NATIONAL HEALTH SERVICE (FOREIGN VISITORS) (Hansard, 8 April 1949)

§ Sir Waldron Smithers (Orpington)
I wish to raise the question of the National Health Service Leaflet No. 2. This is a matter of much more importance than would appear on the surface. I need only read the short paragraph on the outside cover of this pamphlet. It says at the bottom: The National Health Service will provide you with all medical, dental and nursing care. Everyone, including all visitors to this country, whether of British nationality or not, can use it or any complete part of it. There are no charges except for a few special items, and no insurance qualifications are necessary. This leaflet is another bit of evidence of the extravagance, maladministration and irresponsibility of the Socialist Government. I understand that this pamphlet is available to all visitors on arrival at the ports of this country. The National Health Service Act, 1946, in Section 1 (1), states:
It shall be the duty of the Minister of Health (hereafter in this Act referred to as 'the Minister') to promote the establishment in England and Wales of a comprehensive health service designed to secure improvement in the physical and mental health of the people of England and Wales"— I ask the House to note particularly the words "people of England and Wales"— and the prevention, diagnosis and treatment of illness, and for that purpose to provide or secure the effective provision of services in accordance with the following provisions of this Act. I am not a lawyer, but I have taken the trouble to go through that Act and I can find nowhere in it where permission is given to the Minister of Health to issue a leaflet of this kind and offer the medical health services free to the 2440 whole world. The rest of the leaflet deals only with the headings of the medical services:—"Choose a doctor; Hospital and specialist services; Medicine, drugs and appliances; Care of the deaf; Care of the eyes; Home help services; Health centres."
The Minister of Health cares so little for the taxpayers of this country and for the contributors to this scheme that be offers free health services to anyone who likes to come to these shores. Since I have put down this subject for discussion, all sorts of letters have come to me, saying: "Yes, people come here, get spectacles and false teeth and then go off to Antwerp and Amsterdam and sell them." The duty of a Member of Parliament is to defend the interests of the taxpayer.

§ The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)
May I ask—

§ Sir W. Smithers
No. One of the people who have been to see me is a French doctor. He said: "It is all very well, but my patients who can afford the fare over from Calais go over for treatment and we are having a bad time as a result."
I have taken the trouble to give the Minister notice of some of the questions I want to ask. Will the Minister say how many copies of this leaflet have been published, how many have been distributed and what is the cost? Can he say how many foreigners have taken advantages of these services and what is the cost—that is in the case of people who have not paid any contributions and do not pay taxation in this country? May I further ask him—I could not give him notice of this question because the point was not put to me until about an hour ago—a question about the citizens of Eire? On Easter Monday the citizens of Eire become aliens under their recent decision. I should like to know whether the people of Eire are allowed to have free medical treatment? Will the Parliamentary Secretary please say also under which section of the Act this leaflet N.H.S. No. 2 was issued? I ask, because I hope that these questions will be read, that the Law Officers of the Crown and the Public Accounts Committee will look into this matter. If the Minister of Health has done this irresponsible act 2441 outside the terms of the Act, then I shall move that he be surcharged with all the expenses.
As I see it, this is part of the Socialist technique. They want to be able to tell the world: "Look what the Socialist Government of England can do for anyone who likes to come here. We will give you free teeth and free this and free that at the expense of the British taxpayer," and this at a time when we are living on borrowed money and upon the charity of America. I would like to tell the House one reaction at least to this health service. It has come from America. It was reported this morning in the "Yorkshire Observer." The report is as follows: Mr. Jenner, on 'suckers' and Bevan plan wigs. In the United States Senate's Marshall Plan debate in Washington yesterday, Senator William Jenner said: 'We suckers in the United States are paying for such damn foolishness as 30 dollar (£12 10s.) wigs for Britons.' That is the kind of impression that is being created in the minds of the very people on whom we are relying for our very existence. It is time we used all the dollars that are so generously sent to us, not in extravagant Socialist ideas, ideologies and slogans, but for the essential purpose of the economic recovery of this country, so that by 1952 we can again stand on our own feet. I look upon this matter as very serious and I ask the Minister to tell me the answers. The most important point is, in my opinion, whether this National Health Service leaflet comes within the terms of the Act.

