NATIONAL HEALTH SERVICE (SUPERANNUATION)

HC Deb 19 July 1955 vol 544 cc331-45

10.9 p.m.

The Minister of Health (Mr. Iain Macleod)

I beg to move, That the Draft National Health Service (Superannuation) Regulations, 1955, a copy of which was laid before this House on 1st July, be approved. These Regulations, which consist of no fewer than 115 pages, provide for the superannuation of those engaged in the National Health Service in England and Wales, except for employees of the local health and education authorities. They are, in the main, consolidating, although there are some important amendments to which I should like briefly to draw the attention of the House. The principal Regulations that they consolidate are the 1950 Regulations, introduced shortly after the operation of the National Health Service Act.

In these very complicated Regulations, we have taken the opportunity of breaking up some of the longer provisions in the earlier Regulations. I am told, although it is difficult to believe, that the new Regulations will be easier to understand than the previous ones. It is said about the House of Commons that however complicated the subject there is always at least one person in the House who understands it. I put forward these Regulations with some confidence as proof to the contrary, for I find it difficult to believe that, however detailed may be the study that any hon. Member has given them, he has completely mastered this complicated subject.

The matters with which I ought to trouble the House for a moment can be divided into two parts: those dealing with concurrent employments, largely devoted to removing anomalies that have arisen since the Scheme began, and one or two Regulations which in themselves are completely new. I should like, first, to pay tribute to those who drafted the 1950 Regulations. It is remarkable that five years later we should have, on the whole, so few amendments to make in what must have been one of the most complicated sets of superannuation Regulations ever to be laid before the House.

The anomalies that have risen relate in particular to doctors, who seem, more than members in other professions, to be engaged in overlapping appointments. The major proposals that we are putting forward are that all superannuable service can reckon towards benefit unless there has been a disqualifying break of a year without any superannuable Health Service appointment.

The second of the three main points is that for benefit purposes either a medical or a dental practitioner who has contracts with more than one executive council can be treated, with advantage to himself, as though he were in a single appointment. Thirdly, a person who gives up part-time employment at or after the minimum retiring age, if he ceases to be superannuable in respect of a part-time employment which he still holds, can have his superannuation rights preserved in the continuing employment.

There has, of course, been the most detailed consultation before these Regulations were laid before the House. Apart from Government Departments, no fewer than 28 bodies were consulted, in particular the Staff Side of the General Whitley Council, the Trades Union Congress and the British Medical Association. I claim that there is general agreement with the Regulations, but I would not claim that I have been able to meet those associations in. in some cases, matters of importance, and, in other cases in matters of detail, which they have presented to me. In particular, on the question of appeal from the Minister's decision and the question of giving further rights of option, we have not been able to reach complete agreement with the bodies who were consulted.

The new provisions are explained fully in the Explanatory Note to the Regulations, and I pick out only four Regulations on which I should say a word or two to the House. First, by Regulation 10 I take powers to grant a gratuity or an annual allowance to either the widow or the dependants of a person who dies as a direct result of injury sustained, or disease contracted, in the actual performance of his duties. At present, that power is limited to a grant to widows only.

Secondly, in Regulation 19, there are new and most important provisions which extend the period normally constituting a disqualifying break in the case of a person who leaves employment which is superannuable under the scheme if he is taking up a course of study or training which fits him better for the new appointment that he is subsequently going to undertake.

Thirdly, in Regulation 58, I make provision for those employed in the old Ministry of Pensions hospitals. This is a point of particular interest to the hon. Member for Brierley Hill (Mr. Simmons). If it becomes necessary, as, for example, recently, with the Dunston Hill Hospital, at Gateshead, to transfer, because of the number of beds vacant, a hospital from the administration of the hospital department in my Ministry to the ordinary structure of hospital management committee and regional hospital board in the National Health Service, I must reserve the rights to pensions of all the people concerned.

The last point that I want to make refers to Regulation 65, which has special provision relating to the remuneration of general practitioners. The medical profession has asked for a special regulation, which is included in these Regulations, to enable medical practitioners who are in partnership to have their remuneration allocated between them in an agreed proportion which can take into account the amount of remuneration that comes from hospital employment. I am told that it is not necessary to extend that provision to the dental profession. The B.D.A. does not wish it, because the structure of dental partnership is apparently rather simpler and does not need the great, complicated reckoning which Regulation 65 enables us to make.

