§ Order for Second Reading read.
§ 1.41 p.m.
§ Mr. Ronald Williams (Wigan)
I beg to move, That the Bill be now read a Second time.
In proposing that the Bill should be read a Second time, I should at once refer, as I think all hon. Members in the House would wish me to refer, to the fact that but for a serious and protracted illness my hon. Friend the Member for Bradford, East (Mr. McLeavy) would have been here today to propose this Motion, having obtained leave to do so under the Ten Minutes Rule some time ago. I know that hon. and right hon. Gentlemen in all parts of the House will wish me to convey to him our good wishes and our hopes for his early and complete recovery and our regrets that he is not here today to bring forward this Measure.
I am in the happy position today of being able to say with some confidence, not only that this happy and well-intentioned Measure receives the support of hon. Members in all parts of the House, as will be seen from the names which appear on the Bill, but that I have not yet come across any direct opposition to the Bill. Certain questions have been raised which might properly be the subject of discussion in Committee, but the general underlying principle of the Bill rightly receives the commendation of all those who have studied it.
It addresses itself to Section 31 of the National Assistance Act, 1948, and seeks to amend that section. Section 31 of the National Assistance Act, 1948, a very short section, reads:A local authority may make contributions to the funds of any voluntary organisation whose activities consist in or include the provision of recreation or meals for old people.I cannot think of anybody, even in these days of controversy and political tension, who would disagree with that section.
I pay tribute to the voluntary organisations who have done so much and are doing so much for old people in this matter. The Bill in no way detracts from the great work which is being done by voluntary organisations, but, despite the work they are doing, there is so much 1397 distressing evidence of cases in areas where voluntary organisations are not functioning that something should be done to help old people. We do not suggest that the work of voluntary organisations should in any way be prejudiced by our proposals.
In fact, we specifically say in the Bill that local authorities may have power to do certain things through a voluntary organisation or otherwise, so that we underline not only our support of the principle laid down in Section 31 of the Act of 1948, but give a clear indication of our approval of what has been done and our feeling that it should be even further extended. In other words, our approach to voluntary organisations is not only friendly but seeks further and closer co-operation. We say to voluntary organisations, "More power to your elbow; we will give you all the help we can, and this is one of the ways in which we can do it."
I say that with the object of eliminating at the outset any possibility of it being suggested with any force that the Bill would take away the influence or powers or authority of voluntary organisations. They are doing a good job. We want an even better job to be done. However, when the voluntary organisations have done all they can, there are still large areas where there are old people living in the most distressing circumstances who will not be helped by voluntary organisations because the voluntary organisations simply are not there.
How can the local authorities act? At the moment they can act only by making a grant to the voluntary organisations doing this type of work. They have no power themselves to do the work. We seek to give them that power. We seek to empower local authorities to make their own arrangements to enable old people to have meals and domiciliary service and recreational facilities in their own homes. I should have thought that everybody, whatever his political views, would be strongly in favour of that.
I do not propose to give detailed illustrations of cases, but I must put one to the House. We have all read of cases where an elderly person has been found dead in his home, having been dead for several day before the body was discovered. I am sure that we all feel a 1398 sense of shame and shock when that occurs. It does not need much imagination to realise what has happened in that home. In each case one can see that through the years it may have been the happiest of homes and then, as the elderly person got on in years and his friends died and the members of the family went to other parts of the country, his sense of independence would, in effect, turn out to be his enemy, because there would be a period of loneliness and a sense of not being wanted, a feeling that nobody cared, and ultimately there would be a lonely death.
Those things need not be if we, with the ample powers which we have, give power to the local authorities to see that certain things are done. If in these cases there had been adequate schemes under which the elderly persons concerned had at least one good meal a day provided, not only would that have been a tremendous difference to the elderly person, but it would have given him a sense of being wanted, a sense of being cared for by the law itself, a sense of having a service as of right. There is nothing in the nature of charity in the Bill at all. It seeks to provide something as a legal right once it is established on the basis of a scheme. It does not impose upon any local authority the legal duty to enter into the arrangements contemplated, but it gives them the power to do so.
