§ [FOURTH DAY]
Order read for resuming adjourned debate on Question—[9th June]:
That an humble Address be presented to Her Majesty, as followeth:
Most Gracious Sovereign,
We, Your Majesty's most dutiful and loyal subjects, the Commons of the United Kingdom of Great Britain and Northern Ireland, in Parliament assembled, beg leave to offer our humble thanks to Your Majesty for the Gracious Speech which Your Majesty has addressed to both Houses of Parliament —[Mr. Simon.]
§ Question again proposed.
§ 3.38 p.m.
§ Dr. Edith Summerskill (Warrington)
It will be recalled that on 4th May we had a debate on the social services. That was only a few weeks ago and it was on the Consolidated Fund Bill. On that occasion the Minister of Health and the Minister of Pensions and National Insurance replied for the Government and at that time, of course, as will be remembered, an Election was imminent. The Minister of Health will recall, perhaps, that he made what was described by some people as a pre-Election speech. I am sure that his memory of it is quite fresh. May I say that I am pleased to see him in his place so early this afternoon?
Perhaps I may refresh his memory, if he does not recall the details. He asked me whether I would read the Conservative manifesto "United for Peace and Progress," because he was of opinion that it would be appropriate reading for me. I did indeed read it and now, as I say, I wish to refresh his memory, because this is an excellent illustration of Tory professions and their subsequent performance.
May I recall what the Minister of Health said on 4th May, a very few weeks ago:Perhaps I may repeat something which I said about the Labour Party's proposal for health in its new Election manifesto, I said that it seemed incredible that a party claiming to be interested in social services and to be a progressive party could seriously write paragraphs 429 about health and not include the words 'doctor, dentist, nurse, poliomyelitis, cancer, tuberculosis, infant mortality, hospital buildings.' I really cannot see, if those words are left out, what claim the party opposite can have to a progressive attitude towards the national health.I intervened then and said:This is a political manifesto and not a medical text book.Then the Minister of Health said:I recommend the right hon. Lady to read 'United for Peace and Progress,'"—
§ Dr. Summerskill
Wait a minute—which includes all the words which I have just mentioned."—[OFFICIAL REPORT, 4th May. 1955; Vol. 540, c. 1747.]The Election has come and gone, and no doubt the Minister of Health amplified sections of the Conservative manifesto and received warm support for his proposals. No doubt his proposals and promises helped his party to win the General Election. The manifesto, surely, should reflect the Queen's Speech. I have carefully examined the Speech and find that there is not one word in it relating to the Department of the right hon. Gentleman. While there are 12 paragraphs relating to foreign affairs, there is not one word about the poorest in the community, the aged, the widows, the disabled and the sick—not one word.
§ Dr. Summerskill
Of course, the excuse can be advanced that it is early yet and that there is plenty of time, but I would say that there are two categories in the community who cannot afford to wait for help—the sick and the aged. They have no time. After his boastful references to the Tory manifesto and his invitation to me to read it so that, perhaps, I might improve the Labour Party manifesto, the Minister might tell us today why there is no mention in the Queen's Speech of the aspects of the work of his Department which he emphasised in this House a few weeks ago and in the country.
In turn, may I draw the right hon. Gentleman's attention to the Tory manifesto? The Tories said that they would:seek to open new beds where they are most needed, to recruit extra staff and to provide better facilities.430 There is no indication of that in the Queen's Speech; therefore, they are committed to nothing. I should like the Minister to answer this point. I should like to hear particularly how many new beds will be provided this year for our overcrowded mental hospitals. I want to know what methods he proposes to recruit extra staff for the mental hospitals and tuberculosis sanitoria, which are desperately in need of increased staff.
The Election manifesto also said:We shall encourage local health authorities to build up their home help services and to provide half-way houses for the old.I understand that the present plans for new hospital buildings do not include that type of accommodation. If I am wrong, perhaps, at the end of the debate, the Minister will quote from any documents relating to that kind of building and show me that I am wrong. I take it that he is responsible for this part of the manifesto and that he says he is anxious to provide more home helps for the aged. Will he tell the House how he proposes to provide more domestic help through the local authorities?
I believe that the whole House realises that it is urgently necessary to make appropriate provision for the aged as soon as possible. I was astonished, when reading the Gracious Speech, to see that the problems of the aged population were entirely ignored. I would remind the right hon. Gentleman of the Phillips Committee's Report, which said:Perhaps the most striking change of all has been the increase in the number of old people living entirely on their own; and, it may be, in great loneliness … no fewer than 750,000 elderly women and 168,000 elderly men were living alone.When we have discussed this matter on former occasions, I have always been of the opinion that the right policy is to enable old people to live in their own homes as long as possible. To ensure that, there must be made available assistance of all forms, from monetary assistance to home helps. Some of us, when canvassing recently, again realised the tragedy, the poignancy of lonely old age and the utter dependency of old people on the community for a change in their conditions—which, in the last analysis, means on the Government.
I wish to raise a matter which is not one for the Departments of either the Minister of Pensions and National Insurance or the Minister of Health, but 431 which is for the Home Office. It concerns the Gowers Report. I raise it for this reason: in discussing the social services we are ranging rather wide and I regard the Gowers Report as one which concerns the prevention of disease. The modern treatment of disease by antibiotics and modern drugs is spectacular, but still the most rewarding approach to disease is the preventive approach. The Gowers Report was made by a committee of inquiry—a distinguished committee—into health, welfare and safety in non-industrial employment. It embodied recommendations which, if implemented, must reduce the incidence of accident and disease in this country.
The committee was set up by my right hon. Friend the Member for South Shields (Mr. Ede) and hon. Members on this side of the House have frequently pressed the Government to implement the committee's findings. I think it was in February last year, when the Government were urged to take action, that the Parliamentary Secretary to the Ministry of Labour and National Service hotly denied that the Government were dilatory. He said:we are considering very closely proposals for legislation to give effect to the Gowers Committee recommendations on safety, health and welfare, in such places as shops, offices, catering establishments, indoor entertainment, railways, agriculture and forestry."—[OFFICIAL REPORT. 26th February, 1954; Vol. 524, c. 759.]It was hoped, after that half-promise, that there would be something in the Gracious Speech of last year, but the matter was not mentioned.
Three years ago a former Home Secretary who now presides over another place said:The Government have considered the Report of the Gowers Committee … and are in sympathy with the general tenor of the Committee's recommendations on this subject." —[OFFICIAI, REPORT, 1st August, 1952 Vol. 504, c. 208.]Finding the Government completely unresponsive, my hon. Friend the Member for Leek (Mr. Harold Davies), who was fortunate enough to secure a place in the Ballot for Private Members' Bills, moved the Second Reading of the Non-Industrial Employment Bill on Friday, 1st April, the purpose of which was to implement the recommendations of the Gowers Committee. Before my hon. Friend did that, he had the full approval of the T.U.C. 432 I understand that the T.U.C. advised him and helped him to draft the Bill. Therefore, it could not be regarded simply as the effort of a private Member, whose views might be rejected by the House. but as a corporate effort by an organisation which is highly respected by both sides of the House. That was on 1st April. An Election was pending, and the Government's attitude to that debate had a special significance.
On Second Reading, my hon. Friend reminded the House of the very large numbers of workers toiling in dirty, ill-lit, badly-ventilated shops and offices who are afforded no protection whatsoever under the existing legislation. The medical officer of health in Glasgow had produced a report revealing the conditions under which many workers in shops and offices worked. I was very impressed with this, because one of the most serious aspects of that important medical officer's report was that he revealed that between one-third and one-half of these workers were under 18 years of age. Therefore, this House must have a special responsibility for these young workers. It means that at a most vulnerable age they are exposed to infection. Furthermore, their youth would make them reluctant to complain of bad working conditions, of dust, dirt, bad ventilation, and so on.
My hon. Friend the Member for Ogmore (Mr. Padley), who represents a large union catering for these workers, reminded the House of some of the conditions. I ask the House to forgive me for repeating what my hon. Friend said, but I consider this matter to be of such importance and urgency that I am anxious, if possible, to evoke the sympathy of hon. Members opposite in this matter.
In quoting cases which illustrated the bad conditions of some of the workers, my hon. Friend said:The first is in Frome, in the West Country, where there is a block of offices and shops employing staffs of both sexes. The shops include butchery, grocery, hardware, footwear, pharmacy, and confectionery businesses. No toilet facilities of any knd exist. When the staff need to use them they must leave the premises and go to the public conveniences in the town. That is not an isolated example. There are many thousands of such cases in all Darts of Britain.The second example is in Plymouth, in a retail tailoring shop where three males and 433 one female are employed. One toilet is provided. It is in the shop and is partitioned off by a curtain about three feet from the cash desk in which the female employee works. Again those sort of conditions can be paralleled in thousands of cases up and down Britain."—[OFFICIAL REPORT. 1st April, 1955; Vol. 539, c. 733–4.]Hon. Members may say that my hon. Friend is partisan. No doubt he was putting the case as strongly as he could for those whom he represents. But I do not think hon. Members opposite will say that the Chief Inspector of Factories is biased in this matter. Surely, he is not partisan. What did he say about this? The Chief inspector of Factories, who has an overall knowledge of conditions, uttered this warning in his Report:The supply of juvenile labour which will be available during the next decade can be forecast accurately; it is well known that it will be inadequate and that no wastage can be made good. Young persons, in fact, constitute industry's most precious raw material, and employers would do well to ask themselves if they are watching over it with all the care that it needs.A very strong case was put on that occasion, and that important debate was replied to by the Minister of Agriculture, Fisheries and Food, who, we would all agree, has an excellent bedside manner. We rather fancied that he was put up by the Government to defend an indefensible position. That Minister, speaking on behalf of the Government, said, only a few weeks ago after this House had debated that important Measure:I repeat the assurance that we mean to introduce legislation in this field as soon as Parliamentary time can be found for it. A great deal of the work of preparing that legislation has been done, and it is simply and solely the shortage of Parliamentary time which prevents it being introduced.That, of course, was immediately before the Election and nobody expected the Government to find Parliamentary time a very few weeks before the Election.
The Minister of Agriculture, Fisheries and Food went on to say:We intend to introduce legislation just as soon as we can, and I would advise hon. Members on this occasion to wait for that Government legislation which will do much better justice to the object which we all have in mind than would a Private Member's Bill, however Well devised."—[OFFICIAL REPORT, 1st April, 1955; Vol. 539, c. 756–7.]The House accepted that assurance of the Minister. My hon. Friend accepted it. The House had complete faith that when 434 time was available, legislation would be introduced.
The Bill was agreed to and was read a Second time, and now, in the Queen's Speech, we find that, while legislation is to be introduced in respect of those employed in agriculture and forestry, nothing is to be done for the shop and office workers, the railway workers—whose case was put in the debate—or for any other workers whose conditions were described in this House. Here, again, is an illustration of Tory professions before the Election and the failure of the Tories to fulfil their promises afterwards.
