§ (1) At any time after a Regional Hospital Board has been constituted the governing body of any voluntary hospital in the area of that Board may represent to the Board that it is unable to maintain the existing services of that hospital out of its income without financial assistance and the Board, after such inquiry as it thinks necessary, shall determine whether such financial assistance is required, and shall pay to the governing body such sums, if any, as it shall find to be necessary for the said purpose.
§ (2) If any Regional Hospital Board is satisfied that the services rendered by any hospital ought immediately to be expanded or developed, the Board may make such payment as it may think fit to the governing body or local authority concerned subject to 'such conditions as it may determine.—[Commander Maitland.]
§ Brought up, and read the First time.
§ Commander Maitland (Horncastle)I beg to move, "That the Clause be read a Second time."
This Clause is simple. Its object is to assist voluntary hospitals during the difficult time through which they will go after the passing of the Act, and before the appointed day. In commending the Clause to the Committee, I would point out that the time is now drawing closer when the Bill will become an Act of Parliament. We shall have to forget all our past arguments, and our strenuous efforts to make the Bill a better one. We shall have to put everything we have into extracting the last ounce of benefit from the Bill for the patient. I ask the Committee to approach this Clause in no partisan spirit, but to regard it merely as a bridge to carry us over the very difficult period ahead.
I well remember when I was serving my apprenticeship in local government, being very irritated by Members of Parliament when new Acts were passed. It seemed to me most unfair of them to take all the credit for the work they had done and the tremendous effort they had made, when I found the clerk, the surveyor, and myself with wet towels round our heads trying to put the new Act into practice and effect in the district where we had to administer it. It is for this reason that I am most anxious to try to see that the people who are destined to make this Bill a reality shall, when they take over, find a healthy organisation, eager for change, and not a starved and listless organisation which has suffered more in its last 18 months 1711 than probably at any other time during its career.
The subject which this Clause covers has been raised from time to time during the proceedings on the Bill. It was raised during the Second Reading by the hon. Member for Huntingdon (Mr. D. Renton) and myself, and by many other Members. It was raised in the Standing Committee, as the hon. Member for Nuneaton (Mr. Bowles) will remember, in order and out of order, whenever we could. If I may say so without any offence to the Minister, I personally regard him as a tiger, and I may say that I admire him and like him for that attitude. But it is curious that whenever we managed to bring the tiger to the water, we were absolutely unable to make him drink. He changed, and I say this without any offence, from a tiger into a barnyard hen. All he did was to cluck at us that there were difficulties in the way, that there were practical difficulties, and that he hoped the voluntary organisations would go on. If a Minister is not there to solve practical difficulties I cannot quite understand why he is there. Therefore, this Clause has been put down to make it clear that we seek to place in the hands of the Minister the power, and on his shoulders the responsibility, to ensure that where he is satisfied that the need exists, no hospital shall be prevented, by lack of finance, from maintaining its efficiency or making steady progress.
In the Committee we on this side, and I think also Members on the other side, asked for powers to be delegated to organisations or committees closer to the patients themselves. On every occasion, the Minister, possibly rightly, resisted that. His argument was always the same. He maintained that as his was the responsibility so the power should rest in his hands. That is quite a good argument, but I think that the reverse is also true, and that where the power rests it is important that the responsibility should rest also. That is the object we have in bringing this Clause forward. We were also told, and here I heartily agree, that we must consider the interests of the patient as paramount throughout. It is inevitable that any great national Measure of this sort must uproot and upset the existing organisation. It must, in fact, create uncertainty in the minds of the committees who have to manage the hospitals and it 1712 is, of course, on the efficient management of the hospitals that the comfort of the patient ultimately depends. Uncertainty is often the father of inefficiency, and by this Clause we seek to remove, as far as the financial aspect is concerned, the uncertainty which undoubtedly exists in the minds of those who are responsible for managing voluntary hospitals today.
4.45 P.m.
In conclusion, I would say that I am perfectly certain that it always pays to tell the British people exactly where they stand. If the Minister finds himself able, as I hope he will, to accept this Clause, I do not think that there will be any falling off of subscriptions or assistance from voluntary sources in the interim period, but rather the reverse. I think that when the committees know exactly where they are, they will set to and keep themselves going in a far more efficient way than they would if they were left in any doubt. That will mean that they will be able to turn over their endowments, in due course, with the capital untouched, not frittered away in day to day expenses. That is something which we all very much desire. What a tragic thing it would be if, after all the work that we in the House and in Committee have done on this Bill, the first effects were to be that the hospital services available for the sick people of this country suffered. That would be terrible. It would be almost as bad if they stood still, if they marked time, because service to the sick must proceed on an ever advancing scale. We cannot afford in this year of grace to stand still. We have to go ahead. We want to see benefits derived immediately from the great scientific discoveries which are perhaps the only beneficial effect of a great war. I suggest that we cannot allow to go out from Parliament a Measure which might hold still the hospital services of this country. I, therefore, commend this new Clause to the Committee with some confidence.
§ Sir P. HannonIt seems to me that the appeal made by my hon. and gallant Friend the Member for Horncastie (Commander Maitland) to the Minister is irresistible. I had not the privilege to be a Member of the Standing Committee, and I would be very glad to know what the Minister has done, what machinery he proposes to establish, to maintain these hospitals in full efficiency in the conduct of their affairs, especially in the interests 1713 of the poor, in the interim period. The plea of my hon. and gallant Friend is based on common sense, and I feel that the Minister ought to provide machinery by which the voluntary hospitals would he protected against the financial misfortunes that might attach to them
§ Mr. BevanAs has been mentioned, this principle was discussed in the Standing Committee, and I am afraid that I can give no other reply today than that which I then gave. I, myself, share the anxieties and desires of those who have put down this Clause, but I am convinced that in moving it, they have done a disservice to their own desires. It is true that in the meantime, between now and the taking over of the hospitals, there is a period—not of uncertainty. There is, obviously, a period of certainty, because hospitals are to be taken over from a certain date. But as the hospitals will become a State charge from that date, it will be rather more difficult than before to collect voluntary contributions. But so far from that leading to a diminution of activity in collecting voluntary contributions. there should be increased exertions, because to the extent that the voluntary hospitals fail to obtain money to carry on in the meantime, they will have less free money at their disposal when the new scheme is established. Therefore, I have previously made, and I again make an appeal to everybody concerned with voluntary hospitals, to maintain their interest and their contributions towards the voluntary hospitals in the meantime.
