLEMING

Does the hon. Member know whether this particular woman has ever applied to the public assistance committee for the extra cost of the insulin?

Mr. GRIFFITHS

I do know; that is what I am stating. I would not state the case if I did not know.

Mr. FLEMING

Was she refused?

Mr. GRIFFITHS

The only money she could have was the 15s. inclusive. [An HON. MEMBER.: "That is the scale."] My hon. Friend says that that is the scale, but it is only the scale, in my locality, for people who are well. This is an exceptional circumstance, and should be considered exceptionally, and I say that, if the Minister will issue a circular to the local authorities pointing out these things again, I am satisfied that they will be able to get something. I wanted to put that point to the Minister, and I hope that the 200,000 diabetics in the country—and their number appears to be increasing—if they require insulin, will be able to get it. Almost invariably, however, if the husband is working, the relieving officer will turn them down and tell them they have no right to apply. That happens almost without exception, irrespective of the amount they may be getting. We have some people who are working only two days a week, but, because they are working, if they make an application to the relieving officer, he says: "You cannot have any, because you are working." I say that even if a man is working, if his wife is suffering from this dread disease, the public assistance committee have a right to consider the case of that woman and give her sufficient insulin to keep her alive until she passes away naturally, and not through diabetes.

9.21 p.m.

Mr. LEVY

I have listened to this Debate with great interest since four o'clock, and, although the supply of water is one of the most important services in the country, it has only been mentioned en passant by one or two speakers. I rise with some diffidence to-night to speak on the subject of the water supply, because it is well known that we have had quite a lot of water lately, but that sort of water is only haphazard. A farmer said to me the other day that he was "fed up" with the way in which he has to obtain his water supply—that what he would like would be an adequate drainage system when we get these floods, and a properly conserved and distributed water supply when the drought came. Of course, such conditions would be what I should describe as a farmer's paradise. I think every Member of the House will admit that the rural areas have waited far too long between the hell of floods and the hell of droughts.

A number of tributes have been paid to-night to my right hon. Friend, and I want to pay him a high tribute for what he has done in this important matter of water supply. It is well known in the House that I have been pursuing this subject for several years, in the last Parliament and in this Parliament, but it was not until my right hon. Friend went to the Ministry of Health that I felt satisfied that some attention would be paid to it. I have every reason to believe that he will give to this important problem the same care and assiduity that he gives to the other varied aspects of the work of the Ministry of Health. As a result of his efforts, some impression has been made on this primary problem of rural water supplies, and, if my right hon. Friend can hold out any hope to the rural community that they will soon be delivered from these two purgatories, he will have done them and the whole country a service, and will equal, if not eclipse, the fine work that we all admit he has done in the Post Office and in the general field of public health service in which water supply plays so important a part.

It is true that the grant of £1,000,000 which was provided by the Exchequer has already been provisionally allocated, and it is also true that schemes have been undertaken, with the help of that grant, in 2,350 parishes, at a total estimated cost of £7,000,000. I understand, too, that since March, 1934, loans totalling £1,340,000 have been sanctioned for schemes in another 400 parishes, but those 400 parishes do not get any grant, although in some cases assistance is forthcoming from county and rural district councils. All that is to the good and to the credit of the Minister of Health. But I want to press on the attention of the Department the extra importance of developing the principle of these regional water committees with scope to coordinate the sources of supply and to plan ahead. There have been eight committees set up in large areas, and in all they deal with a population of 14.000,000. One of the biggest difficulties of this water problem is the confusion of interests, the overlapping of water authorities in their areas and the existence of monopoly rights which hinder the freer distribution of water where it is so urgently needed.

It is only by large-scale planning that this problem can be tackled. These regional committees are a step in the right direction, although I want to see regional committees set up in every region throughout this country, having regard to the physical geography of the country, and I want to see these committees with statutory powers dealing with the water supplies within their areas. They necessarily work at present under a grave handicap. They can investigate, survey and recommend, but they can do no more than recommend. They have no authority to carry out any regional schemes. That is their weakness. Vested interests and monopolies are not likely to accept mere advice if they consider that the acceptance of that advice does not further their interests.

The TEMPORARY CHAIRMAN

I am not quite sure whether what the hon. Member is suggesting would require legislation. Is that so?

Mr. LEVY

I am not suggesting that we should increase their power. I appreciate that if I say anything in this Debate which necessitates legislation you will very properly rule me out of order, but what I am doing is to explain the powers which they have. The vested interests and the monopolies are not likely to accept mere advice if that advice does not further their interests. It is for the Minister to say whether he is going to bring in any legislation to give them power. I know that the report of the Joint Select Committee on water supply which is considering the measures required for the better conservation and organisation of supplies has not yet been presented, And I have every confidence that when that report is presented the Minister will give it his sympathetic consideration. I hope very much that their powers and responsibilities will be enlarged, and if they are that will be a step in the right direction to the solution of this problem. If that takes place the rural districts will in time, we hope, be free from these dual torments. If this improvement through the energy of the Minister of Health takes place, may I be allowed with humility to say that he will receive my gratitude for vindicating the campaign I have been waging for so many years in this House?

9.31 p.m.