I should like to say a few words about housing, because I consider that housing is a most important social service, and some of my hon. Friends no doubt would wish to speak on it. If the Minister of Housing is not able to speak in the debate, perhaps he will put his reply in writing so that his right hon. Friend can give it. The Queen's Speech promises the continuance ofa high rate of house buildingand encouragement ofaction to secure the more rapid clearance of slums. …In the Tory Election manifesto we are told:Now that the construction of new homes is going ahead so well. we shall be able to devote a larger part of our resources to the elimination of slums and the modernisation of the older houses.Why does the Queen's Speech make no mention of the modernisation proposals? There are about 14½ million households in the country. In the Housing Act, 1949, the Labour Government made provision for the older properties with a 50 per cent. grant from public money. The restrictions governing this grant were relaxed by the Housing Repairs and Rent Act, 1954, and I believe that up to date only about 16,000 houses have been improved with the aid of grants under the provisions of the 1949 Act.
I understand that there is only a trickle of applications for repairs under the 1949 Act, and I remind the Government that if prompt action is not taken now to deal with the problem of improving older homes, those homes will become a charge on the public funds and will become slum property in the next twenty or twenty-five years. This, surely, is a very urgent matter.
435 I turn now to the services for which the Minister of Pensions and National Insurance is responsible. Here, again, there is no mention of these services in the Gracious Speech except in relation to a limited extension of the family allowances. Does the right hon. Gentleman recall the speech he made on 5th May, when he told us that he anticipated introducing more legislation? I read it last night. I do not want to weary the House by reading from it. He went into detail about the kind of legislation he was anxious to introduce. Will he tell us, therefore, why none of this legislation has been mentioned in the Queen's Speech?
I am astonished, also, to find no reference to the aged, having regard to what has been said about them in previous debates. I remind the right hon. Gentleman that before Christmas he promised us a day to debate the Phillips Report. At the beginning of May he said that we had not had time, but that he would try to find time for that debate. Why has he pigeon-holed a Report which he himself said was of the utmost importance? I think that that is not only discourteous to the distinguished Phillips Committee, but shows a callous disregard for the needs of the aged. He knows who were the distinguished people who served on that Committee for many months—indeed, I think it was for nearly two years—and whose Chairman was regarded as one of our most brilliant civil servants. I ask the right hon. Gentleman to arrange time for a debate on that Report.
In the Queen's Speech it is said that the Government promise to… extend the period during which family allowances are payable for children who remain at school.In their General Election manifesto the Conservatives promised to increase maintenance allowances for senior pupils who might otherwise leave school before finishing an advanced course. Does this mean that the family allowance is a substitute for the maintenance allowance? How would the right hon. Gentleman define "school" in this context? Does this extension of family allowances include children at all colleges, technical and otherwise?
§ Dr. Summerskill
My right hon. Friend mentions apprentices. We need more skilled technicians, and family allowances would be a great encouragement to apprentices, and would encourage young people to become skilled technicians rather than to undertake unskilled labour.
There is another anomaly about which the right hon. Gentleman could do something. He knows that there is such an individual as one who remains mentally retarded, is uneducable, quite unemployable, has a childish mind, and who, except that he has an adult body, remains dependent upon his parents. When the right hon. Gentleman is thinking of extending family allowances would he extend them to include people of that category? Those people are not, of course, insane; they are mentally defective; they are children, for the most part harmless. They could quite easily be included in the extension of family allowances.
§ Mr. Frederick Gough (Horsham)
Would the right hon. Lady elaborate that point a little? I am interested in it. How would she define that class of people?
§ Dr. Summerskill
Medical officers have registers of them, and they define them. I have said that that type of person is unable to benefit from any kind of education, and those people are unemployable, even in the simplest jobs. We see them, particularly in villages, standing in cottage doorways, perhaps helping mother in all kinds of little chores. I think that that category could be included in the extension of family allowances.
§ Mr. Cyril Osborne (Louth)
Why does the right hon. Lady say she sees them only in villages? There are more in towns. I represent a rural constituency, and I know that there are more in the towns. The right hon. Lady ought to withdraw that remark.
§ Dr. Summerskill
The hon. Gentleman must be longing to speak in this Parliament. When we drive through villages we see those people standing at cottage doorways, but it is not so easy to distinguish them in busy places like London.
437 I also ask the right hon. Gentleman what he intends to do for those who are known as the 10s. widows. All of us have letters from those women, despairing little notes describing their miserably inadequate resources.
§ Dr. Summerskill
This question was brought up last year and the year before, and the right hon. Gentleman came to that Box and said to the House that he had the matter under consideration. He is advised by an excellent committee, and I know that he had asked that committee to consider this subject. This group of people is a dwindling group. When new social legislation is introduced there are always groups who are in the unfortunate position of not benefiting by it. Here is a dwindling group. The right hon. Gentleman should ask the chairman of his advisory committee to expedite consideration of this matter and to report forthwith. The right hon. Gentleman was asked about this yesterday. He was also asked about it two months ago, and he still says it is being considered. Perhaps by the end of the debate we may have a report from him.
We have heard today about the increasing prosperity of the country. The Chancellor of the Exchequer has told us that the country is prosperous. It is difficult, in view of these pronouncements, to understand why the very poorest have not had any mention in the Queen's Speech. Those on National Assistance have not been mentioned in the Queen's Speech; nor were they mentioned in the Tory Election manifesto. Some hope, at least, should be given to the 1¾ million on National Assistance who have recently been so harshly dealt with.
The most striking feature of the Government's proposals for the ensuing Session is the complete omission of any reference, even by a word, to the most helpless in the community, the aged, the disabled, the sick, and the widows. There is no mention of food prices, the control of which would be of inestimable benefit to those in the lowest income groups. There is no mention of any matter of concern to the Ministry of Health, and only one in connection with the Ministry 438 of Pensions and National Insurance, although those great Ministries form the very foundation of the Welfare State.
§ 4.7 p.m.
§ The Minister of Pensions and National Insurance (Mr. Osbert Peake)
The subject chosen by the Opposition today, which they wish to debate on the Address, is that of the social services. It is, of course, a very wide subject. I notice that an hon. Member whose maiden speech I was unfortunate to miss yesterday complained that there was no reference at all in the Queen's Speech to the social services. However, "social services" is a very wide and embracing term, and many people—most people, indeed—would include such matters as education, rehousing and slum clearance as social services.
The debate on the Address is the grand inquest of the nation. Hon. Members can and do raise any subject which they please. In intervening in the debate I shall try not to take up an undue amount of the time of the House because I am sure we all look forward to interventions by back benchers who are new to the House—but the Front Benches cannot be altogether ignored, and I would say that word in defence of the Front Bench speeches.
The social services must rest and depend on the foundation of prosperity and productivity, and our productivity and our prosperity rest upon the skill and industry of our people working within a system of free enterprise. It is the enterprise, skill and industry of our people which provide the revenue without which we could not sustain the great social services which the country enjoys at present.
§ Mr. Peake
The right hon. Lady the Member for Warrington (Dr. Summerskill) ranged over a large number of subjects. I am sure that she knows already, for she has been in the House for quite a long time, that the Queen's Speech is not exclusive. It does not mean that because something is not mentioned in the Queen's Speech it will not be made the subject of legislation during the Session. Nor is it practicable 439 to put in the first Queen's Speech in the first Session of Parliament everything that a party has, in its election manifesto, promised to do.
Matters of health and the administration of the health services which the right hon. Lady has raised will be dealt with later in the debate by my right hon. Friend the Minister of Health. I will say a few words about the proposal regarding family allowances, which is mainly an educational proposal, but as to education generally and housing, I am quite sure that the right hon. Lady would not expect me to add anything to the considerable observations which were made on these two subjects by my right hon. Friend the Prime Minister in the first day's debate on the Address.
The right hon. Lady had a great deal to say about the delays in legislating on the Gowers Report. I think that the House is aware that the Gowers Report involves three separate Measures, one dealing with agriculture and forestry, one dealing with railways, and a third, and perhaps the biggest, dealing with conditions in shops and offices. Included in the Queen's Speech is a proposal for a Bill, founded on the Gowers Report, dealing with agriculture and forestry. I am sure that most people who have given close study to this matter and have followed the increasing accident rates in agriculture, as the industry has become ever more and more mechanised, would agree that it is right to give priority to agriculture in this respect.
The Prime Minister said, and I emphasise it again, that if there should be time in the first Session of Parliament a further Bill dealing with safety and health on the railways would be presented. The third Bill, dealing with shops and offices, is much the biggest. It is almost certain that it will be impossible to introduce it in the first Session.
I remind hon. Members of the magnitude of the subject with which we are dealing. I was in the Home Office in 1939 as Under-Secretary, in the early days of the administration of the new Factories Act, 1938. I remember what an immense amount of work had gone into the preparation of that Statute. I also remember our receiving the Report of the Royal Commission on Safety in Coal Mines, 440 1939. We did not get legislation on that until my right hon. Friend the present Minister of Fuel and Power took over the job in 1951.
The fact is that these Measures dealing with safety and health are immensely complicated. Their preparation demands an enormous amount of consultation with trade unionists and employers' organisations and so forth. Not only is there an enormous amount of consultation prior to the introduction of the Measure but, as all hon. Members who have been in this House for a number of years know, these Measures require very detailed scrutiny in Committee. Each of them takes many months in Committee upstairs.
§ Mr. Harold Davies (Leek)
The whole point of our arguments and discussions in the last Parliament was that these negotiations had been going on with the T.U.C. for years, and that there are more or less streamlined drafts of these Bills in the Home Office all ready to be placed before Ministers.
§ Mr. Nabarro
Will my right hon. Friend not be deflected from giving priority to dealing with agriculture and forestry, for it is there that the loss of life through accidents is occurring? There is no such loss of life in offices and shops.
§ Mr. Davies
The hon. Member is evidently not aware of the accidents. disease and ill-health in other types of industry, and that if we on this side of the House had not pressed the claims of agriculture they would not have been mentioned in the Queen's Speech, for the party opposite lost ground in the rural areas.
§ Mr. Peake
I assure the House that we are most anxious to get on with this legislation at the earliest possible moment. It is out of the question to have two of these enormous Bills proceeding through the House at the same time.
The right hon. Lady the Member for Warrington said a few words in her speech about National Insurance and National Assistance, for which I answer in the House. I should like to say something about the review of the main National Insurance Scheme. When the Scheme was framed, provision was made, by Sections 39 and 40 of the National Insurance Act, 1946, not only for annual 441 reports by the Government Actuary, but for a grand financial inquest at five yearly intervals and a report which the Chancellor of the Exchequer was to lay before Parliament. As soon as may be afterwards, the Minister is required by the Act to review the rates and amounts of benefit. The first of these statutory reviews fell to be made last year. It was completed when I made my report to Parliament last December.
I was able, at that time, to announce the Government's decision to give effect to my conclusion. In consequence, the National Insurance benefits and pension rates have been increased to figures which compare favourably in value with those originally proposed in 1946 and, of course, they are substantially higher than those which came into operation in 1948. There was, however, for a long time—under the previous Government, under the administration of the right hon. Lady—
§ Dr. Summerskill
The right hon. Gentleman represented the previous Government, the one before the present Government.