§ Commander MaitlandThe right hon. Gentleman said that we had done a disservice. May I ask him to define exactly what it is?
§ Mr. BevanI was about to do so. The committees of voluntary hospitals are not at the moment appointed under any of the principles of the National Health scheme. They are, in many respects, self-appointed persons. What does the hon. and gallant Member suggest here? Does he suggest that I should give a blank cheque to self-appointed people?
§ Commander MaitlandNo.
§ Mr. BevanThese bodies which are voluntary, self-governing bodies should maintain their exertions in the intervening period. If, owing to exceptional circumstances, they find it impossible to carry on 1714 with the activities of the hospital, they should come to me, but in the meantime they should do their best to carry on.
§ Commander MaitlandIs the Minister accepting the new Clause?
§ Mr. BevanNo, I am not. It does not even satisfy the purpose the hon. and gallant Member has in mind. He talks about the Regional Hospital Boards. The Regional Hospital Boards are not the bodies to deal with the difficulties of hospitals during the intervening period. The person to deal with those difficulties is the Minister and not the Board. In fact, they will have their difficulties. I would not want to put this additional task upon them. I am certain that all that would happen would be that hospital authorities would become financially irresponsible. I am astonished at hon. Members opposite. If a hospital management committee, by not exerting itself in its customary way, found itself falling heavily into arrears and unable to obtain credit, and knew very well it could go to the Minister or to the Regional Hospital Board and obtain money, then at once we would have the beginning of slackness and irresponsibility among the voluntary hospital authorities. It is no good an hon. Member saying, "Oh, no;" because in fact one of the cardinal principles of this House——
§ Mr. Sidney Marshall (Sutton and Cheam) rose——
§ Mr. BevanPermit me to finish. I could not possibly accept the view that I must pump out public money to any hospital which finds itself, under any circumstances, in financial difficulties. Hon. Members are now reversing the argument we have heard before. In the past they have extolled the virtues of the voluntary hospital system and the advantages of private generosity. Now they are asking us to take over financial responsibility for the voluntary hospitals before we have taken over the management of the voluntary hospitals. That is a situation which I cannot possibly accept. I assure hon. Members opposite that from my information, the voluntary hospital organisations are dismayed by this Clause. They hold the view that it is most unfortunate, because it would have the effect at once of slackening the efforts of the organisations concerned with obtaining funds for voluntary hospitals. I am convinced that those who are in charge 1715 of voluntary hospitals are so dedicated to the work that they have in hand that they will do their very utmost to carry on the hospitals under their management. Where they find themselves in such difficulties that the services cannot be maintained, then they must come to me for assistance.
§ Lieut.-Colonel Dower (Penrith and Cockermouth)I do not think the Minister can deny that the result of this Bill will be to make it infinitely more difficult to raise funds for voluntary hospitals. I happened to be in Brighton when people were trying to raise funds for the local hospital. Time after time the ladies who had the collecting boxes were asked, "What is to happen to these funds? Are these funds to be taken by the Minister, or are they going to go to the voluntary hospitals?" I am merely pointing out that the right hon. Gentleman has created a great deal of disturbance in the minds of those people who used to contribute to these causes, and he will make it much more difficult for them to raise anything like the same amount of money which they could raise before. I feel that this is a reasonable request and that the right hon. Gentleman should contribute at any rate the amount of extra effort required because of his own proposals which interfere with the voluntary hospitals. I think he should make good that extra amount of energy required. The voluntary hospitals have always worked extremely hard. I cannot see either that it is reasonable to ask them to work harder, because they have worked very hard, or that it is reasonable for the right hon. Gentleman to wash his hands of the extra burden which he has placed upon the people who have raised funds in the past. He should give an undertaking that he will make good the extra energy which will be required to raise funds.
§ Sir Henry Morris-Jones (Denbigh)The right hon. Gentleman in the latter part of his speech said he would deal sympathetically with hospitals which might be in distress. He is taking over a large number of hospitals which are in a very flourishing condition, though there are some hospitals which are not so healthy. The right hon. Gentleman has said that in the case of those which may be in a bad way, if they come to him he will consider their requests. Is there any provision in this 1716 Bill by which ha can do that? If there is no provision——
§ Sir H. Morris-JonesIf the right hon. Gentleman assures me on that point, though I consider the new Clause is reasonable, his assurance goes some way towards satisfying me.
§ 5.0 p.m.
§ Sir Hugh Lucas-Tooth (Hendon, South)I wish to follow up the question asked by the hon. Member for Denbigh (Sir H. Morris-Jones). I would like to know whether the Minister has power now to make a payment to the governing body of the hospital which is in need during the interregnum period. The sort of case I have in mind is that of a teaching hospital which urgently required to spend substantial sums of money on repairing and perhaps adding to its buildings. These sums of money, in the ordinary way, could easily have been found by means of a special scheme for that special purpose, but, at the present time, quite obviously, it is impossible to get funds for an addition to or extension of a hospital when the public know that, in a very few months, the buildings will be transferred and will become completely the responsibility of the Minister. I think the right hon. Gentleman would agree that it would be quite useless to start an appeal in those circumstances. The only other way in which the hospital can supply the necessary funds is by dipping into the capital of its endowments. The governors of a hospital are thus placed in a very awkward dilemma. If they take the money out of the endowments and spend it on the hospital, they will reduce their endowments by that amount when the scheme comes into operation. They will be taking money which will be their own property, and spending it on property which, in a month or two will become the property of the Minister. [HON. MEMBER: "Why not?"] I submit that no board of governors ought to be placed in that position. They will say to themselves, "Having regard to the present level of prices, the difficulty of getting things done, and, finally, to the fact that we shall be spending this money in this way and will thereby lose it altogether, the answer must be that we will not spend the money."
