HC Deb 30 March 1950 vol 473 cc689-708

Postponed proceeding resumed on Question, That the Draft National Health Service (Superannuation) Regulations, 1950, a copy of which was laid before this House on 16th March, be approved.

9.47 p.m.

Mr. Blenkinsop

A little earlier this evening I mentioned that the National Health Service Superannuation Regulations which we are presenting tonight are, in the main, simply consolidating what in the past has been dealt with through three separate documents. There is no doubt that that consolidation is itself of great value to all those who are serving within the National Health Service today.

I went on to point out that there are included in these new Regulations certain amendments which I should like to explain briefly to the House. These changes have, of course, been discussed with the staff associations through the Whitley Council machinery, and in fact in many cases our proposals emanated from the Whitley Council itself. The great majority of these changes represent an improvement in the terms of the scheme for the staff, an improvement mainly of convenience rather than involving any increased cost to the Exchequer, except for one of the amendments to which I shall refer later, which does involve some small additional cost to the Exchequer.

In the first place, the widow's pension is basically one-third of the husband's pension and up to now it has been adjusted according to the difference in age between man and wife. The tables which were worked out were fairly complex and resulted, rather oddly, in the fact that for a given difference in age the wife's potential widow's pension—the proportion of her husband's pension—gets less as the man's age increases. Now we propose in these regulations to drop this arrangement, as it certainly adds to the complication without giving any very real advantage. In Regulation 15, two new paragraphs, (17) and (18), deal with a limited number of cases in which otherwise, as the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) said in our last discussion on the subject in the previous Parliament, the Minister would have "dropped down a crack." The same is true of paragraph (16).

The greatest change which is of interest to Members of both sides is that covered by Regulations 28 and 30. Here it is proposed to give the further option to those who, when the scheme was originally introduced, decided to stay subject to the terms which applied to them in their employment before they were transferred. This, I would point out, was an Amendment which my right hon. Friend agreed to introduce due to the representations made to him from the staff side of the Whitley Council; and I might point out that my right hon. Friend was not very willing originally to agree to this amendment, because it does mean quite considerable work and because it must involve a certain added expenditure on staff, and so on, and we cannot, of course, be continually giving new options to those who entered into the scheme or who are at present outside of it, otherwise the whole actuarial basis of the scheme would be endangered.

As I say the staff side of the Whitley Council have asked for this amendment, this further option, that those who are outside the State scheme be given a further opportunity of coming in. They asked for that when we were introducing amending regulations some months ago, and then my right hon. Friend felt that it would not be possible to accede to their request. However, they reiterated their request that we should consider this option in the form in which we have included it in these Regulations, and on further consideration my right hon. Friend felt that it was reasonable that it should be included, for the very fact that, since the original option, there have been several changes in the superannuation scheme all in favour of the staff, and therefore the staff can rightly claim that they ought to have a further opportunity of coming in.

Now we feel that we have reached a period in these regulations when we have completed the preliminary stages, and that we have got to have some sort, I will not say of finality, because we are dealing here with very large numbers of staff, and it is quite clear that it may be some years yet before we achieve any sort of finality—if, indeed, we ever do—but we feel that we have at least got to the point where we can hope that there will not be need for further amendment for some time to come. As I say, this must not be regarded as any precedent for reviving options again, and I understand that the staff side quite appreciate that point.

The new Regulation 28 and Regulation 47 make for greater freedom of movement between the central and local health services. In proviso (iii) of Regulation 46 (2), a limit is proposed to the remuneration which dentists can reckon for superannuation purposes. A generous figure has been taken, and the British Dental Association have accepted it. Then Regulation 46 has also been amended to exempt the general practitioner who employs an assistant from liability for the employer's contribution for the assistant. This is the particular amendment I referred to earlier that will throw some extra charge on the Exchequer, but which we feel is a reasonable adjustment in the financial arrangements between the Exchequer and the general practitioners.