§ Mr. Peake
I was speaking of the Government previous to the one of which I was a member last December.
There was an understanding, both under the administration of the right hon. Lady and under the administration of the right hon. Member for Llanelly (Mr. J. Griffiths) that, whoever was Minister at the time of the first statutory review of benefit rates, there would also be an examination of the Scheme as a whole, especially those parts of it which were novelties in our social insurance system, to see whether improvements of a structural character could or should be made.
It is about this non-statutory part of the review that I want to make the position clear hut, of course, anybody holding my office is bound to have the benefit rates under constant review. He would be a very lucky man if he had to defend them to the House only once a year. Nor is there anything to prevent the Minister from proposing to the House at any time adjustments in benefit rates which seem necessary.
§ Mr. Peake
Legislation to alter benefit rates was passed three times before the 442 first statutory review was made. This non-statutory review is something, of course, which is continuous. Suggestions are made to us. Difficulties and apparent anomalies are brought to our notice, and I and my officials study them. We do not wait for five years or one year to do this, even though I may conclude that no immediate action is required. On the other hand, I may think the issue is sufficiently serious to justify fresh regulations being made or even coming to the House to ask for amending legislation, as the right hon. Member for Llanelly did in 1949 to correct an unintended difficulty in the death grant provisions.
That the Scheme would be under this continual scrutiny was indeed envisaged in the 1946 Act, which embodied unique provisions for the scrutiny and public examination of the Regulations which were to give detailed effect to such a very large part of the Scheme. Under the Act I have to appoint the National Insurance Advisory Committee. Proposals for new or amending regulations have to be sent to the Committee in draft. They are published by them with an invitation to any interested person or body to make representations, and thereafter are reported to me by the Committee. Under the Statute I have to lay the Committee's reports before Parliament along with the substantive regulations, and I have to justify in a covering statement any departure from the advice given to me by the Advisory Committee. In practice I find that I and my predecessors have laid before Parliament no fewer than 70 Reports by the Committee on draft Regulations.
§ Mr. Sydney Silverman (Nelson and Colne)
Can the right hon. Gentleman say whether it is within the competence or jurisdiction of the Advisory Committee to deal with a difficult administrative point, which arouses a good deal of feeling not limited to one side of the House. The point was dealt with a little at Question Time yesterday in relation to the increased statutory basic rates of pension, which were intended to do the job that was explained by the Minister in moving the Bill dealing with them. However, they have left the anomaly that the people who are the hardest hit by the rise in the cost of living, which this increase was intended to cover, get little or no benefit out of the compensating 443 increase. It is stated that that is the business of the National Assistance Board. What I am asking the Minister now is whether it would be competent for the Advisory Committee to make a report about a matter of that kind so as to bring back into the jurisdiction of the House matters which are at the moment excluded by the exclusive responsibility of the National Assistance Board.
§ Mr. Peake
I think the short answer is that the Committee considers matters which are remitted to it by the Minister, and that, broadly speaking, Ministers have not referred to the Committee questions of benefit rates because under the Act these have to be dealt with under the statutory provisions laid down in Sections 39 and 40 of the principal Act.
§ Mr. Silverman
I do not know whether I made myself quite clear, but my point concerns the extent to which people on National Assistance fail to benefit by the increase in benefit rates. What I am asking is whether the Minister could ask the Advisory Committee to make a report about that.
§ Mr. Peake
No, I do not think that would come within the purview of the Committee because the instruction to take into account the National Insurance benefit in computing the amount of Assistance is contained under Section 4 of the National Assistance Act, 1948.
§ Mr. Peake
What I am describing is the rather elaborate procedure under which matters are referred to this most useful body, the National Insurance Advisory Committee.
Section 41 of the Act envisages that the Committee will be asked to advise more generally on questions arising under the Scheme, including proposals for amendment of the Act. Ten Reports of the Committee on such general questions were made to the end of 1953, all of which were published as Command Papers and put into effect, usually in Regulations, but in one case, that of maternity proposals, by way of legislation.
When I considered the best way of carrying out what I have called the non-statutory review of the Scheme I clearly 444 could not have ignored the position of the Advisory Committee. But first I asked my officials to carry out a re-examination of all the provisions of the Scheme, taking account of criticisms and suggestions noted in the course of day-to-day administration. Particular note was taken—the right hon. Gentleman the Member for Llanelly has often asked me about this—of suggestions from local advisory committees. They totalled nearly 1,000 in number.
Having studied all this material I selected certain topics for formal review by the Committee. In making references to the Advisory Committee I excluded, as did predecessors of mine, all rates of benefit, since these are covered by the statutory review. Secondly, I excluded matters which were bound to be the subject of consideration by the Phillips Committee in its very much wider review of a very much wider question. When the right hon. Gentleman asks me about the provision of a day for a discussion of the Phillips Committee Report, I would reply that such a suggestion was thrown out by me in the House before Christmas. We are now in a new Parliament, and I am just as anxious as the right hon. Gentleman for the subject to be discussed. I think it might be taken up through the usual channels to see if time can be made available.
§ Mr. J. Griffiths
I propose to ask only one question. Can I take it from the remarks which the Minister has just addressed to us that he regards himself as having fulfilled the tasks laid upon him by Parliament, under Section 40, by the Report which he presented to us last December? Are we not to have a far more comprehensive report than the couple of sheets which he produced last December? Is that the effect of the Minister's reply?
§ Mr. Peake
I have fulfilled the duty laid upon me by the Statute under Section 40, but I am carrying out the obligations laid upon my predecessors and myself to review the structure of the scheme, and I want to go on and tell the House, because this is important, of the structural matters which are before the Advisory Committee, and what the prospects are of getting reports upon it with a view ultimately to some amending legislation.
445 I have to avoid overloading the Committee with work which it could not undertake. In the result the Committee has four groups of questions before it. The first is a re-examination of all the provisions governing the payment of sickness and unemployment benefit for short spells. This includes such matters as waiting days, the rules for linking separate short periods of sickness and unemployment, the holiday rules and the payment of benefit in relation to provision made by employers, for example, by guarantees of wages during underemployment. These are clearly difficult and technical matters as well as being important to many of the contributors to the Scheme.
The second question I have referred to the Committee, and upon which it has already reported, is the liability for contributions of persons with small incomes. That is a fundamental question in a universal insurance scheme. As the House knows, I have received the Committee's Report, and the recommendations have already been carried into law. The third question before the Committee is what are called contribution conditions. This Scheme is an insurance scheme. That means that the individual insured person's right to the various benefits is regulated by his own record as a contributor.
The fourth question which I have referred to the Committee is one in which the House is most interested, and that is the provisions governing widows' benefits and the increase of benefit for dependants of all kinds. This is a much wider question than that of the 10s. widow, as the hon. Member for Sowerby (Mr. Houghton), who has experience in these matters, will appreciate. It is clearly a most important part of the review, touching as it does so directly the welfare of those who are often least able to fend for themselves. Attention has seemed to be most concentrated on the widowhood provisions, and especially the position of the 10s. widows.
Vital points come up for consideration under the other part of the reference. To mention only a few, there are the circumstances in which a person can be reckoned as a dependent, there is the degree of relationship to the dependent, there is the question of the child at school and the position following separation or divorce.
446 Now a word about the position of widows. The scheme for widows embodied in the 1946 Act was entirely novel. Instead of a rather inadequate flat rate benefit, payable to all widows regardless of their circumstances, there was substituted a more discriminating scheme which sought to select for a more adequate provision those widows whose circumstances were such as to make it difficult or impossible for them to maintain themselves by their own efforts.
I am sure that the new principle is right, but it is clearly not possible to discriminate in this way without creating awkward borderlines which give rise to a sense of grievance. It is implicit in the new approach that the young, able-bodied, childless widow shall not get a life pension, but should he expected to maintain herself in work after a resettlement period, for which a special benefit is provided.
Taking the long view, it is these permanent provisions which are the most important part of the Advisory Committee's review, and I should like to say how much I appreciated the constructive speeches made in the debate last December by the hon. Members for Dunbartonshire, West (Mr. Steele) and Leeds. South-East (Miss Bacon), who spoke on this subject with a good deal of knowledge.
There is also the problem, of which we heard something during the General Election, of the 10s. widow, who does not qualify for a continuing pension under the new scheme, but who is either still getting the pension under the old scheme which she was awarded before 1948 or is one of the increasing proportion of these widows who have, by a special concession given by the right hon. Member for Llanelly when he was Minister, retained their rights from the old scheme despite their failure to qualify under the new provisions.
The problem of these widows is especially difficult, and that is a part of the remit of the Committee. The whole question is one of considerable difficulty, and, in fact, I have invited hon. Members to give me their views about this matter, because I think it is very important that, if we are to reframe widows' provisions of this scheme as we reframed the maternity provisions two or three years ago, we should get something which is 447 generally acceptable in all quarters of the House.
The right hon. Lady asked me to say a word about the proposal in the Queen's Speech in regard to the raising of the age for family allowances. Broadly speaking, what we have in mind is that the age should be 18. After all, a family allowance scheme is in respect of children, and to go on counting people as children for family allowance purposes after they are qualified for National Service under the National Service Scheme would seem to be going rather far. We shall prepare our proposals, and the House will see them just as soon as the Bill can be introduced. I cannot, however, hold out any hope of it being introduced before we adjourn for the summer Recess.
§ Sir Frederick Messer (Tottenham)
Can the right hon. Gentleman say if there will be provision in the Bill for the handicapped child, whose period at school is one year longer than that of the normal child, and in whose case, at the moment, no family allowance is paid?
§ Mr. Peake
I think I know the point which the hon. Member for Tottenham (Sir F. Messer) has in mind. Certainly, we are going to make some provision in the Bill for handicapped children, in respect of whom I have given undertakings previously in the House. One of the reasons why we cannot introduce the Bill forthwith is that there are these questions of what other alterations, if any, in the family allowances scheme should be included in the Bill.
§ Dr. Horace King (Southampton, Itchen)
Will the right hon. Gentleman also bear in mind the most difficult case, which is that of the child so handicapped that it cannot go to a special school at all and is even more dependent on its parents?
§ Mr. Peake
Yes, that is a particular case which I have most in my mind at the present time.
I do not know that I need say very much about the proposals, to which the right hon. Lady scarcely referred, in the Socialist election manifesto. [Interruption.] Does the right hon. Member for Llanelly wish me to address myself to that? As I understand their proposals, they were that we should do away with 448 the National Assistance Board and merge it in a Ministry to be called the Ministry of Social Welfare. I wonder if the right hon. Gentleman had considered, when he put forward that proposal, that the Ministry of National Insurance has already been merged in the Ministry of Pensions?
§ Mr. Peake
The new name of the Ministry is the Ministry of Pensions and National Insurance, and, in the eyes of the public, I am simply the Minister of Pensions, in the same way as the Minister of Labour is, it is always forgotten, the Minister of Labour and National Service. Therefore, it seems to me that there is not very much in the point about changing the name of the Ministry.
