HEALTH ADMINISTRATION.

HC Deb 28 July 1938 vol 338 cc3351-466

4.10 p.m.

Mr. Arthur Greenwood

I desire to bring the attention of the House back, after the supercharged atmosphere of recent minutes, to questions of home affairs. It is not my intention to try to cover the whole of the province of the right hon. Gentleman the Minister of Health, but I desire to draw his attention to two problems affecting his Department. The first is the problem of the housing of the people. His figures show, as figures do year by year, a very substantial progress in the rehousing of the people. In the return which was published not very long ago, dealing with the position at the end of March of this year, it was pointed out that since the end of the War local authorities have built something over 1,000,000 houses, and that private enterprise has built over 2,600,000 houses. The 1,000,000 houses of local authorities, although in many cases the rents were high, were primarily designed for the people whose housing conditions were the worst. The 2,600,000 private enterprise houses which have been built were built on the whole for people with economic resources which enabled them to purchase their houses.

In Table II of the Return the position is made perfectly clear, that so far as the smaller type of houses is concerned, that is to say, those which could reasonably be expected to be occupied by the working classes, two-thirds are in the possession of owner-occupiers, and only one third have been built to be let. Therefore, we are driven to ask whether this enormous building of houses by private enterprise is really meeting the housing problem of to-day. People with means have always had private enterprise at their disposal, and have always been able to provide themselves with satisfactory housing accommodation. The problem with which we are faced to-day is as to whether we are providing houses for the people who need them most. I am not denying that we have made a substantial contribution, but I have noticed in recent years the increasing proportion of non-parlour houses which are being biult by local authorities. It is not the desire of working people to live in non-parlour houses. The local authorities in carrying out their statutory duties have been driven to an increasing proportion of non-parlour houses, because of the difficulty of the people for whom they are catering meeting the rents of parlour houses.

If I may say so, it is not to the credit of this country that in these days, when we know the kind of standard which ought to apply, when the parlour ought to be a national institution, that we are building so large a proportion of non-parlour houses, which will be occupied, I imagine, for the next two generations. Not only so, but we have, particularly in the older industrial areas of the country, a very large number of old and decaying houses which cannot, even on the most modest scale, pretend to conform to modern requirements and needs. That presents us with a very great problem, which so far has not been attacked.

The right hon. Gentleman, in the document for which he now takes responsibility—it was published before his acceptance of his present office—gives in Table I particulars about the houses built in agricultural parishes.

In agricultural parishes, under the only Act which really made special provision—apart from the Act of 1931 which was killed—under the Act of 1924, about 30,000 houses were built in agricultural parishes. But it happens that a number of agricultural parishes contain an industrial population, and it is clear that the whole of these 30,000 houses built in agricultural parishes were not built for agricultural workers. It is also clear that, because of the reduction in the amount of financial aid given to rural authorities, they are not in as strong a position as they were to deal with the problem of the housing of the rural worker. If we are behind in the towns, in the industrial areas, it is clear that we are also behind in the re-housing of the agricultural population. One of the great contributions of which this Government is, as I think, inordinately proud, is the progress made under the Housing (Rural Workers) Act. This is dealt with in Table VII of the Report, which shows that in all, assuming that those which were being altered in March are now completed, about 17,000 houses in the rural areas have been improved, and the amount of assistance which has been given to bring about that improvement is roughly £1,250,000. In effect, this really means that, in order to improve 17,000 rural cottages—some of them on the estates of people who could well afford to improve them themselves, as was shown in a Debate not very long ago—there has been given by way of public grant an average of about £8o per house. I suggest that that is really a misuse of public money. I do not believe it is for the advantage of the nation that it should spend on an average £80 per house in trying to improve and modernise old houses which it will be found very difficult to make sufficiently modern to conform with present standards.

The right hon. Gentleman may refer in his speech to the progress which has been made in slum clearance, and I am glad to think that the Sections of the Housing Act, 1930, which deal with this problem have been as successful as they have; but, while the House can congratulate itself on the progress which has been made in the demolition of slum houses, and on the amount of re-housing that has taken place, it is quite clear to me that that progress is not sufficiently rapid. A number of local authorities are now dealing with the problem of overcrowding, but it is clear that, while the local authorities up to now, largely because of the better financial arrangements until recently, have been devoting their energies to the slum problem, of which overcrowding is one element, the amount of work which has actually been done in the abatement of overcrowding is very small. During the half-year ending 31st March, 1938, 41,290 houses were completed by local authorities under the Housing Acts. Of these, 30,214,or three fourths of the whole, were allocated for purposes of slum clearance, and 5,000 for the abatement of overcrowding. That seems to show that the local authorities, with the assistance they are getting now, are bound to concentrate more on the problem of slum clearance than on the question of over crowding. One would like to ask the right hon. Gentleman what is being done now to "ginger up" the activities of local authorities. It is clear that reliance on private enterprise will not meet the bill.

I have already pointed out, on the figures in this document, that, as regards houses of the working-class type—houses of small rateable value—only one-third of them, on the Minister's own showing, are being built to let, the rest being built for owner-occupiers. Therefore, we are driven back, whether we like it or not—and a good many hon. Members on the other side of the House will not like it—to reliance upon the local authorities. At the end of this White Paper we find a long table, Table IX, covering four or five pages, dealing with the housing activities of the various local authorities and the number of houses built by private enterprise. One finds there the strangest disparity. There are certain areas where all the houses are being built by private enterprise and none by the local authorities, and there are other areas, similar in character, where the local authorities have done something to fulfil their responsibility. I submit that, if the right hon. Gentleman were to go through his own list and compare similar authorities with one another, he would find that a considerable number of local authorities are evading their public responsibility, while others, in equally difficult financial circumstances, are trying to fulfil their responsibility. The duty surely rests on the right hon. Gentleman to see that local authorities carry out the responsibilities which have been put upon them by this House, but a close study of the last table in this document convinces me that that kind of pressure is not being applied by the right hon. Gentleman.

There is another aspect of the housing problem which is bound to cause great anxiety to people who are interested in the question, and that is the steadily rising cost of house-building; I have referred to it before in the House. I realise that it is not unconnected with the rearmament programme of the Government, and perhaps some of it may not be avoidable, but in recent years the peak cost of house-building—I am taking the non-parlour house, and these are the right hon. Gentleman's figures—was in March, 1931, when the figure was £345. Thereafter, housing costs fell very substantially, the minimum being reached in March, 1934, when the average cost for the non-parlour dwelling was £286. Every quarter since then, housing costs have continued to increase, until now, according to the right hon. Gentleman's figures given in answer to a question in the House, on 3rst December, 1937, the average cost of the ordinary non-parlour dwelling was £364. That is the highest figure that has been reached for years; it is higher even than the peak figure of March, 1931. It is clear that, if you add substantially to the cost of house-building, you will sooner or later have a retardation of local authorities' activities in the housing sphere. The fact that, while in March, 1934, the cost of the non-parlour dwelling was £286, at the end of last year it was £364—an increase of nearly £80— shows that, had the local authorities been able to build their houses at the old figure, and had they spent the same amount of money, 30 or 40 per cent. more houses would have been built by local authorities.

I would ask the right hon. Gentleman what steps he is taking to deal with this problem of rising housing costs. I have referred on previous occasions to the activities of various rings, and I will not repeat what I said then. They may be partly responsible. Last year, I think I am right in saying, the responsibility was put upon the increasing price of timber and upon increased wages, but, as the right hon. Gentleman no doubt knows, wages in the building trade are governed by the cost of living, and it is not, therefore, a question of a real increase in wages, but of an attempt to stabilise the position. However that may be, the steadily increasing cost of working-class houses is a matter which calls for very close attention.

One is bound to draw the conclusion that all is not well with the housing programme. Although we have bitten into the slum problem, large numbers of slums still remain; overcrowding is a problem which has not yet really seriously begun to be tackled; the rural problem still remains with us, our progress there being, in my view, even less than it has been in the urban areas; and we are still faced with what is going to be the biggest problem of the next two decades—the problem of completely rebuilding the older industrial areas of this country. Nobody who knows what the best of our municipal housing schemes are like can go into our old industrial towns, where houses 75 or 100 years old are still in regular occupation, and be satisfied that we have begun to deal with the major housing problem of this country. Since the War we have concentrated our activities on dealing with the general housing shortage, which at the end of the War was considerable, because of the cessation of building activity. We have also concentrated our attention on the worst type of houses, the slums, denounced by everybody as being completely unfit for human habitation. We have, rightly or wrongly, tried to make a special problem of overcrowding, and we have legislation for dealing with it. But these, in a way, are the smaller aspects of what is becoming an increasingly important national problem—the problem of taking in hand on a large scale the replanning and rebuilding of our great industrial centres.

There is another problem to which I would invite the right hon. Gentleman's attention, and that is the problem of our water supply. Water is a very necessary servant, but a very bad master. I am not accusing the National Government of being responsible for the weather; I could not in fairness do so; but variations in the weather do present us with very serious problems. We are bound to face the fact that we are not yet using our available water resources rationally. It is clear that we cannot afford to have times of floods alternating with times of drought. What is more serious is that you may have floods in some areas at the same time as drought in others. This is very largely a rural problem. The big centres of population, with their larger resources, have been able to go far afield for their water supplies, and most of them do not fear the possibilities of drought; but in the rural areas the problem is very serious, and it is becoming more serious because of our rearmament developments.

In Biggleswale, where there is a water board, they have decided, because of the drought, to cut off their water supply every night from 11 p.m. to 5 a.m. Within the area comes the Cardington aerodrome, which has been making demands for a perpetual and regular supply of water. Although I understand that they are boring for water, it will be some time before they are in a position to get it. The aerodrome, apparently, consumes 100,000 gallons of water per day normally —in the event of fire there would be, of course, a very substantial increase in the consumption. It is in a rural area, where the consumption of 100,000 gallons of water creates a very serious problem for the local water board. The area is suffering very seriously from drought, and in a recent fire, which was very close to the Bedford and District Mental Home, it was nearly 25 minutes before the water supply was properly available. I agree that although the needs and requirements of the aerodrome must be met, civilian needs must also be met.

I have another illustration of a similar kind. An hon. Member sitting on the other side of the House asked a question on 5th May about the serious shortage of water in certain areas of Wiltshire because of the new Royal Air Force station at Hullavington, Chippenham, which was being supplied with 30,000 gallons of water per day from the local supply. The right hon. Gentleman who was then Minister of Health said it had not created any special difficulties, and he was sending an inspector down. In circumstances of this kind there is need for the closest co-operation and co-ordination of effort. I resent very much the statement which was made by a member of the water board at Biggleswade that working people instead of having one bath every week should have one every fortnight. That seems to me to be no solution of the problem. In rural areas, where the problem of water supply is, in the best circumstances, difficult, it seems to me that where national considerations come in, as regards aerodromes, air stations, and so on, the needs of the civilian population should be properly protected.

I will give another illustration from Chatteris, in the Isle of Ely, a district which has suffered very substantially from floods. We have had Debates in this House—and I have spoken on the subject myself—on the difficulties of the Fen district. Here is a small village in Fenland where, according to a newspaper report, a doctor recently could not find sufficient clean water to provide a patient with a mouth wash. The report goes on to quote a statement made by the president of the Women's Institute in the district who would not be accused of having political partiality: that is to say, she would normally be a supporter of the Government. She said that mothers in some districts were distraught at the state of affairs and it was decided to wire the Minister of Health calling attention to the danger to the health of the children. The proposal was made that the great London and North Eastern Railway goods station at March should be required to reduce its consumption of water. Here, again, we have a conflict between the ordinary civilian human needs and the needs of some other organisations—in this case, industrial.

I suggest to the right hon. Gentleman that this situation in rural areas is one which is of some interest to the urban population. I remember in the summer of 1930 the troubles I had because there was a serious drought, and the fear I had that, through people being driven to polluted sources of supply, the nation might be faced with a very serious epidemic. I do not think the right hon. Gentleman will disagree with me when I say it is perfectly clear that, even with the extending consumption of water in this country, our resources, if properly organised and properly used, are ample to meet our national requirements. I am not going to demand that every hillside cottage in this country should have a pipe supply of water. That, obviously, is not possible. But where there are communities, even small communities, they ought to be properly served with what is one of the vital necessities of life. As in the case of housing, I think this House is entitled to call for a real drive to deal with an important national problem.

I make no reference whatever in detail to the other great services for which the right hon. Gentleman is responsible, but there are certain wider considerations to which the attention of this House is invited. There are disturbing signs that shortly we may be deluged by a wave of economy, which might imperil social services and social development—so I am informed by responsible organs of the Press—and the inspiration for this new movement comes primarily from hon. Members sitting on the other side of the House. Demands, as I understand, are now being made for the restriction of social expenditure because of the heavy financial burden of the arms race, and it has been suggested, even from the Government Front Bench, that the growth of the social services might have to be retarded because of the burden of rearmament. I have pointed out before that financial economy of this kind is a new charge upon the masses of the people. They are being denied services which cannot be measured in money, and which can never appear in an Estimate; and that burden would fall upon large numbers of the poorer classes of our people should there be a restriction of the development of our social services.

Important as rearmament may be—and I am not arguing the merits of rearmament; this would not be the proper occasion—I suggest that the quality of the human material which, in the great eventuality of war, will be called upon to use the means of war, is at least as important, and the determination to increase our material resources for warlike purposes must not diminish, in our view, in any degree the determination to develop and strengthen our human resources. After all, weapons of war are needed only to defend human life and human institutions, and it would be shortsighted folly to cripple those great social services which have done so much to make life worth while for large numbers of our people. I, personally, am not terrified by the growing expenditure on the social services. I regard that expenditure as a national investment of the most productive kind. Through the social services a proportion of the yield of taxation is transmuted, in what I believe is the most economical and effective way, into greater opportunities, greater efficiency and greater happiness for large numbers of our people.

I warn the Government, that should they succumb to pressure to inaugurate a new drive for economy, at the expense of the social services, they will be met by the sternest opposition from these benches. The social services—I do not think the right hon. Gentleman will dissent from this—are great human agencies for enriching the lives of the mass of our people, and, as such, ought to be immune from attack. It is our hope on this side that those services will continue to thrive and develop, in the highest interests of the nation. I hope the right hon. Gentleman will give us some assurances that he and his colleagues do not intend, because of financial pressure from other quarters, to take any part in diminishing in any way the progress of the social services, which we regard as essential to our national life.

4.44 p.m.

The Minister of Health (Mr. Elliot)

I rise to continue the review which has been inaugurated by the right hon. Gentleman of the work of the Ministry of Health. In the first place, I would like to say that the past year was the last full year during which my predecessor was responsible for our health services. His long services, dating from before the War and his devotion to all matters relating to the public health are well known to all Members of this House, and I am sure they would not like his long connection with the Ministry of Health to terminate without a short word of appreciation—in which I know we shall all join—of his human sympathy, his spirit of service, and his drive. I, myself, for some years had some connection with health questions, and, having listened carefully to Debates on this subject of the Public Health in England and Wales, I have always been impressed by the enthusiasm and knowledge of the subject which has been displayed by Members in all parts of the House. Now I find myself cast in a different and a more agreeable role—that of the speaker instead of the listener; and, in the presence of such distinguished gladiators as the right hon. Gentleman the Member for Wakefield (Mr. Greenwood), with his sincerity, his long experience, and his deep knowledge of the subject, I have some diffidence in making what must be regarded as practically a maiden speech.

The occasion for this review is the Consolidated Fund Bill, and it may be appropriate to begin with a few words on the finance both of local authorities and the central department. The net total of the Ministry of Health Estimates for 1938 is £22,732,572, which is an increase of £542,206 over the figure for the preceding year. That increase in the Department's Estimate is mainly due to progress in respect of housing and under the Midwives Act, 1936. For the former the increase amounts to £321,000, and for the latter it is £243,000. There are one or two other small increases and some balancing decreases, but the provision in the Estimates for administration expenditure brings within their scope the cost of all services administered by the Department, including national health insurance and contributory pensions and the block grant. That total, it is estimated, will amount in the current financial year to £174,000,000, as compared with £167,000,000 in the previous year.

In addition to expenditure for which my Department is directly responsible, there is that of the local authorities, a large part of which is reviewed by my Department. The total of sums disbursed by local authorities on revenue account, including trading services, amounted in 1935–36 to nearly £471,000,000, as compared with £455,000,000 in the previous year. It may interest the House to know that the sums actually raised by rates were approximately £165,000,000, the figure for 1934–35 having been £158,000,000. These totals represent very great sums indeed, and I can assure the House that they are receiving, and will continue to receive, careful and continuous review.

The right hon. Gentleman spoke of the dangers of an economy campaign, an axe campaign, but I am sure that he and all of us would agree that expenditure of such magnitude can be defended only if it can be shown that value for money is being obtained, and all our expenditure should be closely scrutinised from this point of view. The question whether full value is being obtained for expenditure which is already being incurred or contemplated is, in the first place, a matter for the many thousands of elected representatives of local authorities, who must be in closer touch than we can be with the conditions of their locality. In view of the criticisms to which they are often subjected, I should like to pay tribute to the good work done by those representatives, often at considerable sacrifice, and also to the great body of local government servants whom they employ. There can be no better work than serving as a member of one of our local authorities. I would emphasise this fact especially to the younger men and women in the hope that they will come forward and take up, in their turn, the task of responsibility for the expenditure on the health and wellbeing of our people. The bodies by whom, and on behalf of whom, these great expenditures are incurred, are often in themselves vast—even omitting the giant aggregations such as the county of London or the three Ridings of Yorkshire.

The county of Lancashire contains a greater population than the Republics of Finland and Estonia put together, and the city of Birmingham has a population bigger than one-third of that of Norway. But, quite apart from their mere size, the tradition of self-government which these units, great and small, enshrine is more valuable even than their populations or their revenues. We have relied successfully in the past, and still rely for the future, on the civic sense and enterprise which these communities have so consistently displayed.

It will and must always be the task of the Minister of Health to remember his earlier title of president of the Local Government Board, and to regard himself rather as a colleague than a superior of the others engaged in that art. I have taken pains accordingly this summer to meet representatives of the smaller units, the rural district councils, of nearly every county in England and Wales, in four conferences—in York, Shrewsbury, Chippenham and Bury St. Edmunds—on rural housing. I hope these conferences have been of help to the local authorities. They certainly have been of very great interest to me.

The right hon. Gentleman said that he would touch upon two points only of the work of the Department, but I think he and the House will pardon me if I review more generally the work for which I am now responsible. The work of my Department falls naturally under two main heads materiel and personal—public works and personal services. I propose, first, to deal with the former. The House will remember that my predecessor issued a circular to local authorities asking them to undertake a survey of their probable capital expenditure during the next five years and to submit to the central departments a programme showing in order of priority the capital works which they proposed to carry out in that period. I think, especially at the present time, the co-ordination of central and local activities is essential, and particularly in view of some of the points made by the right hon. Gentleman about the danger of a rise, let us say, in the cost of building. By working to this priority plan the local authorities will secure not only the smooth progress of their work, but they will also be able to take the fullest advantage in the interests of their ratepayers of periods when industrial resources are not unduly strained and conditions are, therefore, more favourable for the execution of the necessary works. But, apart from that, from the wider aspect of national economic policy, I think that such action by local authorities should make a valuable contribution to the stabilisation of the conditions in industry over a considerable period.

The big activity of local authorities is, of course, that to which the right hon. Gentleman referred. Housing takes pride of place. I think it is true to say that the past year has shown a continuation of steady progress and high output such as has characterised the last two or three years. The building industry has continued to provide houses for the general needs of the country at an exceptionally high rate. The number of houses built by private enterprise without assistance during the year ended 31st March, 1938, was 257,000. This compares favourably with an average of 236,000 for the five years ended 31st March, 1937, but it is considerably below the average of 1936 and 1937 which was practically 273,000, but, as the House will see, it is not greatly below that figure. On the other hand, as I will show the House in a moment, the number of houses built by local authorities—and this is important—continues to increase. The right hon. Gentleman asked me regarding the proportion of private enterprise houses which were built for letting, which, as he rightly says, is a very important factor. He will be glad to hear that private enterprise has been turning during the last year to an increasing extent to the provision of smaller houses for letting; 42,447 houses with a rateable value not exceeding £13 (£20 in Greater London) were provided by private enterprise, without assistance, as compared with 39,872 in the previous year, and an average of 37,700 for the last four years. This represents a percentage increase last year from 44 per cent. to 46 per cent. of the total building of this class, so that very nearly 50 per cent. of these small houses built by private enterprise are now being built for letting, a very important fact.

The great housing activities for the owner-occupier—these vast building operations—have been made possible by the financial facilities provided by the organisation of the Building Societies. Since the War, over 2,000,000 persons have bought newly-built houses, and the total amount which has been advanced by the building societies alone for the purchase of houses has exceeded £1,000,000,000—equal to a quarter of the whole overseas investment of the nation. This is the small man's loan. It is a tremendous achievement. It has been raised by persons who would have difficulty in putting down a couple of hundred pounds apiece. We cannot fully appreciate the scale of our housing investments until we take in the construction by local authorities which brings in a further £722,000,000. The gross total from these two sources alone since the War is thus over £1,700,000,000 sterling invested freely by our own people, in their own ways on their own aims, and this huge sum does not take into account those who build their houses with assistance from the banks, the insurance companies or by means of private mortgages, which may well amount to upwards of £500,000,000 more. If that had been done in some other countries the welkin would have rung with the achievement of the regime that had made that possible.

These general building operations make the largest contribution to the provision of houses for the people at large and of employment for those engaged in the building industry. But the Minister of Health must always be still more closely concerned with the special problem of those persons who live in unhealthy conditions and who are unable to extricate themselves from those conditions. From the point of view of public health, their rescue from these conditions is an urgent problem, and notwithstanding the general improvement in housing conditions, it remains, I agree with the right hon. Gentleman, a problem of substance.

Five years ago the Government embarked upon a programme for getting rid of unfit houses, and three years ago we supplemented this by a programme for the abatement of overcrowding. It is true that building progress has as yet been mainly concentrated on the first, that is, getting rid of the unfit houses, but as a contribution to more healthy housing the programme should be looked at as a whole, and the equal importance of both tasks is recognised by the unification of Exchequer subsidies for the two purposes which was recognised by the Housing (Financial Provisions) Act, 1938. The last year has been one of increased output under this programme. During the 12 months from March, 1937, to March, 1938, the number of houses completed was 67,000, and during the months of April and May of this year a further 11,000 had been completed.

The House may, perhaps, wish to have a forecast of the output under the programme during the current year. As we all know, such forecasts, which are really only guesses, must be given under the greatest reserve, but, especially in view of the fears of the falling off in building activity which have been expressed, I think that even a guess may be of interest to the House and to the country. There are at present 72,000 houses under construction, which is 10,000 up as compared with a year ago. In the absence of any emergency and given reasonable prices, we can perhaps hope, making the reserve which I have made, for an output between March, 1938, and March, 1939, of, say, 80,000 houses. The full programme consists of 631,000 houses (about 431,000 for slum clearance and about 200,000 for overcrowding). Towards this, 205,000 houses were completed by 31st March of this year. This shows that the campaign is now well on the way, though I would not claim for a moment that it had been completed, nor even that it was within sight of completion. But I hope that as we progress towards completion we shall be able to raise some of the standards on which we are working now. At any rate, it does show that a substantial effort has been made in clearing up this programme, and I hope that in the next four years we shall see its completion in the whole of the country, with the exception of a few districts where the problems of overcrowding and slum clearance are exceptionally large. The gross total of houses completed by all agencies during the past year was 337,610, the second biggest number ever completed, and one nearly equal to a new city the size of Manchester and Liverpool put together, built from the grass roots up, with services complete. This is the small man's town, because 90 per cent. of these houses have a rateable value not exceeding £26, or £35 in London.

