HC Deb 21 July 1950 vol 477 cc2735-42
Mr. Bevan

I beg to move, in page 18, line 32, at the end, to insert: () No order shall be made under subsection (1) of section two of this Act unless a draft thereof has been laid before Parliament and has been approved by resolution of each House of Parliament. This gives effect to the promise that I made that there should be an affirmative resolution to the Order made under Clause 2 (1) of the Bill, prescribing the length of the intern period. This is a very important Amendment, and I am glad that I have been able to do this.

Lieut.-Colonel Elliot

I think that we are all agreed that it is a very important Amendment which may go a long way towards obviating many of the difficulties which were foreseen during the earlier stages of the Bill. I think that it is an excellent thing that the House of Commons, which, I think, in any case would have insisted on discussing these provisions, should be able to discuss them under the more dignified procedure of an affirmative resolution, which also means that they will be in general discussion at a more convenient time when the House and the country outside can take note.

I am sure that this will be of the greatest benefit in bringing this Bill into operation. It is at present merely an enabling Bill, and I hope that when he is laying the Order the Minister will have regard to the point that I made that the Order should not be so narrowly drafted as to confine us simply to the moment of time and nothing else, but should have one or two general words, such as "other matters connected therewith," which would enable a somewhat wider discussion to take place.

Amendment agreed to.

Further Amendment made, in line 34, after "than," insert: the power conferred by the said subsection (1) or."—[Mr. Bevan.]

Motion made, and Question proposed, "That the Bill be now read the Third time."—[Mr. Blenkinsop.]

2.15 p.m.

Dr. Morgan

I shall be very brief although I would like to be long. I know that I am a lone lamb, so to speak, opposing this Measure. For 40 years I have lived with the idea of reforming the General Medical Council. All through my student career when we were discussing it in Glasgow University—the right hon. and gallant Member for Glasgow, Kelvingrove (Lieut.-Colonel Elliot) has probably forgotten those days, when he was a democrat—we discussed time and again how and what method we should adopt for the reform of the General Medical Council. Let us see what this Bill is, and how it changes the present situation.

The General Medical Council still consists of three different types of members. It consists of the elected members—very few—the nominated members, and the members appointed by the various universities or teaching schools. We can call them nominated members if we like. They are not elected by the schools but simply nominated by the council of the teaching schools. This House, as it appears, as the elected representative body to pass legislation about the conduct and practice of professionals in medicine, thrusts aside indiscriminately the principle of elected members. In other words, they decide that this body of nominated members should not be elected in any way. They should be specially selected by people who may know nothing at all about medicine and who are simply nominated to come on to the General Medical Council. In my view, the representatives concerned with the medical schools should not be on the General Medical Council.

It is surprising to me that the Minister made an answer to me in the earlier discussions on this Bill that this Bill was not concerned with medical education. He will find in HANSARD that on the occasion of the Second Reading of the Bill, I discussed the question of whether industrial medicine should or should not be taught in the medical schools, which it is not at present in the majority of them, and which the workers want and for which their various organisations have asked for years. I say that these representatives from the teaching schools should not be on a body of this kind. They might be on sub-committees appointed or elected, but they should not be concerned with the higher ethics of the profession, and I submit with the greatest respect to this House that these members are put there for one purpose and one purpose only, namely, to protect the vested interests of medical teaching in medical schools. That is all they are there for; there is no other reason for their presence there.

Every time a recommendation is made for the reform of the medical curriculum by the members who are not there representing the universities or nominated by the universities, these people block every possible change asked for in connection with the teaching schools and the curricula in those schools. Any attempt to cut out the dead wood from medical education, the waste of time, the useless subjects that are incorporated and theories which have been given up years ago, has been denied. Why? Teachers of perhaps 20 or 30 years standing do not want in any way to bring their medical curricula up to date and to cut out all that is unnecessary. All that has not been touched, and that is the reason why reference is not made in the Bill or in any report to the reconstruction and reformation of the medical curricula.