§ Mr. BevanWhat do I understand the hon. Member to mean? He is a mem- 1717 ber of a governing body. Do I understand him to say that, if a hospital required to have money spent upon it, in order to maintain the services at a proper level, they would not spend the money?
§ Sir H. Lucas-ToothNo, I did not say that. I said that if money was required to be spent urgently for adding to or improving the buildings of a hospital—quite a different matter—the fact that this money would have to come out of the ultimate capital of the hospital would weigh very heavily in the minds of the governors.
§ Mr. BevanIf the building was urgently required, the board of governors responsible to the patients of the hospital would very seriously consider whether they should use money given for that purpose, which is exactly what it is given for?
§ Sir H. Lucas-ToothI think it is within the knowledge of the Committee that practically every hospital in this country requires buildings and things of that sort to be provided urgently. The choice before the governors is, therefore, whether they should spend their funds on the building, or on the current purposes of the hospital. It may be, as a matter of policy, that the money ought to be spent on buildings as soon as possible, but there is urgent need in both directions. It is a choice which the governors have to make in their discretion, and all I am saying is that, if the right hon. Gentleman is going to throw into that difficult choice, the further question that, if they spend this money, it will be lost to the capital of the hospital, I am sure most governors, in that difficulty, will come to the conclusion that they ought to keep the capital meanwhile.
§ Sir H. Lucas-ToothWhat we are asking is whether, in a case of that kind, the right hon. Gentleman has power to come forward in cases of need, and, if satisfied that the need 15 sufficient, to assist the governors to do the necessary work.
§ Mr. EcclesThe Minister admits that the coming into force of this Bill must decrease voluntary subscriptions. The right. hon. Gentleman has told us so in Committee, and he has said so again today. I take the view that no manage- 1718 ment committee of any voluntary hospital should lower its standards even if its income is not up to the usual level in the next couple of years. It will, therefore, either have to spend its endowments, and here I disagree with my hon. Friend who has just spoken, or the hospital will, as in the past, have to incur an overdraft at the bank. The result is that, if the Minister does not accept this new Clause, he is deliberately taking action which will reduce the total of the assets of the hospitals when they are finally taken over. The Minister may say, "I do not mind doing that; I am not particularly interested in their having this pin-money when the State system comes in." I believe that to be the view of the right hon. Gentleman, but what he has no right to do is to tell this House that it is against Parliamentary principles that money should be given out to defray exceptional expenses pending the taking-over of the hospitals by the State.
If the right hon. Gentleman looks at the Coal Industry Nationalisation Act, Sections 17 and 18, he will find that they give the Minister of Fuel and Power an obligation to make good to the collieries their increased expenses while waiting to be taken over, not only on income account but on capital account. If the Government are so interested in getting coal that they are willing to recompense colliery companies in the next two years, are they not equally interested in the running of the hospitals in the same period? They make a distinction in the case of the hospitals because there is this cushion of endowments, which they do not mind seeing dissipated in the next two years. I support the new Clause because I want to see the largest aggregate sum at the disposal of the voluntary hospital management committees and the regional boards after the State service comes in. I think there are many things, research and others, which will be more likely to be well done if that money is available to the management committees. The Minister, in resisting the new Clause, is quite clearly taking action to cut down the potentially good effects of the spending of these endowments once the State system has been brought into effect.
§ Mr. Hopkin Morris (Carmarthen)I feel that the arguments on the new Clause have gone rather wide. The object, as I understand it, is to help the hospitals in the intervening period between now and 1719 the taking over by the State, and the object of the new Clause is to make provision for cases when hospitals get into difficulties. With that object, I understand, the right hon. Gentleman is in full sympathy, but he says that the new Clause will not attain it. The right hon. Gentleman must, however, realise the difficulty in which the hospitals will be placed, because despite all the efforts on the part of the voluntary hospitals in the intervening period, there is a real danger that they will not be able to collect the necessary funds. The right hon. Gentleman made an appeal in Committee and has repeated it today, that the whole object this new Clause will be met by the regulations he will make, but I think that there is a real danger that a voluntary hospital will not be able to discharge its functions because of a lack of finance.
What is to happen in those circumstances? The new Clause suggests that the way to meet that situation is to allow the hospital management committees to make their appeal to the Regional Board. The Minister says that is not the way to do it, and that they must make their appeal to him. I agree with the point put by the hon. Member for Denbigh (Sir H. Morris-Jones) when he asked what provision there was in the Bill for such an appeal to the Minister and what powers the Minister has to devote money to meet the necessities of hospitals in those circumstances. If the right hon. Gentleman has such a power, it would appear to me that the object of the new Clause is really met.
