HC Deb 01 November 1954 vol 532 cc153-70

9.59 p.m.

Mr. A. Woodburn (Clackmannan and East Stirlingshire)

I beg to move, That an humble Address be presented to Her Majesty, praying that the National Health Service (Royal Infirmary of Edinburgh and Associated Hospitals Endowments Scheme) Approval Order, 1954 (S.I., 1954 No. 1296), dated 27th September, 1954, a copy of which was laid before this House on 5th October, be annulled. With your permission, Mr. Speaker, I propose to discuss, at the same time, the general principles of the other four Prayers which are on the Order Paper in my name and those of my hon. Friends.

Mr. Speaker

Is that procedure agree- able to the right hon. and gallant Gentleman?

The Joint Under-Secretary of State for Scotland (Commander T. D. Galbraith)

indicated assent.

Mr. Speaker

Then I think it would be for the convenience of the House if that procedure were followed.

Mr. Woodburn

We have tabled these Prayers not, of course, because we want them to be accepted by the House. The last thing we should want is that we should ask Her Majesty the Queen to annul the Orders which have been placed before the House.

One purpose is to mark an important step in the completion of the task which was set the Hospital Endowments Commission in Scotland to distribute the endowments referred to it under the 1947 Act. A second purpose is to give the House and the Government an idea of what, from a public point of view, are the desirable improvements in hospital amenities and other services which are expected to flow from the distribution of these endowments; in some cases their restoration and in others a spreading out of the endowments.

First, I believe myself—and on behalf of the House, so far as I can speak for it —that it is desirable to express our thanks to the Hospital Endowments Commission for its good work, and especially to Sir Sydney Smith, who was the chairman and who has carried out the supervision of this matter. It is fortunate that this Commission was set up at a time when it became necessary for us to consider establishing an organisation in Scotland for the development of research. Sir Sydney Smith was a member of the small group of surgeons, heads of hospitals and heads of universities who met me to consider the setting up in Scotland an organisation for the co-ordination of research.

Sir Edward Appleton, who became the chairman of that advisory council on research, recently gave up that position on the formation of the Scottish Hospital Endowments Research Trust. I think we ought to express our appreciation of the work which Sir Edward Appleton did. It has led eventually to the establishment of what, I 'believe, will be an organisation that will lead to tremendous results in Scotland in the future.

As I say, it was fortunate that the Hospital Endowments Commission was meeting at the same time because, of course, research work requires money. This was obviously a very desirable object for the Commission to consider when allocating the funds placed at its disposal by the nation when making it responsible for the running of the country's hospitals. By the 1953 Act the House allocated an income of £120,000 a year to the Scottish Hospital Endowments Research Trust. Sir John Erskine, now the chairman of the Trust, has reported that it is in good heart and has already started to extend research work.

We now come to the other part of the Hospital Endowments Commission's responsibility, which is the distribution of this money throughout the different hospitals in Scotland. In these Orders the Commission itself has laid down the general principles that have guided it in making these allocations. I am sure the House will agree that those principles are perfectly sound. Suggestions are made in the Orders for the use of endowments. Several are mandatory—presumably because they come from the original purpose of the funds. The Orders lay down that these will be part of the schemes to which they shall have regard in allocating the moneys; for instance, for medals for nurses and for various other desirable purposes.

I am certain that all of us would endorse these purposes, so there is no point in my enumerating them, but the House tonight has an opportunity of suggesting other possibilities, and one of the first things we should consider recommending to the hospitals is that part of these funds should be used for raising the esprit de corps and spirit of enthusiasm in the nurses of Scotland. That is desirable because it is important to recruit nurses.

Nurses, in the old days, were paid largely by honour and they got very little money. It was possible, of course, to get many nurses who were prepared to make that sacrifice. That is not possible today. It has been possible in the last few years to raise the emoluments of nurses, and from the material point of view they are probably in a better position now than they ever were, but that is not enough without the desire for service, which is, perhaps, the mainspring of a girl's devotion to the nursing profession.

We are very fortunate in the nurses we have, and we can pay them honour for the splendid work they do, but many more nurses are required, especially for some troubles the recruiting for the nursing of which is not so easy. Therefore, it is desirable to encourage the spirit of faith in the nurses, and I think that the proposed awarding of these medals is a good thing.

