Clause 5.—(INTERPRETATION.) (Hansard, 8 July 1949)

§ Mr. Peter Thorneycroft (Monmouth)
I beg to move, in page 2, to leave out lines 42 and 43.
This is a drafting Amendment. It is no longer necessary to define the local health authority, as there is no reference to the local health authority left in the Bill.

§ Mr. Godfrey Nicholson (Farnham)
I beg to second the Amendment.

§ Mr. Bing
Before we part with this Amendment, I should like to call attention to the fact that originally this was a Bill to deal with local authorities. That was the Bill to which, in the main, the House gave its Second reading. It is now, to say the least of it, in a slightly odd position. We have now reached the stage of leaving out the definition of a local authority, so little have the powers of the local authority to do with the matter. I think that the attention of the House should be called to the great alterations which have taken place in the Bill and of which this Amendment is, so to speak, a visible sign.

Dr. Guest
May I point out that this is precisely the point to which I called attention on Second Reading, but the definition is now being taken out on the Motion of the hon. Member opposite.

§ Mr. Bing
I hesitated to rise to speak first, because I naturally expected that the hon. Member for Monmouth (Mr. P. Thorneycroft) would take the opportunity of saying a few words as to why we should accept the Bill in its present condition. He has perhaps thought the position is not defensible and has hesitated to do so.
I suggest that the House should refuse to pass this Bill on three grounds. The first of those grounds is that it is based on a legal misapprehension as to what is the law, or, indeed, what was the law. It is also based on an incomplete study of what the leading Members of the party of the hon. Member for Monmouth said on the same matter when considering it on a previous occasion. Secondly, I suggest this Bill should not be accepted because it was carried through Committee and advocated in this House on arguments which can be shown not to be correct and by allegations which were completely unfounded. In view of the fact that in one particular case a hospital has been blackguarded in the public Press, I hope that the House will permit me to deal in some detail with the type of arguments which the hon. Gentleman saw fit to put before the House. The third ground is that it would hinder rather than help the administration of analgesia.
I should like to make an appeal to my hon. Friend the Member for Epping (Mrs. Manning). I hope that she will consider my arguments. As I said in Committee, I always feel that if I find myself going into the same Lobby as hon. Members opposite, perhaps I am doing something wrong, but if I do not find myself going into the same Lobby as my hon. Friend the Member for Epping I am also in doubt as to my political attitude. I hope that she will not put anyone into a difficulty so that we shall have to choose between her view and the contrary, if the House does not accept the 2549 argument which I am about to advance without going to a Division.
Before I come to deal with the argument, perhaps I might be in Order in making one general remark. There has been a concerted attack made throughout the Press of the country on the political honesty of hon. Members who oppose this Bill. There is no reason why the point of view of those who oppose this Bill should not be properly considered. I should like to give the House one example of this kind of irresponsible attack. I know that the hon. Member for Monmouth always takes the view, and I am sure that he sincerely holds it, that he did not introduce this Measure for any party purpose. He thought, "Here is a wrong, and I am the man to set it right." I am certain that that is the position. But what has happened is that he has allowed himself to be used for purely party purposes. I will give one example. Mr. A. J. Cummings, who is usually a reasonably fair critic, so misunderstands the matter, and indeed our Parliamentary procedure, that last Tuesday he wrote: So Mr. Peter Thorneycroft's valuable and inexpensive Analgesia in Childbirth Bill has been talked out.… Of course, that is perfectly untrue. It was not talked out. The House took a reasonable time for its consideration and we are now entering on Third Reading with a reasonable time in which to consider the matter. Mr. Cummings said: So Mr. Peter Thorneycroft's valuable and inexpensive Analgesia in Childbirth Bill has been talked out, though it had the support originally of members of all parties and the majority of the House. Of course, there was a majority of the House in favour of the principle of analgesia. Indeed, the work done by the Minister of Health in that field shows that, but as it can be seen by the votes in the Standing Committee against rather dubious legal proposals contained in this Bill, the Bill has not that support. Mr. Cummings continued: But Mr. Bevan, a victim of stubborn party prejudice, and jealous of his own authority, would not have the Bill at any price. He had little support in the Press, apart from one of his cronies who nearly burst his blood vessels in defence of the Minister. This has been an unpleasant business, which women in general are not likely to forget. Such is the party appeal made against this Government who have done more for analgesia than any other Government. 2550 Fortunately, I think that the majority of hon. Members realised that their duty is, as Burke said, to give to their constituents not only their diligence—if one looks round the Chamber today, there are perhaps some hon. Members who interpret that in a rather liberal sense—but their judgment as well. I appeal to hon. Members to consider this Bill in its actual realities and not on the basis of any possible misrepresentation of their actions which may appear in the Press if they oppose it.
I come to my first point, which is that this Bill was, and is, based on a complete legal misapprehension. The hon. Member for Monmouth came to the conclusion that the Minister of Health was acting illegally in arranging for the administration of analgesia. In order to bolster his position he obtained counsel's opinion. Not only did he obtain the opinion of an English counsel, but he obtained the opinion of a Scottish counsel as well. Both these eminent legal authorities gave to the hon. Member for Monmouth the opinion that what had been done to relieve women in childbirth was quite wrong and improper. If the hon. Member for Monmouth has such a great devotion for the law, he ought to take proceedings and have the procedure prohibited by the Minister. That was not the view of his own party. In both the English and Scottish National Health Acts, in Part III, there is a description of the duties of local health authorities.

§ Mr. P. Thorneycroft
On a point of Order. I do not wish to curtail the observations of the hon. Gentleman, but could he say in what part of the Bill these references to the law relating to local health authorities are made? As far as I know, there is no reference to local health authorities in the Bill.

§ Mr. Deputy-Speaker (Mr. Bowles)
I do not think that that is a point of Order. The hon. Gentleman may make the references if he cares to.

§ Mr. Bing
If I might reply to that point, I would say that one has some difficulty in dealing with this Bill at all. It was commended to the House for a certain set of reasons, and now the hon. Member for Monmouth says that the arguments put forward, the reasons given and the documents adduced do not refer to the Bill now, because all the matters 2551 they referred to have been removed from it. Perhaps I might continue on this line——

§ Mr. Thorneycroft
Might I seek your guidance, Mr. Deputy-Speaker? I think it might help us in our later discussions. As I understand the rules of Order relating to the Third Reading of a Bill, one must direct one's remarks to what is in the Bill and not to what has been cut out or what one thinks ought to have been put in.

§ Mr. Deputy-Speaker
That is true, but the hon. Member for Hornchurch (Mr. Bing), as far as I understand him, is saying that what is in the Bill is not necessary and he is proceeding to give his reasons.

§ Mr. Thorneycroft
I am not seeking to curtail discussion in any way but, if I might refer to what has been cut out, there was an important Clause in the Bill which dealt with the duties of a local health authority. It is perfectly true, as the hon. Gentleman said, that counsel's opinion was taken. The Clause was argued about in two Committees upstairs, but it is no longer in the Bill. There is no reference to it anywhere. If we were all to embark upon a long discussion as to whether I was right or wrong in the views I expressed upstairs about a Clause which is no longer in the Bill, I think that we should get very wide of a Third Reading Debate.

§ Mr. Deputy-Speaker
I will listen very carefully to what the hon. Member for Hornchurch says.

§ Mr. Bing
I do not want to take up too much time on what is a technical point, but in the main this Bill has three Clauses, one of which merely declares the law, that the midwife is entitled to administer analgesia. The second deals with hospitals other than hospitals in the control of the Minister, and when one deals with Clause 1 one is involved in the whole business of the Minister's powers. One can see where the Minister stands from subsection (3)—one of the subsections which we did not remove. There it is stated: The Minister may after consultation with the Board made before the expiry of the period of four years mentioned in subsection (1) of this section extend that period for such further period or periods as he thinks fit. 2552 If I am wrong, I will leave the point but, as I understood it, the argument of the hon. Member for Monmouth—and he was fortified by the opinion of counsel—was that up till now the Minister did not possess the powers. I thought that we would not be asked to include such a provision if, in the opinion of the hon. Gentleman, the Minister already had the powers.

§ Mr. Thorneycroft
The whole discussion about these powers took place on an entirely different matter, which was the giving by the local health authorities of the apparatus, the transport and the drugs to domiciliary midwives. I think it is most regrettable that that Clause was not carried, but at any rate we cannot debate it now. The Clause to which the hon. Member for Hornchurch is referring deals with an entirely different matter, which is a matter which could be argued—the question of training for midwives.

