HC Deb 15 August 1940 vol 364 cc970-1011

(1) Goods purchased on the order and for the use of a voluntary hospital are not chargeable goods for the purposes of this Part of this Act.

(2) In this Section "voluntary hospital" means an institution (not being an institution which is carried on for profit or which is maintained wholly or mainly at the expense of the rates) which provides medical or surgical treatment for in-patients.—[Mr. Storey.]

Brought up, and read the First time.

4.10 p.m.

Mr. Storey (Sunderland)

I beg to move, "That the Clause be read a Second time."

After the discussion which we had last Thursday on the new Clause which I then submitted for the exemption of all hospitals from the Purchase Tax, I would not have placed this new Clause, exempting voluntary hospitals only, on the Paper if it had not been for certain remarks made by the Chancellor of the Exchequer when announcing the concession on newspapers. The Chancellor then said it was not in the national interest that there should be either a decrease in the circulation of newspapers or a diminution in their services to the public; that not only a free Press but a widely-distributed Press was a vital factor in the dissemination of information and the maintenance of public morale. He added that he had particularly in mind many local and provincial newspapers which served those interests so well and concluded that they would suffer and, with them, the public they serve. May I, on behalf of the voluntary hospitals paraphrase those remarks for the Chancellor of the Exchequer. He would then say: "It is not in the national interest that there should be either a decrease in the number of hospitals or a diminution of their services to the public. Not only a hospital system, but a widespread hospital system, is a vital factor in the treatment of sickness and the maintenance of public health." He would add that he had particularly in mind the London and provincial voluntary hospitals which serve our interests so well and he would conclude, as before, that they would suffer and with them the public they serve.

I do not intend to repeat all the arguments which I used last week but I do repeat that I cannot believe that the Chancellor of the Exchequer wishes to raise revenue out of either voluntary subscriptions given for the treatment of the sick poor, or out of the pennies and twopences and threepences subscribed weekly by working people towards the cost of treatment of the sick—which, in one hospital I know, amounts to no less than half the income of that hospital. Nor do I believe that he wishes to raise revenue out of small contributions, based on means rather than on the actual cost, from those who wish to pay something towards the cost of their treatment when sick. But that is, in effect, what the Chancellor's proposal will mean. It could only have one effect and one result—to restrict the services which voluntary hospitals render to the public. Such restriction is unthinkable, particularly in wartime, when good health is essential to the maximum national effort, but such restriction will surely follow if the Chancellor persists in his proposal. Exemption is a practical proposition for, as I pointed out last week, the Canadian hospitals have for many years been exempted from a similar tax.

Mr. Stephen (Glasgow, Camlachie)

On a point of Order. I understand that the hon. Member is Parliamentary Private Secretary to a Member of the Government. Are we to understand that he is moving this Amendment on behalf of the Government?

Mr. Speaker

That is not a point of Order.

Mr. Storey

The fact that I am Parliamentary Private Secretary to the Parliamentary Secretary to the Ministry of Health has nothing whatever to do with the voluntary hospitals, on whose behalf I am moving this Clause. Exemption is a practical proposition, because Canadian hospitals have enjoyed exemption from a similar tax for many years, and the definition of a voluntary hospital which I propose is also practical because it is one which was accepted by Parliament in the Voluntary Hospitals (Paying Patients) Act, 1936, for which I was responsible in this House. As to the cost of exemption, as near as we can estimate, allowing for the concessions which the Chancellor of the Exchequer proposes with regard to medical and surgical appliances, it would be between £400,000 and £500,000, or an addition of about 7 per cent, to their total expenditure on purchase. That is not a large sum to the Chancellor but it is an immense one to the voluntary hospitals. But it is not so much the cost in money as the cost in the services that they can render to the public against which the hospitals appeal. That service is a very real one. The voluntary hospitals system plays a very special part in the hospital and health services of the country. Not only does it play its part in providing hospital accommodation and treatment and in looking after the welfare of the sick, but it is the training school of the whole medical profession, it is the foundation of all medical research and the means of harnessing much voluntary effort and self-sacrifice to the service of the sick and needy and of the State. The Chancellor of the Exchequer is too skilled a physician to need the services of an undertaker, because he ignores those of the surgeon when an operation is essential. I hope, therefore, that he will prescribe an operation on the Purchase Tax, exempt the voluntary hospitals and prolong their life and useful service to the State.

4.18 p.m.

Captain Elliston (Blackburn)

I beg to Second the Motion.

As I supported the Amendment moved last week, I should like to say a few words in support of the appeal that my hon. Friend is making to the Chancellor of the Exchequer. Since I spoke last Thursday I have had several letters from large voluntary hospitals in various parts of the country, and in every case they have told me that their position from a financial point of view is desperately difficult. They are faced with increasing expenditure, especially in regard to milk, coal and other essential services of the hospital. If this Purchase Tax is coming on top of all their other difficulties, it is going to make their position almost desperate. I regret very much that my hon. Friend has felt it necessary to abandon the municipal hospitals. To my mind, they supply a direct public need to the health of the community and are as much deserving of support as voluntary hospitals. No doubt my hon. Friend was influenced by the fact that the Chancellor drew a distinction in his final speech the other night. The inevitable result of the imposition of this tax on hospitals which are already in financial difficulties must be the restriction of services. They will have to look round for means of economy, and it must inevitably mean that in one direction or another the treatment available will be diminished. Therefore with all the emphasis that I can command I appeal to the Chancellor to reconsider his decision and to make this concession.

4.20 p.m.