Mr. DAVID ADAMS

Whatever charges we may have against the Government or the Minister of Health there can be no charge that the Minister himself is not a master of his Department. He has lived in the atmosphere of public health for years. He has had experience for some years on the London County Council—not, of course, experience of the kind he might have obtained if he had been associated with one of the great municipalities on Tyneside. Nevertheless, he is in every sense equipped for the great tasks which fall to him in this, one of the highest offices of the Cabinet. One feels that with his ability and geniality, if one had any complaint to make against the Department one would almost require to say it with flowers, or with music. Nevertheless, it is an obligation on me to-night, in spite of the fact that the Minister is the complete Minister of Health, to declare that we are in a relatively backward condition as far as housing, for instance, is concerned, and I begin with the proposition that the National Government have arrested housing progress by reducing the standards and subsidies, and that overcrowding is not being adequately detected under the 1935 Act. Under that Act, in spite of the protestations in Committee of hon. Members on this side of the House, the living room is looked on as a bedroom, and it is not therefore surprising that as a result of the national inquiry into overcrowding we have merely some 330 cases of overcrowding throughout the entire country. The hon. Member who spoke recently on this side might well declare that as far as London is concerned, in his judgment—and he spoke in an official position—about 50 per cent. of the actual overcrowding had been overlooked under the 1935 Act.

I asked the Minister on 28th May how many local authorities under this Act had applied for subsidy for the building of houses other than flats upon expensive sites, and he advised me that the figure was £1,014 per annum for 20 years in respect of only 217 houses. When you examine that statement you have this remarkable fact. The Minister has power under the Act to grant a maximum of £5 for a period of 20 years. But the average amount that the Minister had allowed on these houses was only £3 10s. per annum for 20 years. I want to know why the local authorities who applied are not receiving the full amount. I have been to conferences where great discontent was expressed that they should not have the money that the Act permits the Minister to grant and, when we are told that there might be some choice to local authorities in dealing with overcrowding, if there are better grants under the 1930 Act than under the 1935 Act, the local authority will select whichever Act will give the largest amount of subsidy, that is a complete fallacy. There is no such choice given. No local authority that is re-housing its people under the 1935 Act will be permitted to use the 1930 Act. That is to say, the maximum amount that any local authority will receive under the 1935 Act will be £5 for 20 years, as against the average of £11 5s. for 40 years under the Slum Clearance (1930) Act. The Minister nodded assent to a proposition made from these benches that we might look upon the present arrangement as a temporary one, and I hope he will bear that in mind, and will not have a return to the not too adequate subsidy under the 1930 Act.

The right hon. Gentleman's predecessor lowered the standard of municipal housing by steadily reducing the square foot area to 760. The result of that has been very interesting. In the North of England certainly, and I suppose throughout the country generally, even under the low standard of the 1935 Act we have a considerable number of the houses built by local authorities declared to be overcrowded because the then Minister determined that local authorities should only build houses of those diminutive proportions. I have a grievance with the right hon. Gentleman to this extent that, while he saw the folly of that restriction and empowered local authorities to build up to an area of 1,130 square feet, he only relaxed the old regulation in May last. We ought to know why we were compelled to continue building to these diminutive proportions which were a great disability to many local authorities, particularly in the north of England. Many houses even under the 1935 Act will continue to be immorally and indecently overcrowded. Two bedrooms up, one down, and a kitchen can be occupied by seven and a-half units, that is, seven adults and a child of from one to ten years of age. You can have this result—a man arid wife, a girl of 18, and a boy of 16 and relatives or sub-tenants consisting of a man arid wife with a girl of 19 and a boy of nine or ten in what is really a three-bedroom house. However placid people may be in this part of the world, we have declared in the north of England that under the Act of 1935 we are not dealing with the gross overcrowding that prevails and that we ought to have fresh legislation. A population of five adults and three children, or seven adults and one child, in that small three-bedroom house is a scandal when one considers the new age in which we are supposed to be living.

There is another matter to which I should like to call attention and express the hope that the Minister may take some action. The whole aim of the monumental Local Government Act of 1925 was to abolish the Poor Law taint. We in Newcastle took very swift action under it. Our hospitals were transferred to the local authority and the name of the Poor Law institution was changed. We went so far as to abolish pauper funerals of the ordinary sort. It was decided that private enterprise should be called in to bury those who ended their days in a Poor Law institution. But we went further than that. Under the Poor Law, those who have lost their National Health Insurance and come to the Poor Law for medical relief are in the main attended by district medical or Poor Law doctors. I think an examination of the position of these doctors throughout the country will reveal what was discovered with us, that the remuneration was altogether too small. In Newcastle it was 6½d., in addition to which the doctor had to find dressings. It is obvious that he could not, and in fact did not, give adequate attention. We, therefore, did what I hope the Minister may see his way to make obligatory. We set up a panel of doctors remunerated upon a proper scale, and we give now a domiciliary medical service to those under the Poor Law as good as can be obtained under National Health Insurance. I wonder whether the Minister can see his way to make it obligatory upon all authorities to set up such a panel of doctors, so that an adequate domiciliary medical service may prevail throughout the country. Until he does that, it is certain that those people will not have the medical attention to which they are entitled.

As far as the maternity and child welfare problem is concerned, undoubtedly the local authorities will be grateful for the determination of the Minister to close the gap between the children who are in attendance up to the first or second year of age and the school age. Many of the authorities—I suppose most of them—are taking very active steps to give the necessary attention during those very formative years up to school age. Is it beyond the possibility of the Government and the Minister to make it compulsory upon local authorities to give help to expectant and nursing mothers, the standard of income of whose husbands is merely equal to that of the unemployed? It is pretty common knowledge in the North that that is being done, but should it not be made compulsory throughout the country? It is useless to expect the standard of health to rise with rapidity unless steps are taken to eliminate the nutritional defects which prevail in all great centres of population. While we have many medical officers of health declaring that 50 per cent. of the sickness is due to the low physical standard in large measure caused by nutritional defects among the population, the matter ought to, and indeed must be dealt with without the passage of much time. The problem is a grave one. The remedy is an expensive one, but it is necessary, and if we are to raise the standard of our people to the height which the Minister desires, we shall have to act promptly upon such lines as these.