§ Mr. BevanMight I answer that question at once? This issue has been discussed on several occasions, and I do not think further Debate will expose the argument any further, as the hon. and learned Member for Carmarthen (Mr. Hopkin Morris) has made it even clearer still. The fact is that the new Clause would not, of itself, accomplish the purpose which hon. Members have in mind, because voluntary hospitals can get into difficulties before the regional boards have been set up. One would therefore suppose——
§ Several Hon. Members rose——
§ Mr. BevanI think I can make the position clear if I am permitted to make a full statement. If I had no power to 1720 assist a hospital, the new Clause would not assist that particular hospital. I am. informed, however, that I have power, and the county has power, to assist a hospital which gets into particular difficulties. Hon. Members ought not to press this matter too far; they should be as anxious as I am to try and foster the enthusiasm and the activities of voluntary hospitals in the intervening period because, as the hon. Member for Chippenham (Mr. Eccles) has indicated to the extent that they do that they will have more money at their disposal when the new scheme starts. I should have thought that it would have been common ground in all parts of the Committee that what the House of Commons cannot do is to give a blank cheque, because that would be the effect of the proposed new Clause. I want to tell hon. Members that I will not do that.
The hon. Member for South Hendon (Sir H. Lucas-Tooth) made a speech which, if I may say so with respect, disclosed a state of mind which filled me with alarm. [An HON. MEMBER: "And despondency,"] It would have done so if I thought that his view would prevail, but I am satisfied that it will not. He suggested that the management committee of a teaching hospital, having at its disposal endowments given for the maintenance of the hospital, would not use them in the meantime for urgent building if they thought that the using of those endowments would reduce the capital at their disposal when the new scheme came into operation.
§ Sir H. Lucas-ToothI was not suggesting that a management committee would not use such endowments; I suggested that they would not spend the capital of those endowments, or, rather, would tend not to do so, if there were a choice between spending capital on development and spending income.
§ Mr. BevanThe hon. Member for South Hendon and other hon. Members opposite are now making the Government's generosity a cause of complaint against the Government. Actually, there would have been nothing wrong in my taking all the endowments and using them for hospital purposes because that is what they were provided for. Hon. Members opposite are now complaining that, in the intervening period, management committees might be asked to use the money for 1721 the reasons for which it was given. Never in the whole history of Parliament have I heard such absurdity. This matter has been thoroughly discussed, and the issues are perfectly clear. We want to get on, but I want hon. Members opposite to cooperate with me in this.
I am informed by persons responsible for the collection of funds for the voluntary hospitals that they would deprecate any decision taken by Parliament which might influence those subscribing in believing that it was no longer necessary to make their subscriptions because the State would automatically come to the hospitals' rescue. I thought I had dealt with the situation, as far as it was expedient to do so, in appealing to voluntary hospitals to try and maintain themselves at the maximum efficiency and in appealing to people to continue to make their contributions. We on this side of the Committee know that working class organisations will continue their subscriptions to voluntary hospitals. I am bound to say that the bulk of subscriptions does not come from rich people, but from the working classes. Hon. Members opposite are really suggesting that poor people have lower standards of generosity than the well-to-do, and that they will not maintain their contributions. The fact is that they will. The people who will not make their contributions will be the well-to-do who will say, "No, we are not going to contribute because the voluntary hospitals are going to be taken over by the State."
My last word on the subject is that, where a voluntary hospital gets into difficulty and the efficiency of its service is likely to be impaired by financial conditions over which it has no control, it can then come to me for assistance. [An HON. MEMBER: HOW can they?"] They should come in the ordinary way; the postal service still exists. If that is done, the circumstances of the particular case will be taken into account, but no general promise can be given.
§ 5.15 p.m.
§ Mr. J. S. C. ReidI have seldom heard the right hon. Gentleman quite so far below form as he has just been. I strongly suspect that his argument is not his own, but a Treasury argument. I suspect that because he will not tell us, although he was pressed upstairs and again today, what his powers are 1722 to help these hospitals. The right hon. Gentleman cannot pay money to hospitals during the next two years without some statutory authority, and yet he will not tell us what that statutory authority is, and nobody on this side of the Committee knows what it is. He was warned upstairs about this. One could forgive him then, although only with difficulty, for not having the exact statutory power in front of him because one would think that those who advised the Committee would certainly have had at their finger ends what those statutory powers were.
If there are such statutory powers, it is astonishing that the right hon. Gentleman has not asked, or has not been told, what they are. To ask the Committee simply to accept the vague assurance, "Come to me, and I will see you out of your trouble" is to treat it in a way in which it ought not to be treated. It is as if the right hon. Gentleman had a bottomless purse from which he could disburse money without any statutory authority at all. Therefore, we must press the right hon. Gentleman to tell us what the powers are as, otherwise, we cannot rest assured with his bare statement that he has certain powers. As I have said, we do not know what those powers are, and we will not rest content until we do.
I hope that when I sit down the right hon. Gentleman will get up and clear up this matter, which he could easily do if he wished. If it turns out that the powers which he is mentioning are so limited as to be useless, then, I am afraid, he is not being frank with the Committee, but if he has powers which are useful, then I can see no reason for his concealment of them. I do not wish to go over the details of this matter again because it has been covered from various angles by my hon. Friends, but I do not think that it has been sufficiently stressed that a number of hospitals—at least, hospitals with which I am acquainted—are hound under their trust deeds to hold the capital as capital and are not entitled to spend it. Indeed, I know of hospitals which are rapidly exhausting, if they have not already exhausted, that part of their endowments which they have legal power to spend. The right hon. Gentleman has not told us what his attitude is to be towards a hospital which says, "It is true that we have£50,000 of endowments, but the trust 1723 deed forbids us to spend that money, and only entitles us to use the income.''' Does the right hon. Gentleman suggest that the governing body of such a hospital should break the law and spend that money in a way for which they can be held personally accountable if they do so spend it?
I can see the right hon. Gentleman's point of view that hospitals which have money which they are free to spend in any way they like are in a position to use that money to carry them over the next two years. But what about the hospitals which do not have enough money which they are free to spend? The right hon. Gentleman has made great play of his generosity and farsightedness in not taking the endowments into the Treasury, but in allowing them to be used by hospitals as a "cushion" or as pin money or pocket money. If he says, "I have so little interest in preserving that 30 million that I do not care a bit if a lot of it is spent before 1948," we are inclined to suspect a little the value which he attaches to this "cushion" when the time comes, because when it is spread over all the beds it spreads out pretty thin, and if it is to be of any value at all, any further substantial diminution is most serious.