I should certainly be more concerned about a proposal to abolish the National Assistance Board. The Board was set up with that particular name as recently as 1948, when it was sponsored by hon. and right hon. Gentlemen opposite, and it has built up an immense fund of good will. It is immensely highly spoken of by ordinary men and women, and I myself have received deputations of old-age pensioners who have told me that the Assistance Board is the old-age pensioners' best friend.
§ Mr. Griffiths
I am very glad that the Minister will deal with that point, and I hope, if I am fortunate in catching the eye of Mr. Speaker, to say something about it myself. We quite agree about the good will which the Board has built up, and all we are suggesting is whether, in the light of experience, we might be justified in this change of name. I do not think anyone denies that the Assistance Board and its officers have done a very good job, and it is not on that account that we are proposing this change. We had better get it quite clear that we are not casting any reflections on the Assistance Board.
§ Mr. Peake
I am very grateful to the right hon. Gentleman for his intervention.
Personally, I have the greatest confidence in the National Assistance Board, and I believe that the arrangements devised, reinforced and built up over the years, starting in 1934, when it was called the Unemployment Assistance Board, and again in 1940, when the name 449 was changed to Assistance Board, and finally, in 1948, when it was rechristened the National Assistance Board, are excellent, and have worked extremely well. The Board's name stands high with the people of this country, and I personally think that it would be a great mistake to abolish the National Assistance Board at this stage.
§ Mr. Shurmer
The question is not one of abolishing the Assistance Board. Everyone, no matter in what district he lives, realises the helpful attitude of the Assistance Board officials, and there are no complaints. Certainly, I could not make any complaint so far as Birmingham is concerned, because they have been very good. The question is whether we should try again to remove that supposed stigma, because there are still thousands of people who will not go to the Assistance Board, but who might do so if the name were changed. There could be no harm in it, because we cannot yet remove that stigma, because of which some people are not prepared to go to the Assistance Board. I am not complaining about the Assistance Board; I have every faith in it.
§ Mr. Peake
One word about National Assistance scales. The right hon. Lady complained—I do not think she could have been serious about this—that there was nothing in the Gracious Speech about the National Assistance scales. Surely, with her knowledge of the Acts and her experience as an administrator, she would not expect to find those scales in the Speech from the Throne. She knows perfectly well that the initiative for the promotion of new scales rests with the National Assistance Board and is a purely administrative matter.
§ Dr. Summerskill
By admitting that, has not the right hon. Gentleman recognised the case for the merging of Insurance and Assistance? He always 450 comes here and says to hon. Members on this side of the House, "I have no power in these matters." He accepts the fact that there might be some hardship but he says that he has no power. Then, when we suggest merging Assistance and Insurance, he asks what is the reason for doing it. It is precisely to give him more power so that he need not make the kind of speech he is making now.
§ Mr. Peake
But when the right hon. Lady complained that there was no reference to National Assistance scales in the Gracious Speech I am sure she did not mean what she was saying. If it were her proposal, or the proposal of her party, that no change could be made in the Assistance scales until legislation had been passed by this House, that would be injurious to the interests of the people concerned.
Throughout the last Parliament, when I was Minister of National Insurance, my main concern was about the numbers having to seek National Assistance. These had been increasing year by year and month by month ever since 1946.
§ Mr. Peake
Well, I will give the hon. Gentleman a few figures.
I was concerned about this matter because if the numbers on Assistance were to continue to grow, there would come a time when our great system of National Insurance would be undermined and destroyed. What did I find? I found that in the 3¼ years between the establishment of the National Assistance Board in July, 1948, and the General Election of October, 1951, the number of allowances in payment had increased by no fewer than 580,000, and as one allowance often covers the needs of more than one person, that represents an increase of about 900,000.
§ Mr. Peake
As compared with about 1 million in 1948.
What has happened today? Today, and partly as a result of the recent changes, it will be found that as compared with that increase of 580,000 in the number of allowances in payment under the Socialist Government, the increase in a similar period under the Conservative 451 Government has been only 150,000 or about a quarter of the number under the Socialist Government during a similar period. Hon. Members may like to know that the numbers going to the Board today are lower than at any time since November, 1952, 2½ years ago.
§ Mr. J. Griffiths rose—
§ Mr. Griffiths
I should like one figure because it is relative to the major debate in which I hope to take part this evening. Can the Minister tell us how many fewer old-age pensioners are, as a result of the recent increase in the basic old-age pension, now asking for Assistance?
§ Mr. Peake
The direct result of the changes recently made in the pensions scales, the scales of benefit and so on, has been that about 111,000 persons fewer are drawing Assistance today. Quite apart from these changes, due directly to what we have done on the Insurance side. the fact that the numbers on Assistance are stabilised is a very hopeful sign for the future.
I believe that, with the growing number of pensioners now coming on to pensions with pensions increased by virtue of having deferred their retirement beyond the minimum age, with the increased number of persons coming on to pension today who have also an occupational or supplementary pension from their previous employment, and with the recovery in thrift and saving which is proceeding at the present tme, there is every sign that we can look forward to a steady reduction in the numbers drawing and having to draw National Assistance in the future. I believe also that we may make a considerable approach to the Beveridge idea of a society in which the means test is hardly ever exercised.
We can claim that much has already been done to rebuild our social services. The value of pensions and benefits, which had fallen steadily before we took over 3½ years ago, is now fully restored and provides better purchasing power than ever before. There is still much to do. In this first Session of the new Parliament the main emphasis will be on education and on housing, but we believe that, given 452 freedom from industrial disputes, given a reasonably steady cost of living and increased productivity, we can look forward to a better future for the beneficiaries of the social services.
§ Mr. S. Silverman
Would the Minister tell the House how he proposes to deal with the clear anomaly which emerges from his speech? The anomaly is that the National Assistance Board cannot deal with the poorer class of old-age pensioner because the Statute compels it to take the full pension into account. On the other hand, the Minister is unable to deal with the National Assistance scales because he is forbidden by Statute to interfere with the operations of the National Assistance Board in fixing those scales. In that situation, how does he propose to deal with the hundreds and thousands of old-age pensioners who, by hypothesis, most need the Assistance which they are now clearly not getting?
§ 4.49 p.m.
§ Mr. Simon Mahon (Bootle)
I ask for the indulgence of hon. Members, Mr. Deputy-Speaker, because I must ask the House to listen to another maiden speech. I come from Bootle and, as the hon. Member for Liverpool, Scotland (Mr. Logan) will tell you, Bootle is the best part of Liverpool. The largest and most important docks on Merseyside are in the borders of my town, which is in a great industrial part of Lancashire. I am not so much concerned about saying such things as about trying to be non-controversial when I come from a town like Bootle, where every foot of the road I have trodden has been contested at one time or another. However, I can promise the House that whatever I say will be said without bitterness or rancour.
In 1945 and 1946, when we came back from the war, we found a town which 453 had suffered greatly from bombing, dislocation of industry and all the other things which hon. Members know so well. Examining the social statistics of my town, I found that we had terrible figures for tuberculosis and infant and maternal mortality; we were the champions of the British Isles in these matters. More people were suffering from and dying from tuberculosis in Bootle than anywhere else. We attracted the attention of the national Press in a semi-castigation of our efforts because of our high infantile mortality.
We have made efforts to combat this, and I want to pay my respects to successive Governments in saying that we have received help of considerable dimensions—and we need it. The whole of our atmosphere is one of social and industrial unrest. I have some comments to make on the social aspect, but before I do that I want to say something about the industrial unrest existing on Merseyside. I shall not enter the field of controversy in this matter, as we have been requested not to do.
I have been a trade unionist for many years. My family must have 80 years' of public service and 100 years' of trade unionism to date. If I were asked what was wrong with industry today, I should say that in the depression years our people were dehumanised by poverty, and, also, there is a possibility that we shall become depersonalised in this day of full employment. We are entitled to full employment. It is neither the Conservative Party nor the Labour Party which has given us the right to full employment. I believe that I was made to the image and likeness of God, and that it was God who gave me the right to work. It did not come from Governments. The duty of government is to bring about a greater degree of social justice in industry and a greater human personalisation for everyone in industry. If this matter were examined by experts, there would be a greater possibility of bringing into industry in the very near future the peace that we all desire so very greatly. Men are "fed up" with being economic ciphers and units of production.
I come from a big family; there were ten of us. I object to anybody saying that I am a participant in class warfare. It was with great regret that I heard such 454 a remark as that on my first day in this House. I do not believe in class warfare at all, but I was born into class warfare. I think it is becoming a matter for the people who have more of this world's goods to stop the class warfare rather than to talk about it to those who have less of the world's goods. I am saying this so that hon. Members may understand the sort of people I represent. They are ordinary, poor working-class people, and I understand my own town and my own people fairly well.
I have a considerable knowledge of the housing situation. I appeal to whatever Government happen to be in power to build houses for families and to raise existing standards. Family life is the very essence and basis of our nation, and a better type of house should be built now that some of the tremendous difficulties of the post-war years have been overcome. I have brought the difficulties of my own people with me, and I want to say something about them. Sixty houses to an acre cannot be endured in this age. I hear people talking about atomic power, nuclear fission, and so on, but there are people in the town where I was born who have not yet had the pleasure of seeing hot water running out of a tap. It is just as well for some of us to remember that now and then. Therefore, in spite of the help that we have had—and we have had a considerable amount—I suggest that legislation to deal with slum clearance should be hastened, and that local authorities should be given power to ensure that people with a foreknowledge of what is likely to happen are not selling houses in clearance areas at great profit.
I want to make a special appeal. Recently, I had the difficult task of trying to retain possession of a house for a woman who had had a clear rent book for 47 years. Such things as this have been spoken about before. What immorality they represent! The woman had lived a decent family life in the house for 47 years. Her only boy was killed at Caen. Her husband died, and at the very time of her bereavement she was evicted from the house. Does that action mirror the sentiments of any decent person in this House or in the country? Indeed, it does not. Responsibility for these matters must be clarified; apart from the tremendous burden placed upon local authorities, the morality of these things must be examined.
455 People are becoming tired of other people talking about laws. Some of us are beginning to think that laws are just a recognition of the dominant force, and if the dominant force is not a moral force the law becomes immoral. I suggest that the law in this respect is completely immoral. Let us try to make housing the social service which it should be in this great country of social service which is the envy of the world. Let us give local authorities money at a more reasonable rate, for there is a tremendous burden upon them.
The waterfront of Bootle is occupied by docks, which are derated. I want, briefly, to give the House some figures to show the position of a town such as ours which is trying to face great educational, social and industrial problems when denuded of more than a quarter of its rateable value. Bootle's net annual value is £819,680, its rateable value is £590,163, and its loss on derating is £229,517, a figure which represents 28 per cent. of the net annual value. Fifty per cent. of this loss is due to the Mersey Docks and Harbour Board. In these days no one would say that this Board is not a very thriving and flourishing concern. Its net annual value is £167,404, but its rateable value is £48,562. The loss by derating is £118,842, or 71 per cent. of the net annual value of the dock estate.
Are we to have no help? We had none after the war, when our town was bombed and knocked about by the enemy. There are other towns like Bootle. The present Foreign Secretary, when he was Minister of Housing and Local Government, told me at Southport on one occasion that there were other towns like Bootle. We received a considerable amount of help from him. We have received help from other Governments. There are other towns like Bootle and my appeal is for consideration at all times for all the towns which are carrying so much of the country's burden.