While we hope that we have reached the stage of some reasonable settlement of these very complex Superannuation Regulations, I would point out again, as I did when I was introducing some amending Regulations some months ago, that we are always most willing to discuss this problem with the staff side of the Whitley Council on any relevant matters they may wish to raise, and that offer, as they well know, stands now as it did then. So, although we are closing the books temporarily, to use another expression of the right hon. and gallant Member opposite, I would again say that we are not closing them finally although I sincerely hope that it will not be necessary for me to come before the House with further amending Regulations for some considerable time to come. It is in that spirit that I present these Regulations to the House and hope that they will be accepted by the House.

Mr. Speaker

I think that it may meet the convenience of the hon. Gentleman and the House if we take this with the following regulations relating to Scotland, as I understand that they are identical.

Lieut.-Colonel Elliot (Glasgow, Kelvingrove)

They are not in fact absolutely identical. There are regulations affecting the Highlands and Islands of Scotland, although the general principles in relation to, say, Regulation 27, of which the Minister was speaking, apply to the whole country. I should think that it would be for the convenience of the House if we could have a short subsequent discussion on the Scottish regulations and that the main points could be covered in a general discussion of the Regulations which have been submitted by the Parliamentary Secretary. Naturally we are entirely in the hands of other Members to say whether that would suit them or not.

Mr. Speaker

So far as I am concerned, that seems to be a sensible arrangement.

10.5 p.m.

Lieut.-Colonel Elliot

In that case I think the first thing is to register a point of general agreement. The point of general agreement is that these are very complex regulations indeed. A second point of general agreement is that they are undoubtedly lengthy. On the whole, however, I think that it is felt that these Regulations are largely concerned with consolidation and that they represent a very long and sustained effort to try to bring the Regulations governing the new service into a convenient form for all who have to work upon them.

I am sure we are agreed that the fact that there is now both for Scotland and England, a body of regulations which one can hold in one's hands and lift without undue difficulty, is, at any rate, an advantage compared with the rather complicated card game one used to play to try to find out exactly what was anyone's right under the proposals.

Mr. Messer (Tottenham)

Even if they cannot be understood.

Lieut.-Colonel Elliot

One is nearer to understanding a single body of incomprehensible print than a variety of documents of incomprehensible print, and the collation of texts has always been the first step towards the introduction of dogma and belief, and we hope that it will be so in the case of these documents also.

The Parliamentary Secretary pointed out that several of these Regulations were an advantage, he thought, to those who would come under them. I am not sure that that holds in every case. I think that Regulation 8 (2) represents a slight worsening of the position for the individual, but that it is in general a convenience for those who are working the scheme as a whole. I think we should all agree that the rather anomalous effect by which the scaling up or down of the pension in accordance with the length of life of the husband actually boomeranged upon the widow in many cases, and was an advantage to her far outweighing the advantage which might arise from a scaling up. I therefore think we should agree to that.

On the regulations governing the carrying around of a person's superannuation rights, as a snail, so to speak, carries its shell, again I think that is an advantage; and we should seek, as far as we can, to make those services of one kind or another interchangeable. Nothing is more annoying, when a person wishes to transfer from one public service to another, than to find that a block comes because the rights which have been carefully built up in one service are forfeited on moving to another service. All my hon. Friends, I think, would be most anxious that this principle should be further extended. I hope it will be able to be extended even within the Commonwealth, so that a much greater freedom of movement can take place than is at present possible.

It is inevitable, in the circumstances of these large services and these complicated documents, that a certain number of persons do not feel themselves fully covered, even after the matter has been negotiated with the Whitley Councils concerned. As the Parliamentary Secretary will know, Regulations 27, 28 and 30 bring up other points than those which he drew to the attention of the House. It is true that under the new regulations further people can get into the schemes. But, as the hon. Gentleman knows, all parties have been approached on behalf of large professional bodies who would seek a further opportunity of getting out of the scheme. They would be more anxious to remain in the federated scheme than in the Health Service scheme, and many of them would feel that they were being transferred automatically to the Health Service scheme which, for some of them, offers fewer advantages than the federated scheme under which they were working.

