HC Deb 13 February 1939 vol 343 cc1446-50

6.50 p.m.

The Under-Secretary of State for Scotland (Mr. Wedderburn)

I beg to move, in page 9, to leave out lines 1 to 3.

This Amendment and the following Amendment are drafting Amendments, arising from verbal alterations made in Clause 4.

Amendment agreed to.

Further Amendment made: In page 9, line 31, at the end, insert: (b) for any reference to the Minister of Health, except in Section three of this Act, there shall be substituted a reference to the Department of Health for Scotland."—[Mr. Wedderburn.]

6.51 p.m.

Mr. Hunter

I beg to move, in page 9, line 32, to leave out paragraph (b).

Under this paragraph, it is feared, Scottish local authorities might be compelled to erect special hospitals for the treatment of cancer. They do not think that that is necessary. They prefer that their case should be covered by Clause 1 of the Bill, which deals with voluntary and other hospitals. We think that the Bill will be satisfactory with this paragraph removed.

6.53 p.m.

Mr. Wedderburn

I gather from my hon. Friend's brief speech that the point he put is the only matter of concern to himself and his friends. I will not, therefore, deal with the wider aspects of the Amendment, but only with the particular point which he has raised. My right hon. Friend thinks that under Clause 1 the power of the Department to require that there shall be adequate provision for cancer treatment in every area will be sufficient, and if it is thought desirable to make plain that this paragraph does not necessarily mean that special hospitals should be built he is prepared to consider redrafting the paragraph to make that plain.

Amendment, by leave, withdrawn.

6.53 p.m.

Mr. Hunter

I beg to move, in page 9, line 41, at the end, to insert: Provided—

  1. (i) that the said expenses shall not exceed the produce of a rate of one halfpenny in the pound for any year levied in any area, and
  2. (ii) it shall be the duty of the county or town council to recover from any person to whom they have provided services under Section one of this Act or from any person legally liable to maintain that person a reasonable charge in respect of the expenses incurred by the council in the provision of the said services, or if the council are satisfied that the person from whom such charge is recoverable is unable by reason of circumstances other than his own default, to pay the whole of such charge, such part thereof, if any, as he is, in the opinion of the council, able to pay."
The purpose of this Amendment is to restrict liability for expenditure by local authorities. Local authorities in Scotland are beginning to feel alarmed, as no doubt local authorities are elsewhere as to the unrestricted liabilities to which they are exposed. They do not know where their liabilities will cease. They would be glad if the Government could see their way to restrict the liability of the local authorities so that it would not exceed a halfpenny in the £ on the rates. They think that would be sufficient. The block grant system leaves them unable to know where their expenditure will end. The second part of the Amendment provides that local authorities shall have powers to press for payment from those who obtain services from the local authorities for the treatment of cancer and to obtain costs from people according to their ability to pay. It is not proposed to take anything from people who cannot afford to pay. That is the same principle as is contained in the Act dealing with maternity and child welfare, and we are merely asking that this Measure should be put on the same basis as that.

6.55 p.m.

Mr. Rhys Davies

I suggest that this Amendment should not be accepted. I always thought that the proverbial meanness of Scotland was a joke, but I am beginning to think that the Scotsman is even more mean than he admits himself to be. I shall be astonished if the cost of treating cancer under this Measure will be anything like a halfpenny in the £ in any case. But if the hon. Gentleman is able to get the second provision inserted in the Bill it will be detrimental to the treatment of cancer in this country, for there are some people who, if they are told beforehand that they are to be mulcted in considerable costs, will not submit themselves to treatment. Municipalities have always borne the cost of treating infectious diseases, and I thought we had almost reached the stage of regarding cancer in the same light. I have always thought this Government stupid, but I do not think they are stupid enough to accept the Amendment which has just been moved.

6.57 p.m.

Mr. Hunter

I always understood that hon. Members opposite were strong believers in the principle that the State should carry burdens which were national and not local. This expenditure would come within that category. Therefore the hon. Member is arguing against the principle of his own party. Here is an opportunity to support the principle that the State should carry the greater burden. I cannot imagine anything more inconsistent than the attitude of the hon. Member.

6.58 p.m.

Mr. Wedderburn

This Amendment consists of two parts. The first aims at limiting the expenditure of the local authorities, and the other is designed to enforce the recovery of expenses from patients. With regard to the first part, the hon. Member for Westhoughton (Mr. Rhys Davies) has, rather surprisingly, accused our countrymen of the vice of meanness. He did not, however, contrast it with the well-known generosity of the Welsh. About that I do not know a great deal. All I can think of is a well-known nursery rhyme which suggests that the Welsh are not always so acute as they might be in perceiving the distinction between meum and tuum.

On the Second Reading, I pointed out that the total estimated expenditure for Scotland would be approximately £100,000 and that the Government grant would amount to £50,000 in Scotland, leaving £50,000 to be borne by the local authorities, and, since the total product of a penny rate in Scotland amounted to £160,000, the average burden would be less than one-third of a penny in the £. The hon. Member for Westhoughton, I think, is justified in his statement that in hardly any case is the expenditure likely, in fact, to amount to so much as a halfpenny in the £. But I do not think we could accept an Amendment of this kind, because it might frustrate the purposes of the Bill by preventing some area situated at a considerable distance from a main centre from sending patients to that centre for the purpose of diagnosis. It might be found in one area that the expense would amount to more than a halfpenny in the £, and I do not think we should be justified in depriving that area of proper facilities for the adequate treatment of cancer on account of an exceptional possibility of this kind.

With regard to the second part of the Amendment, Section 28 of the Local Government Act, 1929, enabled local authorities to recover expenses from patients if they could afford to pay them, and legal opinion has been consulted, and we are advised by our own legal advisers—and I believe that others who have consulted legal opinion have received the same advice—that that is in fact mandatory, that is to say, the local authority are bound to recover expenses for hospital treatment from patients who can afford to pay. In any case we could not accept this Amendment, because it would apply not only to hospital treatment but also to diagnosis, and it is our intention that diagnosis, in the case of the rich as well as the poor, should be given free in order to give people who have any ground for suspecting that they may be in the early stage of this disease an inducement to obtain diagnosis free at the early stage.

Mr. Hunter

I am quite satisfied with the assurance given, and I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Mr. Hunter

The other Amendment in my name—to leave out paragraph (d)—is now not necessary.