§ 3.42 p.m.
§ Dr. Edith Summerskill (Fulham, West)
Since the Second Reading of the National Insurance Bill, last December, we have waited very patiently and hopefully for the Minister of Pensions and National Insurance to come to the House and tell us that he has had second thoughts about certain matters which were raised in that last debate. It is a fact, as has just been mentioned, that very recently he was forced to come to the House and amend a statement that he had originally made, but although that was a matter of importance it was a minor matter.
It will be recalled that the Minister was asked by many hon. Members at the end of last year to discuss the recommendations of the Phillips Committee on the Economic and Financial Problems of the Provision for Old Age. It was to be expected, particularly before this Parliament was dissolved, that the Minister would recognise the urgency of this problem, apart from its human aspects, and would compel the Government to take some action.
Certain organs of the Press have stated that the Opposition have raised this matter because an Election is about to take place. I think I can make quite clear to the House that that was not our intention, when I quote the Minister's own words. Perhaps he will recall that on 8th December he said, with reference to the Phillips Committee and the quinquennial review:Therefore, the House has been left to expect, and rightly so, that a much wider review of the Scheme would be undertaken than the narrow review laid down by Sections 39 and 40 of the Act. I do not think that there is any controversy about this matter, and, in point of fact, this wider non-statutory review is proceeding today. The Report of the Phillips Committee forms part of it, and we are to have a day after the Christmas Recess on which we can debate that Report.1696But there are some very important questions to which I have referred and which are still before the National Insurance Advisory Committee. For example, that Committee is considering the conditions for dependants' benefit, and that, of course, includes all the provisions for widowhood which were novel in 1948 when this Scheme first came into full operation.Later, he said:It is quite likely, I think, in view of the National Insurance Advisory Committee's investigation, that we may have to remodel at any rate the provisions for widowhood and other dependants. May I say, in passing, that that review includes the question of the 10s. widow about whom so many hon. Members have from time to time put questions to me.May I remind the Minister that we would like to hear what is to be the position of the 10s. widow, which subject has, quite rightly, been raised. The Minister has expressed sympathy on many occasions. He has given a half promise that this matter should be debated, and, therefore, we come to him at this time before Parliament dissolves to ask what his opinion is and what he proposes to do. Later in the debate on 8th December the right hon. Gentleman said:The Phillips Report clearly needs a full day's discussion."—[OFFICIAL REPORT, 8th December, 1954; Vol. 535, c. 960–962.]For all those reasons, we have decided that before the dissolution it is necessary to give the Minister an opportunity of telling us precisely what his policy is with regard to the Phillips Report, the widows' and the dependants' pensions, together with other matters that I am now going to raise.
Parliament is to dissolve in two days' time, and the Phillips Report is one of the most important Reports that have ever come before the House. It is quite clear that there will not be time to discuss it thoroughly. We are accustomed in this House to reports being pigeon-holed, but the callous disregard by the Conservative Government of the recommendations of this Report concerning the welfare of the poorest and the most helpless section of the community is unparalleled.
Perhaps I should have said "the cynical disregard," because the Minister of Pensions and National Insurance, when he was playing for time last year, emphasised again and again that he could not introduce legislation until this Report was in his hands. May I remind him that on three occasions in 1954—on 19th March, 21st July and 16th November—the 1697 Minister told us that he could not proceed until the Government Actuary's Report and the Phillips Committee's Report were in his office and he had had time to examine them?
Apart altogether from this disregard of the needs of the aged, and the discourteous treatment of hon. Members, I think that behaviour of this kind—and I speak very strongly—discredits the whole Parliamentary institution, for this reason. The Minister asked a Committee of distinguished people, some of them among the most brilliant scientists in this country, with full and busy lives, to give their time and energies to consider the problems of the aged, which is giving concern to every country where the expectation of life is now much longer than it was 20 years ago, and the right hon. Gentleman disregarded their Report.
Indeed, in the Report the Chairman of the Phillips Committee—who, it will be recalled, is one of our most distinguished civil servants—says that the Committee was asked to expedite the Report, and its members worked particularly hard. Yet this Report has been completely ignored by the Minister.
May I quote what the Chairman of the Committee says in the Report? In paragraph 293, in page 77, he says:The change in age-composition to be expected is, however, neither new, sudden, nor (taking young and old together) particularly large. Nevertheless, it does not follow that the economic and financial problems of making provision for the elderly are to be regarded without serious concern."Serious concern." Those are words used by a man who is accustomed to understatement. What "serious concern" have the Government shown for the aged?
§ Viscount Hinchingbrookeer (Dorset, South) rose—;
§ Dr. Summerskill
If the noble Lord will allow me to develop my argument, perhaps he will agree with me. Perhaps he has never read the Report. I would ask him to get a copy from the Vote Office and read it, when he will realise that the Government have not discussed one aspect of the Report, although Parliament is about to be dissolved.
This indifference is illustrated by the treatment of those on National Assistance. We have heard what has just been said 1698 by my hon. Friend the Member for Oldham, West (Mr. Hale) and by my hon. Friend the Member for Cardiff, South East (Mr. Callaghan) recently. But this is not new. In the debate at the end of last year my hon. Friend the Member for Ince (Mr. T. Brown) pleaded with the Minister—the Minister knows how my hon. Friend has devoted his life to the lot of the aged—to consider increasing National Assistance.
We anticipated what would happen. It will not be news to the Minister that hon. Members on both sides of the House are receiving letters from their constituents asking why they are getting such a small increase. I told the Minister what would happen, and I asked him whether, in view of what would happen in April, he would increase the National Assistance rate and reconsider the whole question of disregards; but the Minister absolutely refused.
I recall being a little protective towards the Minister. I said that I knew precisely what the procedure was. The Minister had to go to the Chancellor. The Minister might have had a soft heart and said, "I know what will happen in April; there will be trouble because these people will get very little," but I said that I knew that he had to go to the Chancellor and that it was a question not of his having a soft heart but of his capacity to soften the heart of the Chancellor.
In view of that background, we were absolutely astonished, when the Chancellor presented his Budget, to learn that he had £140 million to distribute. A few months earlier we had sat here and gathered from the Minister that the Government could not afford any increase in National Assistance to the poorest in the country. I presume that he must have misunderstood the Chancellor on the subject. The Chancellor now has £140 million to distribute, and yet in the Budget—this is not an exaggeration—not a penny was given to the poorest in the country.
Why, for instance, did not the Minister remind the Chancellor of the 1s. increase in National Insurance contributions which the workers will have to pay in June? What has the T.U.C. General Council to say about this? The Minister will agree with me that the T.U.C. General Council is a highly responsible body, for his Ministry is often guided by 1699 its representatives. The Council examined the Budget and in its report, which appeared about 10 days ago, it said that the tax reduction for workers will be less than 2s. a week and that it will be largely offset by the 1s. increase in National Insurance contributions in June. That is the total amount that the Chancellor has done for the poorest in the country, not only the old-age pensioners but also the lowest income groups.
I told the Minister that his new National Assistance scales, combined with the new National Insurance contributions, would not help the old-age pensioners on National Assistance, and letters are now reaching hon. Members to prove that we were absolutely right in our contention. There are 1 million pensioners drawing National Assistance, 95,000 widows, and 141,000 recipients of sickness benefit who draw supplementary allowances from the Board. I gave the Minister full details of how his niggardly treatment in respect of National Assistance would affect old-age pensioners.
I have three more figures to give him to show what has happened. Of the 1 million pensioners forced to supplement their incomes from the National Assistance Board, about 800,000 will be only 2s. 6d. better off. Of the widows, 81,000 will get only an extra 2s. 6d. Of those on sickness benefit, 123,000 will also get only 2s. 6d. extra. The Minister knows as well as I do that most of the people receiving sickness benefit are the chronic sick.
Hon. Members opposite may be inclined to dismiss this as an attempt to focus attention on a grievance for political purposes. However, I read the debate at the Conservative Party Conference last autumn, which was broadcast, and I would remind hon. Members opposite that the delegate who evoked the greatest ovation at the conference was the grocer who asked the Conservative Government to deal more kindly with those receiving National Assistance and National Insurance benefits. The demand has come not only from Labour; even at the Conservative Party Conference there are those who are near the people. The unfortunate thing about the Government is that so few of those serving in it are near the people. The grocer was near the people, but apparently he was ignored. That is all 1700 that I have to say on this subject, but hon. Friends of mine will supplement what I have said.
I now turn to health. I understood that there would be someone from the Ministry of Health on the Government Front Bench to represent the Minister. I made it clear that I should refer to health. In fact, when the Parliamentary Secretary telephoned me the other day I said that I should raise the matter. I find it difficult to understand why the Government have not seen fit to ensure that a representative of the Ministry of Health should be present. Many of my hon. Friends will raise health questions. Indeed, I feel that we should adjourn the House until a representative arrives. I consider that I ought to wait until the Government are represented by someone from the Ministry of Health. Surely we cannot have both the aged and the sick ignored by the Government.
§ Mr. James Griffiths (Llanelly)
As we did the Government the usual courtesy of notifying them through the usual channels that a wide range of subjects would be raised, including health problems, surely it is very discourteous of the Government not to arrange for a representative of the Ministry of Health to be present to listen to what is said.
§ The Minister of Pensions and National Insurance (Mr. Osbert Peake)
I can assure the right hon. Gentleman that there will be a Minister representing the Health Department on the Government Front Bench as soon as possible. "Social services" is a very wide and inclusive term and it has been a little difficult for us to ascertain precisely what points would be raised by the Opposition. However, I have understood always that health services would be among the subjects, and I have asked the usual channels to ensure that a representative of the Ministry of Health comes here as soon as possible.
§ Mr. Tom Brown (Ince)
The right hon. Gentleman cannot ride off with that excuse He must remember that the Consolidated Fund Bill applies to practically every Department. Knowing that, Ministers of the various Departments should be present on the Front Bench—not that they would be very helpful, but it is a common courtesy to the House that Ministers should be here when matters for which they are responsible are being discussed.
§ Dr. Summerskill
I was waiting for the Minister of Health to arrive and he is here now, Mr. Speaker. Having heard him on the radio last night, I can quite understand why he is a little exhausted today. No doubt that accounts for the delay in his coming here. I am certainly sorry to ask representatives of two Departments to appear here today, but, during the last 12 months the Minister of Health has had to answer a barrage of Questions on some days. In my experience in this House I never recall any Minister of Health being called upon to answer so many Questions. On some days I believe that he had as many as 30 or 40 to answer. I remember that once when I was at the Ministry of Food I had as many on one day, but I think that that was unprecedented.
The right hon. Gentleman will agree that on occasions he has had great difficulty in answering hon. Members on this side. Therefore, I think we are quite justified, two days before the House dissolves, to ask those two Ministers, who have not completely satisfied hon. Members on this side of the House, to come here and tell us what their policy is towards certain matters.
I think it fair to say that I almost felt a little diffident today. I almost had to reorientate my views of the Minister of Health and look on him today as Dr. Jekyll, but last night he was Mr. Hyde. As I arrived home last night I heard a voice on the radio, which was almost unrecognisable, screaming abuse against the Labour Party. Every now and then the voice indulged in medical jargon. I am not accustomed to hear people who discuss medical matters scream to that extent and I asked, "Who on earth is this?" Someone staying in my house said, "This is the Minister of Health." I should tell the Minister that I blushed not only for him, but also for the Mother of Parliaments.
The right hon. Gentleman was taking part in a debate arranged by the Cambridge Union. I know all about the Oxford Union and the Cambridge Union and what those young people are like but—I say this quite honestly—I am surprised that they should have got the Minister into such a condition. If he 1702 thinks that that is an over-statement, I ask him—as I take it that his speech was recorded—to have it played over again. He will be really shocked. Anyone who suggests that the debate we are having today was staged for political purposes should have listened to the political broadcast of the Minister last night. It really "missed the bus," because I found myself having to apologise for the Minister. He really shocked me.
§ Mr. Macleod
—;interruption. I must say that the debate last night was relayed on the Third Programme and I had no idea that anyone listens to it. We must get the record right. Perhaps it is worth mentioning that the matter I was debating with the hon. Member for Devonport (Mr. Foot), who is not present in the House, was a motion before the Cambridge Union:That this House will be voting Conservative at the next Election,and that it was triumphantly carried.
§ Dr. Summerskill
I am not surprised. We all know unions. We all know immature youth and that they are not responsible. I debated, at the Oxford Union, with the Postmaster-General many years ago. The subject then was that we should have a health service, and the right hon. Gentleman denounced that on behalf of the Conservative Party. That motion was carried. I am glad that the Minister of Health came here today half apologetically, and said that he did not know he was being heard.
§ Dr. Summerskill
The reason I have mentioned this matter is that some of the questions with which the Minister dealt last night are questions I want to raise today. We have been used to the placatory manner of the Minister of Health and I find it difficult to ask him what is his policy in regard to the 1s. prescription charge, having heard him last night denounce the Labour Party in such a 1703 fashion for daring to suggest that the time had come to remove the 1s. charge.
As I say, I hope that Dr. Jekyll has arrived, and not Mr. Hyde. I am glad to see that the right hon. Gentleman is looking guilty, or at least apologetic. My hon. Friend the Member for Devonport (Mr. Foot) should have reminded the Cambridge Union that the Conservative Party voted against the National Health Service Bill on Second Reading and Third Reading; the Minister would not then have won.
I wish to start with the 1s. prescription charge. Is the Minister satisfied, after his experience, that, having regard to the hardship it imposes and the administrative burden it entails, it should be continued? Let me remind him of a Question put by an hon. Member to the Minister of Pensions and National Insurance, who said that further supplementary questions on the matter should be referred to the Minister of Health. The hon. Member asked:how many 1s. prescriptions charges were refunded during the past year to applicants in receipt of National Assistance.This was on 20th December, 1954. The Minister answered:From 1st October, 1953, to 30th September, 1954, the latest period of 12 months for which complete information is yet available, the National Assistance Board refunded rather more than 9¼ million shilling charges for dispensing of prescriptions.My hon. Friend the Member for Barking (Mr. Hastings), who is a doctor with a tremendous amount of experience and who never attempts to be irresponsible, asked:Is it not a fact that old people who ask for a return of their 1s. have to ask for a form at the time when the money is paid in the chemist's shop and then have to fill in the form and submit it? Is it not true that because of publicity involved many of them very much resent the procedure?"—[OFFICIAL REPORT, 20th December, 1954; Vol. 535, c. 2417–8.]The Minister then, quite rightly, referred my hon. Friend to the Minister of Health. In view of the fact that 9¼ million shillings were refunded, in view of the hardship to these people and the tremendous administrative burden, is this worth while?
So much of the hardship is not revealed but those in the best position to observe the hardship involved are doctors. By 1704 a large majority the delegates to the British Medical Association Conference at Cardiff—the British Medical Association is certainly not dominated by Labour doctors—voted for the abolition of this charge. The mover of the motion urging abolition described the charge as a major retrograde step in the National Health Scheme. He described it as a direct tax on the sick and, of course, we on this side of the House fully support what he said.
Another doctor pointed out that the health of small children in large families was being sacrificed. The Minister of National Insurance particularly, and everyone concerned with assistance, will agree that probably the greatest incidence of poverty in this country is in large families of dependent children. The mothers of those families hesitate to buy bottles of medicine, knowing that each bottle will cost 1s. The doctors bear this out. They say that it is the small children in these large families who are not now, under this scheme, receiving proper care and treatment.
Now I come to the dental charges. What is the effect of this economy measure? According to some medical statistics which I have examined, I find that Lancashire and certain other industrial areas which have always shown a special need for good dental services seem to be suffering more than other counties. I hope that no hon. Member will think that, because recently I have had the honour to be nominated for a Lancashire constituency, I have singled out Lancashire. The fact is that when I looked up the statistics I found that Lancashire had been singled out. Therefore, it would be a little unfair to Lancashire if I left out that county.
It has been shown in parts of Lancashire that dentists' earnings have dropped by upwards of 60 per cent. since 1950. I am not for one moment approving the astronomical earnings of dentists in the initial stages of the scheme; I agree that that was quite wrong. They earned colossal sums which could not be justified, and gradually, as the scheme went on, it was clear that there had to be some amendment.
What I want to know is whether the Minister has made special inquiries in those districts where the processes used 1705 in certain industries may have a deleterious effect on the workers' teeth with a view to seeing whether the withholding of a free service has not resulted in a grave deterioration in dental health. That is very important.
In matters of dentistry—this will, of course, be held against me—I was going to say that we should regard Sussex, for example, differently from Lancashire; but, of course, if there is a scheme it must be universal. Nevertheless, there are certain factors in Lancashire and other industrial areas which do not arise in Sussex.
Now I come to drugs. The Minister will recall that occasionally during the last three years—when I am here I watch carefully the Questions he answers—I have asked supplementary questions about the drug account. I understand that £50 million is spent annually on drugs and that 30 per cent. of this is spent on proprietary drugs. I may not have the percentage absolutely right, but I think it was 30 per cent. at the beginning of last year.
The Minister has agreed—indeed, he has told the medical profession—that it is possible in most cases to find a satisfactory alternative for a proprietary drug. Indeed, that little green book, which he has probably seen, called the "National Formulary," which is an excellent publication, provides that alternative for the doctors. I find it difficult to understand—and the Minister has been asked about this time after time during the last three years—how he can allow this huge sum to go to swell the large profits of the big drug houses, knowing how cheeseparing he has to be in other directions. He comes here very often and tells us of the expense of a particular institution or service which Members are asking him to provide, and yet here we have this £50 million spent on drugs.
I know what the Minister has tried to do. He has tried to persuade his officers to use a cheaper alternative. He has done everything except take strong action, and he knows what the strong action is. He should refuse to sanction unnecessary expense in prescribing when there is a satisfactory alternative.
Among the patients it is only the hypochondriac who would object to that. It is only the hypochondriac who keeps going 1706 to his doctor and saying, "What is the latest thing from America?" The sick person is guided by the good and honest doctor. The only people who would object are the hypochondriacs and the people in big business who are making these colossal profits. The taxpayers, of course, would be delighted, as would be every honest doctor. I should like to know what the Minister is going to do about this appalling waste of money.
§ Mr. Iain Macleod
May I ask the right hon. Lady a question, in a very friendly manner? This is an extremely difficult problem, on which she is a considerable authority. What the right hon. Lady suggests is that power should be taken for the Minister of Health to tell a doctor that he must not prescribe something that he thinks is best for a patient. That seems to me to be the fundamental difficulty in the proposal which the right hon. Lady is making. It would, no doubt, be desirable, in many cases, if doctors would prescribe precisely what is in the "National Formulary" but if a doctor, for whatever professional reasons, thinks it right to prescribe a certain drug, does the right hon. Lady think it proper then to forbid him to prescribe it and the National Health Service to pay for it?
§ Mr. Macleod indicated dissent.
§ Dr. Summerskill
Oh, yes. His officials examine a cross-section of the prescriptions issued throughout the country. When they have come to the conclusion that a doctor is guilty of excessive and expensive prescribing, the doctor is informed. That is part of the machine already. The right hon. Gentleman has established the principle. It is now a question of degree that he is asking me.
§ Mr. Macleod
May I make this one further point? The right hon. Member for Llanelly (Mr. J. Griffiths) is wrong. It is certainly true that advice is given to doctors, say, that a certain drug is not of proven therapeutic value, but if a doctor, in his own discretion, still decides to prescribe that drug, it is perfectly legitimate for him so to do. As I understand the right hon. Lady's proposal, she would take that discretion away from the doctor.
§ Mr. J. Griffiths
Quite recently, I had a case concerning a constituent who had asthma. I am simply stating the facts; I am not able to speak with authority on this. The constituent believed that a certain proprietary medicine was the best for him—we know how people believe that. He had been receiving it on a National Health Service prescription from his doctor. Then it was stopped. I wrote to the Minister, from whose reply it was clear that it had been stopped because it was thought that other prescriptions would be of equal value for the patient.
§ Mr. Macleod
I should like to get this point clear. It was suggested to doctors that the asthma preparations—Brovon and the others—were not of proven therapeutic value. But if, in his discretion, a doctor, knowing that advice, still decides that that should be prescribed for the patient, it is quite legitimate. Anyone who studies all the letters which I have written to many hon. Members on this point will know that it is still legitimate for a doctor so to prescribe.
The difficulty with the right hon. Lady's suggestion, which has great merit from many points of view, is that it might, in certain circumstances, infringe the right of a professional man to decide what, in his judgment, is the best for his patient. That is the matter which I am asking the right hon. Lady, in a perfectly reasonable manner—I want to find an answer to this—to clear up.
§ Dr. Summerskill
The Minister is on a very bad wicket, particularly in view of the interjection of my right hon. Friend the Member for Llanelly (Mr. J. Griffiths). Everybody knows that in asthma there is a nervous element, and that the patient may feel convinced that a certain preparation is the best for his complaint. On this question, I would say that the doctor has probably a right to prescribe that because he is prescribing for a nervous patient who has faith in that particular drug.
The Minister says that he has written to my right hon. Friend and the doctor says that he has been told that he has no right to prescribe that drug. This is the stickiest wicket that the Minister has been on so far. He asks whether I would stop the doctor prescribing the drug.
1708 Not a bit. There is no reason why the doctor should stop, but he has written to my right hon. Friend to say that that is what he has been told. This simply proves that the Minister has got into a muddle, and a very bad muddle, over this. He has written to my right hon. Friend telling him that a doctor cannot prescribe a certain drug to which a nervous patient with asthma responds. That is precisely what I would not do. I would not defend the right hon. Gentleman's action.
I am rather shocked. What he is trying to trick me into saying is that I would do what he has done. He has asked me, "Would I tell a doctor that he cannot prescribe certain things?" Each case would have to be regarded on its merits. I am shocked to learn that he can tell a doctor that he cannot prescribe something for a nervous patient.
§ Mr. Griffiths
In the case I have mentioned, the doctor said that he had had instructions to stop it. That is why I sent a letter to the Minister.
§ Dr. Summerskill
That ventilates the whole thing. It does a world of good. Why have I brought this matter up? We are spending £50 million annually on drugs, and the Minister is not sure of his policy. He is telling doctors that they should not prescribe certain, drugs and now, when he is challenged, he says that they can go on prescribing them. If they can do so, why does he write to my right hon. Friend and say that they cannot, particularly in a case in which I say that the doctor should have every right to prescribe them?
In the last debate but one, I quoted figures showing that the average cost of prescriptions was much higher in areas like Bournemouth and Hampstead than in the East End. Why is that? Are the people of Bournemouth and Hampstead so much more diseased than the people in the East End or the industrial areas of the Midlands? Of course they are not, but they know much more about proprietary drugs.
I do not know whether the drug houses send advertisements to the Minister, but every doctor is deluged every week with advertisements of proprietary drugs. We have this colossal figure of £50 million spent on them, and the Minister has now confessed. He does not quite know what 1709 his policy is, or what it should be. The policy is quite clear. Obviously, where there is a satisfactory alternative—in the case quoted by my right hon. Friend it was not satisfactory—the doctor should be told that he must prescribe it.
§ Mr. Richard Fort (Clitheroe)
The right hon. Lady has given an explanation of the high cost of prescribing in one part of the country. Will she enlarge it by suggesting a reason for the very heavy cost of prescribing in Blackburn and Bolton, both highly industrialised towns, in Lancashire?
§ Dr. Summerskill
We had a debate on this, and I gave the figures. I think the hon. Gentleman is wrong. I think he is challenging me because he knows that I have not with me the figures showing the average cost.
§ Mr. Fort indicated dissent.
§ Dr. Summerskill
Everyone does that sort of thing in this House. We all know the trick. Some fall for it when they are new here, and others do not. I have been here too long to fall for it. I gave the figures, and I would not accept what the hon. Gentleman has said unless I had the figures before me. I have given the figures for the areas to the Minister before in a debate—I remember particularly mentioning Bournemouth and Hamp-stead. The figures have been published in the "British Medical Journal."I have not manufactured them. They were the figures given in an article and in speeches made by doctors on pharmaceutical products and so on.
§ Sir Ian Fraser (Morecambe and Lonsdale)
Is the right hon. Lady sure that she is not mixing up Bolton and Bournemouth?
§ Dr. Summerskill
I will look this up, but I think that I shall find that the hon. Gentleman is wrong. From what the right hon. Gentleman says, he has not formulated any scheme and the matter is still in a rather blurred condition.
Now I come to the waiting lists. When I listened to the Third Programme, during that appalling broadcast last night, am I right in thinking that I heard the Minister shout something like this, "The Socialists want to deny them privacy"? Am I right when I say that I heard last night the Minister shout that 1710 —because I came in in the middle of the broadcast—in relation to private beds? He appears to have forgotten; I am not surprised. I was told by someone who heard the broadcast that he said that in relation to the private beds scheme. That is what I want to raise with the Minister. Questions in the House have elicited from the Minister that in some districts there are long waiting lists for operations of a quite simple character. Indeed, I am informed by friends of mine in London hospitals that a child needing an operation for the removal of tonsils and adenoids often has to wait many months.
Unfortunately, mothers learn that if they could find a few guineas a bed could be provided. Does the Minister think that he is justified in allowing beds to be earmarked for fee-paying patients? I am not talking about amenity beds. I think that he rather confused the Oxford Union last night about that, because one cannot expect those boys to know the difference between a fee-paying bed and an amenity. [HON. MEMBERS: "It was Cambridge."] I apologise. I always think of Oxford, because really there is only one place.
§ Dame Florence Horsbrugh (Manchester, Moss Side)
The right hon. Lady said that there were waiting lists of children who had to wait some months to have tonsil operations. Is it not the case that in the last few years it has been thought by some people in the medical profession that those operations should not be done during the summer months, because many people fear that there is the danger of poliomyelitis during those months?
§ Dr. Summerskill
The right hon. Lady may come across one or two doctors who feel like that about it, but I assure her that that is not the general opinion.
§ Dr. Summerskill
My hon. Friend should know.
I assure the right hon. Lady that I was not speaking about the month of the year, or the summer or spring or winter. I have not said that they are waiting during the summer months only. I think the Minister will agree with me that it is invidious to mention in this House any institution in particular, because there are 1711 always repercussions which are extremely unpleasant. I am talking about the waiting generally and not in relation to the summer.
§ Dame Florence Horsbrugh
Does the right hon. Lady agree—and her hon. Friend the Member for Warrington (Dr. Morgan) seems to think it is so—that there is this idea, and that if, during the months of summer, there can be no operations, or very few, for the removal of tonsils, we are bound to have waiting lists? It has happened in this country, and I am sure that she knows that it is happening in America.
§ Dr. Summerskill
The people who have informed me, who are very responsible people, have not told me that the waiting lists exist because they are afraid to operate during the summer months.
§ Dr. Summerskill
I agree with anything my hon. Friend says.
Does the Minister think he can justify these waiting periods? There are many people with other complaints waiting for beds, and he knows that these beds can be obtained, provided the patient can pay a certain number of guineas.
Finally, I want to deal with mental hospitals. I have read some of the Minister's speeches on this subject and he has, on occasions, intimated that he has sympathy with the mental patients. Indeed, he has opened a hospital—I think it is only one—for mental defectives in the North of England. We have had Questions in the House during the last few years which have been of quite an alarming character. We have heard about overcrowding and shortage of nurses, and these, combined with the activities associated with mental patients, have presented a horrifying picture reminiscent of Hogarth's "Bedlam." That is not an overstatement, because the right hon. Gentleman will remember what hon. Members representing Leeds have said to him on this subject.
I quote from the "British Journal of Preventive and Social Medicine," from an article, "A survey of mental hospitals and mental deficiency institutions in the Birmingham region." It states that on the male side: 1712The number of wards overcrowded by less than 10 per cent. is very small, and no less than 35. 7 per cent. are overcrowded by 25 per cent. or more. At five hospitals more than half the wards are overcrowded by 25 per cent. or more, and at the Central Hospital four of the 11 wards are overcrowded by 50 per cent. or more.It says that on the female side:In fact, half the wards in the Region are overcrowded at night by 25 per cent. or more, and almost one-fifth by 50 per cent. or more.These are mental cases.There is only one exception to the rule that there is greater overcrowding in female than in male wards.This report was made in 1954. I understand that, taking the country as a whole, there are 150,000 patients in mental hospitals occupying nearly half of the country's hospital beds, and the gross overcrowding is represented by 17,500 more patients than can be accommodated.
In view of the Minister's speeches, of what he has said in the past, of what he said when he first came into office, we would like to know what his policy is to be in the future. I do not think he will be sitting where he is, but we would certainly like to know what his policy is. I would remind the House that the mental hospital is still calculated to fill the healthy with a carefully disguised fear and repugnance. The consequence is that few visitors go to mental hospitals, in proportion to the number of patients.
It is an interesting point—and I think the Minister will agree with me—that while there are in mental hospitals these appalling conditions I have described, of overcrowding, with beds in corridors, there yet is no pressure group on behalf of mental patients. Why is that? Very often because, as I say, mental patients fill people with fear. It fills them with fear to deal with them. The mental patient is often friendless because his symptoms very often antagonise his relations and those who were or would be his friends. Furthermore, people feel that there is a stigma attached to mental disease. Therefore, the patients are often friendless—
§ Dr. Summerskill
—and there are very few visitors, comparatively speaking, to mental hospitals to see these conditions, and the consequence is that pressure is not brought to bear in this House on behalf of the mental patients as, I think, 1713 it should be. There are even some doctors who are inclined to regard money spent on mental disease as wasted because of the doubtful return in dividends, in terms of healthy, useful people, to the community. Meanwhile, the mental patient feels himself shunned, and gropes through life in the dark loneliness of his mind.
The House must face this problem. As I say, the Minister has shown himself sympathetic. He has opened a hospital for mental defectives. Now I should like him to give us the latest information about any overall improvement of these conditions, and, following the report from which I have quoted, a fairly recent report in the "British Journal of Preventive and Social Medicine," I ask whether he can say, after he has devoted himself to this matter for a number of years, that the position has entirely changed.
§ 4.34 p.m.
§ The Minister of Pensions and National Insurance (Mr. Osbert Peake)
The right hon. Lady the Member for Fulham, West (Dr. Summerskill) has ranged over a fairly wide area. I myself was in some doubt and difficulty in knowing what the range of today's debate was likely to be. The Minister of Health will intervene later and reply to that part of the right hon. Lady's speech which dealt with the National Health Service and with health questions.
