HC Deb 23 July 1946 vol 425 cc1917-47
Mr. J. S. C. Reid (Glasgow, Hillhead)

I beg to move, in page 25, line 21, to leave out from "application," to "in," in line 22.

This Amendment raises wide questions on which we think it proper that the House, as distinct from the Committee upstairs, should have a chance of expressing its views and coming to a decision, because in our view this Clause, and those which are consequential upon it or go with it, are perhaps the biggest blot on the whole Bill. They have the most formidable and alarming possibilities with regard to the future of the medical profession and its independence and freedom. Accordingly the proposal which I now put before the House is to exclude from Clause 34 the words which limit the right of doctors to get on the list in an area to those who were in practice in that area before the appointed day, so that any doctor will be entitled to go on any list in any part of the country where he offers his services provided that he is not personally objectionable on some ground or other.

As the case was presented to us during the Second Reading Debate, we were told that it was essential, in order to achieve a proper distribution of doctors, that there should be some control over this matter. We disagreed with that, but at that time we took it that this really was the basis of all these objectionable Clauses. But when we got upstairs in Committee a very different picture was presented, because it then appeared that the basis of all those objectionable Clauses was the ideological one that there was something intrinsically evil about the purchase and sale of goodwill, and that this Clause controlling the movement of doctors was a consequence, and no doubt. a necessary consequence, of the abolition of the doctor's right to sell his goodwill and of the new doctor's right to buy it. Therefore the picture is very different today from that which the House had to deal with at the time of the Second Reading. I think this is so important that I might quote from the OFFICIAL REPORT of the proceedings in Committee. The right hon. Gentleman the Minister then said: Even if it were not necessary for the proper distribution of the general practitioner service to abolish the sale and purchase of practices, I should still do it, because it is an intrinsic evil-

Hon. Members

Hear, hear.

Mr. Reid

I will deal with that argument at the proper time. He then went on: Having decided as a first principle to abolish the sale and purchase of practices, it was then necessary to secure the machinery for the appointment of doctors."—[OFFICIAL REPORT, Standing Committee C, 19th June, 1946; c. 631–632.] Accordingly the case now presented to us is that, in view of the first principle, it was therefore necessary——

Mr. Bevan

I said "a first principle," and then "not "therefore."

Mr. Reid

But "then" must mean "therefore."

Mr. Bevan

I admire the right hon. and learned Gentleman's forensic skill, but there is all the difference in the world between saying "the first principle" and "a first principle." It was not the primary principle, it was merely one of the cardinal principles.

Mr. Reid

My more pedestrian mind does not appreciate the difference between a primary and a cardinal principle, but whichever it is, I think I should be right in putting the argument this way: At least the right hon. Gentleman said that one of the main reasons for bringing in this control of the movement of doctors was because it was necessary following on the abolition of the right to deal in goodwill. I do not think the right hon. Gentleman really made any case, at any stage, for this being necessary as a measure by itself. Suppose you left the law with regard to goodwill where it stands at present; the right hon. Gentleman has not made a case that control of the movement of doctors is necessary, and therefore I say that this whole objectionable part of the Bill depends upon ideological and not upon practical reasons.

I propose for a few minutes to examine the matter from a practical point of view. Why is it necessary to put Clause 34 in the Bill in its present form? Why is it not enough to allow the registration of the doctor in any case where he is not subject to some personal disability or objection? The jurisdiction which this Clause seeks to confer upon the adjudicating body is to determine in the first place whether there is already an adequate number of doctors in the area. I do not know, Mr. Deputy-Speaker, whether you will allow us to discuss separately the Amendment which deals with the question of whether the word "adequate" ought to remain in the Bill——

Mr. Deputy-Speaker (Mr. Hubert Beaumont)

May I suggest that both Amendments should be discussed together?

Mr. Reid

If you please, Mr. Deputy-Speaker, I shall do so. One does not know what "adequate" means; it may vary from time to time, and I can see this system of control being used in an extremely strict way because, if you take the view that adequacy is a relative matter, and that because there are 50 per cent. too few doctors in area A, and 25 per cent. too few in area B, therefore in comparison with A, B is already adequately doctored—and that is a perfectly possible way to interpret this—it will mean that all areas will be regarded as adequately doctored except the few where the deficiency is glaring. If that is the view which is taken, and it can be taken under the Bill as it stands, then that means that in fact there is no freedom of movement left to the medical profession. Unless they choose to go to one of the very few of the grossly under-doctored areas they will be told, "No, all others are relatively adequate, and you cannot go there without permission."

I suggest to the House that any such strict limitation of movement as that is wholly uncalled for, even in circumstances as they exist today. Circumstances as they will exist when this Bill comes into operation will be very different. It will be obvious to everybody that, once we have 100 per cent. of the population entitled to free service, and available for capitation fees, and once we have something over go per cent, of the population —I think that is about right—actually going on doctors' lists, then areas which at present are not very attractive will become some of the most attractive areas financially, and there will be very little difficulty, indeed, in getting doctors to go to what are now difficult areas. There will be a certain number of difficult areas which, owing to scattered population or other local circumstances, cannot attract doctors without some other contribution being added beyond the capitation fee; but there might be a cure in those circumstances by the giving of a proper additional salary. I believe it to be true that only a small minority of areas in the future will not attract doctors on the basis of pure capitation fees, plus a small basic salary if that is insisted on; but we can cure the problem without any of these restrictions. Offer a little more salary, and the doctors will go there. It will take a few months longer to sort itself out, but it will sort itself out, and do it very much better, in the long run, than it is done by this Clause.

We think there is no justification for this jurisdiction being conferred upon this Medical Practices Committee. But the objection, as was shown by the Debate upstairs, goes a long way beyond that. None of us on this side was able, by reading the Bill, to discover its inner meaning until we came to this Clause in the Committee stage. I must say I received something of a shock when I discovered what the right hon. Gentleman had in mind. I think that, for the purposes of clarity, it will be as well if I say what I now understand to be the right hon. Gentleman's meaning. I cannot find it in the Bill, but I know that the Bill is so vague that it will cover this. Let me see if it is right. In any area anywhere, as I understand it, if a partner dies, the first thing that happens is that the local executive council advise the Medical Practices Committee that there is a vacancy, if they think that another doctor should come into the area. If they think that, for the moment, another doctor should not come into the area, nothing further is done. But assuming that another doctor should come into that area, to replace the man who has died or retired, then the local executive council advise the Practices Committee, which, I think, advertises the vacancy. There was a great deal of feeling on the other side on that, that that should happen in every case. I am not sure whether that was the Minister's view or not, but that appeared to be the line on which opinion was moving. Then we wait for applicants. Time is passing while all this is going on. Then we find that, although, admittedly, this is not an over-doctored area there are, perhaps, four applicants; and that it has been decided that there is a vacancy, but certainly not four. The existing partners—three of them, let us say—are not allowed to choose the partner they want to come into their partnership. The question is to be remitted to the local medical committee. True, it is composed of medical men; but this may be quite a large district, and one knows that, even in the medical profession, there may be differences of opinion about matters of this kind.

5.45 P.m.

The right hon. Gentleman went so far as to say in the Committee, with regard to the choice of the new men to come into existing partnerships: I hope that individual selection by individual doctors will progressively disappear, and that collectively the profession will make the recommendation.''—[OFFICIAL REPORT, Standing Committee C, 19th June, 1946; C. 640.] That is to say that no doctor in any area is to be allowed to say, however under-doctored it may be—this is apart altogether from the question of distribution; but it comes under this Clause—the remaining three partners are not to be allowed to say, "We want John Smith as the fourth." No, they must take a man selected for them by the committee of their medical colleagues in the district. I am not quite sure that this is fully recognised by the public as yet because, as the Minister knows, the proceedings in Committee upstairs do not receive a great deal of publicity, though, no doubt, they are read by quite a few people. Is it necessary that this very elaborate system of control should be put upon the medical profession?