§ Mr. Bing
I do not want to delay the House unnecessarily and, therefore, if it is to be argued that the powers given to the Minister in subsection (3) of Clause 1 are powers which he already possesses, if it is to be said that that is the argument, then I will leave it at that point. It seems to me to be a strong argument against Clause 1, for Clause 1 is unnecessary if the Minister already possesses those powers. If the hon. Member for Monmouth says that he took counsel's opinion, and counsel agreed with him, on a matter which has now been taken out of the Bill, but that he is not fortified by the counsel's opinion on this matter, then I think he has a very poor case for this Clause on its merits. If he could not secure the same opinion from the same counsel who was so definite on the one matter, then I think that is an argument against this Clause. I do not want to detain the House on this Clause because I think—and the hon. Member would probably admit it—that, as it stands, it means very little indeed and the real point of the Bill and the real Clause with which we have to deal is Clause 2.
Perhaps I may, therefore, leave this Clause and turn to deal with Clause 2, with the Bill generally and with the methods by which the Bill was supported. The Bill was supported in this House on Second Reading, and particularly in Committee and when we discussed the matter in regard to other possible amend- 2553 ments to the Health Service Acts, by arguments in detail, put forward by the hon. Member for Monmouth, which he could have discovered were not in accordance with the facts but which he, in a perfectly reckless way, failed to check in any form whatever.
I will not weary the House with a long description of this, but I will take one argument in detail—that which the hon. Member presented to the Committee upstairs in favour of Clause 2 and of the Bill; and I will compare that argument with the actual facts. The hon. Member read a letter and after he had read it he said: That is one of the reasons the sponsors had in mind for putting forward a Bill of this kind."—[OFFICIAL REPORT, Standing Committee E, 28th June, 1949; c. 118.] He used the letter to justify this Clause. I will read the letter to the House and I will then give the House what I believe to be the true facts in this matter. The letter purported to have come from a lady who had been a patient in a hospital, and it said——

§ Mr. Thorneycroft
I am sorry to interrupt again, Mr. Deputy-Speaker, but the letter which the hon. Member is now about to read and my statement—which he reads quite correctly, and I do not quarrel with his wish to do so—referred to something which has nothing whatever to do with anything now in the Bill. It dealt with the question of the supply of apparatus at one of the Minister's hospitals. I shall not argue whether it was right or wrong, but the House took the view that the Minister's hospitals should be cut right out of the Bill. Therefore, as I understand the Rules of Order, we can no longer discuss the merits of whether they ought to be in the Bill or whether they ought to be out of the Bill. I think I am right when I say we have to restrict ourselves to what is in the Bill. There has been a certain amount of controversy, and I feel that we should now restrict ourselves to what is the Bill—the training of midwives and the supply of apparatus at non-Ministry hospitals.

§ Mr. Deputy-Speaker
Up to the time of the interruption, the hon. Member for Hornchurch had not indicated at all that he was not referring to what was in the Clause. If the hon. Member for Monmouth is right on the facts, he is also right on the matter of Order.

§ Mr. Bing
With great respect, Mr. Deputy-Speaker, I urge with some force that that is an absolutely monstrous point of Order. The hon. Member for Monmouth never once referred to this hospital as being a Ministry hospital. He knows perfectly well, or he should have done, that the hon. Member for Putney (Mr. Linstead), who sat in the same Committee, was the chairman of the management board of that hospital. He referred to hospitals as a whole.

§ Mr. Thorneycroft
On a point of Order. The hon. Member for Horn-church has now worked in the statement that some hospital of which I made some criticism was a hospital of which my hon. Friend the Member for Putney was chairman. The same point was tried upstairs in Committee and was there ruled out of Order. I can give the hon. Member for Hornchurch an assurance that it refers to a Ministry hospital—and I think he will accept that—and therefore any reference to it is plainly out of Order. I ask for a clear Ruling, otherwise we shall be involved in a long discussion on side issues.

§ Mr. Deputy-Speaker
I have already given a Ruling along those lines. If the hon. Member's letter referred to a Ministry hospital it does not refer to Clause 2. I ask the hon. Member for Hornchurch whether that is so or not.

§ Mr. Bing
Perhaps I may refer to what was said by the hon. Member for Monmouth in the Debate immediately after he quoted this letter. He said: That is one of the reasons the sponsors had in mind for putting forward a Bill of this kind. Her case is countered by someone who is given analgesia. I think every hospital in the country ought to be under an obligation to have the necessary apparatus and under an obligation to have that apparatus in working order."—[OFFICIAL REPORT, Standing Committee E, 28th June, 1949, c. 118.] The hon. Member said, "every hospital in the country." It is quite true that we have excluded hospitals run by the Ministry, but this letter was put forward not as an argument that the Ministry's hospitals should have them but, in the words of the hon. Member himself, that "every hospital in the country ought to … have the necessary apparatus." That was reported in the Press. I will not trouble the House at length, because if I made the point of Order in full I should be compelled to read the whole 2555 Debate of the Committee. I hope the House will take it from me that I am not trying to make an unfair point when I say that this was a discussion on a Clause which was dealing with——

§ Mr. Deputy-Speaker
Was it related to the Clause in the Bill or not?

§ Mr. Bing
Yes, with great respect, it was.

§ Mr. Deputy-Speaker
Perhaps I put the question wrongly. I should have said, is it referring to a Clause which is in the Bill as it now stands before the House on Third Reading?

§ Mr. Bing
With great respect, I think it is. It was concerning an Amendment which was, in fact, dealing with the whole question of this Clause. The hon. Member for Monmouth was discussing the possible effects of leaving out maternity homes and discussing the definition of hospitals as contained in this Clause. It seems to me, Mr. Deputy-Speaker, with great respect, that it was, in fact, the only argument adduced in Committee which dealt with hospitals. Although this is not strictly relevant to the Debate, if we look at the Second Reading of the Bill to amend the National Health Service Act, we find that the same letter was there quoted to justify a somewhat similar Amendment with somewhat similar provisions.
I feel that if this Clause is said to be necessary because there is something wrong with every hospital in the country, then the letter which was read by the hon. Member and used to defend the argument dealing with every hospital in the country, and saying they ought to be provided with this apparatus, surely is relevant, particularly, if I may say so, when it was one of the few concrete arguments put forward by the hon. Member for Monmouth to sustain his case. Let me proceed now to read the letter.

§ Mr. Thorneycroft
On a point of Order. The Clause as it originally stood applied to all hospitals—that is, the great majority of them, because now, under the National Health Service, they are Ministry hospitals. The Clause was amended to apply to hospitals other than hospitals in the control of the Minister. Originally, naturally, most of the arguments were directed to Ministry hospitals, 2556 because they formed the larger part of the field. I submit, with great respect, that now we could not possibly start adducing all over again all the arguments, with all the figures of apparatus and of analgesia, about Ministry hospitals, and that we should not seek to discuss any particular one. The field is now a much narrower one. The Bill applies now only to what one may call small private maternity homes. They form the field now. I suggest, with great respect, that if we once start to cover all the hospitals again, we shall be treating something not in the Bill.

§ Dr. Haden Guest
I think that the hon. Gentleman is wrong in taking this technical point of view. The private hospitals outside the control of the Minister, such as he was speaking of, deal with a large number of different things. They may be dealing with invalid children, they may be dealing with the mentally defective, they may be dealing with foreign seamen. I think the point is much wider than the hon. Gentleman suggests.

§ Mr. Bing
I hope that this point of Order is not to be taken any further. We have to consider, if I may say so to hon. Gentlemen opposite, that we must not use our great powers as Members of Parliament to frighten the people of this country, particularly the mothers of this country, and particularly mothers in childbirth in this country, by suggesting that they will be treated in an improper way when they go into hospital. The argument for this Bill is that they will be so treated. To justify that argument the hon. Gentleman quoted a letter alleging some such ill treatment had happened, and went on to say in very positive language, "I think every hospital in the country ought to be under the obligation—" and so on. He has now brought in a Bill in which he says he means only to put in some hospitals. I wish to deal with the argument he used in regard to that hospital. Rather than let me do so, he seeks to insist on a technical point of Order. It may result in its going out from this House that there was some little substance in the reckless charges the hon. Gentleman made against hospitals both privately owned and publicly. Let me deal with the charges. They were these. The hon. Gentleman read this letter from a paper. If he had wanted to do so, he 2557 could have got up and interrupted in Committee, but he did not, and nor did the hon. Member for Putney indicate that he was the chairman of the Committee. This letters runs: I was in St. James's Hospital, Balham, and was kept in Ward S, where waiting mothers are, until 10 minutes before baby came. By the time I was directed to the labour ward and given the machine the baby was born after one more pain. This means that I was in labour until——

§ Mr. Deputy-Speaker
May I ask the hon. Gentleman whether this hospital is a Ministry hospital or not?

§ Mr. Bing
It is under the Ministry. If the argument was put forward by the hon. Gentleman without disclosing that it was a Ministry hospital, and if he used that argument to condemn hospitals——

§ Mr. Deputy-Speaker
The reason I did not stop the hon. Gentleman before was that I did not know what the letter contained. I heard his quotations from another hon. Gentleman's speech, namely, that all hospitals in the country ought to be covered. The hon. Gentleman cannot now quote a letter specifically referring to St. James's Hospital, Balham, which is, he now informs me, a Ministry hospital.

§ Mr. Bing
The point I was going to put was that the facts in this letter are all untrue—all of them.

§ Mr. Deputy-Speaker
That may be so or not. Of course, I know nothing about that. However, that letter refers to a Ministry hospital, and so it cannot be quoted any further, for it would be out of Order.

§ Mr. Bing
Without transgressing your Ruling, Sir, may I continue the argument in this form? This just shows the utter recklessness of the hon. Gentleman opposite, who proceeds to use an argument directed against a Ministry hospital and takes advantage of a point of Order to prevent the counter argument being made.

§ Mrs. Leah Manning (Epping)
I would point out to my hon. Friend that he knows very well that, as the Clause stood at that time, it referred to all hospitals, and that, therefore, there was no obligation on the hon. Gentleman who introduced this Bill to say whether the hospital was a Ministry hospital or whether it was a private hospital, because all hospitals were then covered by the Clause. My hon. Friend knows that very well.