It seems to me that it would be very difficult to find any arguments at all against the proposition, and I hope that today we shall not only have a favourable reception of the Bill from the Minister, but that, if he can give us any help on certain points which are troubling us in the Bill, we shall have his enthusiastic support. I mention that because it is my duty, I think, in introducing the Bill to draw attention to certain possible objections that might be taken, not to the underlying principle of the Bill, but to certain points which we have been obliged to insert in it because of the rules of the House.
I wish to draw attention particularly to Clause 2 which has given the impression in the country that we should be imposing a substantial financial obligation upon local authorities. In fact, that is not our intention. We have inserted Clause 2 because some provision has to 1399 be made for expenditure. We wish that it could be dealt with under the Equalisation Fund, but were we to put that into the Bill we should at once be faced under the rules of the House with the necessity of introducing a Money Resolution, and, that being so, we should not be able to proceed any further without the consent of the Government.
I put it to the Minister that it is not because we have any enthusiasm for the idea of imposing expenditure. We do not think that the expenditure involved will be very great, but we feel that it would be better if even the small expenditure envisaged could come from the Exchequer. With a little good will it could be done, and it would have the approval of hon. Members of all parties in the House. Therefore, I invite the Minister to look favourably at that aspect of the Bill and thus make it an even better Bill than we have tried to do.
I think it is also my duty to draw attention to the only other suggestion I have received. I will not call it an objection; it has not been put as forcibly as that. I have been told that, in considering the future of the schemes contemplated under the authority of the Bill, should the local authorities exercise their power, one should bear in mind that great strides are at the moment being made in connection with the complete reorganisation of local government. I have been asked to bear that in mind and to see what effect it has.
My submission to the Minister is that the Bill should not be held up pending a complete reorganisation of local government. That would take a considerable time, and, in the meantime, the elderly people would be suffering. That, surely, is something which none of us wants. We all know that as far as the claims of the old people to increases in pensions are concerned, that is a subject of great political controversy and pressure at the the present time. The Bill does not affect that at all. Indeed, if every old-age pensioner in the country received every increase in pension that he seeks, and got it tomorrow, he could still not afford to employ a cook. Old people could not guarantee, whatever their income, that they would be provided with a properly cooked, solid meal every day. That is something which can only be done if specific provision is made for it. There 1400 would still be the necessity for this provision to be made.
I am most indebted to my hon. Friend the Member for Bradford, East for bringing forward the idea contained in the Bill. I am delighted that the Bill has received the full support of the House, and I commend it to the House with all my heart and hope that we shall hear the Minister say something of the same kind in the course of his observations.
§ 1.56 p.m.
§ Miss Joan Vickers (Plymouth, Devon-port)
I am very glad to be able to support the eloquent and moving speech of the hon. Member for Wigan (Mr. R. Williams) in moving the Second Reading of the Bill. We on this side of the House very much regret that the hon. Member for Bradford, East (Mr. McLeavy) is unwell and has been in hospital for a considerable time, because we well remember his courage in bringing forward the Bill under the Ten Minutes Rule. The House was so impressed by his speech on that occasion that it unanimously agreed that the Bill should receive a Second Reading.
I think that Members must be very grateful to the hon. Member for Bradford, East for the fact that he has, more or less, waived his right to wait until he can personally move the Second Reading of the Bill. It shows his high ideals and the real and genuine desire he has for the old people that he has allowed his colleagues who are his co-sponsors of the Bill to bring it forward in his absence. I hope that if the Bill receives a Second Reading today that fact will encourage the hon. Gentleman to make a quick and complete recovery.
I support what the hon. Member for Wigan has said, that the Bill is in no way a criticism of any work done by the voluntary organisations. We are very anxious to enlarge the scope of the activities on behalf of the old people, but the 1948 Act lays it down very strongly that the funds can only be given for voluntary organisations and that their activities should consist of the provision of recreation and meals for old people. Section 31 of the Act says:provide meals, domiciliary and other facilities for old people.I am particularly interested today to extend the other facilities for old people.
1401 The difference between the position at the time of the 1948 Act and now is shown by the need for this Bill. If there were sufficient voluntary organisations all over the country to meet the needs of old people, there would be no necessity to bring the Bill before the House today. I suggest that considerable changes can be affected in the welfare of old people if the Bill receives a Second Reading.