I would have thought that the right hon. Gentleman would have realised that once this Bill becomes an Act it will have been established that the hospitals are the responsibility of the State. That is the purpose of this Bill. The only reason why they are not taken over immediately by the State is administrative difficulties. Immediately Parliament has pronounced that this is the responsibility of the State, the right hon. Gentleman is under an obligation to see that that responsibility is met. He cannot say, "Because it does not please me to take over these hospitals until 1st April, 1948, I wash my hands of them and I expect those people who are at present in charge to work miracles and keep them going without any money." I think the right hon. Gentleman is being a little unreasonable about this. With regard to his point that the new Clause will not work, I say that it will work. The right hon. Gentleman has stated that the first thing he will do when this Bill becomes law is to appoint the Regional Boards. I assume he means that they are to be appointed within a few weeks.
§ Mr. ReidIt means that the right hon. Gentleman is not getting on with the job as quickly as he ought to. Perhaps he will listen to what I have to say. Of course, before a Bill of this sort becomes law there are informal consultations with all manner of people as to how the machinery will work. I would have thought that the right hon. Gentleman was neglecting his duties if he was not pursuing those consultations. If he pursued those consultations I would have thought that it would be a matter of weeks rather than months before these boards were set up. But if not, he cannot make 1st April, 1948, the appointed day. That date will have to be postponed unless these bodies get busy quickly—unless, of course, they are to be a mere camouflage and the whole thing is to be done in Whitehall. I do not think that is the right hon. Gentleman's intention, however. If they are to do the work the right hon. Gentleman must see, as he has promised to see, that they are set up promptly. The first thing they will have to do will be to survey the hospitals in their respective areas. Therefore, it seems to us extremely appropriate that they should be the bodies to advise the Minister as to the real needs of these hospitals.
For that reason, it seems to me that the new Clause is a perfectly good one. However, we are quite willing to listen to the Minister if he will tell us, not only of his good intentions, but also of his powers and precisely what it is he is empowered to do. Then we shall know what we can charge him with failing to do if he does not do it. But we cannot rest on the mere assurance, "If you come to me everything will be all right." I cannot imagine why the Minister should be so inclined to conceal his powers in this matter, and I ask him once more to tell us frankly what the position is.
§ Sir E. Graham-LittleI want to put the case of the teaching hospitals, from the point of view of their financial difficulties. There are 12 of these hospitals in London, and more than six of them have been so seriously damaged that they are quite incompetent to carry on. After the last 1725 war in similar circumstances, although not nearly so serious, a special committee was set up for reporting upon what had been done to the teaching hospitals. A very large sum was allocated for the special purpose of restoring the buildings which had been damaged. I would like to know what can be done in a similar way to aid the teaching hospitals. If the right hon. Gentleman says that they must use their endowments for that purpose, I would point out that those endowments are not nearly sufficient to meet this need. There must be a capital sum contributed by the Exchequer; there can be no other way.
§ Mr. GallacherI would like to say a few words arising out the remarks of the right hon. and learned Gentleman the Member for Hillhead (Mr. J. S. C. Reid). He said that the Minister was not going fast enough. That is a peculiar remark, coming from the other side of the Committee. Endowments were made by people who were interested in the health of the people, because the Tories were doing nothing whatever for the health of the people. Nothing was done; there was complete neglect. I am certain that the executors of any of these endowments would readily agree, in view of the services that are now being given to the people, that these endowments should be liquidated. The hon. and gallant Gentleman the Member for Penrith and Cockermouth (Lieut.-Colonel Dower) asked the Minister if he was going to loot these funds.
§ Lieut.-Colonel DowerI never used the word "loot." I said that the public wanted to know whether they were subscribing to the voluntary hospitals, or whether they were giving money which the Minister was going to take—not loot.
§ Mr. GallacherThe hon. Gentleman is confusing the Minister with the Leader of the Opposition.
§ Mr. David Renton (Huntingdon)We have a very simple point before us. It is a question of whether, when the Minister takes over the hospitals on All Fools' Day, 1948, the hospitals are going to be a damnosa haereditas, or as good a going concern as possible. With a view to trying to get this point elucidated when the Money Resolution was being discussed by the House, I asked the Minister 1726 not once, but twice, what powers he had in this matter. I got as plain as answer as possible, that the Minister had no powers and that, therefore, it was essential that voluntary contributions should be continued meanwhile. May I quote the right hon. Gentleman's words?
I am glad that I have had the opportunity to make the matter public in this way. I certainly will take advantage of other opportunities to make it clear to the public that hospital services would gravely deteriorate unless contributions are maintained in the meantime and the whole machinery kept up to date."—[OFFICIAL REPORT, 2nd May, 1946; Vol. 422, C. 448.]We know that in Committee the matter was raised again, and it has been raised yet again today. I am sure that the Committee would be greatly reassured about this whole matter if the right hon. Gentleman could tell us whether the publicity officer of his Department or any agent of the Government has done what is clearly necessary, to impress upon the public the great need far continuing these contributions. We have to be realistic. The Minister has been remarkably realistic in his attitude towards the medical profession, and it is a little disappointing to find him less realistic in. this matter. In default of the necessary voluntary contributions, surely this proposed new Clause, which has been put forward in such a conciliatory manner by my hon. and gallant Friend the Member for Horn-castle (Commander Maitland), offers a constructive suggestion. For that reason my hon. Friend and myself desire to support the proposed new Clause.
§ 5.30 p.m.