§ Mr. Bing
In that case, perhaps, Sir, you would reconsider the Ruling which you gave, because if that was so—and we are told so by a leading Member of the Committee—surely this Clause was being considered——

§ Mrs. Manning
Not at all. That Clause is not in the Bill now. It was then.

§ Mr. Bing
Perhaps, it may be looked at from another point or view. The Amendment which dealt with this particular matter was on the Paper. Indeed, I think it was discussed.

§ Mr. Deputy-Speaker
That does not arise on the Third Reading of the Bill. The hon. Gentleman must confine himself to the Clauses as they are in the Bill. I understand he is dealing with Clauses 1, 2, 3 and 4 seriatim, and he must confine himself to the argument whether he likes those Clauses or not.

§ Mr. Bing
I accept that Ruling, of course. I was only trying to answer a rather confused point.

§ Mrs. Manning
Not very successfully, if I may say so.

§ Mr. Bing
I will leave that matter for the moment. Perhaps, I may just say this. There is no evidence adduced at all in regard to private hospitals—no evidence adduced by the hon. Gentleman with regard to them at all. If there is any impression in the public mind that there is anything wrong with the hospitals, it is induced by evidence brought forward to deal with a Government hospital—evidence which hon. Members on the opposite side took no occasion to deal with, when it was open to them to do so.

§ Mr. Deputy-Speaker
The hon. Gentleman must not go along this line any further.

§ Mr. Linstead (Putney)
On a point of Order. As I am, by inference, expressly challenged by the last remark of the hon. Gentleman, let me say that I did make an attempt to take part in the discussion on this point in Committee, and was ruled out of Order by the Chairman of the Committee for the reason, Sir, that you are ruling this to be out of Order in this House today.

§ Mr. Deputy-Speaker
I think the hon. Member for Hornchurch now understands the limitations on the Debate.

§ Mr. Bing
I appreciate that, and do not want to appear to be challenging any Ruling. However, I think I am entitled to say in general that it was a most unfortunate way in which the case for this was put.

§ Mr. Deputy-Speaker
The hon. Gentleman has said that quite often now, and must not repeat himself.

§ Mrs. Manning
He has said it since the beginning of the Bill.

§ Mr. Bing
Let me turn now to the way in which Clause 2, which, I think, is the only operative Clause in the Measure, works. The House can see that it is to be the duty … of every person having the control or management of a hospital within the meaning of the National Health Service Act, 1946, other than a hospital vested in the Minister to secure— (a) that sufficient apparatus of a type approved by the Board …" is at all times available therein in a state of efficiency for the supply of analgesia to women who desire it in childbirth and are accommodated in the hospital. In other words, every hospital which is controlled by the Ministry must have analgesia apparatus of a type approved by the Ministry, and have it ready for use in case the hospital accommodates any women who may be in childbirth.
The only thing that the Clause does not make absolutely clear is what is a hospital within the meaning of the National Health Service Act. I ought to tell the House what is a hospital within the meaning of that Act. The Act says a hospital is any institution for the reception and treatment of persons suffering from illness or mental defectiveness, any maternity home, and any institution for the reception and treatment of persons during convalescence or persons requiring medical rehabilitation, and includes clinics, dispensaries, and out-patient departments maintained in connection with any such institution or home as aforesaid, and 'hospital accommodation' shall be construed accordingly. What this House is saying is that, in the name of humanity, we should enact that the comparatively limited supply of analgesia apparatus shall be distributed over a large number of institutions, which do not require it. I have been looking into some of the hospitals. I find that very properly the Roman Catholic Church maintains a hospital for 2560 aged priests, who are infirm. It is to help the mothers of this country that the hon. Gentleman and his Friends demand that we should send a supply of analgesia apparatus—and not a museum type but a type approved by the Minister—to such places, and it shall be constantly ready for any miracle that might occur.

§ Sir Richard Acland (Gravesend)
I am loath to interrupt the hon. Gentleman's brilliant wit, but has he correctly read this particular Clause? He will see that if he omits certain words that the apparatus is: for the administration of analgesia to women who … are accommodated in the hospital. The hospital with which my hon. Friend is dealing, would not be included in that since women are not accommodated in it, and the purposes for which it would be required therefore would be nil.

§ Mr. Somerville Hastings (Barking)
Might I suggest that there would be nurses in such a hospital, and they would need accommodation when they are sick.

§ Mr. Bing
That again illustrates the difficulties we are continually up against in this Bill. The wording of the hon. Gentleman the Member for Monmouth is so obscure that possibly it may mean what he thinks, but that is the farthest that one could possibly go. If one looks at it from the strictly legal point of view, the Clause is governed by the opening words, and all the other words must be construed in accordance with them. The opening words are: It shall be the duty of every person having the control or management of a hospital within the meaning of the National Health Service Act, 1946 … There are no exceptions to that. My hon. Friends know how very difficult it has been to frame an Amendment to deal with this problem. It is impossible to cure it in an effective way by altering the definition of a hospital. The principle has been decided by the Committee and I hope, after all this, that we are not going back on what the Committee decided in relation to the Clause. The Clause lays down an absolute duty on persons having control of hospitals. It is quite clear that they are not compelled once the apparatus has been secured, to make it available to anyone else but a mother in childbirth. That is reasonable, but it does not 2561 prevent all institutions from having the apparatus always there.

§ Sir R. Acland
I agree that there is an absolute duty, but an absolute duty to do what? It is: to secure … a sufficient supply … of analgesia to women … who are accommodated in the hospital. If no women are accommodated in the hospital then "sufficient apparatus" is not necessary.

§ Mr. Bing
With great respect, I do not want to be engaged in long arguments with hon. Members and so delay unnecessarily a decision on this matter, but we cannot interpret this obligation imposed by an Act of Parliament so as not to supply any apparatus at all. If an absolute obligation is enforced on everyone it must mean that there must be some apparatus. It may be said that in the particular home which I have mentioned the need for it will not be as great as say as in Queen Charlotte's, but the obligation remains. The position is really an absurd one.
I do not know if the hon. Gentleman the Member for Monmouth is going to give an undertaking that if the Bill receives a Third Reading this will be altered in another place, or whether it is possible to make out what is the real object of this Clause, because, of course, the Clause goes a great deal further than that. It also says that not only must there be a sufficient supply of apparatus but that it must be of a type approved by the Board. The type of apparatus approved by the Board is very simple, and is designed for use by midwives without a doctor being present.
There are privately-run maternity homes, and we all know that some women go there because they do not have sufficient faith in the National Health Service, and so that they can be attended by their own physicians. These are many gynaecologists who have an infinitely varied apparatus for the administration of analgesia, anaesthetic or anything of that sort. If I might use a phrase which would readily spring to the lips of my hon. and learned Friend the Member for Gloucester (Mr. Turner-Samuels), ex hypothesi, that apparatus is a type which is far more complicated than the apparatus approved by the Board. The latter apparatus is very simple, because if it were not it would not be possible for an 2562 unqualified person to administer it. People go to maternity homes so as to avoid analgesia from that type of apparatus. They think that that is not sufficient in their particular case.
What would be the effect of this Amendment? Not only would it lock away a great quantity of apparatus in homes run for clergymen and for children, in foot clinics and places of that sort, but it would also be available in such places where women are constantly in childbirth, such as maternity homes. That is one place where it would not be needed, because those homes are run on the basis that they do not use the National Health Service apparatus, but use something which is special to their own doctors and which they believe is far superior, as possibly it might be. So it must be remembered that under the Bill as it now stands, this apparatus would be sent to maternity homes which do not require it, and to other places where, ex hypothesi, it is not needed.

§ Dr. Barnett Stross (Hanley)
The hon. Gentleman has developed his point at such length and with great accomplishment, and perhaps he will help me with another point, because I do not think he has finished with the position as it arises here. It is a well-known fact that analgesia apparatus is commonly used for other purposes than childbirth. It is very helpful if used for opening a superficial abscess and for setting a simple fracture in the case of the aged—in the case of greenstick fractures in particular.

§ Mr. Deputy-Speaker
The hon. Member seems to be making a speech.

§ Dr. Stross
I will come immediately to the question I wish to ask my hon. Friend. Does he believe it is an argument against the Clause that none of this type of apparatus will be refused because of the inherent other diverse uses I have mentioned?

§ Mr. Bing
The difficulty of this Clause is that when there is a comparatively limited amount of analgesia apparatus, it is provided that it shall be distributed in places where it may not be needed. I should have thought the first priority was that it should be available for mothers in childbirth. It indi- 2563 cates that this Bill, with whatever good intentions it was introduced, will result in less apparatus being available in the places where it is needed.
When we look at the Clause further, we find that a heavy penalty of £10 is imposed for each day of failure to comply with its provisions. Suppose there is a small maternity home with five or six beds run by a retired matron. She may have a physician who arranges to attend her private maternity home from which she makes a small competence. What is the position of a woman of that sort who has always used the apparatus belonging to the physician, if someone comes down and suddenly discovers after a year or so that she has not the apparatus of the type approved by the Ministry of Health? She will be liable to a fine of over £3,000, not for not providing adequate analgesia, but merely for not having an inferior type in her opinion and the opinion of her medical adviser who runs the home. The House should not be asked to pass legislation of that sort.
It is a great mistake that the hon. Member for Monmouth, in the week which has elapsed, did not take the opportunity to set down an Amendment to deal with this position. This is really an impossible Clause, and it is the only Clause which matters in the Bill. It imposes on people doing a good job of work, the small maternity home and places of that sort, a quite unjustifiable burden, and it does not do one piece of good to a mother. If put into effect, it will merely mean that a lot of analgesia apparatus is put in places where it is not needed.
Perhaps I may now turn to Clause 3. All it does is to declare what the law is. We do not need an Act of Parliament for that, because the only person who has raised any doubts about it is the hon. Member and his friends. They are the only people who have said that a midwife is not allowed to administer analgesia. It is perfectly absurd to say that it is necessary for this House and another place with other grave matters to consider, to spend time in discussing whether we ought to declare now that there is no legal obstacle to a midwife administering analgesia, when she has already been doing it up and down the country under 2564 the provisions of the National Health Act.
When we look at Clause 4, we find that all it does is to reverse the decision which the House took when it considered the Bill on Second Reading. When the House considered the Bill on Second Reading, there was a Clause expressly asking for money to be paid by Parliament, which required a Financial Resolution. If the House was then asked to pass this Bill on the understanding that it would require additional expenditure, it is a little difficult for the hon. Member for Monmouth to come back and say we should pass it now even though it does not require any public money. I do not think there is any harm in passing Clauses 5 and 6, which are copied out of other Measures. I am sorry I have detained the House a little longer than I intended.