I believe that those are the only points to which I should draw the attention of the House. These Regulations are inevitably complicated. They deal with an infinite variety of grades and it is important that we should preserve their rights, as we have done. The Regulations are chiefly consolidating, but there are important new Regulations which are mainly designed to benefit those who serve in the National Health Service. I thought it right to give this information in asking the House to approve the Regulations.

10.19 p.m.

Mr. A. Blenkinsop (Newcastle-upon-Tyne, East)

We are grateful to the right hon. Gentleman for giving us an introduction to the Regulations. I have always a great deal of sympathy with anyone who takes on the task of explaining these Regulations to the House. I had a great deal of sympathy with myself when I did so some years ago. One has always a fear that in the House at the time there will be someone who will carry out a searching, detailed examination of some of the more abtruse provisions in the Regulations.

I agree with the right hon. Gentleman that there is probably no one in the House this evening who is fitted to carry out that task. Nevertheless, I think that it is worth saying something about the Regulations. I join with the right hon. Gentleman in his tribute to those who had the responsibility of drafting them originally, and, indeed, to the way in which, on the whole, they have been administered. It is rather surprising how little difficulty and complaint there has been because of the undoubted complexity of their provisions. I think it can be said that the staff have done what they can to explain what at first sight appears to be unexplainable in these Regulations to many concerned.

It would be interesting if, at some time, this House or a committee could examine where we are going in this matter and could look into the whole development of superannuation and its effect upon the economy. I sometimes begin to wonder what the development is to be and whether we are to pay, under the Regulations, more in superannuation than we are to have available for ordinary payment to those who are carrying out their regular duties. I sometimes wonder whether that is the position we shall reach.

On the broad question, there are one or two points I want to raise. I appreciate that this is largely, as the Minister said, a matter of consolidation, but there are some important changes carried out which, in fact, we welcome. In addition, there are one or two questions I want to ask. The right hon. Gentleman mentioned the question of the Minister's determination of claims for superannuation benefit under Regulation 85. I gather that if that were to be reviewed at all it would probably mean a change in the Act itself. I realise that it may very well be undesirable to widen that field very considerably, but there are classes of case which are different and which chiefly arise among mental officers. Many feel that they would wish to have some opportunity of appealing, and I know they are not happy about the position as it stands. I would be grateful if the right hon. Gentleman could say that their views are being taken into consideration in any review there may be carried out on this particular issue.

Then there is another point which also affects mental officers particularly, the question of Regulation 51 and the effect of war service or National Service upon the rights of these officers and the doubling of the years of service for superannuation claims after their first twenty years of mental nursing. The effect of National Service or war service generally, unless they are, in fact, carrying out mental nursing, is to delay the date at which they would be entitled to this doubling of their superannuation claims. It is, perhaps, natural that many of those placed in that position feel that they are being put at a disadvantage when compared with others who have not been in the Armed Forces for reasons quite outside their own control. I am not in any way blaming the Minister for this. This matter came up some years ago, but probably it is time to look at it again and see whether there is any way at all to meet the limited number of cases concerned.

There is also one other factor, the position of opticians. The general practitioners, specialists in hospital, all other medical staffs in hospitals, and dentists are covered under these Regulations, but it is natural that the opticians should feel that they have every right to some further consideration. After all, it is seven years since we talked about our supplementary ophthalmic service which was regarded, in the days when we introduced the National Health Service, as a temporary one. We were then thinking in terms of a hospital based service for optical work generally. But, of course, ideas may well have changed since then as to the practicability of anything of that kind.

Cannot the right hon. Gentleman now say what is the possibility of considering the inclusion of opticians in Regulations like these? It seems to me that the work they are doing is closely parallel in many ways with that of the dentists, and that it might be possible now to think in terms of something more than the temporary arrangements made up to the present.

We on this side of the House welcome these Regulations and feel sure that they will be administered as smoothly and as satisfactorily, broadly speaking, as we found the previous ones to be.

10.26 p.m.

Mr. Iain Macleod

Perhaps I may reply to the three points raised by the hon. Gentleman the Member for Newcastle upon Tyne, East (Mr. Blenkinsop) on these complicated Regulations. I agree with the general remarks at the beginning of his speech that it would be a good thing if, at some time, we could discuss, and be clear about, where we are going with all the different superannuation schemes Government, public and private enterprise, that are being spun like a web around the existing national schemes. Perhaps I may take his points in reverse order, because the most important one he made—that about the appeal—is the one to which I would like to devote a minute or two.