§ 5.2 p.m.
§ Sir Thomas Moore (Ayr)
After listening to the speech of the hon. Member for Bootle (Mr. Mahon), my hon. Friends will envy me this opportunity of congratulating the hon. Member on what he has said. I am grateful for being able to do so, and I am only 456 sorry that the hon. Member should be sitting on the wrong side of the House. Perhaps he will see the light before very long. I must also offer him my respectful congratulations on so quickly and successfully taking the first fence in the House. Possibly the proximity of his constituency to Aintree has given him the necessary impetus.
I am constantly astonished, when I listen to maiden speeches, at the ease with which an hon. Member makes his points. That was evidenced again in the case today, when the hon. Member showed great fluency in putting his case for Bootle. He did it with an obvious sincerity which permeated all his remarks, as did the humanity he has shown for those for whom he speaks. I hope—and I am sure that my hope is shared by all hon. Members—that we shall have many opportunities of hearing him again, especially when he is not under the handicap of making a non-controversial speech.
I know that this debate is supposed to be largely devoted to the social services, but before dealing with that subject I want shortly to refer to the speech which the Prime Minister made last Thursday. Among other things, he analysed the reasons we had won the Election. In that analysis he was characteristically modest. In my judgment, the Election was won on three main issues. The first was the humanity, integrity and sincerity of the Prime Minister himself which, as every day passed, had an ever greater impact on the people. The second was the obvious existence of so many television aerials and, therefore, television sets, particularly in council houses, which effectively demolished the fallacious propaganda about the cost of living. Thirdly, there was the fact that at last the country had had an opportunity of comparing life under the Socialists and life under the Tories. The country preferred life under the Tories; the country preferred Conservative freedoms to Socialist controls.
I come now to the specific subjects which we are debating today, and I will limit my remarks to two of them with which the Minister did not deal. My experience during the Election taught me that they are vital to a great number of our people. One is education and the other is nursing. Both were incidentally 457 touched upon in a maiden speech yesterday. As we know, many improvements have undoubtedly been recorded for both education and the nursing service in the last few years, but I believe that the hopes of many of us, based upon those improvements, have not been fully fulfilled.
Of course, in both cases the main reasons are undoubtedly the conditions of service in each profession and their financial rewards. Indeed, I have never ceased to wonder at the amazing anomaly of treating these two great professions, one of which is charged with the physical well-being of our people and the other with the mental or moral development of our children and ourselves, with less concern than we do many unskilled and relatively unimportant labourers.
I have never been able to understand it. Time after time Government after Government passed on, and so far we have made only the most petty advances in the financial rewards which are offered to student nurses or trainee teachers. Having said that, I need hardly go on to make the point that teachers are grossly underpaid As a result, we are forced to utilise uncertificated teachers, many of whom should still be learning instead of teaching. We are compelled to call upon those in retirement to return to service. We refuse to pay them monthly—and that is another extraordinary anomaly.
I wonder what dockers, or railwaymen, or Members of Parliament would say if they could not get their pay monthly, but had to wait for it quarterly. I hope that we will get an explanation, because this topic has been raised on one or two occasions before and no satisfactory reason, except so-called technical difficulties, has been advanced. If there were a strike in the teaching profession, we would hear no more about those difficulties. Again, we base the retirement pension of the teachers not on modern costs of living or conditions of life, but on what were the conditions of life and the costs of living twenty or thirty years ago. That is obviously wrong.
We have never yet devised an adequate system for dealing with the widows and dependants of those who have given their lives to this great profession. I am not complaining of this or any other Government, but of the House as a whole. We have never really bent our minds to 458 dealing with this problem, simply because there was no strike; there is no industrial impetus behind it. Neither teachers nor nurses ever do strike. Thank goodness they do not. It would be a bad day for this country if they did.
Now for the nurses. During the Election I found time, happily, to read a daily journal which I do not normally patronise. During an Election one has to keep one's eye on many papers one would not normally read. I am particularly mindful of the last two Elections when this particular journal, the "Daily Mirror," was somewhat of a pest.
I found in this journal the report of an interview with the matron of the Christie Hospital, in Manchester. It worried me so much that I made some inquiries and found that the trouble to which it referred arose from a circular issued by the Ministry of Health—I hope my right hon. Friend will listen carefully to what I am saying—which created precisely the same situation as that about which I have just been complaining in respect of uncertificated teachers. It mentioned that unqualified nurses would be recognised as suitable to engage in nursing.
This position is almost exactly comparable to that of uncertificated teachers. They are to be recognised and there is to be practically no differential between them and the highly skilled and highly qualified teachers and nurses. They are being recognised as fitted to perform the same duties and to carry out the same heavy obligations. These unqualified persons are being given the same status and conditions of service, and this accentuates the lack of differential, which is the very point which has caused the railway strike.
§ Mr. R. Moss (Meriden)
Is it not true that uncertificated teachers are recognised only when their experience is equivalent to the necessary qualifications? I have known many excellent uncertificated teachers.
§ Sir T. Moore
I have no doubt that the hon. Member knows many uncertificated teachers who are admirable at their job, but if we lay down certain standards to which persons must aspire in order to reach a certain standard of pay and treatment we must observe them. Once we drift away we create a situation in which persons are paid to do jobs which they are not qualified to do.
459 I have before me a statement giving certain detailed information about pay, the system of service and conditions in the nursing service. It is too long to burden the House with it, but I propose to hand it to the Minister afterwards, because it makes very unhappy reading. I must, however, justify my statement about the lack of differential between unqualified nurses and staff nurses. An unqualified nurse of 21 years of age, working 48 hours a week, receives £315 a year. A fully qualified staff nurse, with three years' training and all the care of human lives in her charge, receives £385 a year, and she also has to pay more for living-in. The differential is obviously too small to compensate for the assiduous training that women must undergo to reach the required standard.
I want to read one paragraph from a letter which I have received from a matron of whom I made inquiries about this matter. I asked her, first, to give me the facts from her own personal experience, and then to lay down what she considered to be certain minimum standards of treatment for the profession. This is what she said:Good, comfortable living accommodation with one bedroom per nurse would make for contentment.She also said that nurses should be provided with up-to-date appliances for lifting heavy patients, and that the bathroom and ward kitchen accommodation is too small and inadequate. These are matters which experience has taught her to be necessary, and that should be of some value to the Minister. She further states that all nurses complain of the large amount of money deducted for board and lodging when they are resident nurses.
Finally, I asked her what incentive she thought should be offered to bring young women into the profession and make them proud and happy. She said, that they first had to be given an incentive to train and that they should have:… a living wage, pleasant accommodation, reasonable time to study, and facilities to help in the nursing of patients … with the incentive on qualifying, of a good status, salary and conditions in line with other professional and business women.I think that that is a very moderate and reasonable demand, and I am perfectly sure that the Minister will give the matter his full attention.
460 I believe that I have said enough to make this House realise that if we and our children are to get proper treatment for our physical well-being, and a proper development of our mental and moral faculties, we must do something to make these professions and the people who enter them worthy of each other.
§ 5.18 p.m.
§ Mr. Frank Allaun (Salford, East)
As a new Member of the House, I crave its indulgence for my lack of experience. There is a matter of growing seriousness which is, unfortunately, not mentioned in the Gracious Speech, and about which many hon. Members will have no knowledge at all. I have recently been making a number of night journeys by lorry between London and the North, to investigate what is happening to the vehicles which British Road Services have been forced to sell. Many of these vehicles have become killer lorries, as I intend to show.
The maximum number of hours permitted by law for driving a heavy lorry is 11 per day or night. In my view that is quite sufficient because of the great strain involved. Thousands of these sold lorries, however, are working for 12, 14, 16 or 18 hours out of the 24, with tragic results. Under British Road Services the system is for a driver to leave, say, Manchester at seven o'clock at night, take his loaded lorry to London, and arrive at the British Road Services depot in north London at seven o'clock in the morning. Thereafter, he goes to his "digs," gets some sleep, and has the opportunity for some leisure before restarting work at seven o'clock the same night.
In the meanwhile, another driver—a shunt driver with experience of the streets of London—will have picked up the loaded lorry from the depot and delivered the load—let us say to a factory on the south side of the Thames. He will have unloaded the lorry, travelled to another factory or warehouse or the docks, picked up a fresh load and will have taken it back to the depot in north London, whereupon at seven o'clock at night the night driver, the trunk driver, takes it back to Manchester.
Today, under private enterprise, all these processes are being done by one driver. As one can imagine, in view of the fantastic hours which are being 461 worked, it is impossible for the driver to maintain the necessary alertness at the wheel. I have seen men nodding in the cabs, I have seen lorries veering across the roads. In a recent journey I saw three serious crashes. One lorry had run right across the road and through the hedge on its offside. That indicates how far the driver was off his course.
A policeman encounters a lorry parked on the roadside with its headlights blazing. He goes to see what is the trouble and he finds nobody moving. He looks inside the cab and finds the driver slumped across the steering wheel flat out. The man had been too tired even to switch off the headlights. There is a shop some miles north of London which has been crashed into by vehicles 26 times. Admittedly at that point the road is extremely narrow and that might provide some excuse, but it is, in the main, tired drivers who are responsible for crashing into it.
I should like to give some information which requires serious attention. At a recent inquest on a driver killed in a lorry crash it was shown that of the last 110 hours of his life he had spent 92 in the cab of his lorry. I should like to invite the Minister of Transport to accompany me on a night trip of that kind. I may say that the night life on the roads and in the all-night cafés is very interesting, in more senses than one, but there are features which would shock the right hon. Gentleman. He would see parked along A.5, A.6, and the other main roads, hundreds of lorries, with their drivers in the cabs snatching a few hours sleep. If these men were working normal hours that would not be happening. These drivers are described as the "night-and-day wallahs."
The really guilty men are the owners of the private firms who encourage the men in these practices. Often the lorries are not properly maintained. Under British Road Services, which directly honoured the regulations governing hours of work, the lorries received regular maintenance and overhaul which are vital to safety. That work is not being continued.
Again, some lorries are being grossly overloaded. If there are many tons too much on the back of a lorry it is impossible for the driver to pull up in time 462 in an emergency. As a result, the accident rate is soaring. I repeat that I have no personal interest in the matter, but I would say that British Road Services did a magnificent job. In the first two years of its operations it reduced by 25 per cent. the number of accidents causing injury in which its lorries were involved. It reduced by 40 per cent. the number of accidents causing death in which its lorries were involved. Today, however, the accident rate is growing.
I want the House to know how bitterly my lorry driver friends feel about this as they see all the pre-war evils of the road returning. Their view, and it is one which I share, is that the only effective solution to this problem is that the Government should stop the sale of any further British Road Services' lorries, and that those already sold should be returned to public ownership.
I wish to refer to one other subject—the intolerable housing conditions in which millions of our people have to live. In the City of Manchester an average of two houses collapse every day because the walls are too old and too tired to bear the strain of supporting the roofs any longer. In the City of Salford, which adjoins Manchester, and the eastern part of which I have the honour to represent, the housing conditions are worse.