§ Mr. Mellish (Rotherhithe)
What about Northern Ireland?

§ Mr. Bing
Northern Ireland, as in so many cases, is omitted.

§ Mr. Mellish
Northern Ireland is referred to in Clause 7.

§ Mr. Bing
It says that the Bill does not apply to Northern Ireland. That is a point it is perhaps not quite fair to argue at this time, although it could be argued that this House should assert its right to legislate for Northern Ireland. We do not want to get away from the strict point that, although we may laugh at the foolishness of some of the provisions, there has been a great campaign throughout the country which has led people to believe that analgesia is not available.
I congratulate the hon. Member for Monmouth on having so constructed his case that within the Rules of Order, when any Members who is equipped with the facts tries to give the necessary information, it is out of Order. But it does not do away with the harm which has been done in the country, and Members of this House take this opportunity to point out the foolishness and harm which will be caused to analgesia by passing a Measure of this sort. Members should not allow themselves to be dragooned and pass a Measure which will not do one thing for one mother in any part of the country, which, if applied, would result in our limited analgesia apparatus being dissipated into hundreds of thousands of homes and institutions where it will never be required.

§ Mr. P. Thorneycroft
The hon. Member for Hornchurch (Mr. Bing) has addressed the House, as he is entitled to, at some length. He has at least made his position perfectly plain. He is a whole-hearted opponent of this Bill, and he has proposed some curious reasons for opposing it. He started off by saying that the Bill was a piece of party politics, and he cited Mr. A. J. Cummings as a Tory Party hack——

§ Mr. Bing
The hon. Member must be fair to Mr. Cummings. He is not a conscious Tory; he supports the Liberals.

§ Mr. Thorneycroft
Mr. Cummings has spent a good deal of his time castigating the Conservative Party. He would have been a most extraordinary person to choose if one were out to make it a party political manœuvre. I am not sure that the hon. Member, in making that quotation from that particular newspaper and writer, did not demonstrate that this is something which cuts across party, and that there is no need to introduce party politics of that kind. The only point I understood him to make, in his reference to Clause 2, was when he tried to argue that it could apply to cats' homes or almost anything else.

§ Mr. Bing
The hon. Member must be referring to himself.

§ Mr. Thorneycroft
No. The hon. Member made a long speech, and he mentioned that it applied to almost any kind of institution. He tried to adduce the same argument before. I have taken what legal advice I can on the matter, and I am told that there is no substance in what he said, as might have been apparent to anybody who read the Clause. It is, therefore, unnecessary for me to spend a long time answering the hon. Member for Hornchurch.
I am glad that we have an opportunity for a Debate this afternoon upon this subject. It is right that people should come out into the open, and say whether they are for or against the Bill. The opponents of the Bill, of whom the hon. Member for Hornchurch is one, can probably defeat us in the Division Lobby or by talking the Bill out. At any rate, let us have it out in the open, and see who is trying to get this reform through and who is opposing it.

§ The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)
Does the hon. Gentleman call the Bill a reform?

§ Mr. Thorneycroft
That is what we are discussing this afternoon. I propose to say what are the reforms contained in the Measure. Plenty of people say that analgesia is bad. The hon. Lady the Member for Coatbridge (Mrs. Mann) is one of them; she regards the whole idea as third-rate, and has constantly maintained that women in Scotland do not mind the first and second stages of labour. She is entitled to that view. Anybody is entitled to say that analgesia is bad, but I do not like people who say they are supporting analgesia but oppose the very Measure designed to make more of it available.

§ Mr. Skinnard (Harrow, East)
I am sure the hon. Gentleman does not want to misrepresent my hon. Friend the Member for Coatbridge (Mrs. Mann). I listened carefully to what she said, and I believe she is anxious only to safeguard the present position of anaesthesia and not to have analgesia brought in as a substitute.

§ Mr. Thorneycroft
One of the classic ways of opposing a reform is to say, "It does not go far enough. We want a kind of Utopia, and we refuse to take an elementary and sensible step which would ease the position." That is the classical argument of the reactionary throughout the ages. Let us have it plain whether people want to have more or less analgesia given to women.

§ Mr. Blenkinsop
I would like the hon. Member to make it clear to the House how the Measure will make any more analgesia available than is being made available by the Ministry at present.

§ Mr. Thorneycroft
The answer to the hon. Gentleman's question is that that is the whole reason why I have risen in this Debate. I am making it clear now that more women would get relief from pain if the Bill were passed than would otherwise be the case. I want to make it absolutely plain that those who vote against the Bill, or talk it out, will, by their actions or votes, remove the prospect of relief from pain being given in a considerable number of cases. It is better that these issues be plain. They are not party issues, or anything to do with party politics. They are concerned 2567 with the benefits of one branch of medical science, so that the skill and devotion of midwives using it could be made available to would-be mothers.
It can be said, and it has been said, that the Bill is not all that the promoters would like it to be because things are missing from it. We cannot debate that point on the Third Reading, but I say that what is left in the Bill is a very valuable contribution in this sphere of medicine. The first thing with which the Bill deals, in Clause 1, is the training of midwives. That is not unimportant. If we put first things first, surely the first thing to do is to make certain that every midwife attending a birth professionally has received training in the relief of pain, assuming that some apparatus is given to her for the purpose.

§ Mr. Blenkinsop
Does the hon. Gentleman suggest——

§ Mr. Thorneycroft
I cannot give way again to the hon. Gentleman; I have given way twice. The hon. Gentleman will have an opportunity of making his own speech. The position about training is shown in figures which I can give to the House on the authority of the Central Midwives Board, who are always in consultation with officials of the Ministry of Health. I had them checked recently, and I have every reason to suppose that they are accurate. The Board inform me that in England and Wales 10,000 midwives are employed in domiciliary midwifery. New entrants are trained, because nobody enters that profession without being trained, in the administration of analgesia, but there is a backlog of midwives who have not been trained. The position about those who are trained is that 4,100 out of 10,000 were trained by January, 1948. By the end of that year the number had increased by 1,400 to a total of 5,500. These are the Ministry's own figures. At that rate, it would take approximately three years to train the lot.
In Scotland, there are 1,289 domiciliary midwives, of whom only 368 are trained, and there are 921 untrained in the administration of analgesia. I have been using the words "trained" and "untrained." I want to make it plain that I am talking only about analgesia. Obviously, skilled midwives have had very careful training in their job of midwifery.

§ Mr. Somerville Hastings (Barking)
Are the midwives to whom the hon. Member has referred actually practising as midwives, or are they maternity nurses doing midwifery under the supervision of a doctor?

§ Mr. Thorneycroft
They are midwives who are in practice as midwives. There has been some misunderstanding about the position in Scotland, where, we understand, at least 27,000 births take place annually attended by a midwife only, and not a midwife acting as a maternity nurse in the presence of a doctor. I hope that that information answers the point raised by the hon. Member for Barking (Mr. Hastings).

§ Mr. Hastings
Yes, it was perfectly plain.

§ Mr. Thorneycroft
That is the position over the whole country. I always think that when we take figures for the whole country they may not be very reliable, and what I want to do is to look at individual cases. I have the figures for Scotland, but I cannot quote them for England because the Minister of Health has not given them to me. In the county of Angus there are 13 midwives, only two of whom are trained, and there is not a single gas and air apparatus available for use, so that there will not be much training in Angus unless something is done about it. In Perth there are 48 midwives, and not one of them is trained in this form of relief from pain and no apparatus is available or on order. We cannot expect these midwives to be trained unless the House of Commons does something about it. In Coatbridge, there are 11 midwives, only one of whom is trained, and there is now one gas and air machine. It will take the united efforts of the training people to forward training in those areas at a speed which will complete it within the four years laid down by the Bill.
I have been informed by all the medical officers of health and all the supervisors of midwifery training with whom I have spoken that if a Clause such as Clause 1 is passed, and Parliament lays down a date by the end of which, broadly speaking, all midwives will have had to complete that training, this will speed up training in the backward areas considerably.

§ Mr. Swingler (Stafford)
How is it possible, by this Bill, to achieve the training of more midwives and the provision of more apparatus without spending more money, which is apparently specifically denied in the Bill?

§ Mr. Thorneycroft
It is competent for the Minister or local health authorities to make arrangements to train midwives under existing legislation. What is required is the necessary impetus to ensure that existing powers are carried out.