Mr. Silkin (Peckham)

If it had been possible to give exemption to both municipal and voluntary hospitals, I, for one, should be supporting the hon. Member who has moved this Clause, but in the circumstances, the Chancellor of the Exchequer having refused to accept a new Clause on those lines, I feel that it would be grossly unfair and most unfortunate that municipal hospitals should have to pay the full amount of the Purchase Tax and voluntary hospitals be exempted. As between the two, I believe the municipal hospitals are more deserving of consideration. I think they are more efficient, they open the door much more widely than the voluntary hospitals and I think they are rendering a far greater service. The Chancellor not having seen his way to exempt municipal hospitals, I think voluntary hospitals should not be given preferential treatment. The case has been made that voluntary hospitals are supported by charitable funds and are carrying out charitable work. I can make a case for scores of similar organisations which are carrying on charitable work out of private funds, and doing equally good work in other directions, and if the Chancellor were to accept this Clause I should certainly ask him to accept similar Amendments on behalf of other organisations with which I, and I think most other Members, have great sympathy. Moreover, I feel that it will be quite impracticable. It is impossible for persons selling goods to distinguish between a voluntary and a municipal hospital. The tax will have been paid already by the wholesaler. I do not see how it would be possible to give this exemption even if the right hon. Gentleman was willing to agree to it. I hope he will not accept this unless he is prepared to extend it to municipal hospitals.

4.23 p.m.

Sir Frank Sanderson (Ealing)

While I am very fully in favour of this Clause as one who takes a very keen interest in hospitals, I really cannot see how it is possible to make a case for voluntary as against municipal hospitals, and, unless my right hon. Friend can see his way to give this concession to both, I, for one, would certainly not support an Amendment for voluntary hospitals as against municipal. I understand that my right hon. Friend is unable to give way in regard to municipal hospitals. If we have to accept that—and I think we have—I do not think it is expedient or wise that this Clause for voluntary hospitals only should be proceeded with, and I hope my hon. Friend opposite will see his way to withdraw it.

4.24 p.m.

Mr. David Adams (Consett)

I support the appeal which has been made to the Chancellor of the Exchequer to include the municipal hospitals together with the voluntary, otherwise it would not be equitable that this distinction should be made. In this Clause we are seeing one of the evils of the Purchase Tax. To increase the burden upon hospitals is contrary to the public interest, and the Purchase Tax does that. The argument which has been advanced in favour of voluntary hospitals in practice is unsound. Voluntary hospitals are in no way superior and, in the main, throughout the country they are inferior in the services which they render to the community. Local authorities are increasing their services, their clinics are being modernised, and the last word in consultations are being made available to the general public. The argument that the great training schools are to be found in the voluntary and not in the municipal hospitals does not bear examination. The estimate of £500,000 as the additional burden thrown on voluntary hospitals by the tax is, I believe, a very low one. I think if the war continues it will be multiplied. If we add to that the burden which will be thrown upon the municipal hospitals, the tax will be likely to have a tendency to cause those who can avoid using them to do so. I think the Chancellor really ought seriously to consider this in the national interest. The last time in the history of a country to add burdens to remedial institutions must be in time of war.

4.28 p.m.

Dr. Edith Summerskill (Fulham, West)

I fully appreciate that the hon. Member realises how difficult it will be in the future for voluntary hospitals to make both ends meet, but surely he does not think that, if they are excluded from the Purchase Tax next year and the year after, we shall find these large voluntary hospitals in a nourishing condition. For years they have found it very difficult to exist at all. To exclude them from the Purchase Tax might help them a little, but it would only be a drop in the ocean. I can see the time next year when all our pockets will be so very empty that the number of people who are able to make contributions to the voluntary hospitals will be very limited. I would suggest to the hon. Member that he should devote his efforts to something much more constructive, namely to merge the voluntary hospitals with the municipal system.

Mr. Storey

If that is the hon. Lady's view, why did she not support my Clause last week, which would have helped that merger, which I desire as much as she does?

Dr. Summerskill

I would have supported it, but I did not know the hon. Member was moving it.

4.29 p.m.

The Chancellor of the Exchequer (Sir Kingsley Wood)

I think I need not devote much time to my reply, not because I am not desirous of helping the voluntary hospitals if possible but because we debated the matter at considerable length, in principle at least, the other day. The House supported me on that occasion, though I recognised the force of the arguments then put forward. This Clause would give a concession to voluntary hospitals only. I think it is self-evident that that should not be done. Clearly such a concession would not be fair to municipal hospitals. In fact, if we included municipal and voluntary hospitals you would have to include also a variety of similar organisations, equally deserving of help, which we all desire to assist. Therefore, for practical reasons, I am unable to accept the new Clause. I ask the House to realise what we have done, so far as this tax is concerned, for hospitals, both municipal and voluntary, and other similar institutions. X-ray apparatus, special hollowware, surgical instruments, anaesthetics, the more expensive drugs and surgical bandages have been made free for the purposes of hospitals and other institutions. The goods to be taxed, as far as the hospitals generally are concerned, represent some 7 per cent, of their expenditure. While I insist upon a contribution being made from hospitals and institutions, for reasons of principle and administrative difficulties, I feel that the tax will not place an undue burden upon them, and certainly will not play any part in the ultimate fate of the voluntary hospitals, one way or the other. I hope to see the voluntary hospitals continue in their splendid traditions and position, but it would be going to extremes to say that this tax will affect the position one way or the other. I hope that my hon. Friend will not press the new Clause.

Question, "That the Clause be read a Second time," put, and negatived.