HC Deb 18 January 1949 vol 460 cc125-36

Motion made, and Question proposed, "That this House do now adjourn."—[Mr. Collindridge.]

7.45 p.m.

Mr. Sutcliffe (Royton)

I want to raise a subject which is causing much concern, the taking over by the State, under the National Health Service Act, of hospitals which have been privately endowed by the generosity of an individual person. A man after a life of hard work has left his savings to found and to endow a hospital for the lasting benefit of the people of his home town. It would be difficult to imagine a better way to benefit the community than that which I have mentioned. Such a man was Dr. Kershaw of Royton. He died in 1909, and after leaving certain personal bequests in his will, he left the residue of his estate to his trustees to be applied to the founding, establishment, maintenance of a General Hospital or Infirmary in the township of Royton, on land owned by him. Such a hospital was to be free and open to all applicants.

The war of 1914–18 intervened, and the difficult years which followed it prevented the building of that hospital until towards the end of the 1920's. It was however built and ready for opening by 1930. Approval was given by the Charity Commissioners to the scheme, according to the terms of Dr. Kershaw's will. It cost £20,000 to build. After that sum had been spent, there was still an endowment fund of not less than £67,000, which now has reached £71,000 because of interest on investments and one or two other legacies which have come in. I want to emphasise that not a penny has been given otherwise by the people of the town or has been collected through the rates or in any other way. There has never been a flag day. The endowment fund was sufficient to last for all time and to fulfil all the purposes of this hospital. The hospital is a self-contained unit of 19 beds, where patients can receive the best treatment under the best circumstances, at as low a cost as 5s. a week in some cases. A weekly payment of 10s. has been quite usual. Many people have come from surrounding districts as well as from Royton, and the proportion of these had been in the region of four to two.

The control and management of the hospital was vested by the Charity Commissioners in a committee of nine, five of whom were to be members of the Urban District Council. The remaining four, two of whom were to be women, were people interested in hospitals generally. It was a thoroughly representative committee. The Charity Commissioners were careful to add that a minister of religion or a person professing Socialist opinions was not eligible to be a member of the committee. That provision was in strict compliance with the terms of Dr. Kershaw's will, in which he laid down that no Socialist or person known to hold or profess Socialist opinions should be at any time a trustee, director or manager of the said hospital. That was in 1909. He was a man wise in his generation, indeed a man who was wise ahead of his generation. Even at that time he could foresee the dangers inherent in a system of Socialism, and great credit is due to him for his foresight. I must add that he also pressed the view that clergymen and ministers of religion should not be trustees of or in other ways connected with the hospital.

The committee fully thought that the hospital would be disclaimed under Clause 6 (3) of the National Health Service Act. Not for one moment did they think it would be otherwise. They were therefore surprised to receive a letter dated 24th September, 1947, from the Minister in which it was stated that the Minister was of opinion that the hospital was transferable to him, and if the committee knew of any circumstances why it should not be, they should take an early opportunity of putting forward their reasons. They therefore applied to be disclaimed under the Clause by letter dated 7th November, 1947. Four months passed without an answer. The Committee naturally wondered what the position was, but they heard nothing until 11th March, 1948, when there came a letter stating that the Minister had decided not to disclaim the hospital. Meanwhile, on 3rd March a notice had appeared in the "Manchester Guardian" giving a long list entitled: Hospitals Under Health Service. Groupings in the Manchester Region. The name of the hospital did not appear in that list, only eight days before the Minister's letter, and I should like to know why it was not included in that list which had obviously been inserted by the Minister of Health. Was it due to the fact that the whole question was still under consideration and that there was some doubt about it? Combined with the fact that there was such a long delay in replying, it suggests some difference of opinion. Perhaps also the Parliamentary Secretary will be able to tell us why the hospital was not disclaimed. I understand that 16 in the Manchester area alone were disclaimed and that a considerable number were throughout the country. I should have thought that this hospital would have been the one to be disclaimed if ever there was one.

