§ 10.10 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Mr. Blenkinsop)
I beg to move,That the Draft National Health Service (Superannuation) (Amendment) Regulations, 1949, a copy of which was laid before this House on 4th July, be approved.These regulations are highly technical amendments to a complicated superannuation scheme. In a large measure they clear up minor difficulties which have shown themselves in the first year's working of the superannuation scheme for the staff of the National Health Service. In some cases they make changes to bring those regulations into line with other similar superannuation schemes. They have been circulated to the various staff organisations and have aroused no comment, and we understand that they are fully in agreement with them. Indeed, in some cases these proposals stem from suggestions made by the staff associations themselves. In many cases they improve matters for those participating in the scheme.
Perhaps the main provision is the one under Regulation 10 which is designed to encourage those who have already retired on pension, or are eligible to do so, to continue in employment for up to a further five years and thus earn an increased pension when they finally retire. This position is similar to that under the National Insurance Scheme. It is obviously desirable that these changes should be made where experience of the working of the scheme proves that they are necessary. As these amendments are generally agreeable to those concerned, I hope that the House will not be detained by detailed consideration of them.
§ 10.13 p.m.
§ Lieut.-Colonel Elliot (Scottish Universities)
It is quite true, as the Parliamentary Secretary has said, that these are highly technical matters, but I think that the House will need to devote a little longer time to their consideration than he seemed to suggest was desirable. It is true that, as the right hon. Gentleman said, the regulations are extremely complex, but although they have been circulated to the various bodies concerned 1511 the very fact of these further regulations having been brought forward indicates that it is not always possible at a single attempt to deal with the whole subject to the complete satisfaction of all concerned. This is the second attempt and it may be that further amendments will be necessary in this immense volume of regulations to which these are amendments.
The original regulations consisted of 87 pages and there are now more than 100 pages of them dealing with this subject. It is true that these new regulations have been circulated and will no doubt be discussed in the appropriate journals, but it is also true that everybody does not always read all the entries in the appropriate journals. For example, not every doctor reads through the whole of the "British Medical Journal" every week, desirable as it might be that he should do so. Unless one reads and applies oneself closely to the technical exposition of the many regulations brought forward, it is always possible that something, to use a colloquialism, "drops down the crack."
These regulations cover a large number of persons. It was estimated in July, 1948, that the superannuation scheme covered 300,000 persons. This scheme obviously covers more people. It would be desirable for the Minister to indicate, if he can, how many more people are covered by the scheme as now set forth, what the actual increase is and what are the reasons for the increase over and above the original estimate. It would help us to have some idea of a subject about which the House has always been curious, and about which, so far, it has not been able to have very much information—the actual size of the administrative staffs concerned. It covers, I think, the schemes of the employees of the regional boards, covers the employees of medical bodies and treating hospitals and executive councils, and other bodies set up under the Act; and I am informed that it covers medical practitioners and dental practitioners, though not ophthalmic practitioners or chemists. It will be seen that these regulations are of a very wide sweep indeed, and that they cover very, very large sums of money. I will come to that in a moment.
1512 There are certain technical points which, as the Minister said, are desirable, such as the point in Regulation 10, in which employees are encouraged to continue in employment up to 10 years beyond the possible retiring age, thereby earning a higher rate. I should like to ask the hon. Gentleman if it also covers those who return to the service, and what rebates for allowances are granted to those who have been out of the service for a longer or shorter period. It would obviously be very desirable, if possible, that people should be attracted back into the service, for the strain on the service is very great just now, and one of the simplest of all ways of dealing with it is to recruit from those who have been already fully trained in one branch or another, and who are still capable of giving many years of good service.
There is, I understand, an important regulation, No. 6, which enables the Minister, where a person dies as a direct result of an injury sustained or of a disease contracted, to pay to his widow a gratuity, taking the circumstances of the case into account. Previously, the payment would be made only if a person were incapacitated, not if a person died. That is how I read the matter, but, perhaps, the Minister could inform me if this reading is correct. I think it is correct, and, if so, it is an example of an obvious gap in the drawing up of the original regulations, which is quite properly being corrected now.