There is no point, however, in confining that proposition to the Royal Infirmary of Edinburgh, and I think that this scheme should be extended far beyond the Royal Infirmary of Edinburgh. It may be possible to make a general acknowledgment of our appreciation of the nurses by providing an opportunity for sending the best nurses from, say, Glasgow and Edinburgh and Aberdeen once a year to a conference, or to a public exhibition illustrative of nursing work and acknowledging the services nurses render to the community.

We can never repay the nurses for all they do, but at least the public could acknowledge its gratitude to them, and I think some way should be sought of expressing that public acknowledgment. I remember that Tom Johnston brought schoolgirls to Edinburgh to engage in a baking competition and preparing a meal, and the Queen then, Queen Elizabeth the Queen Mother, presented the prizes. There is no question but that that kind of celebration provides an incentive to people, gives them encouragement to carry on with their work.

I think there could also be travelling scholarships for nurses, to take them to other parts of the country and even other parts of the world, so that they could see nursing and hospital work elsewhere.

Mr. Deputy-Speaker (Sir Charles MacAndrew)

I was very patient while the right hon. Gentleman developed his first proposition, but there is nothing in these Orders about this suggestion, and, as the right hon. Gentleman knows, we may discuss now only what is in the schemes.

Mr. Woodburn

These endowments are for a very wide set of purposes, and are handed to the hospitals to carry out all kinds of work. It is quite true that the ones I have mentioned are specific, but I respectfully submit to you, Mr. Deputy-Speaker, that, as I am advised, the width of the possibilities in the uses of these endowments is practically unlimited, and that, apart from the five or six specific items, the endowments are entirely at the discretion of the boards of management. Therefore, I would respectfully submit that it is possible for us to suggest some possible uses for the endowments.

The greatest possibility of improvement in hospitals lies, I should say, in the conditions of the out-patients' departments. Waiting at hospitals is still a great problem. I agree that there is a difficulty about time-tables.

In most waiting rooms which we have seen there is a Spartan severity which adds to the fearsomeness of the experience of patients who come to a hospital partly in apprehension and partly in hope. If they have to sit for a long time in waiting rooms, something might be done to brighten the rooms. The patients do not know whether they will have to wait minutes or hours before the arrival of the surgeon, and when they are counting the minutes in such an atmosphere it becomes distressing for them.

The best conditions which I have seen in my travels have been in the Crichton Royal Institution, Dumfries, and, curiously enough, in the Dumfries Infirmary, where there was a system of appointments, where the waiting room was laid out in an extremely attractive fashion and where little tables were provided so that people could sit around them awaiting their turn without having to sit on hard seats and stare at blank walls.

The Royal Infirmaries in Edinburgh and Glasgow recognise the problem, but have great difficulties through congestion and lack of buildings, with no room to expand. Now that money is available there must be some possibility of improvements, however. Reception nurses might be appointed with the duty of seeing that patients are given an idea as to when they will be called, so as to relieve their minds.

It might now be possible to make even the existing waiting rooms much brighter and more hospitable. The Westminster Hospital, for instance, gives a very different impression from that given by the rather Spartan accommodation in some places, which was provided largely because, when the hospitals were built, no money was available for luxurious accommodation.

It might be possible to provide a brighter tea-room so that if patients are to be kept for an hour or two they can be allowed to go to the tea-room. I do not see why there should not be a public address system by which they could be called to the ward, or wherever they are required, some time in advance of the physician or surgeon wanting to see them. I will not go into many details, but I throw these out as suggestions for consideration. There might be better suggestions.

These funds will make it possible for hospitals to consider these problems in quite a different way from that in which they were considered previously when no money was available. In those days the money had to be devoted to the hospital itself and to the purpose of healing. That is now the responsibility of the State. Even during my time in office it was clear to me that the State would not quickly be able to fulfil all its responsibilities-; in other words, with the hospital budgets then developing, the time when these amenities could be provided was getting further and further away and the State was in the same position as that of the hospitals in the past in that it could not afford to do these things. The hospitals now have this money through the boards of management to use at their discretion for the benefit of the hospital, the staff, outpatients and others.