It has always been the aim of the courts and of Parliament to respect the wishes of a testator. The courts indeed have gone to considerable lengths to construe the wishes of a testator in the way which they thought would be his desire. We have always been proud of our care to honour a last will and testament in this way. There is no precedent in history for the Government's treatment of charitable trusts which is shown in this Act. All this was forcibly brought out during the Committee stage of the Bill on 23rd May, 1946, and other days by my hon. Friends. We shall live to regret this direct contravention of the wishes of so many men who have endowed hospitals in this way.

Clause 6 (4) states that all property should vest in the Minister free of any existing trust. However, the paragraph goes on: The Minister may use any such property for the purpose of any of his functions under this Act, but shall so far as practicable secure that the objects for which any such property was used immediately before the appointed day are not prejudiced by the provisions of this section. The words "so far as practicable" leave a loophole which enables the Minister if he wishes to ignore altogether the objects for which the endowments were made. Considerable effort was made in the Standing Committee to bind the Minister as regards trusts taken over and to insert something much more definite than the words "so far as practicable," but all was unavailing. The Minister of Health refused to take the slightest notice of our appeals and by so doing he has undermined all charitable bequests because he is able to wriggle out of everything as a result of the words "so far as practicable. "How different is the Education (Miscellaneous Provisions) Act, 1948——

The Parliamentary Secretary to the Ministry of Health (Mr. John Edwards)

The hon. Member is going into a field of argument to which I cannot possibly reply because it would mean that I should have to discuss amendment of the law.

Mr. Deputy-Speaker (Mr. Bowles)

The hon. Gentleman is wrong. The hon. Member for Royton (Mr. Sutcliffe) was saying that the Minister had a power to disclaim which he had not exercised.

Mr. Edwards

With respect, Mr. Deputy-Speaker, I gathered that he was saying that another Act was so drafted as to give the kind of thing he wanted, whereas the National Health Service Act was not so drafted. I fail to see the point of the argument unless it was that the Act should be drafted differently.

Mr. Deputy-Speaker

No, the hon. Member was still complaining of the non-exercise by the Minister of his power to disclaim. He has not yet got to his argument on the National Health Service Act.

Mr. Sutcliffe

I was about to say that the Education Act, which refers to another Department and is no concern of the Minister who is present, lays down a different proposition altogether, because by that Act the Minister has power by Order in Council to take over the endowments of any educational or semi-educational property which has been vested in the charity commissioners, but in every case their assent is needed when the endowment has been in existence less than 50 years. I was merely saying how much better it would have been if that provision could have been inserted in the National Health Service Act.

I ask the Parliamentary Secretary, and through him, the Minister, to reconsider the position of these hospitals. The Act is already on the Statute Book and presumably the only way in which it can be altered is by way of regulation. Appeals were made to the Minister during the Committee stage to do this, and he still has an opportunity if only he will do it. I make that appeal to him now.

Finally, I want to ask the Parliamentary Secretary what is the future of this little hospital, which is so fully equipped to deal with every kind of case. It has a fine operating theatre which is still ready for full use. I am told that now only half a dozen patients are in it, whereas, previous to this Act coming into force, the beds were nearly always full and there was often a waiting list. I am told that people needing operations are being sent elsewhere because no longer are they using the operating theatre at that hospital. There is, indeed, a suspicion that it will become merely a home for infirm or elderly people. I sincerely hope that will not be the case.

I hope that a similar fate does not await this hospital which befell the Yorkshire Home for Incurables at Harrogate where they had 70 beds and an endowment fund of £100,000 raised by public subscriptions, donations and legacies. Strong protests were made by the committee of that hospital, but they were finally cajoled into giving consent to come in under the scheme by the threat that they would find it difficult to get nurses if they remained outside. Well, they went into the scheme, but instead of that hospital being continued as a hospital, it is used now as the finance department of the local hospital board, and instead of people being admitted from the long waiting list, there is a host of clerks there and the whole building has become offices. I think that must be one of the greatest hoaxes which have been perpetrated upon the committee of any hospital, and I hope that such a fate does not await the hospital to which I am drawing attention tonight.