The right hon. Gentleman asked me about the progress of agricultural housing. We have added to our housing tasks during the current year by including in the Housing (Financial Provisions) Act, a provision for a special subsidy for the general needs of the agricultural population. As a mere matter of numbers the houses required for this purpose may not bulk large in comparison with the huge figures that I have just mentioned, but the lack of these houses is a potent factor in the difficulties of agriculture, and their provision is none the less important, indeed it is all the more difficult, because it involves a large number of building operations on a small scale in place of a larger and more spectacular scheme.

I am very conscious of the need for stimulating this work, and, as I have said, we have held conferences at conveniently situated places in the country for the purpose of meeting the representatives of the rural district councils and discussing this work with them. As the Act was only passed at the end of March I cannot yet point to visible results, but I believe from the spirit shown at the conferences which we held and the evidence of proposals in hand that progress in actual building will follow and that we can look forward to an improvement in the housing conditions of the agricultural workers which will be to the satisfaction of the Ministers of Health and Agriculture, and particularly to one who has held one office and now holds the other, and, what is far more important, for the use and profit of the workers themselves.

Mr. Marshall

Can the right hon. Gentleman give the total annual charge in interest and sinking fund which the local authorities have to bear in respect of their housing programmes?

Mr. Elliot

I am afraid that I cannot give that information off-hand, but I will ascertain it, and my hon. Friend the Parliamentary Secretary will give it when he winds up the Debate. I will leave him also to give the more detailed analysis of the rise in building costs to which the right hon. Gentleman referred, and the reasons for it. I have a large field to cover and I do not wish to detain the House. We have a considerable number of figures which I hope will be of interest to hon. Members.

The other activities of my Department are also of very great general interest. Let me turn to one aspect of this enormous activity with which the House and the country are becoming more and more concerned—the planning of our vast expansion. In town and country planning we are dealing with an aspect of the Ministry's work which does not, like housing, manifest its results at once in visible building operations. It is often the sudden outburst of misplaced or ill-planned structures which calls attention to the need for more effective planning. Planning is necessarily in part negative and in part positive. It aims at the prevention of inappropriate development and the guidance of development along proper lines by the allocation of land to its most suitable purposes. Planning is not simply a method of formal procedure by the local authority. It is a matter of applying the principles of proper development which the study of planning principles and examples has disseminated.

An obvious example of the practical effect of planning is to be seen in the difference between an old industrial town and one developed on modern lines. From time to time I have to drive through Newcastle and it is a great delight to me to see some areas there where the old frontages have been left as a boundary wall, while the new houses have been built behind them. It is like a transformation scene to see, when the old wall is being knocked down, wider and better streets, appearing with greater air space and more sunlight for the houses. It is almost like a scene in a theatre. That is on a small scale. Planning on a great scale has brought about the development of great towns and of the countryside, and it is to that aspect that I now turn.

The public conscience is being stirred, particularly about the inroads on our national heritages such as the preservation of our coasts. I received a most influential deputation recently which brought that aspect of the matter before me. It is not possible to do all these things from the centre. It is upon the spirit and enterprise of the local authorities in using the powers entrusted to them by Parliament that the matter must finally depend. During the past five years planning resolutions have been approved by the Ministry which with previous resolutions cover nearly two-thirds of England and Wales. Close on 15,000,000 acres have been approved, making a total of 24,165,000 acres. A great deal has been done in the last 12 months. Resolutions have been approved in respect of 329,000 acres in North Devon, 280,000 acres on the north coast of Cornwall, 358,000 acres in Mid Northants, 121,000 acres in East Lindsey, more than half of Norfolk and Dorset-shire, and the whole of the Isle of Wight.

Planning control becomes effective as soon as the resolution is approved. The preparation of the detailed scheme necessarily takes time because of the technical work involved, and the importance to success of negotiations with landowners. Examples of the success attained are to be found in schemes like those Sussex schemes which have led to the preservation of the South Downs by agreement between the planning authority and the landowners concerned. But we are also seeing progress at a later stage than that of resolutions. About 4,000,000 acres are included in schemes adopted by local authorities but not yet submitted. About 3,000,000 acres have reached a further stage of inclusion in schemes submitted, and 2,000,000 of these 3,000,000 have been submitted during the last year. So much for planning in its wider and better aspects.

I now turn to another set of subjects which, although they come under the head of "materiel," might also, I think, be described as part of our inheritance from the industrial revolution. I would refer first to one in which many hon. Members, particularly the hon. Member for Leigh (Mr. Tinker) have for a considerable time shown great interest—the question of burning pit-heaps. Of these I am informed that there are no fewer than 214 in England and Wales. I also understand—and I say this with sympathy and not in criticism—that a large number of them are visible to the hon. Member for Hemsworth (Mr. G. Griffiths) when his Parliamentary duties enable him to go home. It is surely a matter for criticism that we should have allowed the formation of what might, perhaps, be described as synthetic volcanoes to the number of 214. I understand that the biggest of these burning pit-heaps has an area of 50 acres, nearly four times the area of the Great Pyramid of Egypt. Although it does not compete in height with that great structure, there is one burning pit-heap which is more than half as high, nearly 250 feet. These heaps are neither beautiful nor historic.

Our forefathers have certainly left us a very difficult problem to deal with in this matter. Early improvement is desirable. Not long ago my predecessor received a deputation from Members of Parliament who are interested in the subject. Since then the staff of my alkali inspectors has been increased and a systematic inspection of all the recorded burning pit-heaps is now being carried out as an urgent matter. In reviewing the question I have been glad to find that colliery owners are increasingly willing to co-operate in improving conditions where practical means can be found. The visits of my alkali inspectors are being made in conjunction with the inspectors of the Mines Department and will, I hope, lead to methods being tried and found which will enable improvements to be made. I am advised that much may be done by improved methods of depositing the spoil to prevent the firing of the pit-heaps, and this question will also be taken up by the inspectors on their visits. The House will appreciate that this is a matter in which the Mines Department is closely interested, and I can assure them that the two Departments are working together on this problem.

Another form of atmospheric pollution is that caused by the emission of smoke. In this matter also the alkali inspectors of the Ministry have been very busy, as hon. Members will see from the recently published report of the chief alkali inspector. As in the case of pit heaps, the main difficulty in making progress is the lack of knowledge of practical means of prevention. Considerable attention is, however, being given to the subject, and I am glad to say that investigations are being conducted not only by the Fuel Research Board of the Department of Scientific and Industrial Research but by the local authorities, by industrial organisations and by university workers. Here also the co-operation of local authorities on a regional basis is most desirable, and I welcome the recent formation of an eighth regional committee, that for Greater London. I sincerely hope that other local authorities will follow suit in this respect. Although smoke from domestic chimneys is not an offence under the existing law, it is nevertheless the chief offender, as it is estimated that more than half the pollution of the atmosphere comes from this source. Many hon. Members, particularly those representing mining constituencies will, I am sure, agree with me when I say that this question of the pollution caused by domestic smoke is a highly controversial and difficult one, and that is one of the reasons for our slow progress.

Mr. Kirkwood

With regard to the emission of smoke as a result of using coal fuel, suppose coal were converted into gas, would not that diffuse as much coal as the common grate?

Mr. Elliot

I can only say that while the treatment of coal before burning is one of the hopeful lines of progress, yet our people are, perhaps too deeply, attached to the domestic fire grate, as I am, and as my hon. Friend is. In spite of all our knowledge as to the pollution of the atmosphere by smoke from the domestic grate, we do like to have a good lump of gassy coal burning well, and we like to poke through the bars and see the glow. Therefore, as long as we are so much attached to it, I am afraid that domestic smoke will continue to be emitted, but we must not revel unduly about the glow from the grate.

Yet another aspect of the cleaning up of the countryside is the treatment of our rivers, which we have abused and mutilated for a century. The loans sanctioned by the Ministry for sewage schemes in the last financial year amounted to £7,000,000, an increase of more than 5o per cent. as compared with the figure for 1935–36. This means increasing progress in the purification of our rivers. Perhaps it is not too much to hope that in our time we shall reach the stage when we have ceased to pollute both our rivers and the air. Certainly, when this is achieved our country will not only be a more pleasant, but also a more healthy place in which to live.

Let me now deal with another important aspect of progress referred to by the right hon. Gentleman—the provision of water supplies. Some indication of the progress that is being made can be obtained by pointing out that the loans which have been sanctioned during the last year for the provision of water supplies, amount to nearly £4,700,000, which is an increase of over 20 per cent. compared with either of the two preceding years. The right hon. Gentleman asked me particulars about one or two areas, Biggleswade and the Isle of Ely. I am informed that the Biggleswade Water Company are getting on with the new scheme as fast as possible. The inconvenience owing to the drought is, I think, temporary; at any rate, the water board are taking steps to deal with the shortage. The Wisbech Water Company are carrying out works which will enable them to provide the whole parish with water. I do not think that the shortening of water supplies to the railway company would help; a new main is required, and, therefore, the water company are undertaking the works.

In view of recent happenings I think it is necessary to emphasise that the general standard of purity of water supplies in this country is, and has been for many years, very high, and we can claim that no country in the world has a better water supply. Indeed, we can prove that by the relative immunity which our population has long enjoyed from diseases due to water-borne infection. The principal of these is typhoid fever, and it is interesting to note the progress which has been made in recent years. The Registrar-General's review for England and Wales for the year 1936 shows that the standardised death rate from typhoid and paratyphoid per million dropped from 12 in the period 1921–25 to 6 in the year 1936, and to 5 in the year 1937; which is halving the rate even in the period since 1921. Although great strides forward in sanitation were made in the latter part of the nineteenth century it is satisfactory to note that we have maintained these gains in spite of the growth of the population, the spread of development and the consequent increased liability to pollution of our water supplies, which I think the House will readily recognise. It is due to three causes—the work and foresight of local authorities and water undertakers, the research work of chemists, bacteriologists and engineers into water purification and methods of sewage disposal, and the care exercised by the central Department to ensure that new sources of supply are as far as practicable free from the risk of pollution, and that safeguards are adopted if risk arises after a supply has been brought into use.

Recent outbreaks have emphasised the fact that this increased safety does not arise without constant vigilance. The Central Advisory Water Committee, under the chairmanship of Lord Milne, has just issued its first report, and the committee is going on to consider the further question as to how better relations and more co-operation can be brought about between the several interests concerned. When the final report is received, the whole question of water supply will receive the fullest consideration. The Inland Water Survey Committee is engaged in a national survey of water resources. I think, perhaps, these points may serve for the time being as an answer to the right hon. Gentleman's question as to what long-range consideration we are giving to the problem of water supplies.

Before I review the work of the personal services during last year I am sure the House will wish me to say a word about a new function which has been added to the responsibilities of my Department—air-raid precautions. As the Home Secretary announced in the House of Commons on 1st June, the Ministry of Health has taken over the responsibility for dealing with questions as to the provision of hospitals in England and Wales for the treatment of air-raid casualties in the event of hostilities, and the Department of Health has assumed corresponding functions in Scotland. Under the conditions of modern warfare, unfortunately, civilians as well as combatants are exposed to the risk of conflict, and provision must be made for the civilian wounded equally with those of the fighting Services. But there is this important difference. In the case of an army in the field, the battlefront may be more or less defined. The casualty-clearing hospitals can be suitably placed in relation to the front, and base hospitals can be organised in reasonable safety, far removed from the line. In the case of air warfare, it is impossible to forecast with certainty where casualties will occur. What is intended as a base hospital may be required to function as a casualty-clearing hospital if casualties should occur in the vicinity, and vice versa. The casualties occurring in a particular locality might prove to be beyond its hospital resources, even if its peace-time accommodation had been considerably augmented. The House, therefore, will see that the problem has to be tackled on broad lines. It cannot be solved by dealing with each local authority's area as a separate unit and attempting to meet its hospital needs without regard to the position in neighbouring districts.

We must aim at pooling hospital resources over a wide area and making provision for additional beds and equipment where this seems to be necessary. Plans have also to be worked out for moving as many as possible of the peace-time sick from hospitals which are best suited to deal with casualties, and for transporting the casualties themselves from raided areas to hospitals in less vulnerable positions. The Department is hard at work on these lines, and will submit plans as soon as possible to the local authorities and others concerned. In the meantime, I am sending the local authorities a circular explaining the general position. A special branch has been established in the Department for these matters, and a survey of hospital accommodation throughout the country has been in progress since the early part of this year. Medical and other officers of the Department have been assigned to various districts in the country in order that they may maintain close contact with local authorities and managers of voluntary hospitals in working out schemes which can be put into operation immediately if required. Co-operation between municipal and voluntary hospitals is obviously essential for the proper planning of this work, and I have no doubt that it will be readily secured.

As regards the London area, a number of hospital experts, presided over by Sir Charles Wilson, Dean of St. Mary's Hospital, were asked by the Home Secretary, who was then responsible for these matters, to advise on the special problems of a casualty organisation for the Metropolis. They have recently submitted their provisional conclusions to me, and I have conveyed them to the Voluntary Hospitals Committee for London as well as to the local authorities in the area. The next step is for the officers of the Department to work out the plan in greater detail for individual hospitals, as is being done in other parts of the country, and this is now being done.

Dr. Haden Guest

May I ask why in the appointment of that committee, the British Medical Association was not consulted?

Mr. Elliot

I think this illustrates the difference between material and personnel. This is more a matter of material. The British Medical Association has kindly undertaken a review of the personnel available, and when we have these two things complete we shall be able to bring the two halves of the plan together.

I should like now to say a few words on what has been called the state of the public health. The vital statistics for the year 1937 continue to bear witness to the improvement in the public health which has been continuous in recent years. The number of live births registered during the year was 610,557, corresponding to a rate of 14.9 per thousand population. These figures are noteworthy in that they record a rise in the birth rate, which rather gives the lie to some of the arguments advanced by the senior Burgess for Oxford University (Mr. A. Herbert) in a recent Debate. It is noteworthy also that the increase in the birth rate since 1933 has been accompanied by a fall in the infant mortality rate, which stood at 58 per thousand live births in 1937 (the second lowest rate ever recorded) compared with 64 in 1933. The crude death rate per thousand population last year was 12.4. This shows a rise of 0.3 per thousand over 1936.

Many deaths were due to the prevalence of influenza and influenzal conditions during the earlier part of the year. In the first quarter of 1938 the deaths in England and Wales showed a decrease of 16 per cent. on the first quarter of 1937—amongst the lowest for any first quarter. Ever since the War the death rate has been in the neighbourhood of 12 per 1,000, whereas about the year 1900 it was 18 per 1,000, clear evidence of the steady improvement in health during the present century. Coming to the growing and adult population, the death rate from tuberculosis provides a convenient index of the success of public health measures since the incidence of the disease depends on living conditions, particularly better housing, preventive measures such as the protection of the milk supply, and scientific advances as well as on the special tuberculosis services. At one time tuberculosis occupied first place among the principal epidemic or general diseases as a cause of mortality, but it has lost completely this unenviable distinction. During the 25 years before 1936 the standardised death rate from pulmonary tuberculosis declined by 49 per cent., and for non-pulmonary tuberculosis by as much as 69 per cent. The crude death rate from all forms of the disease was 692 per 1,000,000 population in 1936, the lowest yet recorded, a rate which was practically maintained in 1937 when the exact figure was 695 per 1,000,000.

There is one other death rate to which considerable importance is quite rightly attached, and that is the maternal mortality rate, not merely for itself, but as an index. I am sure the House will be glad to hear that the 1937 figures show a fall to a rate of 3.13 per 1,000 total births, the lowest ever recorded in England and Wales. Had deaths occurred in 1937 at the same rate as in 1934 no fewer than 814 more mothers would have died. The total number of deaths due to child bearing is of course relatively small. Less than 7 per cent. of the deaths of women between the ages of 15 and 45 are due to this cause; but there is clearly room for renewed efforts to secure a still greater reduction. It is, however, encouraging to find that the measures already taken appear to be showing results. The number of first attendances of children at infant welfare centres, expressed as a percentage of live births, was 63, and the number of expectant mothers who attended ante-natal clinics, similarly expressed, was 54. Both those figures are records.

During 1937, local authorities have been improving their maternity services on the lines recommended in the recent reports on maternal mortality in England and Wales. They have been increasing their maternity accommodation, establishing emergency units to deal with difficult cases in the home, extending arrangements for ante-natal and post-natal supervision and for consultant services, but above all, they have been promoting co-operation between doctors, health visitors and midwives, which is so essential. One aspect of the problem is being studied at present by Mr. Norman Birkett's Committee which has been investigating the question of abortion. The committee has been in frequent session and its report may, we hope, be available before the end of the year.

The House may like to hear what progress has been made in bringing into operation the Midwives Act, 1936. Throughout England and Wales, local authorities have now ensured the employment of nearly 7,500 midwives on an improved and permanent basis, by the engagement of midwives as their own servants and by making extensive use of those voluntary associations which have done such excellent work in the past and which still continue to do so. I think we may say that the establishment of the service has now been substantially achieved, that salary scales have been improved, and that the midwives' conditions of service are now more consonant with the importance of their profession and conducive to its efficient practice than they were before.

In connection with these reforms, the Central Midwives' Board has made rules embodying important alterations in training which will come into force by stages at the beginning of the Autumn. In future, trained nurses will undergo a year's training instead of six months, and other potential midwives will have two years' training instead of one year. Practising midwives will be required to take post-certificate courses at least once every seven years to ensure that contact with modern theory and practice is maintained. By the payment of increased grants in aid of training, it is hoped that the supply of fully qualified practising midwives will be stimulated. In this connection, I am sure we are all greatly interested in the scheme for the provision of certain additional items of diet to expectant mothers—known as the Lady Williams' Scheme—which, with the aid of grants from the Commissioner for Special Areas, was begun by the National Birthday Trust Fund and is now being carried out by the Joint Midwifery Council. Until the final figures are available, the scheme must be regarded as still in the experimental stage, but I can assure the House that I am watching the experiment with sympathy, and that I shall await the final figures with great interest, in the hope that this piece of investigation will be of value to all concerned.

There is no single measure which would do more to improve the health, development and resistance to disease of the rising generation than an increased consumption of safe milk, especially by mothers, children and adolescents. The attention of local authorities was drawn to this recommendation in a circular issued in April, 1937, and they have made increasing use of their powers to supply milk free or cheap to expectant and nursing mothers and children under the age of five. A Bill has now passed both Houses which will enable us to bring into operation, in co-operation with the milk industry, a scheme for securing a reduction in the price of liquid milk to local authorities for maternity and child welfare purposes. These arrangements are now under active consideration, and it is hoped that every advantage will be taken of any such scheme by the authorities concerned. I am sure the House was interested at Question Time to-day to hear from the Parliamentary Secretary to the Board of Education of the increasing use which is being made of the milk-in-schools scheme also.

Although the functions of local authorities are so largely preventive, they have an important part to play also in the attack on disease. In addition to specific services such as those for tuberculosis and venereal disease, the years since 1929 have seen remarkable developments in the general hospital services. The increase in the number of beds has not been strikingly great, but there has been a great improvement in the standard of treatment, equipment and accommodation. An example is provided by the fact that, whereas in 1932, 88,000 beds in local authority hospitals were in Poor Law institutions and only 38,000 in public health hospitals, to-day 69,000 are in public assistance institutions and 60,000 in public health hospitals. The transfer from Poor Law to public health has not only given an opportunity for an improved service, but has made possible, and indeed essential, close co-operation between local authority hospitals and voluntary hospitals.

In many areas co-operation has been developed, and there are signs of a growing recognition by those responsible that general hospital accommodation, however provided, should form a pool for use to the maximum advantage of the whole population. I think we are on the eve of expansion and reform in the hospital world, and in both cases careful planning and close collaboration have an important part to play. The various health figures which I have mentioned are averages for the whole country, and they mask the high figures which are prevalent in some parts of the country. These high rates are often due to circumstances peculiar to the particular areas, but it is none the less true that there is a degree of unevenness in local administration as well. I am sure the House will share my view that it is in the areas with rates above the average that the attack should be intensified.

In order to consolidate gains and to make fresh advances, it is becoming increasingly necessary to "Tell the people." Therefore, last Autumn a campaign with the slogan, "Use your Health Services" was inaugurated by the Prime Minister. We had the support, which I should like most gratefully to acknowledge, of the right hon. Gentleman the Member for Wakefield, the hon. Baronet the Member for South-West Bethnal Green (Sir P. Harris), Lord Addison and others. The campaign consisted in the distribution of literature, in health weeks, exhibitions, the display of health films, lectures and the holding of a very large number of public meetings organised by local authorities in England and Wales. These involved a very great deal of work. A number of the meetings was attended by Ministers and by leading Members of the Opposition parties, including the right hon. Gentleman the Member for Carnarvon Boroughs (Mr. Lloyd George). Valuable support was also given by the Press in the form of special health supplements and in other ways. I should like to thank all Members of the House, particularly hon. Members of the Opposition parties who did so much to make the campaign a successful one. We have some of the finest social services in the world, and this campaign has done much to make them better known. It is, of course, too early yet to assess its results in figures, but even the figures which I gave regarding increased attendances at child welfare centres and ante-natal clinics show that at any rate the services are developing, and I believe that the results for 1937 are in part due to the campaign.

Of course, to draw attention to the health services is only a small part of health education. We have to do our utmost to inculcate positive rules of hygiene and a healthy way of life, and in that the film particularly has a great part to play. Good work is already being done in that field, but there is room for a great deal more, and I hope that local authorities will support the work of the Central Council for Health Education, which is a co-ordinating and executive body on which the principal local authority associations, the medical profession and the leading voluntary societies are represented We ourselves have done our little bit. My Department and the Department of Overseas Trade have collaborated, with the help of various other Departments and organisations, in the production of a health exhibit which occupies one of the four halls in the Government Pavilion of the Empire Exhibition at Glasgow. The title of the exhibit is "Fitter Britain" and I am sure that all who have seen it—and I hope all who have not will take advantage of the holidays to see it—will agree that in this exhibit the resources of modern exhibition technique have been employed to display in an attractive and arresting way the progress made towards better health and the facilities now available. After the close of the Empire Exhibition the exhibit will tour the country, and arrangements for this are now being made; but go to see it at the Exhibition and you will get much better value for your money.

In actual scientific discovery a steady advance has been made on many fronts. For instance, further progress has been made in research on influenza. The first widespread epidemic of influenza since the recent work on the transmission of the virus began in December, 1936. The results obtained confirmed the experimental identification of the virus as the primary cause of the infection. It is interesting to note that in the course of the investigations the final link in identification of the causative agent was provided in an experiment not on an animal, but by an animal. There was a ferret with a bad attack of influenza and it was being examined by the research worker; it sneezed all over him, and the result was that the research worker contracted a typical and beautiful attack of exactly the same influenza. In the matter of pure chemistry, there is remarkable work going on with the drugs of the "sulphanilamide" group. They have been the subject of much further study and application. I will only say that the results of the use of these agents are as good as anything that has ever been shown in the early history of remedies, so good in fact that they must be treated with the utmost caution and checked again and again in the true scientific spirit.

I am sure the House will agree that the review which I have just given justifies a pride in past achievement, but much more important, that it provides an index for the future. We cannot afford to lose every year nearly 2,000 mothers and more than 35,000 children under the age of one. We cannot view with complacency an annual death roll of nearly 30,000 persons from tuberculosis, and nearly 70,000 from cancer, or the estimated loss of five and a half million working weeks every year owing to rheumatism, a disease to which one-sixth of our industrial invalidism is due. These are figures to be kept in mind. We are only beginning to realise how much can be done, even in the case of those who are at present considered normal and fit. Organised knowledge, energy, and good will, have still, without question, great contributions to make towards the well-being of our people. In future years it may well be that we shall read, in the light of the progress then made, the health records of to-day with the same incredulity with which we now read those of a century ago.

5.45 p.m.