The cost, however, is one of the points upon which the Minister did not touch—the size of the figures with which we are now dealing; and it is worth while for the House to take note of the very great scale of the figures which we are now considering. The estimated gross total for the service this year was some £352 million, against which there were appropriations in aid amounting to £92,750,000, of which the largest sum is the contributions paid in the insurance which, as the House knows—though it is not always recognised by the country—is only a small fraction of the cost of the scheme—one-ninth; but in a scheme of this size even a ninth amounts to a substantial sum.
Secondly, there is this insurance contribution of 6 per cent. which is paid by the contributors towards the cost of 1513 the superannuation scheme. The employee pays 6 per cent. and the employer 8 per cent., except the manual workers, in whose case these contributions are 5 per cent. and 6 per cent., respectively. This 6 per cent. amounts to very substantial sums. These appropriations in aid last year were estimated at £44 million for England and Wales. They rose to £62 million when the estimates were completed. That is an increase of about £20 million, and as far as I have been able to calculate there accrued to the Exchequer through these superannuation benefits £30,694,000 for England and Wales.
Now these are very considerable sums, which accrue at the commencement of the scheme, when of course not very much is being paid out. A run-off will take place later, but these moneys are going into the reserves of the scheme, and owing to our system of accounting they appear as appropriations in aid and therefore lessen the apparent size of the charge on the scheme in the initial stages, although it will be clear to the House that when the liabilities begin to appear at a later stage of the scheme this apparent lessening will be diminished and the full weight of the scheme will appear.
The sum of £30,694,000, which is the sum affected by the amendment it is sought to make tonight, is very substantial, because I understand that the only payment out just now under the superannuation regulations is the sum of just under £2 million for England and Wales, so that, as far as I can calculate, the Exchequer has at the moment a temporary surplus of something over £30 million, which in the course of the years will run off as the liabilities begin to accrue. Perhaps the Parliamentary Secretary could inform us whether these figures which I have been able to extract from a study of what, he will agree, is a complicated and intricate scheme, are more or less correct. Perhaps he could also say something about the two main points in the regulations; that is to say, the continuance or recall to service under the scheme, and the payment of a grant for the death of somebody incapacitated or injured during service under the scheme.
Otherwise the regulations in themselves are, I think, a stage in the inevitable tidying up process which is going on as this great scheme begins to be run in. It will 1514 be seen from the very cursory examination which I have been able to give to it, that if my figures are correct the difference between the first and the final estimates is very considerable, and that the sums we are handling tonight are very great indeed. If the Parliamentary Secretary could give us some further information on that, and also deal with the point I raised at the beginning and tell us the numbers first budgeted for and the numbers now being budgeted for, I think the House would feel disposed to give him the regulations.
§ 10.23 p.m.
§ Mrs. Braddock (Liverpool, Exchange)
Do these regulations cover employees of hospital services throughout the country who were transferred to the new service, and who had standing to their credit with local authorities, not superannuation payments but accumulated gratuities which the hospital service would pay to them when they retired? In Liverpool we are at the moment having difficulty with people who were employed by the hospitals of the local authority, who are not superannuated, but to whose credit the local authority put £7 10s. a year. That amount would have been paid to those people on retirement, either at the age of 65 or when they were compelled to retire because they were unfit to carry on. They have not yet been paid any of the gratuity either from the local authority or from the new Health Service, which has not undertaken to pay the amount. The local authority would have paid these employees had their remained with the local authority, and a number of these people are old enough to have to retire. The regulations are very complicated, and I should like to know whether they cover the case I have mentioned.
§ 10.26 p.m.
§ Sir Hugh Lucas-Tooth (Hendon, South)
There are one or two points I should like to put to the Parliamentary Secretary in connection with these regulations. By Regulation 10 it is proposed to add certain new regulations to those originally approved, and the whole of these are entitled "Re-employment of pensioner by employing authority." I tried to decipher the meaning of these words, but did not find it easy. I assume, however, that they would cover the case of someone who had left the service and had come back into it, after two or three years' retirement, for a 1515 special reason. An example would be what might happen in the case of a national emergency, when it might be necessary to call back a number of retired officers for the duration of that emergency.