§ Mr. Lipson (Cheltenham)I ask the Minister this question: Why is there no danger to the administration of the hospitals if any deficiency is made up by him? His argument just now was that if the money came from the Regional Boards, and if the hospital management committees knew that any deficiency could be made good by the Regional Boards, there would be laxity of administration. Yet, if they are in financial difficulties, he says, "Come to me." Why should the fact that they can have their deficiencies made good by coming to him——
§ Mr. LipsonIn the proposed new Clause it is made perfectly clear that the Regional Boards should only make good any deficit after inquiry. Therefore, I cannot understand why the Minister should be so insistent in his opposition to this proposed new Clause. In point of fact, during the interim period it is doubtful if any hospitals would be able to live within their income if they tried, or to maintain their services and develop them where they ought to be developed. There will be a deficiency on all counts. The alternative is, they could make up that deficit either by getting an overdraft or by getting help through the Regional Boards or the Minister. Why he should object to it being made up by the Regional Boards I fail to see
§ Mr. BevanMay I respectfully suggest to the hon. Members who have moved this proposed new Clause that, if they wish to insist upon a Division we might have it now? The issues have been fully exposed. We are now having arguments repeated. There are a number of very important matters which we want to discuss later on, and I think we might now submit the matter to the decision of the Committee.
§ Mr. Willink (Croydon, North)Do I understand that the Minister is finally refusing to disclose what are the powers to which he has referred?
§ Mr. BevanThe right hon. and learned Gentleman knows very well that there are a variety of powers under which it is possible to do this. [HON. MEMBERS: "What are they?"] I can assure hon. Members that I am advised there is no difficulty about providing money for hospitals which get themselves into admitted financial difficulty because of circumstances over which they have no control. I think that on reflection afterwards, hon. Members will find that they are doing a great disservice indeed to the voluntary hospitals.
§ Mr. WillinkI make one more appeal to the Minister. Our attitude on this may depend very largely on whether we are satisfied the Minister has these powers. I ask the Minister to consider this in the interests of the Committee and the hospitals as a whole. We follow his argument that their efforts must not be discouraged, but we do desire to be satisfied that the 1728 Minister has these powers. If he has them, will he not tell the Committee what some of them are?
§ Several hon. Members rose——
§ The Deputy-Chairman (Mr. Hubert Beaumont)I am hoping that the Committee will be ready to come to a decision soon.
§ Mr. Henry Strauss (Combined English Universities)I thank the attitude that the Minister is now adopting is quite unparalleled in the memories of hon. Members of this Committee. Recently we have all known that the Government have refused to disclose figures on various grounds, which may or may not be sound. I have never before known a Minister, when repeatedly challenged, at all stages of a Bill, to state the statutory authority on which he bases his powers—which the right hon. Gentleman now asserts he has —refuse to give that information to any quarter of the Committee which has asked for it. How can we judge the merits of his objections to this proposed new Clause unless he discloses his powers and the limitations that may govern them? Why should he wish to conceal this from the Committee? Why should hon. Members opposite, with the striking exception of the Communist Party, desire that concealment to take place? Is there any reason why we should not know what the powers are on which the Minister relies? There are three Ministers sitting on the Government Front Bench. Surely they can give utterance to some other statement than moving the Closure. The right hon. Gentleman says he wants to get on with this Bill. So do we. We do not desire, unless necessary, to sit all night. We should like to come to a decision on this at once, but it is the Minister himself who is delaying it. When he made his speech a few moments ago he said that that was the last word he would say. He made quite a long speech, but the only thing he omitted was mention of the statutory powers which he says he has. After listening to the speech of the Minister I begin to think he bases himself on a motto which may or may not be the name of a new revue, "Louder and Sillier."
§ Mr. Boyd-Carpenter (Kingston-upon-Thames)The right hon. Gentleman might have taken exception to being asked to quote his powers if he had been taken by surprise on this matter. However, nobody knows better than the right hon. Gentleman that this point has been raised again and again, and he has been given ample warning that he would be asked to quote the authority which he now purports to possess. This afternoon the attitude of the right hon. Gentleman, in making a flat assertion that he has these powers, without condescending to tell the Committee how he has them, is the more curious'when one recollects what the right hon. Gentleman himself told the Committee on 27th June. When he was asked the same question on that occasion the right hon. Gentleman said:
Speaking without examining the matter properly, it appears that, at the moment, I have not got the powers. Powers to provide money under the Emergency Medical Service are restricted to certain purposes. However, I will have a look at the matter further, because I agree that a depletion of a hospital's finances may have a very serious effect upon it, and I will certainly see what interim action can be taken."—[OFFICIAL REPORT, STANDING COMMITTEE C; Thursday, 27th June, 1946; c. 865.]
§ In the light of that, the Committee is faced with this dilemma. Either the right hon. Gentleman did not carry out his pledge to look into the matter further, in which case his assurance to the Committee on 27th June was worthless, or he did carry it out and, as a result of looking into it further, cannot quote one scrap of evidence.
§ Mr. PickthornIt seems plain that the question which is being put is about a matter of fact. I hope the Committee would agree with that. Secondly, it seems plain that the question which is being put is relevant to the matter under discussion. Thirdly, the only reason why the question of fact relevant to the discussion is not being answered is because of the Minister's unwillingness to answer it. I ask hon. Members on all sides of the Committee to consider whether, if I am right in those three points, it really could be proper or decent for anyone who is in the position of being wrong in a discussion to let it come to an end, or for any hon. Member to move the Closure.
§ Question put, "That the Clause be read a Second time."
§ The Committee divided: Ayes,107; Noes, 228.