Recently a house collapsed on a 79year-old bedridden widow. Miraculously she was brought out unhurt. It so happens that a moment before the roof collapsed the rent collector was at the door, and he jumped clear in time. Incredible as it may seem, five minutes later, after the dust had settled, he nipped back and calmly collected the 10s. 1d. rent from a member of the family. I know that because I was there half an hour later, and I saw the 10s. I d. marked in the rent book.
Salford is a city largely inhabited by men who have dirty jobs—rubber workers, engineering workers, dockers and textile workers—yet in that city three out of every five houses have no baths, most of them have no hot water supply and the rooms are so damp, certainly in the southern wards, that the children are seldom free from sickness. I have seen water pouring through the roofs and oozing from the walls, which in many instances are studded with rat holes. One can see marks on the furniture where the rats have gnawed.
463 Is it right that mothers should have the job of trying to bring up children in conditions like that? In the old days we heard about tenants doing a "moonlight flit." In Salford today it is often the landlord who is doing a "moonlight flit." There are whole streets with no landlords. They have left the houses in a shocking condition. The only way to deal with the problem is to arrange that all the houses should be owned by the local authority.
My experience of life, which has been very varied, has taught me that those who do the hardest, dirtiest, most dangerous and most important jobs usually receive the worst pay, the worst treatment and the worst conditions. I plead that a greater share of the nation's wealth should be devoted to industrial cities, such as Salford, where these workers have to live.
§ 5.31 p.m.
§ Mr. John Eden (Bournemouth, West)
I find myself in a somewhat strange position, since it was not many months ago that I had the same experience as the hon. Member for Salford. East (Mr. Allaun) has just had. It is, therefore, with great pleasure, but at the same time a full realisation of my own limitations and lack of experience, that I offer to him sincere congratulations on behalf of this House on his remarkable knowledge and the sincerity with which he spoke in this House for the first time.
Particularly, I admire him for the way in which he was able to speak without any notes. That is something which I frequently try to do but it usually results in serious pitfalls. I also congratulate the hon. Member for Salford, East on the moderate manner in which he voiced his remarks. I cannot claim that they were absolutely non-controversial. In fact, that was the comment made by the hon. Member for Leek (Mr. Harold Davies) after I had made my own maiden speech, and I can therefore return the same compliment to the hon. Member for Salford, East.
During the recent Election campaign I heard one or two comments about the sale of British Road Service vehicles, the taking over of rent-controlled houses by local authorities, and so on, with which I did not find myself in absolute agreement, but which were the subject of fairly 464 lengthy discussions, not always entirely non-controversial. I congratulate the hon. Member on his moderation, because I have discovered, during the short time that I have been a Member of the House, that moderation is respected, though it is not always easy to remain completely apart from the enthusiasm which is natural to those who speak on subjects which cause them concern.
I wish to refer to something mentioned by the hon. Member in his concluding remarks, the slum conditions which he has found in his own constituency. I have not had the pleasure of visiting his constituency, but not so long ago I contested a London constituency, and I saw there some of the bad housing conditions. I was contesting a Parliamentary by-election when the Housing Repairs and Rents Act was first introduced as a Bill by the late Government. I remember that there was a cry from many people in the constituency—notably from my political opponents—that it would bring a great reward to the landlords in that area.
I saw the condition of the houses and met most of the landlords. I am certain that the hon. Member will agree that in many instances these landlords are people of small means and not wealthy men; people who perhaps own only one property, and in many cases live either in the basement flat or in some other part of it.
The hon. Member for Newcastle-upon-Tyne, East (Mr. Blenkinsop) said, in a speech which he made in this House the other day,The worker returns home to a house which he may have been forced to purchase as part of the Conservative policy of a property-owning democracy."—[OFFICIAL REPORT, 10th June, 1955; Vol. 542, c. 174.]However it may be that the person came into ownership of the property, in many instances such property is owned by people who have, in one way or another, come to invest their savings, or a small sum of capital which they have inherited, in a dwelling-house; and in many instances they live in part of it, and let the remainder.
I know that there is a great need for these people to be encouraged still more to carry out repairs to property which in many cases is almost beyond repair. I particularly welcome the reference in 465 the Gracious Speech to the steps to be taken to extend legal aid in county court proceedings. I should also like to see an early extension of free legal advice and assistance. I am not a lawyer, and I do not understand the actual proceedings in these matters. I speak entirely as a layman and as one who, if only for a short time, has represented a constituency in which there are many small land owners and property owners.
In Bournemouth one does not so much find large estates owned by one or two particularly lucky individuals or companies. It is much more the case that a house, or two or three houses, may be owned by people of small means; many being elderly people who have invested their savings in such property and who have come to spend their last years in that part of the country. Since I have been their representative, many cases have been brought to my notice of small landlords who do not fully understand the working of the Housing Repairs and Rents Act, the landlord and tenant Acts, and all the other complicated legislation with which they have to deal today.
They seek protection of some sort against the tenants, and that is an extraordinary situation. An enormous amount of legislation has been built up in order to protect the tenant. While I fully support that, my experience has been more of landlords seeking protection against their tenants, or of trying to secure sonic kind of control over their property. They have met with great difficulties, and I will give one or two brief examples of what I mean.
A case came to my notice of a gentleman who became the sub-tenant of a property. He then used what little capital he had to purchase the house of which he was the sub-tenant. I am told that, technically, he still remained the subtenant and so could not secure any sort of control over the tenant. The tenant, a single man, remained in possession of three rooms. The sub-tenant, who had a family, had two rooms. The sub-tenant tried to secure an exchange of accommodation, but could not do so. When his young family was increased by a third child he found he could no longer live in the two-room accommodation which he had in his own house. Yet he was not able to obtain any help from the local authority, because he was a 466 property owner. That is a case of considerable hardship which is not covered by the present legislation.
There was also the case of a landlord whose tenant kept the property in a very poor state of repair. In trying to secure an eviction order against the tenant, the landlord threatened to take the matter to court. The tenant, however, went to the rent tribunal to secure a reduction of his rent, and the landlord not only had a tenant who was not a good tenant, but also had the further imposition of having the rent reduced by order of the tribunal.
Then there was the case of a very small landlord, an old-age pensioner. This man and his wife together invested their entire capital of £3,050 in a small house. Three years after they had bought the house and a tenancy had been agreed, the tenant suddenly realised that he could live in that property at a much lower fixed rent. He took the matter to the rent tribunal and got the rent reduced with retrospective effect. This old couple then found themselves in the position of having to pay back two years' compensation to the tenant in respect of the excessive rent which had been paid over that period.
I am bringing forward these points to show that there are matters which are considerably complicated. I can assure the House that these particular landlords, whose cases I have mentioned, are in no way bloated capitalists or wicked Tories trying to make money out of the people. These are not cases concerning large landowners and estate owners or of any attempted victimisation whatsoever. They merely illustrate honest efforts on the part of fellow citizens who, having worked hard all their lives, saved a little money and invested that money in property, to make certain that their investment repays them in their old age.
§ Mr. Eden
The main point which I have to make is that in the matter of rent tribunals, which I am very glad to be able to discuss from the landlord's aspect as well as from the tenant's aspect, there should be some right of appeal against the decision of these tribunals. I do not understand the procedure of courts of law, but it does not seem to me right 467 that decisions should be taken by these tribunals against which no one has any right of appeal.
I am not saying that the hardship is all on one side; it applies to both sides—landlord and tenant. The tribunals apparently are completely immune from having to give any reason for the decisions reached, and I feel very strongly that they should not only be required to give reasons for their decisions, but that there should also be some right of appeal against them.
§ Mr. A. Blenkinsop (Newcastle-upon-Tyne, East)
Does the hon. Member not appreciate that in the setting up of these rent tribunals the main object was to avoid the whole legal procedure which otherwise would have made them an entirely different type of body, and one which in fact tenants would not have been able to use effectively? If we developed some form of appeal procedure it would inevitably bring up legal complications which we wanted to avoid.
§ Mr. Eden
As I have said, I do not know very much about legal procedure, but I feel that if any decision is to be made in any form by a tribunal which is binding on the parties concerned, they should have the right of reply and some right of appeal. It may not be necessary to enter into the whole technical legal aspect of a court of appeal. Perhaps some method might be evolved to achieve that end.
The whole of the law relating to rent restriction and rent control is extremely complicated. I hope that I have given examples which indicate that there are, in many instances, landlords who are in a very grievous and serious financial position, and they have every bit as much right to justice as the tenant. I should like to see some overall review of all the legislation which now exists on rent control. I think that that would go quite a long way to remove some of the difficulties and anomalies which still exist.
I have two other points which I wish to make briefly. One concerns housing. In my constituency there are a large number of elderly people. They have difficulties which are peculiar to them. One difficulty is that of suitable accommoda- 468 tion for elderly people—for those who cannot climb stairs easily, those who are single or who can cope with only a very small type of accommodation.
I am glad that a start has been made to try to persuade local authorities to make suitable provision for these people in their building programmes. I would appeal to the Minister of Health, whom I am glad to see here, to provide some system whereby elderly people who are not sick and ill can be given care and attention and not become a burden on the already very limited hospital accommodation. There might be, under the jurisdiction of the local authority, some kind of comprehensive roving nursing system made available to elderly couples or elderly single people in their homes.
A qualified nursing service could be used for regular visits, and to provide for the needs of these people. That would go a long way, not only towards helping the people themselves, but towards relieving the congestion and burden on nursing staff, and would give them a better opportunity of helping those who are really sick and ill. That is a scheme which I know would be well received in a constituency such as mine.
Finally, I want to make a short reference to education. I was glad to see in the Gracious Speech that we are to continue expansion in the building and improvement of schools and thatMy Government will give close attention to the number and needs of the teaching profession.I have never been a teacher, any more than I have been a lawyer, but I have spent a lot of my time in the teaching world. I know how exhausted teachers become at the end of a morning's teaching. Therefore, I would favour any project or scheme which could be put forward to relieve the teachers of the necessity of having to undergo what I would call kitchen fatigue immediately after a morning's teaching.
In other words, some kind of independent school catering service might be a useful addition to the facilities which are now offered to the schools. It is a very exhausting business to try to keep control of a large number of children when they are feeding, and particularly so when this comes at a time when the teachers themselves should be having a break after their morning's effort.
469 I hope that the points which I have raised are not violently controversial. They are not particularly novel. Nevertheless, the need for action on them is very great. I hope that consideration will be given to some of these matters in the light of the very comprehensive programme which the Gracious Speech offers to us.
§ 5.50 p.m.
§ Mrs. Joyce Butler (Wood Green)
I ask for the indulgence of hon. Members in my first speech in the House, although the subject on which I want to say a few words, housing, is usually very controversial.
I am deeply concerned, as I think most of us are, particularly if we have served on local authorities, about slum clearance. I noted the reference in the Gracious Speech to slum clearance and I urge the Government, when they introduce their legislation, to bear in mind the real problems of local authorities who are engaged in slum clearance work. The Prime Minister said last Thursday that local authorities are preparing slum clearance programmes to be submitted to the Ministry, but unless something is done by the Ministry to ease the problems of local authorities, particularly financial, such plans will remain but a dream.