For instance, under the regulations, the pension is awarded only to the individual who serves to the minimum pension age; that is, 60 for men and women, except for nurses, physiotherapists, midwives and health visitors, in whose case the minimum pension age is 55. When retirement takes place before the minimum pension age, the individual in the Health Service scheme only receives back his or her own contribution—the 6 per cent. contribution, plus interest, which is subject to Income Tax. Am I right?

Mr. Blenkinsop

Yes, only in the case of retirement due to illness quite a different point arises, and very much better provision is made under the State scheme.

Lieut.-Colonel Elliot

Yes, but as the hon. Gentleman knows, in the case of female nurses and hospital officers a great number of the retirements are on account of marriage—the nurses being a particularly attractive section of the community, and a section in whom the wastage—if one may use that singularly inappropriate word—due to marriage is extremely high. It is a good thing that the marriage rate should be high and that the turnover should be rapid. The fount of human sympathy is not inexhaustible; after a certain period the springs will tend to run a little dry, and I think that a change-over in nurses does no great harm. I think it is a good thing that those who perhaps have no calling for the profession, should move on to family life where the springs are more constantly refreshed.

Mr. Mikardo (Reading, South)

Let the husband "carry the can" and not the patient?

Lieut.-Colonel Elliot

I should have thought that the husband would be able to endear himself more to his ever-loving wife than a chronic sick person, however attractive. However, this service in which there is a high marriage rate, is not as well advantaged by the provisions which insist on service up to 55, as by provisions which allow for a prescribed period—only five years in the case of a qualified nurse or midwife, who then gets back the whole of the contributions, including the employers 10 per cent., which may be taken in a cash lump sum or an annuity.

It may be asked, why, then, did these people transfer? The applications were so great and the amount of paper work that was going on was so extensive that a great many people did not fully appreciate the position. A very high figure is given, as high as 10,000, of those who prefer to be in the federated scheme. That may be true, but undoubtedly there is a grievance felt. It is impossible to make any amendments, and we also know that there are considerable difficulties in allowing a two-way movement. The Minister will say that we merely get all the bad risks in each of the schemes. I hope he will be able to take a wider view. It is a pity that there should be any feeling of grievance allowed to remain among these people to whom we are so indebted.

I hope that the Minister will undertake to look at the matter and to consider whether some temporary re-opening of the books cannot take place for the outward movements in the same way as he is allowing for the inward movements. I am sure that he does not wish to collect people into the National Health Scheme who would be happier under the federated scheme. We do not deny that there are considerable actuarial difficulties in making any such adjustments. We know that there are many adjustments which still have to be made. When making any further adjustments, I ask that the Minister should consider this one, and if he is prepared to say that he will not shut his mind on the matter, it will be a great relief to those who have brought this matter forward to Members on both sides and have made a very persuasive case.

As to there being some arrangements made for superannuation in the case of dentists, that is, no doubt, inevitable. It will represent some reduction in the share of gold which has been falling upon this worthy class, not all retained for the purpose of fillings, but most of it subsequently being removed by the Chancellor of the Exchequer.

Mr. Mikardo

Extracted, not removed.

Lieut.-Colonel Elliot

No, Sir. It did not remain long enough for the process of extraction to be necessary. It was rather channelled off as it was descending, and I am sure the hon. Member will have experience of it in the industrial undertakings which he advises. It is a pity the dentists' position is so complicated just now and I am sure it will need a considerable amount of readjustment still.

Dr. Morgan (Warrington)

The right hon. and gallant Gentleman said three or four times that representations were made to all parties. Is there any substantiation for that statement, because I have no recollection of any representations being made to Members of this party?