§ Mr. William Ross (Kilmarnock)
Before the hon. Member sits down may I remind him that he referred to the England and Wales National Health Service? Can I take it that he is objecting to Scots people coming down here to get the benefit of the National Health Service? Is he considering them as aliens as well?

§ Sir W. Smithers
That is a most unfair remark. I quoted from the Act itself. There is a separate Health Service Act for Scotland. Scottish people pay their taxes and are entitled to the Health Service. The hon. Member may think himself lucky that he has Health Service officers in Scotland and not our present Minister of Health.

§ Dr. Haden Guest (Islington, North)
I am surprised that even the hon. Member 2442 for Orpington (Sir W. Smithers) has raised this matter in the way he has. Has he any evidence of the large-scale improvident supply of the various matters he has suggested such as wigs and artificial teeth, to people coming from abroad? Does he seriously believe that a large number of people are to be expected to come over here and, instead of admiring the historic beauties of this country, seeing the greatness of London and the beauties of Scotland and Wales and other places, are setting out to spend their time having dentures, wigs, artificial legs and so on fitted? He under-rates the intelligence of the people who come to this country.
I also ask him seriously whether he has any evidence of this being done on anything like a large scale and whether he has considered what would be the cost of setting up an organisation so that every time anybody applied for aid of this description, we had to enter into elaborate research to find his exact status and see where he came from and obtain a birth certificate and a certificate of nationality, and so? I suggest that the hon. Member's subject on this Adjournment Motion is one of the most frivolous ever put before the House.

§ Mr. William Shepherd (Bucklow)
I should not have spoken except for the view expressed by the hon. Member for North Islington (Dr. Guest). I suppose that he is so incensed by the L.C.C. elections results that he has taken this niggling attitude towards my hon. Friend the Member for Orpington (Sir W. Smithers).

Dr. Guest
Surely the hon. Member is aware that we do not yet know the results of the elections. We have not yet heard what Sir Percy Harris has to say.

§ Mr. Shepherd
I have no doubt that Sir Percy Harris will have a lot to say, but I must return to the subject of the Debate on this Adjournment Motion. It is, of course, true, as the hon. Gentleman says, that visitors to our shores would not be able to take much advantage of the facilities offered to them because the Minister of Health has got the main services mentioned—teeth, wigs and spectacles—in such a frightful state of congestion that they would have to stay such a long time that their expenses for stay- 2443 ing here would outweigh the material advantage gained from their spectacles, wigs or teeth. I agree with the hon. Gentleman that we do not stand in any serious danger of losing a lot of money, but at the same time the House is entitled to take very proper note of the complaint made by my hon. Friend.
Here is a leaflet being distributed to every person visiting these shores. Why on earth do we want to tell visitors such particulars of the services offered? We do not want them to take advantage of those services. There is certainly no advantage in bringing these facilities to their notice by means of distributing this leaflet. I should say that it is done because we have got gentlemen known as P.R.O.s in Government Departments. They have probably said, "Would it not be a great boosting idea to tell every foreigner coming to these shores what a wonderful health service the British Government is providing?"

§ Mr. Scollan (Renfrew, Western)
Is there anything else in the leaflet except the paragraph complained of?

§ Mr. Shepherd
I do not think there is anything at all; it is just a leaflet which deals specifically with the National Health Service. I should have thought that to be a matter of purely domestic importance.

§ Mr. Scollan
Will the hon. Member make quite clear about the paragraph complained of. The hon. Member for Orpington complained that it was a small paragraph at the end of the leaflet and that the leaflet had another page.