§ Mr. Thorneycroft
I have already answered the hon. Member's point, and I cannot give way again. The situation is plain. I have been informed that that is the case, and those with whom I have been in touch are the experts on this subject. They want to get on with the training, and they ask for these powers to be made available. If they are made available we shall have taken the first step, which is to see that every midwife in the country has the necessary training to deal with the relief of pain.
I now come to the second main point. Clause 2 lays down that in every hospital other than a Ministry hospital which caters for women in childbirth suitable apparatus for administering analgesia approved by the Board—that does not necessarily mean the simplest apparatus; the Board makes its own rules in consultation with the obstetricians and gynaecologists as to what apparatus can be used and on what terms, and it can have better and more complicated apparatus—must be provided and be in working order. Surely that is a reasonable provision at this day and age. Surely if we are to have an establishment which caters for women in childbirth the House of Commons will say that it shall have available and in working order the apparatus for relieving pain. I shall be amazed if any hon. Member will get up and really contest that position, or try to defeat a Bill which is seeking to secure that end.
Naturally, I have had a great many letters on that subject, and I am going to quote one which is about not a Ministry hospital but a private maternity home. This lady writes to thank me and those associated with me for putting forward the Bill. She says: 2570 How in this enlightened age men can still contemplate the suffering which women have to endure and be prepared to accept it is something to astound one. Not only do local authorities fail to make use of the apparatus available but all the small so-called nursing homes grudge spending the extra money for the relief of pain and will continue to do so until compulsion is used. In my own district— This is in Ardrossan, Ayrshire— there is a small privately-owned home which I myself attended which boasts of no equipment, and the nursing staff consider it sufficient to time the call to the doctor as late as possible, so that the whole event is generally over before he arrives. I was relieved when I could leave as the heartrending groans of the women in labour not only make one ache in sympathy but burn with anger at the sheer callous outlook which makes it necessary. If there is anything which I, in my humble way, can do to further your case I will spare no effort. That was signed by a Mrs. Savage. It is typical of many messages which those who have supported this reform have had——

§ Mr. Thorneycroft
I cannot give way for a moment. I do not know what Mrs. Savage can do in her humble way; perhaps her letter will influence some hon. Members to think again before they oppose this Measure.
As I have said, I am not concerned with party politics in this matter. [HON. MEMBERS: "Oh."] I do not mind party politics. If both parties were competing today as to which one could claim greater credit for putting forward this Bill, I should not mind at all, but it does not seem to me that party politics enter into this. I cannot understand on what grounds the objections to the Bill are put forward. What good is done in trying to kill this Measure? What object is attained? Here is something which is asked for by every reputable women's organisation in the country; it is something for which people have struggled and fought. Why turn it down? Here is an opportunity for the House of Commons, on a Private Bill supported not from one side of the House but from all sides, to do something to relieve women in childbirth. Let us do it this afternoon.

§ Dr. Haden Guest
The hon. Member for Monmouth (Mr. P. Thorneycroft) has spoken with a certain amount of passion. I am sure that he is sincere in his desire to do the utmost possible to help, but 2571 the objection to the Bill is the very simple one that it is no longer necessary. However good the propaganda was in the first instance—and it was quite good—since then, in the Committee stage of the National Health (Amendment) Bill, a Clause was moved covering the whole range of services necessary in midwifery. If I am not out of Order in quoting from the Proceedings of the Committee, I will read the answer given by the Minister of Health to a question of mine about the Clause containing the necessary powers for the removal of doubt about analgesia and everything else. I asked the Minister: Does not that Clause include analgesia and everything else? The Minister of Health answered: It includes the whole range of services which at any moment may be regarded as clinically necessary—not only analgesia, but all services."—[OFFICIAL REPORT, Standing Committee B, 5th July, 1949, c. 136.] There is not the slightest doubt that the National Health (Amendment) Bill in its present form, with the Clause added to which I have referred, does everything which this Bill sets out to do, and so this Bill is no longer necessary.

§ Earl Winterton (Horsham)
On a point of Order, Mr. Speaker, can we discuss the Bill to which the hon. Gentleman has made reference, since it is still before the Committee?

§ Mr. Speaker
If the Bill has not been reported to this House, we cannot discuss it in detail, but presumably the Clause is public property and can be referred to.

§ Mr. P. Thorneycroft
Further to that point of Order, Mr. Speaker, we have had this query before. The hon. Gentleman is referring to a Clause which has no connection with this Bill. It deals with an entirely different matter connected with a local health authority not referred to in this Bill.

§ Mr. Speaker
That is not a matter on which I can give a judgment or Ruling; it is a matter of opinion.

§ Mr. Bing
Further to that point of Order. In the Committee it was decided to report the Bill, as amended, to the House. I am not quite certain whether, under those circumstances, although the 2572 Bill has not yet been considered on Report in this House, that makes the proceedings of the Committee available for quotation here in the House, or whether it is necessary for us to reach a stage where a Bill appears on the Order Paper of the House for Report.

§ Mr. Speaker
Really the question is whether it has been reported to the House or not. If it has been reported, it is in order to quote it.

§ Earl Winterton
But can we discuss a Bill unless we have the Bill before us, Mr. Speaker? Surely it has always been the Ruling of the Chair that we cannot anticipate a stage; that is to say, if a Bill has been reported by a Committee, it is for this House to decide whether it shall reject the Bill or not, and we cannot use arguments about the Bill until it has been before the House.

§ Mr. Speaker
It is the report of a Committee. If a Bill has been reported, then the report of the Committee is within the knowledge of hon. Members. I do not say we should discuss the Bill in detail, certainly not, but it is within the knowledge of hon. Members that there is such a Clause coming before the House.

Dr. Guest
I made that reference in order to clarify the discussion, and to reduce the temperature of the Debate. There is no reason to get so excited about this. The Analgesia Bill has many excellent points, but it has been replaced by something which is better still and which includes analgesia.

§ Mr. Thorneycroft
Will the hon. Gentleman——

Dr. Guest
The hon. Member keeps on reiterating that it does not. There is no necessity for me to give way——

§ Mr. Thorneycroft
I am grateful to the hon. Gentleman for his courtesy in giving way. May I ask a question? The hon. Gentleman says that this Bill has been replaced by something better, and he has been referring to a Clause in some other Bill. Would he say how that Clause could conceivably affect either (1) the training of midwives, or (2) the supply of apparatus in maternity homes, considering that the Clause refers specifically to one body only, which is a local health authority quite outside this Bill?

Dr. Guest
The question which I addressed to the Minister in Committee was whether it included all these powers, and the answer of the Minister was "Yes." I think I can assume that the Minister of Health knows what he is talking about. There is not the slightest doubt whatever on that subject. I can quite understand that it is galling to the hon. Member for Monmouth when he has with great trouble, great enthusiasm and great perseverance, promoted a Bill for an excellent object, to find that it is now no longer necessary because it is being done in another way.—[An HON. MEMBER: "It is not."]—I can assure the hon. Member, and I am speaking from my heart in this matter——

§ Earl Winterton
May I ask a question? How can the hon. Gentleman say to this House that it is being done in another way until he knows whether or not the House will accept the report of the Committee? I suggest that we cannot anticipate a decision of the House in that way. It is quite an unprecedented action to take.

Dr. Guest
The noble Lord may be technically accurate but as a point of common sense he is not accurate at all. Everyone knows that the House would not dream of rejecting that Clause.

§ Earl Winterton
How can the hon. Gentleman say that?

Dr. Guest
I assume that as a matter of common sense, and with all deference to the Father of the House I hope he will learn enough common sense to understand that.

§ Earl Winterton
I can tell the hon. Gentleman that I am much minded to put down a Motion on this subject. I consider this a most improper discussion.

Dr. Guest
I am endeavouring to get this discussion down to the basis of common sense so that we can go on performing an admirable service for the benefit of the women of this country, not only in providing analgesia, but everything else necessary in time of confinement, and doing it as part of the National Health Service which is the way in which it is best done. That is what I believe is now being done, and that is why it is no longer necessary, or will shortly not be necessary, for the hon. Member for Monmouth to persist with his Bill.

§ Mr. Bing
Would my hon. Friend agree with me that in order to meet the point of the noble Lord, if he persists in his intention of opposing the Clause when the other Bill comes back, we could then possibly reconsider this one at a later stage if we do not continue it now?

Dr. Guest
I must leave the Father of the House and the hon. Member for Hornchurch (Mr. Bing) to resolve that dilemma between them because I am not interested in that kind of abstruse point in regard to the procedure of this House. I am simply interested in getting something done for women, and in getting better arrangements with regard to the midwives' service, including analgesia, which every doctor in this House knows is necessary, without all the sob stuff and hysteria which has been imported in certain cases.
This is a simple, an elementary and a desirable reform to undertake, and I am extremely sorry that it has been infected with so much political prejudice, to which I called attention on the Second Reading of this Bill when the hon. Member for Monmouth was speaking. If he is not satisfied with what is taking place with regard to this Bill, he has himself very much to blame for the way he has conducted it. I am speaking quite sincerely on this matter. I believe that this Bill could have been carried through the House without any trouble if it had been conducted in the way in which a non-controversial Measure ought to be conducted, on a level of professional understanding and common sense and with an honest desire to benefit people in this country without seeking any party advantage. There has been too much politics in it and I am glad we are getting away from this Bill to a National Health Service Bill which will do the job in a much better way than anything which the Bill of the hon. Member for Monmouth could possibly do.