9.48 p.m.

Mr. BOULTON

During the course of this Debate the question of housing from diffierent points of view has been much discussed. I want to take this opportunity of referring to the Slum Clearance Act, and more particularly to the administration of that Act by certain local authorities. I do not think that it is necessary for me to assure my right hon. Friend how wholeheartedly I am in sympathy with him in his great efforts to clear away the slums and to try to obliterate the overcrowding which is such a curse in many of our great centres. I should like to congratulate him upon the rapid progress that has been made in slum clearance since he took over his most difficult office. I cannot help but feel that if he had been responsible for the Act at the time, it would not have been drawn quite in the same way as it was. I make no apology for drawing attention to the administration of the Slum Clearance Act, for it is still a burning question in many of our great centres. From the experience which I have had, I consider that it demands a further—I was almost going to say, immediate—review by my right hon. Friend in the light of the experience that we have now gained.

In previous Debates in this House, particularly in the late Parliament, many cases of what were considered cases of hardship and injustice were quoted. I, myself, brought numerous cases to the attention of the Ministry, showing, in my view, in what a merciless manner the administration of the Act was working in respect to many cases. I am not going to weary the Committee to-night by giving any further examples, but if my right hon. Friend would prefer me to give him some—I am sure that he would not, as he knows too many of them—I could litter his desk with cases that go far to confirm what I have said. I complain of the way in which some local authorities are taking advantage of—I would almost say in some cases abusing—the powers that have been vested in them under the Act. We are all familiar with the procedure with regard to clearance orders, how the medical officer of health, who, in some cases, appears to assume almost dictatorial powers, advises the local authority to clear an area, how the clearance order is issued for the particular area, and how the people are taken out perhaps to one of the large new estates being built round our cities. I do not complain of that, but how does this clearance and removal of some of these people affect certain classes of people?

I want to draw attention to-night particularly—I have drawn attention to it before in this House—to the question of the small shopkeeper. What is his position? If he is the owner of the house and shop he occupies, he is ordered to demolish the premises at his own expense. It is true that where he is the owner or the tenant he receives compensation for loss of business, which in most cases is the loss of his livelihood. The average amount, that he would be likely to get would be something like £30. But what if he wishes to make a fresh start or follow his customers to one of these new estates? What does he find? He is debarred from renting a shop. Why? Because the authorities will not build shops to rent for these small shopkeepers. The only alternative the shopkeeper has is to build at a cost of not less than £1,000 which, of course, is quite prohibitive. What is the consequence? These small shopkeepers who have been deprived of their living are, in many cases, to my own knowledge, forced to fall back upon the public assistance.

The trade in those centres which are becoming large townships goes to the co-operative societies and the multiple shops which have unlimited capital and can take up sites and build shops themselves. That is an intolerable position. I want to ask my right hon. Friend particularly this question. Is any local authority which is receiving large grants of money for providing accommodation for these people who are being removed from the slums, justified and within its rights in refusing to provide shopkeepers with shops at reasonable rents, or at any rate for a proportion of the shopkeepers who have been deprived by the local authority of their livelihood? Was this intended? If not, cannot the right hon. Gentleman do something? This is a very serious matter. There are many distressing cases which ought to be looked into. The whole question ought to be investigated from the point of view that I have presented.

There are other cases, with which I will not trouble the Committee at length. There is the case of the owner of property situated in slum areas. I hold no brief for the owner of bad property in a slum area who has extorted rent from poor people, but I do hold a brief for the men and women, and there are many of them, very small people, who put their savings into houses and have kept them in reasonable order, and who, under clearance orders, have been compelled to demolish the property, without the right to recondition it. I have had surveys of many of these properties which have confirmed me that I was right before I put cases to the Minister of Health, and the surveyors have assured me that the houses were in good order and could be reconditioned at small cost. But those houses have been demolished along with the rest. I attribute the reason for this to be the temptation to local authorities too often to demolish the good with the bad under clearance orders, and to avoid the compulsory purchase Clause which the Act provides in respect to the better property. That is the cause of a good deal of trouble. As far as I understand the Act, it provides for such cases and lays a, solemn obligation on local authorities to administer the Act with fairness and justice. I cannot imagine a more solemn obligation or trust that affects the lives of so many of our poor people than that which has been placed on the shoulders of local authorities.

I am well aware that in any big reform of this kind we are bound to have blots. There is the border-line case which is always difficult and cannot always be provided for, but there are many cases that I have come across and have been called upon to investigate which ought to be dealt with, and which compel me to come to the conclusion that the Act is not being administered in all cases as Parliament intended. On the contrary, it is too often being ruthlessly administered, disregarding the spirit and intentions of the Act and of this House. I have no hope now that my right hon. Friend will modify the question of the appeals which are made to the Minister of Health. I have always contended that appeals on the question of clearance orders should be to an independent body. I have not much hope of that being altered now, but I believe that it has been at the root of much of the trouble from which we are suffering.

With regard to the management of the great estates which are being built around our great cities, I should like to see the management transferred to a housing commissioner or a corporation, which is provided for in the Act, and I would have it made compulsory. Unless something of this sort is done I view the position with great misgiving, and I would ask my right hon. Friend to consider this point. I do not want to create difficulties for my right hon. Friend, and I know full well the difficulties that confront the local authorities, but I literally shudder sometimes when I think of the distressing cases that I have had to investigate, which could have been avoided and for which there seems to be no redress. I hope that my right hon. Friend will still be able to do something to remedy the cases which I have mentioned. The ultimate responsibility is with the Government, and I am confident that unless some of these local authorities are called upon and if necessary compelled to act with a greater sense of responsibility towards the trust that has been placed upon them, one day the methods which they are adopting, and in which it may be said that we have acquiesced, will come back like a boomerang round our heads. I want to see what I believe to be a blot on this great reform wiped out, so that it can never be said that Parliament has allowed its will to be disregarded, or that in carrying out this great reform we have been a party to sacrificing many of those who have proved to be good and useful citizens in the past.