It is a little difficult to know how far we can go today, because, as I understand, in a debate on the Second Reading of the Consolidated Fund (Appropriation) Bill we are confined to matters of administration—[HON. MEMBERS: "No."]—and prohibited from embarking on issues which involve fresh legislation. Am I not right, Mr. Deputy-Speaker?
§ Mr. J. Griffiths
I understood that on business of this kind hon. Members could raise almost any matter and that, within the rules of order, if an hon. Member wanted to raise a matter which could not be rectified except by legislation he was not debarred from raising it. In the past, hon. Members could raise general individual and constituency matters. When I first came into the House, 20 years ago, it was the practice to allow back benchers to raise such matters, a variety of matters. That practice may, in recent years, have 1714 been changed a little. I am charging my memory, but I can remember an occasion such as this when I myself raised such a matter. It was many years ago.
§ Mr. Deputy-Speaker
I will give a Ruling in two or three minutes. I am having the question looked into. I was under the impression that what I said just now was right, but I am making certain.
§ Mr. Peake
I am much obliged to you, Mr. Deputy-Speaker. In any event, I do not propose myself to trespass very long on the patience of the House, or to go far beyond questions of administration so far as my Department is concerned. However, I rather anticipated that we should not be in order in discussing, for example, the proposal in the Labour Party's Election manifesto that we should establish a Ministry of Social Welfare and do away with the National Assistance Board.
§ Mr. Deputy-Speaker
Would the right hon. Gentleman excuse me for one moment? My original Ruling was correct. Erskine May states:Debate … is thus limited to relevant questions of administration, and, as in Committee of Supply, questions of taxation and legislation cannot be discussed.
§ Mr. Peake
I am much obliged for your guidance on that matter, Mr. Deputy-Speaker, but I hope that because of that Ruling the debate will not be unduly circumscribed, because in these matters of National Insurance and of industrial injury and of war pensions it is not always very easy, unless one is an expert, to know what changes would require legislative action and what would require merely some subordinate legislative instrument. I shall try to keep within the terms of your Ruling, Mr. Deputy-Speaker, and confine myself to matters which would not involve legislation.
§ Mr. Griffiths
It was the intention of some of my hon. Friends, and, indeed, I proposed myself, if I caught your eye, Mr. Deputy-Speaker, to refer to matters connected with the National Insurance (Industrial Injuries) Act, and matters in which the borderline between administration and legislation is very narrow. I hope it will be possible, for example, to refer to the old cases brought into the scheme without legislation, since they 1715 have been without legislation. Where the borderline between legislation and administration is so narrow I hope we shall not be precluded from discussion. There are some things about which we want to make suggestions.
§ Mr. Peake
I raised this matter only to give notice that I myself was not going to raise matters which involved major questions of legislation, at any rate, like some of those in the Election manifesto of the Labour Party.
The right hon. Lady scolded me, in her usual agreeable manner, for not having made a statement yet on Government policy on the Report of the Phillips Committee. I have here my well-thumbed copy of that most valuable Report which, of course, went far beyond and dealt with much wider issues than the non-statutory review of the National Insurance Scheme upon which we are engaged at present.
The terms of reference of the Phillips Committee were:To review the economic and financial problems involved in providing for old age, having regard to the prospective increase in the numbers of the aged, and to make recommendations.It covered the whole wide field not only of National Insurance and National Assistance but also of provision for old age by means of private thrift, supplementary and occupational pension schemes, and so on, and also the burden which the growing numbers of old people are bound to throw on the nation as the years go by.
When I stated, in December last, that the Government were prepared to make a day available for a discussion of the Phillips Report, I thought that such a debate would be valuable and would help the Government to come to conclusions on the matter. I should have welcomed it very much and I hope that in today's debate we shall have the views of hon. Members on both sides of the House on some of the questions which are raised in the Phillips Report. We have not, of course, kept any aged person waiting for an improvement in pension or benefit on account of the delay that there has been in debating the Report of the Phillips Committee. In fact, hon. and right hon. Gentlemen opposite are just as much to 1716 blame as are hon. Members on this side of the House that there has been no such debate. [HON. MEMBERS: "Oh."] Yes, because there have been 14 Supply Days, for any one of which the Opposition could have chosen the Phillips Report as the subject for a day's debate.
§ Mr. J. Griffiths
Surely the right hon. Gentleman will admit that when a Government set up a special committee to deal with a problem and that committee presents its report, two things are expected to happen. The first is that we should have the considered views of the Government on the recommendations of the committee, and the second that we should have an opportunity to discuss those views and the recommendations. So far, we have had neither.
§ Dr. Summerskill
I have just quoted from the right hon. Gentleman's speech in which he said that we could have a day, and I praised him for it.
§ Mr. Peake
Perhaps we are having one now. In any event, this Parliament is drawing to a rather earlier conclusion than many of us had anticipated.
I assure the right hon. Lady that the non-statutory review of the National Insurance Scheme, which is a wider review than that concerned with benefit rates and contributions, is proceeding at present and that a number of important questions are still before the National Insurance Advisory Committee. They include, for example, dependency and widowhood benefits, which includes the 10s. widow, in whom all hon. Members on both sides have shown such interest. I have also referred to the Committee questions regarding contribution conditions for the various insurance benefits. I have referred to the Committee the provisions for death grants, which were novel in 1948, and a question about the conditions for payment in relation to short spells of sickness or unemployment. The Committee also has with it some draft regulations which I have recently laid before Parliament for the payment of pensions abroad, another question in which hon. Members on both sides of the House have taken a good deal of interest.
1717 I think it is fairly clear, therefore, that arising from these various references and, indeed, from the Phillips Report itself, there will have to be some further legislation at a later date amending the National Insurance Scheme, but I think that we built fairly well in 1946. I think it was a good scheme and I should be reluctant to introduce changes into it just for the sake of changes.
§ Mr. Leslie Hale (Oldham, West)
May I rise on a point of order, Mr. Deputy-Speaker, arising out of the observations which you made a few moments ago when you seemed to be referring to Erskine May at short notice? I have had an opportunity of making a further and more detailed reference. In page 724 of the current edition of Erskine May, which I have just obtained from the Library, it is stated thatDebate and amendment on the stages of these bills must be relevant to each bill and must be confined to the conduct or action of those who receive or administer the grants specified in the bill in the case of an Appropriation Bill,"—that is what we are now discussing—or, in the case of those Consolidated Fund Bills which do not include appropriation, the grants of supply which form the basis of the ways and means resolutions upon which the bills are founded. In general terms, any questions of administrative policy may be raised which are implied in such grants of supply.A note to this paragraph says:As an illustration of this rule, it may be mentioned that discussion has been permitted on the state of Europe, so far as it depended on the conduct of the executive government, including, for example, the use made of the naval forces, or the action of the diplomatic servants of the Crown; whilst on the other hand, observations and amendments relating to the constitution of Great Britain, to the House of Lords, to the course of action taken by that House with regard to various bills, the tenure of land in Ireland, the desirability of establishing a ministry of agriculture, payments charged on the Consolidated Fund, the expense of actions at law, and alleged miscarriages of justice, and the action of magistrates, were held to be irrelevant.This, of course, is the main Appropriation Bill of the Session.
Reference to the Schedule will show that it includes appropriations for the Home Department and Ministry of Welsh Affairs, for the salaries and expenses of the House of Lords, for the British Museum, for the whole of the Defence Departments, the Ministry of Health, the 1718 Ministry of Pensions and National Insurance and, indeed, the whole range of appropriations to the end of the Session. In those circumstances, would I be right in submitting that it would be in order for any hon. Member to refer to those matters in detail so long as he does not make proposals for legislation or new taxation?
§ Mr. Deputy-Speaker
My Ruling was based on the same page of Erskine May as that from which the hon. Member has just read, and I quoted the words:Debate on these bills is thus limited to relevant questions of administration, and, as in Committee of Supply, questions of taxation and legislation cannot be discussed.I think that we are in agreement.
§ Mr. Peake
I must refer briefly to a subject which the right hon. Lady the Member for Fulham, West mentioned, and which is obviously within the sphere of administration. It is the question of the parent's war pension, which was raised at Question Time on Monday. Without going into a great deal of detail, I accept full responsibility that in drawing up this vast scheme of improvement in benefits and pensions of all kinds affecting 6 million or 7 million people we overlooked the adverse effect upon a very limited number of cases.
§ Mr. Peake
That matter has been put right, generously, by the increase in the mean standard from 50s. to 60s.
The result will be that not only will all these parents who are at present drawing either a retirement or a widow's pension get the benefit of the increase in their pension without any adverse effect whatsoever on their parent's war pension but, in a very large number of cases, the parent's war pension itself will be also increased. The hon. Member for Cardiff, South-East (Mr. Callaghan), who, on Monday, suggested that the right hon. Member for Caerphilly (Mr. Ness Edwards) had drawn my attention to this specific point in the debates on National Assistance just before Christmas, was mistaken. I have read through that debate again, and I find that this specific point, which is a rather abstruse one, was 1719 not, in fact, raised in the debate on the 20th or 21st December.
I now turn to another matter for which I accept responsibility and for which I answer in this House, and that is the National Assistance scales. The criticisms which are made of the existing scales are threefold. It is argued, on the one hand, that the scales themselves are too low. Secondly, it is argued, perhaps alternatively, that the scales should not be adjusted when National Assistance benefits or National Insurance pensions are increased; that is to say, it is argued by some that the increase in National Insurance pensions should be disregarded and left out of account in computing the National Assistance supplement. It can be put in another alternative way, which is that the increase in National Assistance scales made last February should be exactly equal to the rise in National Insurance pensions and benefits which is being brought into force at the present time.
May I deal first with what I would call the absolute level of the existing scales. The level of the assistance scales, after the February increases of 2s. 6d. for a single person and 4s. for the married one, compares very favourably with the scales introduced in 1948. The present scales, after those increases, are 37s. 6d. for a single person, plus an allowance for rent, which makes the average payment to single persons somewhat exceed 50s. at the present time.
§ Mr. Peake
At present, about 10s. or 11s. Of course, it varies in regions. I think the right hon. Gentleman the Member for Llanelly was asking for the average overall figure, which is what I was giving.
I was saying that the average payment, including those cases where there is a discretionary addition, is in excess of 50s. at the present time. As far as the married rate is concerned, the addition made in February raised it to 63s., plus the rent allowance, so that the average payment there is somewhere in excess of 75s. at the present time.
1720 If we compare these cash scales with the corresponding cash scales introduced in 1948—which was a time, as I think the right hon. Member for Llanelly will agree, when it was certainly claimed that the poorest of the poor were going to be better off than they had ever been before in this country—we shall see that the present day scales are something like 54 per cent. in excess of the scales fixed in 1948.
§ Mr. Griffiths
These comparisons are interesting, and it is important that we should get them clear. The right hon. Gentleman has given us the average payment and the average rent, but did I understand him correctly to say that he included in these figures the discretionary allowance? If the figures which he now gives to the House cover the basic scale, the rent allowance and the discretionary allowance, were the figures for 1948 on the same basis?
§ Mr. William Warbey (Broxtowe)
While the right hon. Gentleman has said that the value of the cash payment has risen by 54 per cent., did he not agree in the debate before Christmas that the cost of food, which is a major item in the budget of the lower income groups, had risen in the same period by 60 per cent.? Has not the Minister also disregarded the fact that the value of the disregards has fallen during that period, and has not been raised, at the same time as the productivity of the country has risen by some 35 per cent., out of which these people have gained no benefit whatever?
§ Mr. Peake
It is true that the scale rates today are 54 to 55 per cent. in excess of the rates fixed in 1948, and that the increase in the cost of living since that time is about 32 or 33 per cent., but of course it is not true that persons on National Assistance spend the whole of their cash payments on food. They have other things to provide for as well.
1721 In point of fact, the National Assistance scales have been continuously increased to match the rise in the cost of living. They were increased by right hon. Gentlemen opposite in 1948, and I have already referred to it, and they were again increased in 1950 and in 1951. They were increased by this Government in 1952 and again in 1955. The increases of 1950 and 1951 did, in fact, restore the purchasing power of these scales to the 1948 standard, from which they had fallen owing to the rise in the cost of living during the intervening period.
The increase of 1952, as the National Assistance Board made clear in the White Paper which it issued at the time covering this increase, did, in fact, go beyond restoring the scales to make good the fall in purchasing power. It went beyond that, and gave to the persons on National Assistance a better standard than they had ever enjoyed before. The recent increases made in February, 1955, have in their turn fully restored the loss in the purchasing power of these allowances which has taken place since June, 1952; that is to say, the allowances in force today are equal or more than equal in purchasing power to the higher scales introduced in 1952, which, in their turn, had a higher purchasing power than the scales in force in 1948, or indeed at any time during the period of office of right hon. Gentlemen opposite.
§ Mr. Griffiths
I think it would be interesting if the Minister could proceed to tell us how the National Assistance Board arrive at their decision.
§ Mr. Peake
I think the right hon. Gentleman knows as well as I do that the Board has consistently refused to produce a notional budget applicable to all in a great and wide variety of cases for which they have to provide. During my period of office as Minister, I have had very few complaints about the National Assistance Board. Hon. Members in all parts of the House agreed that the Board has used its discretionary powers very freely—some 600,000 cases which I think are subject to a discretionary addition to the scale rates. I must confess that the Board has a very high reputation for the humanity with which it carries out its difficult task.
The second criticism, and one which is far more important as far as I am concerned, is the criticism that there should 1722 be no adjustment made to take account of the increase in the National Insurance pensions. The fact is that National Assistance scales have been increased five times since 1946, whereas the National Insurance pension has been increased on only two occasions, and the National Assistance scale have been increased by considerably larger cash amounts than the insurance pension. The increase for single persons since 1946 has been from 20s. to 37s. 6d., a sum of 17s. 6d. and the pension, on the other hand, has increased by 14s. from 26s. to 40s. The married National Assistance scales have gone up by 28s. since 1946, whereas the married insurance pension has gone up by 23s.
Persons being supplemented by the Board are drawing substantially more in actual cash every week than are persons who depend on and only draw their National Insurance pension. The Assistance Board notified everyone who was getting supplementation at the time it made the February increases that when the increase of pension benefit came to be made in April or May adjustments would have to follow the code which is laid down.
In the National Assistance Act, 1948, for which the right hon. Gentleman who is to reply to the debate for the Opposition, accepted responsibility, it is stated in Section 4 that it is the duty of the Board and its responsibility to assist persons whose resources, including benefits, under the National Insurance Act are inadequate for their requirements. But the Act also lays down that insurance payments must be taken into account in computing requirements for National Assistance purposes.
Of course, at the present time when we are making these very large increases in the insurance pension and bringing it much more into the picture than it has been in recent years as the main defence against want, it would be a very serious reflection indeed upon the National Assistance Board if it were necessary at the same time to increase the National Assistance scales by 7s. 6d. single and 11s. married. Truly, if it had to do that it would indeed be an admission that it had allowed the purchasing power of assistance to fall far below what was necessary or desirable. But I have often heard old-age pensioners and old-age 1723 pensioners' organisations themselves describe the National Assistance Board as the old folks' best friend, and I am quite confident that the Board has been doing its duty to very general satisfaction.
A close analogy to what is happening now can be found in the great operation which the right hon. Gentleman the Member for Llanelly undertook in 1946. In that year the right hon. Gentleman—it is true he had a fairly ready-made scheme devised by the Coalition Government and called the Beveridge Plan—raised the insurance pension from 10s. to 26s. At that time there were—and I want the House to understand these figures because they are important—1,470,000 pensions then being supplemented by the Assistance Board. When the pension was increased by 16s. from 10s. to 26s., 840,000 of these persons being supplemented by the Board received an average increase of income of 4s. 3d., but there remained 630,000 pensioners who got no increase of income at all. They remained on exactly the same income figure as before their pensions were increased from 10s. to 26s.
§ Mr. Griffiths
Is the right hon. Gentleman going to tell the whole story or only part of it? He knows perfectly well that the National Assistance Board in its present form did not exist in 1946, nor was there a National Assistance Act. There was an Unemployment Assistance Board set up for reasons which I do not want to discuss, but during the war or, indeed, before the war, it was permitted to make a supplementation to old-age pensioners, but only to pensioners. It was clearly indicated in 1946 that it was our intention to bring in a National Assistance Board to replace the poor law system. The Minister ought to give the full facts, and anyhow the history of this matter is within the knowledge of the people of this country—they will know.
§ Dr. Summerskill
What is the Minister going to do about the future? We do not want to be concentrating on the past.
§ Mr. Peake
—nearly 1 million, to be exact 940,000 supplements, then being paid by the Assistance Board, as it was then called, were extinguished altogether by the increase in the insurance pension. Let us compare what happened in 1946 with what is happening today. At that time 630,000 got nothing at all. On this occasion everybody, including those on National Assistance, are getting some positive increase in income.
§ Mr. Griffiths
What was the increase given in 1946 to nearly 4 million who were getting National Assistance? The Minister should complete the picture.
§ Mr. Peake
I have given the full picture to the right hon. Gentleman.
I want to say a word about the number of allowances likely to be extinguished by the present increase in the insurance pension, and to tell the House shortly a little about the number upon National Assistance about which I have expressed concern from time to time. On 5th July, 1948, the National Assistance Board, as it became known in that year, was paying 842,000 allowances. At the end of October, 1951, when we took over the figure was at 1,431,000, an increase of 589,000 in three and a half years. At the end of March, 1955, an exactly similar period to that between October, 1948, and October, 1951, the numbers had risen to 1,807,000 that is say, an increase in those three and a half years of 376,000. But the House will observe that the increase in the first three and a half years under one Government was nearly 600,000 compared with 376,000 during the last three and a half years of the present Government.
But there is one more satisfactory feature, and that is that the rate of increase has been continuously slowing down; in the 12 months ending March of this year the increase of those drawing National Assistance was only 8,000 compared with March, 1954. That small rise occurred despite the attraction which 1725 always tends to be created when assistance scales are increased.
The figures I have given of an increase of 8,000 only over the past 12 months takes no account at all of what is going to happen by virtue of the increase in pensions benefits which has just occurred. Those increases will have the effect of reducing the number of persons going to the National Assistance Board by something like 100,000. The House will, therefore, see that we will have the satisfaction of knowing that the number on assistance is definitely stabilised, and, in fact, has at long last ceased to increase. I think that is a matter which will give satisfaction in all parts of the House.
I do not need to say much about the other increases in insurance benefits, industrial injury benefits and war disability payments, which have taken place during the last three and a half years. I shall only pick out two examples at random to show the House the kind of thing that has occurred since October, 1951. The seriously disabled married workman with no children, an industrial casualty not sufficiently seriously disabled to attract a constant attendance allowance, was getting £4 7s. in October, 1951. He is getting £6 12s. 6d. today. That is not a bad increase.
§ Mr. Griffiths
Would the Minister tell us how much extra this has meant from Government funds? Is it not true that practically all this money comes from increased contributions?
§ Mr. Peake
I can answer the right hon.
Gentleman simply by saying that the general increase in all the main benefit rates since October, 1951, is 50 per cent. or more, and that the increase in corresponding contribution rates is between 30 and 35 per cent.; that is to say, the insured contributor is getting a first-class bargain all along the line.
§ Mr. Peake
The figures will be given later in the debate. They involve a 1726 certain amount of addition between the cost of the increases made in 1952 and the cost of the increases made in 1955. I will see that my hon. Friend is furnished with them.
Now I want to speak about the old workmen's compensation cases in which the hon. Member for Bedwellty (Mr. Finch) is especially interested. These are cases in which we all take an interest and for which many of us who have been concerned with industry feel much sympathy. However, it is not as if nothing had been done for those cases. In 1948 the right hon. Gentleman the Member for Llanelly rightly provided that sickness benefit should be made available on top of the workmen's compensation payments, subject to the old rule that there should be no duplication of the allowance for dependants such as the wife and the child. I was happy, in 1953, to remove that restriction. The effect is that a married man on workmen's compensation can now for the future, after the coming increase in sickness benefit rates, draw 65s. on top of his workmen's compensation as against 32s. in 1951.
Again, constant attendance allowance and unemployability supplement have also been increased for these old workmen's compensation cases. This is a difficult problem, however, because it is difficult to assimilate these old cases to the new scheme of industrial injuries. There will always be cases where a comparatively small injury attracts a rather higher rate of compensation, even under the old Acts, than does a corresponding injury under the new scheme of industrial injuries where assessment is made on the percentage basis.
I do not think that my hon. Friends on this side of the House have any reason to feel ashamed of our record in this field during the last three and a half years. All those who are interested in the welfare of the British people may look back with satisfaction on the achievements of the Parliament which is now drawing to a close.
§ 5.15 p.m.
§ Mr. James Simmons (Brierley Hill)
I am pleased to have this opportunity of raising the question of war pensioners. I was interested in a remark made by the hon. and gallant Gentleman the Parliamentary Secretary at the Annual Conference of the British Limbless Ex-Service 1727 Men's Association in 1952. The report was as follows:There is very little party politics or bitterness in any way between Parties which comes into this matter of disability pensions.I agree with the hon. Gentleman that, since 1945, war pensions have largely been lifted above the arena of party politics. That was to be expected because of the splendid record of the Labour Government for the war pensioners and their dependants during those six years. As a matter of fact, there was nothing to attack. Some of us who were 1914–18 war pensioners remember with bitterness the hardness of the administration after the First World War and between those wars. With the coming of the Labour Government in 1945 an entirely new spirit was infused into the administration of war pensions.
First I want to deal with the statement of the Minister on parents' pensions. Already in the Press that concession has been considerably over-estimated. I have here a cutting from a provincial newspaper with the heading "Parents war pensions are raised to £3." Of course it is the means standard that is raised to £3 and it is so raised in order to counter the effects of the increased cost of living. I give the Minister credit for the fact that he tried to make this clear in his interchanges in the House on Monday afternoon. He said:… the means standard for these pensions … has not been increased since 1952 … But these figures of the means standards are, of course, not the amounts of the pensions.Later he said:… many parents' pensions will themselves be increased."—[OFFICIAL REPORT, 2nd May, 1955; Vol. 450, c. 1352–1353.]No doubt that caused the confusion in the minds of our journalist friends who have presented this exaggerated claim for the Government.
The Government are taking great credit for this increase, but under the Labour Government the actual maximum of the parents' pension was raised from 10s. to 27s. 6d. for one parent and from 12s. 6d. to £5 for two parents. The basic means standard was raised by the present Government in 1952 and this was done to meet the greatly increased cost of living. I cannot understand the position in which we found ourselves on Monday. It should have followed auto- 1728 matically, without a flourish of trumpets and a show of self-righteousness, that the pensions and allowances were increased again to compensate for the increased cost of living under the Tories. That should come automatically without Questions being asked from this side of the House quoting distressing cases or quoting cases where half or sometimes the whole of the parents' pension had been swallowed up by the increase in other pensions. When an increase in other benefits is given purely on the basis of the increase in the cost of living, then it is the Government's duty to raise the disregards or to raise the means standard by which the pensions are measured.
The Minister was patting himself on the back pretty well in some of the remarks which he made during the interchange of opinions in the House on Monday. He spoke about "very generous increases" and all the rest of it. But if the Government intend to brag and boast about what they have done for war pensioners, we on this side of the House must in self-defence remind the country of Labour's great record between 1945 and 1951. It was not I who first raised this question of the difference between the two sides of the House. It was raised because of the mistake about the parents' pensions and because the Government, instead of coming along and saying "We were wrong" are trying to brazen it out, and have tried to make out that their record on war pensions is very much better than ours.
Labour not only increased the basic rates but also made improvements in supplementary allowances and many administrative changes which brought under the pension rules many pensioners and dependants who previously had been excluded. I again quote my good friend the Parliamentary Secretary, who was at the time dealing with war pensions. According to a report of his speech to B.L.E.S.M.A. at the annual conference in 1952, he said:Our predecessors raised the basic rate by 5s. in 1946 and, in the years which immediately followed, they concentrated on setting up a Welfare Service and on giving certain allowances to the very badly disabled, and the total of those allowances gradually rose from 1946 to 1951 to a total of £11½ million a year.That was supplementary allowances and benefits, on top of the increase in the basic rates.
1729 Prior to 1946, no allowances were payable for the wife and children of a disabled war pensioner unless liability existed at the time the disability was incurred. I well remember, as a very embittered ex-Service man in those days, reading the debates in the House of Commons and the reply of a gentleman called Ian MacPherson, who was Minister of Pensions at that time. He said that disabled ex-Service men should have more sense of responsibility than to have children and the Government could not be saddled with the cost of keeping their children if they had no more sense of responsibility than that. That was the attitude of those who sat on the other side of the House towards the ex-Service man and his dependants during the inter-war years.
There was a long campaign to bring within the orbit of the allowances the wife whom the man had married after his disability had occurred and the children born after his disability had occurred. We cannot penalise a disabled man by denying him the joys of a family and a family life because of his service to his country. This fight went on for years and years on the Floor of the House, but it was the Labour Government who abandoned that restriction and, by abandoning it, added to the pension roll 200,000 wives and 250,000 children. Those are things which we must not let the people forget when hon. Members opposite want to take all the credit for being the friends of the ex-Service man.
I do not want to weary the House with a lot of figures, but widows' pensions and allowances, which have been mentioned by the Minister this afternoon, were very considerably increased under the Labour Government. When I look at the first Report on war pensions after the end of the Second World War, which was issued by my right hon. Friend the Member for Middlesbrough, East (Mr. Marquand), I find that in the 1939–45 Royal Warrant the widow's basic pension was 15s. 6d. for a widow under 40 years of age without children and 32s. 6d. for a widow over 40 years of age with children.
What was the position after only two years of a Labour Government? The widow with two children, who was paying a rent of 15s. a week, was receiving 69s. a week, a very considerable increase and comparable with the kind of increases which the Government are boasting about 1730 at present. There was the unemployability supplement and the constant attendance allowance and, in February, 1946, it was the Labour Government who brought in a special hardship allowance for disabled ex-Service men. Later they introduced the comforts allowance. Let us not forget, especially we limbless people, that it was the Labour Government who brought in the clothing allowance for the limbless man and that it was the Labour Government who provided 8-horsepower cars for the very badly disabled. No cars have been provided since the Labour Government left office.
Altogether, 2,000 cars were provided under the Labour Government and, as we know from Questions and Adjournment debates in the House, there are still scores if not hundreds of border-line cases which merit the provision of 8-horsepower cars. But this Government have not provided a single car for the war pensioners. The Labour Government first proposed 1,000 cars. When it was seen that 1,000 would not meet the problem, they raised the figure to 1,500. When it was seen that 1,500 would not meet the problem, they raised the figure to 2,000.
Why has this progress not been continued in three and a half years of a Tory Government? We heard about a border-line case from Scotland which was raised from the other side of the House recently. Why have the Government not provided cars to meet such border-line cases? It was the Labour Government who began to eliminate the hand-propelled invalid carriages and to bring in the motor-propelled tricycles and the all-weather tricycles.
It would take me an hour to enumerate, and to give details of, the progress made in the treatment of the war disabled under a Labour Government between 1945 and 1951, but I make it a rule never unduly to trespass upon the patience of the House or upon the time which should rightly be given to colleagues who want to take part in the debate. I will therefore draw to a conclusion by saying that this diminishing number of our fellow citizens, who suffered grievous harm in defence of principles which we hold dear and who helped to keep the shores of our native land inviolate, must never be forgotten.
I repeat the plea this afternoon which I have often made on the Floor of the 1731 House for some special consideration for the limbless of the First World War. These veterans, whose average age is now between 63 and 64—I am nearly 61, so I am approaching the average—have a claim on our sense of justice which we dare not ignore. I am not concerned about the niceties of medical opinion on this matter. I am concerned with the evidence of our eyes and with applying common sense and not medical jurisprudence to the problem, and I repeat what I have said before: those of us who have been swinging 8 to 10 lb. of weight at the end of a stump for 35 to 40 years are bound to have felt the strain—a strain for which we were not compensated when our pensions were allocated. If we were ordinary pensioners suffering from disease or medical disorders, or wounds, we would have had our pensions and our disability allowances increased. But because we are the wearers of artificial aids to propulsion we are overlooked, and I think that this question might be again examined.
We are all delighted to have read the Report of the Rock Carling Committee. We are all delighted to reassure our comrades of two great wars that the loss of a limb does not necessarily shorten their expectancy of life and does not necessarily increase their incidence to cardiac disease. We are very pleased about that, but we are very disappointed that the terms of reference of the Rock Carling Committee were not wide enough to give an appraisal of the physical, psychological and mental wear and tear that the limbless man suffers as a result of wearing an artificial limb. We believe that had that been done, a strong case would have been made for some increase in the pension for that disability.
Some time ago we had a merger of the Ministry of Pensions and the Ministry of National Insurance. We all gave that merger our blessing, although some of us had doubts about its value to the ex-Service community. I must say that I feel that we have had disadvantages from that merger. We have had fewer appearances at the Dispatch Box by anyone directly representing those who are under the control of the Ministry of Pensions. We understand that at least 70 per cent. of the top-ranking staff of the old Ministry of Pensions have now 1732 gone and that gradually this great, humane, big-hearted Ministry is being absorbed into a great machine.
An added disadvantage is that there is now divided responsibility for the war pensioner. It is divided among the Ministry of Pensions and National Insurance, the Ministry of Health and the Secretary of State for Scotland, or one of his minions. The other day the Minister of Health answered a Question of mine about cars. He said that the position in dealing with the provision of motor cars was the same under the present regime as it was before. That is not true, because there was only one authority before the merger and today there are three. The poor ex-Service man is played about like a shuttlecock among three Departments instead of being in the special care of one Department.
I suggest—and this could be considered a suggestion of an administrative character—that there should be at least a Parliamentary Secretary or a Secretary of State with the authority to answer for all Government activities on behalf of the disabled ex-Service man. I believe that this divided responsibility is not a good thing and any tendency to allow the human touch that was developed during the Labour Government in dealing with war pensioners and their dependants to be lost in the great machine of the Ministry of Pensions and National Insurance must be checked by our eternal vigilance on the floor of the House in debates and at Question Time.
I do not want to see the disabled man made the shuttlecock of party warfare, and so I have sought to remind the House and the nation that a new spirit in the treatment of war disabled was born in the Labour Government of 1945, the insistence that the human approach and the personal touch were just as important as the improvements in pensions and allowances. If in reply to statements on the other side of the House I have appeared to infuse too much of the party spirit into my contribution to the debate, let me say that I have done so because I want people to realise that the ex-Service community deserves the support of members of all parties. I urge all parties to give credit where it is due whenever improvements are made in the lot of the war pensioners. Whoever makes those improvements and 1733 whatever we do on behalf of the war pensioner, our debt to him will never be paid in full.