The hon Gentleman described the regulations as merely covering the case of officers continuing in employment beyond the retiring period. He said this was analogous to the case of the ordinary person continuing work after the age of 65, and so earning a larger pension under the National Insurance scheme. I am not certain whether he meant thereby to exclude the case of the person who comes back; we should have an assurance that if there is a gap it will be covered by the regulations. The hon. Gentleman may be aware that in the case of the Armed Services people retire at a much earlier age than under the National Health Service. During the war they came back in large numbers, and it was difficult to deal with someone who was eligible for both pension and pay.
As I understand it, Regulation 16 (c) is applicable to specialists. Regulation 16 (c) of the original regulations enabled general practitioners within the service to choose, if they pleased to continue with their privately arranged insurance scheme, and to obtain benefit from the employing authority equal to the amount that the executive council would have had to put aside for their benefit if they had come within this scheme. I think that the House will welcome the proposal to include specialists. I have no particular point to raise on that. But under certain of the regulations there is a particular class of case which has only obtained notice by reason of the National Service (Amendment) Bill now passing through the House. I understand that under the original arrangements doctors who wished to continue their own insurance schemes had to give notice within three months of the appointed day in the original Act.
Under this new Bill there will be a number of general practitioners who may come into the Act at some future appointed day, and who may have insurance schemes which they will wish to continue after the new appointed day, I am not certain that this class has not fallen between the two regulations. They are not specialists, they are not covered here, and are not within the scheme on 1516 the original appointed day. I hope that the Parliamentary Secretary may be able to give an assurance that I am wrong, and that this class is covered. If it is not, I am afraid I have already indicated to him a new flaw which will mean certain new regulations in the near future.
There is only a further small matter about which I wish to ask the Parliamentary Secretary a question. That is about the chaplains. They are covered by one of these regulations which provides that chaplains who have been eligible for pension in an outside scheme, when they come into this scheme, may be eligible under the scheme. It is noticeable that this only refers to English chaplains. There is no corresponding provision to cover Scottish chaplains. Can the Parliamentary Secretary say why that is so?
§ 10.32 p.m.
§ Mr. Blenkinsop
We have had a series of detailed points which have been very properly raised on these regulations. I should point out that these amending regulations do not extend the scope of the scheme, so that they do not bring in further groups, with the exception of a small number of chaplains who may now come within it, and who were previously excluded. It is true that they do cover, broadly, some 300,000 persons, as the original regulations did. They are amending regulations which, in many cases, make the provisions more acceptable to those concerned; but they do not, in fact, involve much in the way of extra expense.
I was asked a series of questions by the right hon. and gallant Gentleman. First, he raised the question of the period of extra service which will count for pension, and whether that covered also those who would return into the scheme after a short break of service. It does, of course, cover that particular category. The hon. Member who supported the right hon. and gallant Gentleman also raised this point. We are not only providing for those who continue for an extra five years under the scheme, or for a shorter period, an increased pension and increased superannuation benefit when they return, but we are providing similarly for those who return into the service after a break, or who come into the service after leaving some other superannuated service which they may have had in another form of employment. The period is five years.
1517 It is true that Regulation 6 does now bring our injury provisions into line with the Civil Service provisions. We previously followed the local government provisions, where there is a similar hiatus. If a person in benefit had died from an injury while in the service, without being in injury benefit for any period, then his widow would not have received any grant. Under these amended proposals she will be able to receive that grant, as is provided in the Civil Service scheme.
The right hon. and gallant Gentleman made reference to the large sums involved in the regulations generally. I must say again, on that point, that there is no change to the original proposals put before the House some time ago. We are here discussing amending regulations, and any changes which they may bring, rather than the original regulations. My hon. Friend the Member for Liverpool, Exchange (Mrs. Braddock) referred to the question of transferred officers, and particularly the position in her own City of Liverpool. They, too, are covered by the 1947 regulations, and gratuities are covered by Regulation 25. I will, however, look into the position in Liverpool in order to make quite sure that there is no gap, but so far as I am aware, they are all fully covered.