Lieut.-Colonel Elliot

I only know that I received an invitation to a meeting of all parties to be addressed by the representatives of the various organisations concerned. I should have thought that the hon. Member would also have received an invitation to that meeting, but certainly an invitation did go out. It said that it was addressed to all parties, and I see no reason to doubt that.

Dr. Morgan

Apparently it was to specially selected members of the various parties.

Lieut.-Colonel Elliot

If it were only addressed to specially selected members of the parties, it is clear that it was not addressed to any particular political party but was addressed to a group of political thinkers. That is all I said, and I am sure those bringing forward the proposals were anxious to have them considered as a non-party matter, and it is as a nonparty matter I am advancing them tonight.

These are long and complicated Regulations and it would be quite impossible and wrong to try to go through them in detail tonight. They have been subject to a considerable examination by the professional bodies concerned, and on the whole they represent agreement. The House, therefore, would be well advised to support the Motion that these Regulations should now be brought into force. I only bring forward one or two points where, in spite of these complicated workings, there is a feeling of grievance still, and I trust the Minister will be able to give a certain amount of sympathetic consideration to the case I have ventured to put to him.

10.23 p.m.

Mr. Messer (Tottenham)

What the right hon. and gallant Member for Kelvingrove (Lieut.-Colonel Elliot) said is quite true—that this is one of those subjects which cuts across party divisions. One cannot work up very much enthusiasm from a party point of view on a question of superannuation. However, I think the Minister is to be congratulated on doing what has been needed for many years, that is, to codify the Superannuation Regulations.

One of the difficulties which has been experienced in the hospital world has been the different practices as between the public service and the voluntary service. There has been no one recognised superannuation scheme for the staffs of voluntary hospitals. What, in effect, happened was that what was termed the federated scheme was merely a variation of insurance. These staffs were in the position of having an insurance policy the premium of which was paid jointly by the staffs and the governing body of the hospital. In certain circumstances, where members of the staff had service, they were entitled to a return not only of their own contributions but those which had been made by the employer. It had never been the case in the public service that when there was a return of contributions the employer's contribution was given with that of the member of the staff. In some respects, it is true to say that the federated scheme had some advantage over the public scheme.

The introduction of the National Health Service necessitated a comprehensive scheme. One therefore realises that the federated scheme is transitional and that there will be one scheme. Those who had been previously working with the voluntary hospitals had no experience of the superannuation schemes of the public service and were not mentally equipped to judge which was the better. Although we have heard that the Whitley Council were made aware of what was happening and that the staffs' representatives on the Whitley Council were entrusted with the responsibility of conveying decisions to members of the staff, the fact is that there is no contact between the staffs as such and members of the Whitley Council. It is true to say that if we presented to an ordinary nurse, intelligent though she may be, regulations such as these, she could not be expected to understand them. I imagine that it would need a very clever lawyer, with an extensive library of law books behind him, to wade safely through the references which are made, for example, in Regulation 36.

It is possible that some members of the staff opted to come out of the federated scheme without realising all the implications. I do not know what the number is likely to be, but I wonder whether the Minister could say if it is possible for him, if he is convinced that somebody opted mistakenly to go into the national scheme, to give another opportunity to that member? There might be a mass migration from the public scheme to the federated scheme. I realise that any scheme of superannuation must be based actually and that it might be impossible for there to be any mass migration. If the Minister is convinced that there is hardship, would it be possible for him in selected cases, where he is convinced that a genuine mistake has been made, to consider such cases as were brought to his notice?

One big advance that the regulations make is that, in the first instance, the staff were given three months in which to make up their minds. It might have been an ample time for some of them, but not sufficient for the others. The Minister now recognises that three months was not adequate because in the new Regulations he gives six months. He must therefore admit that three months was inadequate. If that is the case, would it not be possible for him to say: "I now recognise that three months is inadequate and I must in consequence recognise the possibility of somebody doing something in error." If that is a good argument—and I hope it is—perhaps the Minister will be good enough to consider the cases of people who will regard themselves as suffering hardship unless some such provision is made.

10.31 p.m.