§ Sir W. Smithers
I said nothing of the kind. I read from the title page of the leaflet. The rest of the leaflet explains the service in detail.

§ Mr. Scollan
That is the main point.

§ Mr. Shepherd
It is clear that the leaflet does not fulfil a dual purpose. It is not like the other leaflets which ask where one stayed for the last fortnight and so on. It is a leaflet which deals with a purely domestic matter, and I can see no justification for dishing up leaflets to foreigners visiting the country explaining what a wonderful National Health Service we have here. Every day we are telling people that we are short 2444 of foreign currency and that we have to import paper and pulp at high cost, and here we are dishing out leaflets to people to whom they are no concern. My hon. Friend has raised a point of substantial importance. There is no point in dragging to the attention of foreign visitors the services which they can get. I agree that it may be administratively impossible to debar foreigners from getting the services, but we are not anxious for foreigners to get them. It is one thing to allow foreigners to have these services, but purposefully to draw their attention to them in order to stimulate them to use the services, seems to be the height of folly. I can only suggest that it is an excess of zeal on the part of either the Minister of Health or a P.R.O. whom he employs. There are two remedies. One is to get rid of the Minister of Health and the other is to get rid of the P.R.O. Both would be a distinct service to the country.

§ Mr. Kenneth Lindsay (Combined English Universities)
I must apologise to my hon. Friend the Member for Orpington (Sir W. Smithers) for not being present when he was speaking, but I was called away suddenly. I think this proposal is an excellent idea. Some 130 Members of Parliament have signed an important Motion about European Union. I want to see the Minister of Health make this service reciprocal. I want to see extended to the health services what the Minister of National Insurance has already done in his field. It would be a good idea if the Minister of Health started with Belgium, which is one of the countries with which we have already made a good arrangement on other parts of the social services. If we mean anything by Western Union, we have to extend it, not only to the economic field, but to the whole of the social services.

§ Mr. Lever (Manchester, Exchange)
May I ask my hon. Friend a question? Is that what is meant by the express intention of the Foreign Secretary to put teeth into Western Union?

§ Mr. Lindsay
That is a helpful remark but I am not sure about its relevance. The Minister of Health is a person of some imagination, and if he could get into contact with the Minister of Health in Brussels, and possibly even France, he 2445 might be able to make a useful arrangement. There are literally thousands of young people going from this country to France, Belgium and Holland this year. If the services in those countries could be made available to them just as the services in this country are being made available to the French and the Belgians and the Dutch, it might well be the beginning of a much greater and more useful side to a good deal of the talk on internationalism which is at present prevalent. I commend that idea to the Parliamentary Secretary, and I hope he will convey it to the Minister.