10.2 p.m.

Mr. AMMON

I am sorry if I am the means of blocking out some speakers, but I have promised that the Minister shall have the greater part of the time remaining. A large number of views have been expressed and grievances ventilated with respect to the Vote under consideration. In reply to the hon. Member who has just spoken I would say that so far as I am aware there is no objection to people obtaining shops on new housing estates; they are certainly built, but the difficulty is that they do not rank for grant. That is what makes the difficulty for people in limited circumstances. On the large housing estates they have shopping centres of a considerable size.

Mr. BOULTON

Speaking of the areas which I know best, I may say there are no shops at all to let. There are only spaces which they have to take and on which they can build.

Mr. AMMON

Then I should say that the local authorities concerned are doing their duty very badly in seeing to the planning of the housing estates. The Minister has heard encomiums from all quarters for his industry and the manner in which he has kept his Department up to the mark in regard to many things with which we are intimately concerned. But I think he was a little less than generous in his acknowledgment of some of the foundations which my right hon. Friend the Member for Wakefield (Mr. Greenwood) laid, particularly with regard to the Mental Treatment Act and the Slum Clearance Act. The right hon. Gentleman might have made some acknowledgment of the fact that he entered into an inheritance which was to a very large extent prepared for him by the work of my right hon. Friend. Perhaps I know less than many hon.

Members of the work that the right hon. Gentleman has done in his Department, but there are one or two things that I should like to raise, without any frills.

I should like to know from the Parliamentary Secretary what has been done with respect to the Hadow Committee's Report on the qualifications, recruitment training and promotion of local government officers. The Committee was appointed in December, 1930, it reported in January, 1934, and the report was issued last year. It contained proposals as to the notification of vacancies, the selection of officers, the security of tenure, the qualifications of candidates and the establishment of a central advisory committee to deal with a common standard of recruitment. The London County Council in March, 1935, intimated their readiness to enter into a discussion on this report, and it will be interesting to know what steps have been taken, or are intended to be taken, on the report, or whether it is going to be shelved.

The question of the inspection of our milk supply has not been raised in the Debate so far. I am aware that the supply of milk is not a concern of the Minister of Health, but the inspection of milk is a matter which is under his direction, and I want to bring to his notice a rather grave position of affairs regarding the purity of milk and the danger of infection which arises. Many hon. Members have received a copy of the report of the People's League of Health which, judging from the imposing list of names at the end, is an organisation of some standing and influence. In their report they say: It is an unfortunate fact that milk is a medium through which disease can be conveyed to man …Milk can be rendered safe for consumption by suitable heat treatment, such as efficient pasteurisation or boiling. They point out that no less than 357,990 children at least are consuming milk which by no admitted standards can be classed as safe from the risk of conveying disease. They say: Let the nutritive values of milk be emphasised by all means. But certainly of not less importance is the demand that milk shall not be allowed to be the medium for the distribution of tuberculosis and of other diseases. We cannot ignore these statements. They further say: About 2,000 children die annually from tuberculous infection of bovine origin, while many others suffer disabling and deforming illnesses…These disasters are due mainly if not entirely to the infection of children through the milk supply. This certainly indicates that there is considerable room for further investigation and inspection on the part of the Department. The right hon. Gentleman is, of course, aware of the serious outbreak of scarlet fever in Denham last year, which arose directly out of the milk supply. No less than 85 persons were infected. Two of them died, one from complicated bronchial pneumonia; the other made a good recovery but later contracted appendicitis and (lied from the operation. These cases of scarlet fever were directly attributable to the milk supply. I want to read to the Committee a rather unpleasant extract from the report of a medical officer of health of one of the London Metropolitan boroughs. This is what he says: As the result of a complaint, observation was kept upon a stable yard situated in this borough. An employé of a large firm engaged in the retail sale of pasteurised milk was seen to take a quart bottle and fill it with water from a large tub standing in the stable yard from which horses were watered. The tub was old and slimy, the water being partly covered with chaff, and at least one bloodworm was seen therein. A bottle of milk nearly full, with the cardboard disc therein partly dislodged and bearing the words "pasteurised milk," was on the van. The bottle of milk was purchased for analysis. During the process of division the roundsman stated that he had added water from the tub to the contents of the bottle. The sample was found to contain 38 per cent. of added water, and gnat larvae were also discovered in the milk. That is in one of our Metropolitan boroughs and unfortunately one cannot believe that it is an isolated case. It certainly indicates that there is a necessity for closer inspection in regard to the distribution and retail sale of our milk supply. In the same report the medical officer calls attention to the increasing consumption, as an article of food, of ice cream amongst adults and children, and he points out, what I did not know, that at present there is no bacteriological standard for ice cream and that ice cream constitutes a favourable medium for the growth of bacteria, including disease-producing germs. In this case also there is a necessity for a greater measure of control and inspection in order to ensure purity as in the case of milk.