It would be wrong to conclude without paying tribute to the work of these great hospitals. I have had personal experience of the Edinburgh Royal Infirmary and I have visited hospitals all over Scotland. Some of my colleagues have had more recent personal experience of Edinburgh Royal Infirmary and they have nothing but the highest praise for the treatment which they receive. I have had a letter today from a lady who has undergone an operation, and she says, I have had a marvellous rest and every one tells me that I look a picture of health. The kindness and attention which I have received here is wonderful and I cannot speak too highly of the Royal Infirmary. That could be repeated about almost every one of our Scottish hospitals, and we ought to pay tribute to the care which is shown there, sometimes in very difficult conditions. Those of us who have had personal experience of it can reinforce that tribute with great warmth. My hon. Friend the Member for Kirkcaldy Burghs (Mr. Hubbard) and my hon. Friend the Member for Edinburgh, Leith (Mr. Hoy) have spent a considerable time in the care of the surgeons. My hon. Friend the Member for Kirkcaldy has perhaps had more experience of these hospitals than any other of my hon. Friends, and I am quite sure that if he had been able to be here he would have spoken with deep appreciation of what has been done for him.

These funds should give us an opportunity of warming up the precincts of the hospital and providing a little necessary upholstery. It should provide the means of warming the dry bones of the Spartan system which we had to endure when every penny was devoted to buildings and nothing to amenities. Here we have an opportunity to develop, and I hope that as a result of this step forward in Scotland the distribution of this money to hospitals which, in the past, had no money for this purpose will make a complete difference to in-patients and out-patients, and that those who visit the patients will recognise the benefits which flow from this change which has now been made.

10.16 p.m.

Mrs. Jean Mann (Coatbridge and Airdrie)

I do not wish to detain the House very long on a subject on which, I think, we are more or less agreed. We are very glad to acknowledge that there are such things as endowments, and doubtless each of us would have a different way of disposing of endowments. On the whole, I think that we might agree with the provisions here, but there are three points which I should like to mention.

The first is, what sort of instruments are our surgeons using in Scottish hospitals? Are they thoroughly up-to-date? Are the surgeons criticised or frowned upon if they ask for instruments in keeping with those which they had used in, let us say, Westminster Hospital? If certain instruments are necessary for Westminster Hospital, then I think that it is wrong to expect some of our Glasgow surgeons to go on using outmoded instruments, simply because they were good enough for the surgeons of 20 or 30 years ago.

I know that it probably means capital outlay and not just ordinary revenue expenditure. It may mean capital expenditure for an instrument costing £500. If it is necessary, I think that the endowment fund might be expended to modernise the instruments which are in the hands of our young surgeons in the hospitals in Scotland.

The second point is in regard to the expenditure on medical research. Paragraph 12 of the Order states: Before deciding to expend on any one research project any sum exceeding £1,000 the Board shall consult the Advisory Committee on Medical Research in Scotland. We are all very glad to know that attention is being directed more and more to the necessity of research, but should not the scope be narrowed and the amount increased? I think that we ought to explore new channels, because we have largely conquered many of the past terrors by means of the sulphanamide and antibiotic groups, and I think that research could be narrowed to coronary and other distressing ailments that are taking away, not only old lives but young ones. I hope that instead of there being a widespread expenditure on research, we might narrow it into channels that at the moment are proving distressing to the medical profession.

On the Order relating to the Glasgow South-Western Hospitals Endowments Scheme, there are awards to nurses which I find myself comparing with the awards for the nurses in connection with the Royal Infirmary of Edinburgh

Commander Galbraith

Surely the hon. Lady realises that these are the continuations of endowments given for that purpose to the hospital, and which are being continued for that purpose.

Mrs. Mann

I am glad of the right hon. and gallant Gentleman's help in pointing that out—it is just as I thought; but I must draw attention to the fact that there is a sum of £1 as a prize for a nurse in Shieldhall Hospital, to be known as the Sister Barrie prize whereas in the Edinburgh Order the first item is the sum of £100 on the provision of medals, prizes and scholarships … What have the Edinburgh girls got that the Glasgow girls have not got?

Mr. E. G. Willis (Edinburgh, East)

They have an endowment.

Mrs. Mann

Edinburgh has a certain superiority, apparently, over Glasgow, even down to the distribution of awards to nurses. To hand out £1 as a prize to a nurse is rather insulting. I can imagine her telling her friends that she has been awarded the Sister Barrie prize. Her friends would congratulate her and say. "Oh, congratulations! How much?" Then, the nurse might say, "A lousy £1, but if I were in Edinburgh, the award might rise to 100 guineas."