§ 5.37 p.m.
§ Sir Ian Fraser (Morecambe and Lonsdale)
My hon. Friend the Member for Brierley Hill (Mr. Simmons) was Parliamentary Secretary to the Ministry of Pensions. He is a recognised leader of ex-Service thought and opinion in the House and we all respect his point of view. Even he, in the circumstances of the day, may be allowed his little bit of party politics, without that in any way detracting from the friendly regard in which we hold him.
I voted against the merger of the Ministry of Pensions with the Ministry of National Insurance. I did that as a protest against the fact that at that time the Government had not made a substantial review of war pensions which I thought they should have made. I did not anticipate that the merger would produce many difficulties, although I did think that perhaps the claims of the ex-Service man might become merged into the machinery and that the distinctive assistance and help which I wanted him to have might thus be forgotten. I am bound to say that I do not think that that case can now be established.
As to the status of the Minister and whether we get the same say in high places as we had before, we have now a more powerful Minister—indeed, we have the Minister in the Cabinet where we also have the Minister of Health—and he is in a position in which he can exercise the greatest influence upon the Chancellor of the Exchequer. As I said at the time, the proof of the pudding is in the eating and during this Parliament very substantial improvements in war pensions have been made. That belies any suggestion that the case of the ex-Service man would have been forgotten as a result of the merger.
I agree with the hon. Member for Brierley Hill that it is very important for the disabled men that we should not, even for brief moments, make party comparisons, or party bitterness about their plight. To raise their hopes beyond levels which we in this House, with our long and deep experience, can best understand, is not wise; it is not even helpful to disabled people. It tends to make some who are on the threshold of deciding 1734 whether they will work, or whether they will become pension-minded, become even more pension-minded than they would otherwise be.
That is not to say that justice should not be done to them, but it should be done by discussion among ourselves rather than by whipping up feeling on platforms. That is my view and in support of it I ask to be allowed to call the mind of the House back to a fact of which hon. Members will not be aware, because I do not suppose anybody noticed it. At the last General Election when hon. Gentlemen opposite were defending what they had done, I did not make one speech in the country about war pension matters. I claim no special credit for that, but I mention it to show that I practised then what I am preaching now.
I earnestly hope that it will not be necessary for us to stump the country and to defend the Conservative Party, or the Government, against attacks in matters of war pensions. That is the last thing I want to do. I am due to speak in 15 different constituencies and I would much rather not mention the matter at all if it can be understood that all of us, to whichever party we belong, have done the best we could.
There are one or two points of fact which should be quoted, in view of what the hon. Member said. It was in 1943, under a Government which was predominantly Conservative, that the splendid allowance called the unemploy-ability allowance was introduced. It was also in that year that the widest spread of war pensions was made, so that from then on pensions were given to those who were rather doubtfully in the war pensions category. The benefit of the doubt was changed over in that year so that the Ministry had to prove a case against an appellant in certain circumstances instead of the appellant having to prove the case against the Ministry. As a result, very many cases which, in earlier times, had been controversial ceased to be so and great numbers were added to the war pensions list. Those two reforms took place in 1943.
Then came the Labour Government, and they introduced the wives' and children's allowance, long advocated by me and by the British Legion. They also 1735 introduced the provision of motor cars and improved the then established unemployability allowance. They raised the basic rate. Therefore, it will be seen that both parties have played their part according to their lights in this matter. I do not think it right or proper for either side to claim a special pre-eminence of any kind.
The doubtful emotional claim that a new spirit entered the Ministry of Pensions for the first time is the least capable of being established or confirmed. That new spirit was not a party spirit. It was the feeling of the country relieved of the pressure of war by the advent of peace which reflected itself through the Government of the day in better and more anxious concern for the men who had suffered in the service of the country. That would have happened whatever Government had been returned to office.
§ Sir I. Fraser
But it did in 1919, when there was just as great a move forward in sentiment and feeling by comparison with that which existed between 1900 and 1918. There was the Royal Warrant brought in at that time, incidentally by a Labour Minister, the late Mr. Barnes. The proposals he put forward then showed as much of a new spirit as compared with 1914 as anything which occurred after the last war. It can be accepted that after a war an upsurge of public feeling will lead to more generosity and a better feeling expressed through the Governmental machine.
We have just had a change in the parents' pensions. Both sides of the House thought that the Ministry was at fault, and the Minister came to us and explained that he had overlooked this administratively trifling matter. Being a wise and sensible Minister, he realised that it was not trifling to the people concerned and he took the first opportunity to put things right. If hon. Members opposite asked more questions than we did, it does not follow that they brought more persuasion to bear on the Minister. We met the Minister and told him what we thought, and our view prevailed.
§ Sir I. Fraser
No. Both sides "had a go" and both sides won a little victory. Let us place that on record; it seems the best thing to do.
I have just come from a British Legion Conference, at which I addressed about 5,000 women in the Albert Hall. I congratulated them on having helped us to "beat up" every Government, including this one, and especially this one, because, as a result of our "beating them up," in the past three and a half years we have had the best ever rise in the basic rate which any Government have ever given. The British Legion is much to be congratulated upon that. The difference amounts to about £25 million to be added to the Bill, while the Government continue to carry the full bill which previous Governments had added to by their many generous acts. Let us go into this Election and see whether we can avoid following each other round making speeches about ex-Service men and war pensions.
§ 5.47 p.m.
§ Mr. Kenneth Robinson (St. Pancras, North)
I hope that the hon. Member for Morecambe and Lonsdale (Sir I. Fraser) will forgive me if I do not follow him in the remarks which he has made. I want to discuss one specific matter which has some relation to the general theme of the debate. This is one of those rare but fortunate occasions when it is appropriate for hon. Members to discuss in this House the grievances of their constituents. I want to raise a matter which I had hoped was settled.
I should like to give the House a summary of the facts, and if I quote rather more than is my custom I hope that hon. Members will forgive me; my speech will probably be shorter if I quote. On 30th March a constituent of mine, Mr. F. A. Kitson, came to to see me and told me what had happened to his son, who had that day been taken to Hampstead General Hospital with a fractured arm. What he told me constituted a prima facie case which disturbed me. I asked him to put the facts in writing and told him that I would gladly take up the matter with the Minister.
Some days later I got a letter from him stating clearly what had happened. I should like to quote part of it. Mr. Kitson starts by explaining how his son 1737 fell in the playground at school and was taken to Hampstead General Hospital. He continues:John arrived at the hospital at 11.15 a.m. accompanied by his mother, and the injured arm was immediately examined by a doctor who ordered an X-ray to be taken. … In the meanwhile, news of the accident had reached me at my work and I arrived at the hospital at 11.45 a.m. to find my wife and son seated in the Fracture Clinic awaiting further attention. At my request and because at this time John was complaining of feeling faint, he was permitted to lie down on a table in the Clinic. Following my departure from hospital at 12.20 p.m. the boy and his mother were moved from the Fracture Clinic and seated in an adjacent corridor. Subsequently, my wife complained about the delay, etc., and as a result of a conversation between the Sister and Matron, John was again moved and allowed to rest on a bed in the Children's Ward. A bowl was supplied in case he should vomit! At 4.20 p.m. I received telephone advice from my wife to the effect that John had received no further attention since my visit earlier in the day. … I returned at once to the hospital and voiced a strong protest to the Sister in charge of the Fracture Clinic. Both she and the Matron expressed their deep concern but regretted that this particular case was by no means an isolated one.At approximately 5 p.m. I was taken to the hospital Secretary … who also was most sympathetic and agreed that I had every cause to complain. The explanation he offered was that during the whole of the waiting period there had been none of the resident orthopaedic registrars available. He then got in touch with a doctor by telephone, and at 5.45 p.m. John was taken to the theatre and received the medical attention … which had apparently been unavailable … for the space of 6½ hours since his admission at 11.15 a.m.It should be pointed out that at no time during this long period of waiting was the child offered food, drink (other than a glass of water) or a sedative of any kind, although I believe he suffered a certain amount of pain and shock.I received that letter just as the House was rising for the Easter Recess. I wrote to the Minister and enclosed it, and I also warned the Minister that I should probably feel obliged to table a Question when the House reassembled. I did not table a Question until the last moment at which I could be sure of getting a reply from the right hon. Gentleman. But about an hour before Question Time last Monday I did get his reply, and I should like to say at once that I found it wholly satisfactory. He said:I have had inquiries made of the Board of Governors of the Royal Free Hospital (of which the Hampstead General Hospital is a part) and I am afraid that the information obtained confirms what Mr. Kitson has said in his letter to you. I very much regret that such 1738 an occurrence should have taken place and I should be glad if you would convey to Mr. Kitson my regrets and those of the Board of Governors. The Board take a serious view of the matter, and I am informed that the person responsible has been reprimanded. I hope, therefore, that the steps taken by the Board will prevent anything of this nature happening again.When I asked a Question, the Minister said very much the same thing in, perhaps I may say, even more forthright terms. He said:… it is clear that the hospital staff failed grossly in providing proper attention.He then repeated his apology which, of course, I accepted. It was the kind of apology that this House always accepts from a Minister who comes to the Dispatch Box and admits responsibility on behalf of his Department. In reply to a supplementary question he said:I am bound to say that the only thing I welcome about this issue is that the hospital, at once, frankly admitted an error."—[OFFICIAL REPORT, 2nd May, 1955; Vol. 540, c. 1337.]Anyone might have assumed at that point that the matter was closed. I wrote to my constituent, and sent him an extract from HANSARD containing the Minister's reply, and no doubt he is as satisfied as I am.
But not so the matron of the hospital, who immediately began to give interviews to Press reporters. The first of these appeared in yesterday's "Daily Telegraph," which stated that Miss M. R. Wickham, Matron of Hampstead General Hospital for nine years, said it was untrue to say that John Kitson had no medical attention for six hours. She said:A fully qualified doctor saw him almost immediately on his coming in.Of course, it is customary that any patient coming in as an emergency case to a hospital is seen by the casualty officer at the time. I think that rather a quibble, considering that the boy received no other medical attention for the next six and a half hours. The matron goes on to give a certain explanation, and says:After he had been X-rayed we had to have a specialist to do the operation. There was a delay while one arrived from another hospital in the group, as ours was not available.The parent hospital of this group is a matter of a quarter-of-an-hour away by motor car from the Hampstead General Hospital. It seems to me very curious that six and a half hours elapsed while a doctor was found to do the operation, or to 1739 set the arm. The matron went on to say to this reporter that it was wrong to give a patient food before an anaesthetic. If a child were given a sedative beforehand, an anaesthetic might knock the child over.
These are medical matters about which I do not feel qualified to argue, but the point is that these excuses were not put forward by the Minister, and I have no doubt at all that the Minister made full inquiries before giving his reply in the House and in a letter to me. The matron concluded by saying that she had not heard of anybody at the hospital being reprimanded.
That was bad enough; but in today's "Daily Express" there is some more information about this matter. It is announced that the Board of Governors controlling Hampstead General Hospital has ordered an investigation into the case. I should have thought it not unreasonable to suppose that a full investigation had taken place during the two or three weeks between my getting in touch with the Minister and his sending me his reply. The matron repeats that:The boy was kept waiting for six hours because it had been impossible to get a specialist to the hospital sooner.She goes on to say:He was not offered food, or a sedative, because we knew he was to have an anaesthetic …She then says:We have always prided ourselves that we stood high in the public regard. Now we cannot but feel that we have been maligned in such a way that much of our good work has been undone.I have only one comment to make about that. In the course of today I have had two further cases of alleged negligence on the part of the staff at Hampstead General Hospital and the Royal Free Hospital. In one of them I asked my informant to write down the particulars, which I said I would send to the Minister. The other case is one in which the administrative officer of the hospital has already admitted complete responsibility, and sent a most sincere apology.
One other thing the matron said: that the Minister of Health had been "unfair" to her staff. I do not wish to generalise about matrons. I share the very great respect that the House and the country has for the nursing profession; a very 1740 deep respect and sense of gratitude. At the same time, it seems to me that on occasions, when some members of the nursing profession reach the higher ranks of their profession, they are, in a sense, rather resentful of criticism of any kind. They have positions of great responsibility and also of very great authority, and on the shoulders of some of them, it seems to me, the mantle of authority does not sit very comfortably. I can only think that this is one of those cases.
The matron of this hospital has, in effect, repudiated the Minister's admission on behalf of the Board of Governors of responsibility for this negligence. She has repudiated his apology to my constituent, and I felt that the matter could not be left there. I am very grateful to the Minister for being present today and I hope that he will be able to give the House his comments on this very unhappy affair.
§ 5.58 p.m.
§ The Minister of Health (Mr. Iain Macleod)
It may be convenient to the House if I intervene at this moment, first, to deal straight away with the matters raised by the hon. Member for St. Pancras, North (Mr. K. Robinson) and, secondly, to deal with one or two wider issues raised by the right hon. Member for Fulham, West (Dr. Summerskill) in her opening speech.
In the case of John Kitson and the Hampstead General Hospital, I am, if I may say so, grateful for the way in which the hon. Member for St. Pancras, North put his case. Again, if I may say so, not only was he wholly right to raise it in the first place but, in view of the statements which have been made, he was wholly right to raise it again on the Second Reading of this Bill, because this is exactly what this sort of Bill is for—to enable hon. Members to discuss grievances. I, like the hon. Member, had hoped that with the very full apology which I made on behalf of the board of governors and, in particular, on behalf of the Hampstead General Hospital, the matter had been closed.
The hon. Member raises two points. First, he asks why it is necessary to have any further inquiry and, secondly, he refers to the comments made by the matron. I think that the first point is fairly easy to dispose of. The reprimand to which I referred, and which has 1741 already been given, was given by the officers concerned to the person responsible, but when the board met a day or so ago it decided that there might be a flaw in the whole of the arrangements within the group, and it therefore set up a small sub-committee to consider the question in the light of what I might call the Kitson case. I do not think, therefore, that there is any inconsistency in the fact that there have been two inquiries.
The second point is the more serious one. I was considerably startled when I read, in my morning newspapers, the comments which the matron had made upon this case. Incidentally, there was one comment which the hon. Member did not quote—I do not know whether he has seen it in the newspapers—which was a good deal more serious than either of the two which he has given to the House this afternoon. The position is that the answer I gave was given after consultation with the board of governors, and it had the agreement and encouragement of the people responsible. In response to a supplementary question, I said that the only thing I liked about this case was that the hospital had said at once that it was at fault here—and I very genuinely mean that.
I receive very many complaints from Members of Parliament and others, and it is necessary to make investigations at different hospitals throughout the country. From time to time one gets the impression that the people concerned are a little reluctant to admit that they were in error—because they think that that may reflect upon a hospital of which they are rightly proud. In my view, that is a wrong attitude. If such inquiries are made, and a fault is found, nothing does a hospital more credit than to say at once that it is wrong, and it is right that an explanation should be given frankly to the House by the Minister responsible—as was done by me in this case.
We all know perfectly well that if millions of people use—as they do—the National Health Service as out-patients, it is only natural that something should go wrong from time to time, but when it does go wrong, and if it is serious enough to be brought to the attention of Parliament, I think that all concerned should say so frankly and at once. Because a hospital has slipped in one particular instance, it does not mean that 1742 it is not a fine hospital, with long traditions, as I am quite certain is the case here.
There is one other thing which I should like to say before commenting upon what I understand the matron to have said. We all very much admire the quality of loyalty, and we all, very naturally, flare up at once in response to an attack which is made upon those for whom we have a certain responsibility. One can very easily understand a matron who is very proud of her hospital and of the people who work in it resenting, perhaps a little too quickly, any suggestion that that hospital has slipped in its duty. We all understand the attitude of mind that makes an instinctive response and defence to such a suggestion.
Having said all those things, however, I would add that what was said was unwise and unfortunate; it should not have been said, and I am quite certain that the matron in question very much regrets having made an allegation—as I understand she did—not only against the hon. Member who laid the information, but against myself, who accepted that charge and apologised on behalf of the hospital. The answer I gave to the hon. Member stands. It was given to me upon information which I have checked, and believe to be wholly accurate, and the apology which I have given to the Kitson parents on behalf of John will, I hope, do something to take away the unhappy memory of the hours that the boy spent at that hospital. I am most grateful to the hon. Member for raising the matter in the way that he has.
There is one other matter which I should mention, since both protagonists—or perhaps, according to a correspondent of "The Times," I should call them "deuteragonists "—are present, namely, the question of prescribing. We have had a considerable to-ing and fro-ing about the exact position in regard to a drug which is not considered of proven therapeutic value. The right hon. Member for Llanelly (Mr. J. Griffiths) said that I had written to him saying that the drug had been banned. I said that the position was that the drug is not banned; doctors are advised not to prescribe it, but if, in their own discretion, they still think that it is right so to do, that is a matter entirely for them.
1743 In the end, I thought that the only thing to do was to send for the letter in question to the right hon. Gentleman, because the right hon. Lady the Member for Fulham, West (Dr. Summerskill) had a lot of fun about this matter, and she was entirely wrong from beginning to end. Perhaps I may quote a sentence or two from the letter, to make the position clear. It is dated 17th February, and refers to the prescribing of a certain proprietary medicine for asthma. In it, I say:I am advised that"—this medicine—"which is a proprietary medicine, is not therapeutically superior to the standard preparation … On the other hand, it is much more expensive and, believing as I do that doctors would not wish the funds available for the Health Service to be spent unnecessarily, I have asked them not to prescribe it. I cannot prohibit them from doing so, and while I hope doctors generally will comply with my request, I am sure they quite understand they are still free to prescribe whatever they think necessary in the individual case.I hope that that makes the matter quite clear, because it is rather important. Upon the advice of the Cohen Committee, from time to time it is suggested to doctors that they should not prescribe a certain drug, but I do not interfere in any way—and I would regard it improper to do so—with the clinical freedom of doctors, if they so wish, to prescribe a particular drug in relation to a particular patient.
§ Mr. J. Griffiths
I am grateful to the right hon. Gentleman for sending the letter to me. I charged my memory, and my memory was at fault. I express my regrets—I say that quite frankly. This man had been given this drug; he thought that it was a very good thing, and he had very great faith in it. I understood that it had been stopped. I believe that I sent the Minister's letter to him. If I used the word "banned," I withdraw it, because it is not the right word. I understood the Minister to say that he advised against the use of the drug.
I have only one question to ask him. Is it completely within the discretion of doctors to continue to prescribe these things? Is there any question of their being charged, or questioned about it afterwards? Questions are sometimes asked about these matters, and it would be an advantage to know what is the actual position.
§ Mr. Macleod
I accept straight away what the right hon. Gentleman says. He and I have crossed swords many times, and if his guard slipped, as no doubt mine has done on some occasions, I understand.
If a doctor chooses—I will not say to ignore—to go against advice that is given him, that is quite all right. He would not be surcharged for that. It is possible—and this is a different point—that his prescribing as a whole might be looked at, and one element might be the over-prescribing of one particular drug. The answer to the right hon. Member for Llanelly is that it is wholly and entirely within a doctor's discretion to prescribe a particular drug even though it has been suggested by the committee and by the Minister that, on the whole, it is advisable that that should not be done.
The difficulty I am in, as the right hon. Lady suggested—and I do not want to pursue the point because it is too difficult to go into—is that I do not see how we can achieve what she seemed to have in mind, which was related to the prescribing of the ordinary substances on the list without interfering with the ordinary clinical freedom of doctors. That is a dilemma which I understand, and which the right hon. Lady understands. I believe that the authorities are doing their best to find a solution. I would not wish in any way to interfere with the right of a doctor to prescribe at his discretion in individual cases.
§ Mr. Hale
My sympathies are entirely with the Minister on this point, and I am not rising to make any criticism. He will no doubt remember the case of byssinosis, for which a proprietory drug had been widely prescribed and had won a considerable reputation. My advice was that the drug was useless, and I wrote to the manufacturers and asked them to tell me why they said that the drug was good for byssinosis. Their reply was very unsatisfactory.
The right hon. Gentleman will also remember there was a great deal of agitation on the matter, particularly from Lancashire, and that even the textile unions wrote and said, "We have members who, for a number of years, have taken this drug and are deriving benefit from it, possibly because they think it does them good." That is the sort of 1745 thing that happens when people think a drug does them good. Even water may be beneficial, and may be one of the few things that help in these cases.
That is why I am wondering—I put this seriously to the right hon. Gentleman—whether, when he writes to doctors and says, "Do not prescribe this drug" he makes it clear that they can do so if they think fit. We ought to cut out things which we think are useless, but not from people who have had them for years and who might be deriving benefit from them in the way I have described. Let us cut them out from the new cases where no benefit can be derived.
§ Mr. Macleod
I entirely agree with the hon. Gentleman and, therefore, there is no great force in this point. It is made clear from the extract I have quoted that if a doctor chooses to prescribe that kind of drug for that sort of reason he would not be surcharged on that account.
The right hon. Lady had some gallant fun with some observations I made last night elsewhere—
§ Mr. Macleod
I am not in the least apologetic.
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 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.
§ Mr. Macleod
I recommend the right hon. Lady to read "United for Peace and Progress," which includes all the words which I have just mentioned. It is not a medical textbook either.
§ Mr. Macleod
The right hon. Lady referred to private beds as one of the positive proposals in the Labour Party's manifesto. It is worth mentioning what is the scale of this problem. About 1 per cent. of the beds in the National Health Service are private, and about a third of those at any given time are occupied by non-paying patients, either on grounds of medical urgency or to see that the beds are filled. Therefore, in this proposal, we are talking about two-thirds of 1 per cent. of the beds in the country. It is incredible that the party opposite cannot find anything to say about the other 99⅓ per cent. of the beds in the hospitals, but must concentrate its only practical proposal on two-thirds of 1 per cent.
The proposal itself is a breach of the pledged word of Socialist Ministers, which perhaps is not particularly important, and it is also a breach of faith with millions of people who paid into contributory schemes so that they might have a certain amount of privacy in hospital. I tell the Opposition quite frankly that I shall believe in this proposal when they practise what they preach and when I see members of their party, when they are ill, going into the public wards of our hospitals.
§ Mr. Somerville Hastings (Barking)
Does the Minister realise that for every bed used by a private patient there is another bed in another hospital kept empty waiting for another private patient?
§ Mr. Macleod
The occupancy figures which I have, and which we can go into if hon. Members wish, do not bear out that statement at all. For reasons which the hon. Member knows very well, the occupancy rate of private beds over the whole country is lower than for the public beds. That is reasonable, because over the whole country there are one or two private beds in each hospital, and if there is a shortage of staff those beds are closed.
The right hon. Lady raised questions about prescriptions and charges, and gave figures relating to the very large proportion devoted to proprietary medicines. The total bill for England and Wales in 1747 this matter is about £43 million, not including hospitals and within that sum £24 million or a little more than half is due to proprietary medicines. I am dealing with cost alone. The non-proprietary prescriptions would be more than half in number because the others are more expensive.
Many of the very greatest discoveries have been made by private firms and are, in fact, proprietary medicines. We all know of these successes, among which the antibiotics are the obvious example. It is also true that the pharmaceutical industry have a very important export trade. I am in close touch with the Association of British Pharmaceutical Industry and we have been working out formulas which will enable us to arrive at a satisfactory guide to what profits may be suitable in this field.
I have two more points of great importance which the right hon. Lady mentioned, and on which I wish to say a word or two. The first is dental treatment. She talked about the change in the pattern of dental treatment, which has taken place partly as a result of the charges introduced by the party opposite. The important fact is that conservative treatments, which do not require approval from the Dental Estimates Board at Eastbourne, have gone up from 4,670,000 in 1951 to 5,800,000 in 1954. That is a most encouraging and a most satisfactory increase, which is a direct result of the charges that have been imposed.
Secondly, in the school dental service the numbers, which had fallen at the end of 1951 to 713, had risen at the end of last year to 979, and the dental treatment of the priority classes is a great deal better than it has ever been. So far as remuneration is concerned, as the House knows, I have recently restored the 10 per cent. cut which was made a few years ago and I am engaged in discussing with the profession a new scale of fees.
§ Dr. Summerskill
Before he leaves that aspect, would the right hon. Gentleman answer the question on regional distribution of dental trouble?
§ Mr. Macleod
I do not know that I have any particular figures, but I would not necessarily quarrel with what the right hon. Lady said. It may well be that there were conditions of dental treatment 1748 which would mean that certain areas would be more grievously affected by the charges which were introduced, because there they had been doing a higher percentage of denture work than is normal in other parts.
The right hon. Lady referred to mental beds. The real problem is how big the waiting list is and to what extent we are getting on top of it. The mental hospitals have no waiting list; either someone goes straight in on certification or goes in as a voluntary patient, but in any case there is no waiting list there. The beds that are being provided, which number 3,500 in the pipeline—if one might call it so—are a contribution essentially to the problem of overcrowding.
The mental deficiency side can be put more clearly. There is there a waiting list of about 7,000. The beds that we have available in the pipeline, either completed or nearly complete, come to 5,967 and there are also 945 beds in the 1953–54 programme, not all of which can be actually occupied now. We have, therefore, a programme of at least 6,000 beds as against a waiting list of something like 7,000. That is not the end of the story because, as the House will know, we have recently announced a very substantial hospital building programme and the mental deficiency side will get its full share of that.
To say that the problem is conquered would be far too big a claim to make—I believe that no Minister will be able to make it for many years—but at least our plans measure up to the size of the problem and, when, in conjunction with the regional boards, all these schemes swing into action I think that the problem will diminish greatly from the serious one which it represents at present.
I have tried to deal with some of the very wide-ranging points mentioned by the right hon. Lady in her survey at the beginning of the debate. This is not perhaps an occasion for a full-dress health debate but this, at least, I think we can say: that the health of the people, by whatever standard it is judged, has never been better than it is at present, and that the true indices of health—tuberculosis, infant and maternal mortality, and so on—are standing at record low figures. We can all reasonably hope—this not a political matter—that whatever party is in power those things will go on. The 1749 National Health Service is something of which we are all extremely proud and I think that in the years to come we can look forward to its continued progress.
§ 6.25 p.m.
§ Mr. H. A. Marquand (Middlesbrough, East)
The right hon. Gentleman has referred to what he thought were grave omissions in the short document which the Labour Party has put forward for the next Election. In particular, he was surprised that we said nothing about hospital buildings. I wondered why he did not go on to give a vote of thanks to this side for all the pressure which we put upon him—no doubt he was very glad indeed to have that pressure—to increase the rate of hospital building. It eventually led to the Chancellor of the Exchequer giving way.
It is true that our document is very short, but we shall have a lot more to say on this subject in the course of the Election. In particular, we may point out that the allocation for hospital building in the present year is £10 million. The right hon. Gentleman himself told me quite recently, in answer to a Question, that to provide what I provided for £9 million in 1950–51 he would need £12 million today. At present, therefore, the rate of building—certainly the rate of allocation and almost certainly the rate of building—is lower than it was then.
He referred to the resolution, now incorporated in the manifesto, passed by the Labour Party Conference, for the abolition of pay-beds. Surely he must know that that resolution arose from the mounting indignation throughout the country caused by the feeling that from time to time these beds were being held back for the benefit of individual practitioners when they might have been used. We have never said that we were against amenity beds.
It may well be that a large number of the private beds there are at present will, because they are in single rooms, become amenity beds and some charge will be made. They will be available and the charge will be imposed simply because of the special amenity they provide. It is true that certain undertakings were given about this in times past. We are now serving public notice of the termination of that agreement and asking the electorate to approve it.
1750 I do not wish to pursue the debate on specifically health questions. I had the honour, from July, 1948, to October, 1951, to be, first of all, Minister of Pensions, and then Minister of Health, and if I may I should like to draw attention for a short time to an aspect of the social services which is concerned with the Ministry of Pensions, the National Assistance Board and the Ministry of Health. I refer to welfare. Perhaps I may be permitted to illustrate what I want to say by a true story.
In my constituency there is a young man who was born crippled, and who reached the age of 30 just about the time when my right hon. Friend's legislation, the National Assistance Act, 1948, was put on the Statute Book. Until then that young man had rarely, if ever, left his house, had never been able to do any work at all, and was a source of constant anxiety to his parents who, of course, were growing older all the time. The father was a railwayman and was shortly to go on a railwayman's small pension. They were wondering anxiously what was to happen to their son when they died.
At that moment, in came the National Assistance Act, and for the first time in his life the lad became entitled to assistance in his own right. For the first time, he had an income of his own.
§ Mr. Marquand
As my right hon. Friend says, without a means test at all. The old family means test was done away with.
Very shortly after that—and this is what I mean by welfare—it became possible to provide the young man with an invalid tricycle and, for the first time, he was able to go abroad on his own as an independent person and not be carried about by someone else. He was able to go where he wished and pursue what activities appealed to him, instead of always being taken by his parents as if he were still a baby. To cap the story, after getting an invalid tricycle he was able to take a job and go to work.
I tell that story to illustrate the point I wish to emphasise, that the mere provision of adequate sums of money—and we have heard a lot this afternoon about adequate sums of money in the form of National Assistance, old-age pensions and the like—is only a foundation for welfare.
1751 for a complete life as a civilised human being. When a person becomes dependent upon one or other of these social benefits, whether it be the retirement pension, industrial injury benefit, National Assistance, war pension or whatever it may be, not only does that person become all too often a victim of loneliness, depression, pain, worry and a sense of insecurity, but his family also becomes affected.
How many of us when talking to our constituents have not been struck by the fact that again and again not only is the individual in difficulty but there is a whole background of family difficulty? In nine cases out of 10 I would say that when these people come to see us about their pensions and allowances, if we ask the right sympathetic questions we discover that there is a family problem.
I am not suggesting—I do not believe it—that it is the business of the State to interfere in family affairs. Far from it. I must not be misunderstood about that. There are, however, occasions when, if it works properly, the State—the Government or the community acting through the State—can help to rehabilitate and build up the family. It was largely because of that sort of consideration that I initiated the Welfare Service when I was Minister of Pensions. The welfare officers became the friends and advisers of the war pensioner and the war pensioner's family. For the first time they frequently initiated claims on the Department.
I will not go into the details of the long past history of this matter. I do not want to make cheap political points. But there was a bad history of the issue of instructions to officers that they should never do anything which might initiate a claim. Now all that was changed. A welfare officer might suggest to a man that he may be eligible for an unemploy-ability allowance, or for an allowance for a lowered state of occupation, or that he might get some help from the Assistance Board for his daughter and so on.