§ Mrs. Leah Manning
It is always unfortunate in this House that when a Member of Parliament sets out to be the jester of his party, no one will listen to him unless he tries to be funny, and in a Bill of this kind I think it is much more important that we should deal with principle rather than with impious suggestions that miracles might happen to aged priests in certain types of hospitals. 2575 I cannot consider that those arguments are of any avail on a Bill which has been put forward by myself and by hon. Gentlemen and hon. Ladies in other parts of the House with deep sincerity and entirely without hysteria. If there has been hysteria, it has certainly not been on the part of anyone who has spoken on behalf of this Bill, although I think there has been some hysteria among people who have spoken against it on more than one occasion.
Those of us who have, by our work, got this Bill as far as its Third Reading have done so from no party motives. My name would not have been on the back of this Bill if there had been any party advantage to be gained, unless it had been an advantage to my own side. I should make it quite plain that it was I who asked the hon. Member for Monmouth (Mr. Thorneycroft) if I might put my name upon his Bill because I thought it was unfair to my own party that the Bill should be backed only by the Opposition. Therefore I got out of my car one day and asked the hon. Gentleman if he minded my name appearing on the back of this Bill. The hon. Member acceded to that request, which does not seem to me to point to any desire to have party advantage out of the Bill. I have to say that, because that point was raised with a great deal of gusto by the hon. Member for Horn-church (Mr. Bing).
I want to deal shortly with the Bill as it now appears. I am sorry that in the course of reaching its Third Reading it has been mutilated. I think it would have been a better and more useful Bill had it remained in the form in which it was first presented to the House. I am quite sure that by the discussions we have had on the Bill, even if we are defeated in the Lobby this afternoon, we shall have gained a great moral victory as far as the Bill is concerned, because there is not the slightest doubt that the propaganda which has been made as a result of the extent of our discussions upon it during the past few months has had a very great effect upon local authorities up and down the country, and upon midwives, mothers and local organisations, in trying to get analgesia used far more extensively than it was before or than it possibly would have been 2576 used, if the Bill had never come before the House.
The hon. Member for Monmouth has dealt very fully with Clause 1. I want to address myself to Clause 2, for it was upon this Clause that I directed most of what I had to say on Second Reading. It was then a different and much wider Clause. We were told that the width of the Clause as it then stood was unnecessary, that everything that was necessary would be done by the Minister, and so on; but without it the women who go to small maternity hospitals and other institutions are left in an even more dangerous position.
Something has been said about matrons who set up these little hospitals and maternity homes in order to make a small competence. They are the very people who try, very often, to run these homes on the strictest lines of economy, who do not have any more apparatus than is absolutely necessary, and who do not, as has already been said, call the doctor until the very last moment. It is our desire to protect the women who go to this kind of home—who hope very unwisely, perhaps, that they will get better treatment than they would get at a hospital of the Ministry. Perhaps it is because of snobbishness or for some other similar reason that women go to these homes, but a further and definite reason for their doing so—I ask the Parliamentary Secretary at least to answer this—is that at present there are not the necessary beds available in the Ministry's hospitals to take all the maternity cases—the primaries and the difficult cases—that need to be dealt with.
The Bill might not be so important if sufficient beds were available to enable all the women who want to have their children in hospitals to go to the hospitals of the Ministry. I am not blaming the Ministry—there are a thousand and one reasons why those beds are not available—but the important thing is that there are a vast number of women who want to have their babies in hospital—especially the primaries and difficult cases—but who cannot do so because the beds simply are not available. Those are the women who will be driven back to the provisions of Clause 2 in its application to hospitals and small maternity homes not run by the Ministry. Those are the very women who would like to come under the pro- 2577 tection of the Minister but are forced to go to other places. Those are the women whom we want to protect by Clause 2.
I ask hon. Members on this side of the House, who say they want the very best for the mothers of this country, for the sake of the women who cannot have the advantages of the Ministry's hospitals and who may have to wait a very long time before they can enjoy those advantages, I ask hon. Members on this side to vote for the Bill, because in it is the only protection these women will ever be afforded.

§ Mr. Godfrey Nicholson
I for one want to thank the hon. Lady the Member for Epping (Mrs. Manning) very much for her speech. I am very glad that she asked my hon. Friend the Member for Monmouth (Mr. P. Thorneycroft) if she might have her name on the back of the Bill. That disposes effectively of the charge directed from the other side of the House that this is a party Bill. Even if we wished to gain party credit for the Bill if it became law, we could not do so with the knowledge that the hon. Lady's name had been on the back of the Bill and that she and several of her hon. Friends had given it their full support.
I wish the same could be said about another hon. Member whose name appears on the back of the Bill. If an hon. Member backs a Bill, I should have thought it might reasonably have been assumed that he was in favour, at any rate, of the principles underlying the Bill, if not of its actual details. I should, in fact, have deemed it incredible that that hon. Member would vote against every single Clause in the Bill, and, in Committee actually make a speech opposing the principles lying behind the Bill, and that on Third Reading he should violently attack it. I refer, of course, to the hon. Member for North Islington (Dr. Guest). In view of his extraordinary conduct, I ask the House to do as I am sure they will do, that is, to ignore his last speech; I ask all Members of the House, on every side, not to follow that example, which, I submit for the judgment for the House, is very bad Parliamentary practice and, if constantly pursued, is liable to render Members of this House open to charges of the gravest insincerity from a political point of view.

Dr. Guest
Does the hon. Member not think that when a better method is offered of doing desirable things, it is better to choose the better method and not that which is less good? That is clearly the case.

§ Mr. Nicholson
Any hon. Member who was present during the second Sitting of the Committee would know that that was not the attitude of the hon. Member. He made a speech——

Dr. Guest
That is quite untrue.

§ Mr. Nicholson
—attacking analgesia. He has opposed the Bill root and branch, tooth and nail, from the start, after putting his name on the back of it, and I do not think he should have done it.

Dr. Guest
That is quite untrue.

§ Mr. Nicholson
The House, especially if hon. Members have read the proceedings in Committee, can very well judge between the hon. Member and myself. All I say is that the hon. Member would have been well advised to have kept silence, and to have intervened no further in the proceedings, for it does not look very good. I make that protest not from any personal animosity against the hon. Member, who, I know, believes that he is acting with perfect sincerity, but because he has, I think, set a very bad Parliamentary example. Do not let us look at the Bill from the party point of view. I assure hon. Members that if the Bill becomes law I shall not attempt to make one ha'porth of political profit out of it in my constituency, and I expect that I can give that pledge on behalf of my hon. Friends.
I should like for a few minutes to recount the story of the opposition to this Bill. It has been a repetition of the opposition to every single, decent reform that has ever been made by this House. People have come to us and have said, "We are entirely with you in principle, but you will be doing more harm than good if you do it in this particular way." They have said, "Of course, the Minister has the power already and the Bill is completely unnecessary." One hon. Lady—the Member for Coatbridge (Mrs. Mann)—professed to be entirely satisfied with the situation and then admitted that she did not believe in analgesia at all, although over 600 confinements took place in her own constituency last year 2579 without those mothers having the opportunity of analgesia.

Dr. Guest
I do not want to interrupt the hon. Member too much, but the hon. Lady the Member for Coatbridge (Mrs. Mann) is not here. The hon. Member misrepresented me, but please will he not misrepresent the hon. Member for Coat-bridge, who is not here to reply.

§ Mr. Nicholson
If I may refer to the proceedings in the Committee, the hon. Lady said: Women in Scotland do not mind the first and second stages—and analgesia is suitable only in the first and second stages. …"—[OFFICIAL REPORT, Standing Committee E, 23rd June, 1949; c. 15–16.] During the second Sitting the hon. Lady said: … we regard the gas and air apparatus as a third-rate and inferior apparatus. …"—[OFFICIAL REPORT, Standing Committee E, 28th June, 1949; c. 54.] At Question Time in the House on 22nd March the hon. Lady said: … mothers of Scotland … will not now be fobbed off by midwives.…"—[OFFICIAL REPORT, 22nd March, 1949; Vol. 463, c. 191.]

§ Mr. Nicholson
Let me finish what I am saying. I assure the House I have not misrepresented the hon. Lady, although I am sorry she is not here. At any rate, she did not back the Bill.

Dr. Guest
Will the hon. Member not say that the hon. Lady suggested an alternative, namely, better anaesthesia, which is quite a different story?

§ Mr. Nicholson
Quite untrue; she said she did not believe in analgesia. [HON. MEMBERS: "Where?"] I will certainly quote it if I can find my way through the report of those proceedings. I am afraid I cannot find it, and I will not weary the House with it. I believe I am right. [HON. MEMBERS: "Withdraw."] I see that I shall have to find it.

Hon. Members
Withdraw.

§ Mr. Pargiter (Spelthorne)
Perhaps I can help the hon. Gentleman. The words of the hon. Lady the Member for Coat-bridge (Mrs. Mann) appear in column 108. She said it had been said that … Members, including myself, do not want analgesia. I should like to repudiate that 2580 innuendo."—[OFFICIAL REPORT, Standing Committee E, 28th June, 1949; c. 108.]