If hon. Gentlemen opposite think that control of this kind is desirable for its own sake, then I join issue with them. I do not stop to argue with them, because it seems to me to be a question of fundamental difference between us. If they think this kind of thing is for the good of the profession and for the good of the country, irrespective of whether it is necessary to cure existing evils, then I join issue with them. If they say it is necessary to cure existing evils, then I say they are wrong in fact, and that nobody has yet produced any fact which would justify the extremely elaborate system of control. We tried upstairs to get the Clause limited to something more reasonably equivalent to the interests of hon. Gentlemen opposite. Hon. Gentlemen opposite see a great deal more maldistribution in future than we do, because we think it will sort itself out, if the salary is worked properly. But even supposing they are right, and that the adjustment of salaries will not cure the problem, then the Clause goes far beyond what is necessary to cure this. It is not inspired by any question of maldistribution. It is inspired by a desire that there should be some collective control over movement in this profession. If hon. Gentlemen opposite think that that freedom of doctors, to go where they like and serve whom they like, is not in the public interest, and that, equally, the freedom of partners to choose the men with whom they are to work, is not in the public interest, then I say hon. Gentlemen opposite have a curious view of the public interest.

If one wants to encourage doctors—and I believe the right hon. Gentleman does—the first essential is to make quite certain that we give the utmost possible freedom to people to come together into partnerships; and not try to dictate to the existing partners whom they are to take in future. This is a clear dictation, saying, "You must take so-and-so or you do not get anybody else." It is quite clear that the Minister wants to dictate to them.

Mr. Bevan

The Minister wants to dictate?

Mr. Reid

Certainly.

Mr. Bevan

Certainly not.

Mr. Reid

Yes. He wants to dictate, because he wants this Bill, and he wants to institute a system of dictation to partnerships, whereby certain persons— other doctors, no doubt—but certain persons shall say to existing partnerships, "You cannot have the man you want. You must take the man we think you ought to have." That is a perfectly fair picture of what the Minister said upstairs. [HON. MEMBERS: "No."] If the right hon. Gentleman wishes to modify it now, I shall listen to him. My colleagues and I listened to him in Committee. We tried in the course of the Committee proceedings to get this proposal into our heads. It was not in the Bill. It was not referred to on Second Reading. This is the best that I can make of it, having read, two or three times, what the Minister said in Committee. What I have just said is the best I can make of what he said. If he now tells us something different, it will be interesting.

I think that this Clause is unnecessary, because it is possible to cure the matter much more easily, in another way—by adjusting salaries. It is not really necessary, even in the Minister's view, because it comes in as consequential on this ideological decision about goodwill. Even in the simplest form, namely that you apply control only where there is plainly an over-doctored area, it would be objectionable. The Minister picked me up at once when I ventured the opinion that there were to be certain open areas, as I call them, and certain closed areas, the closed areas being the apparently over-doctored areas. I checked over that and as far as I can discover there are to be no open areas in the sense in which I used the expression, and no areas where doctors can walk in without the "by-your-leave" of this committee. If there is no part of the country to which a doctor is to be allowed to go without getting the permission of some committee——

Mr. Bevan

In the public service.

Mr. Reid

If there is no part of the country to which a doctor in the public service is to be allowed to go without getting the permission of some committee, then we are miles away from any question of maldistribution, because maldistribution would lead to differentiating setting aside over-doctored areas which cannot be entered without permission, from under-doctored areas where everyone is welcome. That is not to be the case. In this wide sense, it is really another example of right hon. and hon. Member opposite desiring to have control for its own sake.

I am reminded that I should say a few words about the subsidiary Amendment. If we have to accept this Clause, I suggest that the right way to do this would be to have a quota for each area. That quota would not be fixed in the way I suggested it might be fixed in the earlier part of this discussion, namely, by considering every area in relation to every other area. A fair quota should be fixed by the executive council who know the circumstances. If the Minister desired, there could be some power with the central committee to override the executive council. I would not object to that, but we ought to have a quota for each area, and be able to say that if any area is below that minimum quota, all this elaborate control does not apply and anyone, in the public service, can walk in. The quota is a difficult thing, and we may find that we should have to let people in above the quota, because one or two doctors might be semi-retired and so on. Nevertheless, we ought to have a quota in each area for six full-time doctors, or 20 full-time doctors, or whatever number is appropriate, and then not let in any more until all the other areas are up to strength.

Captain Baird (Wolverhampton, East)

Who is to adjudicate between the areas?

Mr. Reid

Obviously, the executive council, because they are the people responsible in this matter. If the Minister prefers that the executive council should be subject to provision by some more central body, that is another matter. We wanted to object to the whole principle of the Clause, but if that view is not accepted, at least we want to get rid of some of the serious and widespread difficulties. I think this Amendment will do so.

Mr. Bevan

My hon. Friends and hon. Members opposite who were Members of the Committee will recollect that this subject received the most attention from the Committee. We argued it at considerable length, and in so doing filled a number of volumes of HANSARD. The issue is perfectly clear. The right hon. and learned Gentleman the Member for Hillhead (Mr. J. S. C. Reid) is trying to claim that there was a contradiction in what I said in the Second Reading Debate and what I said in the Committee. There is no contradiction at all. In the first place, I said on Second Reading that the buying and selling of practices in itself was, to us, repugnant. He may disagree with that, and he probably does, but it does not matter, because that is our view. That was the first principle. There was another first principle, and that was that we should seek to bring about an equitable distribution of a general practitioner service. That is another first principle, and it does not matter which of these principles we take. If we take the former—what we regard as the objectionable character of the buying and selling of practices—it necessarily implies that we must now set up machinery for the distribution of general practitioners, because general practitioners will no longer distribute themselves all over the country by the buying of practices. On the other hand, if we take as our primary principle, that we wish to bring about a proper distribution of a general practitioner service, we must abolish the buying and selling of practices, and then the method of obtaining a successor is abolished, and we must again have a principle of redistribution.

I explained this at some length in Committee, and I am surprised that the right hon. and learned Gentleman is returning to the charge, because there is no contradiction at all. Both principles follow, and both are, in fact, of equal status. The right hon. and learned Gentleman must not make the mistake of supposing that there is a democracy among facts; some facts are more important than others. It is to our first principles we attach great importance, either of the two principles involved, the elaboration of the machinery for distribution and the appointment of doctors. What then have we done? We have suggested, in the first instance, that the selection of doctors shall be by the local executive council, because, as I said in Committee, it is necessary that the new doctor shall be a person who is agreeable to the colleagues with whom he is to work. That is particularly the case when we come to group practices. Therefore, when the medical practices committee inform the executive council that a vacancy has occurred, either by inadequacy of the general practitioner or by the death of a general practitioner, the vacancy is, first of all, made known.

I am astonished, when the right hon. and learned Gentleman talks about delays taking place, because far less delay will take place under this machinery than takes place at the present time. The medical practices committee will have available at the centre a complete picture of the situation throughout the country, and any doctor wishing to enter into contract will be able to see where any vacancy exists at any moment.