Another point which I desire to bring to the notice of the Minister is a question which arose in Croydon quite recently regarding some controlled houses in the possession of a company known as the General London and Urban Properties, Limited. This case came to my notice because some of the persons who are the victims of this outrage, as I think the House will agree it is, are members of the Union of Post Office Workers. The majority of these persons have been residents on this property since pre-war days, so that there can be no question of their being controlled houses. They were served with this notice: We hereby give you notice to quit and deliver up possession of the house or flat you occupy… on Monday, the 6th of July, 1936. In the alternative please take notice that if you do not leave the house or flat the rent as from Monday the 6th July will be 16s. per week. Signed, G. B. Ashton. Many of the people were not to be intimidated by that notice, because they could go to people who could give them expert advice. But many of them were intimidated. In spite of the advance of education there are still a number of people who are scared by a printed form, particularly if it bears the imprimatur of the Government. At least one old lady was taken seriously ill as the result. They took expert advice and were told to offer the normal rent and get a receipt; and to take no notice. But the persecution still goes on. That is why I am calling the attention of the Minister to it. On Monday last my hon. Friend the Member for Pontypool (Mr. Jenkins) asked the Minister of Health whether his attention had been drawn to a recent judgment in the Court of Appeal which placed on the tenants of controlled dwellings the onus of proof of such control, and in the course of his reply the Minister said: The Acts impose substantial penalties on a landlord who knowingly makes a false claim that a house is decontrolled."—[OFFICIAL REPORT, 13th July, 1936; col. 1663, Vol. 314.] I submit that there ought to be very substantial penalties on persons who know that a house is not decontrolled and seek, by means such as those to which I have referred, and by false representations, to get possession of the properties and to scare people in the way they have done. I hope the Minister will look into this question very seriously and make these people understand that this sort of thing must stop.

There is another side of the question that has arisen recently with regard to intimidation and pressure brought to bear upon poor people in connection with houses. Many hon. Members, particularly those representing London constituencies, will be aware that certain syndicates have been buying freehold poor properties in the city and then serving notices of dilapidation on the tenants, who are often working people who have struggled all their lives to get the properties. Those notices have been such that it has been impossible for the people to meet them, and the result has been that many have been forced to forfeit their houses, and the gang has recouped itself by selling them at a very much higher price.

It seems to me that if any powers are to be given to the Minister of Health to deal with this matter, the sooner they are given the better. This is not something which happens only here and there. I gather that other hon. Members have experienced it. When I was acting as chairman of the assessment appeals committee in the Borough of Camberwell I had before me a postman who had taken his pension. As hon Members know, when a postman has completed 40 years' service, he goes on to a pension and receives a lump sum as well. The postman in question had used his lump sum in buying a house, and that house was in a group which was bought up by the gang to which I have referred. He was served with a notice of dilapidation which was far beyond anything which he had in his possession, and indeed was more than he had given for the house. Unfortunately, he sought advice too late, as often these people do, and came to me after he had lost his property and his gratuity. These cases are not uncommon, and the practice is a growing one. I hope that the Minister will give considerable attention to the matter.

There is a general point I would like to raise with regard to the housing question. It is a point to which reference has already been made in some measure by the hon. and gallant Member for North-West Camberwell (Major Guest). I make no reflection either on the local authorities or the Government if I say that to a large extent our efforts to solve the housing problem have been pursued along muddled and unscientific lines. We have been anxious that housing accommodation should be provided for the people, but instead of working out a scientific and planned scheme, houses have been put up in such a manner that they will constitute a tremendous store of social trouble for future generations. For instance, the constituency which I represent is one of the most densely crowded districts of London, and in some parts of it there are 1,100 people to the acre. These people are at least two miles from the nearest open space. We have a tremendous slum problem and we are being forced, under certain Measures adopted, to solve that problem by erecting huge blocks of flats. The result is that density of population is increasing and that process is going on throughout London. The people are far removed from open spaces, it is difficult for the children to find places in which to play, and I know of one borough where it is said that the public-houses are doing increased business because there are no gardens to which the men can turn in the evenings for recreation. A tremendous problem is being created in that way; and there is also the problem of the extra time and money spent by people in travelling if they go outside the district.

I do not know whether it is too late to do something in this matter. I believe that something could be done administratively, and I suggest to the Minister that he has the energy and enthusiasm to do something even yet. It might be possible to have a plan on the lines of satellite towns, but in such a case industry would have to be planned also. Industries should be induced to go there, and the population could then go out to those towns. That would prevent the difficulty of people having to travel continually and prevent congestion of population such as we find at the present moment. Existing conditions add tremendously both to present difficulties and contribute to those which are bound to arise later. If we were to be involved in another war—and I pray that that may never happen—and if bombs were dropped in some of these crowded places which are now being built up, the imagination boggles at the consequences. The time is not too late, though it will soon be too late, to deal with this matter and to prevent these housing schemes straggling out as they are doing at present. It would be necessary to go out about 30 miles now in order to establish any scheme worth while on the lines that I have suggested.

Take, for instance, such a scheme as that at Becontree. As a member of the London County Council at the time, I know that when that scheme was first mooted it was intended that there should be a satellite town, that industries should go there, and that there should be all the necessary amenities. Now look at it. Long, dreary, heart-breaking lines of streets of uniform houses, the only advantage of which one imagines is that they encourage temperance because a man would not be able to know his own house from the other houses if he had imbibed too freely. Those are some of the problems which are already beginning to show themselves. I ask the Minister to give particular attention to them and to see whether it does not lie in his power even yet to evolve some scheme and add to what he has done already by making a bold stand for a Government-planned scheme of housing on self-contained lines which will give us something better than the dreary miles of uniform buildings which we are now getting, and give a proper sense of communal life to these new communities which are growing up around us.

10.24 p.m.