The welfare officers then began to take a sympathetic and friendly interest in the circumstances of the pensioner not only as a disabled man but as a whole man. To do that, they had to become coordinators. They had to get in touch with all kinds of agencies in this field of social service. Meetings were arranged 1752 throughout the country—I spoke at one or two myself, and the Permanent Secretary spoke at a great many others—bringing all the Departments together, so that when cases of this kind arose, the whole apparatus of government could be brought to bear and every aspect of the family circumstances could be considered at once and not in separate pieces.
I should like to know whether those co-ordinating meetings still take place, whether there still is machinery for associating together for common consideration those circumstances in which more than one of the social service Departments are involved in a case. If that machinery does not exist, it should do. There have been one or two instances which have raised some doubt in my mind, whether those meetings are going on, and I should like to know.
We instituted also the homecraft service, after the Welfare Service had developed for some time, to give a better and fuller life to the bedfast disabled men tied to their own homes. That was a great success, as well as the Welfare Service. In fact, it was an outstanding success, as I am sure everyone will agree. If it has been a success since the merger of the functions of the Minister of Pensions and the Minister of National Insurance, has it been extended to industrial injuries? If not, why not?
The Welfare Service has proved its value, and to a considerable extent it may already have done its job for the war disabled, and, therefore, there may be fewer calls upon the services of the war pensions welfare officers than there used to be. They are trained men, for a course of training was provided for these people. I would switch some of them to the service of the industrially injured. This is a voluntary service, but it is also a personal, human and flexible service, and it concentrates on rehabilitation and restoring the individual as far as possible to the normal life of the community, which is what all such injured people want above anything else.
There are numerous welfare services operated by the local authorities—not merely the maternity and child welfare service, but services for the aged, the disabled and the mentally afflicted. I should like to see a much closer co-ordination between those local authority services, the 1753 voluntary associations and the services of the welfare officers of the Ministry of Pensions and National Insurance than seems to apply at present.
The local authorities should take the lead in this matter, and we should encourage them to be the local coordinators, the local initiators of proper case study of difficult family circumstances. Every local authority ought to have a full-time welfare officer of its own, and ought not to rely solely on the voluntary associations, although I make no criticism of voluntary associations. There is immense power in the work of volunteers and good neighbours.
May I refer briefly to two of the local authority welfare services in particular? First, I want to refer to chiropody for aged people. At first sight, to those who have not appreciated its significance this might appear to be a sort of luxury service. It is nothing of the kind. It is not a frill. I have discussed this matter in different parts of the country with more than one medical officer of health, in particular with the Medical Officer of Health for Middlesbrough, who is specially interested in it.
They all assure me that there are many aged retirement pensioners or people living on National Assistance who are kept at home, perhaps constantly but certainly far more than they ought to be, because they lack attention to their feet. Because of deformity or perhaps because of corns on their feet, they are unable to walk about properly or even to look after themselves and to walk from the kitchen to the pantry or the sitting room, still less to walk out in the street. Yet they could be made fit.
The disquieting factor about this is that in Scotland these grants are made. The Secretary of State for Scotland provides grants for local authorities for this purpose. It is explained in page 70 of the Report of the Department of Health for Scotland for 1953 that the Secretary of State has helped by grants the provision by local authorities of this kind of service. In England and Wales there is no help at all from the State. Local authorities can assist voluntary organisations if they wish to do so, but they get no grant for the purpose—and they want a grant. This is something for which they are reasonably asking. It is a 1754 service which would cost comparatively little and which would yield an immense amount in improved human welfare. I think it ought to be done.
The Minister of Health has told us that he knows of higher priorities than this. That is possibly so, but hardly a higher priority for the same price, for the cost of this service would be very low indeed. It could easily have been included in the Health Service Estimates this time, especially when there was a large Budget surplus and when so much of it was given away to people who did not need it.
Lastly, I want to refer to the other end of the age scale—to the children. The children have suffered because of certain actions of the present Government. By permitting, once again, full freedom, as they love to call it, to certain manufacturers, the Government have lowered the nutritional standards of a great deal of the bread now sold in this country. The Report of the Ministry of Health on The State of the Public Health for the year 1953 says, on page 149,that the nutritive value of such 'reinforced' low extraction flournow permitted by the present Governmentis inferior to that of 80 per cent. flour to the extent of the nutritive value of the other nine or ten factors.The wording is very cautious, as one would expect, but, reading between the lines, it is obvious that the Chief Medical Officer is distressed at the fact that this un-nutritive bread is now available for people. If that is so, and if it is necessary for one reason or another to have this bread, then it is all the more necessary to develop the use of the welfare foods.
Here, I admit, we are faced with a problem. When I was Minister of Health the consumption of the welfare foods was beginning to decline. My advisers were worried about it and efforts were made by the Ministry of Food, then in charge of the welfare foods, to popularise their use. Many hon. Members, I am sure, had their photographs taken at the Ministry of Food looking at pictures of bonny babies from their own constituencies, and they gave their aid to the propaganda for extending the use of the welfare foods. Admittedly, an educational job has to be done in persuading 1755 mothers to use these foods. I suggest that the need for the foods is even greater now that we have this wretched white bread available again instead of the bread containing the nutritive properties of the germ of the flour.
If the Minister of Health were here, I should apologise to him for not having been in my place on Monday when I had a Question on the Order Paper on this subject. I was detained elsewhere, a fact which I had not foreseen when I put down the Question. The figures which the right hon. Gentleman gave me are printed in Monday's HANSARD in col. 90 and they show that, comparing the six-monthly periods July to December, 1953, and July to December, 1954, the consumption of dried milk is one-tenth less than it was, the consumption of cod liver oil is one-sixth less than it was, the consumption of vitamins A and D is one-fifth less than it was and the consumption of orange juice is one-seventh less than it was.
These figures are significant, because the six months July to December, 1954, are the months during which the local authorities have had responsibility for this service. When the Ministry of Food was amalgamated with the Ministry of Agriculture and Fisheries, this service, not unreasonably—I do not complain of that—was handed over to the local authorities. I do not say for a moment that that is a mistaken policy. What I say is that the result is very disappointing and that it is not sufficient for the right hon. Gentleman to say, as he said in that answer, thatthe Department will maintain a close watch on developments."—[OFFICIAL REPORT, 2nd May, 1955; Vol. 540, c. 90.]He should do a great deal more than watch. He should not imitate the President of the Board of Trade, who is always watching something or other but never doing anything about it. The Minister should get into action and urge the local authorities to get into action.
I promise him that when we are returned to power, next month, we will urge the local authorities to go into action and we will take action ourselves. We will take over the whole of the hospital building programme which the right hon. Gentleman has put forward and we will improve upon it.
§ 6.48 p.m.
§ Captain Richard Pilkington (Poole)
The right hon. Member for Middlesbrough, East (Mr. Marquand) began and ended his speech on a note of party politics which, if I may say so, was absent from the intervening part of his speech. He was responsible for one immense error of fact in his closing sentence when he said that his party would be returned to power in a month's time.
§ Captain Pilkington
I think the British electorate will be proved right and will vote the right way.
The right hon. Gentleman ended his remarks on a partisan note by saying that under the present Conservative regime the children's health was deteriorating. I defy him to show any evidence whatsoever of that. The reason which he produced for it was that the quality of bread had deteriorated. May it not be that the general level of food under this Government has more than counteracted any change in bread?
§ Mr. Marquand
If I said the children's health was deteriorating, I certainly did not mean to say it. I meant that there was a danger of it deteriorating—and I think that is what I said—if the welfare foods were not maintained.
§ Captain Pilkington
If the right hon. Gentleman said that, then I slightly misunderstood him. He can rest assured that the improvement in nutrition generally in this country will look after the health of the children.
The right hon. Gentleman added to the many claims which the Labour Party have made in the debate on what they have done for the social services. He said that it was the arguments used by the Labour Party which induced the present Government to build the hospitals. If it were the influence of the Labour Party which induced this Government to build the hospitals, why was it that the Labour Party built no new hospitals while they were in power for six years? It certainly could not be because they were building the very necessary houses.
I suppose it is inevitable in a debate on the social services that both sides 1757 of the House will lay claim to having done the most for the wellbeing of the people of this country, but in this debate I did not notice one claim which is habitually made by hon. Members opposite, the claim that they were responsible for the creation of what today is called the Welfare State. That claim has not been made in this debate, but I see that it is made in the Election manifesto put out by the party opposite. It says that it was the Labour Government after the war thatbegan to abolish the fear of old age, sickness and disablement.
§ Captain Pilkington
They know that that is completely misleading and was put into the manifesto merely to try to get a few extra votes. As hon. Members opposite know, all parties have been responsible for the building of the Welfare State over the greater part of this century. Hon. Members opposite also know that the main pillars of that Welfare State as it exists today were erected not by themselves but by other parties—
§ Captain Pilkington
The hon. Member keeps interrupting whilst still seated. If he wants to interrupt, I will give way to him. Hon. Members opposite know that the main pillars of the Welfare State were erected by parties other than their own. The payment of family allowances, insurance for unemployment, sickness or injury, pensions for widows, orphans and old age, were all inaugurated by parties other than the Labour Party, and not least by the Conservative Party. The Labour Government's Acts of 1946 attempted to put into effect principles which were decided upon by the Coalition Government. Those Acts were essentially Acts of extension and co-ordination, but were in no way the creation of what today is called the Welfare State.
Personally I think it a good thing that all parties should have had something to do with the moulding of the Welfare State. In a way, I think it is a pity that it is so much a part of party politics, but no doubt that is inevitable. The great 1758 problem of the future of the Welfare State is the strain it is putting on national resources. Its justification can only be if it acts not as a burden but as a stimulant to the nation as a whole. If by relieving anxiety, worry and hardship in families, it can enable individuals to increase the general level of productivity, if it can create goods which can be sold at a profit abroad and so draw into this country greater wealth, then and then only can the Welfare State be maintained and the general level of the standard of living continually improved. That is what we all hope will happen.
Though the Welfare State must be a stimulant, that in itself is not sufficient to make certain that the State is going to survive; we must also have a strong and sound economy. It was there that our predecessors, the Labour Government, fell down, because in those six years when they were in power they were concentrating on such things as nationalisation and were having periodic crises. All that had the effect of weakening the Welfare State which they had done a certain amount to bring into effective working order by their Acts of 1946. During those six years, because of the weakness of our economy, we saw the benefits which were being paid and the pensions decreasing in value to the extent of more than 5s. in the £. We saw also that because of the weakening of our general economy right hon. Members opposite were impelled to institute various charges in the working of the National Health scheme.
Today our economy is immensely stronger than it was in those six years. Provided that we can keep it stronger when we are returned after 26th May, we can go on bringing about improvements of the type which we have already shown in the three years in which we have been responsible—increases in assistance, in benefits, in pensions and improvements in the various health services. On the other hand, in the unlikely event of hon. Members opposite being returned—although they say that is a likely happening—'they tell us in their manifesto that they would abolish the charges. No doubt they have some right to do that as, largely, it was they who initiated those charges. They say they 1759 would set up a new Ministry, perhaps in the belief that a rose by any other name would smell sweeter.
§ Captain Pilkington
No "sweeter" in this connection. They say they would vary the benefits according to the cost of living; they say they would increase National Assistance, but they do not give any hint of how much all this would cost the taxpayer. They do not give any figure. They fail to give a figure at a time when, according to them, this country is being threatened by the approach of another economic crisis.
§ Captain Pilkington
The right hon. Member presumably put his signature and gave his full backing to this manifesto, which includes, among other things I have listed, varying the amount of pension and benefit to be paid according to the cost of living, but he is on record as having stated a very different view.
§ Mr. Griffiths
Since the hon. and gallant Member is referring to the manifesto, I should point out that we do not use the term "automatic." Perhaps he will read the document.
§ Captain Pilkington
The manifesto says:we shall institute an annual review, and in any year in which there has been an increase in the cost of living, the scale of payments will be increased accordingly.On the other hand, this is what the right hon. Member said nine years ago—I quote from HANSARD of 6th February, 1946:We are definitely of the view that it is undesirable, as well as impracticable, to have automatic adjustment. This method of pegging benefits to a specific cost of living and adjusting them automatically was tried at the end of the last war in war pensions, and broke down the first time it came to be applied. We are convinced, after examination, that it will break down again."—[OFFICIAL REPORT, 6th February, 1946; Vol. 418, c. 1741.]
§ Dr. Summerskill
Does the hon. and gallant Member recall what the Conservative Party stated many years ago that a 5s. pension would destroy the moral fibre of the workers?
§ Captain Pilkington
I do not know what reference the right hon. Lady is making, but I am quoting what was said by her right hon. Friend. Perhaps he has changed his mind in those nine years. If so, it would be very interesting to see whether he was right nine years ago, or is right today.
§ Mr. Griffiths
The hon. and gallant Member will of course have noticed, as I asked him to read the manifesto, that what we say in the manifesto is rather different from the problem with which I was dealing in the speech to which he has referred. That is why I asked him to read the manifesto.
§ Captain Pilkington
There may be some extremely subtle difference, but I should have thought that to anybody reading this with an unbiased mind the two things tied up precisely. However, the right hon. Gentleman will no doubt explain to the electors where they differ.
So much for what the Labour Party undertakes to do, with no hint as to what this will cost the taxpayer. On the Conservative side, we say that we will carry on, as and when we can, the improvements which we have been putting into effect over these last three years. And in view of the record of those last three years, I believe that the majority of people will certainly consider that Conservative deeds are very much better than Socialist election promises.
§ Mr. J. A. Sparks (Acton)
The hon. and gallant Member said just now that in six years the Socialist Government had not constructed a single hospital. His information must be entirely wrong, because these are the figures which his right hon. Friend the Minister of Health gave to me the other day. In the last year of the Labour Government £6,416,000 was spent on new hospital accommodation and extensions. In the next year, under the hon. and gallant Member's Government, expenditure went down to £4,549,000. In the following year it was only £5,371,000, and last year it came up roughly to the level of the last year of the Labour Government at £6,539,000.
Will the hon. and gallant Member permit me also to correct his arithmetic in regard to health centres? In the last year of the Labour Government one new health centre was erected. In 1952 three 1761 were built as a result of schemes approved in the previous year. But in 1953 there were none, and in 1954 there was only one; and I do not think that there are any in the present year. I hope that the hon. and gallant Member will accept these figures, because they come from his right hon. Friend.
§ Captain Pilkington
I accept the figures as the hon. Member has given them, but he quotes them against me in connection with words I did not use. I have said nothing in my speech about health centres. I did say that no hospitals had been built. Although there have been hospital extensions under both the Labour and Conservative Governments, I think I am right in saying that no new hospital was built under the Labour Government. If I am wrong I am open to correction, but I believe that that is the case.
If we are permitted to carry on the work which we have been doing, what are the points in the social services at which we would like to see improvements, provided always that we have a growing economic strength? Hon. Members have from time to time given instances of improvements which they think should be made. All hon. Members know from their postbag some of the things which worry their constituents. My right hon. Friend will be familiar with those points and with the problems and difficulties which hedge them round about. There are some half dozen points which I will list briefly in respect of which it seems to me, from the painful experience very often of my own constituents, that improvements can and should be made as soon as possible.
My first suggestion concerns the level of the earnings rule in connection with retirement pensions. If any improvement could be made in this, it would be an excellent thing. Secondly, there is the case, which has been much discussed in the House already, of the 10s. widow. Thirdly, there is the level of public service pensions. I have in mind particularly the case, which has also been raised in the House of retired officers, together with Service pensioners and civil servants. The people who depend upon these pensions have not had them increased in the way that other pensions have been increased.
Fourthly, there are the people who live on small fixed incomes. I had a pathetic letter the other day from an old lady aged 86, who refers to 1762poor elderly ladies now struggling along spending our small capital all the time and fearful of what will happen should we live much longer.My fifth point is that it is felt by some people that contributors to friendly societies in the past do not receive the same dental benefits under the National Health scheme as they received under the old arrangements. In some cases there is very bitter feeling. My sixth and final point is that a National Health Service patient should not have to pay another National Health Service doctor if his own National Health Service doctor is unavailable.
Those suggestions affect individuals who are not sharing, or are only inadequately sharing, in the general benefits which today help the great majority of people. But in spite of cases of that kind, it is surely undeniable that there is, and has been, under this Government an upward trend in the circumstances of the poorer section of our people. That has been brought out recently by two statements which have been made in the House.
My right hon. Friend the Minister of Pensions and National Insurance referred in his speech to the figures of people in receipt of National Insurance. He gave those figures in reply to a Question of mine on 2nd May. They presented a picture showing how very much smaller has been the increase in the number of people receiving National Insurance in recent years.
§ Captain Pilkington
I beg pardon; I meant National Assistance. I would express the position somewhat differently, in this way: from 1948 to 1952 the average increase in the number of people on National Assistance was 164,000, but in 1953 the number fell to 95,000, and in 1954 it fell again to 35,000.
The second statement which was made in the House and which shows the upward trend of the poorer section of the people was also given in reply to a Question, when my right hon. Friend the Chancellor of the Exchequer stated categorically that those who were receiving less than £10 a week income had had, thanks to the Budgets which my right hon. Friend had introduced, a 50 per cent. improvement in the benefits which 1763 they have been given. Taking all those facts into account and thinking back to the speech of the right hon. Lady the Member for Fulham, West (Dr. Summerskill), who began this debate, and remembering some of the adjectives which she thought fit to use about the attitude of the Conservative Party—that it was indifferent to the welfare of the old and was callous and niggardly in its attitude—one sees from the facts how completely partisan are the sort of adjectives which the right hon. Lady used.
§ Dr. Summerskill
Has the hon. Member had any letters from his constituents who are living on National Assistance? Did they agree with what he has said or with what I said?
§ Captain Pilkington
I have had many letters from them. I have no hesitation in saying that they would agree that the case as I have presented it is a far fairer presentation than that put forward by the right hon. Lady in opening the debate. In view of all this, and with the continued expansion of the country's prosperity, I believe there will be no doubt that the people will see that a Conservative Government are once again returned on 26th May.
§ 7.9 p.m.
§ Mr. Tom Brown (Ince)
I am sure that the hon. and gallant Member for Poole (Captain Pilkington) will forgive me if I do not follow him in all the points that he has put forward. I can, however, agree with one or two of the six suggestions which he has made. In this debate, we are not so very much concerned about who was the architect or parent of what has come to be known as the Welfare State. What we are concerned about today is how we can improve the furnishings and trimmings of the State which we have built up, and make it possible for people to live decent lives.
I want to say a few words about what the Minister said about the work done by the National Assistance officers and the National Assistance Board. He gave the impression that we on this side of the House failed to appreciate the services of the Board. We have praised its officers when they have done their work. We have expressed our appreciation of the services which they have rendered, but let 1764 it not be thought that they are all alike throughout the country. Here and there we come up against some National Assistance officers who do not approach the case of old people quite as humanely as they ought to do. I pay my tribute to the main body of the National Assistance officers, but I must say, as we say in Lancashire, that there are one or two of them who are "devil up back." They do not treat our old people as they ought to be treated.
I will say, however, that they would go a lot further than they are allowed to do if the regulations permitted them to do so, because they come across some very sad cases which they find it very difficult to deal with to the satisfaction of their consciences. It must not go out from this House that we do not attach great importance to the work done by the National Assistance Board and its officers, but we welcome this opportunity of raising several points.
We had a debate in the House on 8th December when we dealt with the National Insurance Bill. On 20th December, we had another debate on the National Assistance regulations. On both occasions hon. Members on this side—and I think that I am safe in saying a number of hon. Members on the back benches opposite—made certain suggestions through the Minister to improve both the National Insurance Bill and the National Assistance regulations. I could mention many hon. Members on this side of the House who made the prophecy on that occasion that neither the National Insurance Bill, which we accepted on 8th December, nor the National Assistance regulations, which were accepted on 20th December, would meet the needs of the people they were designed to help.
Now we have an opportunity of analysing the effect of the National Insurance Bill and the National Assistance regulations. I have received a considerable amount of correspondence, not only from individuals, but from institutions, about the regulations. Today, I received an urgent letter from a powerful trade union. That union has been considering the effect of the regulations upon some of its older members, and it protests very strongly about the effect of the regulations.
I have said before, and I repeat, that one of the things in that Bill contains 1765 the seeds of industrial unrest, and it is the job of the Minister and his Department to prevent those seeds from germinating. We can only do that if he agrees to provide for these people a degree of contentment, if not satisfaction. I know that the Minister has said that he has had very few complaints about individual cases, but I would remind him of what I said in the speech which I made on 20th December:I want to ask the National Assistance Board, through the medium of the Minister of Pensions and National Insurance, why the disregards have been disregarded. The disregards allowed under the National Assistance scales since 1948 have never been changed.We have continued from time to time to increase the scales. We have increased the pension rates. The Labour Government were responsible for some increases and the present Government were responsible for others, but both have failed to increase the disregards. I said at that time:Last week, we were concerned with improving disability pensions and the rates for compensation for loss of faculties, and many increases were agreed upon in the Measure that was then passed. But when these people receive their increases, they will be worse off because of the fact that the disregards have remained unchanged."—[OFFICIAL REPORT, 20th December, 1954; Vol. 535, c. 2510.]In the light of experience, that prophecy, which was reiterated by some of my hon. and right hon. Friends on this side of the House, has proved to be true. Therefore, one of the things which the Minister can do immediately, without legislation, is to improve the disregards by bringing in Regulations. I know that to increase the basic pension would require legislation, but here is an opportunity for the Minister to give these people the full value of the increases in the pension of 7s. and 11s. which were provided a few days ago, on 25th April.
Who are the people who are suffering most because of the disregards being disregarded? We made mention of them during the debate on 20th December. I said then that it is the poorest of the poor who suffer as the result of there being no improvement in the disregards. Altogether, there are six categories. The supplementation of the non-contributory old-age pensions is one section, and they amount to 143,521. The retirement pensions or contributory old-age pensions total 948,893; the widow's or widowed 1766 mother's allowance, or widow's pension, 91,370. Those in receipt of sickness benefit—and there are many chronic cases, as I know from experience—total 105,190. Industrial injury or disablement benefit total 1,688, and those in receipt of unemployment benefit and forced to go to the National Assistance Board, total 23,120.
I mention these figures to show that it is the very poor who have been hit by the regulations which we accepted on 20th December. The Minister said that he had not received any complaints. I can tell him that I have received scores of complaints. Other hon. Members have received complaints. We have received scores of complaints from poor people who anticipated that on 25th April they would receive 7s. 6d. increase. Old married couples with old-age pensions anticipated that they would receive 11s. increase on their basic pension. What a delusion. Many of those people have experienced grave disappointment because the Government's promise to them about the value of their pensions has not been fulfilled.
I have a letter here from an organisation which has a membership approximating to 750,000, every one of whom is over 60, if a woman, over 65, if a man. I propose to quote this letter. This is what it says:The Government, in publicising their increase of 7s. 6d. for single pensioners and 11s. for married couples, raised the hope of those who were already in receipt of supplementary pensions so that there was bitter disappointment when it was found that at its best, the increase for single pensioners was only 2s. 6d. and for married couples only 4s. The people who receive supplementary pension are the lowest strata and living on the razor edge of poverty; they have had to prove their poverty, and, as you know, we did a lot of research work as to what the supplementary pensioner had left for food; you know the result, not only of our own work, but of others, that after essential costs had been met, the poor supplementary pensioner was left with less than 2s. 6d. a day for food; the increase of 2s. 6d. a week, means another 4d. a day, which is a scandalous state of affairs.I am quite sure that, were it not for help by relatives and neighbours, many of these poor folk would have to die. I find that many of these people cannot realise that they are not to have the increase promised, and they come to me every day, bringing their books with them; it is pitiful to have to explain that notwithstanding the Government's promise, they will not get any more than 2s. 6d.That is not a letter for which I asked. It is not a letter with which I have had 1767 anything to do. It comes from a man who is well respected throughout the country for his work on behalf of old folk. It came to me this morning. Whether the writer knew that this debate was to take place, I do not know. If this were the only such letter there would not, perhaps, be much justification for my reading it, but I have here two or three letters from other organisations, all of which are very much concerned about the treatment of the pensioners by the Government and the way they have been manipulating the pensions.
We cannot get away from the fact that what the Government have done to the old people is to give to them with one hand and to take back with the other. I ask the Minister or the Parliamentary Secretary to deny that. It may be that some—but very few—are getting the full value of the increase, but many of them are not getting the full value of the increase which was promised by the Government, and that is our grouse.
I come to another matter: how the Department—and I say this despite the great respect I have for some of the civil servants—tries to intensify the anguish and the grief which these people experience. When notification is sent to these people informing them that their basic pension and their supplementary pension will not be increased—or not increased by such an amount as they had expected—as many as three or four letters are sent to one person and from the same office, signed by different people. Surely that ought not to be.
Here I have two letters from one office sent to one poor woman. One was sent on 15th April and the other on 19th April, and they tell her almost one and the same thing. The first letter opens the wound of despair, and then the officials pour into that wound not iodine but brine salt, aggravating the feelings of the pensioner, who knew very well from the first letter she would not receive the full increase. I ask the Minister to tell his officials that one letter for each person, if it is received, is sufficient to tell him or her that his or her economic status is to be reduced by the Government.
I know that there are several things which have been referred to the Advisory Committee. I want the Minister to refer 1768 to the Advisory Committee cases like this one I am about to describe. Some time ago the Government decided that they would create an incentive to induce people to work beyond the retirement age, 60 in the case of women and 65 in the case of men. The incentive was that for every six months they worked over and above the pensionable age they would be entitled to 1s. 6d. on the pension, and that if they continued at work for 12 months they would be entitled to 3s. Many of the old folk who were physically capable and who were doing jobs they could manage to continue to do responded to that call, and they continued to work three and four years after attaining the age of retirement.
I will quote an individual case, asking the Minister or the Parliamentary Secretary to consider the principle of the policy which they are pursuing, and which is operating against the people to whom they extended many years ago the invitation to carry on at their jobs, saying they would get an extra 3s. pension for every year they worked beyond retirement age. This is the case of Mr. H.
Mr. H. remained at work and earned increments of 8s. per week so that when he finally retired his pension was 32s. 6d. plus 8s. That is a total of £2 0s. 6d. basic pension. Having a rent of 10s. a week, Mr. H. decided to ask for a supplementary pension, and was granted, under the old regulations prior to 7th February this year, the sum of 4s. 6d., so that his total income was now £2 5s. When the scale rate of the National Assistance Board was raised, in February, Mr. H. received a further 2s. 6d., making a grand total of £2 7s. 6d., but when the basic pension was raised at the end of April, not many days ago, the whole of the supplementary pension of Mr. H. was wiped out. He is now left with the basic pension of £2 plus the increments he earned of 8s., giving a total of £2 8s. Mr. H. is now 6d. better off.
Is that generous treatment? Is that fair play? Is there any degree of honesty in asking men—and women, too—to continue to work, because of the need of their labours, and promising them an extra pension, and then, when they reach the age of retirement, penalising them by taking away from their basic pension?
1769 I have details of another case of a man being penalised because he continued at work. During the whole of that time he received no pension and had to pay contributions at 5s. 9d. a week. If that man had not responded to the call made by the Government and had retired at 65 he would have been receiving a total pension of £2 5s. a week until February of this year, when he would have then been receiving £2 7s. 6d.
This is the treatment. There may be only a few cases, but whether it is one case or a million cases, if an old man or an old woman is receiving unfair treatment it is the duty of the State and of the Department concerned to see that he or she is protected from any injustice. I know that on Monday the Minister of Pensions and National Insurance retreated from the position which he took up when we were debating this subject on 8th December and 20th December. He said on Monday that he was unaware of the effect of the regulations on certain people, particularly those who were in receipt of pensions in respect of sons lost in the war. He said that he and the Department were unaware of this.
I suggest in all seriousness that in a very important matter like this the Minister and the Department should have made themselves aware of it. They rushed headlong into this scheme, although they had had plenty of time to consider it. They were concerned with captivating the people for General Election purposes. They said to themselves, "We will give these increases and make the people think that we are gods from heaven. We shall thereby get hold of them." That is a totally wrong approach to a problem of this kind. I repeat what I have said many times before—that the problem of the old, the sick and the infirm is not a political problem but an intensely human problem, and it must be approached from that standpoint.
I have in my possession a letter from Downing Street, not the one which is a very important place in the eyes of the nation and of the City of London, but the Downing Street which is in Manchester and which, therefore, may not be of sufficient importance to people here. A lady writes from that address:My mother has just learned that her pension of 14s. a week in respect of her son ('massing, presumed killed' in 1941) has been 1770 cut to 7s. a week. Therefore, the increase in her old-age pension will benefit her by only 6d. a week.Will the nation stand for that kind of treatment? Is that good enough?
This old lady was not only entitled to and received an old-age pension, but she had given a son in the Second World War. Yet, under the regulations made and the policy pursued by the Government without any thought or desire to play fair, her old-age pension was first increased and then the Government took away almost 90 per cent. of her dependant's pension. No man or woman who designates himself or herself British can tolerate such treatment.
I know that the Minister has retreated and has apologised, but he will not undo the grief and anxiety and trouble which he has caused these unfortunate people. In this case, again, two forms were sent out from the same office, signed by different people, dated the 15th and 19th of the same month, and telling the woman the same thing. With all respect, those who are responsible for the administration in that Department should be ashamed of themselves.
Hon. and right hon. Members opposite have seemed to boast that everything in the garden is lovely as far as National Assistance and those who are in receipt of it go, but, according to their own records up to and including 29th March last, 1,807,466 people are in receipt of National Assistance. One can search the records back for donkeys' years, as the saying goes, but one will find that never in our history have so many people had to seek recourse to National Assistance. There has been a continual and progressive growth in the number of applicants. The Parliamentary Secretary to the Ministry of Health, who is in her place, may think that I am exaggerating, but she should look at the records of the Departments concerned for the period from 1948 to 29th March last.
Can the Government rest satisfied with their record? I know that the hon. Lady is not responsible, but I wonder whether the Department concerned can rest satisfied when there has been this alarming growth over a number of years in the number of people who apply for National Assistance. This growth indicates that the poorest of the people 1771 are becoming poorer still under the present Government.