The hon. Member opposite for South Hendon (Sir H. Lucas-Tooth) raised the question of whether we have covered those who fall back into service after a gap. They are covered in Regulation 10, to which he himself referred. He also raised the point of the option given to part-time specialists to contract out. The provision in Regulation 16 (c) was made to meet a point which was raised by the British Medical Association. Practitioners coming in after the appointed day are not covered. It was a special concession, and I doubt if it could be extended. Regarding the point raised by the hon. Member about chaplains, there will be separate Scottish regulations dealing with the Scottish people; but there will be very few cases arising in this class.
I hope that with this explanation of the points which have been raised tonight, the House will be prepared to approve this Motion. In matters of this kind, as we get experience of the working of the scheme, it will obviously be necessary to consider further Amendments from 1518 time to time to the regulations. The House will agree that we have had comparatively short experience, and we do not deny that there may still be points worthy of consideration as our experience extends. On our guarantee to re-examine the matter, after we have had more experience, I hope that the House will give these amending Regulations their approval.
§ Lieut.-Colonel Elliot
I can only speak again by leave of the House. I should like to say that we are interested in the Parliamentary Secretary's explanation, and also in his willingness to go farther into these regulations, if necessary. I should, at the same time, like to say that I sympathise with the hon. Member for the Liverpool, Exchange (Mrs. Braddock), who, when asking if certain officers were covered, was referred to Regulation 25. May I remind the House that this states:In regulations 4 (1) and 9 (2), the proviso to regulation 11 (1) and regulations 13 (1) and 17, otherwise than in their application to practitioners, references to pensionable age shall be construed as references to an age greater by five years than pensionable age or, in the case of a person who before attaining such greater age has completed forty-five years contributing service or forty-five years contributing and non-contributing service, the noncontributing service being reckoned at half its actual length, his age at the date on which he completed such service or if that age is less than pensionable age then pensionable age.I take it that the person who has spent many years in the service of a local authority in a subordinate position, might well be in an even greater difficulty in trying to interpret these remarks than a Member of this House. If I were subjected to a cross-examination on the meaning of this regulation, I am quite certain that I should not pass with full marks. I have not read the second, third or fourth paragraphs. Paragraph (4), for instance, states:In regulations 6, 9 (2), 10, 11, 30 (4) and 38 (3). there shall be substituted for the word 'forty' wherever it occurs the word 'forty-five.'Or, for instance, paragraph (5):(5) This regulation shall not apply in relation to any person to whom Part III or Part IV of the principal regulations applies, or to any person who is or was over pensionable age on the date on which he first becomes or became an officer not being a person who before becoming an officer was entitled to a pension or injury allowance payable out of public funds, otherwise than under the National Insurance 1519 Acts, 1946, or who, apart from this regulation, might become entitled to a pension under the principal regulations.It will be seen that the clarification by subsequent paragraphs is, perhaps, not fully complete and, therefore, I trust that the Parliamentary Secretary's assurance that the hon. Lady's question was covered by this regulation will be borne out by subsequent facts. For my own part, I would not be able to pronounce upon it, one way or the other, from the cursory reading which I have been able to give it.
The Minister made a further reference to a point raised by my hon. Friend the Member for South Hendon (Sir H. Lucas-Tooth) as to the position of medical practitioners who would come under the scheme at a second appointed day by virtue of legislation now passing through the House, and he indicated that he feared it might not be possible for them to be covered by these regulations. I trust that the Minister will have a look at the Bill which is now before the House to see whether it is not possible to bring in such practitioners in the subsequent stages of that legislation. I think it would be the strong desire of hon. Members on this side of the House that those practitioners should be so brought in, and I should have thought that the legislation passing through the House would be a very suitable opportunity for them to be brought in.
Apart from that, as I say, on this occasion the House will have to cast itself to some extent upon the broad bosom of the Parliamentary Secretary and the still broader bosom of the Minister, and pray that their admirable intentions are being borne out in the somewhat complicated language which the House has to consider. With the pledge from the Parliamentary Secretary that this is not the final occasion upon which books are to be closed and no further Amendments introduced, we on this side of the House will be willing tonight to approve these regulations.
§ Queston put, and agreed to.
That the Draft National Health Service (Superannuation) (Amendment) Regulations, 1949, a copy of which was laid before this House on 4th July, be approved.