Mr. Mander

I congratulate the Minister of Health very warmly on the most interesting, clear and wide survey of the work of his Department which he has just given to the House. The right hon. Gentleman brings to his new office knowledge and enthusiasm, and we hope that he will make a great success of it. He paid a tribute to the work of the local authorities, and in that connection I wonder whether steps could not be taken, as has sometimes been suggested, to give some form of recognition to those who hold the chief offices, not in the cities and large towns where they have their Lord Mayors and Mayors, but in the urban and rural districts. The term "Warden" has been rather spoiled by its use in connection with air-raid precautions, but there are other good old English terms which might be used in order to indicate a recognition of the public service which many men render in connection with these authorities.

The right hon. Gentleman also referred to the work of housing and slum clearance. A great deal has been done, but I cannot help thinking that there has been a certain amount of unnecessary delay in approving of slum clearance schemes. I hope attention will be given to that matter, and that these schemes will be allowed to go forward as rapidly as possible to the local authorities. In relation to these schemes I ask the Minister to consider this point. In the areas where slums exist one sometimes finds little communities of people, who are closely associated and have common interests. Each of these little communities has a distinct personality of its own, and it would be a great pity if they were to be scattered about the outskirts of cities under the new schemes and were to lose all that communal feeling which they possess at the present time. I have in mind the typical case of the Moseley Village in my own constituency. I am sure the Wolverhampton Borough Council will do everything possible to preserve that community, but it is a point which ought not to be overlooked in regard to these schemes generally. In these vast new housing estates you find people coming together with no community interest, and it is difficult to know how to interest them. I have suggested one way. Let them carry on from their past associations.

The Minister made a brief reference to rheumatic diseases, and I hope that the Parliamentary Secretary later on will give us rather more information on that point, because it is a matter of great importance. These diseases are very widespread and impose a great strain on the resources of the approved societies. A great deal of good work has been done at Peto Place, and I understand it has been decided to open another centre at Sheffield. We should like to know, I am sure, what other plans the Ministry have in view for dealing with this very important matter.

To pass to another point. I am very glad to see that action has been taken for the first time under the Minister's powers to deal with the preservation of buildings of architectural or historical importance. The Minister has approved of two orders this year, one in connection with some old buildings at New Romney and the other in connection with Grange Court, Leominster. I hope that the example of the Surrey County Council will be followed. They are making a survey of all their historic buildings and if other counties do that, it will place them and the Minister in a much stronger position when the time comes to act rapidly in the case of a building being threatened with destruction or removal.

I wish particularly to call attention to the subject of national parks, in which tremendous interest is being taken at the present time. The subject has become of additional importance in view of the extension of the holidays with pay movement, the increased leisure which is now available and the revolution in transport which has taken place in the last few years. People with slender resources can now cover great distances and get into the heart of the country in a manner which was impossible 10 or 20 years ago. The case for national parks which would fall under the care of the Ministry, has been very ably stated by the standing committee on National Parks of which Mr. Norman Birkett is chairman. They have presented their case recently very clearly to the Members of this House and to the public. The history of the national parks movement goes back to 1931 when we had the report of the National Parks Committee, but it came at a time when great economy was necessary and no action could be taken on account of the expenditure involved. Then, on 9th December, 1936, we had a Debate in this House which I initiated, and a Resolution was carried unanimously by the House to the following effect: That this House urges the Government, especially in view of the new national health crusade, to take whatever steps may seem most appropriate in the light of the recommendations of the National Parks Committee, 1931, to stimulate and develop action for the preservation of the countryside and its amenities including the reservation of areas of national interest against disorderly development and spoliation and the improvement of their accessibility to the public. I have endeavoured on numerous occasions since to extract from my right hon. Friend's predecessor, and even from my right hon. Friend himself, during his short period of office as Minister of Health, a statement of the action which the Government intend to take and of their policy on this matter, but it has been impossible to get any intelligible reply. The last reply which I received from the Minister was on 7th July, when he said that he proposed to consider the matter in connection with a report on the adequacy of existing planning powers which he expected to be submitted shortly by his Advisory Committee on Town and Country Planning. I do not know whether that report has been submitted yet. Perhaps we shall have some information about it later.

If I may state the general policy which is advocated by those who are in favour of national parks, I would say that the general objective of the movement is first that there should be a sufficient number of areas carefully selected from the unspoiled, wilder country of Great Britain and that these should be strictly preserved and specifically run as national parks; secondly, that the remainder of the unspoiled, wilder country of Great Britain should be regarded as a reserve for further national parks in the future, and that any development there should only be permitted in special circumstances. I understand that what I call the unspoiled wilder country would cover something like one-third of the whole area of Great Britain, and that the area to which I have referred as being immediately suitable would cover something like one-quarter of the whole area of Great Britain.

I am not referring to such schemes as the Green Belt scheme, which is very valuable, or to municipal parks, or to the admirable arrangements of the Forestry Commission for their parks. I am referring to such areas as the Lake District, Snowdonia, Dartmoor, the New Forest, Exmoor Dovedale, including the Manifold Valley—where great progress is being made through the generosity of Sir Robert McDougall and others—the South Downs, the Peak District—although in the Peak District and in Scotland the full advantage would not be obtained from these parks until some Measure such as the Access to Mountains Bill is put on the Statute Book—the Bowland Forest, the Forest of Dean, certain parts of the Roman Wall, Cannock Chase, the Trossachs, the Black Mountains, the Brecon Mountains and the Cairngorms area. Those are some of the best known examples. There are many others, but I think I have mentioned enough to go on with for the moment.

The policy advocated by those in the national parks movement is based on the report of 1931 which asked that the Government should make a public declaration that national parks on an adequate scale would be established as an essential national service and that there should be set up two National Parks Commissions, one for England and Wales and one for Scotland, with a joint committee to co-ordinate the work of the two. No doubt a good way to do that would be to set up a Statutory Commission, but that would involve legislation and would be out of order, and in what I am saying now it must be assumed that I am referring to a voluntary body which, of course, could do the work, although perhaps not quite as effectively as the other kind of body. It would be absolutely necessary to equip these national committees with adequate funds.

The National Parks Committee made two alternative proposals, one that a sum of £100,000 a year should be allocated to the commissions for a period of five years and the other that a sum of £10,000 a year should be provided for five years. If we really intend to do anything I do not think we need bother about the second alternative. If we are going to allocate money the problem is of such importance that we require something on the scale of £100,000 a year. We must bear in mind that at the moment the Treasury is providing £200,000 a year for the upkeep of the London Crown Parks alone. The argument put up by the Government in the past has been that a full use of the Town and Country Planning Act by local authorities in these national park areas would be adequate to secure their preservation. Those who have had experience of the question are convinced that that is absolutely untrue.

Since 1931 local planning has proved insufficient to protect national park areas, and it would be impossible for it to secure and maintain national parks for these reasons. First, national park areas are of their nature the areas with the lowest rateable value and, therefore, the poorest authorities, financially; secondly, sufficient prohibition or restriction of building operations cannot be imposed without compensation which these local authorities are too poor to risk undertaking. That is the fundamental need for the grant to which I have referred, because without compensation you cannot get on at all with the problem of protecting these areas. Furthermore, many of the most serious threats to these areas such as mining and quarrying, commercial afforestation, water catchment and water power schemes, Army and Air Force establishments, overhead cable lines, road development are outside the control of the Town and Country Planning Act. It would be necessary to have a body which would co-ordinate the following among other Departments—the Defence Departments, the Central Electricity Board, the Forestry Commission, the Ministry of Transport, the county councils the new Coal Mines Commission and the agricultural interests.

It would be impossible for the right hon. Gentleman's advisory committee under the Town and Country Planning Act to contemplate anything of that kind. It is a Departmental Committee and could not control or supervise the work of these other great State departments. The local authorities have no means of determining which areas should be national parks and have no special knowledge of the requirements. They have shown little readiness in the past to combine for joint action over the whole of any potential national park area, and in many cases are little interested in the preservation of such areas. In regard to most of the wilder parts of Wales and Scotland, the preparation of planning schemes has not yet begun. If these parks are to be worthy of the name of national parks, they will require not only preservation but the provision of facilities for the visiting public in the nature of reserves and things of that kind, and for work of that nature the local authorities have no mandate and have no resources. It is entirely outside their scope. Local authorities using their planning and other powers must obviously play a very large and useful part in the execution of the national parks policy, but they must be stimulated, guided, co-ordinated, and reinforced from the centre by these two National Park Commissions, with ample funds at their disposal.

May I now rapidly refer to the tasks which would fall to these Commissions? First of all, there would be the selection of national park areas. There is no existing body which can undertake this rather invidious task, because people have different ideas about it, and it requires specific surveys, skilful negotiations with independent national bodies, and somebody concentrating on the job and really doing nothing else from one year's end to another. Then they would have the task of the guidance and co-ordination of local authorities. It is not that they would take over and disturb any of the ordinary functions of the local authorities in the areas, but they would give them guidance and support and the co-ordination which is required, and they would give them a clear picture of the objective towards which the nation wishes them to move. Then there would be the question of the allocation of the Government grants, and a wide variety of measures would be necessary to maintain these parks when they were established, to facilitate their use and to check their abuse, and all these again must be guided from the centre in the same way. Then there is the question of the development of policy and the guidance of public opinion, a very important matter, which requires national attention and concentration. Furthermore, they would have to hold a sort of watching brief to deal with the further areas not intended at present to be dealt with, in order to prevent their being disfigured by developments which might take place.

I think that presents, I hope clearly, the case for giving special attention to the national parks movement. I do not know whether the Government ever think about such things, but it would be an exceedingly popular policy in all parts of the country under present conditions. I urge that the Minister should take an early opportunity of going into it thoroughly, making the necessary approaches to the Chancellor of the Exchequer, because I appreciate that that is where a certain amount of difficulty lies, and announcing a definite decision before some of these areas get absolutely spoiled for all time and are lost to the nation. In conclusion, I will show the importance attached to this matter by the committee, who say, in paragraph 84: In conclusion we desire to record our conviction that such measures as we have advocated are necessary if the present generation is to escape the charge that in a shortsighted pursuit of its immediate ends, it has squandered a noble heritage. I hope it will be my right hon. Friend's task to take the final and decisive steps in maintaining for the nation their great heritage in the matter of national parks.

6.4 p.m

Captain Elliston

The Minister has given such a comprehensive survey of the various activities of his Department that I think it will be most useful if we confine ourselves to a few points which we consider of immediate importance. I should like at once to congratulate the Minister on the very remarkable success achieved by that experimental course of health education which was carried through by the Ministry during the autumn of last year and during the recent spring. We have realised for a long time past that the health services of most of our municipalities are so complete that any further progress must depend on the efforts of the people themselves, and it is necessary, to ensure that, that you should go to the people and persuade them to use the services provided for them. Reports are coming from all parts of the country that the success of this campaign has been almost embarrassing, and it is a fact that there has been such increased attendances at many of the clinics as to involve local authorities in considerable additional expenditure.

This seems to indicate that the system of fixed block grants in operation since 1930 calls for more frequent revision and adjustment in accordance with the additional commitments resulting from legislation. In one borough alone, with which I am familiar, where there is a population of some 200,000, the expenditure on maternity and child welfare alone has increased from £21,000 in. 1931 to £41,000 in 1937. During the same period, in response to the campaign in regard to malnutrition, the annual expenditure on milk and food for mothers and infants has increased from £140 to £3,200 in that borough alone. Meanwhile, the fixed grant for maternity and child welfare work in that area increased from £8,000 to only £11,500, which means that while the local authority was assisted to the extent of 37.20 per cent. in 1931, the proportion had fallen to 26.50 per cent. last year. This example is typical of what is happening in large areas all over the country, and I hope that the Parliamentary Secretary will be able to tell us that it is intended to revise the distribution of these block grants and to increase them, so as to meet the results of their most successful work of health education.

At a time when we are all gravely concerned about our national expenditure and when, perhaps, we shall have to face very considerable economies, it may seem unreasonable to press the Government for further assistance to local authorities in connection with social services. But I think that experience during recent years has proved that public opinion in this country will support any measures that are necessary for two purposes—firstly, for the maintenance of our naval, military, and air defences, and, secondly, for the provision of essential health services. Both these are accepted as matters of life and death importance to the safety and contentment of the people. In 1931, when preparing the country for drastic economies and cuts, the National Government promised that there should be no reduction of essential health services. That promise was repeated in 1935, and was, in my opinion, largely responsible for the renewal of confidence which the National Government received from the country.

One hopes, therefore, that the Ministry will persist in the education of the people so hopefully begun, in order that full advantage may be derived from our invaluable health services. There is still need for increased use of the measures provided for the prevention and early treatment of tuberculosis, venereal diseases, dental defects—to mention just a few activities of health and school medical departments, and for such protective measures as immunisation against diphtheria. Equally urgent it is to educate insured persons and the necessitous poor to make early consultation with their doctors, so that they may receive treatment before mere minor ailments become of serious consequence.

Lord Horder has just rendered a very great public service by exposing the cruel exploitation of the people by vendors of quack medicines. He has moderately estimated the expenditure on these medicines at £30,000,000 per annum, a sum equal to the total cost of our municipal and voluntary hospitals. Lord Horder is not afraid to say that an enormous proportion of these preparations, which are sold at fantastic profits, are not only worthless but fraudulent in the claims made for them. Many of us, who are thankful for small mercies, will welcome the promise made by a Member of the Government in another place that he would see whether anything could be done to incorporate in the educational side of the National Physical Fitness movement something of a warning nature against the misuse of drugs.

But no reply has been made to another statement of Lord Horder's, that the Government seem to have protected this unscrupulous traffic by the exclusion of proprietary remedies from the operation of the Food and Drugs Bill, which within a few hours will have become an Act. I would like the Parliamentary Secretary to tell us later whether that statement of Lord Horder's was correct, because many of us had hoped that under Clause 6 of the Bill local authorities would be encouraged to proceed against—I quote the terms of the Clause: any person who gives with any drug sold by him a label which falsely describes that drug, or is otherwise calculated to mislead as to its nature, substance and quality. It will be a grievous disappointment if it is found that that Clause is of no use in combating misleading advertisements and the lying claims which are used for many of these quack remedies.

I hope I may refer very briefly to another matter on which I think the public should be more fully informed, and that is what we regard as the grave menace of depopulation. I was astonished this afternoon to hear the Minister refer almost in a note of optimism to the very small recovery in the birth rate which had occurred. I am told by those who have investigated this matter, and who must be treated seriously as authorities, that this little recovery is very misleading and is merely the result of a number of marriages which had been delayed by the trade depression, and that it indicates no real advance towards the rate existing in former days. While this problem is the subject of expert investigation, and before we know the factors not included in the Memorandum which was submitted to the House by the Senior Burgess of Oxford University (Mr. Alan Herbert), it seems desirable that the Minister should expound from time to time the significance of the Registrar-General's statistics. We all know what a bracing effect it had when the Minister was telling us month by month of the progress of the housing campaign, of how many houses had been built and how many plans passed. It created almost a competitive feeling between the local authorities throughout the country. In the same way, if we could have, perhaps once a quarter, a note by the Registrar-General for the information for the public on the course of the birth rate and the probable effects of the existing rates on the future, it might rouse the public to grapple with the situation.

No doubt the Minister is watching the effect of housing and overcrowding measures on the birth-rate. With the conversion of large houses into flats it seems that the landlords are making "no children" a condition of tenancy. I have in my hand a leaflet issued by a reputable house agent in North London offering 18 flats for hire at rents varying from 10s. 6d. to 30s. Of these 18 flats it is stipulated in the case of 12 that there should be "no children." In another four it states "No young children." In the case of only two of these flats there is no such stipulation. If that sort of thing occurs on a large scale it will be a very serious matter. For my part, I hope that young married couples will take these flats and forget all about the landlord's restriction.

I would like also to refer to abortion as a factor in the fall in birth rate. This question must be considered sub judice to-day because it is under investigation by an inter-departmental committee, but the hon. Member for Hitchin (Sir A. Wilson) has already asked the Minister whether we shall be able to see the evidence on which the findings of that committee are based. Here, again, the question of educating the public comes in, and it is hoped that the public will be allowed to understand why Parliament takes a certain course in this matter. When the information is available some consideration should also be given to the important report issued during the last few days from the Health Department of the Royal Borough of Kensington. There has been an investigation in that borough into the cases of 500 women attending the ante-natal clinic. There was a confidential inquiry in which the women gave much information to the doctors and the nurses. One hundred of these 500 women admitted that at some time or other they had attempted to procure abortion. In 19 cases they had been successful, and in 10 cases they admitted that they had used those female pills so cunningly advertised in the less reputable newspapers—the sort of remedy to which Lord Horder referred the other day.

There is no time to summarise the important recommendations in the report of the Kensington inquiry, but there are three recommendations of the Medical Officer of Health which I will mention. The first is that mothers attending clinics should be educated in the dangers of abortifacients. Another recommendation is that the sale of abortifacients should be prohibited. The third is that there should be an extension of the notification to include "termination of pregnancy," so that the doctors will at the welfare centres be able to look after women whose health is in danger as a result of the action they have taken. The fact that of these 100 women, 53 had been using proprietary pills is conclusive evidence of the need of such a campaign as we have been advised, by such a great authority as Lord Horder, to take. The defeat of the advertisements of these remedies and the maximum efficiency of our health services can only be secured by the continuance and extension of these educational methods. We must go on with the campaign the whole time, and I was glad the Minister referred to the good work done by the Central Council for Health Education. As the Minister said, the local authorities should be prepared to support that campaign so that the work of education can be continued.

6.22 p.m.

Mr. Silkin

The Minister of Health, in the comprehensive survey which he made of the health services of the country, naturally dealt with satisfaction and pride on the development of those services for which his Department has been responsible. He dealt, also, with some developments for which his Department has not been responsible, such as the erection of dwellings by private enterprise. It is the function of Members of the House to point out to the Minister some of the defects of his Department in the hope that he may be spurred on to still further efforts and to increase the social services. I feel that I ought to warn the Minister against the grave danger he will have to meet during the vacation in the shape of a number of his friends who are proposing to spend the Recess in making an attack on the social services. I hope the Minister will not mind my warning, because he is young and innocent and may succumb to the blandishments of some of his own friends.

We all agree that in this vast expenditure on the social services there ought to be a close scrutiny, and nobody who is responsible for the administration of any local authority will take the slightest objection to it. Some of us, however, are a little suspicious that this scrutiny is coinciding with the requirement that the Minister should give a five-year forecast of our expenditure, and the propaganda which is being organised by the hon. Member for South Croydon (Mr. H. G. Williams) and other Members on the other side of the House. I should like to warn the Minister that, although we may be prepared for the closest scrutiny of our public health services, any attempt to cut them down will meet with the fullest resistance, not only on this side of the Chamber, but, I imagine, from a number of Members on his own side as well.

The Minister referred with pride to the amount of housing which has taken place in the past year, and to the large number of dwellings which have been erected by private enterprise. According to his own figures only one in six of the dwellings erected by private enterprise has become available for the particular class which is really in need of houses, namely, the poor. According to the Minister, about 44,000 dwellings were erected by private enterprise in the last year with a rateable value of £13 a year or less, and the remainder were erected for a class of family which is not in the extreme need which the poorest members of the community are. I agree that some progress is being made with slum clearance and, although somewhat less, with overcrowding. In case the Minister is becoming complacent about it, I would like to draw his attention to the conditions existing in London and in all large towns which the local authorities have not begun to touch. Two families out of every three in London are sharing a house. Only one family in three is living in a self-contained dwelling or flat.

If we take working-class families, I think it would be true to say that four families out of five are living in a house or dwelling of some sort which was originally built for a single family. Many of the dwellings which are sublet in London and the large towns are quite unsuited for more than one family. In the majority of cases there is no separate water-supply or water-closet I have come across hundreds of cases where there are in a house four or five families who have to go through somebody else's scullery or kitchen every time they want water or go to the water-closet. There are no proper storage facilities for food and no facilities even for cooking, except sometimes a gas stove on the landing. The local authorities have not even begun to deal with these conditions, because the families are not living in overcrowded conditions as defined by the Housing Act, 1935, nor are they living in slum dwellings.

I would remind the Minister, also, of the large number of families living in underground illegally-occupied rooms. There are 50,000 of these rooms in London where families are living in conditions of which no Member of the House could possibly approve. It is impossible for the local authorities to deal with such conditions unless the Minister of Health becomes a partner in, and takes a real active part in, providing for the rehousing of these families. The right hon. Gentleman realises, I am sure, that it will require fresh legislation to deal with this vast number of families who are living in unhealthy conditions, but which, unfortunately, are not slum or overcrowded conditions. I would like the Minister not to be satisfied about the progress that is being made in houses. On his own figures of the progress which has been made in the past few years, I calculate that it will take something like 16 or 17 years to deal with the existing slums. It is the experience of London, and it must be the experience of every large city, that every year dwellings which to-day are not slums, become slums. We calculate that in London 3,000 dwellings every year fall within the category of slums. Therefore, while that problem is being solved to a certain extent, new problems are arising year by year. Furthermore, nobody can defend the existing overcrowding standard; inevitably, in the next year or two, it will have to be altered, and then a new problem will be created. Therefore, unless more energetic steps are taken by the Minister of Health to deal with the housing problem I suggest that in 10 years' time we shall be substantially no better off than we are to-day.

I want to put one or two points of detail in respect of housing. While we are all anxious to deal with slum clearance as rapidly as possible I do not think that the Minister, through his own organisation, is assisting local authorities as much as he might. I refer particularly to the time taken in dealing with inquiries. A great deal of preliminary work has to be done before a slum dwelling can be demolished, work by the local authority which inevitably takes a long time, but anything up to 10 or 12 months may elapse from the time when an insanitary area is notified to the Minister until the time when it is possible to acquire some of the dwellings. The Minister takes three, four or five months to fix the date for the public inquiry, and after that a similar period elapses before the result of the inquiry is known. I make no complaint against the inspectors appointed by the Ministry of Health. They are an admirable body of men, who do their work efficiently and well, and I would pay tribute to the conscientious way in which they do their work, but the Minister has not apopinted a sufficient number of them.

These delays not only retard the progress of slum clearance but are a hardship to the families concerned in the area, and no one wants to inflict unnecessary hardship on anyone involved, not even the landlord, but it is a fact that insanitary dwellings are sterilised for a long period—from the time when the first representation is made until the local authority is in a position to acquire the property. Sometimes the property is sterilised for two years, and the owner is unable to deal with it, and that is an unnecessary hardship on him. I think it is incumbent upon both the local authority and the Ministry of Health, as soon as they have made up their minds to deal with an area, to proceed as rapidly as possible so as to impose the minimum of hardship on all concerned.

My second point concerns the Housing (Financial Provisions) Act. Every hon. Member must deplore the necessity for the erection of large blocks of flats in London and the large towns, and would prefer to provide a reasonable number of cottages. As a result of discussions which took place between the London County Council and other local authorities and the Minister of Health prior to the passing of that Act it was made possible, without loss of subsidy, to undertake a mixed kind of development in London and the large towns. As a result of that agreement it is possible, so long as the average height of the dwellings on a new estate is three storeys, to get a mixture of dwellings of two, three, four and five storeys, but, unfortunately, it is not possible to provide cottages. For some reason which I do not understand the Minister allows a local authority to build two-storey flats without loss of subsidy but not to build cottages. I should be glad if the Minister would look into that point, because I am certain he would wish local authorities to provide a certain number of cottages on their estates, particularly for those with large families. A house with its own garden is much more suitable for large families, and we are almost able to provide such dwellings, but not quite. If the Minister would jump over this last hurdle and let us build two- storey cottages instead of two-storey flats the trick would be done, and I am certain that housing development would very much improve.