On the question of opticians, all we can do in Regulations is to carry out what the Act says. The Regulations cannot create new law. They merely come within the limits of the parent Act which, in this case, is the National Health Service Act, 1946. Section 67 laid down that provision should be made for medical practitioners and for dental practitioners, but there was no provision for opticians. Equally, there was no provision for chemists who, in some ways, it could be argued are in a comparable situation.

The hon. Gentleman asked me for my proposals. All I can do is as I have done in these Regulations, but the question of opticians might appropriately be considered when legislation comes before the House, as it will in due course, based on the Crook Report. We shall then have a full opportunity to discuss the position of opticians in relation to the larger scheme of the National Health Service.

Mr. Blenkinsop

Could not the Minister say when we can expect that Report?

Mr. Macleod

Not on these Regulations or in any other capacity tonight.

The second point made by the hon. Gentleman was one which has not very much substance if one looks more closely at it, namely, the rights of the mental health officer. Rights are given to these officers to compensate for the difficulty and stress imposed upon them in dealing with mental patients. The mental health officer is defined—and this to some extent links with my next point about the appeal—as someone who "devotes the whole, or substantially the whole of his time to the treatment or the care …" of mental patients or defectives. As compensation for that stress these officers may have certain rights which enable them to retire earlier and to count certain years as more valuable to them in the calculation of pensions.

The suggestion was that if they were away on National Service, they should carry such rights with them. But, of course, if they were on National Service, even if they were engaged on nursing, as they might well be in one of the Armed Services, they would still not be dealing with mental patients. Consequently, the stress for which added value is given to their superannuation would not be present at that time. I do not think there is a very strong case for considering that they should have these extra rights while they are doing their share in National Service.

Mr. Blenkinsop

Will the Minister agree that it causes a little difficulty to have mental officers who have done, broadly, the same period of work in mental nursing, short of their period in the Armed Forces, working next to others who because their work has not been interrupted by a period in the Armed Forces are able to claim the extra rights? There are such difficulties as between one man and another.

Mr. Macleod

The mental health officer counts his period of National Service for superannuation purposes in the ordinary way; he merely cannot count it extra. I should have thought that as what we call the "additional stress" was removed from him during his period of National Service, that was, on the whole, fair. He may not continue to gain while he is doing National Service, but at least he does not lose in comparison with anyone else.

I now come to the most important point made by the hon. Gentleman, which relates to the question of the appeal. Again, all I can do in Regulations is to carry out the parent Act. Incidentally, Regulation 85, to which the hon. Gentleman referred, is an exact copy of the 1950 Regulation. The Act lays down, in Section 67, that determination of all questions arising under the Regulations shall be made by the Minister. Therefore, so far as the law is concerned, all I can do is to present to the House the Regulations in this form.

Whether it is wise to do that is, of course, another matter. It is probably worth detaining the House for a couple of minutes on this point. A very interesting case came before the High Court and the Court of Appeal a year ago in which someone sought a declaration that he was a mental health officer although I, as Minister, had decided that he was not.

When the issue came before the High Court it was pleaded on my behalf that the court had no jurisdiction to consider the question because I had already decided it under the Regulations and under the authority given to me by the Act. The High Court and, later, the Court of Appeal upheld that view, but I think it is worth quoting two rather differing views on the matter which were expressed.

In the High Court, Mr. Justice Cassels said: I cannot help feeling that it is a matter of some concern that the question … should not be decided by a court of law instead of, under the Act and Regulations, by a Minister acting, doubtless, through one of his departments. Nobody knows what submissions, if any, were made. Nobody knows how, if at all, the case for or against the plaintiff was put. Something was decided against the plaintiff behind closed doors. A rather differing view was put by Lord Justice Denning in the Court of Appeal, when he said: I would say that the questions arising under these Regulations are for the most part much more suited for determination by the Minister than by the court. The courts have ample powers to see that the Minister does his work properly but they should not seek to do it for him, or to do it all over again, possibly with a different result. One can, of course, add that Parliament, apart from the courts, has its checks in various ways upon whatever action the Minister may take.

I do not say, I do not attempt to say, which of those two views by learned judges is correct, but it is true, and I say this in answer to the hon. Member for Newcastle-upon-Tyne, East, that on this side of the House we are very much concerned with this whole problem of administrative tribunals. The House will be aware that in the Queen's Speech we undertook to have an inquiry into practice and procedure in these matters.