It is action of this kind which makes people apprehensive of the future. Already, by taking over its endowments without any consultation with the committee or anyone in the town, the local character of this hospital has been to some extent destroyed. Feeling has been running high, I can tell the Parliamentary Secretary, ever since it was known that it was to be taken over, because this town is proud of the work which the hospital has done for its people and for those in the neighbourhood. Unless the hospital is allowed to play its full part, it is no exaggeration to say that it will be a scandalous betrayal of the wishes of the testator. Indeed, it will be detrimental both to the town itself and to the surrounding neighbourhood. I hope that the Parliamentary Secretary will be able to give an assurance on this point or, at any rate, if he cannot go any further, say that the hospital will continue to be used to its full capacity as a hospital for the purpose for which it was endowed.

8.5 p.m.

Mr. Roland Robinson (Blackpool, South)

I have listened with great interest to the plea for Dr. Kershaw's Cottage Hospital at Royton which has been so well made by my hon. Friend the Member for Royton (Mr. Sutcliffe). He can speak with first-hand knowledge of the conditions of the hospital and for the people of Royton in a way which I could never hope to do. However, I should like to put the matter to the Parliamentary Secretary from the point of view of the family of the late Dr. Kershaw.

There is one son surviving, Mr. Raymond Kershaw, who is a constituent of mine, a man whom I have known personally for a good many years, and he is, I believe, a man of integrity whose views should be respected. After the decision of the Minister was announced, he came to me and brought to me a copy of his father's will, which he asked me to read carefully. Of course, I did so, and then he told me something of the surroundings when the will was made. He pointed out at the time that he and the rest of the family were grown up, they were standing on their own feet, and when their father said that he wished to leave the money to endow this cottage hospital, they said that they were all in perfect agreement that they should give up their inheritance in order that Royton might have this cottage hospital.

With that in mind, it is no small wonder that the surviving members of the family still take a keen interest in the hospital. He told me that they were all, and still are, in agreement with the views of their father when he laid down that no person known to hold or express Socialist opinions should at any time be a trustee, director or manager of the hospital. The matter was discussed with them by their father before he died, and they believed that he was right, and I and many of us on this side of the House will think that he was wise well before his time in foreseeing that that would give bad administration, and therefore trying to do all he could to avoid it. Indeed, the behaviour of the Ministry of Health on this matter seems to reinforce what has happened, and the very fact that the first time the hospital desires to take up so important a matter with the Ministry, it takes them four months to reply to a letter, seems to me to be strong evidence of bad administration of the type that Dr. Kershaw wished to avoid.

Be that as it may, he left the money, and the family gave up what they believed was to have been their inheritance, for the public good upon certain conditions. Above all, the father and the family wanted to see his hospital with good administration and run on grounds so that there should be no racial, religious or political discrimination, and they felt in their hearts that by not having Socialist administration they could get what they wanted. So far as I know there have been no complaints about the running of the Royton Cottage Hospital. The people connected with it in the past have done their job well. The people of Royton who have passed through the Hospital are well satisfied with it, and the members of the family have been proud of its administration over the past years. Therefore they were very distressed when it was to be taken over under the new scheme, and Mr. Raymond Kershaw wrote to me: Is it to be the law of this country that the wishes laid down in my father's will, the terms on which he left money for the public weal, should be cut out, be ignored altogether? I urge the Parliamentary Secretary to consider this matter. It is not in any way a matter of legislation but simply one of a small hospital which is a borderline case and one in which the Minister could quite well have exercised his discretion to leave it under its previous system of operation. I submit that it is not too late, that without the loss of any face and with goodwill, the Minister could reverse his decision in a case where feelings are high. After all, it has been said that the Socialists these days are greedy for power. Here is an opportunity to show that there is no such greed, and to carry out the wishes of a dead man and the present day family who gave up their money for this purpose.

If the Minister cannot do that, can he at least say that, so far as is practicable, he will try to carry out the wishes of the testator, and have the hospital administered by a board of governors of the type which the testator wished to administer it? The Minister has the opportunity to do the right thing tonight will he do it?

8.10 p.m.