Therefore, he would be able to decide to what particular place he wished to go, and to which executive council he wished to make application. I understand, therefore, that once that happened, the local executive would consider the application, and the local medical committee would make representations; and, in the case which the right hon. and learned Gentleman has mentioned, the partner, as far as he could, would obviously influence the appointment. It is true that he would not himself be the final determinator. We do not want him to be the final determinator. I will come to an important point on that in a moment. It is true that the doctors would be normally consulted, in which case, I would point out to hon. Members, the doctors have a greater privilege than the members of any other profession. They would, in fact, be consulted. Then the executive council would make the appointment, and the medical practices committee would confirm the appointment.

6.0 p.m.

I explained in Committee that the reason why it is necessary that the appointment should not be valid until the medical practices committee had validated it was because it was always necessary to have a reserve power against any irregularity. It may be that locally someone has been appointed who ought not to have been appointed. Some undue influence may have been exerted. I agree that to have an appointment of an individual doctor made by the medical practices committee would indeed be a bureaucratic centralisation, but the appointment has to be validated by the medical practices committee, and that always leaves open the possibility of the medical practices committee being appealed to in the event of there being some irregularity about the appointment, but normally that would not happen. What is the actual implication of the Amendment? It would, of course, wreck the Bill—wreck the whole scheme. The right hon. Gentleman made it clear that that was his intention, because he does not like it. There is a complete conflict of opinion between us. What he suggests is that the doctors themselves should have the right, in any part of the country, to enter the public service at their own will, claiming something which no other profession has. When a person enters the public service, surely a nation is entitled to say where it wishes this service to be given. It is only some doctors who would claim that, at any time, they should be allowed, without any principle of distribution being exercised at all, without anything being asked of them, to attract public money——

Sir H. Morris-Jones

The right hon. Gentleman is taking away from them the right which they have now, and they have never asked for that right to be taken away.

Mr. Bevan

The hon. Member is quite right, but I wish to point out that doctors are not yet in sole control of the country. It is we who have decided that we are going to have a public health service, and, therefore, what we must do is to construct the principles which make that service practicable. Certainly the doctors have not asked as a body for a national health service, but the doctors have supported the national health service, and the proper organisation of the National Health Service implies that we must make available to the whole population an equal share of the doctors, and the only way in which that can be accomplished is by having a proper distribution of general practititioners. If doctors are allowed to go anywhere, the task imposed upon the scheme would be formidable and almost impossible to exercise, because we would never know where the doctors were going until they had gone. Under this Amendment, not only can they go at any time, but they can go anywhere they like—enter the public service and immediately attract public money——

Sir Hugh Lucas-Tooth (Hendon, South)

Will the right hon. Gentleman indicate what sort of machinery there is for regulating where teachers go, for example?

Mr. Bevan

I think that the hon. Member had better take one of my hon. Friends outside—any hon. Friend—and he will receive precise information.

Sir H. Lucas-Tooth

Could I have an answer to my question?

Mr. Bevan

The answer is that the teacher is appointed, and if he is not wanted he is not appointed. If the hon. Gentleman wishes to press the analogy, what the teacher would suggest is this: "I am," he would say, "a properly qualified teacher, and I would like to live at Folkestone. Can I go to the Folkestone education authority and say, 'You must employ me'?"

Sir H. Lucas-Tooth

He will, of course, have negotiations with the Folkestone education authority, but the Board of Education, or some central body, has no right to say to the Folkestone education authority, "No, you will not employ that person."

Mr. Bevan

Oh, yes, it has. The hon. Gentleman, instead of answering my argument, is merely exposing the dark caverns of ignorance in his mind. Of course, the State exercises control over it; it refuses to pay grants to an education authority for over-employment of a staff. The hon. Gentleman has given the whole case away. It is only some of the doctors who have insisted that they themselves, without any argument at all, and without any other consideration, shall determine where they shall give their services in the public service. I am not saying that if they do not enter the public service they should be under restraint. They may put up their plate wherever they liked, but if they wish to receive remuneration from the public service the State is entitled to attach conditions to the remuneration, and one condition is that the doctor shall serve where his services are most needed. Rather, I will put it differently, because it is much better for the doctor than that: The doctor shall not serve where his services are not needed. In other words, it is a negative control over distribution. I should have thought, therefore, that the whole situation was perfectly reasonable. It is well understood. It was argued on Second Reading in some detail; it was argued in Committee upstairs, and the more the scheme is examined, the more it stands up to criticism. I must, therefore, resist this Amendment.

Mr. Henry Strauss (Combined English Universities)

The right hon. Gentleman is of course quite right in saving that this part of the Bill has caused the greatest controversy between the two sides of the House. It did so to some extent on Second Reading, and it did upstairs in Committee, although the right hon. Gentleman exaggerated the number of days which it actually occupied. This Clause and the next Clause took altogether less than three mornings. Nevertheless, he is quite right in saying that this is one of the crucial points which divide us on this Bill.

I think that anyone who reads the speech of the right hon. Gentleman on Second Reading, and also reads the proceedings upstairs on the 14th day of the Committee, will agree with the right hon. and learned Member for Hillhead (Mr. J. S. C. Reid) that there was a great difference in the approach of the right hon. Gentleman, in the emphasis that he laid on what governs his mind in this matter; one wonders whether the provisions of Clauses 34 and 35 were in his opinion necessary for producing a proper distribution of the medical profession, or whether, on the other hand, they were rendered necessary by his own objections to the right of the doctor to goodwill. It is perfectly true that upstairs the right hon. Gentleman, as he explained himself, was challenged on this point, as he was again this afternoon, and he then said there could be more than one primary purpose and that he regarded both of these objects as primary purposes. I suggest to him that, if he is to have several primary purposes, he should certainly have one more, and that is that the doctors entering the public service should be happy in their professional work, and that they should enjoy as much sense of freedom, and not as little, as is compatible with the necessary arrangements.

I should have thought—in fact, the right hon. Gentleman has admitted it—that if this whole scheme is to succeed and if this Bill is to be the great advance that I know many hon. Members opposite sincerely believe it will be, the thing that, above all, is necessary is that a great many people, as well as some of the best people, shall enter the medical profession, and not only enter the medical profession but be willing to enter the national health service, I ask what chance is there of that, if this ancient and honourable profession is deprived of some of the essential freedoms which govern the actions and influence the choice of so many people who adopt it. I ask what chance is there of a successful partnership when the freedom of partners to choose each other is limited and denied. It really is producing a sense of unhappiness and misery in the service which will go very far indeed towards prejudicing the success of the whole scheme.

Let me deal with the two questions separately. First, the goodwill is involved in this Clause, but I will only deal with that as far as it was dealt with in the preceding speeches, because it is more relevant to the next Clause than to that with which we are dealing. Belonging to the profession to which I belong, I had a fairly open mind on the question whether a professional man should or should not be able to sell his goodwill, In the profession to which I belong there is no sale of goodwill and the question seems to me to be really what is in the public interest. Is it or is it not in the public interest that doctors should have this right? I must say that, had I had any doubt of the answer, that doubt would have been laid at rest by seeing what is involved in the Minister's Own view if goodwill is to be abolished. Any one reading Clauses 34 and 35 will become very conscious of the disadvantages of that prohibition. I believe that many hon. Members on both sides of the House will not take the view of the right hon. Gentleman, that to deprive the doctors of their right to build up and enjoy their own goodwill is a desirable thing, but they genuinely believe that something of this kind is necessary in order to secure better distribution of doctors.

6.15 p.m.

