NATIONAL HEALTH SERVICE (SCOTLAND) (Hansard, 27 July 1949)

§ Lieut.-Colonel Elliot (Scottish Universities)
Nobody can complain that there has been any obstruction from this side of the House tonight, and I trust that the spirit of sweet reasonableness will prevail throughout. I would call attention to the fact that these regulations cover large sums of money and considerable numbers of employees. As they affect Scotland, they cover moneys which were brought in and they apparently diminish the great weight of the burden of National Health Service expenditure. It is only apparently diminishing that burden because, later on, these sums which are now being brought in, will be drawn upon to deal with the superannuation benefits which will have to be paid. But at present, as far as I understand the position, a sum of something like £2,500,000 for Scotland alone is being brought in to diminish the apparent weight of the cost of the National Health Service. The only payment out is a sum of £140,000. A very substantial sum is being brought in and, relatively speaking, only a small one is being paid out.
I should like the right hon. Gentleman the Secretary of State for Scotland to say something on the point that admittedly these regulations cover a much larger number of employees than was originally budgeted for. I should like to know whether the right hon. Gentleman can give any estimate about how far the number now being brought in exceeds the original number. The estimating on the National Health Service has been what one might call sketchy and indeed of a provisional character. It is now time that we were beginning to be a little bit more precise on these matters. If the right hon. Gentleman could give any information we should be very glad.

§ The Secretary of State for Scotland (Mr. Woodburn)
The point is that these regulations amend the original regulations. While there are slight adjustments here and there, the amount of money involved is negligible. No money at all is involved in the regulations and nothing 2606 in particular is added to the cost of the scheme. These adjustments are being made as a result of various matters which have come to light since the superannuation regulations were originally introduced. Of course, a large number—about 50,000 employees—is covered. But there is no increase there. If there are any other details about which the right hon. and gallant Gentleman would like information, I will try to give it to him.

§ Lieut.-Colonel Elliot
I can only speak again by leave of the House, but perhaps I might say that I should be grateful if the Secretary of State would look further into the points I have raised and write to me upon them. As the right hon. Gentleman has said, these regulations cover the conditions of employment of some 50,000 persons in Scotland. The regulations are of such complexity that I would not even hazard trying to read bits of them to the House after the heavy week which we have had. I tried it upon the previous occasion with the English regulations, but they were of such complexity that nobody on either side of the House was any more enlightened after hearing several passages of them read aloud than they were before, and if that could happen when we were all fresh before an all-night sitting, I tremble to think what would happen after one.
The original regulations covered 87 pages, and the amended regulations in 1948 consisted of 10 pages. The present ones cover 16 pages—16 pages of Amendments to 100 pages of regulations covering the conditions of employment of 50,000 persons. The House should realise the way in which it is enmeshing itself through these regulations affecting the citizen. These complicated documents are laid before us and the Secretary of State has had to cast himself upon the mercy of the House tonight, because all these matters are of such complexity that he would not like to try to explain them to us. I hope, however, that he will be able to explain them later by correspondence.

§ Mr. Niall Macpherson (Dumfries)
There is one point to which I should like to refer, and, complicated as these regulations are, I think it is straightforward. If I might direct attention to paragraph 19 of these regulations, which deals with the application to voluntary organisations, we find that it says— 2607 Provided that the terms and conditions of any such admission as aforesaid"— that is, admission to a local government superannuation scheme— may contain provision that any previous period of employment by the organisation of an employee so admitted as aforesaid shall only be reckonable as service in such manner and to such extent as may be agreed between the local health authority and the organisation. Out of the 50,000 employees involved, I have in mind particularly the members of the Queen's Institute of District Nurses. I know that there are negotiations going on at present, but I should like to remind the House that, under the existing Queen's Nurses Scheme, the pension to which they are entitled amounts to 30s. per week. That is all they get. Unlike civil servants whose pensions, on the whole, are calculated on the basis either of their retiring earnings or a period of time immediately before they retired, this superannuation sum is calculated only on the basis of the payments made by themselves over a period of years, together with charitable contributions raised in various ways.
It seems to me that this raises an entirely different question. The serious thing is that, in spite of very successful appeals for funds by district nursing associations, which raised very nearly £100,000, the pension fund is still £80,000 short of the sum actuarially required to meet their obligations. The main source of revenue is the Scottish Gardens Scheme. I understand that, under the arrangements contemplated, some of the district nurses in the areas for which local authorities are taking direct responsibility for the home nursing service will be admitted to the superannuation scheme, but without any back credit at all, contrary even to what is said in this particular paragraph, whereas those for whom the local authorities are indirectly responsible will only enter if they make their own back payments. That is the only condition on which they can enter. The Scottish Gardens Scheme has been raising funds for the last 18 years at the rate of £10,000 a year, His Majesty's gardens at Balmoral being the biggest contributor.
It seems to me that they are going to have very much more difficulty in future in raising sums of this character. In the first place, the county nursing associations are gradually being wound up, and as 2608 they cease to function the local people, no doubt, will not longer feel the same responsibility for providing these funds. In the second place, of course, there is a difficulty arising owing to the lack of petrol, since not so many people are now able to visit the gardens. In consequence, the garden funds are suffering substantially. It seems to me objectionable that public servants, such as the district nurses now are, should have to depend for their pensions either partly on public funds and partly on funds raised by charity, or else, in the case of the older nurses, wholly on funds raised by charitable subscriptions, with, of course, their own contributions added.
It seems to me that the regulations ought to have made more generous provision for this, and I am afraid that in paragraph 19 amending Regulation 42, quite insufficient provision is made. Indeed, it seems limiting, and gives local authorities power to negotiate individually on a basis which would be most unsatisfactory. I know that negotiations are going on, but it seems that the right thing to do, so far as the district nurses are concerned, is for the Institute to divide their funds into two parts—first, the part required to meet their obligations in respect of nurses who retired before the scheme came into force, and, secondly, to hand over the rest to the Secretary of State for Scotland so that he would in future be responsible for the payment of pensions to district nurses on the basis of the present regulations. I hope the Secretary of State will have something to say on this matter, because we all know that the Queen's Nurses give, and have given for the last 60 years, the most marvellous service to Scotland, and are well deserving of the best treatment.

§ Mr. Woodburn
With the leave of the House, perhaps I could say a word to the hon. Gentleman. I had a visit from the representatives of the nurses' associations, and this matter is being arranged in accordance with their wishes. They wish, of course, to retain their independence—that is the first point—and though they have the right under this Bill to contract in, as it were, for pensions, they would not be able to afford to pay all the arrears in order to get immediate pensions. The purpose of this is to enable each of them, as it suits their circumstances, to enter into arrangements with the local authorities in order to come to 2609 an arrangement mutually advantageous. This does not lay down any limits or restrictions as to how that arrangement will come about. It will be done by mutual agreement. I can assure the hon. Gentleman that the nursing associations are very jealous of retaining their individuality and wish to retain their right as organisations to help in this particular way. They do not want the Secretary of State to take them over in regard to the points raised by the hon. Gentleman.

§ Mr. Macpherson
What about the associations which are being wound up at the present time?

§ Mr. Woodburn
That, again, is a matter for negotiation. There are so many associations and so many differences that, naturally, everything has to be treated on its merits.