The second item in the Edinburgh Order is the sum of £10 per annum on the provision of a prize for a student nurse in the Royal Infirmary of Edinburgh to be awarded for proficiency in the theory and practice of dietetics … The study of dietetics is, of course, important, but not so very important in the profession of a nurse, because she should not be in the kitchen.

Mr. Willis

Surely it is the continuation of an endowment.

Mrs. Mann

I suggest that the continuation of the £10 might be reduced to £5 and that the girl in the Shieldhall Hospital, who at present gets £1, might get £5 also.

Commander Galbraith

The honour is not in the amount of money, but in getting the Sister Barrie prize.

Mrs. Mann

Now that the right hon. and gallant Gentleman has enlightened me so far, can he further enlighten me as to why the prizes are so mean in Glasgow but on a more appropriate scale in Edinburgh?

Mr. Thomas Steele (Dunbartonshire, West)

Glasgow is no mean city.

Mrs. Mann

It is, according to these awards.

Then, in the Glasgow Order there is The sum of three pounds for the provision of prizes for nurses in the Southern General Hospital … That hospital has been doing marvellous work. It caters for every class of the community and has a splendid staff of nurses. Such a sum for professional prizes is humiliating. I am merely asking the right hon. and gallant Gentleman if it is possible to bring these awards more into line with present-day practice.

The last item is another £2 10s. for the nurses in the Southern General Hospital to be known as the Catherine Marson prizes. These are totally different from the four items in the Edinburgh Royal Infirmary, the first of which is £100, the second £10, the third £10, and in the case of the fourth, the board is from time to time to decide the conditions governing the award of the Affleck medal.

I want to make an appeal to the right hon. and gallant Gentleman to tell us in his reply why it is not possible to raise the standard value of the prizes in Glasgow to that of the Edinburgh ones. I am fully convinced that the nurses in Glasgow are at least equal to the nurses in Edinburgh. I will not stimulate controversy by making a statement any stronger than that.

10.27 p.m.

Mr. George Lawson (Motherwell)

I should like to sound a note of apprehension about the point made by my hon. Friend the Member for Coatbridge and Airdrie (Mrs. Mann). The apprehension arises on her suggestion about the income derived from this fund and its possible uses. One of the first arguments she advanced was that it might be used to assist some young surgeon to obtain the instruments for his profession. As I understand it, that is very far from being the use to which it should be put, and I should be very much concerned if the money were used for any such purposes.

I hope the money will not be employed for the normal purpose of running a hospital. This money cannot be used at the discretion of the board of management, with certain limitations, and it is with those in the paragraphs defining the use to which the money can be put that I am concerned, and on which I wish to speak for a very short time this evening. I agree with the main limitation that has been imposed, for although it is in two parts it is really a single limitation. The first part lays down that a board of management shall not be permitted to spend a sum exceeding £1,000 on any one research project without consulting the Research Advisory Council for Scotland.

The second part of that limitation states that no board of management shall be permitted to spend a sum exceeding £1,000 on any one building project or on any other project that is not a simple replacement of some piece of equipment or plant. Those limitations are wise. I think, for example, it is wise to control the research work engaged in by one group of hospitals, more especially as in Scotland we shall be setting up an institute which will be concerned with this question of research. It seems wise that, before any group of hospitals engages in any research work of a character which is going to cost more than £1,000, there should be consultation. It does not mean that the hospitals would not be permitted to engage in that work. It is in order to avoid duplication of research work that this wise provision is introduced.

Similarly, with the single expenditure on any one item of a sum exceeding £1,000, it seems wise that the hospital, or group of hospitals, should be obliged to consult the regional hospital board. Again it does not follow that the board will disallow this expenditure, but it is wise to have that type of consultation, so I approve of this limitation.

On the other hand, I am delighted to read in the Orders that the boards of management are to be allowed to spend the funds or income obtained from the funds—not the capital, of course—more or less at their discretion. Until I was elected to this House, I was a member of a hospital management board covering the Royal Victoria and associated group of hospitals in Edinburgh. The members of that board showed a great concern for the well being of the group of hospitals under their charge, but there is no doubt that their scope of action was limited, in the sense that everything they spent, or proposed to spend, came under the close scrutiny of some higher authority.