The subsidy arrangements under the 1954 Act dealing with deferred demolition are the worst that have ever been made by a Ministry with a local authority. Since 1919, the theoretical basis of subsidy between Government and local authority has been a relationship of three to one. Before the war it was never lower than two to one. Under the 1954 Act, the basis is that the Government are prepared to pay only 50 per cent. of the interest on the loans on the purchase price of houses under deferred demolition, and the local authority has to meet the other 50 per cent. While it is true that the Exchequer is prepared to pay £3 per house per annum, it will do so for only 15 years, whereas the loan period is 60 years. During this time the local authority have to continue to make payments. If we are serious in tackling slum clearance there must be more generous provision to local authority finance.
It follows logically that the local authorities who have the biggest slum clearance problem are those who have the biggest housing responsibilities and the 470 biggest financial commitments on housing. Where there is a need for slum clearance there is invariably a surplus of population to be housed. Again, the authorities concerned with slum clearance are those who have little or no vacant land on which to house the surplus population cleared by slum clearance.
There is a reference in the Gracious Speech to an inquiry into tribunals, including land, which could offer scope to local authorities. I am afraid that it will not offer much scope unless arrangements are made for some form of appeal by local authorities to an independent authority when the Minister has refused to sanction a compulsory purchase order. When a compulsory purchase order is made, and if the Ministry orders that it should not be proceeded with, there is no appeal by the local authority. There is no means of finding out why that C.P.O. has been turned down. It should be possible, as the result of the proposed inquiry, to cover both those points; it is necessary to give the local authority concerned with housing an opportunity of acquiring land, either compulsorily or otherwise. The land problem is the very root of housing and slum clearance.
One other point I wish to raise is of very great importance to my constituency, Wood Green. We have a large shopping area. We had recently an application made to us by the owner of one of these large shops to extend the premises at the rear. This extension would involve the demolition of five houses. The local authority considered the matter, and, remembering the Minister's circular dealing with housing accommodation, it decided that it could not allow that application because of the acute housing need in the borough.
Although Wood Green is only a small borough it has a waiting list of 1,545, 60 per cent. of which are urgent cases. In addition, we have to release 210 requisitioned units, we have 166 prefabricated houses which are on public open space and which have to be removed, and alternative accommodation found for the families in them. When the present building programme is finished there will be only 100 dwellings still to be erected in the borough of Wood Green, which means that, apart from redevelopment, there is no possibility of any further accommodation being available.
471 In these circumstances, the local authority decided that it could not grant this application for the demolition of the five houses. The case went before the local planning committee of the county council, and it granted planning permission. Subsequently, the local authority appealed to the Minister. The Minister's decision has now been received. The Minister has ruled—and here I quote—thatDemolition does not constitute development.…Where no dwelling exists the question of a change of its use cannot arise.Therefore, there is no need for the shop concerned to make application to demolish these five houses. These five houses are vacant today. Families have been moved out. There is nothing whatever, on the Minister's ruling, to stop five perfectly sound houses being demolished, yet we are spending public money on "Operation Rescue" to bolster up semi-derelict property.
That is not the end of the story. We have already heard of another shop the owners of which are proposing to do the same thing. Word of the Minister's ruling has evidently got round to them because they have not applied for planning permission. We heard of their intention only because one of the houses which they proposed to demolish is requisitioned property and they have applied for it to be released. We also heard about it from the tenants of one of the other houses who told us, in great distress, that they had been told to find alternative accommodation as it was proposed to demolish their house to make way for shop extension.
In this small area there are 50 houses that could be demolished in this way without reference to the local authority or to anyone else at all. What is true of my constituency must be true of others elsewhere, and once this ruling becomes known it will be quite simple for anyone wanting to change the use of premises merely to demolish them, instead of applying for planning permission, which may be refused. They can then do anything they like subject, of course, to whatever local and other provisions there may be.
I appeal most earnestly to the Minister to reconsider this decision before it comes to the point where we have the wholesale demolition of sound houses at a time when the country's housing need is so acute that we are bending every effort to 472 try to preserve every possible house. I appeal particularly on behalf of my own constituency, while bearing in mind that this is a problem which affects the whole country.
§ 6.0 p.m.
§ Miss Edith Pitt (Birmingham, Edgbaston)
I think myself very fortunate in having been able to catch your eye, Mr. Deputy-Speaker, immediately following the maiden speech of the hon. Lady the Member for Wood Green (Mrs. Butler) in that it gives me the opportunity, on behalf of all Members of the House, to offer her our warm congratulations. My own maiden speech is not very far behind me. I still vividly remember the agony I went through then, so I imagine that the hon. Lady now feels probably the most relieved Member on the benches opposite; and rightly so.
Her speech was a model of sincerity, of clarity and of knowledge. I cannot say to her, as has been the case with previous maiden speeches from the benches opposite, that she spoke without notes. I observed that she had some in her hand but probably, as with most of us, that was for moral support. But I did notice that she did not consult her notes. I hope the House will acquit me of any especial feminine interest when I say again to the hon. Lady how glad I am to have the privilege of congratulating another woman Member on her speech.
I wish now to refer to three or four points mentioned in the Gracious Speech. The right hon. Lady the Member for Warrington (Dr. Summerskill) said that in that Speech she found no reference to matters within the province of the Minister of Health. I find reference to at least four matters which, although they may not necessarily be the direct responsibility of my right hon. Friend, most certainly have a bearing on the job he does; and if the proposals in the Queen's Speech produce the effect we all wish they may even diminish his job and he will probably be very glad of that.
The proposals are those for health and safety in agriculture and forestry; the road programme which, amongst other things, aims at reducing danger on the roads; the proposal for the rapid clearance of slums; and the proposal for the reduction of air pollution by smoke and other causes. I single out these because they have a common factor. They are all 473 preventive. They are all aimed at preventing any reduction in health and at taking the fullest advantage of the progress we have already achieved in our health services.
They have the virtue of proposing something which will eventually save money, and though I do not put that as a first priority it is not without importance. They will add to our production, which is certainly vital to our prosperity, by keeping the people healthy. Most important of all, if these proposals are carried through, and succeed in preventing illness or accident and loss of work, they can add immeasurably to the total happiness of our people, and that certainly is a first priority.
With regard to this preventive work, I should like first to mention something to which the Minister of Health himself has referred in a statement over the weekend—preventive dental work, or conservative treatment as the experts call it, although that has no political flavour. This week-end my right hon. Friend launched a drive for better dental health, and I am sure that all hon. Members would wish to support him. Since the introduction of charges for dental service—and again, that is the responsibility of both sides of the House, because a Socialist Government introduced charges for dentures and the Conservative Government introduced the charges for dental treatment—we have seen a change in the pattern of dental work.
It has been a change for the better. We now have more dentists available to help in the work of the school dental clinics—a priority service and, essentially, preventive work. We also have more dentists available, some full-time, some giving sessional service, for the maternity and child welfare services. I do not say that that service is perfect now, but it is very much improved.
In the school dental service, the number of dentists dropped after the introduction of the National Health Service Act, 1946, to a total of only 800, but we have made such progress since that there are now more than 1,100. We also have more in the maternity and child welfare service, and the figures of treatments provided again emphasise the preventive aspect of the work being done.
§ Mrs. Harriet Slater (Stoke-on-Trent, North)
I wonder whether the hon. Lady 474 is aware that one reason the number of dentists in the school dental service fell was that the dentists preferred to go into private enterprise and get the rake-off as a result of the introduction of the National Health Service? Another reason was the lack of agreement on a scale of salaries for dentists in the school dental service. The rise in the figures is due to circumstances, and not to any action of the Tory Party.
§ Miss Pitt
I am certainly well aware that we failed to recruit for the school and maternity and child welfare services because a Socialist Minister of Health made it so attractive for them to earn their money in private practice. The salaries are not too attractive but they have been increased, and the imposition of dental charges, which has given the private dentist less work to do, and improved salary scales have brought about an improvement in the school dental service. I think we would all agree that is a very good thing.
I was about to say that the figures of work done also underline this preventive aspect. Whereas, in 1951 approximately 2½ million dentures were supplied, that figure had fallen in 1954 to 1½ million, but, while in 1951 the number of preservative work courses—preventive work again—was 4½ million, that figure had increased in 1954 to nearly 6 million. The emphasis, again, is right—saving teeth instead of having to supply dentures. I do not suggest that we have the whole answer, but I do think that that is a step in the right direction.
For the consideration of my right hon. Friend, I suggest that attempts should be made to encourage integration of the dentists in private practice with the local authority service, not for actual dental service but for dental education. If I might give an example of what I mean, in my own local authority, in Birmingham, we had some doubts whether, when the appointed day arrived, our maternity and child welfare services would suffer; whether the long years of educating mothers and expectant mothers to go for help to the city welfare clinics might not, to some extent, be negatived —that mothers might go to the general practitioner for their ante-natal care.
Experience confirmed some of our fears numbers tended to fall—but I am 475 happy to say that the reverse has now happened. The local authority maternity and child welfare services are now playing their full and proper part in the antenatal and post-natal care of women. But a large part of the credit for that result lies in the fact that the general practitioners and the local authority servants of their own free will got together and established a liaison. The general practitioners hold clinics in their own surgeries for expectant mothers, and the midwives and the health visitors assist at those clinics in the doctors' surgeries, so that we have the two aspects of the service integrating.
I should like the Minister to encourage something on the same lines in dentistry. Could not the dentists undertake a certain amount of health education, with the assistance of health visitors or other local authority servants who are able to help in practical work? I am sure that the dentists would be willing. I know that their numbers are limited, but I am sure that this emphasis on health education, and particularly on sound teeth, deserves consideration.
There is one other point I should like to mention on the question of teeth. I liked the Minister's comment in his latest leaflet:Sound teeth make good health.I hope that he will have that phrase displayed everywhere, making a real propaganda point of it, so that all families will remember the necessity for preserving good teeth.
The second type of preventive work to which I would like to refer is in tuberculosis. That is a matter in which I have a special interest. Tuberculosis notifications are still high in this country. In my own area it was slightly higher last year than the year before, and I think it was probably the same throughout the country, although the figures are not available. That does not mean that there is more tuberculosis throughout the country; it means that we are diagnosing the cases and treating them early. I am very happy to say that the death rate is still falling.
The main source of contracting tuberculosis is through contact with infection. Here, again, I wish to stress the preventive aspect of the matter, because if we have more treatment facilities, and 476 especially more surgical facilities, we shall clear up the existing burden of active tuberculosis and remove the risk of infection, thus getting nearer to the day, which we all believe is within sight, of eradicating tuberculosis entirely.
There are still too many patients on waiting lists who need treatment in sanatoria or tuberculosis hospitals. That is certainly so in my own area. Yet I hear of other parts of the country where, because of the reduction of cases, there are now beds available in tuberculosis hospitals. I suggest that this is a matter for integration between regions, in order that the beds available in one part of the country may be put at the service of another area thus enabling treatment to be given to anyone suffering from tuberculosis and preventing the disease from being passed on to others.