The terms of that inquiry have not been announced and I cannot prophesy what they will be. I do not know whether this subject will come within its purview. But it does at least seem likely that it will and the answer to the hon. Member is that I am very much concerned to see that these matters are both administered fairly and that people believe that justice is done. I am quite prepared to look at—I am looking at—some proposals for altering this situation and it seems at least likely that this matter will come within the purview of the committee of inquiry when it is set up.

However, so far as tonight's business is concerned, all I can do is to follow the intention of the parent Act and carry out that intention in Regulation 85. I hope that I have answered the three points raised by the hon. Member for Newcastle-upon-Tyne, East and I hope that the House will agree to the Regulations.

Resolved, That the Draft National Health Service (Superannuation) Regulations, 1955, a copy of which was laid before this House on 1st July, be approved.

10.37 p.m.

The Joint Under-Secretary of State for Scotland (Mr. J. Nixon Browne)

I beg to move, That the Draft National Health Service (Superannuation) (Scotland) Regulations, 1955, a copy of which was laid before this House on 30th June, be approved. I do not think that the House will wish me to say very much about these Regulations, because their purpose is to apply to the National Health Service Superannuation Scheme in Scotland the same superannuation arrangements as have just been approved by the House for the Health Service in England and Wales in the Regulations moved by my right hon. Friend the Minister of Health.

Like the English Regulations, these Regulations consolidate and reproduce, with some amendments, the provisions of the principal Regulations which were made in 1950 and amending Regulations made in 1951, 1952 and in 1953, when provisions were made for the ex-Ministry of Pensions staff who were transferred into the Health Service for Scotland at that time.

The Scottish and English Health Service Superannuation Schemes have always run on parallel lines and there is complete interchangeability between them. I will not explain them in detail, unless hon. Gentlemen ask me so to do, so with those brief remarks I confidently commend these Regulations to the House.

10.39 p.m.

Miss Margaret Herbison (Lanarkshire, North)

When one looks at the extent of the Regulations and the amount of paper they take, one realises how complicated they are. I have tried to study them, but tonight the Under-Secretary might have dealt with the changes that have been made in the original Regulations, which were produced in 1950.

I know that the Regulations which have come in years subsequent to 1950 have been mostly to deal with matters not covered by those of 1950. There were definite reasons for those Regulations and I realise, of course, that these Regulations are consolidating. But the Under-Secretary has himself said that there have been some amendments and we would like him to deal with any matters that have been amended by the Regulations which are now before us.

I take it that there was the same consultation with the interested bodies in Scotland as there was with interested bodies in England and Wales. Have all these Regulations been agreed with the interested bodies? Have there been points of difference between these bodies and the Government? I want the Joint Under-Secretary to tell us the major points of difference which the Government decided they could not cover.

I turn to Regulation 35. This applies to the return of contributions. In (1, a) we find that if an officer ceases to be employed by reason of resignation there shall be no right to a return of contributions, but that the Secretary of State, if he thinks fit, can return to him, to his spouse or to any dependant, a sum equal to the whole or part of his contribu- tions. I have had a number of cases brought to my notice of male mental hospital nurses who complained to me that if they wished to resign to go to other work their contributions were not returned. Men have wished to go abroad. They felt that they had unjust treatment by this Regulation, which is the same as the Regulation was for 1950.

Would a man going abroad find that the Secretary of State would exercise the discretion given to him in these Regulations, and return the contributions, or would the Minister firmly adhere to the letter of the Regulations and refuse to do so?

10.43 p.m.

Mr. J. C. Forman (Glasgow, Springburn)

I am surprised that the Joint Under-Secretary should try to dismiss these Regulations simply on the basis that we have just agreed to the English Regulations. He must know that we have a number of advisory commitees in Scotland dealing with the health services. I should like an assurance that these committees have been asked for their observations and have been fully consulted on the matters embodied in the Regulations.

Male nurses engaged in mental work only have the right to earlier retiral than ordinary nurses because of the nature of their work. I should like an assurance from the Minister that their superannuation rights are fully safeguarded in this Measure.

10.45 p.m.