We should all, I am sure, wish to pay tribute to the various voluntary organisations. I will not mention many of them this afternoon, because I want particularly to make reference to local Councils of Social Service, to the many Old People's Welfare Committees, to the Women's Voluntary Service, the British Red Cross and the many church organisations, of all denominations, which play such a leading part in this work. I should like, to give an example of how, perhaps, extra work can be handled if the Bill receives a Second Reading today.
One of the schemes which deserves support was mentioned by me in our debate on the National Health Contributions, namely, the scheme for boarding out old people. The hon. Member for Wigan would probably agree that the visitation of old people by regular visiting officers employed by local authorities is a very necessary provision if we are to avoid the sort of tragedy which the hon. Member mentioned.
Recently, in the City of Plymouth-part of which I have the honour to represent—powers have been given to a voluntary organisation to board out people. These old people are boarded out in the same way as young people. This scheme has been a great success, and at the moment over 100 old people are boarded out. This scheme entailed a lot of work. The local authority was fortunate in having a very good Council of Social Service, which was able to do this work. In order to carry out the scheme a special committee has been set up and the scheme had to be passed through the Council under what was called the "Boarding out Scheme for Old People."
In order to operate the scheme it was necessary to make four provisions—the first giving power to the Council of Social Service to set up a committee to operate the scheme; the second providing 1402 that all the accounts relating to the operation of the scheme were to be examined by the City Treasurer; the third providing that the Medical Officer of Health was to be given facilities to supervise the scheme; and the fourth providing that the operation should be subject to annual review.
It was fortunate that a voluntary body was found to undertake the work once it has been agreed to by the council. Many local authorities have no such organisation to undertake this work. This is a reason why I support the Bill. It will give local authorities, where necessary, powers to board out old people themselves, to have them visited and to supervise their general welfare.
It does not cost local authorities any more money, because most of these people are old-age pensioners, who contribute £2 of their pensions. At present they are supplemented by National Assistance. It usually costs £3 in all, and the National Assistance Board pays the other £1. The old-age pensioner has a little pocket money from National Assistance. If the work is to be done satisfactorily there must be somebody available to supervise it.
Since 1948 the number of old people has increased. This is due to their living longer because of the many new drugs which we are able to give them to prolong their life and maintain their health. I am thinking in particular of the great number of old people who used to die from pneumonia. Thanks to the new medical services, this does not happen with such frequency. In fact, in this last winter, which was a fine one, without any smog, 1,000 fewer old people died in London and the surrounding districts than died last year.
With the aid of these new drugs many of these old men and women can remain in their own homes, where they can be visited by doctors. It is no longer necessary for them to go to hospital to be treated. In view of their age, however, they need extra domiciliary care. They can also be extremely lonely; in many cases their immediate friends, with whom they were brought up, have died. I want facilities provided—especially clubs—in order that they may make new friends even in their old age.
1403 At the moment it is possible for voluntary organisations to run these clubs, but it is not possible for local authorities to give direct assistance. In these days of full employment many more people go out to work, and have less time to devote to voluntary work. Also, many more women take up professional work and. whereas when their families grew up they used to turn to voluntary work during the day, they now take another job. For economic reasons, also, many women who did not previously want to work now take a paid job. If we are to provide these services, therefore, it will become necessary to pay the people to do the work, which is not always possible through voluntary organisations.
The hon. Member for Wigan mentioned the question of hot meals and "meals on wheels." I agree that it is very beneficial that these people should have regular meals, and meals can be provided very much more cheaply when they are cooked for a lot of people than when they are cooked for just one. That is another reason why I want to see more of these clubs for old people. They can then go to these clubs for a meal. They will have to pay for the meal, but they will pay very much less than if they cook for themselves. In this way, too, they will be sure of getting a hot meal, which they would probably not bother to cook for themselves. When one gets older one finds it excessively tiring and troublesome to have to cook for oneself.
I should also like to see an increase in the number of home helps. This could be brought about if the home helps service for old people were brought directly under the control of the local authority, as is the service for mothers and children. At the moment, most local authorities have to ask voluntary organisations to provide these home helps. A chiropody service should be provided within the list of domiciliary services, because it is badly needed.