I would only mention that the General Medical Council has passed on its pharmacy duties to the British Pharmaceutical Society. I think that is the wrong thing to do. As I pointed out earlier, the General Medical Council has three duties—the question of pharmaceutical supervision, medical teaching and keeping up the register. I know that the keeping of the register is the most important, but someone should protest that the General Medical Council has passed on its duties in this way.

I want again to stress my opposition to this Bill on the grounds that the G.M.C. should be an elected body, and that those representing the universities should come from a specially elected facet of the universities. All the members, except those nominated by the Government, should be elected members. Just imagine the nomination of an officer of any Government Department to the G.M.C. I do not know how that appeals to Members in the House, but it seems to me to be quite wrong. The membership of the G.M.C. should be carefully watched in future, and we should see that matters of this kind are not abused in any way.

I know that we are not supposed to discuss G.M.C. expenditure in the House. I was told by a prominent person that it would be an outrage if any expenditure in regard to the G.M.C. were discussed in the House. "Outrage" was the word that was used. What would be said if, public money were being spent in some other direction, and, when the matter was raised in the House, Members were told that it was an outrage to do so? I could go on, because I feel very strongly on this, but I have now come to the conclusion that I should not have been in Parliament at all, but should have confined myself to writing. I think I should have achieved more good by writing instead of indulging in speeches. In future, having failed to make my views efficacious, I am going to devote myself to such writing as I have learned to do in the past.

I am certain that the G.M.C. will remain practically the same body as it has been in the past, and that there will be the same abuses and the same injustices continuing. I believe that the same sort of men who are there now will continue to be there in the future. The Minister is always talking, as I used to talk in my young days, about the protection of the public. The public have not been protected, of course, and must be protected—and protected against the lawyers as well.

I know that education is to be reformed from the point of view of the public, so that a doctor is a good doctor with the necessary medical knowledge. But the fact is that the doctor, both young and old, is entitled to the best justice that can be given to him in the course of the carrying out of his profession. There are not sufficient institutions in the country to provide men with posts in their last year. This Bill, in my opinion, is a deliberate attempt to keep the working classes and scholarship students out of medicine.

Mr. Iain MacLeod

Nonsense.

Dr. Morgan

The hon. Member may think I am talking nonsense, but I have not yet heard him talk sense. It does not matter, because abuse is no argument. It is my opinion that this Bill is an attempt to keep the working classes out of medicine. The working class doctors have proved their value in medicine. They know the conditions under which their own class live. They try to get into the homes of the people and do the best they can from the point of view of public health and medical education.

Having said that, I do not think that anything has been changed by this Bill. The position remains nearly the same as before. The G.M.C. will have the same powers. Not a word is said about the age of the members, or about legal advice coming not from one source but from many. With great respect, I ask the House to agree, in genuine sympathy for a lone Member, that whatever may be thought of my views I have at any rate followed this subject with assiduity through the years, hoping that at some time the G.M.C. would be reformed. I resume my seat still with that hope active in my mind.

2.27 p.m.

Lieut.-Colonel Elliot

No doubt the House has every sympathy with the hon. Member for Warrington (Dr. Morgan), but for all that I think we would prefer the Goodenough Committee to what I might call the "Hyacinth Morgan Committee."

Dr. Morgan

No personal abuse.

Lieut.-Colonel Elliot

I should not have thought that the name given to the hon. Member at baptism would be regarded as abuse. I fully agree that the hon. Member is not responsible for the terms by which he is designated, but he is responsible for the arguments he puts before the House. I think that he greatly exaggerated, to put it no higher, when he said that the purpose of the Goodenough Committee was to make it impossible for members of the working class to attain medical qualifications. That is a statement which, on sober reflection, I am sure he will regret having made.