Mr. SHAKESPEARE

We have had a very interesting and constructive Debate and on this, I think the fourth occasion on which I have wound up the annual Debate on the Ministry of Health Vote, I should like to record the fact that the note of controversy seems to be growing less and less strong. Considering the great variety of controversial subjects dealt with by the Department including housing, insurance, local government, water supplies, drought, floods, rabbits, and all the rest, considering that we administer something like £130,000,000 every year, I think I am right in claiming that the benevolent purpose of the Ministry under the aegis of my right hon. Friend and the speed with which we are carrying out certain reforms of a humane character in administration, are more and more appreciated in all quarters of the country. I think next year the hon. Gentleman who has just sat down and who has made such an interesting speech will wind up on behalf of the Government—

Mr. AMMON

Are you resigning?

Mr. SHAKESPEARE

I mean, on behalf of the Opposition, by moving a vote of thanks to the Government. I have a large number of rather technical questions to answer, and I will try to do justice to the main questions, but if any hon. Member is not answered, he will receive a letter either from my right hon. Friend or myself on the point. I will gather together some of the stray matters in connection with general policy. First of all, the hon. Member for North Camberwell (Mr. Ammon) referred to the Hadow Report on the Qualifications, Recruitment, Training, and Promotion of Local Government Officers. He will realise that this is primarily a matter for the local authorities concerned. Many of the recommendations have been approved by the great associations of local authorities, and in December of last year model standing orders were issued by the Minister, embodying many of the recommendations of the Committee with the result that they are now in force under quite a large number of local authorities.

His next point was with regard to the milk supply, a question of very great importance, but I am glad that the only case he could give of an infected milk supply which caused an outbreak of scarlet fever did not occur in the year in respect of which the Estimates are now issued. As a matter of fact, that scarlet fever infection, if I remember rightly, was in the Eton rural district. Immediately steps were taken by the medical officer of health to pasteurise the milk, and no case has subsequently occurred, as far as I know. But the question is one of very great importance. A very great proportion of London milk is pasteurised—well over 90 per cent. of the London supply—and I think London has the safest supply of clean milk in the world.

Mr. AMMON

The hon. Gentleman will remember that the incident I mentioned was a London matter.

Mr. SHAKESPEARE

I think the hon. Member will agree that the medical officer in a particular borough would have a very difficult task in supervising every glass and every bottle of milk, and he will not dissent from my general proposition that the supply is a very clean supply. He raised the question of the firm that acquired houses in Croydon and immediately served notices and put up the rents. This came to the attention of my hon. Friend the Member for South Croydon (Mr. H. G. Williams), who got into touch with the Minister of Health and with the company and pointed out that he was going to ask a question in the House, and as a result the notices as regards controlled houses were immediately withdrawn. I am glad the hon. Gentleman raised this matter, because as he pointed out and as my right hon. Friend pointed out, there are severe penalties in the Rent Restrictions Act of 1932. I have riot got the Act by me, but I believe it is under Section 2 that any landlord who knowingly makes a statement in respect of a controlled house, that it is decontrolled, is subject to very heavy penalties, and it is just as well that the owners of property should know it.

Several hon. Members have referred to the question of the sterilisation of the unfit. To attempt to introduce so far-reaching a change so soon after the issue of the report would not be in accordance with the usual practice.

Sir F. ACLAND

It is over four years.

Mr. SHAKESPEARE

In my experience in the House it has been discussed for only one hour on a Private Member's motion and only casually referred to on another occasion. If you are introducing a reform which so much touches religious susceptibilities, you must pause a good deal until there is a widespread demand for it.

The hon. Lady the Member for Frome (Mrs. Tate) raised the question of nursing homes. The local authority, whether it be the county or the county borough, is responsible for the supervision of nursing homes, and I will consult with my right hon. Friend, in view of the complaints made, to see whether anything can be done to strengthen the degree of supervision. The question of contracting encephalitis from the lymph of rabbits is a medical question on which I, like the hon. Lady, am not competent to speak.

Mrs. TATE

In due deference, I was quoting a medical man with every form of qualification after his name.

Mr. SHAKESPEARE

Then I will quote the opinion of a medical man equally well known, of international reputation, who is our own Chief Medical Officer of Health. In his view, and in the view of our advisers, encephalitis in rabbits is quite different from postvaccinal encephalitis in the human being. The hon. Member for Mitcham (Sir R. Meller) asked several technical questions touching the operation of the Insurance Act of last year. One was whether it had simplified the insurance scheme. I think that the evidence of those associated with approved societies is that it has simplified the administration. The changeover was naturally difficult, but as that period comes to a close I am sure that the approved societies appreciate the simplification made as a result of the new Act. He also asked what has been the effect on the finances of the approved societies owing to the contributions they are required to make to the unemployment arrears fund. The amount of levy on the contributions is at a very low rate, about one thirty-sixth and the increased revenue of the bulk of the approved societies as the result of increased employment has more than offset the levy made. The hon. Member asked about the men who were falling out of pension rights on account of long unemployment and whether they had been reinstated. The answer is that 95 per cent. of these men are now back in full pension rights owing to that Act. They number 200,000 persons. and come particularly from the distressed areas.

Mr. G. GRIFFITHS

How many are left out?

Mr. SHAKESPEARE

They consist largely of young men under 30 with small insurance records. Ninety-five per cent. of the total are back in full pension rights, The hon. Member also asked what happened to those who, fearing their pension rights were going, took the precaution of becoming voluntary contributors. The answer is that we have made regulations reinstating those men in their full pension rights and given them the opportunity to cancel their voluntary insurance. Finally, he asked that persons might have notice when their employment closes that they have a right to become voluntary contributors. We have been in touch with the approved societies, and issued a model form of notice in as simple language as we can, so that in such an event an employed contributor can know his or her rights. Then came my hon. Friend the Member for Elland (Mr. Levy) on the subject of water. When I heard his familiar voice it made me quite thirsty. I shall not reply to him in detail, because we have had so many little "scraps" in the past, except to say that I am not ashamed of the water supply record in the last few years. The total of the loans sanctioned for water supply in rural areas down to 1933, including the years when the unemployment grant was available, averaged just over £400,000 a year. The loans sanctioned last year totalled well over £2,000,000; in other words, the National Government has sanctioned five times the average loan totals of previous years for water supplies in the rural areas. The trouble with the National Government is we set such a level of achievement that our friends sometimes become impatient because we cannot always go at that speed.