The Minister spoke of the large number of dwellings erected by private enterprise, and said that an increasing number had been built for occupation by the poorer section of the community. Everybody who has studied this question realises the danger to owner-occupiers who are not in the position, not having the requisite knowledge, to satisfy themselves that the houses they buy are in a satisfactory condition and have been properly built. In other words, everybody knows that there is a large amount of jerrybuilding, and owner-occupiers, particularly the smaller ones, find after a few years of occupation—some hon. Member says, "after a few months"—that they have to spend larger sums of money upon repairs than their pockets will allow. Last year the right hon. Gentleman's predecessor told us that a voluntary scheme had been devised by builders with the object of certifying houses. Any prospective purchaser could get one of these certificates which would certify, in effect, that the house had been inspected on three occasions and was, in the opinion of the certifier, a satisfactory house. I should like to know what has happened to that wonderful scheme, because since last year I have heard nothing about it. I have never met anyone who has a certified house, and there has been no other public statement about these certificates, and I should be obliged if the Minister would tell us whether the scheme is a success or, if it is not, what he proposes to do, because the evil is a real one and I feel that there is going to be serious trouble in future unless the question is taken up seriously.

The Minister also dealt with atmospheric pollution and smoke abatement. He was a little bit jocular on the subject, and I do not think he realises the seriousness of the problem in the large towns. I wonder whether he realises that the position to-day is admittedly no better than it was in 1921, when a Departmental Committee reported on the question. Everybody who has studied the question states definitely that we are suffering just as much to-day from atmospheric pollution and smoke as we were 17 years ago. Something like 2,500,000 tons of soot descends over the towns and cities throughout the country every year. It comes from domestic and other fires—about half the quantity from domestic chimneys. A great deal of trouble is caused by industry—by the grit, smoke and acid emitted from power stations, from gasworks, from trains and from vessels. Every year the London County Council have to conduct a considerable number of prosecutions against railway companies for permitting excessive emission of smoke from locomotives. At any rate the law does forbid the emission of excessive smoke from industrial premises, but residential premises are exempt, and I wish something could be done about them.

In London alone 400,000 tons of sulphuric acid are liberated into the atmosphere every year, and I imagine that Members of this House get their fair share of it. So far as I know very little has been done with this problem since the Departmental Committee reported. It is hardly necessary for me to emphasise the results arising from this evil—the injury to health and buildings, the losses and delays caused by fogs in London and other large towns. This smoke nuisance involves London in an annual additional expenditure of 24s. per head, and that in itself is a powerful argument for action being taken. What can the Minister do about it? I think he can help to educate the public. To-day there is no need for the public to burn domestic coal. There are excellent substitutes which, I am informed, are more economical and more satisfactory. He ought to discourage the use of the open coal fire, however much he likes it himself, and ought to encourage the use of smokeless fuel, and he could extend and co-ordinate research into domestic heating problems generally. He must regard this as a serious and, indeed, vital problem in urban life.

I have one or two observations to make on the subject of town planning, a subject which, I think, has not been touched upon. I feel that town planning should take account of and provide for a balanced development, should provide for all the needs of a healthy society. One of the most important needs, that of preserving agricultural land, is completely ignored in our town-planning schemes. Areas are zoned for various forms of development, for residential, business and industrial building, and for private and public open spaces. If agricultural land is zoned as residential land on which 4, 6, 8, or 12 dwellings to the acre may be built, an inducement is at once given to the owners of it to offer their land for sale. Speculation in land is encouraged, and the owner of the agricultural land becomes unsettled and disinclined to proceed with agricultural work.

It is the fact that around Greater London alone far too much land has been zoned for residential purposes—sufficient for dwellings to house the whole population of the British Isles. I submit that something ought to be done to ensure that this agricultural land should be retained as agricultural land. After all, agriculture is one of the most vital industries of this country, and will be of increasing importance in the event of war, but nothing is being done to preserve this agricultural land for the purposes for which it is needed. There really is no need to zone so much of the land of this country for residential purposes. If it be true that the population is declining the need is all the less, but even on the basis of the existing population I imagine that it is possible that three or four times the population of this country could be housed in the areas which have been zoned for residential purposes. I must apologise for having taken so long, but I feel that some of the points which I have mentioned are of some importance.

6.45 p.m.

Mrs. Tate

I listened with interest to the speech of the hon. Member on the subject of housing. We know that he is a very great authority upon it. I heard with very great sympathy his description of some of the slums of which we are trying to get rid, and I wish I could think that every house that is being built as a result of slum clearance activity was in actual fact replacing a slum house. Unhappily, in isolated instances, which are not less tragic because they are isolated, what could be made perfectly good houses are being torn down in order to build a council house of very doubtful construction. Some of the houses that are being put up do not compare in quality of building with the houses that they are replacing. The Minister has been exceedingly sympathetic to difficulties which have arisen in my own constituency, and I would urge upon him that until the Housing Act, 1936, can be amended to give power of appeal to people whose houses have been scheduled under a clearance order in a rural district, instructions should be given to local authorities not to press forward too rapidly with the demolition of cottages the owners of which are ready to repair and make sound those cottages at their own expense.

In some cases, aged inhabitants occupy cottages which it is proposed to demolish, and I urge that in such cases the cottages should be spared if, in the opinion of reliable people in the localities, the buildings could be made sound enough to last the lifetime of the occupier. In my division is a cottage which is only 10 years old. It is proposed to demolish it, but a local builder has certified to the hon. Member for Bath (Mr. Guinness) and myself that it is sound. He has said upon his authority that it is criminal even to consider pulling it down. The inhabitant is a crippled woman of 80 years of age. A local doctor has said that the threat to her house has already gravely endangered her health, and that if the order is confirmed and she is forced to move, it will almost certainly mean her death. I urge that in isolated cases such as this the cottage should be spared during the lifetime of the owner.

A word about water supplies. We all heard with very great gratitude that a survey is to be made of the nation's water supplies. In my own division a very serious case has arisen in the village of Peasedown St. John where there is a central school with some 400 children. I am told that since 13th June, there has not been one drop of water in that school, and it is not possible to give the children a drink when they come in from their games or to enable them to wash their hands. The school teachers have brought small quantities of drinking water in bottles and flasks, but everyone who has had care of children will know that it is impossible to provide children with a small bottle of water when they have to go a long distance to school. Even if a child started from home with the bottle it would not, in every case, arrive at the other end with the bottle. The Bathavon Urban District Council, which is responsible for the water supply of Peasedown St. John, disclaim responsibility for the lack of water in the schools. Here is a letter from the chairman of the Peasedown St. John Water Committee in which he says: The council, of course, has the blame, and yet water is there"— that is to say, in the school— for both house and school, if and when the responsible people for piping the water from the main take the trouble to thoroughly overhaul and test their system of pipes. Before any central school is built to supply the educational needs of 400 children, we should make certain that the water supply is there. A serious shortage ought not to arise. I believe there is a shortage of water in Peasedown St. John. This year has, I know, been exceptional, and I believe that the people have been short of water for their own ordinary domestic use, but the conditions in the school create a grave scandal which should never have been allowed to arise, and I should be grateful if the Minister would look into the position for me.

The right hon. Gentleman rightly spoke of the improvement in health, and of the diminishing number of deaths resulting from maternal mortality, tuberculosis and other diseases, but no mention was made—mention is very seldom made—of the appalling number of people in the mental institutions of the country. I regret that the Health Estimates for the year are seldom printed in time for us to study them before we have to discuss them in the House. I read the report of the Board of Control for 1936 from cover to cover. I think I must be one of the few people who do so. I found that the total number of people suffering in institutions from mental disorder was about 155,000, and that the mentally defective people under control—we all know that that is not by any means the whole picture—was between 80,000 and 90,000. In ordinary hospitals, I think, there are only about 198,000 beds. Thus we have a terrible picture of mental ill-health, approximating very nearly to the whole physical illness of the nation. Some mental hospitals are up to date and really give curative treatment but, as the Minister well knows, of a large number of hospitals all you can say is that the sufferers are being kept out of harm's way. Remedial treatment is not given and is quite out of the question, both because of understaffing in doctors and nurses, and of accommodation.

I urge that the patients in the category known to medical men as the old, turbulent lunatics, for whom you can do absolutely nothing except keep them housed, fed and warm, because they will never be cured, should be segregated into the more old-fashioned mental hospitals, and that the more up-to-date hospitals should be kept for cases in which there is a chance of cure if adequate treatment is given. In answer to a question to-day with regard to mental deficiency in Lancashire, figures were given which are extremely disturbing. It is time that some sort of committee again studied the question of voluntary sterilisation of the unfit. This is a difficult and unpleasant question to touch upon, because we all know that life has to be regarded as sacred; but you cannot continue to have this awful incidence of mental deficiency in the country without trying to find out whether such people ought to be allowed to go on propagating their species.

While I am on this question, I should like to say a word about the case which aroused national interest the other day. I refer to the case of Dr. Bourne, who performed an operation on a girl under 15 years of age for the removal of her child. We all know that he asked to be tried because he might have been considered, according to the law of the land, to have performed an illegal act, but no one who studied the case with care, whether agreeing with the verdict or not, could think that it showed a satisfactory state of affairs. It is true that Dr. Bourne said he was convinced that in that case there was danger to the health of the mother, and that he was, therefore, able to perform the operation legally, but it is time that we considered such cases as those of girls who are only about 14 years of age and who have been subjected to rape. Whether a girl's health is in danger or not, we ought to decide whether she ought to be allowed to be the mother of the child. The situation needs investigation. We all know that circumstances arise in which mentally defective girls are subjected to rape or in which the man is a mental defective, and it is time that the whole question were fully and carefully investigated.

Some years ago I asked that more careful inspection might be made of the nursing homes of the country, arid especially of the conditions of hygiene in them. The Minister spoke this afternoon of influenza, and cited the case of a man who was examining a ferret suffering from influenza when the ferret sneezed over him. The man contracted the identical influenza. I wonder how many cases there are of people who go into nursing homes with one complaint and contract some other disease, the germs of which had been left in their room. No one with any knowledge of hygiene and bacteriology can go into some London nursing homes without seeing carpets on the floors, curtains at the windows and coverings upon the chairs which must be a source of infection. When nursing homes are inspected, more careful attention should be given to their conditions of hygiene.

In regard to the nursing profession, it is generally known that there is a shortage of people entering the profession, but I wonder whether it is equally well known that in some cases there is a shortage of trained nurses. Members of the nursing profession in London have brought to my notice the fact that nursing co-operatives who send out nurses to private cases are by no means always staffed with fully-qualified nurses. The more reputable are so staffed, but by no means all the others. If a patient is paying the full fee for the services of a State-registered fully-qualified nurse, and if the patient is being deceived because the nurse who is sent is neither State-registered nor fully-qualified, the patient has the right to know. In every case where a co-operative sends out a nurse who is not fully trained, instructions should be sent to the patient, stating the qualifications of the nurse. Private nurses are often sent out to very serious cases, and usually, whatever the nurse receives, the patient has to pay an adequate fee. The doctor in charge of the case and the patient have the right to know whether such a nurse is fully trained and is State-registered.

6.59 p.m.

Dr. Edith Summerskill

I listened to the comprehensive speech of the Minister of Health this afternoon, and must confess to being very disappointed. Although he explained that the maternal mortality rate had decreased this year, he did not enlarge upon the measures which he expected to introduce during next year in order to reduce the rate still further.

The Parliamentary Secretary to the Ministry of Health (Mr. Bernays)

If the hon. Member is making an attack upon the Minister, I would venture to interrupt in order to point out that my right hon. Friend was precluded by the Standing Orders from making any suggestion involving legislation.

Dr. Summerskill

I was not suggesting that he should speak of legislation, but that he should put into effect recommendations which have already been made to the Government.

Mr. Bernays

By way of legislation.

Dr. Summerskill

No. I think those recommendations could be put into effect without legislation. These are recommendations which can be put into effect without any legislation.

As I listened to the eloquent speeches of the miners' representatives on Monday dealing with the fate of miners, I wished that someone might follow me this afternoon who would speak as eloquently of the fate of the mothers in this country. Sixteen miners, we were told on Monday, die every week in the pits, but 45 women die every week in childbirth, which is supposed to be a normal physiological process. Most of these 45 women are in the prime of life and enjoy good health, and their death spells disaster to husband and to the children who are left. When he dealt with the morbidity rate of this country I was sorry that the Minister of Health did not also discuss the morbidity which follows childbirth, because not infrequently the mother survives but she is left with some disease or disability, her health is impaired and her usefulness diminished. Unfortunately, we have no accurate statistics of this particular morbidity rate, but it is interesting to notice that Professor Blair Bell, of the Royal Infirmary, Liverpool, has said that 47 per cent. of all gynaecological operations are concerned with local injuries and infection following childbirth.

I am not asking the right hon. Gentleman to make any investigation into this matter. The investigations have already been made, and it is my experience that while investigations are being made Ministers concerned feel that they need not do anything. The last report we had on maternal mortality was in April, 1937, but nearly 10 years ago a Departmental Committee sat and gave a first interim report and in 1932 a final report, and, comparing the recommendations of the reports of those two committees, I find that in all essentials they are very much the same. There is no question of there not being any room for improvement in this matter. The final report of the Departmental Committee stated that half the deaths that occurred were preventable, and of these lack or failure of ante-natal care constituted 15 per cent., error of judgment about 19 per cent., lack of facilities 3 per cent. and negligence on the part of the patients 7 per cent. If the Parliamentary Secretary will carefully examine those figures he will see that of those who died and should be saved 3 per cent. died from lack of facilities, and 7 per cent. through negligence on the part of the patient, but 35 per cent. of the deaths are due to lack or failure of ante-natal care or error of judgment.

As a result of these figures the latest report comes to the conclusion that inexpert midwifery is a factor of major importance, which operates both in those areas where there is a high and where there is a low maternal mortality rate. I am very anxious to bring this point home to the Minister of Health, because I regret that my own profession does not face up to this important factor, and if my profession does not face up to it, then I hope that the Minister of Health will take a leaf out of the book of the right hon. Gentleman the Member for Carnarvon Boroughs (Mr. Lloyd George), who in 1911, I think, had to bring pressure to bear on my profession. It is absolutely essential that this inexpert midwifery should cease. These recommendations were made six years ago when many doctors who are now qualified were only potential students, and still the recommendations have not been put into effect.

One of these important recommendations was that the education in obstetrics for medical students should be improved. I qualified in 1924, and ever since then I have felt very much that the education in obstetrics is not as it should be. I must confess that, like most students, I tried to do as little work as possible, though I tried to get through my examinations, and it is a fact that I was qualified in midwifery simply by being in a room where 20 confinements were conducted, and I never went near a bed or touched a patient. That position is deplorable. I was lucky, because my father was a general practitioner and I was able to go home and have expert tuition—and no doubt that was why I was lazy. I agree I could have thrust myself forward and have got through, as many of the students and midwives did, and got near the patient, but the fact is that I did not because I knew I could get my tuition at home; and I was signed up and certified as being qualified to conduct a confinement without ever having conducted one in a hospital.

Sir Henry Morris-Jones

Would the hon. Lady be good enough to say whether in her tuition in midwifery she attended any cases outside in London, or wherever she was studying, because that is the general custom of medical students, certainly as far as my knowledge goes?

Dr. Summerskill

I did not attend one case outside. You have to remember that I was qualified in 1924, and at that time we had a number of students who had come from the War. But I might tell the hon. Gentleman opposite that I am here—and I feel it my duty to expose these things—I am here representing the mothers of the country, and not the medical profession. This factor is, I consider, of tremendous importance. The Under-Secretary most probably will tell me that on 1st November, 1938, the licensing authorities are going to be told that the education of students in obstetrics must be improved. I have here a copy of the recommendations that are to be made, and although I find that a medical student has to attend certain lectures, and has to live in a hospital for a certain time, to my horror I still find that he is to be signed up after only 20 cases, and these cases need not necessarily present any abnormalities. I know that people will say it is extremely difficult to get sufficient cases for every student. That is not an argument. I say that if a student does not have adequate instruction—and I suggest that attendance at 20 cases is not adequate instruction—then he should not be allowed to go out and attend confinements, because it is a kind of confidence trick played on the mothers. They believe that every doctor is fully qualified. I am fully aware that most people have a tremendous faith in most general practitioners, and the general practitioner is one of the most hard-worked people in the whole country, but these doctors should not be allowed to go out and practise without further instruction. That recommendation was made eight years ago, and still the Government have done very little about it.

Another recommendation is in regard to the education of public opinion. I was very glad to hear from the Minister this afternoon that films and lectures are used as a means of instruction, and as a result people are becoming health-minded, but I do not think that is enough. I would refer the Parliamentary-Secretary to the speech made by the President of the British Medical Association last week, when he said that the time has come for every boy and girl in the elementary schools to have elementary instruction in anatomy and physiology. The ignorance of the average patient as to the location of his organs when he goes to see the doctor is equal to that of a native in darkest Africa who goes to consult his medicine man. This condition of affairs should no longer exist. I feel that this should be done particularly in the case of potential mothers who cannot be expected to attend ante-natal clinics or take an interest in their own pregnancy unless they have this elementary instruction.

The third recommendation which I want to bring to the notice of the Minister of Health—again made eight years ago—is that for more hospital accommodation. Here we have the Minister of Health saying this afternoon that he is very sorry but he is afraid that during the last year very few additional beds have been provided in our hospitals. Frankly, I look forward to the day when every woman goes to a hospital for her confinement unless she has ample accommodation, every facility, good nursing, specialised treatment, and opportunity for a quiet rest after the confinement. There are people who are amazed at this almost revolutionary suggestion, but if the right place for a woman with an abnormal confinement is a hospital, I cannot understand why the hospital should not be the right place if it is a normal confinement. I was instructed by one obstetrician who said, "Never call a confinement normal until baby and mother are both safely tucked up." I think that is a very good maxim. People say," There is something about a home that you cannot get in hospital." The only thing I have observed about the home that you cannot get in hospital is the husband, and it has never yet been proved to me that a husband's presence is a safeguard against a dangerous confinement. I think that those women who are not unduly pressed by their husbands will agree with me that they would far rather be in a place away from husband, away from children, away from housekeeping, somewhere where they can have quiet. In spite of this recommendation there is a deplorable lack of beds in this country, and in the industrial areas expectant mothers are clamouring for accommodation.

The final recommendation which I want to bring to the notice of the Parliamentary Secretary is the medical staffing of maternity hospitals. In case the hon. Gentleman opposite might think I am suggesting something which is not in accordance with general medical views, let me read the recommendations of the final report of the Departmental Committee. I am dealing with the staffing of maternity hospitals, because I feel that if, when a patient is sent into a maternity hospital, she believes, and the doctor who sent her in believes, that she will there get specialist treatment, she should have it; but unfortunately to-day many patients who are sent into maternity hospitals are treated by assistant medical officers who have not the knowledge that is possessed by the doctors who sent them there. The Departmental Committee said: It appears from the Committee's inquiries into maternal deaths that it is not uncommon for urgent and serious cases admitted in labour to a hospital to come primarily under the care of a house surgeon of limited obstetric experience, who is often expected not to send for a member of the visiting staff until his own attempts to deal with the case have failed. The committee unhesitatingly condemn this practice. They consider that experience in the management of such cases and in actual manipulation, which it is of the greatest importance for junior practitioners to obtain, should be acquired under the direct supervision of an experienced chief. I am very concerned about this matter, because I remember my father, who was a general practitioner for 50 years and who delivered thousands of women, saying very bitterly, "Well, this is a peculiar system. Here am I, with all my experience, but, if I did want help, I should have to send the case to the local hospital, where a man who, perhaps, has only been qualified for a few months, and has not had anything like my experience, would try to bungle my case." The, committee's recommendations were made nearly 10 years ago, and yet these appalling conditions still exist in our hospitals. I sincerely ask the Parliamentary Secretary and the new Minister of Health, whom I look upon as a new broom, in view of his medical education and of the even finer education that he had in the Fabian Society, to consider these recommendations very seriously and to put them into effect.

7.19 p.m.

Sir Ernest Graham-Little

I would like to make, first of all, a few comments on the statements of the hon. Member for West Fulham (Dr. Summerskill). Of course, it is obvious that it is difficult to obtain experience for students in maternity cases, and the difficulty of the problem was referred to some time ago by the Labour Members of the Standing Committee on Scottish Bills, who protested against pregnant mothers being visited by what one Member called "a young ragamuffin" instead of by a qualified practitioner. The system of training students which has been adopted in London is very excellently adapted to meet the position, and I may say that the maternal mortality rate of London, that is to say, the district served by the great hospitals of London, is such that I do not think the position is quite as serious as the last speaker suggested, the maternal mortality being about two per thousand in that district.

I want to deal with quite another question, but, before doing so, I might perhaps, as a senior member of the medical profession, be permitted to compliment my right hon. Friend on his elevation to the chief post in the health services of this country, and to express my satisfaction that he as a doctor has been chosen for that position. I hope it may be a good augury, and that he will be able to give some of that close personal knowledge which he cannot help having acquired in his profession to the problems of health, for surely it is the medical profession that must be chiefly responsible for any improvement that we can expect in our health services.

I desire to lay stress on the fact that, as has already been indicated, one of the most important subjects of medical practice in which no improvement, or at any rate very little improvement, has been made, is that of mental diseases, and I cannot help thinking that the reason for that lies in the faulty education that is offered and the faulty provisions that are made for medical officers in mental hospitals. This applies not only to the provinces, but also to London, and it so happens that in the last few weeks there has been a constant stream of letters in the medical Press from assistant medical officers in mental hospitals—all anonymous, because they have been afraid to state openly what is happening—complaining of the conditions which now prevail in the junior posts in mental hos. pitals. Last year a case was tried in the Court of King's Bench, and the very remarkable position was established that it is possible, under the Lunacy Act of 1890, for any visiting committee of a mental hospital to discharge an officer of the hospital without giving any sort of reason. We have to remember that the visiting committee of a mental hospital consists largely of persons with no knowledge of the very technical matters with which the hospital deals, so that it is not really possible for them to make any adequate inspection.

There is another very important reason why the mental hospital is not a place to which an ambitious man would like to go. In the first place, the only officer who is recognised as an officer of such a hospital is the medical superintendent. He is in a position of practically supreme authority, and he is able to rule his community with an extraordinarily autocratic rule. I have here some evidence which points to the sort of conditions that prevail. In the asylum which was described to me, no assistant medical officer could be absent from the institution without the leave of the medical superintendent; the only time at which he could get away at all was at the annual holiday. He lived in the hospital and was unable to marry, and he remained there sometimes for 20 years in that very unhealthy monastic condition. When we remember, in addition, that these assistant medical officers are, as I think, inadequately paid, the reasons for their discontent are obvious.

I had an opportunity, during the term of office of the last Minister of Health, to speak to him on this particular point, and I hoped I had interested him in the matter. My reason for being so much interested in it myself was that we were trying to improve the training of medical officers in mental hospitals by instituting in every university an improved diploma in psychological medicine. A committee, of which I was a member, was appointed by the University of London to meet members of the Board of Control and representatives of the Colleges of Physicians and Surgeons, which also issued a Diploma in Psychological Medicine. We had a number of meetings, and suggested improvements in the training of medical officers at mental hospitals, but the difficulty was the question of finance. The training required for such a diploma in psychological medicine required an absence of at least six months for the purposes of attendance at a recognised hospital, and it was found very difficult to persuade medical officers at mental hospitals, who had their patients to look after, to take on this very desirable extra qualification at their own expense. Accordingly, I asked the late Minister of Health whether he could not arrange for some fund in his Estimates out of which provision for study leave could be made for this purpose. I think that such a provision would pay for itself many times over.