Furthermore, in order to keep their limbs supple and their minds occupied, handicraft work should be provided. Once old persons have been given some idea of the type of work they can do and which is within their physical capability, it is surprising how quickly they pick it up—whether they do it in their own homes or are able to go to one of 1404 the clubs—and what remarkable progress they make. Only the other day in Plymouth there was a demonstration in a public hall. It was called "Skilled Hands", and all the exhibits had been made by old people who had gone to various clubs or had been taught in their own homes. This service should be enlarged and carried out in many more places, especially in the rural areas.
The old people pay something towards the cost of providing this service and in return they benefit from the sale of their work, which encourages them to go on. Since they also contribute towards the cost of their meals it can be seen that we are not asking for enormous sums of money to extend these services. What we want are better facilities, to enable this work to go ahead.
The Local Government Act of 1948 says:The Minister shall… estimate the aggregate of so much of the expenditure incurred by the council of the county or county borough or, in the case of a county, by any other local authority in the county … in providing' services which it will be the duty of the Minister to provide under Part II of the National Health Service Act, 1946.It should therefore be possible to make the necessary grants in this case. The whole matter is based upon the fact that the local authority should be able to make the grant and not merely have power to authorise voluntary organisations to do the work.
I agree with the hon. Member for Wigan that we may well get some answer from the Minister on this point, that is a fact that local government finance is about to be reorganised. I believe that one of the suggestions is that there shall be a block grant to local authorities. It would therefore be better to start this scheme straight away, because any authority which takes advantage of it now will be able more accurately to estimate its needs for the future, and it will also be able to make a good start with the work.
I am quite sure that we shall have many discussions on the Bill before it is passed, and I do not want to see the work delayed.
I suggest also that it is much better to keep the old people in their homes instead of taking them to hospital or to special homes. I am certain that old people are much happier, even if they only have a bed sitting room, to continue 1405 to live in their own surroundings, in a neighbourhood in which they have probably lived most of their lives and with their personal belongings which mean so much to them. That is far better than any type of home or hospital, however excellent they may be. We must realise that there are many proud old people who do not wish to go to a home or a hospital. For one thing, they may not have many relations to call upon them.
I am visualising that the future may be very different for a lot of old people. I am not certain that we are not beginning to build too many homes for old people, in view of the different type of life that the present generation is having. We realise that many old people today, those over 60, have had an extremely hard life. Most of them have been brought up in very hard and difficult circumstances. We sometimes hear about the "good old days" but I think those days were for the very small minority and not for the people really in need of attention today.
I believe the present generation will have an easier old age. Many of them will not have had such a hard life. They will have had better feeding, with school meals and so on, and have better medical attention. They will also have, we hope, the benefits of automation and so on so they will not have to work so hard physically. Therefore, they will be in a better state to look after themselves in their old age.
I should like there to be an extension of domiciliary work rather than an extension of the system of putting people into homes. We all want to make the life of old people happier and easier, and this can be achieved by means of domiciliary work through the local authorities if this Bill is accepted. If we can help these pepole in their own homes in the ways that I have suggested, it will not be necessary for them to go to hospital or to special homes. I am certain that if this Bill gets a Second Reading, although it is only a three Clause Bill, it will be of infinite benefit to the people concerned.
§ 2.14 p.m.
§ Mr. A. E. Hunter (Feltham)
I am very pleased to support this Bill amending the National Assistance Act, 1948, which was moved by my hon. Friend the Member for Wigan (Mr. R. Williams) in his usual 1406 sincere and kindly way. Both he and the hon. Lady the Member for Devon-port (Miss Vickers) have stressed fully the very human elements involved in this Bill, and, therefore, my speech will be very brief.
This Bill aims at enlarging the scope of the voluntary organisations. I am sure we are all agreed on the excellence of the work done by the voluntary organisations in almost every district. In the Feltham urban district we have a very good Council of Social Service which is performing the work to which the hon. Member for Devonport referred, namely, the provision of meals and of friendship for old people.
We have very limited financial resources in Feltham for this social service, the funds being raised from voluntary organisations, in addition to a grant from the local urban district council, but we manage to give the old people one hot meal a week at a cost of Is. Cards are issued through the Council of Social Service so that the old people are able to get one hot meal once a week in a restraurant where special arrangements are made for 1s. Although at present this is done on a very limited scale, I know from personal contacts with the old people that this service is much appreciated, and I would like to see it extended in other parts' of my constituency.