Then came my hon. Friend the Member for Central Sheffield (Mr. Boulton) with the question of the hardships of shopkeepers in areas where slum clearance schemes are carried out. I am sure that he knows the feelings of both my right hon. Friend and myself on this matter, and anything we can do to help by administration we will. We altered the law in favour of the shopkeeper in the Act of 1935, partly as a result of the long conversations which I or the then Minister had with him on this matter. I agree with him that it is the hardest of all cases—if the hon. Member will bring any case to our notice we will immediately take it up—because the shopkeeper not only loses the house but loses his living. We have again and again urged upon local authorities that they cannot proceed with this great national crusade if any vestige of injustice is associatd with it, and compensation in generous measure is due and is being given by the great bulk of local authorities to those disturbed by slum clearance.

Now I turn to the main criticism against the Government on matters of general policy associated with housing. For the benefit of those hon. Members who did not go through the long debates on housing, stretching over three or four years, when the right hon. Member for Wakefield (Mr. Greenwood) was the great protagonist, let me set out as concisely as I can the reasons why we altered the whole policy of housing and have embarked on what I think is a successful policy. At the end of 1932, when we surveyed the housing position, we found, that, although what is called the Wheatley subsidy had been utilised by local authorities, comparing the census figures for 1930 with those for 1920, and in spite of the outpouring of subsidy money, the number of overcrowded families remained constant. For some reason which I have never understood the payment of £13,000,000 or £14,000,000 a year in Wheatley and Addison subsidies had had very little effect in abating overcrowding. Moreover, slum clearance had not been touched, in spite of the good Act of the right hon. Gentleman. It was like a car lying in a garage without any petrol, without any dynamo and without anyone to drive it, and there it would have remained but for the National Government.

Private enterprise was not competing against subsidised municipal houses. We were getting the worst out of private enterprise and the worst out of the local authority, and neither the slum tenant nor the overcrowded person was getting help from the State. The then Minister of Health said: "For 12 years there has been a subsidy to rehouse persons alleged to be in need. Let private enterprise come in to deal with the problem for those who can afford to pay, and let local authorities clear the slums, make a direct scientific attack upon overcrowding, and provide really cheap-rented houses, which are the need of the hour." I claim, with great humility, that no Member of the Opposition can stand on any platform in this country and say that any aspect of our housing policy has failed. If he goes down to any constituency in the land, a miners' constituency or any other, and stands on a platform and says that the national housing crusade has failed, he will be laughed to scorn.

Mr. BATEY

Come to mine.

Mr. SHAKESPEARE

That is true in any constituency in England or Wales.

Mr. JOHN

Come to the Rhondda Valley.

Mr. SHAKESPEARE

Let me reaffirm the figures given by my right hon. Friend. In the 45 years to 1919, as regards slum clearance, the average number of people who left the slums was 2,000 a year. As regards the 10 years from 1920 to 1930, the average was 5,000 a year. Then came the 1930 Act. Before we started the crusade, in the two and a-half years from 1930 to March, 1933, the average number of people rehoused from the slums was at the rate of 15,000 a year. To summarise; the average was 2,000 in the 45 years before 1919, 5,000 in the decade afterwards, and 15,000 in the two and a-half years after 1930. Then came the crusade, and in the three and a-quarter years since April, 1933, we have given rehousing approval for 700,000 persons, of whom 400,000 are now living in new, modern homes, and as regards 250,000 the houses are in various stages of erection and the people are waiting to go in. That is a total of 117,000 persons a year dealt with under the National Government. Let any one go round the country and say: "You, the local authorities, have done it all, and the National Government stood in the way." No local authority would believe any Member who said that.

My right hon. Friend has given figures as regards private enterprise. Let me add that not only have houses been found for a record number of persons but these houses, in the course of time, have become owned, owing to the building societies. Nothing gives greater stability than a large number of persons owning their own homes. Let me take up a point made by the hon. Member for Blaydon (Mr. Whiteley) who made a very reasonable speech. I know his great interest in this subject, and I know how great is the housing problem in Durham. Let me assure him that if the general subsidy had remained, overcrowding and slums would not have been touched. As regards slum clearance and overcrowding, Durham has a very heavy seven or ten years before it, and I know we can rely on the hon. Gentleman's co-operation. It may be that he would like to do it in one way, that he looks with some suspicion on the North-East Coast Housing Association; but I know his interest in housing, and I know that he wants to get the men whom he serves rehoused, and that he will co-operate with the Durham County Council to see that that is done.

The next contribution came from the hon. Member for Peckham (Mr. Silkin), who is chairman of the Housing Committee of the London County Council. To anything that he says as a local government administrator we should naturally give serious attention, but when he talks as a politician I claim the right to answer him in his own coin. He said that the standard of the 1935 Act was too low. But who has ever claimed that it was a high standard? All that we say, as practical administrators, is that if overcrowding is to be attacked the best way to do it is to fix a standard, even if it be a low standard, and make a determined attack on that basis. If the standard fixed is one that nobody can enforce, it discourages local authorities who try to carry it out. Surely, the figure in London, namely, 7 per cent., or some 70,000 overcrowded families, shows that the standard is not too low. In the case of the London County Council housing estates, 10 per cent. of them are overcrowded on our standard. I say to the hon. Gentleman—I do not want him to admit it here to-night—that London will be busy on its slum clearance and its overcrowding programme for the next 10 years, low as the standard may be; and when London has completed that task, and when other local authorities have done likewise, from what I know of my right hon. Friend—[An HON. MEMBER: "He will be dead"]—he will be very much alive—we can then consider tightening up the standard. But I suggest to any practical housing administrator that you must choose a standard which can be enforced.