§ Mr. Nicholson
The hon. Lady said it repeatedly. I was present at the second and third Sittings of the Committee. She said that she was completely indifferent to whether an analgesia service was supplied in her constituency. I said that I deduced from her remarks that she did not think it necessary or desirable that analgesia should be provided, and she did not contradict me. [HON. MEMBERS: "Withdraw."] She is perfectly entitled to her point of view, and she did not back the Bill. If the House thinks she is being attacked unfairly, I will certainly withdraw, but that is the impression I got. I say that, not because I think I am being unfair to the hon. Lady, but because I have not the time to find the appropriate quotation.
Having infused some heat into the Debate, I now wish to appeal to the House without heat. I ask hon. Members to ask themselves this question: is the situation satisfactory now? In answering that question, it is no good their saying that Ministers have adequate powers, or that people have adequate intentions. Let them also ask themselves this question: are all mothers who desire it given facilities for analgesia? A study of the figures shows that that is not the case, and that the position is very unsatisfactory today. I think that hon. Members are bound to come to that conclusion.
I would then ask them to ask themselves this question: will the passage of this Bill mean that even one more mother will have the facilities of analgesia provided who would not get it if this Bill was not passed? I suggest that it is certainly bound to be a help, and that it cannot possibly do any harm. I ask hon. Members not to put all their faith in a new Clause in another Bill which has not yet become law, not because it has not yet become law, but because that new Clause is sponsored by people who have opposed this Bill from the start, and who are very suspect in regard to their views on analgesia.

§ Mr. Bing
The hon. Gentleman must not mislead the House in this matter. This Clause was sponsored by the hon. Member for North Islington (Dr. Guest), who, as the hon. Gentleman has said, was a backer of this Bill.

§ Mr. Nicholson
I think we had better leave out any further reference to the hon. Member for North Islington. If the hon. Member was a sponsor of the Clause I do not know what deduction can be drawn from that; it is too complicated for me to make a deduction.
Does any Member doubt that if this Bill becomes law a certain number of mothers will have provided for them these facilities which they would otherwise not get? I put the argument in its extreme simplicity. No man can know what the torments of childbirth are to certain sensitive types of women—I do not mean hysterical types, but women who feel pain very deeply and keenly. As a father, I am anxious, and have been anxious ever since I first became a father, that this House should do something to save even one mother from unnecessary torment. I do not wish to make an emotional appeal, although this question is supercharged with emotion. In the name of common humanity and common decency, even if we are helping only one mother, let us pass this Bill, I promise hon. Members that we on this side of the House will not try to make party political capital out of it. I beg the House to pass this Bill.

§ Mr. Pargiter
There are only two points to which I wish to refer, and to which I would like to know the answer. As the Bill is drawn, in both Clauses 2 and 3 there seems to me to be a dangerous principle involved. Clause 2 deals with the question of the supply of apparatus and drugs, and it goes on: for the administration of analgesia to women who desire it during childbirth … The same phraseology is used in Clause 3. I am open to be corrected technically on this point, but I believe, and my advice is that under certain circumstances the administration of analgesia may be a danger to the health of the patient. Neither of these Clauses makes any provision of any kind to deal with that situation. It is simply stated that if the woman desires analgesia it shall be the duty of the midwife to give it to her. If the doctor says that she should not have it the midwife would have to say "Under this Act I must administer it." We should not allow to go through this House a Bill which contains words of that kind without any safeguard what- 2582 ever. There is no medical safeguard in the Bill. The doctor or the midwife may say that it may be dangerous to administer analgesia in a particular case, but if the woman says, "I desire analgesia," it is the duty of those concerned to supply it.
I do not wish to detain the House for long. The principles of the Bill have been well debated——

§ Mr. P. Thorneycroft
The hon. Member is making a fair and proper point for anyone to make in the Debate, but I can reassure him. No midwife is entitled to administer analgesia, nor is any mother entitled to have analgesia, save in accordance with the very strict rules which have very properly been laid down by the Central Midwives Board.

§ Mr. Pargiter
That is not in the Bill, and I do not know that it is in any rules which are laid down by the Central Midwives Board. The question of whether analgesia can be administered or not is governed by other Acts of Parliament. This Bill would cut across anything which has previously been done, and its provisions may well be used to the detriment of the patient. I feel that we should be quite clear on that point. If I can be satisfied about that, it might ease my mind a little, but at present I cannot believe that we should adopt a Bill which contains in their present form the Clauses to which I have referred.

§ Mr. Linstead
The whole burden of the hon. Member's argument was based on the assumption that there was in this Bill a duty placed on the midwife. Can he point to any Clause of the Bill which imposes a duty on a midwife to give analgesia to anyone who asks for it? I do not think that is in the Bill.

§ Mr. Pargiter
The management of the hospital have a duty to provide and administer it. So far as the midwife is concerned, Clause 3 says she shall be entitled to administer it to any woman who desires it. Surely if a woman cannot demand it, and if a midwife is perfectly free to administer it or not entirely as she thinks fit—apart from medical considerations—what is the advantage of the Bill or of that Clause? If a duty is placed on people to provide apparatus and drugs in order to supply a certain form of analgesia to a woman who desires it it 2583 means that if she wishes to have it it is their duty to provide it. I cannot read any other meaning into it.

§ Mr. Linstead
The burden of the argument of the hon. Member earlier was that there was a duty on midwives to supply it and I can find nothing in the Bill about that. Clause 3 is the Clause referring to midwives, and I cannot see anything in it which imposes a duty on the midwives.

§ Mr. Pargiter
So far as Clause 2 is concerned, there can be no question that there is a duty to provide it. This really must be cleared up before we go any further.

§ Mr. Blenkinsop
I think it desirable that I should intervene at this stage, because it appears to me that a number of speeches which have been made by hon. Members opposite have been made on the assumption that the Bill is intended to provide analgesia, as is stated on the Title of the Bill. It says the Bill is to Make provision with respect to the administration of analgesia to women in childbirth; and for purposes connected therewith. I think it would be rather more accurate to say: Make provision with respect to the administration of analgesia to women in childbirth in private homes run for profit; and for purposes connected therewith. It is only that restricted field with which me are dealing in this Bill today.
The Bill, as it has been put before us this afternoon, first of all raises the problem of training the midwives. The hon. Member for Monmouth (Mr. P. Thorneycroft) spent a good deal of time in referring to that matter. But the important issue which he completely left out was the fact that—although it is true that there are still midwives to train—the Bill does nothing more to ensure the quicker training of those midwives than do the powers already in the hands of the Central Midwives Board; and he himself congratulated the Board upon using those powers so effectively. If the hon. Member and other hon. Members opposite had argued that the Board were failing in the duty imposed upon them by previous Acts, and that they were not doing the training which he and all of us would wish to see carried out, I could have understood why 2584 the Clause concerning this matter had been put in the Bill, because it might have been of some assistance in ensuring that it did the work which ought to be carried out. But that is not the argument. The hon. Member and other speakers quite rightly said that the Board are carrying out their responsibilities fully in this regard, and they congratulated the Board on the way in which they have succeeded in obtaining much more rapid training for midwives throughout the country.
During the last year, for example, some 2,600 midwives were trained, and it is quite clear that at that rate the problem of securing the training of midwives who have not yet been trained will be solved within a short time—within the three years that the hon. Member mentions, and well within the four years laid down in the Bill. But even supposing that he were right, and that training does not proceed as rapidly as we should all wish, does the Bill ensure that it shall be done in the four years? No, of course not. It has to provide the necessary saving Clause to ensure that in proper cases the Minister shall be able to extend that period, more than once if necessary, if there are areas where the training cannot be carried out within the time specified. Therefore, the Bill does nothing at all to speed up the training of midwives.
We are proud, and, I think, rightly, of the way in which this work has been carried out during recent years. We congratulate the Central Midwives Board on the way in which they have done their work, and I think we are entitled to some praise, too, for the way in which that work has been encouraged. If one were to believe hon. Members opposite, one would get the impression, if one did not know the facts, that my right hon. Friend was trying to impede the work of the development of analgesic provisions. How utterly untrue that is, as every practising midwife knows. It is because this utterly misleading impression has been created and developed by hon. Members opposite—and, to some extent, by my hon. Friend the Member for Epping (Mrs. Manning)—that we resent the assumption, without any effective argument, that the tattered remains of this Bill will do anything at all to provide analgesia to any woman who would not otherwise have got it.
2585 The Bill makes no effective extension of existing powers. Clause 1 deals with the training of midwives. It is commonly agreed that this Clause does nothing to increase the number of midwives who will be trained. In fact, the only assumption one can make is that there is some feeling in the mind of the hon. Member for Monmouth, or in the minds of his hon. Friends, that the Central Midwives Board are not doing the job which they are fully empowered to do, and which I believe they are carrying out most fully and adequately. Clause 2 deals with the question which was fully and properly discussed by my hon. Friend the Member for Hornchurch (Mr. Bing). It concerns the provision of apparatus and drugs at hospitals and maternity homes other than those vested in the Minister. This includes a wide variety of hospitals. It includes those excluded from the National Health Service Act—about 280 in all. It also includes, and this is the larger number, private nursing homes of a variety of sorts run for profit, which did not come within the general scope of the National Health Service Act. The point about these hospitals is that we believe that there is validity in the argument advanced by the hon. Member for Hornchurch that the wording of this Clause would not exclude the obligation upon all the hospitals to provide apparatus even though it was perfectly obvious, except in cases of very exceptional character, that it would not be needed. In our view it would mean that a variety of hospitals, serving all sorts of different categories of people, would require provision of this apparatus and would take away apparatus from those centres where it was much more urgently needed.
We also think it is perfectly valid to make the argument that small maternity homes which are run privately and are not within the National Health Service Act are chosen by women for the reason that they think the provisions in those homes are better than the provisions in other cases. That may or may not be the case, but many of these private maternity homes are not fully occupied today because people are naturally choosing to go to the hospitals which are within the National Health Service Act. It is obvious that in most of those private homes the provision made for women going in for childbirth is frequently of 2586 a different character altogether. Very often they have apparatus which is not the apparatus approved by the Central Midwives Board, but which they, and possibly the medical profession, may regard as superior. It would be fantastic—as this Bill provides—to insist, in those cases, that the apparatus which is approved today by the Board must be available in those hospitals when possibly better apparatus is already available.
Moreover, where we have a small nursing home which takes in a few, but only a few, maternity cases, that home might quite properly provide that the midwife or the doctor shall bring with them a portable apparatus. That is quite common, but it would not be allowed under this Bill. It would be essential to have the apparatus permanently at the hospital so long as this apparatus is in short supply. I therefore suggest that, far from making wider provision, this Measure may very well, by taking away apparatus from where it is needed, reduce the amount of the apparatus available to women throughout the country.