What we really want—and I know the Minister takes a kindly interest in these matters—is the voluntary organisation scope to be enlarged to provide a hot "meals-on-wheels" service. Owing to the size of some of these districts, it is not possible for an old person living in an outlying estate to journey to the centre of a town where there is a restaurant where arrangements have been made for this service. There is the cost of the bus fare to be borne in mind, and in addition some people may not be fit enough to make the journey. A hot "meals-on-wheels" service would enable hot meals to be taken to the people; so that we can be sure that old people will get a hot midday meal.
In Feltham, we are endeavouring to raise £1,000 for this purpose. We have, of course, difficulty in raising voluntary funds. Therefore, if this Bill gives an opportunity to local authorities that assist in this matter, it will be of enormous help, though I would pay a tribute to 1407 the financial help local organisations have given us.
I should like to make another suggestion. In Feltham, through the Council of Social Service, there is a card system to meet points to which the hon. Member for Devonport referred. The Minister may have heard of this scheme before. Old people often become lonely and sick. If they require help, they put one of these cards in the window, and a member of the committee, seeing the card, reports the matter and arrangements are made for a visit to the person concerned. That is not an expensive scheme, and if the Minister could give some attention to it, it would operate with great success throughout the country. As my hon. Friend the Member for Wigan has said, old people have died before anyone has known, and I am sure we have all heard of cases in which the only indication of a sad death having taken place has been the accumulation of milk bottles on the doorstep after several days. This card system could be of great help in these circumstances and would bring aid to old people who are ill.
Another asset would be the provision of club rooms where the old people could meet for a game of cards, dominoes or darts and buy a cup of tea and biscuits at a reasonable price. This is already done by the Darby and Joan clubs and by many branches of the National Federation of Old Age Pensioners. All that we can do to extend this work will be of great value. An over sixty club on these lines operates with great success in Hounslow.
The hon. Member for Devonport said —and I am sure we all agree with her— that the majority of the old people today have lived through rough times. But nowadays people are living much longer. This is no doubt due to many causes, such as advances in medical science, medical services, improved hospital facilities and, above all, the ever-raising standard of life in this country, which must continue. I believe that today people live from ten to fifteen years longer than they did at the turn of the last century, so that now we have millions of old-age pensioners in need of the services I have mentioned. We must pay great attention to this problem, so that the latter years of their lives are bright and happy.
1408 My hon. Friend the Member for Wigan said that this Bill did not deal with the question of increasing old-age pensions. That is a matter both he and I strongly support, as do all hon. Members on this side of the House. However, this Measure will do something for our old people. It may ensure that they get a hot meal every day. Probably we can then enlarge the restaurant service and hot "meals-on-wheels." We may be able to go forward with the provision of old people's clubrooms and the scheme for S.O.S. cards for old people. It is a small Bill in Clauses but it deals with human problems and its implementation will mean very much to the old people. I hope, therefore. that the Minister will be able to give it his blessing, and so open prospects for welfare and friendliness for the Old Folk in the evening of their lives.
§ 2.21 p.m.
§ Mr. Douglas L. S. Nairn (Central Ayrshire)
I am glad of the opportunity to give my support to this Bill and to express the hope that it will receive a Second Reading and full consideration during the Committee stage. I am particularly glad to support it, because its provisions are in line with a resolution moved by representatives of my constituency, Central Ayrshire, at the Scottish Unionist Conference and carried. The resolution commenced by stating that the conference was concerned that the needs of many retirement and old-age pensioners were not being adequately catered for, and it is interesting to note that it was moved by the younger supporters of my party. It is clear that today young people appreciate the needs of the old people.
This Bill can do something to help many of the really old people. It is those of 75 and over who suffer most. My hon. Friend the Member for Devon-port (Miss Vickers) referred to the need to arrange for visitors for the old people. If the provisions contained in this Bill are to have their full effect, we must tackle the problem of ensuring that old people are visited regularly. In the Municipal Journal of 19th April, there appeared a report of a survey among old people in Salfbrd which was said to be the first of its kind. The survey lasted over a period of five years and disclosed financial and other problems affecting over 17,000 people.