I believe it is a general desire throughout the House that there should be a proper distribution of doctors. The question is what is the way to bring that about. I should have thought the commonsense view would be that we should see what distribution of doctors is brought about by the coming into force of the National Health Service, which will greatly alter the existing distribution, without anything else being done at all, just as the coming into force of the first National Insurance Act did. Steps should then be taken to see that we attract a sufficiency of medical practitioners to those districts where there are still far too few. I say far too few, because over the whole country there will be too few. The right hon. Gentleman in his speech talked about what a monstrous thing it would be if doctors entering the public service themselves were to say where they would practise. in the public service. Of course, that really disguises the fact that the people who would really make the choice, if the medical profession were given freedom, would be the public themselves.

What many of us here think is that the best judges of whether a district is or is not over-doctored are the public in that district. The resistance to the proposals in this part of the right hon. Gentleman's Bill is so much in the public interest, that I am delighted that the doctors are resisting them, because I can see a great deal in them which might have attracted the less good elements in the medical profession. I gave an example upstairs, which I should like now to give to the House if the House will allow me. There may be in all parts of the House hon. Members who practise at the Bar. I ask them to remember the time shortly after their call, and their start in their profession, and to imagine that it had been open to some professional body of the Bar to say, "London is now an over-barristered area." [HON. MEMBERS: "Hear, hear."] I am delighted to hear the cheers from the opposite benches because it strengthens my point. If any district were over-barristered it would be London, and if we adopted for the Bar what it is proposed to adopt for the medical profession, no additional barrister would be able to practise in London, and those in London would be freed from further competition and free to enjoy complete security and livelihood without any additional effort on their part. I think in the interest of the public, and in order to have a good legal profession, the existing legal profession should always have competition.

I think the same thing may apply to the medical profession. I do not believe it is in the public interest in this new service that any district can say "There are enough doctors here and there are other districts which have less." If that were so, then the new entrant would have to go to those other districts, and the doctors in the barred district would be freed from all stimulus to maintain their efficiency. This is the very crux of the Bill in the view of a great many of us. I know there are hon. Members opposite who are convinced—and I give them credit for the genuineness of their views—that to deprive members of the freedom they have hitherto enjoyed is a right thing in itself. There are others—and I think they must be very few if they have studied the evidence—who have thought, even apart from that conviction, that they must do something as drastic as this, in order to secure a proper distribution of doctors. No doubt by studying their correspondence and meeting their friends—because there is not one of us in this House who has not friends in that great profession—they have formed a view as to what the doctors are feeling.

The thing that has struck me is how little the objection to this Clause depends on the political views of the doctor concerned. I am glad to say that I know some doctors who have no strong political views, but I know some other doctors who share the political views of hon. Members on the other side of the House, though they do not share the approval which those Members are giving to this Clause. In fact, some of them go so far as to say that they would not enter this service because they are not satisfied that they could efficiently continue in their profession when they are deprived of something absolutely essential to their happiness and efficiency, namely, a sense of freedom. I believe the great defects of these two Clauses are quite unnecessary to the National Health Service which the right hon. Gentleman is setting up. I do not believe they can possibly be explained by any necessity to secure good distribution of doctors, for the reason that redistribution of doctors will automatically occur by reason of the mere passage of this Bill into law, and the under-doctored areas can be dealt with in the way which the right hon. and learned Member for Hillhead and others have already suggested. The only explanation of this provision is the desire, which the right hon. Gentleman admits as one of his primary desires, to do away with the doctor's goodwill. I do not believe that that is in the public interest. I am certain it is causing great unhappiness in the medical profession, and I believe it is ruining what certainly should be the third of the right hon. Gentleman's primary purposes—since he has no objection to any number of primary purposes—and that is the happiness and sense of freedom of the doctors who enter the profession.

Mr. Linstead (Putney)

I make no apology for the continuation of this Debate because this is one of the crucial Clauses of the Bill. There are one or two parts of the Bill that have got out of proportion and I suggest to the House that Clause 34 is one of them. It is possible to find reasons why these provisions for the direction of doctors have been put in this Bill, but I am reasonably certain that the argument that compulsory powers of direction are necessary in order to secure proper distribution of doctors cannot be substantiated either by the expanded National Health Insurance Act or by the proposals in this Clause. If we take the National Health Insurance Act which does provide the medical service for half the population of this country we find, in fact, that the doctors have broadly distributed themselves, naturally and without direction, in the area where the services need them. I know that figures can be given which will show that Bournemouth, Harrogate, Bath or the more pleasant places have a larger proportion of doctors than any other parts of the country, but we need to take the individual doctors and ascertain such facts as their age, their condition of health and so forth. If those statistics are worked out, as they were worked out by the Central Medical War Committee, we find, in effect, that these medical practitioners have gone in a great many cases to these places for personal reasons, and not mainly on the grounds that they could make a better living there than anywhere else.

I do not know whether hon. Members opposite have also appreciated the fact of the complete exemption for assistants which is given in this Clause. So long as a man is not going as a doctor but only as an assistant, this Clause does not apply. Therefore, on the basis of the Clause itself, there is a considerable loophole which will enable medical practitioners to take assistants' posts in order to go where they desire to go. I suggest that as assistants are exempt from this Clause, they will go where a job is offered to them, and on the experience of the Insurance Act the need for direction in order to secure the proper distribution of the medical practitioners is not proved. Looking for other reasons why this altered structure has been dealt with, one admits at once that it has probably been erected in order to prevent the sale of practices. If that is the reason, it should be put into the forefront of the arguments in favour of this Clause, and not the unjustified argument that the Clause is needed to get adequate distribution.

I think that the argument against the abolition of the sale of practices has probably been put sufficiently cogently, but surely it amounts to this, that a man who has the freedom to sell his own practice, human nature being what it is, is likely to be the man who will give the greatest attention to building up that practice and who will give the best medical services. When one adds together direction, plus the abolition of the sale of practices, plus the desire to put as many general medical practitioners as possible into health centres on a basic salary, I think one gets very much nearer to the real intention behind the. Clause. As I see it, whether that be the real intention or not, the effect of it certainly will be that, within five or 10 years, a large proportion of the medical practitioners of this country will have become salaried servants of the State. If that is the intention, it should be brought out and should be explained by the Minister. To disguise it, as it is disguised here, on the ground that these powers are necessary in order to secure adequate distribution of medical manpower is simply to ignore the facts as they are.

Mr. Gage (Belfast, South)

I want briefly to reinforce what has been said about the position of partnerships as they will be effected by the Clause, unless the Amendment is accepted. I think I can best do that, shortly and simply, by taking what I think will be a typical case that will arise. Let us suppose that, in a certain area, a vacancy occurs because one of the partners practising in a particular firm or partnership has either died or retired. Let us suppose there are four applicants for that particular area. Naturally, the existing partners will look carefully at the applicants. They know that only one can be selected, and it is very likely they will consider that one of those men is a congenial person. I think we shall all agree, as certainly the Minister will agree, that the whole essence of partnerships is that the people should get on well together and be congenial one to another. The existing partners may select that person.

What has to happen? The executive council make the selection, and if the partners want a certain person to be selected, they have to go to the executive council, or to the local medical committee, and say, "We want So-and-So." They have in some way to make their position known to the executive council. But the executive council may reject that person and put in his place someone who is utterly and completely uncongenial. I do not think there is any doubt about that. The Minister said that probably it' would not work out in that way, but it might do so. The executive council might say, "Doctor X is perhaps not so congenial to you, but he has been waiting to get into the area for a long time; he is a doctor with many good qualifications, and we are going to select him." If they do that, and if the doctor is determined to practise in that area, one of two things can happen; either he will go into the partnership and all the partners will be thoroughly unhappy, or he will not go into the partnership, and gradually it will break up.