Mr. Linstead (Putney)

I should like to join my right hon. Friend and the hon. Member for Tottenham (Mr. Messer) in congratulating the Minister in having consolidated these Regulations. It is true they are extremely difficult to understand, but more than anything else that is some indication of the complicated history of the hospital system of this country over the last 20 years. We have brought into the National Health Service hospitals which were in the hands of guardians, of poor law authorities, of local authorities and of voluntary governors; and every one of these sections has brought its own superannuation scheme into the National Health Service, and these schemes have had to be dovetailed into the new Regulations. Consequently, it is a tribute to the Minister and his advisers that they have been able to make a coherent and unified scheme out of a jigsaw puzzle of old provisions.

The Parliamentary Secretary, in introducing the Regulations, made one reference which I should like to take up. He indicated that these Regulations had passed through the Whitley Council machinery and he was content to rest upon that fact in claiming that those who, on the staff side, come under them accepted them and had been consulted with regard to them. These Regulations will affect not only those who are to be in the National Health scheme, but also those who may be in private practice and may voluntarily come into the National Health scheme.

These sections of the staff are not represented on the Whitley Council, but they are represented by their professional associations, and the Minister might make note of the fact that the three or four associations who met members of the House yesterday said that they had had no opportunity of considering these Regulations at all and in fact only had copies of them yesterday morning. I think the Minister will agree that the Regulations are sufficiently complicated for the professional bodies which have some serious interest in them, and I think that in future some steps should be taken to see that they are not expected to consider the Regulations only one day before they are approved by the House. The Minister may say that is not the fact. I can only repeat to him what was told to us yesterday.

The third and last point I should like to make is to reinforce the plea already made for opening up a two-way option. The Minister has improved the National Health Service superannuation scheme and is giving a second choice to those who did not come into it in October, 1948, to choose to come into it if they want to do so. I believe there is strength in the claim that some of those who entered in October, 1948, may regret it and wish to have second thoughts. The hon. Member for Tottenham said that they opted to come into the National Health Service scheme. In fact, it was not a question of contracting in; they had to opt to come out, and inertia and confusion and misunderstanding were all in favour of making no choice.

If I may mention to the House a personal experience of the condition of mind of hospital staffs during the three months when they had to make a choice, I can think of a hospital with which I am associated where I found, only three or four days before the last date—4th October I think it was—the whole staff in confusion about the meaning of the Regulations to such an extent that I had to come to town, find a member of the Superannuation Section of the hon. Gentleman's Ministry, put him in my car, take him to the hospital and, at no more than three days' notice trying to get an explanation for the staff of that hospital. There was not only confusion at the meeting, but, I regret to say, that helpful officer was caught out on his own Regulations, and had to write some days afterwards to explain what the situation was. I do not blame him, he did his best.

I am certain there were scores, perhaps, hundreds or thousands, in no position to make a choice between July and October, 1948, during the "flaps" and chaos there were in the hospital system at that time. It would be justice for these people, even if it means administrative difficulty, to give them the opportunity of having another look at the alternatives and of making a choice—not by default, which was what the majority of them did at the time—and possibly coming out of the scheme and back to the one in which they were before 4th October. With those remarks I agree that we can unreservedly commend these Regulations to the House.

10.37 p.m.

Dr. Hill (Luton)

In the few remarks I shall make, I will try not to add to the feeling of intellectual exasperation which is apt to overcome one when one examines and considers these Regulations. They do achieve an almost inevitably high standard of intelligibility, but in part that is due, it is only fair to add, to the readiness with which the Minister has made a number of small smoothing out points which have been put to him from various sources. I should like to join my hon. Friend the Member for Putney (Mr. Linstead) in giving a general welcome to these Regulations, and to congratulate the Minister and his advisers—with a special word for his advisers in this peculiarly difficult job—on what has been done.