1409 It was discovered that there were over a hundred of them who did not realise that they were eligible to be registered as blind or partially blind, and that there were a large number who needed medical and hospital treatment. Some of these old people did not even know that they could apply for National Assistance. Therefore, while I support this Bill, I do not think that it will achieve its full purpose unless county councils, district councils and voluntary organisations can combine to work out some way to ensure that old-age pensioners are visited, and that those of 75 and 80 are never left to find out for themselves the benefits to which they are entitled. There should always be someone who is prepared to solve their problems for these people. I hope that the Bill will receive a Second Reading and that, during the Committee stage discussions, we shall be able to improve it.
§ 2.25 p.m.
§ Mr. Barnett Janner (Leicester, North-West)
This is a small but extremely important Bill. Its importance cannot be gauged by its size. The House will be indebted to my hon. Friend the Member for Bradford, East (Mr. McLeavy), who was responsible for this Measure but who, unfortunately, is not able to be present today, and to my hon. Friend the Member for Wigan (Mr. R. Williams), who introduced it. Particularly will the House be indebted to the hon. Lady the Member for Devonport (Miss Vickers) for her endeavours to obtain as much support as possible for the Bill. We do not always see eye to eye with the hon. Lady, but it is a great pleasure to me to know that on this occasion we do.
I hope that the Minister will not tell us that the difficulties which exist, and which give rise to the need for a Bill of this nature, will be put right in due course, and that therefore there is no need for the Bill. Time runs against these old people. By this Bill we are trying to provide some kind of relief for them, and every day counts. Even though the provisions of the Bill may not cover anything like all the problems involved and even though the Minister may intend to deal with them in the future, that should not prevent the right hon. Gentleman from accepting this Measure.
1410 In my own constituency there are many people who take part in the voluntary services rendered to old people. From time to time it is a pleasure to see how these old people, who otherwise would be entirely neglected, are enjoying themselves in the company of each other. They meet in clubs and other places provided by good-hearted voluntary workers, and old men and women well advanced in years enjoy, not only the ordinary amenities of sedentary recreation, but dances as well. I have danced with a lady aged 85 who proved to be an extremely good dancer—much better than many girls of 20 or 30 or even "teen-agers."
The fact that these old people can meet together to enjoy the facilities available to them helps to prevent them from becoming lonely. We should do all we can to relieve people from a sense of loneliness, particularly aged people who feel that they have done their work in the world. Naturally, they are losing friends by death almost day by day. Very often their relatives are loth to come near them, or cannot do so because of the vicissitudes of everyday life.
We must look at this question against its great background of the desire of everybody in the country to make the old persons feel less old and give them the feeling of still being members of the society in which they live. I have often raised in the House the question of the aged sick. Today, they are benefiting by geriatric treatment to keep them out of hospital and to train them to become useful, not in the sense of making productive efforts but in the sense of becoming part and parcel of a happy community.
Nowadays we can regard our people as a community, as a family. It is very good that we have reached the stage where we can regard every individual as a part of that family and not as somebody who we need not bother ourselves about. Geriatric treatment is a success, because it enables people to carry on their lives without having to remain in a hospital bed, at considerable cost to the community, for the rest of their lives; but once they are out of hospital they depend on others to make their lives enjoyable.
Great praise is due to the voluntary organisations for what they do in that direction, but we all know that there is a hiatus. When one visits old people, one 1411 often finds that they have been neglected, in the sense that nobody has come to see them, and that they are only too delighted to have a visitor because it means somebody to talk to. It relieves the monotony of a lonely life pervaded by a sense of being neglected. They often feel, "It doesn't really matter about me. All I have to wait for now is to pass out." The Minister knows that I am not referring to isolated cases, and that this is the kind of thing that happens.
We have been told that younger people are now beginning to realise their obligations to the old, but I am not sure about that. I remember the days when the family was so united that its old people were kept within the home, and were warmly loved and looked after. That feeling still exists, but the constant pressure of life causes the younger people to be out of their homes and in different places, whereas years ago they would have spent much more time in their homes and would have been able to look after their old folk.
What answer is there to the changed conditions? If old people are not getting the meals that they should have, meals must be provided. Who can deny that? We know that in many cases old people are not getting sufficient to keep body and soul together. I am not making a political point at the moment. There is considerable anxiety about the people who are not able to meet their needs, even with National Assistance, and who do not get the minimum necessary for physical and mental comfort.