The hon. Member referred to the reduction factor, and here again he was talking politics and not housing. The speed of slum clearance has not been affected one whit by the change with regard to the reduction factor. Indeed, the figures I have here—it may be due to the hon. Gentleman's administration—show that the speed is increasing. The same criticism applies with regard to the suggestion he made as to the time schemes take in the Ministry of Health. We are anxious to speed up as much as possible, and, if the London County Council will do what some local authorities do, and submit a year in advance the number of orders that they are going to send in, we can make a schedule and save a good deal of time. I know that the hon. Gentleman, like ourselves, is anxious to remove every obstacle which means that slum tenants have to live a day longer in their miserable hovels than is necessary. He referred to the technical question of the redevelopment areas, which, as anyone who knows the housing problem in London will agree, will do a great deal for the redevelopment of big tracts of London—I am thinking of the East End. There is a difficult point in administration which is so technical that I will not go into it to-night except to say this. The local authority, if anyone stands out from the re-development plan, must purchase, but the local authority can relet or even sell, so that there is no reason to anticipate any loss to the local authority if any owner is recalcitrant.

Let me answer a request of several Members, including the right hon. Member for North Cornwall (Sir F. Acland) and the hon. Member for Brigg (Mr. Quibell), and give a short summary of the progress in rural areas. As regards the slum problem in the rural areas rural authorities have informed us that in five years they have 38,000 slum houses to deal with. It is interesting to compare that total with the overcrowding total which is now coming in. The total of overcrowded houses in rural districts is something in the neighbourhood of 43,000 for England and Wales, and hon. Members will agree that if you have to deal with 38,000 slum houses and 43,000 overcrowded houses, in respect of which subsidy is available, it will take the rural districts all their time to overcome these bad housing conditions within the next five years.

Let me say a word about the 1926 Act. Progress in respect of this Act for some reason or other has not gone nearly as well in England and Wales as in Scotland. Scotland has reconditioned some 23,000 houses and England and Wales only some 11,500 houses. Devon County Council, which takes pride of place, has reconditioned 1,400 houses. Then come East Suffolk and Essex. Of rural district councils Liskeard in Cornwall, Atcham in Shropshire and Durham are the three best.

More use can be made of this Act. By putting on a new roof or installing a bathroom a picturesque cottage can be made fit for human habitation with, at most, a slight increase of rent. The landlord cannot increase the rent except on the lines laid down in the Statute. The Minister has referred the operation of this Act to the strong advisory committee which is advising him on all these matters, and we hope that as a result of their advice, which I expect will be on the lines of giving increased publicity, which is the essence of this business, to what can be done under the Act, we shall see further progress in the next few years. The question of community centres was raised in a charming speech by the hon. and gallant Gentleman the Member for North-West Camberwell (Major Guest). Nothing is quite so deadly as a housing estate with no recreational or community interests. What always strikes me about foreign housing estates—I am thinking of Vienna—is that, in the Karl Marx block, for instance, some of the houses are allocated to members of the professional classes, doctors, lawyers and so on, and you get a difference of type and leadership under those conditions.

I am sure the work that is being done by the National Council of Social Service is a very great work, bringing about a sense of civic responsibility and developing social instincts. My right hon. Friend has sent out a circular to local authorities pointing out that we shall always encourage the provision of these community centres. Since we have consolidated all the housing accounts together, the maintenance of these community centres becomes a part of the housing account and, where there is a surplus in the housing account, owing to the generous subsidies available to the local authorities, it may be utilised for the maintenance of such centres. Moreover, if it is a juvenile centre, there is a 50 per cent. grant from the Board of Education. With this provision, and the encouragement that my right hon. Friend has promised to give, we hope that, with the co-operation of local authorities, in these new housing estates that are growing up all over the country and in those now existing there will be facilities for communal activity, recreation and leadership.

The hon. Member for Hemsworth (Mr. G. Griffiths) asked what are the rights of a diabetic who through poverty cannot obtain insulin, or perhaps a diabetic who is the wife of a man in work. Can she go to public assistance or is she disqualified by the fact that the husband is in work? If a diabetic is insured, of course he gets insulin free, but there is a provision in Section 133 of the Public Health Act, 1875, by which local authorities, on getting the sanction of the Ministry of Health, can issue medicines free to poor persons, and that would cover the wife of a miner working three or four shifts a week and getting, say, 30s. who could not afford five or six shillings a week for insulin. If the hon. Member has any case in mind and will notify us, we will immediately take it up with the local authority. A poor person can go to the public assistance authority and get insulin free over and above any allowance he or she is entitled to as a poor person. I hope that meets the hon. Member's point.

10.59 p.m.

Mr. SEXTON

It seems a great anomaly, living as I do amidst the hills, where there is plenty of water, that many rural villages have to go without water. We in the western part of Durham provide water for the towns in the east, but for the villages themselves there is practically no supply. I believe the hon. Gentleman is a water diviner. We do not need his help in Durham. We need not water, but money spent by the Special Commissioner or the Ministry to bring water to the houses in the rural villages. We must all realise the value of a good water supply. When we compare the supply in the towns with ours the towns are to be envied.

It being Eleven of the Clock, The CHAIRMAN left the Chair to make his Report to the House.

Committee report Progress; to sit again To-morrow.