The Parliamentary Secretary to the Ministry of Health (Mr. John Edwards)

I am grateful to the two hon. Gentlemen who have spoken for the way in which they have put this case and I will try to deal with them in a similar manner. It is true that the hospital service of this country has been built up largely by private benefaction. There is no doubt that we owe to the kindly thoughts of people in the past many of the institutions of which we are now proud. I put it to the hon. Gentlemen that that was well known at the time of the passing of the Act, that everyone knew that we would be taking over large numbers of voluntary hospitals and that it was necessary in the Act to provide for how they should be transferred and for what was to happen to their endowments. Section 6 of the Act deals quite clearly with what is to happen about transfers and Section 7 deals equally clearly, I think, with what is to happen to endowments.

It is obvious that the late Dr. Kershaw was a very public-spirited man. Indeed, he seems to have been a man of considerable parts. I noticed that his views about Socialists met with the approval of both hon. Gentlemen. I was not clear from what they had said, however, whether this late doctor's views on ministers of religion met with their approval also. It is very difficult to argue as though we knew what would be the views of Dr. Kershaw were he alive now. Reference has been made to his son and to his will but in this respect this particular hospital is no different from hundreds of other privately endowed voluntary hospitals which existed and were taken over on the appointed day.

The hospital was administered under a scheme for which the Charity Commissioners were responsible. The Charity Commissioners did not in any way oppose the transfer, and I do not think that the hon. Member for Royton (Mr. Sutcliffe) suggested that we had not acted within the law. Had there been any suggestion to that effect the Minister could have taken the matter to arbitration under the regulations which he made.

Mr. R. Robinson

May I ask the Parliamentary Secretary a question before he leaves that point? 1 think that my hon. Friend the Member for Royton (Mr. Sutcliffe) made clear our feeling that this hospital is in a different position from the others which have been taken over because, although the others initially may have been endowed by one person, in general they have been maintained by public subscription. I think it fair to say that this hospital is the result of the money of one man, and one man alone, and that appeals for support have not been made to the general public.

Mr. Edwards

That may be perfectly true, but the hon. Gentleman is wrong if he supposes that this is the only hospital to which such a statement applies. There are other hospitals of precisely the same kind. In any event, if we are talking about a matter of principle it does not really matter whether there was only one person or whether there were many more. Quite a number of voluntary hospitals which we took over on the appointed day come essentially into this category.

Under the Act the Minister had to answer the question: Do we need the hospital for the new service? It was said that the committee thought that the hospital would be disclaimed, and the hon. Member for Royton (Mr. Sutcliffe) rather took us to task because it took four months to decide what should be done. What, in fact, happened, was this. We did not take each request as it was received. We took all the requests and had to wait until we had the advantage of consulting the regional hospital boards which we had set up. That was a reasonable thing to do. It was no use taking the cases piecemeal. We had to have some idea of the general principles upon which we would work and we wanted the benefit of the opinion of those who were to be the Minister's agents in running the new service.

On the face of things, it appeared that this hospital ought to be transferred because it was needed in the new service. We did, however, seek the opinion of the regional hospital board, who expressed the same view. It is true that 16 hospitals in the Manchester region were disclaimed, but not one of them can be said to be comparable to the particular hospital about which we are talking tonight. They were hospitals either run by religious bodies or, quite frankly, ones which we did not want. In fact, only by some queer twist could some of them have been called hospitals at all. It was really a question of need.

I admit to some difficulty in arguing with the hon. Gentlemen because, supposing we had said that we did not need the hospital, by whom would it have been needed? If it is said that it was needed by the people of Royton, which I imagine to be the argument, then the Minister of Health, through all the agencies established under the Act, is responsible for providing the health services in Royton. It seems to us therefore, that if we had, as we had here, a cottage hospital well equipped, it was essentially part of the provision which had to be made in that place.

It is true that the "Manchester Guardian" on 3rd March published a list of hospitals with their groupings, but I think it was erroneously understood that if this hospital was not in the list it would be disclaimed. I have already explained that we were holding all the applications for disclaimer until we could look at the position as a whole and ascertain the local views. As we approved the lists the groupings went back to the regional board. Doubtless it was the regional board who gave the list to the "Manchester Guardian." It would have been silly for us to put into our grouping list cases which we were then considering and in which we had not decided whether or not to disclaim.