The Parliamentary Secretary described the advantages of the Regulations. It is true that he mentioned that any practitioner now contemplating holy matrimony will no longer have to engage in complicated mathematics to see what effect the margin of age between the practitioner and his bride will have on the widow's pension in certain circumstances. Further, he has removed an anomaly under which the widow who was herself a practitioner is no longer prevented from enjoying the widow's pension as well as such pension as she has herself earned.

I would like to reinforce the plea put forward for further consideration of the two-way option. I think the hon. Member for Tottenham (Mr. Messer) made the main point in this connection. There were 88 pages of Regulations governing superannuation in the first draft, and within the space of three months certain groups, mainly nurses and members of some societies, and physiotherapists, had to decide for themselves whether it was to their advantage to do nothing and pass automatically into the new superannuation set-up, or take the step of opting out. The extent to which human inertia played a part in the complicated situation, led to a situation in which the individual found himself or herself inside the scheme and there was a failure to appreciate the effect of the decision on a considerable number of the individuals. It would be wise and fair, I suggest, on some appropriate future occasion—perhaps an early occasion—to meet this two-way point, despite the admitted difficulties.

As the Parliamentary Secretary pointed out, this is the fourth document, embodying, as it does, the other three. All four sets of Regulations have in fact been submitted to this House in this form for a single decision, to affirm or not to affirm. That has led to very considerable difficulties. A new body of superannuation legislation has been set up by that method, with the result that it has been practically impossible for this House, as a House, to seek, and to make certain, of any particular changes it desired to make. The choice before the House tonight is to affirm or not to affirm the whole of this document, embodying the consolidation and change of some 28 Regulations.

I put to the Minister the suggestion that consideration should be given in future, now that the fluid stage is over—and I do not deny the great advantage of the Regulation method in that fluid stage—to dealing with superannuation by dissecting out the principles from the details and embodying the principles in a Bill to come before the House, so that it can be discussed here and in Committee in all its details. He could then give the House an opportunity not only of accepting or rejecting the draft in toto, but of submitting the various parts of the scheme to that scrutiny which will lead not only to a fuller understanding on the part of the House of the superannuation position, but to a more satisfactory position.

This has been an intellectual feat which must have caused many headaches. The Minister is to be congratulated on the general result. But I hope that he will not wish us to take too seriously the hint which he gave that we are approaching finality in this matter. He should be ready, as new problems and new angles to old problems come to him, either through the Whitley machinery or by direct representation, to put forward draft Regulations, bearing in mind the difficulty which confronts the House when it has to say "yea" or "nay" in relation to a large and complicated document.

10.43 p.m.

Dr. Morgan (Warrington)

I wish to congratulate the Minister on producing regulations which will be acceptable to everyone. The hon. Member for Luton (Dr. Hill) made two points which I hope the Minister will not accept. I hope he will stick to his present plan. The hon. Member for Luton spoke of the "human inertia" of those who did not get into the scheme by their own action. But this was not the result of human inertia. To get exempted from the National Health scheme they had to make an application within three months to be left out. That was a deliberate action on the part of those individuals, who knew what they were doing.

Dr. Hill

Is it not a case of inertia when, by doing nothing, one drifts into the new scheme without asking oneself whether the new scheme has advantages over the scheme which covers one at the moment?

Dr. Morgan

They had the option of doing nothing and getting into the new scheme, but they quite deliberately, after consideration, within three months, put in an application saying that they did not want to go into the new scheme but preferred to remain in the old scheme. I have their own document in front of me which was sent to me today for the first time, and which was sent only to selected Members with a notice of a meeting yesterday.

Mr. Linstead

If the hon. Member will permit me, I still think he has not grasped the point. There are a certain number of people who took no action at all and consequently found themselves in the scheme. On reflection, they may have wished that they had taken action and had remained in the old scheme. It is on behalf of those people, who have got in through no action of their own and who may wish to get out, that this plea is being made.