The argument he advanced in general terms was that he did not approve of the G.M.C. in its present form, particularly because it was not more elective. The test of these things is that there should be a good Medical Register, and the fact is that there is a good Medical Register in this country. To be on the Register as a British registered medical practitioner is universally recognised as one of the highest medical qualifications in the world.

I have had some experience of the young colonial universities growing up, and of their great desire to see that their students should be fitted to be placed upon the General Medical Register. So highly is this Register thought of that we see the remarkable fact that the Republic of Ireland, which has severed its connection with the Commonwealth in so many respects, still maintains a common interest in this great Register. I commend that to the House and, indeed, to the world as an indication of how highly thought of is this Register, and what a privilege it is considered to be to have one's name inscribed upon it.

The work which the Committee and the House have done has been done swiftly and well. As I previously said, the House has been working as a smith works upon a piece of ironwork, hammering it, shaping it and making it a considerably better instrument than it was when we first took up the hammer to it. Both in the case of the other place and our own Chamber we have worked with the common consent of all and have greatly improved the Measure, more particularly by the introduction of the affirmative Resolution in place of the negative Resolution. We have already spoken of that, but it is worth while to bring that point again to notice on the Third Reading as an example of a proposal put forward by the House and accepted by the Minister, thereby doing credit to both.

There is no doubt that the working of this Measure will require further careful scrutiny. The danger of overloading the curriculum is great, and the danger lest the dead wood should not be cut out is always present. Unless the dead wood is cut out, the medical curriculum becomes unwieldy and finally defeats its own object. I am sure that those whom we have entrusted with this duty under the Bill will also have that in mind, and that many reforms will continue to be made in the medical curriculum in the years immediately ahead. Otherwise, we should have had no advance from the doctrines of Galen and the proposals of the Middle Ages.

The suggestion made by the hon. Member for Rochdale that the university representatives were merely concerned to maintain the vested interests of the then teaching schools cannot stand up against the many instances in which reforms have been secured and introduced into the medical curriculum. It is not yet perfect, but if we accepted all the views which any person put forward it is possible that the present curriculum would not be any more perfect than it had been; its imperfections would merely be in another direction. In a multitude of counsellors there is safety, and in the numerous voices brought together in the British Medical Council, as it will be constituted, a consensus of opinion allowing for steady progress and the incorporation of new knowledge and doctrine will be found.

It is in that belief that we give our blessing to the Bill and send it forward. We hope that it will have as its effect the improvement of the great medical schools of this country and the continued improvement in the public health of this country, which is one of the joys of our whole medical administration, and, one might say, of our whole Western way of life. The constant improvement in the health and condition of the ordinary man and woman is one of the most striking facts, so striking that there have now come those who say that the ghost of that excellent and dead clergyman of the Church of England, Dr. Malthus, has risen from its grave and is stalking the world, a spectre more terrifying than many of the spectres of disease and famine that we have successfully dispelled. That is a problem to which we have to look, but the problem with which this Bill is concerned is that of dispelling disease and suffering, and because that is its aim that we give it our hearty support and blessing.

2.35 p.m.

Mr. Blenkinsop

I merely wish to express on behalf of the Government our appreciation of the way in which Members on both sides of the House have co-operated in the proceedings on this Bill to try to secure its easy and speedy passage, and to ensure such amendment, as would clearly make it a more useful and valuable Measure. Even though we have discussed this Measure at rather odd times of the late evening and early morning, we have done so with general good will and without acrimony.

In the Measure that has finally come before us we see an improvement here which commands very general support, if not from my hon. Friend the Member for Rochdale (Dr. Morgan). I should not like it to go out from this House that there is in this Bill anything which will tend to restrict the opening of opportunities of working men and women to enter this great profession. Rather, I think, we can be assured that from this added intern year we shall be securing both better conditions for the general public and a higher professional standard which should be the aim of all of us.

Question put, and agreed to.

Bill accordingly read the Third time, and passed, with Amendments.

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