Mr. J. N. Browne

Before explaining the differences in the new Scheme as compared with the old one, I shall deal with the points which have been raised. There has been the same consultation as there was in England. In fact, 28 different bodies have been consulted, and I am advised that there are no major points of difference. Consultations have been carried out over a very wide field indeed.

The next point related to the return of contributions to people wanting to go abroad. I understand that, since the Health Service began, all contributions have been repaid, so if the hon. Lady the Member for Lanarkshire, North (Miss Herbison) has any particular case in mind I should be very glad to have details.

As I did not quite catch the point raised by the hon. Member for Spring-burn (Mr. Forman), perhaps he would be kind enough to repeat it.

Mr. Forman

The male mental nurse has the right to an earlier retirement because of his onerous duties. Are his superannuation rights safeguarded?

Mr. Browne

Oh, yes. Because he is dealing with mental cases every year that he serves after twenty years counts as two. If he wishes to retire after twenty years he can do so, but if he does not retire every year served after that counts as two. His rights, therefore, are properly safeguarded.

Very briefly, these are the principal amendments to the Scheme. First to include new and to amend existing provisions related to "added years" of service granted for local government superannuation purposes to certain employees with special qualifications in local government. Secondly, to include new provisions relating to persons holding more than one appointment simultaneously in the hospital or general practitioner service. Thirdly, to amend the provisions relating to the method by which the remuneration of medical practitioners in partnership is taken into account for superannuation purposes. Fourthly, to make new provisions, and changes in existing provisions, the more important of which are as follows.

First, to extend to dependants of a deceased person who was subject to the Health Service Superannuation Scheme the provision which enables the Secretary of State, in prescribed circumstances, to grant a gratuity or annual allowance to the widow of a person who died as a direct result of an injury sustained, or a disease contracted, in the actual discharge of his duties and specifically attributable to the nature of his duty.

Mr. William Ross (Kilmarnock)

Perhaps the hon. Gentleman will allow me to intervene, as I had intended to raise a point under Regulation 11. It is not very clear how the Secretary of State is to make this payment. So far as I can see, it is entirely at his discretion. Though I have read most of the Regulations I cannot get enlightenment. I think it is a very wide discretion. The man is to receive …such gratuity or annual allowance as the Secretary of State may consider reasonable, having regard to all the circumstances of the case… That has not worked very well at all in other Schemes, and I wonder whether any representations were made on this point. As far as I can see, this must cover nurses who come into the nursing service—particularly on the T.B. side, who might well contract the disease, die and leave dependants. This type of case has already arisen, and I should like elucidation of what the Secretary of State has in mind for this kind of thing.

Mr. Browne

The hon. Member raises a very proper point. These provisions, I understand, fall into line with the Local Government Superannuation (Benefits) (Scotland) Regulations, 1954. We are bringing the present proposals into line—

Mr. Ross

The hon. Gentleman misses the point. This is the extension of a provision; it is something new. It is a gratuity payable at the discretion of the Secretary of State. In the case of permanent injury or the contraction of a disease resulting in loss of employment, there is already provision for payment of up to two-thirds of the remuneration; that is already payable. But in the case of a dependant, there is no existing Regulation and the provision is being made for the first time. Again, it is a gratuity, but no scale is laid down. It is to be entirely at the discretion of the Secretary of State. To my mind, that is not entirely satisfactory.

Mr. Browne

The hon. Member may not think that it is satisfactory, but it has been approved by all the bodies who are interested; and, as I say, it is in line with the practice in the Local Government Superannuation (Benefits) (Scotland) Regulations, 1954. At this time of night, I am afraid that I cannot give the hon. Member any further information than that.

Let me continue to record the new provisions and the changes that are being made. The Regulations extend to the period of the disqualifying break in service to a person who has taken a course of study or training which fits him better for his duties in his new employment. Next, they secure that a re-employed pensioner who is receiving a pension under the conditions of a scheme for which he opted on entering the National Health Service may be able to earn extra benefits under the main provisions of the Regulations. They also provide for the average remuneration of a dental practitioner to he taken over the whole period of his service instead of over the last three years, as at present, that is, for the purpose of calculating a short-service gratuity or a death gratuity, either on death or in prepaid form. This concession is made at the request of the British Dental Association.

Those are the main amendments, and I am grateful to the hon. Lady for giving me an opportunity of putting them on the record.

Resolved, That the Draft National Health Service (Superannuation) (Scotland) Regulations, 1955, a copy of which was laid before this House on 30th June, be approved.