The real reason why research has been so stagnant in this department of medicine lies in the very unfortunate conditions which have prevailed for so long in the hospitals which treat mental disease. There can be no question that many of them are antiquated, out of date, and quite inadequate to deal with the cases which they take. A very curious grievance has come to light quite lately in connection with the London County Council Mental Hospitals. The chairman of the Mental Hospitals Committee, with whom I have been in communication, tells me that for some time they have insisted on the Diploma in Psychological Medicine, but they are now further insisting that their medical officers should also take the membership of the Royal College of Physicians of London—a very onerous and difficult examination. I had a conversation lately with the President of the Royal College, and he strongly deprecated the idea that that should be insisted on in the case of a mental hospital officer holding the Diploma in Psychological Medicine. The net result is that the officers concerned are undertaking an impossible task. They are asked to study for an exceedingly difficult examination, in which the failure rate is some 80 per cent. The difficulty of anyone taking an examination of that type while he is at the same time doing his work, if he is doing it properly, in the hospital, is obviously very great, and it is quite beyond the requirements of the case. If I may say so, the Diploma in Psychological Medicine, either of the Royal Colleges or of a university, should be made a condition of employment in any mental hospital receiving a public grant, but I do not think that anything more should be required, because, after all, that is a specialist qualification, and is a proper requirement for a man who is going to make the treatment of mental disease his life's work.

Anything beyond that is, I think, asking too much, and is putting an intolerable strain upon the officer who has to undertake it. But that is beginning to be the practice, and officers to my knowledge have been told that they cannot hope for promotion in the London County Council mental hospitals unless they have a good M.D. or M.R.C.P., or both, in addition to having the Diploma in Psychological Medicine as well as the qualification which puts a man on the register. That is a matter which I feel should be looked into very carefully by the Minister. The position in mental hospitals is such that they do not attract the best men. The Minister has given us a very reassuring account of the position of research in other departments of medicines but can he point to any kind of advance that has been made in the study of mental diseases in this country in the last 20 years? That is one part of the subject with which I wish to deal. It is a very important part, because the expenditure of our mental hospitals is something like £10,000,000 per annum, and the nature of the troubles with which they deal is so terrible that any increase in the rate must be a very disturbing factor.

I want now to touch on quite another subject. I want to deal with the hospitals which have come under the charge of the London County Council since the 1929 Act. That Act transferred poor law institutions in London to the control of the London County Council. They became hospitals from that date. I quite admit that the time which has elapsed since that Act came into operation has been too short to achieve its full effect, but there are considerable dangers which ought to be faced in regard to the present position of the London County Council hospitals. They have, in my submission, very inadequate personell as compared with the voluntary hospitals. I have personal experience of both these institutions. I have been officer of a municipal hospital and of a voluntary hospital, and I can. I have here a very careful summary by a man whom I know well, who has been an officer under the London Country Council for many years. He has given me an example of the work he is obliged to do in the ordinary course of his day's occupation. One hospital where he was assistant medical officer for some years had 400 beds. It had four assistant medical officers, no house surgeon, no house physicisn, no students. That staff of four had to deal with all the work of the hospital.

The nature of the cases coming to these hospitals has changed entirely since 1929. They take a very large number of quite acute cases, and this officer told me that in 20 months of service he was called upon to deal with 530 cases of illness caused by attempted abortion—unskilled and dangerous abortion. He had one experience which I think might be taken as an example of understaffing. A ward which was under is medical control, a ward containing 30 infants, was placed in the charge of a single probationer nurse. One of the children in the ward managed to get his head between the bars of his cot, and was asphyxiated and found dead. That caused a coroner's inquest. The officer attended the inquest and gave evidence as to what, in his opinion, caused the accident. He said that, in his opinion, the cause was inadequate staffing. He was upbraided by the authorities of the hospital. They said that he had no business to make that public. The tendency in these hospitals has been to provide more expensive and more handsome equipment, all kinds of new gadgets which the voluntary hospitals often do not have; but the personnel is of first importance. There is an old Greek adage which says that the strength of a city lies not in its wall but in the men who man them. The same applies to the hospitals and I hope there will be some means, within the Ministers's own capacity, of keeping a watchful eye on the development of the municipal hospitals in this particular aspect.

7.36 p.m.

Mr. W. Joseph Stewart

We have heard a very comprehensive survey by the right hon. Gentle man of the health sevices of this country for which he and the various local authorities are responsible. We have listended since that speech was made to medical and surgical dissertations on what is needed in our general hospitals. We have also had speeches dealing with the question of housing, pointing out the great desirability of this country getting on wigh vast schemes in order to provide for the proper housing of our people. I wigh to deal with one or two questions which up to now have not been before the House. One is the question of-old-age and contributory pensions. During the past year many questions have been asked and many speeches made about the inadequacy of the State pensions and the anomalies which exist in regard to both the contributory and the non-contributory schemes.

I am not going to suggest amending legislation, knowing that if I did I should be subject to your ruling, Mr.Speaker, but I would point out that the pensionspaid to-day are totally inadequate; that 10s. a week for a single man and 20s. for a man and wife are not sufficient to maintain a reasonable standard of comfort in old age, to provide for coal, food, light, rent and clothing, and to help to meet the very substantial rise in the cost of living. We have the position obtaining in the country that, owing to the inadequacy of pensions, old people are continuing in industry because of financial insecurity. It is computed that there are in industry to-day 500,000 persons over 65 years of age who dare not leave in dustry, because they have not the necessary financial security.

Mr. Speaker

The hon. Member's complaint is essentially one that would require legislation to deal with it.

Mr. Stewart

I bow to your ruling, sir. But I would say that the great majority of those people have not the means to make provision for old age. The number of people who, by their own thrift, can put away sufficient for old age is very small indeed. One must come to the conclusion that, if those people have to be provided for, funds must come from some direction or another. I would like to mention, if I am permitted to do so, one or two anomalies which exist in our pensions schemes. One of the most satisfactory types of case is that of the old man who reaches the age of 65 and has to leave industry. Very often, owing to his partner in life not being 65 years of age, he and she have only 10s. between them.

Mr. Speaker

The hon. Member must not go into these points. They, obviously, would need legislation.

Mr. Stewart

Owing to those things obtaining in Durham County—I think I am all right this time, as it is not a question of amending legislation—we have more than 10,000 aged people drawing pensions. We have 1,717 cases of men receiving contributory pensions, and 337 cases of married couples where the man only is receiving non-contributory pension. Altogether, we have in the county 10,317 aged people who have to draw Poor Law relief because they have not sufficient funds on which to exist. That costs the ratepayers in Durham no less than £4,000 a week, or about £220,000 per annum, which is equal to a poor rate of 1s. 6d. in the £. I suggest that something ought to be done, if not to meet the needs of those people, to see that at least the local authority has not to provide this large amount of money out of the local rates.

Mr. Speaker

Again I have to point out that this is essentially a matter which would need legislation.

Mr. Stewart

I wish, if I may, to come to the question of Durham and the great amount it has to provide for Poor Law purposes. I hope that I am in order this time. I remember that in 1934 the right hon. and gallant Gentleman the Member for Hornsey (Captain Wallace) made a very comprehensive survey of Durham to find out exactly the conditions that prevailed in that large industrial county. In his report of that survey he suggested, among other things, that there ought to be an annual subsidy given to Durham to help to make the poor rate comparable with that of the rest of the country.

Mr. Speaker

I am afraid that that again would mean amending legislation.

Mr. Stewart

I have got in my point, Mr. Speaker. I was reading in the Northern Press to-day that in Durham this year we are to spend over £6,000,000 to meet the necessary social services, that £1,619,000 of this sum is required for Poor Law purposes, and that we shall have to pay out of the latter sum, £318,000, equal to a rate of 3s. 8d., to meet the type of case that I have been trying to put before the House. I ask the right hon. Gentleman the Minister of Health to take into consideration the conditions which exist in Durham to-day, with a view, as far as possible, without amending legislation, to introducing means to help to lift the heavy burden that we have to meet there. In Durham to-day—and the Minister, I think, will be aware of it—we are having to levy a rate for Poor Law purposes of no less than 10s. 5d. in the £. In Surrey, the rate levied for Poor Law purposes is 1s. 37d.; in Sussex, 1s. 5.3d.; in Kent, 2s. 1d.; in Leicester, 2s. 4.9d.; and in Middlesex, 1s. 5.3d. The reason I mention these figures is that perhaps when representations are made to the right hon. Gentleman by a deputation from local authorities in this county in the near future he will consider sympathetically Durham and the conditions which prevail through industrial depression and see if something cannot be done to come to its aid.

One of the great problems which Durham has to face is the question of the transference of the best of its people. That is going to play a very important part in the future of that county. Since 1932—and I have quoted these figures before—there have been transferred out of Durham over 41,000 persons, men, women and children, and they are the best of our people. Consequently, we shall be left with middle aged and aged people who will be a permanent charge upon the ratepayers. If in the near future there is a recession in trade and the unemployment figures increase in the county, our poor rate will be bound to soar and the ratepayers will be further penalised. I ask the right hon. Gentleman to bear these facts in mind, and if I am precluded from introducing matter that I would have liked to have introduced, I hope that he will remember those things which have been relevant in my speech to-night, and that he will do whatever he possibly can to come to the aid of Durham, when Durham asks him in the near future to consider that county and to do something worth while to help to relieve the pressing rate burden which is levied for Poor Law purposes.

7.52 p.m.

Sir Waldron Smithers

I am not qualified to take part in this Debate from a technical point of view as a doctor or member of a branch of the medical profession, but I want to refer to a matter which I do not think has yet been raised this afternoon, though it is really the lifeblood, as it were, behind the speeches that have been made. I want to talk about local government expenditure and its control. I hope the House will believe me when I say that I intend to approach this subject in a constructive spirit. It can be said that the year 1925 was a turning point in regard to this matter. The passing of the Rating and Valuation Act—I had the honour to serve on the Committee which considered that Bill—was a first step to give greater spending powers to local government. The natural consequence of that Act was the Local Government Act of 1929, the 1925 Act being, so to speak, preparatory.

I want to ask the Minister whether he will seriously consider the following suggestion. Is not the time now ripe, in the light of the experience gained since the passing of these two Acts, for the whole system of local government finance and control, with its increased and increasing responsibility, to be overhauled? Local authorities are organised for extravagance rather than for economy. The technical and executive officials work directly through the sub-committees, and the drawback is that the councils and the executive committees are both executive and deliberative bodies. The House of Commons is not an executive body, and therefore it has an enormous advantage in criticising expenditure. Here, in contradistinction to the local authorities, we have the Public Accounts Committee and the Comptroller and Auditor-General who reports for and to that committee, while hon. Members can ask questions of Ministers in the House of Commons. The controlling officer is personally responsible for the acts of all his subordinates, whether technical or lay, and he is also responsible for the propriety of the expenditure and must see that it comes within the ambit of the Vote. And further, no expenditure, even when voted, is legal without the expressed sanction of the Treasury. That system supplies a series of healthy checks upon the expenditure of money through this Mother of Parliaments. That system is lacking in local government. The local authorities are run by their executive committees.

Mr. Tinker

Will the hon. Gentleman say what he means by that? Will he develop it a little further?

Sir W. Smithers

Perhaps the hon. Gentleman will alow me to develop my argument. The local authorities are really run by executive committees, who are advised by technicians. I would like to see the clerk of the council have more real control, more treasury or budgetry control over the expenditure of the council. The clerk of the council is only really a general adviser on procedure. I pay tribute to the wonderful voluntary service given throughout the country by members of local authorities. I have raised this question locally on several occasions, and local councils always say, "You complain about our heavy expenditure, but a great deal of the expenditure in local authorities is because you in Parliament have ordered us to spend money." That is quite true. I want to make it quite clear that, if I mention the county of Kent, in which I live, and give examples from there, it is not because I wish particularly to criticise that county. I understand that it is one of the best run counties in the country. I am criticising the system, which I suggest to the Minister should be reorganised and should contain more of the traditional and effective control mutatis mutandis that we have in the House of Commons in regard to expenditure.

By the courtesy of the Ministry figures were sent to me yesterday—and I want to quote them—which show the extent of the responsibility that has been put upon the shoulders of councillors in all these local authorities. For the year ended 31st March, 1936—these are the last available figures—the grand total of income of all local authorities was £481,000,000, the expenditure was £470,000,000 and the gross loan debt outstanding on the same date was £1,451,000,000. In Command Paper No. 5609 published on 8th December last, the total expenditure for public social services in 1935 was given as £503,750,000. These figures are serious, and I again assert that the control of expenditure requires reorganising. I want to give an example from the county of Kent, and again I am not picking out that county for special criticism. It is an extract from the "Kent Messenger" of the 20th November, 1937, which emphasises my point: After spending most of the day talking of economy, the council at a late hour decided in principle on a new hospital service for the county at an estimated cost of £1,247,000; approved in principle a new sanatorium estimated to cost £308,000; and referred to the Roads Committee consideration of a new £2,240,000 arterial road. The same paper on the 23rd of this month gave a report of the district auditor. He comments on the continued and apparently irresistible increase in expenditure and suggested that the council must ultimately resort to a system of rationing each department. He pointed out that the increased expenditure on motor car allowances had increased from £13,000 to £18,000 in 1936–37. This expenditure had increased by 37 per cent.

Public expenditure by local authorities on a grand scale is relatively new and the trend of modern legislation gives that expenditure a steep upward curve. Local councils are responsible for the disbursing of public money under two headings—money collected from the rates, and the detailed dispersal of grants voted by Parliament and distributed through Government Departments. With regard to the second function of distributing money, that is by Government grant, great control is exercised by the Departments concerned so that they can see whether the expenditure, be it wise or not, comes within the four corners of the Act. As regards the first duty of local authorities, the distributing of money collected from the rates, there is not this safeguard, unless the expenditure is illegal, and the ratepayers have to depend on their councillors and the officials to see that the expenditure is within the means of the ratepayer and that the money is spent efficiently and to the best advantage.

It is in the sphere of policy that real economy has to be found. Hon. Members opposite will see that I am not being destructive when I say this. Economy does not mean parsimony but rather the proper ordering of the household. Economy may, and often does, mean the timely expenditure of large sums of money. Expenditure beyond the means of the ratepayers and the taxpayers can never be beneficial, however splendid the service. Inefficiency and waste are nearly but not quite as deadly as that which comes under the heading of policy. Economy in local government requires not only judgment in policy but also proper machinery to secure control. I suggest that what is wanted is machinery to keep the financial picture as a whole always before the councillors when considering policy; that is expenditure. The pressure to spend is omnipresent, and solvency is only possible if the spending committees relate the ends and objects which they have in view to the means of their constituents.

Every spending committee should be a finance committee. There cannot be administrative responsibility without financial responsibility. I wonder whether the councils have the will or the machinery to cut their coat according to their cloth. What is wanted is a permanent system, (1) to protect the ratepayer against the administrative waste and (2) to keep expenditure within his probable means. Will my right hon. Friend consider the advisability of setting up a Royal Commission or a Departmental Committee or some authoritative body which will review the whole situation, the whole working, especially the financial working, of the raising of rates and the efficient expenditure of money, in view of the experience gained since the passing of the Rating and Valuation (Uniformity) Act, 1925, and the Local Government Act, 1929?

I tried at the beginning of my speech to compare the procedure of the House of Commons with the procedure adopted in local authorities, and I should like the House to note that in Parliament, frequently, a proposal which a Minister has declared to be necessary—I put "necessary" in inverted commas—has had to be abandoned, not because of its inherent unsoundness, but because it was financially inopportune. That is to say, it did not fit in with the whole picture. I would not for a moment suggest what the terms of reference should be, if my right hon. Friend agrees with the suggestion, because they would have to be thought out, but what we do want in local government is more of the kind of objective control which is exercised by the Treasury over all the spending Departments. The coun- cils of this country have one great disadvantage in that they are both deliberative and executive bodies.

I have tried to speak on very general lines. Since I have taken an interest, I will not say in reducing local expenditure but in seeing that it is properly and efficiently managed, I have had a mass of correspondence sent to me from all over the country giving me details, some of which amount almost to scandal. I must mention one case that is typical. In my county they seem to have gone mad on kerbstones. They are laying them alongside the roads—when I inquired they told me that the cost was £400 a mile—in uninhabited districts, and I am told that it is because the engineer says the roads must have lateral support. I looked up the report of the German roads delegation. Hon. Members opposite need not fear that this has anything to do with totalitarianism, because it was a British delegation. They say that the kerbstones need not necessarily be above the level of the road. Throughout the County of Kent, however, we have this extraordinary expenditure on kerbstones, for what reason I do not know, except that they make the roads much more dangerous and tend to prevent people from using the amenities of the countryside and to drive them to the pictures.

Mr. Marshall

In view of the fact that the Ministry of Transport makes contributions towards first class roads, is not the hon. Member's charge of extravagance also levelled against the Government?

Sir W. Smithers

I have tackled the Ministry of Transport over that. If I omitted to mention that, I am sorry.

Mr. Marshall

How does that square with the hon. Member's assertion that Government audit and control over finance is absolutely rigid and complete?

Sir W. Smithers

The answer is that if we have extravagance here, we do it knowingly. There is proper control over expenditure. If there is expenditure from the House of Commons it is because the House of Commons has willed it. I am saying that we are wasting money on kerbstones and sign posts which serve no useful purpose.

There is one further point with which I should like to deal, and that is that it is frightfully difficult to get any detailed information from the local authorities about expenditure. They put all sorts of obstacles in the way. If you ask what is the detailed cost of this or that piece of work that has been done in the district, they say you must look at the accounts, but, as the Minister knows, the accounts do not come out for nearly two years afterwards. There is no more useful time than Question time in this House. I believe that Ministers and permanent officials hate more than anything series of questions by back benchers. If there were some means of bringing to the light of day what some of us consider to be extravagances, wasteful local expenditure and expenditure which does not fit into the whole picture, it would be a point to be considered by the Minister.

Mr. Ammon

Is the hon. Member not aware that in the leading municipal authority there is a question time and the chairmen of spending committees are there?

Sir W. Smithers

I am perfectly aware that in the big councils there is a question time, but if the hon. Member only knew the difficulty that I have had in trying to get some details of expenditure on certain work in my own district, he would understand what I mean. The details of that expenditure have been withheld, and it is in the public interest that they should be made public. I only wish there was a question time in that particular local authority. Adaptability is the birthright of the English people. Let local administration adapt what is best in the Government machine to its own needs and, above all, let councils remember that finance is the life-blood of administration and that only a strong finance department can maintain a spending organisation with equilibrium.

8.11 p.m.

Mr. Tinker

The hon. Member for Chislehurst (Sir W. Smithers) has dealt with a very interesting subject and one that might be examined very carefully by those who believe in local government, as we do, but I do not think that he is altogether fair in his criticisms. Has he been a member of any local authority?

Sir W. Smithers

No.

Mr. Tinker

If he became a member of a local government body he would find that the people there, who are elected, are very keen on seeing that the money is not wasted.

Sir W. Smithers

I am not doubting that for one moment. What I am attacking is the system. I believe that the local councillors themselves would welcome a better system of control than they have at present.

Mr. Tinker

I am at a loss to know what the hon. Member means by "a better system." The money that they have to use comes from the ratepayers and from the Government. On the one hand, they have to satisfy the auditor that the money has been spent properly, and, on the other hand. every three years they have to go before the people, and if there has been any wasteful expenditure of money one may depend upon it that the people will have been warned about it. We have to face the criticisms of members of the party opposite about disgraceful expenditure, when all the time we are trying to make things better for the ratepayers. I do not believe that it is true economy, on many occasions, to think only of saving. The hon. Member mentioned kerbstones. Surely, it is better to have some kind of protection to prevent vehicles from running on to the footpaths, as they would do if there were no projection to stop them. It is possibly for that reason that the local authority in the hon. Member's district has been so attentive to the question of kerbstones. I have seen in certain districts lights which show motorists on dark nights how near they are to the kerbstones. If the hon. Member will examine this question more carefully I do not think that he will have much ground of complaint against local authorities. If he has time to spare from his Parliamentary duties I would suggest that he should become a member of a local authority and help them. If they are wasting money, let him show them where they are wasting it.

The hon. Member for Frome (Mrs. Tate) dealt with the subject of water supply. That is a most important question. I was surprised to learn that in that part of the country they are not as well supplied with water as they ought to be. The Minister of Health might direct his attention to that matter and see whether he can improve it. With regard to the two hon. lady Members who have spoken, I should like to say that I have noticed the freedom with which lady Members tell the House about sex subjects. I admire them for it. That is where they are more daring than men. Many times under the cloak of false modesty we are afraid to touch the matters with which they dealt. I agreed with the hon. Member for West Fulham (Dr. Summerskill) when she said that the time has come when the older children at school, children over 10 years of age, ought to be given more instruction on sex matters than they are. It would be helpful to them in later life if they got a better knowledge of sex affairs and did not have to wander about wondering when mother had a baby, and listening to the old tale of the gooseberry bush. If you trust the children they will be all the better for it.

The subject with which I want to deal has been mentioned by me many times before in this House.—It is the question of burning spoilbanks or pit-heads. I had the matter before the House in the form of a Bill, but the other night I withdrew it because it has met with so much opposition from hon. Members opposite that the only dignified course for me to take was to withdraw the Bill. What are the reasons for the opposition? Hon. Members opposite say that in the present Ministry of Health Acts there are sufficient means of dealing with the matter, If that is so, I want the Minister of Health to make use of all the powers he has under the law. I have in my hand the annual report of the chief alkali inspector, to whom I want to give credit for a valiant attempt to get colliery companies to deal with this important matter. Anyone who takes an interest in this question should read this report. After all, we are dealing with health questions and this matter of burning spoilbanks and pit-heaps plays a large part in the lives of many of our people.