The income from these funds will work out at about £2 per bed per annum, and will at least provide a measure of scope for initiative on the part of those boards. I have sufficient confidence in them to believe that they will spend the money on projects of a character designed to enhance the well being of the patients primarily under their charge. I can think of many things upon which they might spend money, items that would not normally be covered. For example, those hospitals which have inmates who stay for a long period might improve the library service at the disposal of those patients, especially hospitals concerned with infectious diseases which find that it is not easy to get a sufficiency of books.

It may be that on the basis of such money they can provide means for enabling patients to entertain themselves. It may be that they might help to provide occupational therapy, for which it is difficult to obtain the tools. It may be that they can help nurses. I should not like the money to be spent in, say, providing modern beds for nurses, although I am aware that it is sometimes difficult to persuade young nurses to sleep in old-fashioned ones, because I think it is the duty of the service to provide suitable beds for them. However there are no doubt many other small things which could be added to the amenities of a hospital to make it attractive both to nurse and patient.

May I stress the point of leaving to the discretion of the boards of management the spending of this income as they think fit? We hear a great deal in present-day society about bureaucracy. Those who talk of the despotism of bureaucracy in our society are doing an unwarranted injustice to our civil servants and, apart from that, I suggest that they fail to recognise the great extent to which our social services are dependent upon voluntary assistance.

They fail to recognise the extent to which our social insurance services are dependent upon those large numbers of appeal tribunals functioning day in and day out throughout the country on an unpaid basis, with the exception of the legal man who is there as chairman. They fail to recognise the very large number of people engaged in running this voluntary hospital service, the large number of members of the boards of management who are not paid at all, save for fares and similar expenses. That is voluntary service given in the running of our society.

I think that this provision will be good for democracy. I am pleased that it has taken this form, and I am happy to have this opportunity of commending, from my own personal knowledge, slight though that may be, the excellence of the service being rendered by the many voluntary workers in our hospital service.

10.36 p.m.

Mr. Thomas Oswald (Edinburgh, Central)

It is not my intention to burden the House for very long, having regard to the fact that this is a short Scottish debate and that many Scottish Members travelled all last night and are still here at this late hour. However, being privileged to represent the Edinburgh Royal Infirmary, which is in my constituency, I should like to pay tribute to the whole of the staff of that institution. I say that with every respect, because, both medically and surgically, the Edinburgh Royal Infirmary is known all over the world.

Like those of my colleagues who have already spoken, I have been looking very closely at the provision of prizes for nurses, and to the fact that the sums enumerated in the Order are a continuation of endowments for specific purposes. My only criticism is that those prizes, even in the Edinburgh Royal Infirmary, are, in my opinion, quite insufficient and offer no real incentive after the magnificent work performed by the nurses in that institution. These nurses cannot be classified as industrial workers; they can in no way qualify for piece work, bonuses or output or tonnage allowances, which might otherwise be at least some incentive, although they have a tremendous amount to do after the hard day's work is done.

Paragraph 10 (a) says that each year there shall be applied the sum of one hundred pounds on the provision of medals, prizes and scholarships in the plural, and yet only £100 is allowed, whereas elsewhere specific sums are given for individual prizes, in one instance for a student nurse, or for the benefit of nurses in the Royal Infirmary as the board sees fit.

My right hon. Friend the Member for East Stirlingshire (Mr. Woodburn) pointed out that something might be done to provide amenities during waiting periods for patients who might have to wait for attention when undergoing treatment. I am happy to say that two weeks ago I learned that a considerable amount of research on this subject has gone on in the Edinburgh Royal Infirmary, and it is hoped to have a full report ready in a very short time.

Perhaps there could also be a speedier turn-round—if I might use an expression used very largely in dockland—of patients awaiting attention in the dispensary after having been given medical or surgical treatment. Patients have to wait before being attended to by doctors or surgeons, and then after treatment they have to spend a considerable time waiting in the dispensary before being supplied with the appropriate medicines or instruments to assist them to recuperate.