If, on the other hand, the executive council selected the person whom the partners desired, and the local medical committee confirmed that selection, one of the other doctors who wanted to go into the area might complain and say that some unfair influence had been exercised by reason of the other partners having approached the executive council. There might be an objection and an appeal to the Minister. Therefore, in this way there would be far more appeals to the Minister. I feel that this Clause, as it stands, will have exactly the reverse effect from that which the hon. and right hon. Gentlemen opposite want. It will be inclined to break up existing partnerships and prevent them from carrying on. That is one of the reasons I support the Amendment.

6.30 p.m.

Mr. W. J. Brown (Rugby)

I did not have the opportunity of sitting on the Committee upstairs and, therefore, I would like to express a view on this matter now. The Minister has said that this Clause is absolutely vital to his Bill, and that if it is wrecked then, in effect, the heart of the Bill will be destroyed. I want to make it plain at the outset that I do not want to destroy the Bill, but I do not think it has yet been demonstrated that this Clause, in its present form, is essential to the working of the scheme. In making that complaint, I am not hostile to the Bill, but a supporter of it, and I want to discuss the merits of the argument which is now before the House.

Is this Clause necessary, or can it be amended, with advantage to the scheme? It ought to be possible to discuss that dispassionately, whatever side of the House one sits on. In opening the discussion, my right hon. and learned Friend above the Gangway said that the Minister had rather changed from one leg to another in his support of the Clause. He said that originally the weight of the emphasis was laid on the necessity to secure an equitable distribution of doctors, and that at a later stage the emphasis was shifted to the undesirability, as a matter of principle, of medical practices being bought and sold. The Minister replied to that that whether there had been a change of leg or not did not matter, because whether you start from the principle that the buying or selling of practices is itself undesirable, or from thedesideratum of securing an equitable distribution of the supply of doctors, you are bound to be driven to the same conclusion—that either principle involves the elaboration of machinery concerning the distribution of the supply of doctors.

The comment I would like to make on that is that, whichever of those two principles you start from you are driven, through the elaboration machinery, to secure an equitable distribution of doctors. But that is not the point. The point is: Is this the machinery we are driven to, or is there some other less objectionable machinery that could be found? The Minister quite properly makes the point—and nobody can complain of it—that if, under the Bill, doctors are to become State servants, if they are to attract remuneration from the State, it is unreasonable for the doctor himself to expect to determine where he should serve. In the same way that a teacher is posted by the employing authority to where he is needed, and the civil servant is posted by the employing authority, the State, to where he is needed, so, says the Minister, the doctor cannot object to being posted where he is needed——

Mr. Bevan

On the contrary, I said that the doctor should be stopped from entering into the public service in areas where the public service does not need it.

Mr. Brown

I was about to deal with the point of negative, rather than positive, direction. Let me amend what I said. The Minister says that the doctor has no right to complain if the employing authority, which now becomes the State, says that he shall not work where he is not wanted. [An HON. MEMBER: "Does the hon. Member object to that? "] I am just about to tell the House. I have never seen such eagerness to wait upon the words which fall from my lips. There are three ways of securing the desired result of the equitable distribution of doctors. One conceivable way is to give the Minister power of positive direction——

Mr. Bevan

I, too, have been waiting for the words to fall from the hon. Member's lips, because I was wondering what relationship the speech he is now making has to the Amendment. The Amendment says, in effect, that the doctor should enter the public service where he likes. I should have thought myself that that is the point to which the hon. Member's speech should he addressed.

Mr. Brown

Up to now every argument I have addressed has been to meet the argument made to the House by the Minister. I suggest that we are agreeing with the objective which the right hon. Gentleman wants to get in his Clause, namely, the equitable distribution of doctors. It is being suggested, in this Amendment, that there are other and better ways of getting that equitable distribution than the way which is proposed by the Clause.

Mr. Bevan

On a point of Order. That is precisely, in my submission, Mr. Speaker, what is not in the Clause. In the Clause there is provision for the distribution of doctors by certain machinery. The Amendment seeks to leave out that machinery, and if that is done what is then left is theipse dixit of the doctor himself. I suggest, Sir, that it is not in Order to roam over all kinds of alternative methods of distributing doctors.

Mr. Speaker

The right hon. Gentleman is, in the main, correct. We are discussing an Amendment, and not the Clause as a whole. Further, we are on the Report stage, and we must stick to the Amendment very closely.

Mr. C. Williams

With great respect, Sir, I think your predecessor ruled a short time ago that we were discussing this Amendment and the following three. Amendments on the Order Paper together. That being so, I think that would enable us to discuss the position of doctors fairly fully, without going very far. I draw your attention to that, in case it might ease the position.

Mr. Speaker

The hon. Gentleman has just said, "Without going very far," and those are the limiting words.

Mr. W. J. Brown

What we are discussing, it seems to me, is an Amendment to delete from Clause 34 certain lines which make it obligatory upon a practitioner to obtain the consent of a particular body before he can serve in a particular place. If I can show—or if I can argue, since I do not need to convince hon. Members on this side—that the Minister can obtain the results he wants with these words deleted, it does appear to me that this is absolutely to the point. I would ask the Minister to agree that in matters of this kind the less the degree of compulsion, negative or positive, the better, provided one can obtain the end desired. If that is true as a general principle, then I think that of all professions in the world it is true of the medical profession. There are some types of job which can be measured in output per man hour, and some which can be measured in other ways, but nobody can make a doctor a good doctor by compulsion. This is the sort of job where the mental attitude of the person concerned is of first importance and I therefore suggest that the Minister should not use compulsion, negative or positive, if he can get results in other ways. It is not so much a question of whether the individual who is going to attract money from the Government should be able to choose where he shall or shall not serve, but of whether from the point of view of obtaining the best results for the public health service, it is not better to rely on inducement rather than compulsion. [An HON. MEMBER: You might not get the same results at all."] We must not start on the assumption, "What's the good of anything? Nothing let's go out into the garden and eat worms." Surely we are entitled to tie up the ends, and I must say that the principle which has been advocated here is one which has been applied by many Departments of the Government. If there is a place to fill which is unpopular there is nothing more common in the public service than to offer some inducement to go to that particular place, either by way of a special allowance or in some other form.

Mr. Bevan

On a point of Order, Mr. Speaker. In my respectful submission the hon. Member's argument goes entirely beyond the province of the Amendment. The hon. Member is arguing that we could do something which is not mentioned in the Clause and relates to an entirely different part of the Bill. He is saying that we could offer inducements to the doctors to get them to go where we needed them. In my submission all the hon. Member is entitled to argue is that the Clause, with the omission proposed in the Amendment, would achieve the purposes he has in mind, which could not be achieved under the Clause as it stands.

Mr. Speaker

As a matter of fact I was on the point of rising. I do want to remind hon. Members that these interruptions often lead to various discussions which it is rather hard for the Chair to check. There was an interruption which the hon. Member took up very quickly, and it led him astray.

Mr. Brown

I deeply regret that I should have been led astray but may I not argue, Sir, that as in so far as the Amendment is directed to removing a specific part of Clause 34, I am in Order in arguing that if that part of Clause 34 were deleted, there are other means within this Bill whereby the same results can be achieved?

Mr. Speaker

We must confine ourselves to Clause 34 as it stands with these matters deleted, otherwise we get too wide a Debate.