The hon. Member for Peckham (Mr. Silkin) has told us that the smoke nuisance in London has very ill-effects on London people. If that is so, I should like hon. Members to realise what these smoking pit-heaps mean in the mining parts of the country. I do not think the extent of the nuisance is generally recognised. In his report the Chief Inspector speaks about what he calls "burning spoilbanks." He says: The spontaneous combustion of spoil-banks is due to an accumulation of heat generated by the slow oxidisation of carbonaceous matter and possibly pyrites. In general, it may be said that spoilbanks into which air cannot enter will not fire, and it is therefore desirable to (1) reduce carbonaceous matter in the waste to a minimum and (2) pack the refuse in a dense mass or otherwise make it impervious to air. He then deals with the measures which are to be taken to prevent firing, and says: Conical dumps are particularly likely to fire for the reason that the larger lumps naturally tend to roll to the bottom, thus producing a heap with an open base which allows easy access of air. I will tell hon. Members what that means. In the old days they made the dumps at the pit-heads in a square mass and it was then not so liable to fire. Latterly, in order to save money, they have by means of a carriage airway dumped it down in a conical shape with all the sides exposed to the air, and before long it is bound to burst into flame. The colliery companies are taking advantage of this cheaper method of dealing with pit refuse but it means that there is a greater liability for the heap to get on fire. The Chief Inspector is making every effort to deal with this problem, and on page 40 of his report he gives a number of collieries which he has visited for the purpose of calling their attention to the matter. He deals with the collieries by numbers—which I rather regret. I wish he had named each colliery so that we should know those which are trying to deal with the matter properly and those which are not. In regard to No. 17 he says: No progress. Conditions as before. Attempts at abatement have been halfhearted. He gives a number of collieries where better-intentioned employers recognise what this means to the inhabitants of the district and to their own workpeople. They do attempt to deal with the problem and follow the inspector's advice. But the next colliery owner refuses to be advised by the inspector and proceeds in the same way regardless of any trouble. What is the result? The honest employer who is trying to meet the wishes of the inspector realises that his neighbour is not doing anything at all in the matter and that he is consequently saving a small percentage on each ton of coal, and as he has to go into the same market as his competitor he asks why he should continue to follow the advice of the inspector. Therefore, you get no real attempt to rectify this nuisance. I want this afternoon to ask the House of Commons to do something in this matter. The report sums up the position in this way: The matter of burning spoilbanks is a serious one and it would seem that in future the policy should be adopted of building spoil-banks in such a manner as to reduce the risk of ignition, and for this purpose the following suggestions are made. I want to put these suggestions on record. 1. All carbonaceous material, such as low grade coal, table pickings and timber, should be carefully separated from the stone, crushed and either treated in a washery plant along with current production, or in collieries where no washery exists, burned under the boilers. By this means the greatest potential form of firing is removed. The cost of installing and operating crushing-plant will probably be at least offset by the value of the coal recovered. 2. Spoilbanks themselves should be in a series of steps or layers, each layer of depth not greater than 10 feet, so as to permit of the thorough consolidation of the refuse and to prevent the separation of the large stones at the bottom. 3. Where an existing spoilbank has become ignited, the first object should be to obtain a safe dumping-place for future use. This is often not easy to achieve by means other than complete separation from the existing bank by an air space, with the consequent abandonment of the spoilbank for some considerable time but in some cases, where the intense fire is limited to one part of the bank, dumping may be continued at the cold part of the bank after insulating the face with a thick layer of inert material. 4. The fires themselves can best be controlled by depositing over the affected places a heavy bed of incombustible substance such as sand or earth. In places where the coal occurs associated with clay the washery sludge may be used and this material often proves extremely useful for the purpose, as wet clay sludge consolidates to a hard mat which prevents ingress of air Another material which may be used, if available, is the red ash from another burnt-out and cold spoilbank. There are the means of prevention. Those suggestions are made by an inspector under the control of the Minister of Health. What I ask is that, if there is a colliery owner who refuses year after year to pay attention to the advice of the inspector, the Minister should adopt some means of dealing with that person. The Minister ought to point out to him that it is a menace to the health of the people in the vicinity, and that he must take steps to do as the inspector asks. The Minister should tell him that if he does not do that, the Minister will take some steps to deal with the matter. I will conclude by giving an example which shows how this matter can be dealt with. In my constituency, I have made myself so obnoxious to the colliery owners in this matter that rather than be mentioned in the House of Commons time after time, they have determined to do something. I have in my possession an article from the local newspaper which shows the benefit to the nation of intensive propaganda work in trying to remove nuisances. The report in the local newspaper was headed, "Barren pastures now contain crops," and it read: Where a plough has not been, and where seeds have not been sown for 50 years or more, crops are now growing in several places at Tyldesley. This is due to the handiwork of Mr. James Marsh, an employé of the Manchester Collieries, Ltd., who superintends his own scheme of tipping, a scheme that for the most part reclaims land that has been barren or waterlogged for many years. Nearly four years ago the Manchester Collieries, Ltd., were bombarded with complaints from Tyldesley residents about the objectionable fumes that were coming from burning slag heaps. Questions were asked in the House of Commons"— That was by me— the company sent for Mr. Marsh, told him that he had full power to deal with the job as he thought fit, and told him to get on with the job at once. Since that day Mr. Marsh has worked wonders. Acres and acres of land have been reclaimed and given back to the farmers on the colliery company's land, and it has not cost the farmers a penny piece. Smoke and fumes have vanished. Mr. Marsh has made hopeless ground once more fit for crops. Only two weeks ago he handed over seven acres of land to a farmer and it is now well sown with potato crop. That is an example of what can be done with a little determination, and I say that in the long run it is a saving to the colliery and certainly a saving to the people. This matter ought to be dealt with immediately. If one colliery can deal with it in the manner that I have described, others can do so. All that is needed is determined action by the Minister of Health. I understand that the Parliamentary Secretary is to reply to the Debate. The hon. Gentleman has stayed in that office for some time. One of the troubles in the House is that Ministers so often change their Departments, and therefore we are not able to hang on to them for very long. They are quickly shifted from a matter, and have to leave it to somebody else. But I make an appeal to the Parliamentary Secretary. I ask him to give me some hope that he will press the inspectorate to remedy this matter, and make it better for the people who have to live in the industrial areas. If he does that, he will earn our thanks for doing a good job by removing this desperate nuisance and menace to the health of the people.

8.30 p.m.

Major Mills

I wish to congratulate my right hon. Friend the Minister of Health upon his excellent review of the work of his Department during the past year, but I also want to criticise a small part of that work. Before coming to my criticism, however, I should like to refer to the speech of my hon. Friend the Member for Chislehurst (Sir W. Smithers). I have been a county councillor for over 30 years. I gathered from my hon. Friend's opening remarks that he wanted more power over finance to be given to the clerk of the county council. To do that would be to place an impossible burden on that official of the county council. The clerk and the treasurer give expert advice to the county council, and they do that very well, but the power to deal with finance must remain in the hands of the elected councillors, for, as the hon. Member for Leigh (Mr. Tinker) said, they go before the electors every three years to render an account of their services, and they can be "called over the coals" if they have been extravagant. The power over finance must remain with the elected councillors, or there is an end of democracy. I do not believe for one moment that my right hon. Friend the Minister of Health would change the system in that way.

My hon. Friend the Member for Chislehurst also said, in excuse of extravagance, that duties are thrust upon the county councils by Parliament. That is the case to a certain extent, but the excuse is only partly true, because although duties are given to the county councils by Parliament, some discretion is left to the councillors as to how they carry out those duties. They cannot evade that responsibility, and it is no good trying to put the whole of it on this House.

I come now to the criticism I wish to make. I want my right hon. Friend to consider the hardship which arises on account of the fact that he has no power to suspend or rescind demolition orders. As things are at present, once a demolition order has been made, no one, not even the Minister, can suspend or rescind it. It seems to me to be absurd that these departmental orders should have the force of the laws of the Medes and Persians. I think that much could be done by departmental administrative action the demolition orders are made. I know that there are a good many formalities and that a public inquiry is held by an inspector of the Ministry of Health before the demolition order is made, but even so hardships arise, particularly in country districts, as my hon. Friend the Member for Frome (Mrs. Tate) said. It is not the big landlord who is affected, for he can get expert advice, and probably knows the law himself. The person who suffers is the poor man, the owner-occupier of an old cottage, or the man who lives in one of a pair of cottages and lets the other one—property which very likely represents the savings of a lifetime, or a much valued family inheritance.

A man of that sort does not realise how serious the public inquiry is. I do not think he is even told by the local authority exactly what is wrong with his house or why it is unfit for habitation. That in itself is a hardship. He ought to be told precisely what is wrong and what he has to do to recondition it and put it into proper order. If he were told that, it would help him to know what sort of offer to make at the inquiry, when naturally, he says how much he is willing to spend on reconditioning the property. But he is not told that. When the inquiry takes place, it is very natural that he should offer to spend a limited amount on the house; it is probably not nearly enough; and he expects that he will be told so and given a chance to increase his offer. But his offer is taken seriously by the inspector, for not unnaturally the inspector does not expect to argue with the man and try to drive a bargain with him. As the amount is obviously insufficient, only too often the demolition order is made. Then comes the trouble. When that decision, so full of fate for him is announced, he would very gladly spend more money on the property and preserve it if he could possibly raise the money. But he is not allowed to do so. However much he might now be willing to spend to save the property, it has to come down. Nothing and no one can save it.

Again, the Minister has not even power to suspend an order so as to allow an old couple who have lived in their own house, perhaps for 50 or 6o years and who will be perfectly miserable as well as hard-hit if they have to move into a new house, even though it should be a better house. Surely they might be allowed to end their days in their own house after a certain amount of repair had been done to it, even though it is to be demolished subsequently. To their honour it must be said that some rural district councils do manage to arrange that, even if it is not now strictly legal. I ask my right hon. Friend to consider what can be done to remedy this distressing situation. I believe that he can find ways of doing much by administrative action, such as circularising the local authorities, and, in particular, by issuing fresh instructions to the inspectors who hold inquiries. If anything more is wanted, it is only a question for the Minister of an appeal from himself to himself.

8.37 p.m.

Mr. Ellis Smith

There are several aspects of the administration of the Ministry of Health with which I wish to deal, but I propose to devote the time at my disposal mainly to one specific aspect of the Department's work, because of a growing concern, to which I am bound to give expression, among the people to whom I belong. We know that in 1931 the first people to suffer from the economy campaign were the poorest of the poor, many of whom still suffer from the effects of the legislation then introduced. Therefore, we are bound to feel concern about the growing demand in certain quarters in this House, which also finds expression in certain newspapers, for another national economy campaign. We know from experience that campaigns of this kind are, generally, at the expense of the poorest people of the country, particularly in relation to the social services. Although I have not time to deal with the broader aspects of the question as I would like, I wish to place on record some evidence to which I hope attention will be given by Members of the House and the people of the country, during the Recess. I base my observations upon a question which I put to the Prime Minister on 7th April: To ask the Prime Minister whether his attention has been directed to the concern expressed in industrial parts of the country through the continued increase in rates; will he now appoint a Royal Commission to investigate the unsatisfactory nature of the rating system, the unfair incidence of local taxation and the anomalous situation created through the effect of the present system of rating; or what other steps does he propose to take to deal with this problem."—[OFFICIAL REPORT, 7th April, 1938; col. 518, Vol. 334.] The Prime Minister referred me to an answer given previously by the then Minister of Health, the right hon. Gentleman the Member for West Woolwich (Sir K. Wood) to the hon. and gallant Member for Epsom (Sir A. Southby) but on referring to that answer, I found that it had nothing to do with the question which I put to the Prime Minister. Whoever was responsible for drawing up that answer for the Prime Minister had not given attention to the serious matters involved in the question which I asked. Therefore I wish to produce evidence so that it can be put on the records of the House, and so that Members of the Government can give attention to it. Prior to doing so let me quote from the "Manchester Guardian" of 16th June of this year: Mr. Frederick Steadman in his presidential address at the annual meeting of the Institute of Municipal Treasurers and Accountants held at Southport yesterday said that the anomalies in the present rating system could only be removed by the development of local government on three lines—first, the transference of functions to the State, second, the equalisation of the rate burden between local authorities, and third, the diffusion of rate burdens over a wider area. I hope the Parliamentary Secretary will be good enough to give attention to that address delivered to the Conference of Municipal Treasurers. We are bound to take notice of an important conference of that description. I admit that, generally speaking, the principle of the 1929 Local Government Act was good. In certain areas it brought about substantial improvements, but we found by experience that the adjustment made did not go far enough and as a result of internal developments and the effect of the international situation on internal conditions, the circumstances which existed when the 1929 Act was passed, have altogether changed. I ask for a re-examination of the whole question. I know it would be asking too much to ask for immediate action in regard to this question, but it is reasonable to ask that as soon as possible an examination should be made of the problem. If such an examination is not made, it is only a question of time until certain local authorities, in certain areas, will be throttled. The burden will become so top-heavy, that a very serious situation will be reached in some areas.

I would direct special attention first to the disparity in rates, and, second, to the increase in the rates in certain districts. In 1930 the total of rates charged was £168,250,000. In 1937 the total was £191,812,000 or a rise of approximately £23,000,000. The Ministry of Health, apart from the political complexion of the Government of the day, must have credit for adopting a magnanimous and benevolent policy—a policy of keeping pace with the needs of the people within the limits imposed by the difficult situation with which they have to contend. It is much to the credit of the Ministry that they constantly urge on local authorities the need to improve local amenities—which certainly need improvement in the localities which some of us here represent—and to improve the environment in which the people live.

This is greatly needed, and it is a real joy to go into the parks in these days and see the beautiful way in which they are laid out and the way in which the poorest people of the country respond to that new environment, and to see that the best guardians of the beautiful vegetation in these parks are these people. It is also a real joy to go into the new play parks, where the children do the paddling, and to walk around these places and see the joy of the parents looking after their children and the joy of the children themselves. One is bound to be very greatly pleased at the development which is constantly taking place. At the same time, many local authorities would like to do more than they are doing, but they are restrained from taking the action that they would take because of the very serious financial situation in which they find themselves involved. Therefore, it is most unfair as between the children living in certain parts of London, where they are relatively well placed, and the children living in the areas for which I am speaking.

In the financial year 1937–38 the seaside resorts in this country with the lowest rating were Hove, where the rates were 7s. 9d. in the £; Bournemouth, 7s. 10d.; and Blackpool and Southport, 8s. 6d.; and I would like hon. Members to contrast those rates, which are paid in the beautiful parts of this country, where relatively well placed people live, people who have been fortunate enough in life to be able to retire and live among beautiful surroundings, with the rates in Merthyr Tydvil, for instance, where the people are paying 26s. 6d. in the £, West Ham, where they are paying 20s. 4d., and Hull, where they are paying 19s. 8d. The wealth of this country is not produced in Eastbourne, Bournemouth, Brighton, or Hove. The wealth upon which this country depends, the national income upon which the country and the Chancellor of the Exchequer depend for fulfilling the requirements of National Defence and other expenditure, is, generally speaking, derived from the wealth-producing centres for which I am speaking, yet we find in these areas rates amounting to anything between 16s. and 18s. in the£.

The real burden of these figures can be shown more clearly, however, on a per capita basis. For example, the average rateable value per head in Stoke-on-Trent is 4s. 6d. and the average rate collected is 3s. 10d., whereas in Eastbourne the average rateable value per head is 15s. 8d. and the average rate collected is 6s. 7d. I want to ask hon. Members in all parts of the House whether they consider this a satisfactory state of affairs. Do they consider this situation to be fair or reasonable? Will they have regard to the fact that these increasing rates are bound to have some effect upon the cost of production and are bound, therefore, to have some effect upon the question of employment? In addition to that, they affect the lives of our people in many ways, as, for instance, in rents. People who have scraped throughout their lives in order to purchase their own house are seriously affected, and these figures also have a serious effect upon local business people. I find that Blackpool has the lowest public assistance rate, amounting to 5¼d., whereas Merthyr Tydvil, the highest-rated centre, is paying 22s. 6d.

It was with these figures in mind that I put the question to the Prime Minister some time ago. In addition, I also put a question to the Parliamentary Secretary to the Board of Education, and as a result of that question, which was based upon some information with which the hon. Member for Farnworth (Mr. Tomlinson) was good enough to supply me, I find that the Association of Education Committees are so concerned at the unfair methods adopted to deal with the question of providing the necessary finance for education that they have made a statistical analysis of the situation throughout the country, and the information and the evidence which are provided in their booklet are astounding and ought to receive the attention of every hon. Member of this House. The product of a penny rate per child in my area is 2s. 4d., whereas in Brighton it is 10s.; in Bournemouth, 16s. 5d.; and in Eastbourne, 16s. 3d. Then I find, as a result of an examination of these figures, that the net expenditure on education per child in average attendance for my area is £12 10s., whereas in Hastings it is £15s. 14s. and in Eastbourne £15 9s., and the average throughout Britain is £15 4s. 5d., or, to put it in another way, nearly £3 a more per child is being spent on education throughout the country than is being spent on the children whom I have the honour and privilege to represent in this House.

I bring these questions to the attention of the House hoping that something will be done. Fortunately, I am not asking the House to accept only my word in this matter. I am not exaggerating in any way at all—there is no need to exaggerate—the seriousness of this question. I find, according to the "Manchester Guardian" of 22nd March last, that so concerned were the Manchester City Council with this question that they called a special meeting of their finance committee to discuss with local Members of Parliament the question of the increasing burden which is being borne by the city council as the result of legislation which is imposing upon local authorities a financial responsibility for services of a national character which, therefore, the local authorities maintain, ought to be met out of national resources. In addition to that, I find that the Salford City Council were so concerned about the situation that they called a special meeting of their health committee and considered the question of economising to such an extent that it was proposed to make cuts in so many ways that even the relatively backward members of the city council were not prepared to stand for those economies.

I want to conclude by giving one or two other figures concerning the area which I represent. The number of widows receiving pensions under the Contributory Pensions Act who were forced to seek public assistance in 1933 was 332, where- as in 1937 the number had increased to 584. The number of those who were receiving old age pensions and who could not manage without seeking assistance, also increased. It is unreasonable to expect old people to manage on 10s. a week, and anyone who knows anything of the lives of our people realises that nobody can manage on that amount. It is as much as many people pay for one meal in the City. The number who were forced to accept public assistance in 1933 was 757, and in 1937 it was 1,406. I want the Parliamentary Secretary to call the attention of his right hon. Friend the Minister of Health to this question, which is becoming very serious in many parts of the country, particularly in South Wales and the North of England.

I ask the Minister not to pay any heed to the demands for economies which are coming from certain quarters of which we are very suspicious. If there is to be any economy let it be made at the end of the social scale where it can easily be afforded. Let not this Government be a party again to carrying through an economy campaign of the kind that was carried through in 1931. What we want in this country is a fairer distribution of wealth. The Ministry of Health can go a long way to bring that about by increasing the expenditure on the social services and by bringing about a more scientific management of the affairs of the local authorities and a fairer incidence of local rating. I plead that the Ministry of Health should have an examination made of this problem in order that they can consider whether legislative action is possible in order that the burden of social services and the burden of the defence of this country should be placed upon the whole of the country and not on certain areas as it is at the present time.

8.59 P.m.

Mr. H. Strauss

May I join with the many Members on all sides of the House who have congratulated my right hon. Friend on the first speech which he has made as Minister of Health reviewing the work of his great office? As one who admires the originality and boldness of his ideas which have been revealed both in his writings and his speeches, may I express my conviction that there is no Department of State where those qualities are more urgently needed than in the Ministry of Health, whose affairs he now directs. Many hon. Members have made interesting speeches on those matters of which they have particular knowledge. As one who serves on the executive bodies of one or two amenity societies, perhaps I may deal with some of the questions which are causing those concerned with amenities the greatest possible anxiety. I want to convince my right hon. Friend that he has a great chance to do something now, that that chance is transient, and that if it is missed irreparable harm will be done. My right hon. Friend had so many subjects to deal with in his review, that no one can complain if he dealt with any particular one shortly, and I make no complaint that he dealt somewhat shortly with the question of planning. I did not give notice of my intention to raise that subject, and I shall refrain from putting the many specific questions which I wished to put, because at this late hour it would be unfair to expect my hon. Friend the Parliamentary Secretary and those advising him to give answers. I would only express the hope that my right hon. Friend, with his usual courtesy, will allow me to put before him later some of those matters which I do not propose to mention in detail to-night.

My right hon. Friend, in dealing with the question of planning, spoke far too optimistically of what was being achieved under the Town and Country Planning Act. He made allusion to the undoubted fact that in some two-thirds of the area of England and Wales the first resolution to start town planning had been passed. It almost seemed for a moment that he was giving the House the impression that as regards that two-thirds we need have no fear of the continuance of the destruction of urban and rural beauty. I wish that that were true, but it is not. It bears no resemblance whatever to the truth. The destruction of the beauty of rural and urban England is proceeding at least as fast in that two-thirds of the country as it is in the remaining one-third. Let me remind the House, although those who are interested know it already, that after the first resolution has been passed to start town planning, the Interim Development Order follows shortly afterwards. After that a speculator who may wish to build some houses in a place where they will utterly ruin the prospects of successful town planning can apply, in order that he shall have security against having to destroy his houses without compensation, to the local planning authority for leave to build houses in that place. If the planning authority refuses to give him leave, he can demand an inquiry and the matter will eventually come before the Minister of Health.

If, on the contrary, the town planning authority, perhaps rather friendly to the speculator, negligently, or foolishly, or ill-advisedly decides to grant the application, then, although every amenity society, although the county council, and although the Minister himself may think that the building of those houses at that place will be an irretrievable disaster, nothing can be done to stop them. Many of the rural district councils are utterly unfit to be planning authorities. I know that I must not propose details of new legislation. I can only express the hope most strongly that the Minister will listen to his advisory committee when they bring before him this undeniable and serious disadvantage of the present Act. I think it is essential that there should be a right of appeal in someone against the grant of leave to build after an Interim Development Order, as well as the existing right of appeal of the would-be builder if leave is refused.

Then there is the question of compensation. I believe, as everybody who has studied the working of the Town and Country Planning Act believes, that the question of compensation alone makes it quite impossible for some of the best scenery in England to be preserved by the local authorities, very often quite poor, who happen to be the planning authorities for the areas in question and on whom would fall the burden of compensation for that preservation. But what I principally want to say to the Minister is this: Even supposing I was wrong in everything I said; even supposing that the Town and Country Planning Act had none of those defects; even supposing that, given good will and the best working possible, it might save the beauty of England—still, is that a ground why the Minister should not open his eyes and see that it is doing nothing of the sort? Is there any rule of democracy, any rule of Toryism, any rule of Socialism or any rule of Liberalism, is there any principle of any of those parties, which says that if something wrong is taking place before your eyes you are to be prevented from stop- ping it. I say to the Minister that whatever his theory may be about the Town and Country Planning Act he should open his eyes and see what is happening.

On 18th June last year, the Supply Day for the Ministry of Health, I made a speech in this House on the subject of the beauty of urban and of rural England. I expressed the view which I held then, and hold now, that the destruction which had taken place and was still taking place was a public scandal and a national shame. I drew the attention of the House and the Minister to this fact, that on 10th February of last year the House had, by a unanimous resolution, deplored that destruction and declared it a matter of national concern. I suggested, perhaps in my inexperience and innocence, that when something was deplorable and declared to be a matter of national concern, possibly the Government might do something about it. I made a plea to the then Minister to act and to act in time. After no other speech that I ever delivered in this House or outside have I received such an immense correspondence from every quarter of this country, from every party in it, and from Englishmen abroad. The idea that the Government seems to have that this is a matter that concerns one or two odd cranks in this House and a few amenities societies is utterly wrong. The first political party that really shows itself in earnest about this problem will rouse a support of which it does not yet dream, and I care so much more for the preservation of England than for the interests of any party that I do not much mind which party it is, though I hope it will be my own party, which first shows itself in earnest in this matter. I am convinced that if one party will seriously show that it means to deal with this scandal every other party will be compelled to follow suit.

In the speech which the Minister made in reply to the Debate on that occasion he was good enough to express approval of a great deal of what I said and sympathy with all of it, but he added that he thought that I was unduly pessimistic. Let me refer the House to two tests to see whether I was right or whether the Minister was right. I put two questions to the Minister to test whether anything was going to be done in time. I pointed out that we had been too late to prevent ribbon development along our roads, and that it was still proceeding, and I asked, Are we also to be too late to prevent the beribbonment of our coast? The second test that I put was this: I said there was one bypass out of London which still had not been spoiled, which still passed through some real country, the Barnet By-pass, but that already the sides were being offered for sale, and I asked the Minister whether he was going to take action in time or whether there was going to be destruction as usual.

Let us see whether my pessimism was right or whether the Minister's optimism was right. I mentioned the Barnet by-pass and I said that we might perhaps have the wisdom, which was shown, for instance, in so many Continental countries and in the United States, to have parkways out of London, as they have out of their great cities. I mentioned the matter from the point of view of amenities, but I thought there were other reasons also which might have made the Minister of Health think that possibly it was worth while to preserve the country through which the Barnet by-pass goes. I should have thought that even from the point of view of the defence of London there was something to be said against attracting new industries here. I should have thought that even from the point of view of air-raid precautions there was something to be said against letting the indiscriminate growth of London go further. I should have thought that there were some areas in this country more fitted to take new industries, perhaps those where old industries have decayed and the population badly need new industries. I wonder how many people saw on the back page of the "Times" yesterday an advertisement, of which I will quote a few words: Build your factory near the greatest market in the country: London. One mile frontage to Barnet by-pass. Publicity on Britain's most important arterial road. I wonder how much the Minister of Transport likes the use to which these arterial roads which are for the relief of the traffic problem and of use for defence, are being put. The advertisement goes on to say: The Barnet by-pass at this part will be 140 feet wide, with a 120-feet wide boulevard on each side, making a total width of 380 feet. It had afforded one of the last possibilities of providing a good parkway out of London. Of course, my hon. Friend who will reply to the Debate may say that there is now sitting a Royal Commission on the location of industries. So there is, and perhaps I have been foolish in suggesting that it would have been otherwise than premature for planning authorities to exercise their intelligence meanwhile.