Mr. Sutcliffe

In those circumstances would it not have been much wiser to wait until all the answers had been received and considered before publishing an official list?

Mr. Edwards

We did not publish an official list. Neither could we have waited when there were only a dozen or so cases of application for disclaimer. We could not have waited for the grouping of the hospitals, because the regional board had the task of setting up the hospital management committees for each group. It was quite impracticable for us to hold up everything pending a decision on disclaimer in these cases.

Therefore, the view which 1 am bound to take is that this hospital is not in any fundamentally different position from large numbers—indeed, hundreds—of voluntary hospitals up and down the country, and that the Minister's duty was perfectly plain. He had to decide, under the Section, whether we needed the hospital or not. I hope I have made it plain that we could not come to the conclusion that this modern cottage hospital was not necessary for a proper service in Royton and district.

Mr. Selwyn Lloyd (Wirral)

I understand that the Minister wants to use this cottage hospital as a cottage hospital. If that is so, for how long does he intend so to use it; or is it the intention ultimately to make it merely an emergency hospital and to transfer the more permanent patients to a larger and new institution?

Mr. Edwards

That point has been put forward already and I was coming to it in due course.

If the arguments advanced by the hon. Gentlemen are really sound, it would follow that we should have had to disclaim, I believe, the overwhelming majority of our voluntary hospitals. 1 do not think there is any reason to suppose that the hospital will serve the neighbourhood less efficiently as a unit within the new service than if it were left on its own. I think that the opposite will be the case and that this hospital as part of the National Health Service is likely to become of greater service to the people of Royton than if it remained as a solitary, isolated institution. There is a lot of public misunderstanding but when hospitals become part of the National Health Service they do not cease to be the property of those they are serving. I beg the hon. Member to go back and assure the people of Royton that this is their hospital and that it is just as essential as ever it was that they should take an interest in it. Otherwise, it will not be the success we want it to be.

I think the general intentions of the late Dr. Kershaw will be maintained. The regional board and the new management committee, as agents of the Minister, are under an obligation to have regard to the past purposes of the hospital in determining its future use. In practice it means that the hospital management committee, or the regional board, are not entitled to divert it to other uses, unless it is absolutely clear beyond any kind of doubt that the services needed by the neighbourhood are able to be provided in other ways. One cannot speculate about the distant future, but one can say that the hospital will be used as a cottage hospital, as in the past. If the intention of the late Dr. Kershaw was that there should be no racial, religious, or political discrimination, certainly that intention will be fulfilled for there is no likelihood that there will be discrimination of that kind in one of the hospitals for which the regional board are responsible to the Minister who is responsible in turn to this House. Whether that particular control would accord entirely with the late doctor's wishes, I would not begin to speculate, but I feel that the kind of institution which the late Dr. Kershaw wanted will be kept on under the present administration.

I think it better for the hospital to be part of the big national service, with all the link-ups which that means, and with the specialised services and so on, than for it to be quite independent. I have every reason to suppose that the hospital will be fully used although it may, as in the past, serve an area somewhat wider than the township of Royton. I ask the hon. Members who have raised this matter to believe that we have acted in what we believe to be the best interests of the people of Royton. We have quite faithfully exercised the powers given us by the Act. I hope that any misunderstanding or any disquiet there might be will be allayed by the explanation I have given and that the people of Royton, recognising that this will still be their hospital, will do their best for it.

Mr. Selwyn Lloyd

Will the hon. Gentleman answer the point I made? Will he say that there is no intention at all of changing the function of the hospital and no scheme afoot to turn it into a casualty clearing station?

Mr. Edwards

I am sorry, I had no intention of evading the point. I have made it clear that, without speculating about the long-distant future, it is the present intention to use the hospital as in the past as a cottage hospital.

Adjourned accordingly at Twenty - five Minutes past Eight o'Clock.