Mr. Brown

The point I am making, if I may put it to you, Sir, is that with this part deleted, and with Clause 34 to that extent modified, there will then be power under this Bill to obtain the result that the Minister wants by way of the equitable distribution of doctors.

Mr. Bevan

Further to that point of Order, Mr. Speaker. If the hon. Member were permitted to argue that, then we should have a wide and roaming discus sion over all kinds of methods of attracting doctors, and relating to other parts of the Bill, so that, in my respectful submission, we should be getting back to a Second Reading Debate.

Mr. Speaker

We must stick to the Clause and must not roam over the Bill; I am afraid I must rule the hon. Member out of Order.

6.45 p.m.

Mr. Brown

I did not intend to go beyond the arguments made by the spokesman who opened the Debate this afternoon, and they did appear to me to be highly relevant to the point at issue. To sum up, I do not think the Minister needs the powers under this Clause to obtain the results he desires, and inasmuch as my principle is to try to obtain the desired result with the minimum of compulsion—and I dislike compulsion for its own sake—I hope very much that the Minister will not persist in his opposition to the Amendment.

Lord Willoughby de Eresby (Rutland and Stamford)

I should like to put forward one consideration to hon. Gentlemen opposite which I hope may help them to view this Amendment with sympathy, although I do not expect that any words of mine will gain their support for it. I have always taken the view that if any person takes money from the State, to a certain extent he sells his freedom, and much the same will apply in this case. The doctors will soon be entering into a public service and will be dependent on the Minister and the Treasury for their fees, and he who pays calls the tune. The consideration I put forward is that a large majority of these doctors did not ask to go on what I might call the public pay roll or to become employees of the State. For better or for worse, this House has decided that there shall be a State medical service in this country, and soon that will be the case. I feel, then, that we should give every consideration to the people who are entering this service and going on to the public pay roll even, perhaps, against their wishes. If we can obtain our proper distribution of doctors throughout the country without any compulsory powers, so much the better. I have listened to all the arguments, both in Committee and in the House, and although I am not going to repeat them now, I would say that I am not convinced that it is necessary for the Minister and various bodies to have these powers so as to get the necessary distribution. Until I am convinced I will not support such a proposal.

Mr. C. Williams

I listened to what the Minister had to say on this matter with great care and interest and I believe that hon. and right hon. Gentlemen on both sides of the House have one desire in their minds—to obtain a fairer distribution of doctors over the whole country. I will not deal with the question of practices, which was referred to by the Minister, except from the point of view of whether, under this Clause, with its prohibition of doctors going to an area, the system is likely to work in such a way that the areas concerned will be provided with a good and contented medical profession. I hope the Opposition may prove wrong; I hope that it will work, because I am convinced that the Government mean to shove this through "any old how." I say quite frankly, however, that I shall oppose the principle because I do not believe that it is right to apply the particular form of pressure laid down in this Clause, to a medical profession which, over a very long period, has endeavoured to serve the public well.

I am speaking not so much on behalf of the great industrial areas as from the standpoint of the West Country, where we have a very strong and independent point of view. There is a wide and strong feeling that the medical profession, and those who depend upon it for their health, will not be so well off as they were before, under the operation of the Clause as it stands. The Minister has made little or no attempt to remove that impression. In his speech just now he presented mere tactical arguments against the Opposition. Instead of trying to allay feeling against the Clause, the Minister has undoubtedly made the position much worse than it might have been, if he had used more conciliatory and helpful methods. For that reason, in a matter which is of such great public interest, he should have been able to work out, under the Clause a method which would give the publics a better and happier service.

Mr. Willink (Croydon, North)

It must be considered right in all parts of the House, that there should be a discussion of reasonable length upon what is one of the most important and far-reaching proposals in the Bill. As these discussions have proceeded, we have got a clearer idea of what is in the mind of the Minister. He tells us now that the whole thing is based on two primary principles. The first is that the sale of goodwill between one general practitioner and another, and the method of the choice of successor, are inherently improper and, to the Minister, repugnant. I do not enter into that argument now, except to point out that if that principle was one of the primary motives for this far-reaching proposal, I am amazed that the Minister's conduct has not been more consistent. The House, and the public outside, should realise that the sale of goodwill as between dentists, and between specialists who change practices on that basis, is left entirely unchanged within the service, by the terms of the Bill.

The second principle is that there should be a better distribution of doctors. If my hon. Friends and I, upon this issue as upon all others, were satisfied with the prophecy of the Minister that this would be necessary after the appointed day, and after 100 per cent. of the population were entitled to benefit under the scheme, we should look upon the matter in a very different manner. Apart from the doctrinaire matter to which I have referred, and on which the Government's proposals are hopelessly inconsistent, the argument is based upon an appreciation of the future. We are told that when the general medical service of this country is organised upon an entirely new footing, the distribution of general practitioners will not be satisfactory. That is a prophecy. What the Minister calls "elaborated machinery" with most serious additions to the criminal law is being introduced into the Bill before the facts are known and before they can be known. I was very glad to hear the hon. Member for Rugby (Mr. W. J. Brown) pointing out what is indeed obvious, that the deletion of Clauses 34 and 35 would not wreck or damage the scheme at all. The Clauses are entirely severable. The Minister has complete power in other parts of the Bill to remunerate general medical practitioners in any way that he thinks right, in order to induce proper distribution. Therefore, to call this a wrecking Amendment is a misuse of language.

I desire to say little more, since the mind of Members on this side of the House has already been made quite clear, but there are two other points on which I ought to comment. The Minister made one astonishing observation with regard to the effect of the proposals in relation to medical partnerships. The term "partnerships" indicates that they are associations of gentlemen or ladies who choose to work with one another. The Minister said that, in this matter, doctors would be in a better position than any other profession. I challenge the Minister to name any other form of professional activity in partnership, in which surviving partners have their new partners selected for them by a Central Practices Committee, such as is set up by the Bill. Doctors will be in a uniquely unfavourable position, because there is no other form of professional partnership in which, there being an acknowledged vacancy, partners cannot choose those with whom they want to work, out of those who apply. This proposal will, in our view, militate most seriously against the continuance of those partnerships or groups of practices which the Minister professes to be so keen to foster.

The next observation I wish to make is on the complete fallacy of the Minister's observation as to the effect on the general medical practitioner in the public service who is drawing money from public funds —[An HON. MEMBER: "State service."] An hon. Member corrects me and says, "State service." That is what some people hope it will become, but the hon. Member may not be aware that the right hon. Gentleman always disclaims that term. The situation in regard to the public money which the general practitioner in this service will attract is wholly different from the situation in regard to the teacher, with one exception. If the Minister persists in his unwise proposal to give every one of these doctors a salary, then there is some parallel with other forms of public service. If every general practitioner on the list had a salary, it would be strange indeed to allow whoever went to a place to come on the list, and attract a salary which the Government Department considered unnecessary and uncalled for. If the Minister wishes to do what I am sure the majority of the medical profession wish, he will continue the system of payment by capitation fee. He would find that no more capitation fees and no more public money would be drawn from an area, whatever the number of general practitioners, except to this extent that as there are more and more attractive general practitioners in the area, closer to 100 per cent. of the public will avail themselves of the service. I cannot help imagining that the objective of hon. Gentlemen on the other side is that the population should, to the maximum possible extent, use the service. In other words, they want capitation fees for 100 per cent. of the population to be drawn by the doctors working in the area. How does it prejudice the Treasury or the taxpayer that that money is drawn by 25 rather than by 23 doctors? There is no additional public charge, as the Minister sought to suggest.