I think we ought if we can, to persuade the Minister to see that a greater sum of money is spent on the maternity hospitals. A considerable sum might, for instance be spent on the great Simpson Memorial Pavilion, the annexe to the Edinburgh Infirmary to improve conditions for all, including nurses, patients and members of their families and friends who wait. In this respect, I am thinking of the young husbands who, waiting for the news to be broken that they have become fathers, are in many instances worse than the patients. I welcome the suggestions in these Orders, and hope that the Minister will examine the suggestions made from this side of the House with the intention of seeing that they are brought to fruition at an early date.

10.41 p.m.

Mr. E. G. Willis (Edinburgh, East)

I should like to make one or two points briefly about the Orders dealing with the Edinburgh Royal Infirmary and associated hospitals. I think that a good job of work has been done here by the Commission, but I cannot understand why the almoner's fund should disappear. It is a useful fund, which could have been continued. I support the suggestion from this side about the use of money to try to improve the status of nurses.

My third point relates to paragraph 13. I do not agree with my hon. Friend the Member for Motherwell (Mr. Lawson) that paragraphs 12 and 13 are necessarily good. Paragraph 12 deals with the amount to be spent on medical research, and in spending it the board consults the advisory committee on medical research. That is understandable, because it is only an advisory committee and has no power to stop the money being spent. But, in the case of any project or acquisition on which the board desires to proceed, or for the provision of any one piece of equipment which involves expenditure of more than £1,000, the board must obtain the consent of the South-Eastern Regional Hospital Board. I think that this power might have been left with the hospital management board.

In the case of the Edinburgh Infirmary and associated hospitals, the size of the endowments indicate the esteem in which the institution is held in the south-east of Scotland. The management board, I think, is well fitted to be trusted with the job of spending more than £1,000 without having to obtain the consent of the regional board, and it seems to me that for the infirmary not to be able to spend more than £1,000 for a piece of equipment without obtaining the consent of the regional board is unwarranted. If paragraph 13 had read, "The Board shall not, without consultation with the South-Eastern Regional Hospital Board" —that would have been sufficient. I can under- stand consultation to avoid duplication, but having had that consultation, it could be left to the good sense and discretion of the hospital board, which for many years has administered this institution in an admirable manner, to spend the money properly without the need to obtain consent being imposed.

10.45 p.m.

Mr. William Hannan (Glasgow, Maryhill)

We all try to be brief when it comes to this time of night, but remarks made earlier have provoked a thought or two which I should like to express. I should like to return to the point made by my hon. Friend the Member for Coatbridge and Airdrie (Mrs. Mann). She drew attention to the small sums which are mentioned in paragraph 8 of the Schedule to the National Health Service (Glasgow South-Western Hospitals Endowments Scheme) Approval Order.

There is a sum of £15 for the provision of prizes for nurses in the Southern General Hospital. It would be interesting to know how many nurses are involved, and also how many are involved in the further prize of £2 10s. for nurses. The House should note that the word is in the plural in each case. What sum is likely to accrue to any one of the nurses concerned?

There is a proviso in the Order that …nothing contained in this section shall preclude the Board from perpetuating the name of any endowment included in the Endowments Fund. That would mean that the board cannot alter the name of any fund; but there appears to be no power to prevent the board changing the purpose of a fund. Is it not possible to provide under the Order that one or two trusts could be combined to ensure bigger prizes for nurses? We should be interested to have some information along these lines from the Joint Under-Secretary.

10.48 p.m.

The Joint Under-Secretary of State for Scotland (Commander T. D. Galbraith)

I am sure that the House is very grateful to the right hon. Member for East Stirlingshire (Mr. Woodburn) and his hon. Friends for initiating a debate on these schemes with reference to endowments. Before I speak generally on the subject in reply to him, I should like to take up one or two points that have been made in the debate, particularly that made by the hon. Lady the Member for Coatbridge and Airdrie (Mrs. Mann) and those who followed her, with regard to those endowments which are mentioned as prizes for nurses.

The hon. Member for Maryhill (Mr. Hannan) clearly understood that these are endowments which are being continued. I would draw the attention of the House to Section 8 of the 1947 Act, which requires the Hospital Endowments Commission to have special regard to (a) the spirit of the intention of the founders or donors of the endowments to which the scheme relates and in particular to conditions intended to preserve the memory of any person or class of persons;… It was for that reason that I drew the attention of the hon. Lady the Member for Coatbridge and Airdrie to the prizes which she did not consider much of an honour. I pointed out that the honour was connected with the name of the endowment.