Spokesmen for the Government can tell us about the present higher standard of living, and I admit that to a degree there is some substance in that claim but, at the same time, 4,500,000 people are living on the borderline of poverty. It is a tragedy at a time when there is increased productivity and increased prosperity created, not by the Cabinet or the Minister, but largely by the loyalty and the workmanship of working people. It is for these people, who, like their grandfathers and grandmothers and great grandfathers and great grandmothers before them created the wealth of the country, that we are now appealing from this side of the House.
This Parliament is nearing its close. Before it comes to an end I hope that the Government will come forward and say, "We will seek a way to help these people in the economic position in which they find themselves, due to no fault of their own." Let the Government go out, as I hope they will go out, with this matter off their conscience. People are poorer today—the old folk, the unemployed and the sick—largely as a result of the Government's policy.
§ Mr. Brown
The Joint Parliamentary Secretary dissents. I have great respect for him. He has speeded up one or two things lately for me, and I hope that he will speed up the tackling of this problem.
Once a great man, who was troubled about the condition of the people whom he represented went to higher authority. Higher authority was baffled by the problem and simply said, "Go thou and sit where they are sitting." If the Parliamentary Secretary will sit where the old people are sitting, he will not say "No, no; it is not so."
I conclude with this plea for the old folks so that those who are now undergoing this experience of anguish and trouble will at least have restored to them pensions of the value of £2 and 65s.
§ 7.41 p.m.
§ Mr. Harold Finch (Bedwellty)
My right hon. Friend the Member for Fulham, West (Dr. Summerskill) criticised the policy of the Government, in the first place in connection with National Insurance, and made particular reference to National Assistance rates. I think that the criticism of my right hon. Friend was justified.
I must express my disappointment at the policy of the Government in regard to National Insurance during the last three years. When the Minister of Pensions and National Insurance came to the House in December last, his Ministry had just issued a Memorandum on the National Insurance Bill, in paragraph 8 of which it is stated:There is no scientific way of deciding what rate of benefit it would be appropriate to provide under an insurance scheme. In the last resort the selection of rates must be a matter of judgment and in arriving at them the various considerations touched on in this report must be weighed up and balanced against each other.In the Report of the Phillips Committee, to which my right hon. Friend referred, there is another suggestion. In paragraph 311 on page 81 of that Report, we read:A contributory scheme cannot be expected to provide a rate of pension which would enable everybody, whatever his circumstances, to live without other means. Such a pension rate would be an extravagant use of national resources.I think those two quotations rather indicate the general policy which this Government have followed since they have been in office, and the quotation which I have made from the Ministry's Memorandum is in entire and flat contradiction of the recommendations of Lord Beveridge. It is also in flat contradiction of the policy followed by the Labour Government in 1946, when that Government introduced new insurance benefits.
The aim was laid down by Lord Beveridge that ultimately there should be established a subsistence minimum—a minimum on which a person with no other means could live, and that, at the same time, there should be a right to such benefits, irrespective of what means of another kind might be available to them. In other words, the principle was then laid down that a subsistence minimum should be established for all the people in this country whose circumstances require it. That was the aim of the Labour 1773 Government, as it was the recommendation of Lord Beveridge. That was the principle put forward, and I say at once that that principle has been departed from during the period of office of this Government.
Why do I say that? Whatever there is to be said about the policy of this Government, I know that in 1946, when the Labour Government introduced their first Bill—I do not want to be too partisan, but to deal with the facts as I find them—the position was clearly laid down then that the 26s.—and I am not going to suggest that 26s. could be regarded as an adequate minimum subsistence allowance—was, after all, the first stage.
It was laying the foundation for the minimum subsistence allowance. At that time, we had just come out of a war which had shattered our economy and placed us in a state of semi-bankruptcy. After all, when this 26s. was laid down as a minimum, it was even then something far better than the people had had before, and the intention was that we must progress from that stage onwards. That was the general principle.
Above everything else, the Labour Government inserted a provision in the Bill that, at the end of five years, there would be a quinquennial review of the situation. We had it in mind that we should then be able to look back on the experience which we had had of the working of this piece of comprehensive legislation, find out its strength and weakness, and look at its virtues and faults, analyse the anomalies that were then found to exist and take steps to remove them. It was thought that any Government, whatever their complexion, in power at the time would look at the problem in that way, but what happened?
We all looked forward to the quinquennial review, and those of us who are concerned with the mining industry were particularly interested in the results that would be produced at the end of five years. We thought that the Government of the day would certainly review all the principles and provisions in this great National Insurance Measure but, instead of that, what really happened?
The Minister of National Insurance came to the House with the quinquennial review and the Bill, and I think that the 1774 date of both documents was approximately the same. He said that he had the figures in his possession, which he did reveal, and the House debated some of the anomalies which existed under the National Insurance Act, but without any recommendation from the Minister himself. All the right hon. Gentleman did was to comment upon the Actuary's Report. That was the situation at the end of 1954, when we had all looked forward to removing some of the anomalies which existed in the National Insurance scheme.
Of course, the figures revealed some pleasant features, and it is only fair to say so. The Actuary had based his original calculations on a rate of unemployment of 8½ per cent., but he revised that to one of 4 per cent. Again, interest rates, which had been 2¾ per cent., had been revised to 3 per cent. He also found that the sickness benefit could be revised, because the sickness rate had not been as high as had been expected. These were the happy features of the Actuary's Report. Some of us therefore concluded that, according to that Report, there was no need for any appreciable increase in contributions, because the position was a happier one than we had expected. We felt that the Minister could review the position of the pensioners, and that he would take into consideration the increased productivity of the country.
It was in that atmosphere that the Minister came forward with certain proposals for increases in rates of benefit, but also with a proposal to increase the weekly rate of the contributions. We felt that the 1s. from the worker and the other 1s. from the employer were not at all justified. I do not want to go into a mass of figures, but it was proved conclusively that the Government were calling upon the contributor to pay £60 million to provide for uncovered liabilities. As I said at the time, a young man was being asked not only to pay for his own insurance, but for that of his grandad's as well, because that £60 million was equivalent to 7d. or 8d. per week by way of contribution. In addition to that, the Government refused to restore the one-fifth Exchequer grant. All these points were discussed during the debate, and it was clearly demonstrated that the 1s. contribution was really unnecessary, but the Minister insisted that it should be 1775 imposed, and it has in fact been allowed to come into operation. The Minister had the opportunity of aiming at a subsistence minimum. He could have said, "I will certainly impose a 1s. increase, but with greater benefits than exist now." Then we should have arrived nearer the position of the subsistence minimum which we all have in mind, and which Lord Beveridge suggested. It may be that we could not immediately have had the figure which we all desired, but at least there could be a definite policy towards it.
Where I blame the right hon. Gentleman is that he has failed to face up to the situation. He has failed to carry out a progressive policy for the pensioners during the three years he has been in office. I do not want to go into this matter at any length, but, as I have indicated already, we did hope that he would deal with some of the anomalies arising under this Act, anomalies which could have been dealt with by regulation. We looked forward to that. But when the Minister introduced his Measure he gave no indication about dealing with anomalies at all. Not one of them was dealt with at that time. There was, to be sure, a promise that certain matters would be referred to the National Advisory Council, but that was all.
I am not going to weary the House with details of these anomalies. Hon. Members on both sides may like to say something on the subject, but I must mention one or two to which I have drawn attention many times hitherto. First there is the question of the widows, an anomaly which could have been dealt with. For three years the Minister has known about the position of the 10s. a week widow. It is nothing new to him. It has been there for some time, but the right hon. Gentleman last December did not make any recommendations to the House about these unfortunate widows.
Then there is another aspect of the widows' position, the restriction on earnings above £2. If a widow earns more than £2 a week, in certain circumstances the pension is affected. Next there is the industrial widows' pension when she is under 50. She gets 20s. a week, but there was nothing in the last Bill to increase those rates for her. I think I see behind the Minister of National Insurance 1776 the figure of the Chancellor of the Exchequer himself. The right hon. Gentleman may be regarded as the Chancellor's pet, but he is not the widows' "Peake." He has done very little for those widows.
My hon. Friend the Member for Ince (Mr. T. Brown) referred to incentives. If there is one thing we hear more about these days than anything it is incentives, and rightly so. Do not let anyone make any mistake about it, we on this side of the House are anxious to see increased productivity and incentives given towards that end. But the Minister of National Insurance, by the policies he follows, is not giving the slightest encouragement on incentive in support of greater production.
My hon. Friend mentioned the case of those who stay at work after they are 65 years of age. When the scheme was put into operation during the days of the Labour Government they were given 1s. 6d. extra for every six months and 3s. for each year plus 1s. for their wives. These added increments were given for working after 65, but there was nothing in the Minister's proposals last December with the object of reviewing these incentives, to give an extra 1s. or 6d. to these people working on after they could have retired. Yet, on the other hand, we are told that we should do everything we can to encourage people to work after 65.
But that is not the worst side of it. My hon. Friend referred to the case of a worker who stays on at work for two years after he is 65 and earns the 3s. or 5s. extra. Then if he falls on evil times and has to apply for a certain amount of National Assistance the Government take into consideration these added increments. That is not a very great encouragement to get people to work after reaching 65 years of age.
A more serious aspect on the question of incentive concerns the younger men in industry. The Parliamentary Secretary will be aware that I have referred to this matter before, but I must be pardoned for mentioning it again. I hope this question will be one of the priorities under any new Government Act. It could be done by regulation. I am referring to the question of hardship allowances. The rate should be increased, but this Government are going out and they will not have an opportunity of dealing with it.
1777 Under the Industrial Injuries Act a hardship allowance is payable where a man continues to be permanently disabled after the injury benefit period has expired or he is permanently incapable of returning to his regular occupation. But what happens in a number of cases of men who have sustained industrial injury is that they return to their trade and they continue to work at their regular occupation for a period of, say, six to nine months. Then they find there is an aggravation of their old complaint, but they cannot get any hardship allowance.
What is happening in the coalfields is that men are getting to know this position. They tell their colleagues, "If you go on with that work for six or nine months and then find you cannot continue because of the original injury you will not be allowed a hardship allowance." That allowance was really intended to cover the case of men who were unfit to return to their normal employment, but even under the old Workmen's Compensation Acts, where a man was unable at first to return to his pre-accident employment but ultimately was able to do so and then at some later stage failed to continue, he would receive compensation. But that does not apply under the Industrial Injuries Act.
It is true that if a man is under medical attention for two or three months and fails at his pre-accident employment, he gets a hardship allowance, but those to whom I am referring are men who really think they are better and who return to their pre-accident employment. But if they continue for six or nine months and then find they cannot go on, they will not get a hardship allowance. This is no incentive for men to continue at their employment or do what so many of them are doing in present circumstances.
There are just two other matters, too, in the form of anomalies which could have been dealt with by the Minister. He has done nothing more about them. I want to refer to pneumoconiosis and the problem of men certified by the medical board. The boards are conscious of the fact that many of the men have deliberately put off the evil day of discovering whether they have the disease. Many suspect they have pneumoconiosis but do not like to go to the board. Ultimately they are compelled to go, but although the board is quite conscious of the fact that these men have 1778 been suffering from this disease for six or 12 months, it is prohibited from anti-dating the certificate for more than three months. Therefore there is no retrospective compensation in such cases because of the three months restriction on back pay. This is an anomaly which could easily be remedied.
Secondly, there is the case of those who are deaf because of pneumoconiosis. Here again, the Parliamentary Secretary knows that I have raised this matter on a number of occasions. I am getting tired of raising it, but I can assure the Parliamentary Secretary that unless something is done about it in the near future there will be grave disquiet in the mining industry. There are a number of men, particularly in South Wales, suffering from pneumoconiosis. Many of them are 100 per cent. disabled. Ultimately death takes place and an application is made for a death certificate.
Invariably it is the policy of Her Majesty's coroner to hold an inquest after local medical men have conducted a post mortem. Arising out of the evidence given as a result of the post mortem examination, it is decided that the man concerned has died from pneumoconiosis. However, as this is a matter for benefit purposes, the organs of the deceased have to be examined by the medical board who, in a number of cases, have pronounced a different decision, that the man has not died from pneumoconiosis.
We have to deal with these cases every day and they arouse bitter feeling. Often it is stated in the Press that the coroner, on the evidence before him, has decided that death was due to pneumoconiosis, and the widow naturally thinks she will be entitled to an industrial pension or compensation. And then the pneumoconiosis medical board says otherwise. The widow then has two death certificates which she takes to the union concerned or to her Member of Parliament and asks what is her position.
This policy calls in question the competency of the medical board and creates much unnecessary distress. Since I raised this matter originally there has been a tightening up of the policy of holding inquests by coroners in South Wales. They now defer their decision about the death certificate until they hear the report of the medical board. That is helpful. The Minister has also decided that a 1779 pathologist should be brought in. Again that is of some help, but sometimes a pathologist disagrees with the decision of the medical board. There is one such case in Aberdare, a well-known South Wales pathologist asserting definitely that the man died from pneumoconiosis, the board stating otherwise.
I do not want the House to think that there are numerous cases, but there are a number, and the matter calls for investigation. I am referring not only to medical practitioners at these postmortems but also to pathologists, in such places as Newport and Swansea, where they have differed from the medical board in quite a few cases. The Parliamentary Secretary said that he had only 24 hours left, so I ask him, in the short time at his disposal, to try to do something about this matter.
The right hon. Gentleman referred to the old workmen's compensation cases. I was hoping that by now we should have had a statement from the Minister that he was prepared to deal with these. We have two schemes for industrial injury; the old workmen's compensation cases—men who sustained their accidents prior to June, 1948, who come under the 1925 Workmen's Compensation Act—and those who come under the Industrial Injuries Act.
Those under the former Act have had no increase in basic rate since 1948, the single man still getting £2 a week, whereas the man under the Industrial Injuries Act gets 67s. 6d. a week. There is a similar disparity in the cases of married men with children. Some time ago my hon. Friend the Member for Lanarkshire, North (Miss Herbison) tried to introduce a Private Member's Bill. One of the most miserable experiences I have had since I have been in this House was to see an hon. Gentleman opposite walk into the Chamber at one minute to four o'clock and, when my hon. Friend tried to get her Bill committed to a Committee, he objected to it. That was a Private Member's Bill which concerned 50,000 injured people. It was a miserable policy to adopt on the part of hon. Gentlemen opposite.
When I look back on the three years of office of the present Government and realise also what the Chancellor of the Exchequer has done by a stroke of the 1780 pen in reducing the taxes of the higher paid and the rich people of this country; when I realise how the right hon. Gentleman has relieved the industrialists and how he has left the disabled and the sick, then I say to the Parliamentary Secretary that I wonder how he and his right hon. Friend have the audacity to go to the country and ask for a vote of confidence in view of their policy in connection with National Insurance.
§ 8.5 p.m.
§ Mr. William Warbey (Broxtowe)
A debate of this kind must, to some extent, be a measure of the record of the two main political parties in the matter of the social services. The last speaker from the Government benches, the hon. and gallant Member for Poole (Captain Pilkington), raised the matter from this point of view and tried to show that it was not the Labour Party alone which could claim most of the credit for the building up of the Welfare State. I noticed that he covered up the miserable record of the Conservative Party on the social services by speaking of the work done by other parties and not specifically by the Conservative Party.
The hon. and gallant Gentleman gave away, in a few words, a typical attitude of his party towards the Welfare State by saying that the purpose of the Welfare State is to enable people to increase the production of the country. The attitude of the Labour Party is the exact inverse of that. We would say rather that the purpose of increasing production is to build up the Welfare State. In other words, we do not believe in production merely for its own sake, or to enable a limited number of people to derive a profit from the surpluses which arise; we believe in production as a means of providing for the increasing well-being of the mass of the people, and the Welfare State is an essential part of this.
Following the excellent example set by the Labour Government, this Government have produced a popular and readable booklet so that people can understand the workings of the National Insurance Act, the new rates of benefit and contribution. It is described as "Everybody's Guide to National Insurance." This is not a party political document. I do not complain that it is produced at this moment. It is right that it should be, because it is valuable. The Minister has contributed an 1781 introduction which, again, is not a party statement, but is an unofficial statement by a member of the Government. It is interesting to note, however, that in writing this foreword the Minister has revealed the unconscious attitude of his own party, and of Conservatives generally, towards the question of social security in the Welfare State. He says:Britain is rightly proud of her system of social security, built up and developed over the past forty years.I will refer to that later—National Insurance, the backbone of the system, is well suited to our way of life with its emphasis on the responsibility of the individual to provide for the future needs of himself and his family.Certainly, the individual has such a responsibility, provided that he is given the opportunity. One of the aims of the Labour Party has been to enable people to have opportunities to help themselves and their families which they did not have in the past. At the same time, we have always recognised and stressed that society has a duty towards its own members; that a good deal of what happens to individuals depends upon their social environment, and that society has a responsibility to look after the children, the weak, the sick, the needy, the elderly and the less fortunate of its own members. We in the Labour Party stress that aspect of the social services and the Welfare State rather than the essentially individualist and charitable approach which we are used to getting from the Government benches.
In the foreword to this booklet, it is interesting to note that the right hon. Gentleman, in referring to a system that had beendeveloped over the past forty years,was a little imprecise about the figure. If he had used the figure "47" it might have reminded people that when the Radical-Liberal Government of 1908 introduced the Old Age Pensions Act, with the support of, and to a large extent under the pressure of, the newly formed Labour Party, that Measure was opposed bitterly by a very large number of Members of the party now on the Government benches. At that time, 39 Members of the Unionist Party voted against the Second Reading of the Bill and the rest of them dared not vote against it because they were afraid of what would happen to them at the next General Election.
1782 They did their best to emasculate it in Committee, where 55 of them tried to get an Amendment through which would have removed entitlement to the old age pension of 5s. a week. The Act would merely have said that the 5s. should be paid to them. In other words, they were anxious to make it clear that the payment would only be a charity and not a right to which the old people would be entitled. That was the characteristic attitude of Government supporters and it has not changed in essence.
Their attitude was very well described by Mr. Asquith in this House in 1909, when he said:I do not suppose that there is a more discreditable chapter in the whole history of British politics than that which records the dealing of the Unionist Party with old age pensions.Further, he said:I say deliberately that for ten years this promise of old age pensions was dangled before the people. It was used to catch votes; it was used to win elections, and during the ten years when hon. and right hon. Gentlemen opposite, sat where we now sit, with a docile majority in both Houses of Parliament, they never raised one finger to give effect to the pledges they had offered to the constituencies."—[OFFICIAL REPORT, 3rd November, 1909; Vol. XII, c. 1945.]That was the attitude of the Tory Party in 1909 as described by the Leader of the Liberal Party, and it has not changed yet. In these days the party pays lip-service to the Welfare State and to the social services, but still with the old attitude of charity secretly in its mind and still making belated concessions, mainly with a view to retaining its seats in this House and the Conservative Party in power.
Lord Lansdowne said in another place that the 5s. per week pension would weaken the moral fibre of the nation. If we come a little further up-to-date we find that in 1939, just before the last war, Mr. Neville Chamberlain was resisting pressure from hon. Members in the Labour Party for an increase in the miserable 10s. a week pension, after 20 years of the Tory Party being practically the whole-time ruling party in this country. He did it on the ground that the country could not afford it in the days of rearmament.
§ Mr. Warbey
Then we come to the situation after the war, when the Labour Party introduced the great schemes upon which an hon. Member on the Government benches tried to pour cold water. Those schemes have done a great deal to build up the Welfare State. The hon. Member tried to claim that his own party was giving full support to those proposals, which, incidentally, went far beyond what Lord Beveridge proposed during the war. I well remember the occasion on which Sir John Anderson, as he then was, said, speaking from the Tory Opposition front bench, that the Labour Party had been over-hasty in introducing family allowances and in substantially increasing old-age pensions.
§ Captain Pilkington
The hon. Member has just said that the Labour Party introduced family allowances. Will he say who passed the Act?
§ Mr. J. Griffiths rose—
§ Mr. Deputy-Speaker (Sir Rhys Hopkin Morris)
The hon. Member for Broxtowe (Mr. Warbey) is in possession of the House.
§ Mr. Griffiths
I only wanted to mention the history of this matter, which is very interesting. The Family Allowances Act was passed during the time of the Coalition Parliament and of the Coalition Government, but it did not begin to operate. It was brought into operation, and payments were made, in August, 1946.
§ Captain Pilkington
With great respect, Mr. Deputy-Speaker, the right hon. Gentleman's statement was wrong. The Family Allowances Act was introduced by the Conservative Government.
§ Mr. Deputy-Speaker
Hon. Members must await their turn. We cannot have a debate across the Floor of the House.
§ Mr. Warbey
It is a fact that the Act was implemented by the Labour Party, in the sense of beginning to pay family allowances. We were opposed by Members of the hon. and gallant Gentleman's 1784 party, who said that we had been over-hasty in putting the Act into effect and paying the allowances. That was said by Sir John Anderson. On the same occasion he said that we had been over-hasty in making substantial increases in old-age pensions. Moreover, he repeated that in 1950 and said that we had also been over-hasty in introducing the whole scheme of Health Insurance.
§ Mr. Hale
I want to help my hon. Friend. What the hon. and gallant Member for Poole (Captain Pilkington) meant when he referred to the Conservative Government was the Government that was formed after the defeat of Dunkirk in 1940, on a vote in which the great majority of Conservative Members voted against the Prime Minister.
§ Mr. Warbey
I am sure that the hon. and gallant Member for Poole knows the facts of history as well as I do.
§ Captain Pilkington
The hon. Member for Oldham, West (Mr. Hale) is quite wrong. I meant the Conservative Government of 1945.
§ Mr. Warbey
That was the "Caretaker" Government, which was merely carrying on a process initiated by the Coalition Government, and which the Labour Government put into effect, as my right hon. Friend the Member for Llanelly (Mr. J. Griffiths) reminded us.
I am recalling this record because it shows that all through history the party on the Government side has resisted improvements in social services as long as it could, and has only improved them when under the pressure of the electorate. That has been the record right up to the last 12 months, when, as has already been said, on three occasions, the Labour Party pressed the Tory Government to make substantial increases in old-age pensions and other benefits and to help those who had been suffering extremely badly as a result of shocking increases in the cost of food. That has taken place under the Tory Government. We pressed them on no fewer than three occasions, and on every occasion they told us that the country could not afford it, as the Chancellor of the Exchequer did in connection with his 1954 Budget, or they told us that we had to await the report of a committee, or something of that kind.
1785 The pressure became so strong—not only from this side, but also from those people who were unlucky enough to be represented by Conservative Members—that at long last, at the Conservative Party Conference, last October, it was realised that something had to be done. There we had staged that astonishing and rather disgraceful farce in which rank-and-file Conservatives were allowed to describe the miseries being suffered by old-age pensioners. There was the grocer who said that the old people came into his shop, looked at the ham and butter and then asked for a 2d. tea cake, a quarter of margarine and 4d. worth of potted meat. That was at a time when right hon. Gentlemen opposite were assuring us that the old-age pensioners were enjoying a vast increase in their food consumption.
After the way had been prepared by that demonstration, we had, at the Tory Party Conference, the Minister of Pensions and National Insurance coming forward and saying, with all the floodlights on him:We are going to produce before Christmas a policy to improve the condition of the old people and those drawing pensions and benefits generally.He also said:When you see it it will be a good policy, and when the time comes it will be a useful weapon in your hands.The time has now come, but when the Tories go round their constituencies they will find this weapon thrown back in their faces. It is not a good policy but a mean one, as the people are now finding out. They know that it is a policy of paying out with one hand and taking away with the other.
In "Everybody's Guide to National Insurance" we have an interesting list of dates. In page 4 there is a list of the dates on which the increased rates of benefit and contribution will come into effect. It reads something like this:25th April, 1955—retirement pension, widows' benefits and allowances …16th May, 1955, maternity benefits.19th May, 1955, sickness benefit, unemployment benefit, industrial injury benefit …Then, on 6th June, 1955, the increase in the contributions.
There is one date which is missing from that list and that is 26th May—the date of the General Election—carefully, nicely and precisely chosen to take place 1786 one week after the last increase in the rate of benefits and 11 days before the increases in the contributions. How carefully that Election date has been selected by right hon. Gentlemen opposite—but the electorate will find them out. Hon. Members opposite are discovering, as we have found from letters-we have received on this side—and I have no doubt that hon. Members opposite have also received such letters—that the old people and others realise that they have been cheated by the party opposite.
They have been cheated not only by this mean trick of the National Assistance to which reference has been made, but also because the net result of what they have received puts them in a position not even as good as that which they were in in 1948. As I pointed out when I interrupted the Minister earlier today, although the total increase since 1948 amounts to 54 per cent., on his own showing the price of food, which is the main item in the budget of the lower income group, of old-age pensioners and others has risen in that time by 60 per cent.
§ Mr. Warbey
I think he said 60 per cent. If it is looked up I am sure it will be found that the Minister said that the price of food had increased during that period by 60 per cent.
Even this improvement—or rather this stabilisation, because that is what it really amounts to—is achieved only by disregarding the element to which my hon. Friend the Member for Ince (Mr. T. Brown) has referred. During that period our production has increased by no less than 25 per cent., so that the whole of that section of the community which is in the greatest need, the elderly, the infirm, the sick, the weak, and so on, are getting no benefit whatsoever from the increased production of the last seven or eight years.
If one compares the situation of different people, one realises what a contrast there is in the way in which the different sections have been treated by the party opposite. I think of the case—and it is typical—of an old miner in my constituency who is now 67, a widower. He worked in the pits for over 50 years, 47 of them underground. He then had 1787 to work above ground because, according to his own doctor and the union doctor, he had contracted pneumoconiosis. When he went before the board he was told it could not certify him as having pneumoconiosis and he therefore does not get a disability pension.
That miner today is drawing a retirement pension of £2 a week, 15s. miner's pension—to which he has contributed—and 3s. National Assistance. That is a total of £2 18s. for a man who worked during those long years of both short-time working and days off, years of low wages; whose health has been effectively undermined and ruined by his work in the mines—his respiratory system is undoubtedly affected although it is not in a form scheduled under the Act. After all that time all he gets is a miserable total of £2 18s. a week.
I think of the case of a man of the same age who has been the manager of a small business. His health is good and he is still able to go to his business from his suburban residence for three days a week. On the other days he can play a round of golf. He gets a salary of £1,000 a year and some expenses. In addition, some years ago he invested £10,000 in industrial equities. What is the position of that man, and how has his situation developed under a Conservative Government? The £10,000 in 1951–52 paid 10 per cent. dividend and he had a net income from that, after taxation, of £525.
Under the beneficent action of a Conservative Chancellor of the Exchequer that man has now been relieved substantially of taxation and his dividends have also substantially increased. This is quite an average case. His dividends have gone up from 10 per cent. to 12½ per cent., and as a result of that increase and as a result also of the tax reliefs given to him by the Chancellor of the Exchequer, his net income has now increased by nearly £200. In other words, he has had an increase of 37½ per cent.—far more than the increase in the cost of living during that period.
That is not the whole of the story, because the value of his capital, which was £10,000 in 1951, is now £15,000 as a result of the rise in share values on the Stock Exchange. He has a tax free gain of £5,000. He can sell one-fifth of his 1788 shares for £3,000 today; on the remainder he will still draw a tax-free income higher than the income he drew in 1951, and he can use that £3,000 to have a jolly good spending spree.
That is the typical man who has benefited from the policy of the Tory Party, and he compares with the miner of the same age in my constituency, whose total weekly income is less than what the other man has gained under these three and a half years of Tory rule. Those two cases are typical and are symbolical of the difference between the two parties in their attitude towards the members of the community. I believe that the electors will recognise that fact when the time comes to vote at the forthcoming Election.
§ 8.31 p.m.
§ Mr. G. B. Drayson (Skipton)
I should like to take this opportunity of drawing my right hon. Friend's attention to the effect of the earnings rule on old-age pensioners. It will be recalled that in the 1946 Act the old-age pension was changed to a retirement pension where retirement was a condition of payment at the age of 65 for men and 60 for women, but paid in any case at the age of 70 for men and 65 for women.
This new retirement principle for those who wish to draw the old-age pension together with an earnings limit of 40s. per week is not one with which I wholly approve, and I have had many complaints from constituents who wish to remain in employment and feel that this rule acts unfairly against them. Last year, the Minister said that he did not consider that the present earnings rule must be maintained unaltered, but that some earnings rule was essential. I hope that the Minister can indicate tonight that it is his intention, when this Government is returned at the end of this month, to deal with this matter as speedily as possible.
We all know that many of these people who reach retirement age possess great skill in industry, and we cannot afford to lose them from our present productive effort. Perhaps the increment which is given to those who continue in employment without drawing their retirement pension could in some way be adjusted, because the Phillips Report says that there was little evidence to show that the increments themselves were an important factor—in keeping people at work.
§ Mr. Deputy-Speaker
I am not at all clear whether the changes which the hon. Gentleman desires could be effected by regulation, or would need legislation. If they need legislation, it is not in order for the hon. Gentleman to discuss them on this Bill.
§ Mr. Drayson
I do not know how this would be done, Mr. Deputy-Speaker, but I hope that it could be done by regulation. I was saying that the Phillips Committee found little evidence that the increments which can be earned by those remaining in work were any great inducement to the people concerned to do so.
Some consideration might, therefore, be given to an adjustment of these increments at the same time as consideration is given to a substantial increase in the earnings rule. There was an addendum to the report by Professor Cairncross, who said that it was not so much a question of whether to retire but how much to retire. When these people reach retirement age I think they would like to feel that they can draw the pensions which they have earned as of a right and perhaps take on easier or part-time work without being hampered by the earnings rule of £2 a week, a figure which is considered to be far too low. I should be most grateful if the Minister could say something on this subject tonight.
§ 8.36 p.m.
§ Mr. G. M. Thomson (Dundee, East)
I should like to support what the hon. Member for Skipton (Mr. Drayson) said about the earnings rule. I do not know whether such a change requires regulation or legislation, but the Government seem to be able to do everything very quickly this week and I am sure that if they wished to do something about this before the General Election they could find a way of doing it.
May I draw the attention of the House to paragraph 196 of the Phillips Report, which puts the case for this change—a case which in the long run will have to be accepted. If we cannot go so far as to abolish the earnings rule at present, I will certainly support some relaxation of it, and in particular I recommend to the Minister's attention the suggestion discussed by the Phillips Committee that the earnings of old-age pensioners should at least be averaged out over the whole year. The adoption of that suggestion would give some assistance in this matter.