Dr. Morgan

The more I am interrupted, the more I am certain I am correct. As a matter of fact, in the course of my medical duties I attend to more cases of superannuation than any other professional Member in the House—[An HON. MEMBER: "Advertising,"] I am not advertising. There is no need for me to advertise, because my post and salary are fixed. But here is the statement or document about one-way action: Nurses and other staffs of the old voluntary hospitals were mostly subject to the federated scheme before July, 1948. On the transfer of hospitals to the State, transferred F.S.S.N. members were automatically brought within the Health Service Superannuation Scheme unless, within three months of the appointed day, they had exercised a right of option by making written application to remain superannuable in the F.S.S.N.

Mr. Baird (Wolverhampton, North-East)

rose—

Dr. Morgan

I want to make a very short speech, because I want to get home. I know this thing upside down. I am on the executive of a trade union—[Interruption.]—I am sorry this is causing a considerable amount of levity because sometimes it involves great hardship to workers in all grades who come into a superannuation scheme. I want to thank the Minister, and to say how much we and those concerned on the Whitley Council, who have been fighting for this superannuation scheme, congratulate the Department on bringing forward a good scheme, a very fine scheme, and we hope the Minister will stick to the principle of the one-way option and not give way on it, because it is the best point of the whole scheme.

10.48 p.m.

Mr. Blenkinsop

By leave of the House, Mr. Speaker, I should like to reply to one or two points raised in the Debate from both sides of the House. We are certainly grateful for the atmosphere in which these regulations have been received and for the very helpful points put from both sides of the House. I should like to express my own gratitude for the work of the staff who have been chiefly concerned with these very complex problems. It is no easy job, as any of us know, because any superannuation scheme, whether this or local government superannuation or the multitude of private superannuation schemes, are all exceedingly complex to work. It is to the great credit of the staff that they have succeeded in mastering the scheme and that there have been so very few complaints to deal with in its operation to date.

The main issue raised, both by the right hon. and gallant Gentleman and by others, has been this question of option—whether the option should be a one-way or a two-way option. I think that everyone who has raised the matter has expressed an understanding of the difficulties that we are faced with in any consideration of a two-way option. I want, first, to make it clear that we ourselves and I understand the officers of the federated scheme did do their utmost to make the terms of the two schemes understood to the staffs of the hospitals and to other staffs concerned with the scheme on both sides. I have in my hand a copy of one of the explanatory leaflets—I should almost say "booklets"—issued by the Ministry, certainly in much simpler language, which were distributed Very widely to everyone throughout the hospitals and which were there in good time for hospital staffs to consider.

It is also true that on the staff side of the Whitley Council there are representatives of some of the chief organisations that have recently made some representations on this matter to hon. Members on both sides of the House. As they have been associated with the proposals on which we are actually working, they certainly must have had very full information on these proposals, because they indeed made them. Had they not on the staff side put forward these proposals, my right hon. Friend would probably not have put them forward himself.

This is a very real administrative problem. Taking the one-way option, it would apply to some 46,000 people. We are giving a new option to some 46,000 people, which is a very real administrative strain, and at this time we have got to think of that very seriously. But we do feel that the advantages to the scheme over the long-term are such that it is worth taking that strain now. Were we to make it a two-way option it would mean having to revive an option for some 140,000. That is a very different matter indeed, and I suggest to hon. Members on both sides that, realising as we do today the importance of administrative problems, the question of staff, finance and the rest, this would be impracticable in that form.

I appreciate that there must be individual cases of hardship, and my right hon. Friend has already found ways of dealing with certain individual cases that have been brought to his notice. I certainly can say that he would be very willing to adopt a similar attitude to any other individual cases of hardship that may be brought to his notice in this coming period. I hope that with that assurance—that we recognise the problem, that we will look into individual cases, and that this is the best practical way out of the problem that we can offer—hon. Members will approve these Regulations.

Question put, and agreed to.

Resolved: That the Draft National Health Service (Superannuation) Regulations, 1950, a copy of which was laid before this House on 16th March, be approved.

10.54 p.m.