There is nothing to stop the board of management from giving other prizes with the endowments. It is left entirely to their discretion. Therefore, I do not think that there is need to beat that horse any more. The board are free to extend the prizes. The endowments specifically mentioned are in continuation of the wish of people who gave sums of money for that purpose, probably many years ago.

I should like to join with the right hon. Gentleman—and I am sure that my right hon. Friend the Secretary of State would also join with him—in paying a tribute to the work done by Sir Sydney Smith and his colleagues; and I gladly pay a further tribute to Sir Edward Appleton for the work which he has done, joining with all those, both inside this House and elsewhere, who have expressed their thanks to him.

I think the House will find that the Endowments Commission has done its work in a very fair-minded way. It has tackled that work with the utmost impartiality, and it has been greatly helped by the full measure of assistance afforded it by the hospital management boards, to whom the endowments were transferred under the 1947 Act. As hon. Members may know, the principle of allocation for the hospital endowments was settled by that Act—under which the Commission was constituted with power to transfer endowments from one board of management to another, or to a regional hospital board. Then we had the Hospital Endowments Act, 1953, which set up the Hospital Endowments Research Trust, and extended the powers of the Commission to enable them to transfer endowments to the Research Trust. The general principles governing this were mentioned by an hon. Member tonight and are contained in the memorandum which has been circulated and are, therefore, presumably known to hon. Members.

The Commission has established that every board shall have a reasonable Endowments Fund at its disposal, and the regional boards will have small sums in their possession to meet contingencies as they arise, and the Research Trust will get something in the region of £100.000 a year from the total of about £450,000 a year. I think the House will agree that, in handling this vast amount, the Commission must have consideration of various matters. It is not just a matter of simple arithmetic. No board of management will be left with less than £2 a bed, and many boards will have considerably more than that. The Commission is a responsible and impartial body, entrusted with this work by the 1947 Act, and I am glad that the feeling of the House is that it should have left the boards with full discretion and not tied them down, except in some respects concerning research and new buildings and equipment.

As the hon. Member for Motherwell (Mr. Lawson) indicated, we do not want to waste money on research work. We have a lot set aside for that purpose now, and the kind of work which we should like to see going on is that being done in different hospitals at present. If there is a desire to go beyond this £1,000 limit, it is only right that the advice of the advisory committee should be sought. If it is a question of a lot of money, then the regional board concerned should be consulted. If thousands of pounds are to be spent on, say, a new building, there might otherwise be interference with the work of the regional hospital board.

It is not the intention to divert endowment income to meet what is called ordinary hospital expenditure. The funds will undoubtedly provide a very useful source of expenditure on marginal items —things which, while perhaps not necessities, add to the comfort of patients and staff.

Mr. Willis

The point I made was that in order to spend more than £1,000 on new equipment, it was not simply a question of consulting the regional hospital board but of getting permission. The right hon. and gallant Gentleman's argument was that it was reasonable to expect consultation. I agree, but it seems to put the board of an institution, such as the Edinburgh Royal Infirmary, in a rather absurd, a rather derogatory, position to say that it must go to somebody else.

Commander Galbraith

I would not agree with the hon. Gentleman, but I do not want to argue the case with him now. The right hon. Gentleman the Member for East Stirlingshire mentioned many matters on which he thought endowments might be spent. I thought that they were all very excellent ideas, but it will be for the boards themselves to decide. No doubt the publicity given to his remarks will convey to the boards the kind of thing that he would like to see the money being spent on.

Tea rooms, public address systems, improved out-patient waiting rooms and all that sort of thing come under the heading to which I referred. No doubt they will be in the minds of the boards. The hon. Member for Edinburgh, East (Mr. Willis) spoke about the almoner's fund having been discontinued. The general powers under the scheme cover that already, and no doubt if the almoner wants money for a purpose which the board approve the money will be forthcoming.

I conclude by again expressing my thanks to the right hon. Gentleman and his hon. Friends for initiating the debate, which I think has served a very useful purpose.

Mr. Woodburn

I thank the right hon. and gallant Gentleman for his reply. I beg to ask leave to withdraw the Motion.

Motion, by leave, withdrawn.