My final point is this: The Minister blurted out—and quickly corrected himself—that the condition under which every doctor would serve in the future would be that he should serve where his services were most needed.

Mr. Bevan

It is not true.

Mr. Willink

The right hon. Gentleman corrected that, it is true. It is because vagueness such as is in the Clause leaves it perfectly possible for any Minister to introduce that situation, that we must divide against the Clause. If the right hon. Gentleman challenges me and says that that is not true, I reply that it is within the power of the Minister to deal with the whole question of adequacy, as my right hon. and learned Friend the Member for Hillhead (Mr. Reid) pointed out. If adequacy is dealt with on a relative and not an actual basis—and I gather that the Minister is refusing our Amendment which would leave it to local people to decide whether the number of doctors was adequate or not—the effect is to turn this negative form of direction into something which is, in substance and reality, direction in its most positive form.

7.0 p.m.

Lieut.-Colonel Sir Walter Smiles (Down)

I wish to refer to what was said about partnership by the hon. Member for South Belfast (Mr. Gage) and the right hon. and learned Member for North Croydon (Mr. Willink). I understood them to say that if one of a well-established partnership of doctors dies or retires, the remaining partners cannot select whoever is to join the partnership. I can imagine some very embarrassing positions occurring. I am acquainted with a partnership of four. One is an old doctor, who is a married man, and the other partners are bachelors. When the old doctor dies, who is to be appointed? I am sure that the remaining three bachelors would prefer to have another man, but this committee might appoint a good looking young woman of 25 years. Things are not always equal in this life, though I have known many good-looking young women, who also had the brains to pass the final

examinations as a doctor. Perhaps the Minister would say what would happen in a case like that, and how he would propose to overcome that difficulty.

Question put, "That the words proposed to be left out stand part of the Bill."

The House divided: Ayes, 277; Noes, 128.