§ Mr. Frederic Harris (Croydon, North)
I understand that the Parliamentary Secretary's case is that many private nursing homes have vacant beds. I challenge the hon. Gentleman to give me the name of one private nursing home with vacant beds at the present time. I deny that his statement is true.

§ Mr. Blenkinsop
I receive repeated representations from many private nursing homes which say they cannot continue to maintain the home because they are not having beds occupied, and are asking the National Health Service to take them over.

§ Mr. Harris
Will the Parliamentary Secretary name one area or one home?

§ Mr. Blenkinsop
Yes, if the hon. Member will put down a Question. I am receiving representations about them from hon. Members very often.
There is one final point with which I want to deal. Under the Public Health Acts, maternity homes are required to be registered with the local authority who may, for reasons connected with the equipment of the home, refuse or cancel registrations. If there are cases of small maternity homes where, as is alleged, proper provision is not made, then their 2587 registration can be cancelled by the local authority. If the authorities are satisfied that the provision made in them is inadequate, or if the home are unwilling to make provisions, that can be done. Again, therefore, the power already exists, and the fact that we say it over again in another Bill does not mean that it becomes any more operative. When we impose on these private homes a charge, a penalty, for the non-provision of a type of apparatus which may often be regarded as not of the type which that home requires, we impose a penalty of a very severe character indeed.

§ Mr. Marlowe (Brighton)
The hon. Gentleman has repeatedly put forward the argument that this Bill does nothing. Is it not a fact that at the moment there is no statutory duty on private nursing homes to provide this apparatus? If the Bill goes through, there will be such a statutory duty. Does the hon. Gentleman think that that is nothing?

§ Mr. Blenkinsop
I suggest that there is already power for the local authorities to refuse registration of such homes if they wish to do so.

§ Mr. Marlowe
That is not a statutory duty.

§ Mr. Blenkinsop
This new provision is merely a repetition of what already exists. [HON. MEMBERS: "There is no statutory duty."] The whole of this Bill

§ Mr. Nicholson
It makes such provision a statutory duty.

§ Mr. Blenkinsop
What I am most anxious that not only the House but the country should realise is that during the past two or three years, particularly during the years since the passage of the National Health Service Act, we have made great progress both in the provision of analgesic apparatus and in training people to use it.

§ Mr. Nicholson
In Scotland?

§ Mr. Blenkinsop
Yes, in Scotland, too. We have made great strides forward in this provision, and we are satisfied that before long every woman in childbirth who requires and wishes to have analgesic provision made for her confinement will be able to have it. That will be under the National Health Service Act, in startling contrast to the state of affairs which prevailed during the long period when hon. Gentlemen opposite had the power to make this provision but made hardly any provision at all.

Division No. 202.]	AYES	[3.30 p.m.
Acland, Sir R.	Lennox-Boyd, A. T.	Smiles, Lt.-Col. Sir W.
Agnew, Cmdr. P. G.	Linstead, H. N.	Smith, E. P. (Ashford)
Beamish, Maj. T. V. H.	Lipson, D. L.	Smithers, Sir W.
Boles, Lt.-Col D. C. (Wells)	Lloyd, Maj. Guy (Renfrew, E.)	Spearman, A. C. M.
Bowen, R.	Macdonald, Sir P. (Isle of Wight)	Studholme, H. G.
Bower, N.	Mackeson, Brig. H. R.	Sutcliffe, H.
Boyd-Carpenter, J. A.	Macmillan, Rt. Hon. Harold (Bromley)	Teeling, William
Buchan-Hepburn, P. G. T.	Macpherson, N. (Dumfries)	Thorp, Brigadier R. A. F.
Clarke, Col. R. S.	Manningham-Buller, R. E.	Thurtle, Ernest
Crosthwaite-Eyre, Col. O. E.	Marlowe, A. A. H.	Webbe, Sir H. (Abbey)
Drewe, C.	Moore, Lt.-Col. Sir T.	Winterton, Rt. Hon. Earl
Duthie, W. S.	Nicholson, G.	Young, Sir A. S. L. (Partick)
Harris, F. W. (Croydon, N.)	Nield, B. (Chester)
Hulbert, Wing-Cdr. N. J.	Roberts, Emrys (Merioneth)	TELLERS FOR THE AYES:
Kerr, Sir J. Graham	Robinson, Roland (Blackpool, S.)	Mr. Peter Thorneycroft and
Legge-Bourke, Maj. E. A. H.	Shepherd, W. S. (Bucklow)	Mrs. Leah Manning.
NOES
Adams, Richard (Batham)	Bing, G. H. C.	Colman, Miss G. M.
Albu, A. H.	Blenkinsop, A.	Cove, W. G.
Allen, Scholefield (Crewe)	Boardman, H.	Crossman, R. H. S.
Attewell, H. C.	Bowden, Flg.-Offr. H. W.	Davies, Haydn (St. Pancras, S. W.)
Austin, H. Lewis	Brook, D. (Halifax)	Delargy, H. J.
Ayles, W. H.	Brown, George (Belper)	Driberg, T. E. N.
Balfour, A.	Bruce, Major D. W. T.	Dumpleton, C. W.
Bevan, Rt. Hon. A. (Ebbw Vale)	Callaghan, James	Dye, S.
Ede, Rt. Hon. J. C.	McEntee, V. La T.	Skeffington, A. M.
Edwards, W. J. (Whitechapel)	McGovern, J.	Skinnard, F. W.
Evans, E. (Lowestoft)	Manning, C. (Camberwell, N.)	Smith, H. N. (Nottingham, S.)
Ewart, R.	Marquand, Rt. Hon. H. A.	Smith, S. H. (Hull, S. W.)
Fairhurst, F.	Mellish, R. J.	Snow, J. W.
Fraser, T. (Hamilton)	Mikardo, Ian	Sorensen, R. W.
Freeman, John (Watford)	Mitchison, G. R.	Steele, T.
Gaitskell, Rt. Hon. H. T. N.	Morley, R.	Stewart, Michael (Fulham, E.)
Ganley, Mrs. C. S.	Moyle, A.	Stross, Dr. B.
Gordon-Walker, P. C.	Naylor, T. E.	Swingler, S.
Grierson, E.	Nicholls, H. R. (Stratford)	Symonds, A. L.
Griffiths, Rt. Hon. J. (Llanelly)	Noel-Baker, Capt. F. E. (Brentford)	Taylor, H. B. (Mansfield)
Guest, Dr. L. Haden	Noel-Baker, Rt. Hon. P. J. (Derby)	Taylor, R. J. (Morpeth)
Guy, W. H.	Paling, Rt. Hon. Wilfred (Wentworth)	Taylor, Dr. S. (Barnet)
Hall, Rt. Hon. Glenvil	Pargiter, G. A.	Tomlinson, Rt. Hon. G.
Hastings, Dr. Somerville	Parker, J.	Viant, S. P.
Holman, P.	Paton, J. (Norwich)	Wallace, G. D. (Chislehurst)
Holmes, H. E. (Hemsworth)	Proctor, W. T.	Wallace, H. W. (Walthamstow, E.)
Hudson, J. H. (Ealing, W.)	Pursey, Cmdr. H.	Warbey, W. N.
Irvine, A. J. (Liverpool, Edge Hill)	Ranger, J.	Wheatley, Rt. Hn. J. T. (Edinb'gh)
Irving, W. J. (Tottenham, N.)	Rees-Williams, D. R.	Whiteley, Rt. Hon. W.
Isaacs, Rt. Hon. G. A.	Reeves, J.	Wigg, George
Jenkins, R. H.	Reid, T. (Swindon)	Wilcock, Group-Capt. C. A. B.
Kenyon, C.	Ridealgh, Mrs. M.	Wilkins, W. A.
Key, Rt. Hon. C. W.	Robens, A.	Willey, F. T. (Sunderland)
King, E. M.	Robinson, Kenneth (St. Pancras, N.)	Williams, Ronald (Wigan)
Lee, Miss J. (Cannock)	Ross, William (Kilmarnock)	Williams, W. R. (Heston)
Lindgren, G. S.	Shawcross, Rt. Hon. Sir H. (St. Helens)
McAdam, W.	Silkin, Rt. Hon. L.	TELLERS FOR THE NOES:
		Mr. Daines and Mr. Binns.