1731| Division No. 261. | AYES. | [5.40 p.m. |
| Amory, D. Heathcoat | Hogg, Hon. Q. | Peake, Rt. Hon. O. |
| Assheton, Rt. Hon. R. | Holmes, Sir J. Stanley (Harwich) | Peto, Brig. C. H. M. |
| Beamish, Maj. T. V. H. | Howard, Hon. A. | Pickthorn, K. |
| Beechman, N. A. | Hurd, A. | Ponsonby, Col C. E. |
| Boothby, R. | Hutchison, Lt.-Cm. Clark (E'b'rgh W.) | Prescott, Stanley |
| Bower, N. | Jeffreys, General Sir G. | Ramsay, Maj. S. |
| Boyd-Carpenter, J. A. | Keeling, E. H. | Rayner, Brig. R. |
| Braithwaite, Lt. Comdr. J. G. | Kerr, Sir J. Graham | Reid, Rt. Hon. J. S. C. (Hillhead) |
| Bromley-Davenport, Lt.-Col. W | Lambert, Hon. G. | Renton, D. |
| Buchan-Hepburn, P, G. T. | Lancaster, Col. C. G. | Roberts, Maj. P. G. (Ecclesall) |
| Carson, E. | Legge-Bourke, Maj. E. A. H. | Ross, Sir R. |
| Challen, C. | Lennox-Boyd, A. T. | Sanderson, Sir F. |
| Clarke, Col. R. S. | Linstead, H. N. | Savory, Prof. D. L. |
| Clifton-Brown, Lt.-Col. G. | Lipson, D. L. | Shepherd, W. S. (Bucklow) |
| Conant, Maj. R. J. E. | Lloyd, Maj. Guy (Renfrew, E.) | Smiles, Lt.-Col. Sir W. |
| Crookshank, Capt. Rt. Hon. H. F. C. | Low, Brig. A. R. W. | Smith, E. P. (Ashford) |
| Crosthwaite-Eyre, Col. O. E. | Lucas-Tooth, Sir H. | Smithers, Sir W. |
| Darling, Sir W. Y. | MacAndrew, Col. Sir C. | Stewart, J. Henderson (Fife, E.) |
| Dodds-Parker, A. D. | Macdonald, Capt. Sir P. (I. of Wight) | Strauss, H. G. (English Universities) |
| Donner, Sqn.-Ldr. P. W. | Mackeson, Brig. H. R. | Stuart, Rt. Hon. J. (Moray) |
| Dower, Lt-Col. A. V. G. (Penrith) | McKie, J. H. (Galleway) | Taylor, C. S. (Eastbourne) |
| Drewe, C. | Maclay, Hon. J. S. | Taylor, Vice-Adm. E. A. (P'dd't'n, S.) |
| Dugdale, Maj. Sir T. (Richmond) | Macmillan, Rt. Hon. H. (Bromley) | Teeling, William |
| Duthie, W. S. | Macpherson, Maj. N. (Dumfries) | Thorp, Lt.-Col. R. A. F. |
| Eccles, D. M. | Maitland, Comdr. J W. | Turton, R. H. |
| Eden, Rt. Hon. A. | Manningham-Buller, R. E. | Walker-Smith, D. |
| Fletcher W. (Bury) | Marlowe, A. A. H. | Walt, Sir G. S. Harvie |
| Fraser, Sir I. (Lonsdale) | Marples, A. E. | Wheatley, Colonel M. J. |
| Gage, C. | Marshall, S. H. (Sutton) | While, J. B. (Canterbury) |
| Galbraith, Cmdr. T. D. | Mellor, Sir J. | Williams, Gerald (Tonbridge) |
| Gomme-Duncan, Col. A. G. | Molson, A, H E. | Willink, Rt. Hon. H. U. |
| Graham-Little, Sir E. | Morris-Jones. Sir H. | Willoughby de Eresby, Lord |
| Hannon, Sir P. (Moseley) | Morrison, Rt. Hn. W. S. (Cirencester) | Young, Sir A. S. L. (Partick) |
| Harris, H. Wilson | Neven-Spence, Sir B. | |
| Head, Brig. A. H. | Nutting, Anthony | TELLERS FOR THE AYES |
| Headlam, Lieut.-Col. Rt. Hon. Sir C. | Orr-Ewing, I. L. | Commander Agnew and |
| Hinchingbrooke, Viscount | Osborne, C. | Mr. Studholeme |
| NOES. | ||
| Adams, Richard (Balham) | Glanville, J. E. (Consett) | Porter, E. (Warrington) |
| Adams, W. T. (Hammersmith, South) | Goodrich, H. E. | Pursey, Cmdr. H |
| Allen, Scholefield (Crewe) | Greenwood, Rt. Hon. A. (Wakefield) | Randall, H. E. |
| Allighan, Garry | Greenwood, A. W. J. (Heywood) | Ranger, J. |
| Alpass, J. H. | Griffiths, D. (Rother Valley) | Rankin, J. |
| Anderson, F. (Whitehaven) | Guest, Dr. L. Haden | Rees-Williams, D. R. |
| Attewell, H. C. | Gunter, Capt. R. J. | Reeves, J. |
| Austin, H. L. | Guy, W. H. | Reid, T. (Swindon) |
| Ayles, W. H. | Haire, Flt.-Lieut. J. (Wycombe) | Rhodes, H. |
| Bacon, Miss A. | Hale, Leslie | Ridealgh, Mrs. M. |
| Baird, Capt. J. | Hardy, E. A. | Robens, A. |
| Balfour, A. | Harrison, J. | Roberts, Goronwy (Caernarvonshire) |
| Barstow, P. G. | Hastings, Dr Somerville | Roberts, W. (Cumberland, N.) |
| Barton, C. | Herbison, Miss M. | Rogers, G. H. R. |
| Battley, J. R. | Hobson, C. R. | Shackleton, Wing-Cdr. E. A. A. |
| Bechervaise, A. E. | Holman, P. | Sharp, Lt.-Col. G. M. |
| Berry, H. | Holmes, H. E. (Hemsworth) | Shurmer, P. |