The B.C.G. vaccine which is being used in combating tuberculosis is purely preventive. It is my experience—and I imagine it is shared by other hon. Members—that parents are most co-operative in this preventive work and where facilities are made available they welcome the chance of having their children vaccinated. I think the housing progress that we are making plays a large part in the prevention of tuberculosis because good housing conditions are fundamental in this respect.
On the subject of propaganda, I feel that there is still need to impress upon members of the public the fact that we are making this great progress in the treatment and eradication of tuberculosis, and that they need not hesitate to come forward if there is any danger of tuberculosis in their families. There is still some of the old taboo. People will not speak of tuberculosis. They are afraid of it. If we could make it more widely known that the prospects of arresting tuberculosis, provided the treatment is given early, and enabling people to lead normal lives are so very much greater these days, we should be doing a real job of preventive work.
The other point that I wish to mention in connection with preventive work is diphtheria immunisation. Mention of this subject may seem a little strange, because we hear so little about diphtheria today. I notice from the figures that although the deaths last year from this former killing disease were only nine—a 477 tremendous improvement on recent years—the immunisation figures are falling, and I think that there is perhaps a danger of the public becoming complacent about the disease because we seem to have it under control. In 1954, of the children to whom this most important immunisation should be given—children up to the age of one—only 36 per cent. were immunised out of what everybody in the health world always hopes will be a 75 per cent. target. There is room for propaganda here to remind parents of the danger from diphtheria, not just of its killing potentialities but the dangers of the after effects even if a child survives. We must encourage parents to have their children immunised, particularly in the first year. It saves not only life, but hospital beds and the expenditure of public money.
I wish to refer to the use of factory first-aid centres, or medical centres as we sometimes call them because they are so well-equipped. I feel that they also have their part to play in preventive medicine. They should not exist merely for dressings of the casual injury or for giving the odd "cocktail," as the sister in the factory where I worked called them, to those who fear that they are developing a cold. Factory surgeries employ trained doctors and qualified nurses, and I should like the best use to be made of these highly trained people by encouraging them to play a more active part in health and safety education, and possibly research into the effects of repetitive work such as monotony and lack of interest.
We spend £463 million on the Health Service in this country. I believe we are getting good value from that expenditure, but we could obtain even better value if we concentrated more on preventive work. One of the lessons which the Election taught us was that people are looking forward; they are not concerned with the years gone by. They believe that the future can be better, and surely preventive work in the Health Service is a very important part of that future.
I should like to see much more emphasis on the use of the family doctor. The position has improved since the 1953 salary award, but doctors still have too little time to enable them to be real family doctors and pay full attention to every member of the family. And we still have not enough health visitors. The 478 health visitor today is the handmaiden to the doctor because she accepts responsibility for the whole of the family and not just for ante-natal or post-natal care as used to be the case. There should also be more home nurses.
I believe that there are working parties sitting at present to consider the question of health visitors and home nurses. I hope that we shall have their report soon, and that health visitors and home nurses will be used increasingly in the field of preventive medicine. Finally, I hope that all in the Health Service who are engaged in preventing ill-health and unhappiness will bring to their labours a spirit of good will in order that the public may benefit.
§ 6.20 p.m.
§ Sir Frederick Messer (Tottenham)
The debate has ranged over a very wide field. In a way, I rather regret that, because it is tempting. I had not proposed to say anything at all, or at least very little, about the Health Service, and, consequently, I must refrain from the temptation of following the speech of the hon. Lady the Member for Edgbaston (Miss Pitt). I could agree with much of what she said, as, I think, could most people.
What has been troubling me for a long time was mentioned in one sentence which she used—her reference to integration. We seem to have reached the stage where we separate health from welfare, and, in my view, that is a big mistake. Health is an aspect of welfare and it will be very difficult indeed for us to continue without making art attempt to integrate what is broadly described as welfare with the Health Service.
That lack of integration is particularly marked in the welfare of the aged. The aged come under the Ministry of Pensions and National Insurance for pensions. They are the responsibility of the local authority for welfare—that is, care and attention. They are the responsibility of the Health Service proper when they are ill. It would be as well if we examined how that works.
There has been a great deal of talk about the problem of the ageing population. We are told that the time will come when there will be so many old people that it will constitute a problem for those who are producing to keep those who are not producing, but what is 479 forgotten is that in the process of ageing the population are retaining a degree of activity beyond the years for which it has been customary to regard them as being active. That is one of the reasons for which I think it is perhaps so wrong to discourage aged people from working. [HON. MEMBERS: "Hear, hear."] Support for that statement comes from those who are potentially aged.
There are two aspects to this matter. First, there is the therapeutic value in activity. We are all geared up to a degree of activity, and if we suddenly cease we suffer the consequences, because it is difficult to restart the machine. I remember that some years ago I was broadcasting in Birmingham on the Midland Region with a team dealing with the welfare of the aged and I said that I thought there was great therapeutic value in activity. A doctor, who was a member of the team, said, "That is quite true. I have many patients who are professional people—bankers, solicitors and lawyers—and when they retire, and sit back, they wilt and die." I said, "That is not relief of activity. That is their consciences."
The question has two aspects. The first is the welfare of the individual and the second is the economic value of what he can produce. It must not be thought that, arbitrarily, at the age of 65, a man is no longer of any value. It is quite true that from 65 onwards he will show a degree of reduced capacity. [Laughter.] Hon. Members laugh too soon, for that reduced capacity is often compensated for by increased intellectual capacity. For us to lay down that a man shall be penalised by having to stop work at 65 is to do him a disservice as well as the community. He should be allowed to earn very much more than he is allowed to earn at the moment and to remain in industry. At present, it is not worth his while to do so.
Everybody who has had anything to do with the welfare of the aged knows quite well that occupational therapy is a very real thing indeed. By virtue of the continued exercise we give a person two things: we give him continued strength because of the exercise entailed in the occupation and, more than that, we give him an interest in life and the will to live.
I want to say a few words about some anomalies in our care of the aged. The separation of health from welfare came 480 as a result of the introduction of the National Health Service, because before that the local health authority—the county council or the county borough council—was responsible for both aspects. The result of the previous arrangements was that we did not have the difficulties which we have today in the case of an old person who is not suffering from a disease—a person who cannot be said to be a patient in the sense that he is suffering from a complaint which needs medical attention.
The local authority should be the authority which can see to such a person, but the local authority says, "We cannot do so. He is in such a condition that he ought to be dealt with by the hospital authority." The hospital board says, "No. He has not arrived at the stage when he needs a hospital bed." As a consequence, the old person falls between two stools.
Experiments have been conducted to deal with this problem. I can mention one where the Nuffield Trust offered its assistance. There is a hospital in the western part of London, at Isleworth, known as the West Middlesex Hospital. Some years ago the deputy medical superintendent, Dr. Marjory Warren, started one of the first geriatric units in this country, and a remarkable thing happened. As a result of mobilising the resources which were available, 40 of the patients in that unit who normally would have been bed-bound for the rest of their lives, chronic sick until they died, were able to be discharged.
The unit had used electrotherapy, hydrotherapy and physiotherapy. It had used everything possible to bring some measure of strength back into wasted limbs. The hospital could discharge the patients. But there was no home to which they could be discharged. The Nuffield Trust came to the assistance of the regional board and Middlesex County Council took part. The regional board, the county council and the Trust between them set up a home.
Here is the anomaly to which I want to draw attention. When fresh legislation is being introduced I hope that the Minister responsible will turn up this part of my speech and see whether something can be done to deal with the question. In that home there is the case of the old person who should be the responsibility 481 of the local health authority. In the next bed there is the patient who should be the responsibility of the regional hospital board. The patient from the regional hospital board pays nothing whatever, but the patient coming under National Assistance has to pay. That is an anomaly which made it very difficult to run the place, but at last that difficulty was overcome.
We do not deal with old people and get them out of their difficulties by putting them into an institution. When the patients are well enough they have to go somewhere, but, unfortunately, there are not enough of the right type of institution for them to go into. There are large institutions, which are unsuitable. Old people should have brought within their reach the maximum degree of normality of life within the limits of their capacity. That means that housing authorities should turn their attention to providing the right type of bungalow or flat for old people. Then we would be able to see how far a local authority home help service or a local authority district nursing service can meet the needs of those old people in circumstances which are not institutional for, with all the good will in the world, a patient in a hospital or an inmate of an institute may soon lose individuality if he is with a mass of people for a long time.
It is, therefore, desirable that old people should be allowed to enjoy what remains of their life living that life by the expression of their personality as individuals and not as one of a number. The time comes when no longer can they depend upon just what is provided in their own home. Then, if they have to go to a place where they require constant care and attention, it should be a small place where life can be intimate.
I realise, Mr. Speaker, that I am speaking against a very much bigger interest which is agitating the minds of hon. Members at present. I know that they are not waiting on my next word but on the word of one much greater than I, but there is one other aspect of the welfare service on which I want to say a few words. It concerns the welfare of the physically handicapped. I was very greatly disappointed when I learned that the idealistic scheme of the late George Tomlinson was not to receive the encouragement it deserves. I was very sorry indeed to learn that there are to 482 be discharges from Remploy factories. That seems to me to be going backwards, although—I want to be fair—I must confess that I find it difficult to understand why every man in a Remploy factory, producing something, costs £7 a week in subsidy. An investigation ought to be made into that scheme, for it is difficult to realise why a man doing something in a factory costs the country £7 a week instead of being of some economic advantage to the country.
I realise that Remploy is engaged in a difficult task, a task which starts rather late in life, and I want to make a plea here. Is the Minister of Education satisfied with the number of special schools for the physically handicapped? That is important. If, during those formative years when he is getting an ordinary education, we train a child for a job we prepare him for the greater training which is required later. Such a child is entitled to have a degree of independence. It is true that a large number of physically handicapped people, strange as it may seem, are cleverer workmen because of their handicap. They are cleverer because of their concentration and the necessity for them to keep their end up. I suggest that some attention should be given to this particular phase of the physically handicapped—the training of the child.
There is another important aspect. If a physically handicapped child gets that training and then there is no opportunity for him to find a place in industry the consequent disappointment is probably greater than if he had not received that training. That is where the sheltered workshops are needed. Take an illustration: years ago one class was singled out for attention. It was a pathetic class—a class which got the interest of everyone—the blind. Special Acts of Parliament were passed and the blind were taken out of the Poor Law. In 1938, the blind and their relatives were given old-age pensions at the age of 60. County councils could make domiciliary grants and allowances. The blind were given sheltered workshops.
What do we see today? We see that in the blind community there are people who are independent because of the attention which was focussed on them. I would not say that they deserve any less than they have got, but I say that blindness is one handicap out of many. All those who are handicapped, whether physically 483 or mentally, are the responsibility of the community. I hope that when this Parliament is ended all of us, on both sides, will be able to look back on joint efforts we have made—because this is a subject we can lift out of party politics, a subject which rises superior to our petty party beliefs, a subject which affects each of us who believes that we are our brothers' keepers.