Let me now say something about the most urgent problem of all, desperately urgent, the problem of the coasts. Those who have studied this question know that in the eighteenth century the development of our coasts was confined, on the whole, to those few places where the nobles, the rich and the leisured took their holidays. The next big development of the coast took place when the railways were made, but while the railways caused the development of particular places on the coast they left comparatively free from development the coast between those places. Then came the development which transformed the whole problem, the motor car, which threatened, unless we took proper steps to stop it, the unplanned development of whole areas of the coast and a large-scale destruction of natural beauty.

A still greater force than the motor car has now arrived to transform the situation. Every hon. Member of this House welcomes it: it is holidays with pay. While holidays with pay apply this year or will shortly apply, under agreements already made, to some 9,000,000 workers, they will apply to 18,500,000 by 1940, and we are all looking forward to the day when every worker in the country will get a holiday with pay. Nothing will be more certain then, than that millions of people will wish to go to the seaside. Obviously, that means that there must be development, and if we think it out and use our brains we shall want to see suitable accommodation for the people. People must be able to live at the seaside when they get there, either in temporary places such as camps, which have their purpose, or in more permanent lodgings or hotels, and so forth. In addition to accommodation, we all desire to preserve that which provides one of the motives which will bring people to the seaside, the opportunity to enjoy the beauty and recreation of solitude. People will want long stretches of coast along which they can walk to spend their leisure and long stretches of unspoiled country. By adequate planning, both those things can be provided on the coast, but if the coast is left to indiscriminate private enterprise and to unplanned ruin by the get-richquick speculative builder, the amount of irreparable damage that will be done almost passes the imagination.

What has been done already? I wonder what my right hon. Friend thought when he read about the bungalows at Flamborough Head. I wonder what he thinks to-day when he goes along the south coast. Whatever optimism he may express in his first speech presenting the review of his Department, I know that he feels, as every civilised man feels on going along the Kingston by-pass, or upon seeing the awful mess that we have made with the south coast of this lovely country. I sometimes hear excuses for what has been done. I hear it said: "We can only hope that the local authorities will do this or the other. We cannot do anything, because we are not the planning authority." I do not take the view that a democracy must be inferior to a dictatorship. If Italy and Germany can prevent the destruction of the beauties of their country, cannot our democracy do the same? It is not true that democracies cannot do it. Other democracies are doing it. Does the democracy of Denmark or of Sweden treat its coasts as we are treating ours? Of course not; nor is there any necessity to do so.

A deputation was received by the Minister of Health on 27th June on this question. It represented the joint committee set up by the Commons, Open Spaces and Footpaths Preservation Society, the National Trust and the Council for the Preservation of Rural England. They put before the right hon. Gentleman the urgency of this question and their considered report. My right hon. Friend, as we should all expect from him and as we knew in advance, made a sympathetic reply and showed that he was alive to the problem. Perhaps I am relying a little on what I heard from some of the deputation, but I rely mainly upon the report which appeared in the "Times" next day. Let me recall two passages from the Minister's sympathetic reply which caused me a little alarm. He was awaiting, very naturally, the report which he was to receive from his own committee upon the working of the Town and Country Planning Act and he said that many of the points put forward meant legislation and that legislation involved difficult problems. I know that I must not deal with matters involving new legislation but I hope that, when the Minister said that, he did not mean that if he came to the conclusion, as the result of the advice of the advisory committee, that further legislation was necessary, he would hesitate to insist upon bringing the legislation forward at once.

The other thing which the Minister said was that a great deal could be done under the existing Act without legislation and that he was tendering advice to local authorities. Let me say a few things about that. I have no doubt that the right hon. Gentleman will listen to the grave difficulties of poorer local authorities which may prevent their doing anything adequate in this direction unless financial provision is made for them. Let me also express the hope that if the right hon. Gentleman gives advice to local authorities who do not take it, and if he knows that the neglect of his advice by those local authorities will lead to the further ruin of our country, he will not come to the House next year and say: "I am sorry, but I did my best. This is what the local authorities have done." I hope he will realise that if a national asset is being destroyed the nation's Government Department will be held responsible if it does not do what is necessary to prevent the destruction.

Let me give one more example of the injury that can be done by quite a small amount of housing of an unworthy kind badly placed. Last year I spoke about the Downs, and to-day my right hon. Friend quite rightly mentioned what had been done in the matter of the preservation of the Downs. I do not think that anybody concerned with rural amenities is quite satisfied with what has been done, even with the Downs in West Sussex. I am sure that if the right hon. Gentleman himself knows the district he must be filled with horror when he proceeds from that delightful place, Chichester, towards Itchenor and gets into what was, a few years ago, a most lovely stretch of country, with the Downs on the right and Chichester Harbour in front, and sees what quite a small amount of the worst type of ribbon development and of uncontrolled and loathsome elevations, produced by speculative builders, can do, and how quite a small amount of building has laid waste a most lovely countryside.

Those of us who are pleading for the saving of the countryside are not pleading that there shall be no development; we are pleading that there shall be sensible development, and I must express from these benches my complete agreement with the sentiment expressed in a supplementary question from the hon. Member for Bishop Auckland (Mr. Dalton) when he said that most of the bad elevations were the work of private builders. I find it quite impossible, as one who is concerned with amenities, to pretend that the great injury has been caused by council houses or anything of the kind. It has not. It has been caused by the private speculative builders. They will all fill the papers with their advertisements next Saturday and Sunday, and hon. Members will be lucky if they find a rational, decent design among them.

There are two matters that, quite briefly, I would invite my right hon. Friend to notice. A great deal has been said on the subject of economy. I am not going to argue, especially at this hour, that expenditure does not need to be carefully scrutinised. Of course it does. I do not think there is a serious difference in the House on that—I hope there is not—but if my right hon. Friend is of opinion that to refuse all money for the preservation of England—if money is necessary for the preservation of England—is a true economy, then I beg leave to differ. At the present moment this country is deliberately throwing away a most valuable invisible export. I will give my right hon. Friend, though not in this speech because I do not wish to delay the House, such evidence as has been put before me of a number of potential tourists from abroad who are being kept away by the knowledge of the way that England has been, and is being, destroyed. It is quite useless producing a lovely picture of the Downs and advertising such a poster abroad if, when the poor tourist comes, attracted by that advertisement, the first thing he sees is Peacehaven. Tourists come on the whole not as a result of advertisement, but as a result of what they hear from those who have already paid visits, and we are already losing that invisible export of the tourist trade by the folly, the idiocy and the criminality of the destruction of the beauty of England.

The hon. Member for East Wolverhampton (Mr. Mander) said that if the Government would do something about national parks it would be popular. I agree with him. I believe that for certain reasons the question of the coasts is even more urgent than that of national parks, but I certainly shall support him in his advocacy of national parks. There is no doubt whatever that thousands who will go to the coast for the first time when they receive holidays with pay will be astonished to find the number of places where they are not allowed even to approach the sea. They will be astonished at their inability to take continuous walks along the cliffs and at the ribbon building that is taking place on the cliffs themselves and on the seaward side of the roads that run parallel with the shore. I believe that in the next few years millions will be seeing the beauties of England for the first time. It is for my right hon. Friend more than for any other man in England to decide whether those who see those beauties for the first time will also see them almost for the last time. How few places there are in this country which are safe. I know of few except those places that have already been made safe by the National Trust. I appeal to my right hon. Friend, however optimistic he may feel, to remain as he is a realist, to observe the destruction that is taking place, and to show his determination, whatever it may cost, to end it.

9.30 p.m.

Mr. de Rothschild

We have listened to a very interesting speech from the hon. Member for Norwich (Mr. H. Strauss), which certainly has stirred the feelings of this House and has shown once more that on the matters with which the Ministry of Health is concerned there is great unanimity in this House. In regard to some parts of the speech delivered by the hon. Member, I feel they might have come from some of the benches above the Gangway on this side of the House. I should wish to reassure the right hon. Gentleman, who was not here at the beginning of the hon. Member's speech, that it was not all critical, although no doubt his ears tingled.

I want to draw the attention of the Government to one question, that is the question of water in the rural areas. It is a question that has already been broached this afternoon by the hon. Lady the Member for Frome (Mrs. Tate). I want to put it from a point of view that affects the eastern counties and my constituency in particular. For a considerable time the question of the water supply in the Isle of Ely has been most unsatisfactory. There are towns and villages in the areas, especially those supplied by the Wisbech Water Company, which practically suffer from acute water shortage. In some cases this is due to the absence of a piped supply. Perhaps the right hon. Gentleman will remember that I had occasion to correspond with him on the subject of such villages as Newton and Tydd St. Giles, where in some cases roof water and dyke water are the only source of supply. The inhabitants of these villages have been pressing for a piped supply for years—unsuccessfully in spite of the great danger to their health.

But I wish to-day to draw particular attention to the state of affairs in towns and villages where a piped supply exists. I am particularly alluding to fairly big towns of some thousands of inhabitants such as Chatteris, Manea, and the important railway depot of March. A state of immediate urgency has now arisen in these three towns to which I hope the Minister will pay attention. The inhabitants of Chatteris and Manea have for long been unable to obtain any adequate supply for domestic or sanitary purposes, and this is entirely owing to the intermittent pressure at the mains. This in spite of the fact that they pay a high water rate. I would like to give the House two examples of the state of affairs in Chatteris. In one school in Chatteris children have been drinking water which has been used in connection with the heating system, and which has been standing in the pipes since last winter. Surely that is a disgraceful state of affairs.

If I may give a personal experience, only last week I went to the principal hotel in Chatteris at three o'clock in the afternoon. There was no tap water for me to wash my hands, there was no flushing of the lavatories, and all I was able to get was a small jug which had been carefully prepared and treasured as if it were full of rubies. And yet, when the water company are approached, they put forward the plea that the criticisms are exaggerated. In August last year the county council approached the Ministry with regard to the position, and I understand that to-morrow a deputation from the county council is coming here and will be received by one of the officials of the Ministry. I feel certain that they will get the friendly and helpful reception that deputations always get on such occasions. I only regret that the right hon. Gentleman himself will be called away on other business, as I should have liked him to hear the complaint from these good people themselves. In August, 1937, they were told that a new main was to be laid which would relieve the position in both Chatteris and Manea, and an improvement was promised by May of this year, but now the position has so far worsened that the shortage is increasing and has spread to the town of March, and there is no possibility of alleviating the situation for at least another month.

Emergency meetings of the county council and of the education committee have been held this week, at which the great danger to the health of the population has been stressed, but the company holds out no hope of improvement for at least a month. It was pointed out at these meetings that the London and North Eastern Railway at March, and various factories within the area, receive large supplies from the company, while the domestic consumers are still suffering from an acute shortage. Some time ago it was proposed that the March railway depot should take a supply from the drainage authorities, which would have relieved the situation both in March and elsewhere, but the water company objected. The company, of course, has statutory rights, but I suggest that, if it cannot perform its duty, it is time to review its powers of monopoly. I suggest that this is not an isolated case. It does not exist only in my constituency or in the neighbouring counties. The whole question of the conduct of private water companies should be reviewed. We would like to know how far the private water companies are responsible for the deplorable conditions in regard to water supplies in rural areas throughout the country. Should not the supply of this essential commodity come under the control of public bodies and of the Minister?

At the present time a committee, under the able chairmanship of Lord Milne, is inquiring into this question, and I hope that the report of that committee, when it is published, will show that all these different points have been gone into. An improvement in the supply of water in rural areas will undoubtedly involve considerable expenditure, and the Treasury will have to make more substantial contributions than in the past. But, if those contributions are to go to public authorities, I am sure that the House and the country will be more willing to authorise them than if they were going to benefit private companies. When we are spending vast sums in measures of defence, I suggest that we cannot justify a niggardly policy on this question of water supply. Not only the convenience but the health of the people—the health of the men who provide us with our food and the health of their children—is in many areas deeply involved, and it would be cruel and shortsighted to adopt the slogan of another nation and tell the rural population that they must choose between guns and water.

9.40 p.m.

Sir Francis Fremantle

I would like to join in the congratulations that have poured upon my right hon. Friend from various parts of the House on his extremely useful "maiden" speech as Minister of Health. We hope it means that his unique experience will enable him in his new office to forward many of the objects that we all have at heart. The Ministry of Health, more than any other Department, ought to be able to unite all parties in working for a common goal. Many of the differences which have divided the opposite sides of the House have been to a large extent settled. The main general lines of the housing problem have been settled; the machinery of housing is laid down, and the local authorities generally understand it and the objects to be aimed at. Other problems are under the consideration of the Central Advisory Council, which was set up by the late Minister and which has brought forward many useful reports, notably the report on rural housing which gave rise to the legislation of this year and to which reference has already been made.

The rural housing question requires to be finished off in order to complete the machinery, and possibly there may be just a little dispute as to whether the machinery of rent restriction has really been settled by the last report. The main lines of rent restriction seem to have been settled, at any rate for the time being, and I hope we may all agree as to the impossibility of taking off the restriction on rents in the case of working-class houses so long as a scarcity rental can be charged on those houses. It will, I am afraid, be a very long time before we get such a supply of houses for the working classes of all grades that scarcity rents will not be possible in some area or other, and for that reason we hope that the Minister will be able to continue the good work of increasing the number of houses, because the main cure for the difficulties of housing lies in the numerical factor.

The right hon. Gentleman the Member for Wakefield (Mr. Greenwood) laid stress on the fact that there has not been enough building of houses to let, and that such a large proportion of houses are built by private enterprise for owner-occupation, as though that did not help the problem of the poorer classes. But when people come out to occupy these owner-occupied houses, very often when they cannot afford it and find the greatest difficult in raising the money to pay for them, they vacate rooms or houses in the centre of the town, which sooner or later come down in standing and eventually provide, perhaps at the third or fourth remove, for the better housing of the lowest grade of people. In speaking of the lowest grade, I make, of course, no reflection on their character, but am simply referring to their social status and financial position. There is no question that at the present time the people for whom we most want to cater—those who can least provide for themselves—are the least provided for, not only by private enterprise but by local authorities too. The greatest difficulty we have with local authorities, even the biggest of them, is to get them to give some of their beautiful new houses to people from the slums. They do not want to do so. If they do it, they pick and choose the tenant who is most certain to pay his rent and keep the house in the best order. Therefore, the bad tenant, whether he ought to be or not, is not provided for. He can be provided for only by houses and rooms being vacated for him in the less satisfactory parts of the town.

I think hon. Members on the other side are greatly mistaken in their alarm at the activities of one or two of my hon. Friends here, who suggest that we should be economical in spending money. On that, we ought to feel our responsibilities. We are trustees for the taxpayers' and ratepayers' money, and we should see that we get good value for our expenditure. Those of us who have worked on local authorities know that we do not always get good value. Those who have worked, as I have, as officials of local authorities, know how difficult it is. You get into a groove, with reports of officials and all sorts of paraphernalia, and eventually, when there is another duty that you have to fulfil, that is piled on the top of the original one. There is always an opportunity for real economy. But when those of my friends who talk of economy, without knowing very much about the housing movement, think of this enormous expenditure as if it were money lost, it is because they do not realise, as the public perhaps do not realise, what an asset it is.

Many of us went down last week and saw some of the developments of the last 15 or 20 years in London County Council housing. That sort of thing is going on all over the country, but you see it at its best on the London County Council estates. In 50 or 60 years the subsidy will have come to an end, but the loan charges will also have come to an end. If those houses are not going to last 100 years, the architect and all concerned on the London County Council ought to be hung, drawn and quartered. In the same way all houses put up by local authorities ought to last no years. They ought to be an esset to those who build them. I join with those who have spoken to-day in saying that there is still jerry building going on, especially in some of these private enterprise houses which are put up at £500 or £750. I do not think local authorities carry out their responsibilities—I do not think they are able to carry out their responsibilities—in watching all these houses when they are being put up.

One thing on which one feels strongly is the smallness of the houses. Most of these houses going up are two-bedroomed, non-parlour houses. That is quite enough, I am afraid, for most of the families to-day, but what is going to happen when the population begins to go ahead again, as I hope it will; when it becomes recognised as a tragedy that you should have all your eggs in one basket and all your family love vented on one or two children, instead of four, which is the requisite number to carry on the race? Then people will look back upon us and on the local authorities and say, "What have our forefathers done with this great housing movement that they were so proud of? They were responsible for keeping back families, because the working classes knew there were no places for them to go where they could have more than one or two children." It is one of the greatest tragedies of to-day that the average size of families is going down.

This is, in the long run, the most important question to be handled by this generation. It is more important than Defence, food or any of the other questions. Are we going to have this nation perish for lack of men? It will do so if the present rate goes on. We are told by the statisticians that we shall go down, at the end of the present century, to a population of 4,000,000, instead of 40,000,000. The Government are procrastinating by simply referring to a statistical inquiry what is fairly obvious already. My hon. Friend the Senior Member for Oxford University (Mr. A. Herbert) has told us all about it. Germany and Italy are, by empirical methods, raising their birth rates. Japan is stemming her decline, and the whole crowded nation is looking and feeling, if unconsciously, towards the vacant plains of the British Empire. I hope that something will be done about it, and that the Minister, at any rate, will see whether it cannot be tackled.

Even if we are so hard up for the next generation, we can take great pride in the work of the Ministry of Health and the local authorities and all those concerned in regard to the constant low figure of our English infantile mortality. I stepped in here the other day for the Debate on the Scottish Health Department, and I was sorry to hear that their infantile mortality rate was 87 per thousand, as compared with the English rate of about 59 per thousand. I hope the Scottish rate will follow the English rate. They generally lead us in most things. Perhaps the present Minister of Health will be able to give them a tip after a year or two at our Ministry of Health. We have to make the most of our children and mothers.

There are two or three bogies still to be settled. We have this terrible bogy of abortion, which was brought before us this afternoon. As that is the subject of inquiry by a Select Committee, we have to await the report of that committee before we know what is to be done. There is the terrible question of venereal disease, and I should like to know whether the Parliamentary Secretary, when he replies, will give us some idea of the results of the mission that was sent out by the Ministry of Health to Scandinavia to consider the Scandinavian machinery by which they are able to do what we cannot do in this country, namely, get the permanency of treatment of cases of syphilis. People do not realise the immense gravity of this disease. We do not know the real figures here, but in the United States of America, it was definitely stated in one of the latest reports that no fewer than 7,000,000 people have syphilis at any one time, especially coloured people. In this country the Royal Commission said that one out of every 10 have this terrible disease. It wrecks the whole stamina of the nation, and it will continue to do so unless we tackle the disease. It is being tackled by the British Social Hygiene Council, and I hope that we shall support and get local authorities to support that Council even more.

We have heard of the dangers of the quack medicine trade, and I hope that we may be able to get to work on that, and that the effect of the Drugs Bill, which is now becoming an Act, will enable us to deal not with the popular patent medicines which are universal favourites, and which medical men often prescribe themselves, but with the misleading advertisements in relation not only to medicines but to instruments. One of the greatest tragedies is that of the deaf, and the amount of money that is taken out of their pockets as a result of misleading advertisements of instruments of no value sold at immense cost. These things should be tackled.

But we have to look further ahead. The whole voluntary hospital system is at stake. Voluntary hospitals are on the rocks, and not least the teaching hospitals. If we are to do what seems to be generally required, namely, to bring about easier conditions of service and better rewards for those who are employed in the hospitals, for the nurses and the doctors, many of whom have hitherto given their services for nothing, it will occasion an immensely additional cost. How is it to be done? The future of the voluntary hospitals should be bound up with the municipal hospitals. It is only in that way that we can obtain some kind of co-operation which will still retain all that is good in the voluntary hospital system and at the same time be able to develop it, so as to be useful without carrying on a new uneconomic, system at the expense of faithful service which should be properly paid. I think that the next year will be a testing time for this system, both for the nursing profession and for the hospital medical profession. There is a Departmental Committee sitting on the nursing question, and I hope that as a result of that we shall be given a lead.

We come back again, I believe, to the system of the dependence of the whole of our health system upon the general medical practitioners and upon their education. It is no use in any department of public life expecting such and such things to be brought forward for the benefit of the rising generation unless first of all you instruct your teachers. It is the same with the doctors. They ought to be made the basis of our health system, and yet I believe that the medical educational system requires considerable revision. I must leave it at that, as I have no time to develop it. I welcome the further confidence that is felt in the general practitioners and in their uniting together as they have in the British Medical Association for the benefit of the public service. I hope that they will be consulted more and more by the Government, as the general practitioners are perhaps most able to solve these questions. It is they alone can make the success of the great campaign for the health and fitness of the nation.

I regret intensely that the Government, in starting their fitness campaign, decided to have it in two parts, one run by the Ministry of Health to advertise their institutions, and the other by the Board of Education to bring forward the idea of physical fitness education of the young. We want a much broader system than that. It should be based upon the work of the doctors, who have the most influence in telling people how to live healthily. If from the first the doctors had been induced to work the campaign, I believe that it would have made considerably greater progress. We hope that the whole compaign will be a success, because the fitness of the nation is dependent upon those measures of publicity that can be given by hon. Members in this House and by all of us in our respective callings and constituencies. In that way we can to whichever party we belong back up the Minister of Health and wish him good luck in the work that is before him.

10.3 p.m.

Dr. Guest

I rise to confine myself to one problem only, and that is the question of how a frontal attack on disease, of which the Minister of Health spoke, is to be carried on. I believe that some progress has been made but I would remind the Minister that there are bad problems of housing, bad conditions of health and tuberculosis caused by cellar dwellings within 10 minutes' drive and less of this House. There are many very bad conditions in London, but I want to apply myself to that one problem of a frontal attack upon disease, and to suggest that what is really lacking is a proper staff organisation. Proper staff organisation depends upon research. In the Debate to which we have listened to-night various figures have been quoted. There were the figures quoted by the Minister himself about the amount of money spent on the purification of rivers, £7,000,000; water supply, £4,500,000; mental diseases, £10,000,000; and another hon. Member quoted the amount spent on patent medicines, £30,000,000. All these sums are measured in millions, but when it comes to the question of medical research—and I have in my hand the report of the Medical Research Council for the year 1936–37—we find that the grant-in-aid for medical research from the Government was £195,000 only. What is worse, if one turns to a subsequent page it is stated that: The public moneys available for the work of the Medical Research Council, have again received important augmentations from other sources. Funds for the promotion of particular schemes of research have been provided by the Dental Board of the United Kingdom, the British Empire Cancer Campaign, the Trustees of the late Viscount Leverhulme, the Sir Halley Stewart Trust, the Rockefeller Foundation of New York, the Stock Exchange Dramatic and Operatic Society, and Miss R. M. Rashleigh. The fact that only £195,000 has been provided by the Government for medical research and that the Government find themselves obliged, as it were, to go cap in hand to various funds in charge of private individuals, is a very discreditable fact. I do not mean to say that private funds should not spend money on medical research. It is highly desirable that they should do so, but I think the money from private research funds such as the Rockefeller Foundation or the funds in the hands of Miss R. M. Rashleigh, or the funds provided by the Stock Exchange Dramatic and Operatic Society, should be spent on what one might call pioneering work. The Medical Research Council does not depend upon these funds for pioneering work only, but they are asking for moneys from these sources for such fundamentally important work as research on rheumatism, which is of immense importance, accounting as it does for one sixth of our total sickness, work on cancer, which is one of the most formidable plagues in this country, for work on malaria, which is of fundamental importance to our whole Colonial Empire, and for other work.

I suggest that there should be an altogether new conception with regard to medical research work in connection with the Ministry of Health and that the Ministry should provide very much larger sums. In view of the amount of money which is now spent, I will not say lightheartedly, but at any rate, voted regularly by this House for armaments expenditure a sum now rising to the almost astronomical figure of two billion pounds, the fact that only £195,000 has been spent by the Government on medical research is discreditable. At least £1,000,000 ought to be set apart for medical research. That is not a large figure. There is fundamental work requiring to be done in connection with cancer, malaria and rheumatism. At the present time a private appeal has been launched for the raising of £500,000 for work on rheumatism. If that is desirable and necessary, the money should certainly be provided from Government funds. There is leprosy, hookworm disease and a whole range of scientific research of that kind which requires to be done.