| Bevan, Rt. Hon. A. (Ebbw Vale) | Horabin, T. L. | Simmons, C. J. |
| Bing, G. H. C. | House, G | Skeffington-Lodge, T. C. |
| Binns, J. | Hoy, J. | Skinnard, F. W. |
| Blackburn, A. R | Hudson, J. H. (Ealing, W.) | Smith, Rt. Hon. sir B. (Rotherhithe) |
| Blenkinsop, A. | Hughes, Hector (Aberdeen, N.) | Smith, C. (Colchester) |
| Blyton, W. R. | Hynd, H. (Hackney, C.) | Smith, Ellis (Stoke) |
| Bottomley, A. G. | Irving, W. J | Smith, S. H. (Hull, S.W.) |
| Bowles, F. G. (Nuneaton) | Janner, B. | Smith, T. (Normanton) |
| Braddock, Mrs. E. M. (L'p'l, Exch ge) | Jeger, G. (Winchester) | Snow, Capt. J. W |
| Braddock, T. (Mitcham) | Jeger, Dr. S. W. (St. Pancras, S.E.) | Solley, L. J. |
| Brook, D. (Halifax) | Janes, J. H. (Bolton) | Sparks, J. A. |
| Brooks, T. J. (Rothwell) | Jones, P. Asterley (Hitchin) | Stamford, W. |
| Brown, George (Belper) | Keenan, W. | Stewart, Capt. Michael (Fulham, E.) |
| Brown, T. J. (Ince) | Kenyon, C. | Stress, Dr. B. |
| Bruce, Maj. D. W. T. | Key, C. W. | Stubbs, A. E. |
| Buchanan G. | Kinley, J. | Swingler, S. |
| Burden T. W. | Lang, G. | Taylor, H. B. (Mansfield) |
| Burke, W. A. | Lavers, S. | Taylor, R. J. (Morpeth) |
| Butler, H. W. (Hackney, S) | Lee, Miss J. (Cannock) | Taylor, Dr. S. (Barnet) |
| Byers, Frank F. | Levy, B. W. | Thomas, Ivor (Keighley) |
| Callaghan, James | Lewis, A. W. J. (Upton) | Thomas, I. O (Wrekin) |
| Chamberlain, R. A. | Lipton, Lt.-Col. M. | Thomas, John R. (Dover) |
| Champion. A. J. | McAdam, W. | Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) |
| Chater, D | McAllister, G. | Thorneycroft, Harry (Clayton) |
| Cluse, W. S. | McEntee, V. La T. | Thurtle, E. |
| Cobb, F A. | McGhee, H G. | Titterington, M. F. |
| Cocks, F. S. | McKay, J. (Wallsend) | Tolley, L. |
| Collindridge, F. | Maclean, N. (Govan) | Turner-Samuels, M. |
| Collins, V. J. | McLeavy, F. | Ungoed-Thomas, L. |
| Colman, Miss G. M. | MacMillan, M. K. (Western Isles) | Usborne, Henry |
| Cooper, Wing-Comdr. G. | Macpherson T. (Romford) | Vernon, Maj. W. F. |
| Corlett, Dr. J | Manning, C. (Camberwell, N.) | Viant, S. P. |
| Cove, W. G. | Manning, Mrs. L. (Epping) | Wadsworth, G. |
| Crawley, A. | Marquand, H. A, | Walkden, E. |
| Crossman, R. H. S. | Medland, H. M. | Walker, G. H. |
| Daggar G. | Messer, F. | Wallace, G D. (Chislehurst) |
| Davies, Ernest (Enfield) | Mitchison, Maj. G. R. | Warbey, W. N. |
| Davies, Harold (Leek) | Montague, F. | Watkins, T. E. |
| Moody, A. S | Weitzman, D. | |
| Davies, Haydn (St. Pancras, S.W.) | Morgan, Dr. H. B. | Wells, P. L. (Faversham) |
| Davies, R. J. (Westhoughton) | Morris, P. (Swansea, W.) | Wells, W. T. (Walsall). |
| Davies, S. O. (Merthyr) | Mort, D. L. | Westwood, Rt. Hon. J |
| Deer, G. | Moyle, A. | Whiteley Rt Hon. W. |
| Diamond, J. | Nally, W | Wilkes, L. |
| Dodds, N. N. | Naylor, T. E. | Wilkins, W. A. |
| Driberg, T. E. N. | Neal, H. (Claycross) | Willey, F. T. (Sunderland) |
| Dugdale, J. (W. Bromwich) | Noel-Baker, Capt. F. E. (Brentford) | Willey, O. G. (Cleveland) |
| Dumpleton, C W | Noel-Baker, Rt. Hon. P. J. (Derby) | Williams, D. J. (Neath) |
| Dye, S. | Noel-Buxton, Lady | Williams, J. L. (Kelvingrove) |
| Edelman, M | Oldfield, W. H. | Williamson, T. |
| Edwards, Rt. Hon. Sir C. (Bedwellty) | Orbach, M. | Willis, E. |
| Edwards, John (Blackburn) | Paling, Will T. (Dewsbury) | Wilson, J. H. |
| Edwards, W. J. (Whitechapel) | Palmer, A. M. F. | Wise, Major F. J |
| Evans, S, N. (Wadnesbury) | Parkin, B. T. | Woods, G. S. |
| Ewart, R. | Paton, Mrs. F. (Rushcliffe) | Yates, V. F. |
| Farthing, W. J. | Paten, J. (Norwich) | Zilliacus, K. |
| Follick, M. | Pearson, A. | |
| Foot, M. M. | Perrins, W. | TELLERS FOR THE NOES. |
| Freeman, Maj J. (Watford) | Piratin, P. | Mr. Joseph Henderson and |
| Gallacher, W. | Platts-Mills, J. F. F | Mr. Hannan. |
| Ganley, Mrs. C. S. | Popplewell, E. |