It is not simply a matter of gauging the absolute minimum necessary to make people physically and mentally comfortable, or of a scientific calculation. Each individual has different requirements. It may cost more to provide for one individual than for another. All these subjects are glibly discussed by us and are calculated by statistics; but the human problem is there, which is that in many cases the old people have not the means to provide them with what they really need.
There are many people who have warm hearts and are prepared to do voluntary work. There is a great store of good will in the country. We must get these people moving together, with interest in the 1412 work. It is not always easy to get things organised. There are many places where the local authority should be compelled, in a sense, to direct its attention towards the kind of work that the voluntary organisations are doing, so that the work can be co-ordinated. Local authorities consist of men and women who are devoting themselves to public life, and everybody is grateful to them. They would not regard it as an imposition, but as a privilege, if asked to add this service to what they are already doing.
In the circumstances I hope not only that the Minister will recommend the Second Reading of the Bill but will not leave to the promoters the task of removing any difficulties that it contains. Let the Minister say, "I accept the Bill in principle, although it may require modification". The skill of the draftsman can be exercised to make those modifications; much depends upon the Minister's directions to the draftsman. He knows as well as I do that he can tell the draftsman, "I want this Measure through, so please remove whatever difficulties there are in it". The skill and ingenuity of the draftsman will then put the Bill right.
If the Minister does not want the Bill he can—far be it from me to suggest that he would—give no such indications to the draftsman, which might result in the Bill becoming difficult to operate. I want wholehearted acceptance of the Bill. It is not an essential Measure, but the Minister should not push it aside to await some other kind of action. The elderly people should have as many facilities as possible. Volunteers will come forward, and it will be an inducement to them if the Minister now gives the Bill his warmhearted support. He will in that way earn the gratitude of the old people, as well as of the community in general.
§ 2.40 p.m.
§ The Minister of Health (Mr. Dennis Vosper)
I intervene at this stage, not to terminate this debate, but to give the point of view of the Government on the Bill. Before doing that, I should like to join with, I think every, hon. Member who has spoken in expressing sympathy with the hon. Member for Bradford, East (Mr. McLeavy), who ran the hazards of introducing this Bill as a Ten Minute Rule Bill and who has unfortunately 1413 been prevented from seeing it through its subsequent stages. I hope that the speeches which have been made today may be of some help in aiding his recovery.
Perhaps this assurance will come to the notice of the hon. Member. I wish to assure him that, despite his absence, the hon. Member for Wigan (Mr. R. Williams), my hon. Friend the Member for Devonport (Miss Vickers) and, I think, all the hon. Members for Bradford have, in his absence, done everything possible to ensure that the Bill goes forward as he would have wished. I did not share the pessimism of his hon. Friends that this Bill would never receive a Second Reading. It has much to commend it in principle. To that extent I can go the whole way with the hon. Member for Leicester, North-West (Mr. Janner), but I think he realised that it raises a few difficulties.
For that reason, I expressed to hon. Members who sponsored the Bill the opinion that a short debate on Second Reading was essential, in the first place to obtain an expression of views by hon. Members and, secondly, to ensure that the difficulties underlying the Bill were understood by the House before further stages were commenced. The Bill deals with something which matters greatly to me. A great deal of time and effort and money must be spent on the hospital service, but, as was well said by the hon. Member for Tottenham (Sir F. Messer) in the House a few days ago, our object should be to prevent people from getting into hospital. I hope that the Bill will extend and develop the preventive services.
The extension of welfare services, particularly the domiciliary services, is something with which the Parliamentary Secretary and I are much concerned. I realise that every major local authority is very proud of its old people's homes. I have no doubt that there will be an extension of old people's homes, but it must be my aim and, I hope, the local authorities' aim, so far as possible to prevent old people from having to go into old people's homes and to enable them to stay in their own homes. I am glad to say—because I have had one or two discussions about it—that there is a growing realisation to that effect. Many and, I hope, an increasing 1414 number of organisations and individuals are contributing to that.
I have in mind that very excellent organisation, which must be known to almost every hon. Member, the National Old People's Welfare Council and all its committees. I appreciate very much the point put by the hon. Member for Feltham (Mr. Hunter), who spoke about the importance of visiting old people. I am associated with an enterprise in my constituency which does that work. I fully realise that the provision made in this Bill for "meals on wheels" is a vital element in helping old people to stay in their own homes, and as such I welcome that and some of the other provisions. That is not in any way in dispute. The difficulty is the question of who should do that work and, possibly, when they should do it.