My allotted time is up and I will not detain the House any further, but I would underline the fact that in view of the enormous cost of sickness and illness in this country, estimated at £300,000,000 a year the research allowance of £195,000 is grossly inadequate. Much more money ought to be spent, because it is the best way to prevent disease to find out its cause and how it can be dealt with, prevented and cured in the most efficient manner. I urge that more money should be spent on research as the best means of prevention.

10.8 p.m.

Mr. Marshall

I should like to add my congratulations to the Minister of Health on his elevation to his present high office and to express the hope, as many other hon. Members have done, that he will use his undoubtedly great intellect to expand and improve the service over which he is now the national guardian. He has given to the House, in what he called his maiden speech, a very impressive review of the social services of the country. I think we were all very much impressed with it. The Debate has ranged over almost every conceivable topic. It is one of those Debates into which experts have entered, and when one has made notes one has found that the notes have really become useless.

It is, perhaps, very fitting that on this last but one day of the Session the House should deal with the very intimate and domestic matters represented by the Ministry of Health services. Anyone contemplating the services associated with the Ministry of Health cannot but be impressed by their scope, their great variety and their wide diversity of character. A mere schedule of them makes a very impressive list and comprises some of the most valuable services in our national life. They touch our life at a hundred points. The services covered in the report for 1936–37 embrace the seven ages of man, from the cradle to the grave. They are so important and varied that it is difficult to imagine that even with his ability the present Minister cannot give the necessary detailed attention to every one of these services.

I have looked through the report for 1936–37, and we are all sorry that the 1937–38 report is not available. Had it been available I have no doubt that it would have shown much improvement in many of the services. It is very difficult to keep in mind all the figures which the Minister gave us, but even so the report for 1936–37 gives us a very fair view of the services of the Ministry. If one takes one chapter only, which comes under the general description of public health, one finds that it comprises 14 sections, each one of which deals with some matter of great public interest and welfare. There are four more similar chapters, and when one adds to them public assistance, housing, town planning, local government organisation, National Health Insurance and pensions, one can realise what a terrific responsibility rests upon the Minister of Health in these modern times. I think we shall all agree that many of the questions associated with the Ministry are absolutely above party. The underlying principles of many of those matters have, I am sure, universal assent. Any criticism that we offer must of necessity be constructive. It must be directed towards increased activity and vigilance on the part of the Ministry, to greater expansion, to sins of omission and occasionally to sins of commission.

We have had some very notable speeches to-day, and I want to refer to one or two of them. We cannot but be perturbed at the frequent indications which many hon. Members opposite show of having got the germ of economy in their blood. We have listened to-day to a speech which I thought was very ill-informed from the hon. Member for Chislehurst (Sir W. Smithers). He was all wrong in his comparisons. He tried to make a comparison between the checks exercised on Government expenditure and those which are applied to local government expenditure. He said that local governments were organised for extravagance, whereas there were absolutely rigid and complete checks upon national expenditure. In making such an assertion he showed a woeful ignorance of the machinery of local government. I was a member of a local government for 20 years and I know the absolutely rigid and complete check there is on expenditure. The first thing that happens is that the committee sends its estimates for the forthcoming year to the finance committee where it goes through a very small sieve. They eliminate anything which they think can be eliminated, and when that has been done the estimate goes before the council for its approval before even a halfpenny can be spent. It is not only submitted to a very rigid examination by a finance committee and the council, but ultimately it has to pass the Government auditor and anything which can pass the watchful eye of the Government auditor must be quite proper and right.

I want to rebut very strongly the idea that local authorities are extravagant. As a matter of fact, local authorities cannot afford to be extravagant. They are staggering under a heavy load of expenditure which has been forced upon them by the Government, and they have no surplus in order to carry out many desires for ordinary local government expansions. Take a City like Sheffield, with its £800,000 to £900,000 expenditure on public assistance. Will the hon. Member for Chislehurst say that this should be cut down when all the rates are subject to the Government auditor's approval and the Ministry of Health's approval? Such a thing would drive despair into the heart of every representative of a local authority. Can anyone imagine the effect of that great expenditure on the other services of the City? It means that a cheeseparing policy has to be adopted and that every halfpenny that can be cut down must be cut down. When the hon. Member talks about local authorities being organised for extravagance he does not know what he is talking about. When he was referring to the rigid examination of accounts with regard to Government expenditure I could have told him that only yesterday we passed £400,000,000 in this House, and I do not think a word of criticism was said about it. We know that these Estimates have to go through the small sieve of the Treasury, and it is because we have confidence in the oversight of the Treasury that we feel safe in allowing them to go through without discussion.

We know that there is no extravagance on social services. One would like sometimes a more rigid examination of the expenditure on war material, but one can say quite definitely that as far as the social services are concerned there is no extravagance there. I am somewhat perturbed by the frequent speeches that are made advocating economy. I remember what happened in 1931. The process seemed to be a very simple and innocent one. but it had very dire results. It is for that reason that I feel we ought to be very watchful now.

The hon. Member for Norwich (Mr. H. Strauss) is one of the last hon. Members who, I should have thought, would have qualified to sit on these benches, but the speech which he made to-night certainly could not have given satisfaction to the Minister. I think the hon. Mem- ber for Norwich was absolutely right in what he said. In listening to the Minister's speech, I felt that the right hon. Gentleman was a little too optimistic and too complacent on the question of town planning. I have had the privilege of placing before the Sheffield City Council a town plan or at any rate the first stages of one, and I think I may say that I understand the very great difficulties connected with town planning. I do not think the Minister quite understands those difficulties. In the first place, we put forward a plan for a central area of the city. I shall not indicate the ultimate expense of that plan, because I do not think we can quite tell yet what it means, and it may take us 25 years to carry it out; but the fact remains that we shall be working to a plan, which will be a very great advantage. It is a plan which means alternative routes through the city, widened roads, a civic centre and a circular route in order to make it easy for traffic to get into and out of the city.

The plan also means zoning. Let us consider the difficulties of zoning. Any one who tackles the town planning of a great industrial city will find that dwelling houses are inextricably mixed up with factories and industry generally. In Sheffield, in the area scheduled as a residental area, there are about 25 acres of industrial property, factories and so on, and in the industrial area, there are residential dwellings. It is impossible to draw any clear line of demarcation. It will take many years before we can say that an area is zoned and is occupied only by either residential dwellings or industrial property. The Minister will understand that this involves very heavy compensation costs. That is one difficulty. Another difficulty is that as slum clearance goes on, various areas are entirely cleared of buildings and are open spaces, but those sites do not belong to the corporation. They are in the hands of private enterprise. It is the fact that that land is owned by private enterprise and that an extortionate price per acre is demanded for it which is preventing local authorities to-day from putting the land to proper use.

Indeed, town planning ultimately boils down to a question of compensation, and unless the Minister gets that thoroughly into his mind, we shall not make the progress which he desires. I was very much impressed by the speech of my hon. Friend the Member for Peckham (Mr. Silkin) in which he referred to the necessity for preserving large stretches of agricultural land around cities. I believe in that. But I read something in the report that shows that the Ministry does not contemplate that. It is pointed out that total reservation is practicable only to a limited extent, as it would clearly be inadvisable for local authorities to expose themselves to claims for immediate compensation for loss of potential value of tens of thousands of acres within the next few years.

What the Minister seems to advise is that local authorities should schedule these agricultural areas at a density of one house to so many acres. That is not town planning. I believe it is necessary, especially on the outskirts of great industrial cities, that large stretches of agricultural land should be preserved. We would all like to see the town dweller able to enjoy the sight of the practice of the ancient industry of husbandry. We would all like to see the town dweller able to go to the outskirts of his city and see fields of golden grain and smell new-mown hay. But if we dot these areas over with cottages and bungalows, no matter how small the density, we are simply taking suburbia out to them and there can be no real agricultural reservation.

In the committee over which I presided we determined to make large reservations of agricultural land round the city and we increased the reservations from about 3,000 acres to about 10,000 acres. One instance will show the Minister what we were up against. I wish it to be understood here that I am not blaming the landowner or the builder. They are entitled to get what they can for their land. But I would like to say something about the principle which underlies this kind of business. There were 90 acres of land on the borders of Sheffield comprising the gateway from that city to the beautiful Derbyshire moorlands. Everybody agreed that this area should be preserved. A builder got hold of it. We know that he paid about £9,000 for it. To have allowed development to take place there would have been a scandal and the matter went to mutual arbitration. It had gone too far for submission to the Minister. We have had to pay £22,000 for that land.

If we lay it down that there is to be a green belt round each of our cities, that kind of thing will take place on the borderline between the green belt and the development area in almost every case. It simply means that the people are buying their own country over again. The question of national parks has been mentioned by my hon. Friend the Member for East Wolverhampton (Mr. Mander) in a very moving speech. That question again boils down to one of compensation. The local authorities and the Government have to face the question of purchase unless they can do something to sterilise the land so that it shall not be used for development or unless it is enacted that local authorities may buy it at the agricultural value. The money which this land costs over and above its agricultural value, represent a value created by the community. The community puts in sewers and takes services there and it is a strangely ironical situation that when we want to save the countryside and preserve these amenities for the dwellers in congested towns, we have to pay for the value that we ourselves have created. I know that this matter goes to the root of the land question, but unless the Minister can do something on the lines which I have suggested, then, as the hon. Member for Norwich said, the country will be gradually ruined under his eyes.

There is another question, the question of regional relationships. I have a circular here from the Lancashire branch of the Council for the Preservation of Rural England, which says that the branch, being deeply concerned at the difficulty which planning authorities, especially in the poorer rural districts, have to face at present with regard to the protection of areas of natural beauty from building development, are of opinion that the progress of town and country planning is being unnecessarily delayed by the existing law and practice, which requires to be modified; in particular, that more effective machinery shall be set up by which any compensation, when this arises, shall be apportioned fairly between the authorities benefited by the preservation of an area; also that, in the case of any area having national as well as local value as an open space, a contribution in proportion to that value shall be made from national funds. I cannot see how the Minister can avoid making some contribution to the preservation of such areas. It is a problem that he will have to face. I know an area which everybody would agree ought to be preserved, a natural beauty spot, half of which is in a big local authority's area and the other half of which is in the area of a poor rural authority. Certain approaches were made, and we were told, quite frankly, that we could preserve it if we liked, but that we would have to pay for it. The consequence is that, in order to preserve these places which are in the hands of small rural authorities, the great local authorities will have to foot the bill. You can try as much as much as you like to come to some regional arrangement, but you cannot help it.

Take another case, one of which I have had some experience and on which I have some very strong views. Another poor local authority offered to put a sewerage works down, and to allow a certain builder to fill nine acres of land with houses to put down there, and that will mean that nearly the whole of a very beautiful valley will be brought into the drainage area. The consequence is that we can do nothing about it. That is what is happening all over the country, and unless the Minister faces up to many of these difficulties, I am afraid this country will go to utter ruin under his very eyes, and that all the lovely beauty spots that we have treasured as the very flowering of our landscape will practically be gone for the rising generation.

I would like to say a few words about the Rent Restrictions Act, for which the right hon. Gentleman is not responsible, but it was a Bill passed at the instance of his predecessor, and I think it will be a very black day for the 400,000 tenants who will find their houses being derestricted—in September of this year, I think it is. I would also like to say—again I am not putting this on the present Minister—that with the difficulties that local authorities are facing to-day, with the annual interest and sinking fund charges going up every year, so far as housing is concerned—at Sheffield, for instance, they have gone up in 10 years from about £23,000 to £65,000—I think it was a great disservice to local authorities to reduce the subsidy just about this time. From that point of view, I think the Minister has a great work in front of him, and we trust that he will rectify these things and take a really progressive and enlightened view of them.

10.34 P.m.

Mr. Bernays

The speech of the hon. Member for the Brightside Division of Sheffield (Mr. Marshall) illustrates, I think, the connection that there is between the local authorities and the central Government in the work of health administration. I understand that the hon. Gentleman, who was asked to wind up for the Opposition to-night, is himself an ex-Lord Mayor of Sheffield, a city of half-a-million people, and I think it was Sheffield that was the first place that my right hon. Friend visited when he became Minister of Health. He was, therefore, able to see something of the problems which the hon. Gentleman has so interestingly discussed.

I have the responsible task to-night of winding up a Debate on a Bill which, I believe, involves something like £400,000,000. It is the Consolidated Fund Bill, which contains the salaries of all Members of the House, and I am deeply conscious that if by any fault of mine this Bill is lost, it will be a serious matter for the country. Fortunately, however, my own responsibilities are concerned only with health administration, and this general review has been so extraordinarily friendly that I hope I shall not in my combative way dissipate the wedding breakfast atmosphere that has characterised this Debate. It has been a very useful one. I think it was Lord Baldwin who once pointed out that no Session of Parliament has ever been dedicated to the sole task of examining the results of previous legislation. I think, however, that a Debate of this kind to some extent achieves that purpose. We are able to see how far the legislation already passed is achieving its purpose.

Unhappily, the hopes held out when laws are framed are not always realised when laws are passed, but there is one sphere of legislation where that is not true, and that is housing. One sees all round one to-day the transformation that is going on as the result of the Housing Acts passed by successive Governments, and the great building programme which is evident everywhere is an answer, I think, to some of the criticisms that have been made. It is to those criticisms that I come, and first to the criticisms of the hon. Member for Peckham (Mr. Silkin). In his very informed speech he complained of the fact that public inquiries regarding slum clearance are too slow. We have to face the fact with regard to slum clearance that a man may be deprived of his property and that he must have the fullest opportunity of stating his case. After all democracy does mean the rights of people to be heard, and it involves the whole question of liberty. It may be possible under a dictatorship to move faster, but you do not move as surely. The confirmation of orders, as a matter of fact, keeps pace in a general sense with house-building, which in itself depends upon the resources of the building industry. The hon. Gentleman further raised the point that the Ministry of Health prefer a flat to a cottage. That really is not so. It is true that there is a larger subsidy for a flat than for a cottage, but that is because of the increased cost of flats owing to the increased cost of land and materials.

Mr. Silkin

I hope that the Minister will read my speech, and he will see that he has completely misconceived the point I made.

Mr. Bernays

I must say I was very surprised, after consultation with my advisers, at what I understood the hon. Gentleman to mean. Now I come to the question raised also by the hon. Member for Peckham and by the right hon. Member for Wakefield (Mr. Greenwood) regarding our attack upon overcrowding. I understood them to say that they thought the position was unsatisfactory. At any rate, we have made this progress, that overcrowding is now an offence in all areas. The appointed day has been fixed for every area in England and Wales. Therefore, we do know the dimensions of the problem and are attacking it. The number of new houses which have so far been approved specifically for the abatement of overcrowding is 22,209. It is known, however, that a great deal of overcrowding is being relieved in other ways, such as by the rehousing of tenants of unfit houses which were also overcrowded, and also by the interchange of tenants and the normal movements of the population. The only information available as to the amount of overcrowding which has been relieved in this way is that contained in the reports of local medical officers of health. The total number of overcrowded houses in areas for which reports have been received, was 84,548, and the number of cases of overcrowding which have since been relieved is 25,728, or 3o per cent. That shows that we are making a determined attack upon the problem. It may, of course, be argued that the overcrowding standard is too low, but we must first get rid of the overcrowding under the present standard, and then we can tackle the other problem.

The right hon. Member for Wakefield also asked me to deal with building costs. It is true that there has been a slight increase in building costs. It is due to some extent to increased labour costs, but more important is the increase in the cost of some materials, particularly timber and cement. The prices of materials are being investigated, and as regards timber the peak has now been passed and decreases in prices have occurred. Lead, which rose sharply a year ago, has fallen equally sharply. On the whole, therefore, though building prices have risen over the last two years, there are signs that the peak has now been passed, and during the, past few months prices have steadied.

Now I come to the point raised by my hon. Friend the Member for Frome (Mrs. Tate) with regard to rural cottages. She made two statements which I must challenge. The first was that perfectly good houses are being pulled down. I cannot possibly accept that statement. No cottage is condemned unless all reasonable doubt is removed that it is unfit for human habitation. She then said, "Give the owners of these houses some power of appeal." In fact, they have that power now. There is always a right of appeal by interested parties when a council makes a clearance order. Specific provisions are laid down, first, that all interested parties are to be made aware of the order; secondly—and this deals also with the point raised by my hon. and gallant Friend the Member for the New Forest (Major Mills) that they are informed of the grounds on which the property is condemned as unfit; and thirdly, they have an opportunity of putting forward any reconditioning proposals for the consideration of my right hon. Friend. In the event of any objections the Minister is bound to hold a local inquiry.

The hon. Lady raised the question of the hard cases of aged persons. As the House knows, Parliament has placed upon my right hon. Friend the inescapable duty of ensuring that there is no house that is not fit for human habitation, and that must apply to the whole community, but clearly the best plan with regard to aged persons is to proceed, if possible, by reconditioning. My right hon. Friend does not want any houses pulled down unnecessarily. Apart from considerations of hardship, every house pulled down involves State money in the way of subsidy for new accommodation. My hon. Friend the Member for the New Forest also raised the question of demolition orders and suggested that in some cases there was a danger of their being made without owners understanding the opportunities that they might have of reconditioning the cottages. The predecessor of my right hon. Friend appointed a committee under the chairmanship of the Bishop of Winchester to consider the administrative position. I believe that that committee concluded their labours this afternoon and that their report will be in the hands of my right hon. Friend to-morrow. He will, of course, give it every consideration and will be in a position after the Recess to announce his decision upon it.

The question of rural water supplies was raised by the hon. Lady the Member for Frome and by the hon. Member for the Isle of Ely. I really could not give answers on the points they raised without having the full facts in front of me, but my right hon. Friend will give every attention to those points. We are prepared to entertain loan applications for such purposes as the hon. Members mentioned, but at the moment I cannot hold out any hope of a further capital grant, in view of the existing financial stringency.

Now I come to the question of national parks. The hon. Member for East Wolverhampton (Mr. Mander) asked what progress we were making, and seemed to think that no progress was being made at all. That is not the case. The House may be interested to hear of a number of beauty spots that have already been saved: 12,000 acres of the South Downs will be preserved in their natural state, under the Hailsham Rural District Council's Planning Scheme; part of the Downs in West Sussex are being leak with in the same way; a scheme including Ambleside, Langdale, Trout-beck and Patterdale has been submitted to my right hon. Friend for approval, and in Dovedale and Manifold Valley much valuable preservation has been secured by voluntary effort working through the National Trust. Those who visit those spots in the holidays will be comforted by the thought that where they stand the hand of the destroyer has been stayed. I think the House will agree that definite progress has been made in the preservation of those natural park areas.

All this suggests that the preservation which the hon. Member has in mind can be done under existing statutory powers and can be done without undue expense. I assure him that my right hon. Friend is not so frightened of the Chancellor of the Exchequer, but that if he felt that anything was required he would at any rate see whether it was possible to get it. My right hon. Friend has just obtained £20,000 from the Chancellor of the Exchequer for a sports ground for the Civil Service. That is a beginning, and is an example of the successful way in which he has dealt with the Chancellor of the Exchequer. We have to be certain that the money is needed. Reference has been made to a Motion which was accepted by the House on 10th February, 1937. Action was taken on that Motion. The Advisory Committee on Town and Country Planning was asked to investigate the question of the inadequacy of planning powers to prevent destruction of beauty in town and country. That report is expected shortly, and I can assure the House that my right hon. Friend will give it close consideration, and will be careful to note it if in fact this Committee do recommend that the existing powers are not adequate for their present purpose.

The hon. Lady the Member for West Fulham (Dr. Summerskill) raised two interesting suggestions with regard to the measures that she thought would be of assistance in reducing the rate of maternal mortality. She wanted, first of all, further education in obstetrics, and she also complained that there was a difficulty in medical students getting sufficient cases. She said that no doubt I would put that forward in argument. It is not an argument, it is a fact—arguments and facts are not always the same. She asked me whether I could say a word about the improvement of medical education. That as a matter of fact comes under the General Medical Council, and a question would have to be asked of my right hon. Friend the Lord President. She asked also about the supply of maternity beds. The provision is steadily increasing. In the last two years the number has increased by 1,000, and plans are under consideration to increase them still further. The hon. Lady the Member for Frome also raised the question of mental hospitals, and her proposal, as I understood, was to redistribute curable and incurable patients and concentrate the latter in the old hospitals. I thought myself that that was rather a counsel of despair. Surely what we must do is to bring the old hospitals up to date, and that is what we are in fact doing. Of 101 mental hospitals 45 have separate admission units, and 55 have separate convalescent units, and each year we are improving on that figure. In due time we hope that all hospitals will have admission and convalescent units.

I should like to deal for a moment with the very interesting speech made by my hon. Friend the Member for Chislehurst. He had really two main proposals with regard to rating and expenditure. He pleaded for a stronger sysetm of control over the departments, but the hon. Member for Brightside pointed out that there is already something closely similar to the Treasury system of control in local affairs. I think the hon. Member will bear me out when I say that in general no liability exceeding £50 may be incurred by a county council except upon a resolution of the council, acting upon the recommendation of the finance committee. He also asked for a Commission to review policy, and made some very interesting statements in this connection. I think my hon. Friend will not expect me to give him a Royal Commission at five minutes to Eleven. I can only say that my right hon. Friend will, of course, consider the question very carefully.

The hon. Member for Stoke (Mr. E. Smith) raised the enormous question of rating inequalities, and I can only deal with it very shortly now. I would remind him that concessions are made in the block grant to the hard-pressed areas, and that they are estimated on the basis of relative need. That, really, is the answer to the hon. Member for Houghton-le-Spring (Mr. W. Joseph Stewart), who made the same point with regard to Durham. Durham, after all, has had a special measure of relief.

A question was also raised by my hon. and gallant Friend the Member for Blackburn (Captain Elliston), who asked me whether it was proposed to make an increase in the block grant to meet the new services of the local authorities. These block grants were based on a statutory investigation, and they were embodied in the Local Government (Financial Provi- sions) Act, 1937. That was only last year. There will be another statutory investigation before the block grants are in full operation, and there are not in fact any extensive new services to justify any interim change.

With regard to the whole question of rating expenditure, which has been raised on both sides of the House in this Debate, there is really only one test of rating expenditure, and that is, does it or does it not produce value for money? I would make this claim for our rating expenditure, that it has added to the wealth of the country far more than it has taken away. It has added to the wealth of the country enormously in the extent to which the health of the country has improved, and, after all, many of these services are revenue-producing services. Health is the only capital which is not affected by Stock Exchange slumps or adverse financial reports. I have here some interesting figures taken from the report of the Medical Officer of Health for Sheffield. It is a report on the weight and height of school children, and it shows to a remarkable extent the value of our health services. The average increase of weight in boys of 14 since 1920 has been 13.2 lb.; the average increase of weight in girls of 14 since 1920 has been 15.75 lb. I will take the case of Post Office employés, who, after all, are a fair sample of the whole country. The height of boys of 16 increased by 1½ inch, and their weight by 16 lb., while the height of girls of 16 increased by 1 inch and their weight by 10 lb., in the last seven years. These are most encouraging figures, After all, the test as between democracy and Fascism is which system of Government can produce the greatest sum total of human happiness. We shall not preserve democracy by merely making perorations; we have to produce results, and the Fascists in all countries are judging our claims, not merely by our output of guns or the extent of our industrial production, but by our general well-being; and it is because I believe that on this test of wellbeing our progress in this country has been so swift and so sure that I commend with such confidence the record of the Ministry of Health to the House and to the world.

Question, "That the Bill be now read the Third time," put, and agreed to.

Bill read the Third time, and passed.