§ The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)
May I first mention that the last matter raised is already under consideration and discussion. On the major issue raised by the hon. Member for Orpington (Sir W. Smithers), that is a matter which I am rather surprised should be raised by an hon. Member with such a background, and one who is so well known for his opposition to red tape. One of the virtues of the National Health scheme is that, so far as the patient is concerned, very little red tape and form filling is involved. The proposal of the hon. Member for Orpington would inevitably mean masses of new red tape—indeed one hon. Member seemed to suggest that he accepted that fact—and a great deal of new organisation in order to discriminate in a highly undesirable way between one section of the people in this country and another.
Now may I answer the question of which the hon. Gentleman was good enough to give me prior notice. He questioned the legality of this leaflet. There is no question at all about the legality of the issue of notification to those coming to our shores of the provisions available for their use. There is no question at all that there is provision in a series of different Sections of the Act which cover this position completely. I refer to Sections 3, 27, 33, 38, and 41. If the hon. Member for Orping-ton would refer to those later, he will satisfy himself that there is no question at all about the legality of this matter.
The hon. Member conjured up some frightful vision before our eyes of an invasion of our shores not by the sea—a subject with which I was dealing a short 2446 time ago—but by those anxious to obtain glasses, false teeth, wigs, artificial limbs, and so on. That, of course, is merely a figment of his disordered imagination. I understand that similar fears were expressed when the National Insurance Act, 1911, was introduced, and that there were stories at that time about false teeth being sold in the bazaars of the East. I have no doubt that it is the same false teeth about which the hon. Member for Orpington is having some messages today.
The hon. Gentleman asked me how many leaflets had been printed and how many, up to date, had been distributed. Seven hundred and fifty thousand copies have been printed and up to date 170,000 have been distributed. He asked me some questions about the number of foreigners who have been treated under the National Health Service Act. We cannot give him those figures because we do not—and do not intend to—discriminate between one section of the people who are here in our land and another. To do so would immediately raise the very issue I have mentioned. If we were to discriminate—to try to get the sort of statistics the hon. Member wishes—it would inevitably mean that we should have to require the completion of some difficult forms; that we should have to require people of all nationalities inside this country to submit themselves to an examination about their nationality, and all kinds of provisions that, I should have thought, the hon. Member for Orpington would not particularly desire. Certainly, the Government have no intention of introducing any regulations of that kind, which, as my hon. Friend the Member for North Islington (Dr. Guest) has mentioned, would in all probability cost a great deal more than the cost of the minor provisions now being made.

§ Sir W. Smithers
I also asked the cost of printing.

§ Mr. Blenkinsop
Four hundred and twenty pounds.
One or two other comments were made. In particular I was really surprised at the hon. Member's reference to the comment of an American in a Debate in the American Congress. I wish he had read also the comment of another Congressman who replied on this very issue; I hope he will do so at some later time. On this matter of the attitude of Americans, 2447 Canadians arid others who come to our shores and have experienced the value of the service we provide, I would say that not only do they express themselves as delighted and gratified with what we are able to do for them, but that it enables them to go back with a deeper sense of friendship for us in this country. In this respect I agree very much with what the hon. Member for the Combined English Universities (Mr. K. Lindsay) said in his intervention. The provision of these services has helped to provide a very much greater friendship for this country. We have had tributes from very high officials in America, Canada and elsewhere. Letters of appreciation come in regularly which show how much this work is appreciated. In securing better relationships between the countries of the world this is, perhaps, a small but useful step in the right direction.
Finally, I should like to put the matter in its proper perspective. How big an issue is it? Statistics show that last year approximately some 633,000 foreign visitors came to these shores. If we were to assume that they were to stay about a month in this country—that is too long an average, but let us use that basis—and were to make the average use of our services which our ordinary population enjoys—which, again, is highly unlikely—the cost, on these assumptions, would run out at something like £200,000 a year. I do not feel that that sum of money which is certainly a very generous estimate of what the cost is likely to be, should arouse any anxieties in this country. On the other hand, I am absolutely certain that everyone in this country would bitterly resent any attempt of the hon. Member to tie us up in further 2448 regulations and restrictions, which I am sure would be objectionable to us all. I suggest that the scheme introduced and its general availability is one of its greatest attractions. It is doing very valuable service, not only to people of our own country, but to those who visit us and we are satisfied that for the very small expenditure which may be involved we are doing good service to our friends throughout the world.

§ Mr. K. Lindsay
The hon. Gentleman was good enough to answer my intervention by saying that discussions were going on. I think that is the first news we have had of them. Could he say whether they are being actively pursued?

§ Mr. Blenkinsop
I could not say, except that a Question was answered by my right hon. Friend yesterday relating to this matter.

§ Mr. Shepherd
Does the hon. Gentleman think it is a proper thing, in view of the intense congestion in all the health services, that we should draw the attention of foreigners to this service which is provided for them?

§ Mr. Blenkinsop
We take the view that those coming to our shores should know what facilities are available in case they need them and I believe that is the right attitude to take. It would he wrong to try to hide what provision was available and to try to dodge a service we could properly render to people coming to this country.