The Joint Under-Secretary of State for Scotland (Miss Herbison)

I beg to move: That the Draft National Health Service (Scotland) (Superannuation) Regulations, 1950, a copy of which was laid before this House on 13th March, be approved. The Scottish and English Health Service superannuation schemes have always run on parallel lines, and there is complete interchangeability between the two schemes. The Scottish Regulations which are before the House tonight contain all the Amendments which the House has just approved for the English Health Service. Because of that I do not propose at this hour to repeat any explanation of these Regulations.

There is, however, one additional Amendment which has no counterpart in the English Regulations, and I feel that I ought to give a few words of explanation on that particular Amendment. In paragraph (2) of Regulation 43, the Secretary of State has power to make supplementary payments on retirement to certain doctors in the Highlands and Islands of Scotland—to those doctors only who gave service before 5th July, 1948, in the Highlands and Islands Medical Service Scheme. Under the original Regulation, those supplementary payments could only be made to doctors when they retired. The Amendment which we propose in the Regulations is to give these supplementary payments to doctors who decide to leave a practice in the Highlands and Islands so long as they continue to serve under the National Health scheme.

There are very good reasons for that new decision. The Highland practices, in the main, cover very large territories. Very often the doctor has a journey not only by car but by boat. It is very possible that as a doctor becomes older these journeys and having to look after such a practice really go beyond his physical capacity. We would not wish any doctor in that position to remain in a practice in the Highlands or Islands because of his fear that he would lose his supplementary payment.

We wish to give a doctor in that position the chance to find a practice in another part of the country which would tot be such a physical strain, and thus to take away the danger of a doctor remaining in the Highlands and Islands when he is not really physically able to cope with the work. That is the reason we have introduced this further Amendment to the Scottish Regulations. The Amendment would not cost a great deal of money to the scheme. There are only about 50 of these doctors who could benefit from this further provision.

The Parliamentary Secretary to the Minister of Health has given an assurance, on the question of option, that where it can be proved that real hardship is obtaining because of insufficient opportunity to exercise the option the Minister of Health will give them his consideration. I can give the same assurance for my right hon. Friend, the Secretary of State for Scotland. With that assurance and with the explanation of the only further Amendment which we are making in the Scottish Regulations, I commend them to the House.

Lieut.-Colonel Elliot

I am sure we would not desire to detain the House, especially after the attractively presented speech of the hon. Lady, and the more so because, retaining her Scottish nature, even in her charm, she has commended to us the difference between the Scottish and English proposal—that it will not cost very much more—an unusual argument from her side of the House which makes all the greater appeal.

The hon. Lady gave the same assurance as the Parliamentary Secretary that individual cases of transfer on the two-way option might be considered. I do not yet think that that is quite adequate. I trust that she and the Secretary of State for Scotland will press on the Minister of Health the arguments, to which he has not had the advantage of listening, in favour of a rather further opening of the book. The Parliamentary Secretary gave a figure of 46,000 affected by the one-way transfer and as many as 140,000 by the two-way transfer. Let the House observe that that is the measure of the number of people who might have a grievance. The Government should not only look at it from the point of view of those who cause administrative trouble but of those whose grievance might be removed. I do not take that as the full answer. I trust it will be possible to look at this matter, and, if possible, to remove the feeling of grievance, which I do not think will apply to anything like the larger number mentioned. Even the four societies which came before us mentioned only 10,000, and proportionately it will be smaller in Scotland. As the problem would be more manageable in Scotland, the Minister might be able to deal with it in a subsidiary Regulation, as in the case of the Highlands and Islands. The more compact nature of our population might enable him to deal with this matter without the enormous disadvantage which the greater nation suffers through differences of size and complexity. Otherwise, I am sure we should all desire to see the Regulations approved tonight.

Question put, and agreed to.

Resolved: That the Draft National Health Service (Scotland) (Superannuation) Regulations, 1950, a copy of which was laid before this House on 13th March, be approved.