1790 The point made by the hon. Member for Skipton, equally with other points made by the hon. and gallant Member for Poole (Captain Pilkington), his predecessor in the debate from that side of the House many speeches ago, illlustrates the dilemma in which the Conservative Party and the Conservative back-benchers find themselves when we discuss the social services. The suggestion which the hon. Member made and that which his hon. and gallant Friend made about helping the 10s. pension widows no doubt come from their hearts—but all such suggestions involve the expenditure of money; and the difficulty of some Conservative Members is that, while their hearts are in the right place, they are very much rooted to the ground by their pockets.
After all, this is a matter of politics. The social services form one method of redistributing the wealth of the community, and that is why, taking the historical view which was so clearly described by my hon. Friend the Member for Broxtowe (Mr. Warbey), while all parties have contributed to the creation of the Welfare State which we have today, the impetus for its creation has come continuously during the present century from the Labour Party in Parliament, and the Conservative Party have conceded the Welfare State only reluctantly and when they felt finally compelled to do so.
Perhaps I may join in the historical dispute which went on across the Floor between my hon. Friend the Member for Broxtowe and the hon. and gallant Member for Poole about family allowances. The Family Allowances Act was passed by the Caretaker Conservative Government, but that short-lived Government lived for a few weeks the kind of life which the present Government appears to be living in these last few days. It devoted its time to doing the kind of things which would be an advantage to it at an Election—but the kind of things which would not necessarily be carried out once the votes had been won by what they had promised.
If the Conservative Party had won the 1945 Election, it is most likely that Sir John Anderson, as he then was, would have been the Conservative Chancellor of the Exchequer: and it is certain that if 1791 he had been the Conservative Chancellor of the Exchequer, the Conservative Party would never have implemented the Family Allowances Act passed before the General Election. That is the kind of difficulty in which the Conservative Party finds itself.
I noticed some restiveness on the other side of the House when my hon. Friend was going back to 1908. One of my distinguished predecessors who had the honour to represent Dundee came to the city in the year 1908. He was the former Prime Minister. If hon. Members opposite wish to find exactly the attitude of their party to the original old-age pensions Bill, they can find it described in the most blistering language by the right hon. Member for Woodford (Sir Winston Churchill). He attacked the Conservative Party with very great vigour in those days.
I think it fair to look at the history of this sort of thing, because, in a more shortened perspective, it seemed that the main defence of the Minister of Pensions and National Insurance was to compare his arrangements—historically and rather speciously I thought—with those of previous Labour Governments. That comparison would not have been a very proper or valid one, even if it had been done accurately. The kind of redistribution of wealth that can be carried out in the community by social security depends on the particular circumstances in the country at the time.
The circumstances in this country today are very different from those which operated during the period of the Labour Government. [HON. MEMBERS: "Hear, hear."] That, of course, is not due to the policy of the Government. As I think everyone agrees, this country is very much at the mercy of world economic trends. When world prices are high things are difficult in this country and when they are low things are easier in this country. We have been enjoying a precarious prosperity in the last two or three years.
§ Mr. Thomson
I agree with my hon. Friend, but I was pointing out that we are enjoying a precarious prosperity in this country. The valid comparison that this House should make and which the country should make during the Election period is not between conditions now and those in the aftermath of the war, or during the period of the Korean War. It is between what the Conservatives have done with this precarious prosperity, how they have distributed a 25 per cent. increase in production and how a Labour Government would have distributed it. The indictment we make against the Minister of Pensions and National Insurance is that, even in the small circle of old people and widows, he has contrived to carry on the Conservative policy of unfair shares. I would hardly have believed it possible, but the net effect of the pension increases he has carried out is that those persons in the greatest need have got the least from the present Conservative Government.
When one looks for an explanation of that, I think the most biting, but I am sure the truest, explanation is to be found in the comment the "Economist" made on the pensions proposals of the Government at the time. I am sure that if I were to give this explanation I should be accused of very unfair Socialist prejudice, but here is what the "Economist" said at the time:How much politics has weighed …"—in the decision to increase pensions by 7s. 6d. and National Assistance scales by 2s. 6d.—and how little human compassion is demonstrated by the fact that the better off pensioners get an increase of 7s. 6d. a week whilst the poorest—those in real need—get an increase of only 2s. 6d.The "Economist" went on to say:There are three times as many voters in the former class as in the latter.That is the indictment we make against the kind of arangements the Conservative Party has carried out.
It is not sufficient to say that National Assistance scales are decided by an independent body. Nor is it sufficient to say that National Assistance scales have gone up by such and such a percentage. I think everyone agreed before the present proposals came forward that there was great hardship among the old people and the greatest hardship was suffered by 1793 those most dependent on National Assistance. Those were the people who, if there were some dividend to be gained from the present increase in production, should have had the first claim upon it. It is they who have had least out of it.
There are one or two particular points within the arrangements to which I should like to draw attention. Various anomalies exist in the sphere of widows' pensions. I think that Dundee has rather more widows than many other cities. Many of its widows have had very hardworking lives in an industry which was not kind to them before the war, and the anomalies over widows' pensions cause great resentment. There is particular bitterness in the case of the widows who receive only 10s. a week. Not only do they get nothing from this Government, but they are worse off as a result of the arrangements which have been made by the party opposite. After the Election they will find that they lose 1s. out of their meagre wage packet—many of them are in part-time jobs—to pay for their increased National Insurance contribution.
Another of the petty meannesses in the Regulations in relation to widows affects those who are receiving the full widow's pension, and who are subject to the earnings rule. Many of them in Dundee—and this will be true of other places—work in the school meals service, which grants a free lunch to all the women who work in that service. If a woman is married, she gets the benefit of a free lunch, but if she is a widow and in receipt of a pension, a certain sum is deducted weekly from her pension to pay for the free lunches which the local authority gives her. I ask the Minister at least to look at this small point and see whether the Regulations cannot be amended in such a way that there is not this discrimination between one kind of school meal worker and another.
Another point concerning the general welfare arrangements to which I wish to draw attention is what has been happening in the sphere of welfare foods, although in my case this is more the responsibility of the Secretary of State for Scotland than of the Minister of Pensions and National Insurance, who is at the moment occupying the Government Front Bench. A Question was asked yesterday as to what was happening in connection with welfare foods. The Parliamentary 1794 Secretary to the Ministry of Health gave figures which showed that there had been a marked decline in consumption of all the welfare foods for babies and for nursing mothers. The hon. Lady had what seemed to me the audacity to give as an excuse for the decline the continued improvement in the general diet and standard of living.
Everybody, I think, knows that quite apart from any dispute as to the general standard of living, the only reason for the decline in the consumption of welfare foods is that the party opposite has disbanded the Ministry of Food and has handed this service over to local authorities in conditions of chaos. Many mothers do not know where they can get the welfare foods. Whatever the general standard of living in the community, the welfare food service, which was started during the war and has gone on for many years, is one of our most important social services. Many hon. Members, on both sides of the House, have played their part in trying to educate the public to extend the use of this service. Within recent months many of us have been across cooperating with the campaign at the Ministry of Food offices, but never was there a suggestion that the welfare food service was something that could decline even if the general standard of living in the community rose.
My final point concerns the Ministry of Health. There has been talk about the regulations for prescriptions by doctors. I wish to draw attention to one aspect. While it is true that the doctor has the final right to decide whether it is right to prescribe a particular drug, it is also true that if a doctor is thought to be prescribing above the general average disciplinary action can be taken against him.
There has been some anxiety in Dundee recently because a number of doctors have had this action taken against them. I think that this arrangement has a number of undesirable aspects which the Minister of Health and the Secretary of State for Scotland might well look into. In this case a number of doctors were brought before a committee of their fellow doctors in the city and only two of them were finally fined. The two who were fined included the one who had the highest level of prescriptions and the one who had the lowest level of prescriptions. No 1795 regulations are laid down for the amount of fines that are to be imposed. This case was the first of its kind in the city. It seems to me that while one must exercise control over the quantity of drugs given, as my right hon. Friend said in opening the debate, it is very important that this matter should be administered in such a way that the patient has every confidence that he is getting the kind of treatment to which his particular illness entitles him.
I think that it would be better if these committees, while they ought to be committees of doctors, had a chairman who comes from outside the city in which the committee is sitting. It would also be better if the actual scale of fines was laid down by regulations and if the committees regarded it as their primary function to go to the doctors who were over-prescribing and talk with them to find out whether there was a valid medical reason or whether it was due to lack of experience or something of that sort. The whole question of over-prescribing by doctors and the arrangements to control it require the closest investigation, and I hope that the Minister of Health and the Secretary of State for Scotland will give this matter their close attention.
§ 8.52 p.m
§ Mr. Leslie Hale (Oldham, West)
Before I come to the subject to which I particularly want to refer, I should like to make a few observations about some of the speeches which have been made. My hon. Friend the Member for Bedwellty (Mr. Finch), in a typically able speech, finished up with a summary of the anomalies which remain in the National Insurance Act which have had no attention from the Minister over this long period. An hon. Member opposite referred—and I agree with him—to the necessity of trying not to deter people from continuing work after retirement age. I have said, so far as the retirement pension is concerned, that there are many people who are not fit to work at 64 but who go on working until they are 65 in order to get the retirement pension, but there are also many people who can and who would prefer to go on working, and they should have every encouragement to do so, to long as they are fit and well and want to do it.
1796 I think that the hon. Member might have given an explanation of the insidious words in the Tory Election programme, which appear to run contrary to the explicit pledge of the Minister that he would not interfere with the retirement age. We on this side can give that pledge that we shall not interfere with the retirement age, and I hope that no one is thinking of doing so.
The hon. Member also referred to limitation of earnings. I recall a case in which there were two additional anomalies to which I want to refer, both occurring in the same household and about which I was consulted as recently as Sunday last. It was the case of a man who served in the war, a man who joined up fit and who suffered acutely from meningitis, contracted during the war, and who had a long period in hospital. Now he is suffering a very grave mental illness which wholly incapacitates him from work.
The Minister said, as he has said in so many cases—and I am not trying to make party points for it has been said by successive Governments—"You have failed to establish to our satisfaction that your present illness was caused or aggravated by war service, and you will get no pension."
Let me deal with that point first: We have the melancholy experience of what happened after the First World War and the way in which pensions tribunals treated cases in those years when we were having a genuine economic crisis and people were disposed to try to turn people off pension and so reduce taxation. When these rules were made, Mr. Justice Jennings, who was allocated as pensions judge, made one or two far-reaching decisions. Mr. Justice Jennings said that the onus in these cases is not upon the man to show that he got his disability through war service.
His interpretation was the complete reverse, that the onus is upon the Ministry. In the case in which there is prima facie establishment of certain facts, in the case in which the man went into the Armed Forces fit, in the case in which there is a type of disease as to the cause of which medical opinion can give no conclusive answer, he said, and laid down in a whole series of judgments, which I am summarising, probably a little inaccurately, but as accurately as can be done in a brief compass, that the onus 1797 can be shifted on to the Ministry, and that it is for the Ministry to show that the incapacity was not caused by war service.
These judgments are important, and this conclusion is important, and it has never been applied. Time after time in such cases as this I am told, "You have the right of appeal to the High Court." So we have to go to the High Court, with all the expense that means for a man who cannot even afford any help for which he has to pay, with all the difficulty that means for a man who has no medical advice, a man who has no doctors. We ought to go to the High Court, of course; but each time we who are called on to advise the people concerned say to them, "You have had all these years of worry and anxiety. Is it worth your while to make an appeal to the High Court with all the expense involved, and still run the chance of the rejection of your case?"
This is no small matter. How many illnesses are there from which these men suffer? Some of them are the most dreadful scourges that afflict humanity. Hon. Members on both sides of the House who interview their constituents must know. They must have met men with bent spines, trembling and shivering, suffering those nervous ailments that get progressively worse; men who have disseminated sclerosis, Parkinson's disease, mental illnesses, all forms of neurosis—whole realms of illnesses, and all covered by the wretched definition that they were not caused or aggravated to the Ministry's satisfaction by war service.
The doctors say, "It is no use your coming along and saying that you served in a tropical climate because there is no evidence that your complaint is due to a tropical climate. It is not use your coming along and saying that you fell off your motor bicycle and injured your head, because there is no evidence that your condition was caused traumatically. It is no use your coming along and saying that you were A1 when you joined the Services, because you may have been carrying a dormant germ at that time that was not then located."
So it goes on. I have never advocated, never joined in saying with my hon. Friends, "Fit for service, fit for pension." There must be exceptions. However, if a man was generally fit when he joined the Service and comes out totally 1798 or very grievously incapacitated, why do we not do something about it, why do we not change the miserable policy followed by successive Governments, which has no fundamental decency about it?
That man is as devoid of hope of work, devoid of hope of health, devoid of hope of joy, as any man can be; is totally and permanently and dreadfully crippled. His wife tries to look after him. The wife of such a man showed me the pension they got, and she asked me, "How can we buy food on that?" She has a National Health benefit for her husband and a National Insurance benefit for herself and her children. She asked me, "What can I do about it, Mr. Hale? I ought to be looking after him, but I must try to go out to work. If I do go out to work part-time and earn £2 they take it off me." She said, "That is the limit."
The Minister of Pensions and National Insurance shakes his head, but he did not know much about the parents' pension until Monday, and if he shakes his head about that it shows that he does not know much about the way his regulations are applied. She can earn up to £2 a week. If she earns any more she loses it. If she goes out to earn it she has to pay for someone to look after her husband who is sick.
I have always had respect for the right hon. Gentleman. Until his last speech or two I regarded him as a lamb in wolf's clothing, as, indeed, I have regarded so many hon. and right hon. Gentlemen opposite. Now the day for the shearing has come. A little more accurate zoological identification is possible from the observations which the right hon. Gentleman made on Monday and the alibis which he has provided for himself.
I am anxious to refer to the observations of the "Manchester Guardian" correspondent who, in statesmanlike terms, called attention to the desirability of all of us giving no impression that we had in mind future events in discussing political questions. He said that we should try to be objective and dignified and put matters with a complete lack of obvious partiality and try to apply our minds precisely to the facts before us. It is good advice. I have great respect for the "Manchester Guardian." It is a fine paper.
1799 During the last Election it spent its time declaring that my Liberal opponent in Oldham, West was going to win, that he could not help increasing the poll, and was certain to knock my block off. He did not win and he polled only one-twelfth of the votes cast. The "Manchester Guardian" made no effective apology for the inaccuracy of its predictions, but we are all prone to err sometimes. None of us is immune, but I will try to be so and try to put this matter in as objective and restrained a manner as I can, using no extravagant words.
In my humble opinion, the history of the series of measures dealing with pensions is about the most contemptible thing in Parliamentary history since the war. I emphasise "since the war" to show my impartiality, because dirtier things happened before the war.
It might be convenient if we started first with the events of last Monday. The Minister rose in his place after Questions on Monday, One sometimes feels that Mondays are selected as days when, if a statement is made early enough, Parliamentary rules may act like God and, as Laurence Sterne says, temper the wind to the shorn lamb. I am not quite sure about the lamb but the Minister, whatever his zoological connotation, made an announcement about parents' pensions in which, as the House knows, I take great interest and about which I have constantly taken a prominent part in debate.
What was the Minister's alibi? He said, "I did not know. It is a most remarkable thing but we all overlooked this. You would not believe it, but even when the thing in general was in our minds it never occurred to me to think of these parents' pensions." When the Minister made an announcement on Monday, many people thought that something was being done. I think the Minister said that this problem occurred in 4,000 cases. I will give way if the Minister wishes to comment.
§ Mr. Hale
I am much obliged. We are all learning a little as time goes on.
1800 I certainly did not understand that from the Minister, and I am very glad to hear that correction. The Minister also said, as I understood, that, without being able to give an estimate of what the benefit would be, he thought that the total would be in the region of £200,000, or he said that the last increase was about £200,000 and he thought that this was about the same amount.
§ Mr. Peake indicated assent.
§ Mr. Hale
I thought it meant that at least 4,000 would receive something, but I understand that there are 48,000 in receipt of parents' pensions. That is what the Minister has said. There are 48,000 people drawing parents' pensions, 4,000 do not benefit at all and, therefore, 44,000 do. If 44,000 will receive only £200,000 between them, they will receive a miserable and inadequate benefit. But that is not the point. The point is that the number of people who are drawing National Assistance is 1,800,000, and nothing was said about them on Monday.
As to the question of parents' pensions, I want the Minister to apply his mind to that matter and tell us what happened. He made a statement to the House on the 1st December, and there were some ebullitions of joy on the other side of the House, notably from the hon. and gallant Member for Knutsford (Lieut.-Colonel Bromley-Davenport), who said, "There will be joy all over the country about this." My hon. Friend the Member for Bermondsey (Mr. Mellish), who is very acute and very able, spotted the twist at once, and said, "Nearly all my people are on National Assistance, and they will get only 4s. instead of 11s., or 2s. 6d. instead of 7s. 6d."
I asked the right hon. Gentleman whether, when he presented figures to the House, they had already been worked out or not, and whether he had incorporated in these figures the figures of parents' pensions. Had he had it all worked out about how much they would cost and the amount that would be saved by contra? The right hon. Gentleman came along gave us a long speech on the National Insurance Bill, and, on the question of National Assistance, gave us a long speech giving the details of the estimated cost. Indeed, he went further.
The right hon. Gentleman, to find out what money was needed to finance this. 1801 introduced a Bill and said that the total cost would be £123 million. He said that the overwhelming burden would be cast back on the poor, but he did not intend to tell them about that too clearly until after the Election. He said that payments would be made in February and May—the principal increase in February and some adjustments in May, and that in June they would all be called upon, employers and employees alike, to pay an extra 1s. each week. He apparently thought that people do not realise the calamities that befall them until after they have happened, and he hoped they would not do so until the ballot boxes were closed and the votes had been recorded.
If the right hon. Gentleman was able to make the computation to the extent of £123 million of what the whole of these benefits added together would cost, having put on one side the amount to be paid out and having put on the other the amount which would be saved by contra, what happened to the parents' pensions? I do not want to interrupt the private conversation of the right hon. Gentleman, but I am pressing certain questions upon him which, I hope, someone will answer. We are concerned to know whether parents' pensions are included or not. In making the computation, did the right hon. Gentleman miss out the contra in the balance sheet?
When my hon. Friend the Member for Bermondsey called attention to the disastrous effect on the sick, and after letter after letter had poured into the Ministry of Pensions from hon. Members on this side of the House, and no doubt from those on the other side too, when did the light strike the right hon. Gentleman in this connection? When did the right hon. Gentleman suddenly say, "We have, somehow or other, missed this out altogether. We never thought of it." When my hon. Friend the Member for Cardiff, South-East (Mr. Callaghan) raised a particular case a few days ago was it then that the right hon. Gentleman saw that one had missed out this figure. Who missed it out? Was the whole computation false, or was it this sum of £200,000 that was left out? Is that it?
I will try to deal in a wholly impartial way with the question of contributions to National Insurance. The people in National Insurance have been swindled for years, and they are swindled generally 1802 by being told that a Government actuary computed that, in the immediate future, a tremendous number of burdens will come on the National Insurance Fund which never came on it before. We have been told, year after year, that we have only to study the census sheets for the last hundred years to know for certain that there are fewer people making money and more people drawing money out, and that the burden on the Fund will be greater. Year after year, we have been told that story, but what has happened?
Two years ago, the right hon. Gentleman pinched £300 million out of that Fund. Of course, I am not suggesting for a moment that the right hon. Gentleman-took it home with him, but he transferred it to the Insurance Reserve Fund, which now stands at over £1,000 million, which is ten years' income from the Bill which the right hon. Gentleman, who is now smiling, arranged to introduce in December. The right hon. Gentleman shifted that sum from line 1 to line 2 so that it was then in reserve and he was careful to forget about it. If we look at the figures of the National Insurance Fund they do not refer to any reserve but to the income, the expenditure, the amount left in balance, and so on; and this balance has gone down by £300 million, all of which makes the argument a little more valid.
What was done this time in the statement—not even in parenthesis but in a footnote in small print—was to write off £14 million of a loss on the value of the investment of £300 million. This £14 million of public money was written off in a footnote. I see that my right hon. Friend the Member for Llanelly (Mr. J. Griffiths) smiles.
§ Mr. Hale
I am talking in the friendliest manner and in the friendliest mood. I can understand it is the nicest thing in the world to smile about these things, because one should not get indignant about them at this time of the day. But what a hullabaloo there was about the £3 million of Purchase Tax which was given to Lancashire a week or so ago and the £3 million given again yesterday, making a total of £6 million, which is half the sum the Government have written off in a footnote in the last National Insurance Report. That is how this money is being dealt with and how this scheme is being administered.
1803 I should like now to direct attention to what really happened in connection with the introduction of these pensions and benefits. It will be remembered that my hon. Friend the Member for Ince (Mr. T. Brown), in March of last year, moved a Motion calling attention to the very serious plight of the old-age pensioners and of the necessity for urgent action. I always listen to my hon. Friend the Member for Ince, than whom the old-age pensioner has no greater friend in this House, with great respect and sincere emotion. But I want to call attention to another aspect, to the wicked swindle of talking about the cost of living in relation to old-age pensioners and using the Interim Index of Retail Prices in connection with their cases. The right hon. Gentleman did it again today, and he knows by now how false and how cruel it is.
This morning I had a letter from a lady who said, "My total income under the new rule is £2 11s. and that is supposed to include 12s. 6d. tuberculosis supplement." I do not know whether the figure is right, but I will send the letter to the right hon. Gentleman tomorrow. She asked, "How can I pay rent and food for myself on this? What food can I have?" Everyone knows that over this period the price of food has gone up, by the deliberate action of the Government in the abolition of food subsidies, and by the indeliberate inflationary policy. As I just said, we have the melancholy spectacle of the world price of wheat going down while the price of bread increases.
Everyone who has tried to study the case of the old-age pensioner knows that the first thing that he has to buy is his food, unless there is rent to pay, and where there is an increase above the minimum it is paid for by way of supplementation. The main thing is food; and the price of tea has gone up, margarine has gone up, sugar has gone up, bread has gone up, all the absolute essentials have gone up constantly during this period with which we are dealing, so that many of these prices are 50 per cent. and 60 per cent. higher than they were four years ago. It is all due to this Government for interfering with the food subsidies and for pursuing the policies that they have.
1804 I see that the right hon. Lady the Member for Moss Side (Dame Florence Horsbrugh) shakes her head.
§ Mr. Hale
I am much obliged. If the right hon. Lady did not shake her head, I can take it as some kind of assent, as she displays so much interest in the matter.
But all this was done, and the three items in the budget of the old-age pensioners are food, fuel and light—and clothing if they can manage it. Clothing, if they have an allotment. Clothing, if they have some method of supplementing their food resources. If not, they carry on with the same clothes year after year and make do and mend them. If hon. and right hon. Gentlemen opposite tried to do that, I am sure they would realise that this is a matter to which more attention should be paid.
And all the time the right hon. Gentleman comes to the House and says that the Interim Index of Retail Prices shows that prices have not gone up so much. And he takes into account such things as wardrobes, linoleum, carpets and furniture and says that on that index he estimates how much it costs an old-age pensioner to live. It is disgraceful. These cases have poured in over these last few days. In Oldham on Sunday I interviewed case after case. There was one case of which the right hon. Gentleman appears to have taken note. The woman concerned lost her husband in the First World War and she lost her only son in the Second World War. Now she is on her own. One day there came a notice to say that she was to have a little more. Two days later there came the other notice to say that she was to have just as much less. So it goes on.
It goes on in connection with 1,800,000 potential cases. This is a shocking state of affairs and I shall say frankly what I think has happened. Were we able to call the shade of the late Sherlock Holmes into this Chamber, I am sure that he would be able to devise a provisional hypothesis in a short time. The right hon. Gentleman will remember, as he is a Holmes fan, that one of the most famous of the stories was of what happened to the dog in the night time. It was a mystery about what happened to 1805 the dog. The dog did not do anything in the night time. He did not bark. Holmes said that was the mystery: why did not the dog do something in the night time?
The mystery of this problem is what the National Assistance did at night time and why that dog did not bark. The simple answer is that they sacked the dog. We put George Buchanan there as Chairman of the Assistance Board. He is a man of great heart, a man of great ability, a man of great knowledge and understanding. He brought about a new service, and the National Assistance Board gave a service of great value, a service full of humanity.
In those days, I could write letters knowing that they would be considered by someone who knew all there was to know about poverty and how to deal with it, who knew about the needs of humanity and about the suffering of people. Yet they sacked the dog and there is only the kennel there now. They sacked the dog and they made room for an eminently respectable Conservative Member of Parliament who, according to the Index of HANSARD, has scarcely ever spoken about matters of this kind in his time here. That is not surprising, because he is an expert on local government. I turned up the Index today, because I would not like to say anything unfair, and I noted that he said nothing material about these matters. I admit that it was a perfunctory glance, and that I am liable to be corrected.
No one ever told us why George Buchanan had to go. No one has told us why the poor people had to lose such a good friend. If we put this in its perspective we get this picture: we get-my hon. Friend the Member for Ince, last March, saying that something must be done about the old-age pensioners. Hon. Members opposite decided not to vote against the Motion and they are entitled to the credit of all their benevolent intentions. One assumes that they agreed with the Motion up to a point because it was carried without a Division. However, the Chancellor of the Exchequer said that there was an economic crisis at the moment and nothing could be done.
The right hon. Gentleman never said what the crisis was. He never has said what these crises are. In point of fact, we have smaller gold and dollar reserves at 1806 the moment than we had in 1951 and the balance stands lower in the New York market than it did in 1951. All the time the Chancellor has told us that we have had an economic crisis here and another one there, an economic recovery here and another one there. We had an economic recovery in the Cabinet meeting on Monday morning. That enabled another £3 million to be chucked out by the Chancellor on Thursday night.
In this matter, we had, in March, "Old-age pensioners when we can do it." The right hon. Gentleman the Leader of the House may be going to another place. There are rumours, though I agree that one does not pay much attention to them. No doubt, as a good leader, the right hon. Gentleman has said to himself that the present Government will come to an end some time. Just as Lord Randolph Churchill forgot Goschen so the Minister of Pensions forgot pensions, and the Leader of the House forgot that there was to be an Election. This shows what one might call a contradiction in terms, or an absence of mind, on the Government Front Bench which wears a slightly sinister aspect.
We got to the period of the long vacation, and the announcement by the Minister at Blackpool that something worth while would be done, something which would inspire confidence. I cannot remember the phrase, but it rather hinted that it would bring big electoral dividends. At that time the possibility of an Election first occurred to the Minister, so the Minister came to the House on 1st December. There were demonstrations of joy about the 6d. that people were to get on balance, and that many people have got on balance, although my hon. Friend the Member for Bermondsey expressed very grave doubts about it.
In the course of the debate, my right hon. Friend the Member for Caerphilly (Mr. Ness Edwards), a former Postmaster-General, called attention in detail to the point that, to the best of his information, the Government seemed likely to make a profit on the transaction. They were to get £100 million by the extra taxation paid after the Election and £23 million in other ways. My right hon. Friend said that the Government would save at least £12 million on the money they would get back, while the amount they would have to pay would be insignificant 1807 The figures left the Government in the position of contributing only £7 million to the National Insurance Fund. In the absence of any explanation from the right hon. Gentleman, it seems that the Government have pinched £25 million from the Insurance Fund, in respect of the payments which they have made in the course of the last few years. I speak subject to correction, but in the table which I find in the Annual Report of the Ministry of Pensions and National Insurance for 1953 I find that the contributions from the Exchequer in the year ended 31st March, 1951, were £95,750,000 and an additional sum of £44 million.
The Minister shakes his head. I cannot help it; this is his document, and it costs 4s. 6d. If it is inaccurate it seems rather highly priced. In the year ended 31st March, 1953, the Exchequer contribution was over £65 million, with no additional sum. Therefore the actual reduction in payment from the Exchequer over that period was about £70 million. That is why, at the end of the year, there was about £1,300,000 in the National Insurance Fund.
It is in the face of those figures, those contributions, it is in the face of those liabilities that the right hon. Gentleman comes here and says that they are getting 6d. He said so on Monday. He said that everyone would be a bit better off. There are no cases in which we have done as the Chancellor did and taken off in tax reductions less than was put on. We may have put on 7s. 6d. and taken off 7s. but it has always been at least 6d. less. There are hundreds of thousands of people who will be 6d. better off at the Election but who, a fortnight later, will be worse off. That is all we have got from the Minister's statement.
§ 9.25 p.m.
§ Mr. J. A. Sparks (Acton)
We have listened to a very eloquent speech from my hon. Friend the Member for Oldham, West (Mr. Hale) in support of the pensioners. I believe that he was right in what he said about the Minister of Pensions and National Insurance and his latest proposals for increasing the amount paid to old-age pensioners. It has not been the willing policy of the Conservative Party to raise old-age pension rates. Not very long ago the right hon. Gentle- 1808 man the Member for Woodford (Sir Winston Churchill) in a letter to Mr. Halliday, Chairman of the Midlothian Committee Old-Age Pensioners' Association, and quoted in the "Edinburgh Evening News" of 8th February, 1949, said, amongst other things:The Government Actuary has estimated that by 1970 the cost to the Exchequer for retirement pensions will be £501 million. This being so, we do not consider it possible to raise the basic rate of the pension. Our object is by sound financial measures to keep up the purchasing power of the £ so that it buys as much as if not more than it does now.It is quite obvious that the then Leader of the Conservative Party, speaking in that tone, had no idea whatever then that there was justification for a rise in the retirement pension. Presumably, the policy of his party having failed, prices having risen and the cost of living gone up, they felt that they must do something for the old-age pensioners or probably face the prospects of a landslide in any subsequent General Election.
Merely increasing the retirement pension amount is not really the end of this problem, and I should like to deal with another aspect of the question of welfare and the care for old people. Hon. Members may or may not have seen in some of the daily papers today the report of Mr. B. M. Curtis, the Secretary of St. James' Hospital, King's Lynn, Norfolk, to the management committee on the 3rd May. He reported on the difficulty the hospital was having in persuading relatives to receive back into their homes an aged person once that person had been admitted into the hospital. This is not peculiar to one hospital but is general throughout the country, and particularly in built-up areas such as London and our other great towns and cities. The report says:It is a hospital, not a home for old people. Some relatives will not understand this. Once their father or mother has been admitted as a genuine hospital case they refuse to accept the responsibility of taking their parents home when they are ready for discharge.Commenting on that, the chairman of the committee, Sir Stephen Green, said:We cannot shove these old people in an ambulance and dump them on the doorstep of their relatives.It is not the fault of the relatives in most cases. In the overwhelming majority of cases, what have these poor old folk 1809 to come back to after having entered hospital for treatment for diseases and complaints some of which are permanent and can only be temporarily alleviated? What are their prospects on having to go back to an overcrowded dwelling occupied by a relative who probably has a family of small children trying to live in one or two rooms? What a prospect. Can one wonder that in cases like that, people feel that they are unable to take the responsibility of receiving back into their homes an aged relative who is failing in health and for whom they know they cannot provide the necessary treatment and attention? We should bear this aspect of the problem in mind. Increases in pension rates cannot solve this problem, and the housing shortage is still acute in our big cities.
