§ 6.5 p.m.
§ Mr. SilkinI beg to move, in page 5, line 7, to leave out "all councils," and insert "the council."
1433 This Clause deals with the financial provisions, and among other things provides that the Exchequer grants shall be made by reference to the additional cost incurred by local authorities, a cost which is based upon the estimated net average cost either throughout the country or in particular areas. It is the object of this Amendment to provide that in calculating the average net cost it shall be the average net cost of the particular council and not the average throughout the country. As the right hon. Gentleman is aware, the present cost of administering hospitals varies very considerably, and there is no reason to suppose that the additional cost of administering this particular service will not vary in the same way. The cost varies by reason of differences in the standard of treatment, differences in the cost of living in different parts of the country, the varying number of beds in different hospitals—an important factor—and the fact that some hospital authorities are more extravagant than others and that some are unduly economical.
Therefore, I submit that it is unfair to take an average of costs throughout the country and to base the Exchequer grants upon that. An average really means nothing when you take into account the wide range of costs in different hospitals. In municipal hospitals the costs per bed per week range from £1 3s. 9d. to £7 3s. 11d., and an average based upon those extreme figures would be really meaningless. In voluntary hospitals the average cost per bed per week ranges from £2 8s. 10d. to £7 16s. I submit that in calculating the Exchequer grant the fair thing is to take the average cost to the particular authority, which is what would be done under this Amendment, or to take particular classes of authorities, such as the county boroughs and county councils, and average each class. I am not particular whether the grant is based upon each hospital's costs or upon the costs in a particular class of hospitals, as long as they are grouped together in some form and the average is not one for the whole country. I understand that the Minister has recognised this difficulty, because upon Second Reading he said:
To meet a point made by local authority representatives in all parts of the House … about the undesirability of having the same unit for the whole of the United Kingdom, provision is made whereby different units can be prescribed for different areas, so that we are not to have the same unit 1434 applicable, say, to Denbighshire and to the London County Council."—[OFFICIAL REPORT, 12th December, 1938; col. 1655, Vol. 342.]In fact, the Minister has not made that provision in the Bill, or, rather, it is still possible for the Minister—not perhaps this particular Minister, but some successor less scrupulous than he is—to take an average over the whole country. We are anxious that the Minister should do what he himself has recognised to be desirable and make it impossible to base a grant upon an average for the whole country. He should base it either upon the actual cost to a particular council or on the average for a group of authorities either those in the particular locality or a comparable group.
§ 6.10 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Bernays)As the hon. Member knows, the question is a complex one, and if my right hon. Friend the Minister cannot accept the Amendment as it stands I hope that I shall be able to reassure the hon. Member upon the important point which he has raised. I understand that what he requires is that the expenditure of a council under the Bill shall be estimated by reference to the estimated average net expenditure of that council or that class of council and not that of the average expenditure of all councils. His Amendment, if carried, would restrict my right hon. Friend to only one method of assessment of grant, and that is a position which, as I am sure the hon. Gentleman will appreciate, my right hon. Friend cannot accept, for clearly there will be cases in which the standard of expenditure over a large number of councils will be approximately the same and in which undoubtedly it will be convenient to group councils together for the purpose of establishing a unit of expenditure. What my right hon. Friend desires and what this Bill gives him is a discretionary power, a power of considering each case upon its merits. That power is given in paragraph (b) of Sub-section (8) of this Clause where it says:
(b) may also provide that the amount of any expenditure so incurred in respect of any particular services by a council, or by a council of any class specified in the directions, shall be estimated by reference to the estimated average net annual expenditure incurred in respect of those services by all councils or by councils of that class.The whole object of the Sub-section is to make it possible for a separate unit of 1435 expenditure to be fixed for a group of councils of the same class if a case is established for such separate treatment. I know that the hon. Member and the right hon. Member for South Hackney (Mr. H. Morrison) had in mind the particular case of London, and I can give this assurance that if the Minister were satisfied that the circumstances in London were different from those of any other authorities it would be permissible for him, under the terms of the Clause as drafted, to approve a separate unit for any particular part of the service for London. Whether this will or will not be done will, of course, depend upon the facts when the proposed arrangements are submitted to him, but, as I have said, there is nothing in the Bill to prevent it if in the opinion of my right hon. Friend the facts warrant it. Indeed, there is a specific provision in the Bill to secure what the hon. Member for Peckham (Mr. Silkin) desires.
§ Mr. SilkinIs it possible in the case of the London County Council for the Minister to take the view that London stands in a class by itself? If he is prepared to accept that possibility I will not press it further.
§ Mr. BernaysThat is the assurance which I am advised that I can give.
§ Mr. SilkinOn that assurance I beg leave to withdraw the Amendment.
§ Amendment, by leave, withdrawn.