Division No. 267.] AYES. [7.2 p.m.
Adams, Richard (Balham) Diamond, J. Kirby, B. V.
Alexander, Rt. Hon. A. V. Dobbie, W. Kirkwood, D.
Allen, Scholefield (Crewe) Dodds, N. N. Lang, G.
Allighan, Garry Donovan, T. Lavers, S.
Alpass, J. H. Driberg, T. E. N. Lawson, Rt. Hon. J. J.
Anderson, A. (Motherwell) Dugdale, J. (W. Bromwich) Lee, F. (Hulme)
Anderson, F. (Whitehaven) Dumpleton, C. W. Lee, Miss J. (Cannock)
Anderson, Rt. Hn. Sir J. (Scot. Univ.) Dye, S. Levy, B. W.
Attewell, H. C. Ede, Rt. Han. J. C. Lewis, A. W. J. (Upton)
Austin, H. L. Edwards, Rt. Hon. Sir C. (Bedwellty) Lewis, J. (Bolton)
Awbery, S. S. Edwards, N. (Caerphilly) Lewis, T. (Southampton)
Ayles, W. H. Edwards, W. J. (Whitechapel) Logan, D. G. I
Ayrton Gould, Mrs. B. Evans, John (Ogmore) McAdam, W.
Bacon, Miss A. Evans, S. N. (Wednesbury) McAllister, G.
Baird, Capt. J. Ewart, R. McEntee, V. La T.
Balfour, A. Fairhurst F. McGhee, H. G.
Barnes, Rt. Hon. A. J. Farthing, W. J.. McGovern, J.
Barstow, P, G. Fletcher, E. G. M. (Islington, E.) Mack, J. D.
Barton, C. Follick, M. McKay, J. (Wallsend)
Battley, J. R. Foot, M. M. Mackay, R. W. G. (Hull. N.W.)
Bechervaise, A. E. Forman, J. C. Maclean, N. (Govan)
Bellenger, F. J. Foster, W. (Wigan) McLeavy, F.
Benson, G. Fraser, T. (Hamilton) MacMillan, M. K. (Western Isles)
Berry, H. Freeman, Maj. J. (Watford) Macpherson T. (Romford)
Bevan, Rt. Hon. A. (Ebbw Vale) Freeman, Peter (Newport) Mallalieu, J. P. W.
Bing, G. H. C. Ganley, Mrs. C. S. Mann, Mrs. J.
Blackburn, A. R. Gibbins, J. Manning, C. (Camberwell, N.)
Blyton, W. R. Gibson, C. W. Manning, Mrs. L. (Epping)
Bottomley, A. G. Gilzean, A. Marshall F. (Brightside)
Bowles, F. G. (Nuneaton) Gooch, E. G. Mathers, G.
Braddock, Mrs. E. M. (L'p'l, Exch'ge) Greenwood, Rt. Hon. A. (Wakefield) Mayhew, C. P.
Braddock, T. (Mitcham) Greenwood, A. W. J. (Heywood) Medland, H. M.
Brook, D. (Halifax) Grenfell, D. R. Messer, F.
Brooks, T. J. (Rothwell) Grey, C. F. Millington, Wing-Comdr. E. R.
Brown, George (Belper) Grierson, E. Mitchison, Maj. G. R.
Brown, T. J. (Ince) Griffiths, W. D. (Moss Side) Monslow, W
Bruce, Maj. D. W. T. Guest, Dr. L. Haden Montague, F.
Buchanan, G. Gunter, Capt. R. J. Moody, A. S.
Burden, T. W. Guy, W. H. Morgan, Dr. H. B.
Burke, W. A. Haire, Flt.-Lieut. J. (Wycombe) Morley, R.
Callaghan, James Hardy, E. A. Morris, P. (Swansea, W.)
Champion. A. J. Harrison, J. Morrison, Rt. Hon. H. (Lewisham, E.)
Chater, D. Hastings, Dr. Somerville Mort, D. L.
Chetwynd, Capt. G. R. Haworth, J. Moyle, A.
Clitherow, Dr. R. Henderson, A. (Kingswinford) Nally, W.
Cluse, W. S. Hewitson, Capt. M. Naylor, T. E.
Cobb, F. A. Hobson, C. R. Nichol, Mrs. M. E. (Bradford, N.)
Cocks, F. S. Holman, P. Noel-Buxton, Lady
Collide, P. Holmes, H. E. (Hemsworth) Oldfield, W. H.
Collindridge, F. Horabin, T. L. Orbach, M.
Collins, V. J. House, G. Paling, Rt. Hon. Wilfred (Wentworth)
Colman, Miss G M. Hoy, J. Paling, Will T. (Dewsbury)
Cook, T. F. Hubbard, T. Palmer, A. M. F.
Cooper, Wing-Comdr. G. Hudson, J. H. (Ealing, W.) Pargiter, G. A.
Corbel, Mrs. F. K. (Camb'well, N.W.) Hughes, Hector (Aberdeen, N.) Paton, Mrs. F. (Rushcliffe)
Corlelt, Dr. J. Hughes, H. D. (W'lverh'pton, W.) Paton, J. (Norwich)
Corvedale, Viscount Janner, B. Pearson, A.
Cove, W. G. Jeger, G. (Winchester) Peart, Capt. T. F
Crossman, R. H. S. Jeger, Dr. S. W. (St. Pancras, S.E.) Perrins, W.
Daggar, G. John, W. Piratin, P.
Daines, P. Jones, D. T. (Hartlepools) Platts-Mills, J. F. F.
Davies, Ernest (Enfield) Jones, J. H. (Bolton) Poole, Major Cecil (Lichfield)
Davies, Harold (Leek) Keenan, W. Popplewell, E.
Davies, Haydn (St. Pancras, S.W.) Kenyon, C, Porter, E. (Warrington)
Davies, R. J. (Westhoughton) Key, C. W. Porter, G. (Leeds)
Davies, S. O. (Merthyr) King, E. M. Pritt, D. N.
Deer, G. Kingdom, Sqn.-Ldr. E. Pryde, D. J.
Delargy, Captain H. J. Kinley, J. Pursey, Cmdr. H.
Randall, H. E. Soskice, Maj. Sir F. Watson, W. M.
Ranger, J. Sparks J. A. Weitzman, D.
Rankin, J. Stamford, W. Wells, P. L. (Faversham)
Rees-Williams, D. R. Stewart, Capt. Michael (Fulham, E.) Wells, W. T. (Walsall)
Reeves, J. Stokes, R. R. Westwood, Rt. Hon. J.
Reid, T. (Swindon) Stubbs, A. E. Whiteley, Rt. Hon. W.
Rhodes, H. Swingler, S. Wilcook, Group-Capt. C. A. B.
Richards, R. Taylor, H. B. (Mansfield) Wilkes, L.
Robens, A. Taylor, R. J. (Morpeth) Wilkins, W. A.
Roberts, Goronwy (Caernarvonshire) Taylor, Dr. S. (Barnet) Willey, F. T. (Sunderland)
Robertson, J. J. (Berwick) Thomas, Ivor (Keighley) Willey, O. G. (Cleveland)
Sargood, R. Thomson, Rt. Hn. G. R. (Ed'b'gh, E.) Williams, D. J. (Neath)
Scott-Elliot, W. Thorneycroft, Harry (Clayton) Williams, J. L. (Kelvingrove)
Shackleton, Wing-Cdr. E. A. A. Titterington, M. F. Williamson, T.
Sharp, Lt.-Col. G. M. Tolley, L. Willis, E.
Shurmer, P. Tomlinson, Rt. Hon. G. Wills, Mrs. E. A.
Silkin, Rt. Hon. L. Turner-Samuels, M. Wilson, J. H.
Simmons, C. J. Ungoed-Thomas, L. Wise, Major F. J.
Skeffington, A. M. Vernon, Maj. W. F. Woods, G. S.
Skinnard, F. W. Viant, S. P. Wyatt, Maj. W
Smith, C. (Colchester) Walkden, E. Yates, V. F.
Smith, Ellis (Stoke) Walker, G. H. Zilliacus, K.
Smith, S. H. (Hull, S.W.) Wallace, G. D. (Chislehurst)
Snow, Capt. J. W. Wallace, H. W. (Walthamstow, E.) TELLERS FOR THE AYES:
Solley, L. J Warbey, W. N. Mr. Joseph Henderson and
Sorensen, R. W. Watkins, T. E. Mr. Hannan
NOES.
Amory, D. Heathcoat Hogg, Hon. Q. Price-White, Lt.-Col. D.
Baldwin, A. E. Holmes, Sir J. Stanley (Harwich) Prior-Palmer, Brig O.
Beamish, Maj. T. V. H. Howard, Hon. A. Raikes, H. V.
Bennett, Sir P. Hulbert, Wing-Cdr. N. J. Reid, Rt. Hon. J. S. C. (Hillhead)
Birch, Nigel Hurd, A. Roberts, W. (Cumberland, N.)
Boles, Lt.-Col. D. C. (Wells) Hutchison, Lt.-Cm. Clark (E'b'rgh W.) Robertson, Sir D. (Streatham)
Boothby, R. Jarvis, Sir J. Robinson, Wing-Comdr. Roland
Bossom, A. C. Jeffreys, General Sir G. Sanderson, Sir F.
Boyd-Carpenter, J. A. Lambert, Hon. G. Scott, Lord W.
Brown, W. J. (Rugby) Langford-Holt, J. Shephard, S. (Newark)
Buchan-Hepburn, P. G. T. Legge-Bourke, Maj. E. A. H. Shepherd, W. S. (Bucklow)
Butler, Rt. Hon. R. A. (S'ffr'n Wld'n) Lindsay, M. (Solihull) Smiles, Lt.-Col. Sir W.
Byers, Frank F. Linstead, H. N. Smith, E. P. (Ashford)
Challen, C. Lloyd, Maj. Guy (Renfrew, E.) Smithers, Sir W.
Channon, H. Lloyd, Selwyn (Wirral) Snadden, W. M.
Churchill, Rt. Hon. W. S. Low, Brig. A. R. W. Spearman, A. C. M.
Clifton-Brown, Lt.-Col. G. Lucas-Tooth, Sir H. Spence, H. R.
Conant, Maj. R. J. E. MacDonald Sir M. (Inverness) Stanley, Rt. Hon. O.
Corbelt, Lieut.-Col. U. (Ludlow) Macdonald, Capt. Sir P. (I. of Wight) Strauss, H. G. (English Universities)
Crosthwaite-Eyre, Col. O. E. Mackeson, Brig. H. R. Stuart, Rt. Hon. J. (Moray)
Crowder, Capt. John E. McKie, J. H. (Galloway) Sutcliffe, H.
Cuthbert, W. N. Maclean, Brig. F. H. R. (Lancaster) Taylor, Vice-Adm. E. A. (P'dd'fn, S)
Darling, Sir W. Y. MacLeod, Capt. J. Teeling, William
Davidson, Viscountess Maitland, Comdr. J. W. Thornton-Kemsley, C. N.
Dodds-Parker, A. D. Manningham-Buller, R. E. Thorp, Lt.-Col. R. A. F.
Dower, Lt.-Col. A. V. G. (Penrith) Marlowe, A. A. H. Vane, W. M. F.
Dower, E. L. G. (Caithness) Marples, A. E. Wadsworth, G.
Drayson, Capt. G. B. Marshall, D. (Bodmin) Wakefield, Sir W. W.
Foster, J. G. (Northwich) Marshall, S. H. (Sutton) Ward, Hon. G. R.
Fox, Sqn.-Ldr. Sir G. Medlicott, F. Watt, Sir G. S. Harvie
Fraser, Maj. H. C. P. (Stone) Mellor Sir J. Wheatley, Colonel M. J.
Gage, C. Molson, A. H. E. White, Sir D. (Fareham)
Galbraith, Cmdr. T. D. Morris, Hopkin (Carmarthen) White, J. B. (Canterbury)
Gammans, L. D. Morris-Jones, Sir H. Williams, C. (Torquay)
George, Lady M. Lloyd (Anglesey) Morrison, Rt. Hn. W. S. (Cirencester) Williams, Gerald (Tonbridge)
Glossop, C. W. H. Neill, W. F. (Belfast, N.) Willink, Rt. Hon. H. U.
Glyn, Sir R. Neven-Spence, Sir B. Willoughby de Eresby, Lord
Gomme-Duncan, Col. A. G. Nicholson, G. Winterton, Rt. Hon. Earl
Graham-Little, Sir E. Nutting, Anthony York, C.
Gruffydd, Prof. W. J. Orr-Ewing, I, L. Young, Sir A. S. L. (Partick)
Hannon, Sir P. (Moseley) Osborne, C.
Hare, Hn. J. H. (Woodb'ge) Peto, Brig. C. H. M. TELLERS FOR THE NOES
Headlam, Lieut.-Col. Rt. Hon. Sir C Pickthorn, K. Mr. Studholme and
Hinchingbrooke, Viscount Poole, O. B. S. (Oswestry) Commander Agnew