What can we do about solving this problem? I looked at the Estimates for the coming year and at the amounts which the Government are proposing to spend, particularly on this aspect of the social services. The county councils have the power to do something about these poor old folk. They have the power to provide homes for aged people, but they are not doing so adequately. In many cases they are refusing to do so because politically the councils are controlled by the party opposite, and they do not believe in that sort of thing. In other cases the county councils are not prepared to pay the expense involved. The burden on the rates is so great today that some local authorities have to consider very seriously the cost of this kind of social service.
The right hon. Gentleman, in his grants for various purposes, makes a contribution towards this service for aged people. I therefore ask whoever is responsible for this part of the Government's work—and I am quite sure that when we on these benches are on the other side of the House this will be one of our first priorities—to speed up the provision of homes for aged people, in order that they may come together and live in peace and happy surroundings, where medical advice is available and where for the remainder of their days they can live in some peace and comfort.
The W.V.S. is doing a very fine job in many parts of the country. It is running these homes with a certain amount of assistance. It is doing a fine job of work, but it cannot touch more than the fringe 1810 of the problem, for it has not the necessary financial resources. When these poor old folk are ready for discharge from hospital after treatment, what a great thing it would be for them if the county authorities could provide them with a decent home where they could meet other old folk, who had common interests, and where they could have a room of their own so that they would not become a burden upon their sons and daughters and the families of their sons and daughters and would not add to existing overcrowding. It is time that some progress was made in that aspect of our social services.
Alternative provision could be made by creating an adequate service of home helps. The policy of the present Government has been to cheesepare not only in expenditure on homes for aged people provided by the county councils but also in the cost of the home help service, which is provided mainly to help aged people—for example, to help an old couple living happily together in their little home who, as infirmity grows, need to rely upon someone coming in and helping to keep the home clean and to prepare meals. Such a home help service enables them to continue to live together in their little home. It is a great social service which needs considerable extension.
The service provided at present is by no means adequate, first because it is not encouraged by county authorities and secondly because the charges made for the services of these home helps have been increased to such an extent that the old folk cannot afford to pay them. Thus, together with invalids and others who may not be regarded simply as old age pensioners, these aged couples are being deprived of a service which only the Government and local authorities together can provide.
I feel that our next step, therefore, should be to consider this aspect of the social problem and to endeavour to do something along a different line. The provision of higher pensions in itself does not solve all the problems. More money should be made available to the county councils to help them provide homes for aged people and to augment their home help service. In return for that we shall know that the old people of our country 1811 are being better looked after than many are now.
Another problem which has been mentioned by previous speakers, but which needs underlining to some extent, concerns the Health Services. There has been a considerable reduction in the amount which is being spent on some of the Health Services. I know that to some extent that is accounted for by the new charges imposed for dental and optical treatment, but they do not account for the entire reduction. If we take the last three-and-a-half years of the Labour Government and compare them with the three-and-a-half years of the present Conservative Government we find these astonishing figures: In the last three-and-half years of the Labour Government £129,291,000 was spent on general dental services. That amount has fallen under the present regime to £78,024,000. For ophthalmic services over the same period the amount fell from £58,528,000 to £22,828,000. Had we been on the benches opposite charges for dental and optical treatment would have been withdrawn in 1954. They were put on in 1951 for three years and only as a temporary measure.
The reduction in expenditure on optical and dental services does reflect an accumulation of ill-health in the community. Today we have a greater number of people in need of dental and optical treatment who, for one reason or another, are unable to meet the charges necessary, particularly in regard to dental treatment as distinct from the provision of dentures. That reduction reflects the indifference of the Government to the general health of the people as affected by the dental and optical services.
Finally, I want to touch upon education. Some figures have already been quoted in an attempt to justify the proposals of right hon. Gentlemen opposite and what they hope to do about expanding the education service. It is important that we should cast some light on what the record has been in the last three and a half years because there has been a definite reduction in the provision of new school accommodation and extensions. The labour force engaged upon new schools and extensions has dropped from an average of 38,000 in 1951 to 31,000 in 1954. Expenditure in the last year of the 1812 Labour Government was just over £47 million. In 1952 it fell to £32,698,000, in 1953 to £41,465,000 and this year—1954–55—it has risen to £51,286,000.
The fact remains that the number of new school places provided by the party opposite has very considerably declined. For instance, in the year commencing 31st January, 1951—the last year of the Labour Government—154,550 new school places were provided. In the year commencing 31st January, 1952—based upon schemes already approved by the Labour Government—the number of new places provided in schools was 158,350, but in the year commencing 31st January, 1953, when in the main they were based on schemes approved by the present Government, the number of new school places fell to 99,729 and, in the year commencing 31st January, 1954 the number dropped to an all-time low record of 29,455.
When we compare that reduction in the number of new school places provided over the period of the last three years with the considerable increase in overcrowded classes from 35,103 in the last year of the Labour Government to 43,751 in 1954, we get a very true picture of the results of the policy which the party opposite has carried through in the past three or four years.
It has been a policy of reducing the educational services, of cutting down still further the dental and optical services, of reducing the social services for the provision and accommodation of aged people, and the home help service administered by the county authorities. It has been a generally smallminded approach to many of the smaller social services which, perhaps, do not loom so large in our attention as some others. It has been a general cheeseparing and cutting down of small social services that are vitally necessary if the more unfortunate people of our country are to have a square deal.
I feel sure that in the matter of a few short weeks there will be a substanial change in the complexion of this Chamber. I am confident that when we are on the benches opposite we will take in hand these urgent social questions and endeavour to bring a higher standard of life and of comfort and welfare to the more unfortunate sections of our community.
§ 9.46 p.m.
§ Mr. A. Fenner Brockway (Eton and Slough)
I am glad that in the last hours of this Parliament we are turning our attention to some of the first human needs of our people, as has been reflected in the speech of my hon. Friend the Member for Acton (Mr. Sparks) and in preceding speeches.
I want first this evening to continue the discussion about the position of the aged. Right hon. Gentlemen on the benches opposite frequently make the claim that during their period of office standards of life in this country have risen. In so far as that is true, it is not a reflection of wage increases so much as a reflection of overtime which has been worked in the factories, on the railways and in employment generally. Indeed, one can say that if the homes of our people are being kept from want and if our economy is kept to any degree poised, it is largely because of the overtime now being worked by those engaged in industry. Whether it is true or not that as a result of overtime standards of life have been improved, it certainly is not true that those in the community who are most in need—the old, the sick, the widowed and others who are unfortunate—are in a better position today than they were a few years ago.
I heard with pleasure in this House—I think it was at the end of last year—of the intention of the Government to raise old-age pensions in April this year.
I took that news gladly to the old folk in my constituency. I raised their hopes, but what am I now finding? I get letters every day. I cannot go to my constituency without being approached by old-age pensioners who tell me that the raised old-age pensions have proved an illusion. I have had many of them come to me and say that their total increases, after National Assistance has been reduced, are, 1s. or 2s., or it may be 2s. 6d. a week, and that those increases are not adequate to meet the increased cost of living.
It is not merely that there have been small increases which have been inadequate. In some cases there have been no increases at all. I hold in my hand a letter from an old-age pensioner whose wife is also an old-age pensioner. She is suffering from the effects of a stroke. The old man has to attend to her and to all the needs of their home. They have 1814 given to me the actual figures of the change in their income as the result of the increased old-age pensions. These figures show that the increase which they received last February from greater National Assistance has now been entirely taken away as a result of the old-age pension increases of 25th April.
In February, their National Assistance amounted to 17s. Because on 25th April their old-age pensions were increased to 17s., their National Assistance had been reduced to 2s. 6d. The result is that today, despite all the claims for helping the old-age pensioners, that old couple are not receiving one halfpenny more than they were last February. Their position is unchanged, although the cost of living is increasing.
When I put a Question to the right hon. Gentleman about this case today—unfortunately it was not reached in time for Oral Answer—the answer was that National Assistance had been decreased because the retirement pensions had been increased. I say broadly that the position of the old-age pensioners today, despite the increase in pension announced from the benches opposite, is no better than it was before the increase was announced.
I desire to draw attention to another matter. I want to make some apology to the House because the representatives of the Ministry are not on the benches opposite. I say to you, Sir, that I have done my best to give notice to the Minister of Transport that I intend to raise this matter. When I wrote to him this morning, I indicated that I would take whatever opportunity there was to draw attention to it, and three hours ago I got in touch with his office and the office of the Parliamentary Secretary and indicated that I intended to raise this matter. I also left an urgent letter in the House of Commons for both the Minister and the Parliamentary Secretary, and I regret very much that they are not on the benches opposite. I have written in detail to the Minister about the case I am going to raise, and I hope that it is not really necessary for me to say that I shall do my best to give publicity to his reply to the points which I intend to make.
About a month ago the Minister of Transport and Civil Aviation announced at that Box that my constituency, particularly the town of Slough, was to be an 1815 experimental area for new methods of road safety. I welcomed that proposal. I was present at the inauguration of that scheme by the right hon. Gentleman, and I have co-operated in every possible way in that endeavour in the town of Slough. If the right hon. Gentleman is appealing to the people of Slough to make it a safety town, his own Ministry must contribute towards that safety.
Last night I was summoned by the Mayor of Slough to the Town Hall, and when I went to see him he handed me a large pile of documents and said, "Mr. Brockway, we have been doing our best about this matter for two and a half years. We can come to no conclusion, and we should be glad if you would raise the matter in the House of Commons." I replied, "So far as this Parliament is concerned, you have not given me much time." I did not anticipate last night that I should be able to raise the matter tonight.
Two and a half years ago the residents of a narrow little street in Slough, Alpha Street, only 18 feet in width, signed a petition to our town council complaining that in that narrow street a depot of British Road Services had been established. As I understand it, there had been previously a small garage there. Then a firm bought it and extended it into a depot, and then, when the British Road Services were formed, they took over that depot and extended it still further.
What has been the result? That little narrow street, occupied by people who live in small cottages, is now crowded with great lorries moving day and night, parking there, making a great noise and causing great obstruction, in a street so narrow that the lorries cannot even turn without occupying the whole of the road and moving on to the pavements. Intolerable distress is caused by noise, by damage to property as a result of the vibration of that heavy traffic, by fumes, and by the traffic obstruction.
I want to put to the Minister of Transport as strongly as I can that when we start services of this kind our first thought should always be for the ordinary day-by-day lives of the people. This narrow residential street has now been made intolerable to the residents. I have had letters from residents there who are 1816 ill, not able to rest or relax and not able to sleep because of the continual noise made by this heavy traffic of the lorries of British Road Services. I have had copies of the new document which the British Road Services has distributed in Slough giving advice to our citizens on how they should conduct themselves in their streets. Passages of these copies have been marked by my correspondents with sarcastic references to how British Road Services is using the depot and breaking all the regulations laid down in the document.
I ask the Minister to begin to interpret these things in the ordinary simple terms of human life and the effect upon men and women in their homes. I have read this correspondence, which has continued for over two and a half years. Hopes have been held out that the depot would be transferred to the trading estate or closed down. Again and again those hopes have not been fulfilled. I ask the Minister to seek to put the matter right so that, after two and a half years of noise and vibration in these little homes, the cracking of walls and the causing of so many difficulties, some hope of rest and peace and relaxation may come to these people who are suffering in this way. I regret that the Minister is not able to be present, but I hope that he will read my words and do his utmost to meet the needs of these people.
§ 10.2 p.m.
§ Mr. James Griffiths (Llanelly)
I presume that the Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance is the only hon. Member opposite who will take part in the debate after I have concluded my remarks. Subject to what he has to say to us, I must say that the debate has been in one respect a very great disappointment. The Government seemed to have run out of concessions because, so far, we have not had any indication that, in this very wide sphere of social services which concerns the whole nation, and, in particular, the old, the aged, the afflicted, the maimed and the injured, beyond what has been already provided the Government have anything more to say to the country or to these people. We have noted it on this side of the House and I am sure that the country will note it.
1817 This has been a very good debate. Every time we have a debate covering these subjects one feels at the end a pride in the fact that in the House and—I do not say this in any partisan spirit—particularly on this side, we bring to the consideration of these problems a wealth of experience and knowledge. I have listened to many of the speeches—I have missed some—but I have enjoyed all those to which I have listened.
I hope the House will permit one personal reference. I was fortunate enough to be in my place when my hon. Friend the Member for Bedwellty (Mr. Finch) spoke. Every time I hear my hon. Friend speak, my memory turns back the pages to the day when he was a younger man than he is now, when I was President of the South Wales Miners' Federation and he was a young clerk who had just begun his life in the office of the miners' union at Pontllanfraith. I induced him to go to Cardiff and specialise particularly in the field of industrial injuries and workmen's compensation. From time to time, when we have listened to him in the House, I think we have all been deeply impressed by his detailed and comprehensive knowledge. I am glad that my hon. Friend is not present to hear me refer to him, because I am sure he would blush.
My right hon. Friend the Member for Fulham, West (Dr. Summerskill) referred to the fact that there is one provision in the National Insurance Act in respect of which we have every right to complain that the Government has treated with scant courtesy. When we piloted this legislation through in the process of translating "Beveridge—plus" into legislation and administration, it was a very great venture. We began with family allowances in the lifetime of the Coalition Government, and they were introduced, not by a Conservative Minister, but by the present Earl Jowitt, who was then Sir William Jowitt, and who was Minister of National Insurance. Then we followed that with the National Insurance (Industrial Injuries) Act.
§ Captain Pilkington
The right hon. Gentleman and I had a little argument earlier. Will he not agree that the Act was passed by a Conservative Government?
§ Mr. Griffiths
The Act was finally passed in the few weeks of the Caretaker Government, but it was introduced and 1818 piloted through this House by my right hon. Friend the Minister of National Insurance, then Sir William Jowitt and now Earl Jowitt. I only make that point to get it on the record quite right.
There followed the National Insurance (Industrial Injuries) Bill, the National Insurance Act, the National Assistance Act and the National Health Service Act, all of which were piloted through this House and came into operation on 5th July, 1948. It was the second great creative period in the reconstruction and expansion of the social insurance services, the first being in the period of office of the Government of 1906–1914, under the Liberal Government of 1906. In the meantime, various Acts of Parliament had been passed by many Governments, and, in the course of the war, an old friend of mine, of whom we all think when discussing this question—the late Arthur Greenwood—set up the Beveridge Committee.
It was a very big scheme which we carried through very quickly—many people said at the time too quickly—but we brought it into operation. It was inevitable, with a scheme of this scope and of this comprehensive character, providing a multitude of benefits in an attempt to do something that had never been attempted in any other country on this scale—in reality, to bring the whole nation within an insurance scheme—that mistakes should be made, that anomalies should be revealed and weaknesses should be found.
Therefore, it was essential that we should provide in the Acts themselves—indeed, in both the National Insurance and the Industrial Injuries Acts—that, after a period when we had had experience, there should be a comprehensive review, in the light of the experience gained, of how these Acts had worked out in practice. That was provided for in the Act in Section 40, which I want to read. First, however, Section 39 provided that there shall be a comprehensive report by the Government Actuary on the workings and the finances of the Act, and that the Minister should himself present to Parliament a review of the rates and amounts of benefit on these criteria. I shall come back to that in a moment.
1819 Section 40 provides that the Minister shall review the rates and amounts of benefit in relation—(a) to the circumstances at the time of insured persons in Great Britain, including in particular the expenditure which is necessary for the preservation of health and working capacity; and (b) to any changes in those circumstances since the rates and amount of benefit were laid down by this Act or any Act amending it and to the likelihood of future changes.This duty fell upon the present Minister. The Government decided—and I think it was a wise decision for them to make—that, in addition to referring certain matters to the National Advisory Committee set up under the Act, they would set up a sub-committee under the chairmanship of Sir Thomas Phillips, with whom I had the privilege of working as head of the Department when I was Minister, to examine the wider aspects of this problem, and, in particular, that of the old-age pensioner and our provision for him.
Sir Thomas and his Committee worked very hard and they presented a Report to the Government. What have the Government done about it? I understand there was one recommendation made by a majority of the members of that Committee which the Government have rejected—or have they? Have they rejected the proposal for an increase in the retirement age? That is one of the proposals, and a very important one. I therefore hope that we shall hear a word about it.
There were many other recommendations by the Phillips Committee, but apparently no attention has been paid to them, for nothing has been done. One is a reference to those cases where rates ought to have some relevance to what is required to maintain working capacity and health. That raises the question of the minimum subsistence standard or whatever we like to call it. The Phillips Committee also called attention to the fact that there is—I am here using my own words, but the substance I take from the Report—no real reliable guide as to what is required to maintain old people on benefits. Nothing has been done about that.
This afternoon the Minister quoted figures to us about the Interim Index of Retail Prices in connection with the cost of living. But he knows, the Minister of 1820 Labour knows and the Government ought to know that the trade unions, when conducting wage negotiations which are linked with the cost of living, refuse to accept that index as the basis. The Trades Union Congress also takes that view. In effect, it says, "Not on your life, we will not accept it." If the T.U.C. will not accept it as a reliable criterion for judging the changes in the cost of living for the wage earner, how much more irrelevant is it for those people in receipt of benefits, the bulk of whose income goes on food, rent and fuel? As far as I know, the Government have done nothing about that.
Moreover, the Minister, in presenting his review under Section 40, appended another document which was published as a White Paper. I must say, quite sincerely, that here was an opportunity to make a real survey of this field and present to the House a comprehensive report. But the Minister presented a report which was a couple of tiny sheets, completely unworthy of the task placed upon him by this Section.
The National Advisory Committee of the Ministry has over 200 local committees, set up under the provisions of the Act. The Committee was asked by the Minister if it would provide from its experience its view of the provisions of the Act and how they worked out in practice. We have never been told what was its report. Here were 240 local committees composed of representatives of employers, trade unions, of friendly societies, of welfare workers, of people with real interest in this wide question, in close touch with the local administration, who have seen these benefits in operation and who have to work in relationship with the local people. Here was a fund of experience which has been available to the Minister and which should have been available to this House.
I say, therefore, that what we have had is a travesty of the duty laid upon the Minister under Section 40 of the Act. We have never had a real examination of the problems that have emerged, of the anomalies that have been revealed, of the weaknesses that have been found in this Act, so that we could carry out the duty as a Parliament, under that Section, of reviewing the work we have done, of removing the anomalies, of making improvements and of considering again 1821 the level and amount of benefits on the criteria laid down.
The Minister has had the great advantage of the Civil Service—to which all of us who have been Ministers owe so much. Any party in opposition has to work on these problems without that great advantage. We have done our best. It is not in order for me this evening to make anything other than a cursory reference to the programme for the reconstruction of both the Ministry and the administration and other aspects of the social insurance scheme embodied in our election manifesto. I will only say that it is the result of careful consideration by the party to which I am privileged to belong. I shall speak about this in other places between now and the date in May about which we think so often these days. I believe that our proposals represent an essential next step in the development of our social security system.
This evening, within the limits of this debate, I will indicate some of the problems which we have seen arise in the last few years in the administration of these Acts. I shall do so to give the background which has led to the proposals in our manifesto. What we sought to do in this insurance scheme was to bring within its scope virtually all the population under three sections: those who are working for an employer, those who are self-employed, those who are not gainfully employed.
It is right to begin by saying that we have not been able to do that within the context of an insurance scheme on the flat rate benefit contribution. Indeed, in the original Act we had to provide that persons with an income of £104 per annum, or less, would be exempted from paying contributions. The Minister, after taking the advice of his Advisory Council, has had to raise that limit. I am not complaining, but stating the fact.
It means that we are declaring that many people will be excluded from the provisions of the National Insurance Act because they are unable to pay contributions at the existing level. How many will there be? Thousands? Tens of thousands? Let us bear in mind that the payment will go up in a few weeks time. If they are excluded from National Insurance the only other provision for sick- 1822 ness, affliction or becoming old is by National Assistance. By excluding people on grounds of income from the National Insurance Act we compel them to go to National Assistance.
When Beveridge presented his Report and we prepared legislation, National Assistance was, in the main, to be a residuary service for those not covered by insurance. The Minister agrees. What happened? The Minister quoted figures. Let me quote figures for which I am indebted to my hon. Friend the Member for Sowerby (Mr. Houghton), who has given me the percentage figures for pensioners on National Assistance from October, 1946, to September, 1954.
In October, 1946, 532,000 pensioners out of 3,400,000 were in receipt of National Assistance supplementation, or 15 per cent. By 1951, there were 737,000 out of 4,100,000, or 18 per cent. By 1952, there were 825,000 out of 4,200,000, or 196 per cent. In September of last year there were 983,000 out of 4,400,000 pensioners in receipt of supplementation, or 224 per cent., who found their pension inadequate and had to ask for National Assistance. In other words, nearly a quarter of the pensioners cannot manage on one of the major benefits of the insurance scheme.
When the Minister introduced his Bill he uttered sentiments—I am quoting him from memory—to the effect that it was the desire of the Government that people should be provided with benefits, pensions and other things as of right, so that fewer would have to go for National Assistance. Increases in insurance benefits are due to take place. The Minister told us that in March, 1955, it was estimated that on the new benefits there would be 100,000 pensioners fewer on National Assistance. Did I understand him aright?
§ Mr. Griffiths
See what happens. The hon. Gentleman told us that there were 1 million pensioners, in round figures, on Assistance. With the new basic pension, paid for mainly by increased contributions, only 100,000 pensioners will be taken off National Assistance. That means that 20 per cent. of pensioners will be in receipt of National Assistance. It means, also, that National Assistance has ceased to be a residual service but has become an integral part of our social insurance scheme. It is that inescapable fact that is 1823 behind our proposal to establish a new Ministry which would absorb the functions of the National Assistance Board in the Ministry of National Insurance, because the two have become inseparable.
I had hoped that the Minister would have given some consideration to the problem of contributions and would have said something about the future. First, there is the relationship between the amount paid by the State and the amount paid by the contributors—the one-fifth and the one-seventh. We shall not argue that now, we have argued it before, but seven-eighths of the new benefits will be paid for, not by the Government but by contributors. Perhaps the Parliamentary Secretary will tell us what part of the benefits increases made since the present Government have been in office have been paid for by the contributors and not by the State.
Another aspect of the problem is that we accept the flat rate contribution. Lord Beveridge accepted it; he thought that it was in keeping with our whole history of social service. I accepted it. I did not accept the escalator. It was decided to bring in the full rate and the old escalator which Lord Beveridge proposed was dropped. As a result we had to put up the contributions initially to 4s. 11d., later increased by 4d.
I think I am on record as asking—and I have talked to my trade union friends and with hon. Members on both sides—about the level to which we could raise a flat rate contribution without making it a regressive tax. I was worried about the contribution going to 5s. Since then there have been changes in the national economy, in the wage structure, in earnings, overtime and all the rest, in taxation and in exemption from taxation.
What is the position now? Only the poorest in the land pay the full contribution—no one else does. Everyone who is within the scope of Income Tax can offset a proportion of his contributions—including the proportion he pays for pension—against his Income Tax. We in this House are all insured; we do not pay the full contribution. Part of it is set off against Income Tax. When these new contributions become payable next month only those who get least will pay the full 1s. Hon. Members will pay not the 1s., but only a part of it.
1824 We have now come to the stage when only the poorest—and I repeat this because it is of vast importance—pay the whole contribution. I am an old collier and I speak of colliers. I worked as a piece worker. The piece worker, with his earnings, will not pay the full contribution—the labourer will. I should have thought that such a problem, which has emerged in the last few years would have been one to which the Minister's Advisory Committee would have given some attention and have presented a report to the House, because it is one of the most important changes that have taken place since I designed the 1946 Act.
The man earning £9 a week pays the full 1s., and people with incomes like ours get 3s. 6d. a week relief. Let the Government look at their much-boasted Budget in that light; let them look at the £140 million in that setting. Let them explain to the £5 and £6 a week man with a family, "You have got nothing from the Budget, and you are the only man who will pay the extra 1s. in full in June." There has not been a word from the Government on that problem.
I now come to another problem. An hon. Member asked me just now if I had changed my mind. I hope that I shall never be afraid of changing my mind or my view. I hope I shall never grow so old that I cannot learn from experience. It is the Tory Party that does not learn. It only finds things out when it receives letters from people. There has only been one experience in the whole of our Social Services of relating benefits to the cost of living and using a sliding scale, and that was in the case of war pensions. War pensions were based upon an escalator, and it broke down and failed. We therefore rejected it, and we said that at the end of five years the whole matter must be reviewed.
One of the problems we found in the last six or seven years of the working of this scheme was how to prevent the erosion of the real value of the benefits. We all have our particular arguments about this matter, and we all have our own views about who is responsible for the cost of living and all the rest of it. But there is the problem. We sought an answer to it, and we have put our answer in our manifesto. The Parliamentary Secretary may reject our answer, but he cannot reject the problem. What is his answer? What is the Government's 1825 answer? Have they one? Have they considered that in an insurance scheme, unless the real value of the benefits can be maintained, the whole basis of the scheme will completely collapse?
We propose that the Minister shall be under an obligation to come to Parliament every year and review the rates of benefit in the light of the cost of living. We do not propose an escalator. If the cost of living should rise, we should increase the benefit. Someone asked what we should do if the cost of living should go down. Why should we consider it necessary to reduce the benefit if the cost of living should go down? Are the pensioners and the sick the only people to be denied the advantage of a reduction in the cost of living? Therefore, we should keep ourselves free to consider that aspect of the matter. But we have an obligation to maintain the real value of the benefit when the cost of living goes up. That is our answer. The Government may reject our answer, but they must provide their own.
I now come to the question of assistance. It seems to me that in the foreseeable future we are likely to get about one million old-age pensioners seeking assistance. I should like to know what the Minister proposes to do about that. He has the power to present regulations. The way in which the Minister has done it is to increase the disregards and lift the income limits.
§ Mr. Griffiths
The right hon. Gentleman has lifted the income limits. Disregards are income limits. They are allowed so much capital, so much in benefits and so much in other resources; they are entitled to enjoy those amounts without having them taken into account in the assessment of their rate of assistance. Now, when the parent's pension is decided, they are asked, "Does the father and mother earn so much?" On that is decided the amount of the parent's pension. That is how it works.
§ Mr. Peake
The parent's pension under the War Pensions Code is a very complex affair. To start with, we have a thing called the means standard. To the means standard is added the amount of support which it is decided the son might have given to the household. From that combined amount is deducted the resources 1826 —and that gives the amount of pension, subject to the maximum.
§ Mr. Griffiths
I know that it is complicated, but let me put the issue simply. What the Minister has done is to agree to pay more to people on a higher income rate than was the case last week. Is that right? I gather that it is.
Does the Minister propose to do the same thing for those who receive benefits other than parents' pensions? What about the small capital resources of those on National Assistance? They have had no capital gain. I am thinking of those with a little capital in the Post Office Savings Bank and savings of that kind. Are there to be any increases in their disregards? If not, why not? Has not the value of their investments been eroded?
Last week I listened to the Economic Secretary to the Treasury referring to the fact that among those who would benefit from the Budget were those living on fixed incomes from investments. As one of the reasons why it was particularly essential to give them this benefit, he said they felt a reluctance to ask for National Assistance. What about these poor people to whom I refer, with their £50 capital, their £375 war savings? Is nothing whatever to be done for them?
I want to draw attention to the Assistance Board's Report with respect to those people who receive supplementation. They have to declare their resources. There are about 1 million of them—old farm workers, old colliers, workers who have given their working lives to the nation. And at the end of it all they have to state what resources they have. I beg hon. Members to read the Board's Report. These men are the salt of the earth. The resources which the Assistance Board has to take into account in these cases form a sad comment upon the return which is being given, in their old age, to these people who have given their utmost efforts to the nation. These are the poorest of the poor, and their number has been steadily increasing.
I want to deal with another matter which is important. I will not quote all the references; they are all available in the Report of the Ministry of National Insurance for last year or the year before that. Perhaps it was the National Assistance Board—it was one or the other. It prepared an analysis which 1827 showed how many old-age pensioners who retired at 65 had assistance, what percentage applied for assistance in addition to benefit and what percentage applied at age 70. The percentage of those who applied at age 70 was substantially greater than at age 65. Why was that? I will try to give the answer. It was because at 65 they may have a penny put by and will not go on National Assistance.
I pay my tribute to the National Assistance Board and its local officers. Therefore, I hope it is understood that I am not criticising them but am concerned with the whole system. At 65 people retire and get the basic pension and have a penny put by, yet we have not removed the taint of the old parish relief from National Assistance. At 65 and 66 these people make do, but when they are 70 they have exhausted their savings and there is nothing left them but assistance. It is in that setting that we say the latest increases were completely inadequate and we will increase them when—as we will—we get back to power at the end of this month.
I want to deal with another aspect of the problem. The hon. Member for Skipton (Mr. Drayson) raised the question of old people's earnings. Let that problem be examined; it has a history. The Minister, like myself, has had discussions with the T.U.C. about this matter. Until the new National Insurance Act the pension was 10s. a week, paid at 65. There were employers, including some public authorities, who, when the workman reached 65 and, continuing to work, got 10s. pension, deducted 10s. from his wages. That is what happened. It is on record and the Minister knows it is on record.
I am a trade unionist and am proud of it. Man and boy, I have been in trade union membership for 50 years and I can say that trade unionists object to employers using the 10s. pension to get cheap labour. I am all for reconsidering the earnings rule, but in the setting, if possible, of legislation which would make it illegal for any employer to use it on that basis. If Parliament increases the pension by £1 or 30s. we have at the same time a duty to pass legislation to protect pensioners from being exploited because they have that pension by being offered and paid low wages.
§ Mr. Griffiths
Yes, Mr. Deputy-Speaker, I will stop there. I can only say that in the course of the debate other hon. Members have been allowed to refer to this matter, and that it was only because of that that I took the liberty of doing so. I fully appreciate that it would require legislation. I am proud to claim part-authorship for the proposals embodied in our Election manifesto. I very much look forward to being a member of a Government which will carry them through.
I come to the question of industrial injuries. There has been no real review of that matter. The right hon. Gentleman has been the father of the new scheme and I stepped in afterwards. We are the only country which adopted it. No other country followed our example of changing the provision for disablement as a result of injury, accident and disease from being an employer's responsibility into a social service in which the worker pays for the benefit which he gets when he is injured in the employment of his employer. We did it for all kinds of reasons.
It is interesting to find that the T.U.C, which is entitled to speak on this matter, has a lot of suggestions and recommendations to make and changes to propose, although as far as the main structure is concerned it does not propose a return to the old system. That is a tribute to the working of the scheme, but it means that we owe it the duty of seeing that in the administration of industrial injuries benefits we now carry these responsibilities ourselves, as a Government and as a Parliament.
The problem of the old cases has now reached dimensions at which it could be, and ought to be, solved. I began to try to find a way to bring all the old cases into the new scheme and, at the same time, to maintain the responsibility upon the employer; for if there had not been an Industrial Injuries Act, the employers would now be having to pay increased compensation for these people who are paid for from the Industrial Injuries Fund; so that in a sense the workers are paying half the increases which have been given to the old workmen's compensation cases.
I admit frankly that I failed to find a way, largely because most employers 1829 insured only from year to year and, therefore, had no sum on one side from which to liquidate claims. Something has been done. The Minister has done something and is entitled to tribute for it. But there are those who are left, who ought to be brought inside the scheme. I want the scheme to succeed, but if it is to succeed we must continually watch it; and when there are weaknesses and defects we must eradicate them.
I gave a great deal of thought to the problem of how I should work the old accident Clause in respect of accidents arising in the course of employment. My hon. Friend the Member for Oldham, West (Mr. Hale) knows about this. I and many of my hon. Friends had a shot at working out a new Clause for it. In the end I rejected the idea because the old Clause in the old Act had over the years been amplified, explained and determined by endless decisions, including House of Lords decisions, many of the decisions being most generous in their context to the workman.
There is some feeling that the interpretation given to the Clause under the new system of administrative tribunals is less generous than under the old Act. Let me quote one case which occurred when I was Minister. There was an outbreak of Raynaud's disease in a certain factory and there were a few hundred cases in a very short time. I was asked that it should be scheduled as an industrial disease under the old Workmen's Compensation Act, before the new Bill was introduced. However. I was told that it had been decided to take the case to court and to claim compensation for it as an accident. It was the case of Alexander versus a company whose name I forget.
The case went to court. The House of Lords finally decided that it was an accident, that each vibration was an accident, and awarded compensation. Since then, I understand, the Minister has referred cases of this kind to his committee and has decided not to schedule the disease as an industrial disease, a course which may be right or which may be wrong. Does the Ministry accept the decision in the Alexander case? In the case of a man working in industry, using precision tools and having to do delicate work, does the Ministry accept a claim for injury and disablement benefit from a man with Raynaud's disease on the basis of that House of Lords decision?
1830 That is one question. The second is this. There are cases of men who, having had accidents, are assessed for disablement pension, and the Ministry's medical boards and appeal tribunals offset a certain percentage of their disabilities as being due to some other and previous accidents. There is a feeling, which many friends of mine in the miners' union feel very strongly, that because of this practice the administration under the National Insurance (Industrial Injuries) Act is less fair and generous than the treatment under the old Workmen's Compensation Acts.
I speak in the presence of hon. Members with great experience of these matters. I ask, is that so? Is the Act, under which the workmen contribute one-half towards the benefits, less generous to the workmen than the old Workmen's Compensation Acts and the judgments under them of the House of Lords? I seriously ask, is that true? I have instances here—I think the Minister has seen them—of these offsets.
I apologise to the House for being so long, but I must say a word about pneumoconiosis. I have the experience, a tragic one, of representing the constituency which is worse afflicted than any other by this disease. There was a report by experts of the Medical Research Council after an investigation in the 'thirties, and if hon. Members care to read it they will find there named in it the colliery where I started work as a boy, Ammanford.
Last year, 330 coal miners were certified to have died from silicosis and pneumoconiosis. I am very glad indeed that the number applying for certification is going down. It looks as if the measures now being taken—how fortunate to have a nationalised industry to take those measures—to suppress dust are beginning to have some effect. I was particularly glad to hear the Minister of Fuel and Power say the other day that steps are being taken to deal with shot firing and its effects in creating dust. I have no doubt that the enormous increase in shot firing in recent years has had a great deal to do with these cases which, in recent years, increased by 100 per cent. Steps are being taken to deal with shot firing, but it still goes on.
I have pressed the Minister at Question Time on this matter, and I put the question to him again now. Before 1928 1831 there was no provision at all for workmen's compensation for coal miners afflicted with dust diseases. Way back in 1842 there was a report upon conditions of work in the mines, and in it reference was made to black spittle, a disease of the lungs. It was confounded with asthma and all manner of things, but, of course, it was caused by dust, and before 1928 there was no statutory compensation for it.
A man had to prove his disease was caused by his work, and the criterion applied was the criterion of silicosis. Then there was the investigation, of which there was the report in which reference is made to Ammanford Colliery. The definition was extended to include not only silicosis but pneumoconiosis and, in particular, reticulation of the lung. That was over 15 years ago.
§ Mr. F. H. Hayman (Falmouth and Camborne)
Would my right hon. Friend also take into account the fact that thousands of tin miners in Cornwall died from silicosis, which used to be known as "miner's complaint"?
§ Mr. Griffiths
I know that very well. My hon. Friend is quite right to call attention to it.
We had the last investigation in the late 'thirties and I press the Minister to have another. It is high time. I believe that the line between pneumoconiosis and emphysema is so thin that there is no justification whatever for making a distinction between them. I speak with due deference as a layman. If experts came to my constituency I could put before them two men in the same condition, one of whom had been certified as suffering from pneumoconiosis and the other told that he had emphysema. I speak in the presence of my right hon. Friend the Member for Fulham, West and the Minister of Health. Emphysema is a disease of the lungs. Will anyone tell me that in the case of a coal miner it is entirely unconnected with the dust which he breathes? It is time that an investigation was made into this matter. This problem should be especially considered in connection with the issue of death certificates.
I have in my hand the death certificate of an anthracite miner, whom I knew well. He worked in an anthracite mine from 1912 to 1914. He served in the 1832 Armed Forces throughout the 1914–18 war and then returned to the mine after the Armistice, working underground until 1934 and afterwards, until 1937, on the surface. On 18th June, 1954, he died. There was a post-mortem examination and a coroner's inquest. The cause of death on the certificate is given as—"(1) carcinoma of the lung; (2) pneumoconiosis." Carcinoma is cancer of the lung. Everybody is concerned about the effects of smog now and again in London and about the effect of smoking. After 25, 30 or 40 years in the mine, the cause of death is given as, primarily, cancer of the lung and, secondarily, pneumoconiosis. Are the experts going to tell me that they are certain that there is no connection between those two, and that no certificate can be awarded?
§ Mr. Griffiths
I worked in the mines for years before coming to this House and I knew members of the Silicosis Medical Board. I pay tribute to them. Though, as laymen, we are entirely in the hands of the experts, I would remind the House that for many years many experts refused to acknowledge the possibility of silicosis among miners. Many of them refused to consider an extension of definitions until, under the Medical Research Council, young Dr. Hart came to South Wales and made a report on Ammanford Colliery. The time has now come for another investigation.
I am certain that in most of these cases—I use the words deliberately—whatever may be the primary cause of death, pneumoconiosis and the consequences of dust accelerate death. Here I come again to the point that the old doctrine of acceleration of death as it appears in the old Workmen's Compensation Act is not fully implemented in the Industrial Injuries Scheme.
I say these things as one who has played some part, with the right hon. Gentleman, in bringing these schemes into operation. The Silicosis Medical Board is a judicial body. It is of the utmost importance that there shall be complete faith in its decisions. I say that for the reasons I have given faith in its decisions is weakening. I want to say this to the Minister, because I shall not have a chance to say it to him again, for the next time we discuss it I shall be talking to a Minister who will be my own colleague. Unless we do something about this very 1833 quickly there will be an irresistible demand to get away from the administrative tribunal and the final decisions of the Silicosis Medical Board and refer these matters to the ordinary courts and particularly to the higher courts. That is coming.
Those are some of the problems and some of them should have been considered under the quinquennial review as laid down in the provisions of the Act. The findings should have been presented in a report of a comprehensive character, not in a couple of sheets. This is a scheme affecting millions of people. There should have been a comprehensive report drawing upon the experience of the trade unions, the employers, the local committees of the National Advisory Committee and the Ministry's staffs and local offices, to present a wonderful survey of the scheme. We have not done it. We cannot have it now in this Parliament. When we get back in power at the end of this month we will do the job ourselves.
§ 11.3 p.m.
§ The Joint Parliamentary Secretary to the Ministry of Pensions and National Insurance (Mr. Ernest Marples)
The right hon. Gentleman the Member for Llanelly (Mr. J. Griffiths) speaks on this subject with great knowledge and has played a great part in this legislation in the past. As a much younger man, I cannot match his experience or his knowledge of the historical events which have led up to the present legislation or, for that matter, his emotions. But I must say that the last point he raised about pneumoconiosis and Raynaud's phenomenon—
§ Mr. Marples
I say "phenomenon" because it is something from which I have suffered without experiencing vibration. I have it in my fingers and it sometimes prevents me from playing those sports for which I am now getting too old.
On the subject of pneumoconiosis, I am sure that the right hon. Gentleman will pay tribute to my right hon. Friend for the part he played in introducing a scheme for those totally and partially disabled 1834 from pneumoconiosis, and I think my right hon. Friend has shown that he has great sympathy on this particular point.
I shall answer some of the other points put by the right hon. Gentleman as I go along, but I think I can say now that the debate as a whole, considering that we are near the end of this Parliament, has been very much more harmonious and tranquil than I thought it would be. We have had some electioneering speeches from some hon. Members opposite and moderate contributions from some of my hon. Friends. I am under three difficulties tonight. The first is that it is out of order to discuss legislation. Secondly, we have already had five Front Bench speakers and, as the sixth, I think my contribution ought to be short. The third difficulty is that tomorrow is the last full day of this Parliament, so that there are not many things which my right hon. Friend can promise to do in this Parliament, although he can promise to do them in the next one.
Having said that, I will try to answer the points raised in all parts of the House in as non-controversial way as possible. The right hon. Gentleman the Member for Llanelly asked what was to happen to several of the recommendations of the Phillips Committee. For example, he asked what this Government proposed about the retirement age. That is mentioned in the Election manifesto of the Conservative Party, and for the benefit of the right hon. Gentleman and of the House perhaps I might be allowed to read from it. The Committee's recommendation which has attracted most attention is the progressive raising of the present minimum pension ages, to start in five years' time. The manifesto says:It is our wish to avoid any change in the present minimum pension ages.The Committee's recommendation on this point was not unanimous and in our statement of policy for the General Election we pointed out that the present minimum pension ages do not necessarily represent the limit of working life and we have pledged ourselves tocontinue to encourage the employment, without regard to age, of all who can give eifective service and wish to do so.That really answers the question raised by the right hon. Gentleman.
§ Mr. Marples
It is rather late. The hon. Gentleman made a long speech himself, and I wish he would allow me to make my speech in a reasonably orderly fashion.
The right hon. Gentleman then asked how many people would not be included in the National Insurance Scheme because their income was below £104—or now £156. The answer is that he cannot be told. It is optional for people with an income of less than £156 to contract out of the scheme. They please themselves, so he is really asking us how many people under that income will contract out. It is only those people themselves who can decide. However, this does not apply to Class I contributors. It applies only to Class II and Class III—those who are self-employed and those not gainfully employed.
Whatever my right hon. Friend has done, he cannot be so bad, because all he has done, in effect, is to restore the position which the right hon. Gentleman wanted to place on the Statute Book in 1946. He said then, "£104 is the minimum income. Below that, I want people to contract out if they wish." All we have done is to raise the £104 to £156, which takes account of the alteration in the value of money and restores the position which prevailed when the right hon. Gentleman started the National Insurance Scheme.
§ Mr. Griffiths
Are we to assume that there will be no addition to the numbers who now claim exemption?
§ Mr. Marples
There may or may not be. It depends on the people themselves. I cannot forecast what they will do now or on 26th May.
The right hon. Gentleman made some proposals to merge the present independent National Assistance Board and the Ministry. I cannot comment on those because they would require legislation, so I hope the right hon. Gentleman will forgive me.
The right hon. Gentleman made another point on the question of taxation of contributions, that contributions are allowed as an expense for tax purposes. [An HON. MEMBER: "Part."] Yes, the portion relating to the retirement pension is allowed for tax purposes, to bring it into line with the contributions to insurance and assurance which people 1836 make in the private sector. I want to put this to the right hon. Gentleman: although that part of the contribution is allowed as an expense for tax purposes, when retirement pension is eventually received that is taxable income. If the right hon. Gentleman takes a premium, and says, "You have to pay that after you have paid your tax", may I ask whether it is his policy and his party's to allow the pension to be tax-free?
§ Mr. J. Griffiths
The hon. Gentleman has not got aright the point I made. Since 1946, when we started the pensions, there have been vast changes in the field of Income Tax. The result is that on 7th June, if the pensioners' income brings them within the scope of Income Tax, the Minister will have to offset it.
§ Mr. Marples
The right hon. Gentleman is wrong. I appreciate his point, but the two are linked together. If the contribution is allowed for tax purposes, the pension that comes in is taxable. You cannot do one without doing the other. If the right hon. Gentleman were reviewing the pensions system, would he also review taxation on pensions?
§ Mr. Griffiths
It should be dealt with in the quinquennial review. Are we to understand that the only people to pay the full insurance contribution will be those who do not earn enough to pay the tax?
§ Mr. Marples
It is a tax problem that was originally raised by Sir Stafford Cripps. He instituted the system of allowing the contribution as an expense for tax purposes, which means that we must tax the pension when it is received. We must do it to both contribution and benefit.
National Assistance came prominently into the field of the debate. The hon. Member for Ince (Mr. T. Brown), the right hon. Lady the Member for Fulham, West (Dr. Summerskill) and the hon. Member for Sowerby (Mr. Houghton) asked whether the assistance at the present rate of 37s. 6d. was not "niggardly treatment" and was fair on the "poorest of the poor." In its Election manifesto, the Labour Party propose straightaway to increase National Assistance.
If it is said by hon. Members opposite that the present rate is not enough and 1837 is niggardly, I would remind them that it is higher now than it has ever been before. It buys more now than ever before. I shall quote from an index I do not like using, the Interim Index of the Retail Prices, which was the creation of the Opposition when in power. It may be bad, but hon. Members opposite created it.
§ Mr. Hale
I have urged for four solid years that the Government should bring in a new index relating to old-age pensioners. I have raised it on the Adjournment, by Question, by interruption on occasion, and in every legitimate, proper and decorous way that a Member of Parliament can raise it. I am almost tempted to say "indecorous" as well.
§ Mr. Marples
The hon. Gentleman could never be indecorous. He came into this House when I did, and has been a Member for 11 years. It is interesting to note that for the last four years he has wanted to change this index which his own Government introduced. It shows that the highest value of National Assistance under the previous Government was in 1948, when the scale-rates would buy goods to the value of 35s. 7d. Our rates buy goods to the value of 37s. 6d., which is 2s. more. If this is "niggardly" what adjectives would hon. Members opposite use to describe their own Assistance rates? I expect that most of those adjectives would be interesting but probably out of order.
I come to the points made by the hon. Member for Ince and by the right hon. Gentleman on the question of disregards. They said that when assessing National Assistance rates the amount of income disregarded had not been altered since 1946. Of course, some disregards would require legislation, but they cannot be linked up with the fact that it would help the poorest of the poor, because the poorest of the poor do not have any income to disregard. That suggestion would only help those people who have an income, and would increase the numbers on National Assistance, but would not increase by one halfpenny the income of the poorest of the poor. Though the hon. and the right hon. Gentleman may put it forward as a good point, they cannot put it forward as a point for increasing the income of those receiving the smallest amount.
§ Mr. J. Griffiths
But I spoke to the Minister about it. That is exactly what the Ministry has done, in essence, with the parents' pensions.
§ Mr. Marples
I am sure that the right hon. Gentleman is wrong. And the hon. Member for Ince, who made an emotional speech on the subject, ought to take back the message to his constituents that he cannot help the poorest of the poor by altering National Assistance disregards.
The hon. Member for Ince also said that two or three letters had been sent to him. If he will send me details I will look at them during the next two days, and after we return.
§ Mr. T. Brown
The letters came from Norcross, Blackpool, from the Ministry of Pensions and National Insurance.
§ Mr. Geoffrey Bing (Hornchurch) rose—;
§ Mr. Marples
No, I am sorry, it is now 11.20 p.m. and many questions have been raised. I cannot give way.
The hon. Member for Eton and Slough (Mr. Fenner Brockway) complained that insurance benefits were not disregarded and said that they should be—and I think the hon. Member for Ince raised the same point. My right hon. Friend is only carrying out the Labour Government's statutory provision. He cannot ignore the law placed on the Statute Book by the right hon. Gentleman. It would require legislation, so it would be out of order; but I must say that I have not noticed in the Labour Party Election manifesto any proposal to alter it. Do they propose to alter it?
§ Mr. Marples
The hon. Member for Brierley Hill (Mr. Simmons), who is not now in his place, interjected what I thought was a very unfortunate party political note, and one of the first acrimonious contributions that we had in our debate. He was effectively demolished by my hon. Friend the Member for Morecambe and Lonsdale 1839 (Sir I. Fraser) on most points. I am told by my hon. and gallant Friend the Joint Parliamentary Secretary who deals with war pensions that this is the first time in this Parliament that war pensions have been dragged into the political arena, and he has asked me to say that he regretted that a great deal.
The hon. Member for Brierley Hill raised two points on war pensions. The first was that the conditions should be altered. That was answered by my hon. Friend the Member for Morecambe and Lonsdale. The other point was that the cash benefits were rather mean. They may be mean—I will not comment on that—but in their six years of office the Labour Government gave from the Exchequer £11 million while in their term of office the Tory Government have given £25 million. The country can judge for itself from those figures.
The other point raised by the hon. Member for Brierley Hill was that the Ministry of Pensions and National Insurance was too big and should not cover war pensions. He does not want war pensions to be incorporated in the Ministry of Pensions and National Insurance—he thinks it too large—but, according to its manifesto, the Labour Party thinks it too small, because it wants that Ministry to take over the independent National Assistance Board. Is it too large, or is it too small?
§ Mr. J. Griffiths
I do not want to interrupt the hon. Gentleman unduly, but may I say that I was fully in support of the proposal to absorb the Ministry of Pensions and the Ministry of National Insurance. Some of my hon. Friends disagreed, as they were entitled to do, but I thought it was the right step. I think that the new step that we propose to take is equally right.
§ Mr. Marples
The right hon. Gentleman has greater faith in his own logic than I have, if he thought that it was too large then and he now thinks it is too small. His hon. Friend whom I am answering said that it was too large, and described it as a vast machine. But, in any case a small organisation would not be able to offer the same facilities to war pensioners, and I think the right hon. Gentleman is on a good point now, because the war pensioners can now use the extensive network of the offices of the 1840 Ministry of Pensions and National Insurance. Therefore, I agree with the right hon. Gentleman, and not with the hon. Member for Brierley Hill.
The hon. Member for Brierley Hill made another point to which I want to refer. He said that the terms of reference of the Rock Carling Committee were not what he would like them to be. The Committee was set up in June, 1950, and at that time he was the Parliamentary Secretary to the Ministry of Pensions. Therefore, if the terms of reference were wrong, I do not think that the hon. Gentleman can blame this Government.
Now I come to my hon. and gallant Friend the Member for Poole (Captain Pilkington), who mentioned a number of points dealing with health and widows. The terms and conditions on which widows receive benefit have been referred to the National Insurance Advisory Committee. He also mentioned the question of pensions increases for public service pensioners. The Conservative Government have already brought in two Measures to assist former Crown and local authority servants, the Pensions (Increase) Acts, 1952 and 1954. I would assure him of this, and I have the Chancellor in support: we mean to keep the position of these pensioners under review sympathetically and understandingly, and if a further Measure is warranted we shall certainly introduce it. The present law on the subject is not like the law of the Medes and Persians, which cannot be altered.
The right hon. Member for Llanelly asked—and I sent him a note to try to get accurately the figures that he wanted—how much of the increase in the Exchequer supplement to the National Insurance Fund was due to the recent changes. It is about £24 million, of which £1 million is for industrial injuries. I hope that gives the right hon. Gentleman the information he wanted.
§ Mr. Griffiths
We all very often make claims in this House for what we did in respect of industrial injuries benefits. I gather that the increase in the Exchequer contribution under the Industrial Injuries Act is £1 million. Can the hon. Gentleman say what is the increase in the contributions?
§ Mr. Marples
I think the Exchequer pays one-sixth. I got the precise wording in writing of what the right hon. Gentleman wanted to know, and I have given him the answer. If he now wants an answer to another question he should first give me prior notice.
The hon. Member for Bedwellty (Mr. Finch) made a reasonable speech—reasonable in tone and content—and most informed, as he is an expert on this subject. It was only in the last two or three sentences of his speech that he did a bit of electioneering, and I thought it was extremely good for an exuberant Welshman to confine himself to only two or three sentences of electioneering. He said that the retirement pension as of right should provide a subsistence minimum. He said that Lord Beveridge recommended this retirement pension. Of course he did, but what Lord Beveridge said in his Report was that he hoped that the subsistence minimum would be reached in about 20 years' time. The question of timing is of great importance.
The hon. Gentleman also said that this Government had departed from the policy and principle laid down by the previous Labour Government. But we cannot have done that, because the present pensions buy more than the pensions that the Labour Government gave. We cannot have departed from that policy. How could we? The hon. Member knows as well as anybody that we cannot have done so.
He raised a number of points about widows' pensions. This matter has been referred to the National Insurance Advisory Committee. The statutory review of pensions was laid down by the Labour Government and is on the Statute Book. It is confined to a review of the rates of benefit, which the Government Actuary had before him. My right hon. Friend has carried that out, and on the basis of official price indices, the increase should have been 5s.—but my right hon. Friend gave 7s. 6d. He cannot be accused of not carrying out that pledge. In addition, he carried out an extra-statutory review of the conditions of widows' benefits, which is more than the party opposite did.
Another point raised by the hon. Member was that of coroners' verdicts. He referred to cases where there was a discrepancy between the coroner's verdict 1842 and what the medical board thought on pneumoconiosis. The problems of the discrepancies between coroners' verdicts and decisions on claims for benefit is serious mostly in Wales—not only in Wales but mostly in Wales, and particularly in the Swansea area. Most disagreements occur over post-mortem examinations carried out for the coroner by a general practitioner instead of by a qualified pathologist.
The Home Office sent a circular to coroners last October—we debated the matter in the House—emphasising the importance of using qualified pathologists wherever possible in pneumoconiosis cases. That has already resulted in the wider use of qualified pathologists and fewer disagreements, but I think it cannot be hoped that such a change in arrangements will wipe out the difficulty once and for all. I think that gradually the disagreements will be reduced in number and that the area of disagreement will be reduced.
§ Mr. Finch
I was raising the case where a pathologist is called in and where there is still a disagreement. There are a number of these cases—not a lot, but they exist. These are cases in which a prominent pathologist has said, after a clear examination, "The person died from pneumoconiosis." I require an investigation of such cases.
§ Mr. Marples
The hon. Member made a good point and it is one of the many interesting points which ought to be investigated when the Report of the debate is read. I can assure him that the point which he made, and others, will be considered.
The hon. Member for Broxtowe (Mr. Warbey), of course, made what I expected from him—an electioneering speech.
§ Mr. Marples
The hon. Member should follow his own example, not necessarily the example of hon. Members on these benches. If he wants to follow the example of this side of the House he should join this party. [HON. MEMBERS: "No."] I apologise to my hon. Friends for making that suggestion. I hope they will forgive me for it.
1843 At one point in the hon. Member's historical reminiscences I smiled, and there was a comment by the hon. Member for Warrington (Dr. Morgan). I assure the hon. Member for Broxtowe that my smile was not out of discourtesy. It was because someone muttered to me, "What were you doing in 1908?" The hon. Member was accusing me of doing all sorts of wicked things in 1908, but I do not think I was taking any part in National Assistance at that time.
I could not reconcile the hon. Member's long historical reminiscences with the title of the Labour Party's Election Manifesto, "Forward With Labour." It should read, "Forward With Labour to 1908" according to the hon. Member for Broxtowe.
I turn, now, to the speech of my hon. Friend the Member for Skipton (Mr. Drayson), who raised some points on the earnings rule. As the right hon. Member for Llanelly said, this is a difficult problem which is necessarily linked with the increments which a man earns between 65 and 70 years of age. The Phillips Committee recommended no change, and if there were to be a change it would require legislation and I should therefore be out of order in replying to my hon. Friend tonight.
I enjoy listening to the speeches of the hon. Member for Oldham, West (Mr. Hale). I always enjoy his natural, if somewhat speedy, eloquence but it is not always easy to catch up with him. He engendered great heat at a great speed and banged his hand in emphasis so hard that I was afraid he would be drawing sickness benefit before 26th May. He said that my right hon. Friend had "pinched" £300 million. I think he was referring to investment in "Daltons." I think he will find that the National Insurance (Reserve) Fund of Securities had holdings of 2½ per cent. Treasury Stock 1975 or after—the stock introduced by the right hon. Member for Bishop Auckland (Mr. Dalton). The nominal value was £211 million odd and the market value on 31st March, 1954, was £138 million. I am sorry that the hon. Member did not refer to that minor discrepancy of £73 million in the course of his eloquent discourse.
§ Mr. Hale
The hon. Gentleman has completely misunderstood the point I 1844 made. I made the point on the Exchequer contribution that in the only table we have—the table in the last Report, Command Paper 9159, which takes us to the end of 1953—the hon. Gentleman had written off £14 million in a footnote without explanation. The principal thing about which I asked was that the Exchequer contribution to the Fund in the year ended 31st March, 1951, was £139,750,000. In the year ended 31st March, 1952, it was £104,500,000 and in 1953 it was down to £65 million. Accordingly, the Government have saved £80 million on Exchequer contributions. How have they saved it, when did they ever say anything about it, and why are they now boasting about putting them up by £20 million?
§ Mr. Marples
The Exchequer contribution was reduced because the right hon. Member for Leeds, South (Mr. Gaitskell) proposed to reduce it in 1951 from £140 million to about £40 million. My right hon. Friend when in opposition was instrumental in restoring most of the Exchequer supplement to contributions, and we are now increasing the supplement made under the 1954 Act to over £90 million in a full year, with an addition of up to £325 million if necessary over the next five years to meet deficiencies.
If the hon. Member looks further in the account for 1953–4 he will find that it was ordered by the House of Commons to be printed on 4th April, 1955, and, for his better and more accurate information, I will personally undertake to send him a copy.
I come to the fracas, as it were, on family allowances. The Caretaker Government put the Act on the Statute. Book and passed it into law on 15th June, 1945. The intention of the Government is to pay continued family allowances—
§ Mr. Griffiths
Does the hon. Gentleman deny what I said? The Family Allowances Bill was introduced into this House by the Minister of National Insurance, the first Minister, who is now Earl Jowitt. I was here and took part in the Second Reading debate. The hon. Gentleman says it was passed by the Caretaker Government, but all that happened was that the last final act was not completed when the Coalition Government broke up. Is he claiming that the whole Bill was 1845 piloted through the House by the Caretaker Government in the one month?
§ Mr. Marples
I will read what I said again. The Caretaker Government passed into law and put on the Statute Book the Family Allowances Act and the date was 15th June, 1945.
§ Mr. Griffiths
It is a matter of history. The Parliamentary Secretary has read that out carefully. Is he saying to the country that the Conservative Caretaker Government introduced and carried the Bill through the House and carried through the Family Allowances Act in that one month? Is that what he is conveying to the country?
§ Mr. Marples
I will try to make it clear. The Caretaker Government passed into law the Family Allowances Act on 15th June, 1945.
§ Mr. Marples
It was a Tory majority, in this House which thought of it, and it was the Caretaker Government which placed it on the Statute Book.
§ Mr. Marples
I do not mind the right hon. Member interrupting me. I think that my record for allowing interruptions is good. I do not think that when the right hon. Member is talking of electioneering he should say that we are afraid of interruptions.
§ Mr. Griffiths
I ask this simple question again. Can the Parliamentary Secretary tell us who was the Minister that presented the Bill to the House for Second Reading?
§ Mr. Marples
I have given my explanation. It is down in the record, and 1846 I am sure that my hon. Friends on this side of the House are satisfied on that score.
§ Mr. Marples
I have tried to answer fairly most of the points raised in the debate, and I have not been unduly controversial, but I want to come to one point which my hon. and gallant Friend the Member for Poole mentioned. The Labour Party has said in its manifesto that it will increase National Assistance. That is a pledge. By how much will it increase it?
§ Mr. Marples
I want my hon. Friends to note this. That is a promise on page 3 of the Socialist Party Manifesto. The party opposite will also—it does not say by what amount—review pensions annually on an upwards direction when the cost of living rises. That is a pledge and a promise, is it not?
§ Mr. Marples
If the Opposition look on the previous page, they will find that their policy is to keep the cost of living stabilised. If they keep that promise, there is no need to make the other one. Have they made their first promise with the intention of not carrying it out? They make these two claims: first, "We shall keep the cost of living stable"; secondly, "We shall increase pensions when the cost of living rises." They cannot have it both ways.
I can summarise in this way. The two major points that the Opposition have tried to make are, first, that the Assistance is niggardly—
§ Mr. Marples
—and that the pensions increase is niggardly and is not enough and is miserable. My first point on that is that National Assistance is higher than ever, and higher than the party opposite made it.
§ Mr. Marples
The second point made by the Opposition is that these are paltry increases and that we are introducing them only to get votes. They cannot 1847 have it both ways, for if the increases are paltry, they will not gain us votes. Which argument do the Opposition want?
§ Mr. Marples
I have tried to answer the questions reasonably in a debate which has been conducted in good humour and spirit. Those points which my right hon. Friend cannot deal with in the life of this Government, he will deal with in the next Government.