My hon. Friend the Member for Devonport and the hon. Member for Wigan made the statutory position reasonably clear, but I hope that the House will forgive me if I repeat it as a preface to what I intend to say about the Bill. Section 31 of the National Assistance Act, 1948, which the Bill seeks to amend, empowers a local authority tomake contributions to the funds of any voluntary organisation whose activities consist in or include the provision of recreation or meals for old people.In this context—this is important— "local authorities" means counties, county boroughs, county districts and Metropolitan boroughs; but in the remainder of Part III of the 1948 Act, dealing with the provision of accommodation and services by local authorities, it means counties and county boroughs only. It would seem, therefore, that this Bill departs from the existing provisions in two respects. First, it empowers local authorities, as opposed to voluntary organisations, themselves to provide meals and recreational facilities; and, secondly, in the remaining provisions of the Bill, it empowers local authorities other than county and county borough councils to provide domiciliary and other services.
I propose to deal with those points separately. Dealing first with "meals on wheels" and recreational facilities, I join in the tribute paid by many hon. Members in praise of the voluntary organisations which undertake that work. I think we are all agreed that that work 1415 must develop, and that it is work particularly suitable for voluntary organisations. I should be sorry if anything resulting from this Bill had the opposite effect. However, I do not think that it would have. I had a letter from the National Old People's Welfare Council, which I think is in general support of the Bill, expressing the hope that, if the Bill received the assent of the House, the local authority would, whenever possible, use a local voluntary organisation as its agent. Therefore, I would hope that local voluntary organisations might play the major part.
We have not had examples of where needs are not being met by voluntary organisations, but I accept the argument that there are gaps in the existing services. If local authorities can provide certain services through a third party it seems not unreasonable that they should be able to provide them directly, as is proposed by the Bill.
It is also noteworthy—I am surprised that it has not been mentioned—that similar powers have been sought by individual local authorities, and granted to them by this House in approving Private Bills. Preston is one such authority. The hon. Member for Leicester, North-West was entirely altruistic, because I believe his local authority has all these powers with the possible exception of one; Leeds and Huddersfield have also received similar powers in the last five years. In addition, two or three Bills are before the House seeking these powers for other local authorities. It may be argued by those who follow me that as the powers have been granted to certain local authorities—and, so far as I know, are exercised successfully—they could be generally extended.
I understand, but I cannot be certain because I do not speak for them, that the local authority associations would in general be glad to have these additional powers. That is an added reason for approving the principles of the Bill. I also understand, however, that one local authority association does not support the Bill so long as Clause 2 remains part of it. If, therefore, on the first part of the Bill hon. Members are convinced that there are areas where voluntary effort cannot fill the gap and at the same time feel reasonably certain that the extension 1416 of the powers of local authorities would not discourage voluntary effort, they will be in favour of that part of the Bill in principle; but I propose to say a word or two later on the question of timing.
I am not quite so happy about what I consider as the second part of the Bill, even in principle. It consists in the provision of domiciliary services by local authorities other than county boroughs and county councils. As I understand the Bill—perhaps this can be explained at a later stage—it seems to envisage the employment of visitors for the rendering of domiciliary services by smaller local authorities. As the Bill applies to all local authorities, there might be a very large number of employing authorities. That contrasts with the present position under which domiciliary workers are employed only by county and county borough councils, so that well co-ordinated domiciliary teams can be built up
Giving these extended powers to all local authorities might to some extent lead to the fragmentation of those services, which would be a pity. The White Paper which is at present before the House, and which I imagine is shortly to be discussed, deals with that very point. In that White Paper we envisage that the welfare services should be delegated to the larger district councils with a population of 60,000 or more, but it is again emphasised that, whatever happens, the domiciliary health and welfare services must be kept together as a group. It appears that the Bill as it stands is a departure from that generally agreed principle, and that therefore that is a point which requires further consideration.
In the absence of further explanation, I am also a little doubtful about what is intended by the words "other facilities", which occur in Clause 1. No doubt these are points which can be considered in due course.
It is because the whole future of local government is at the moment under consideration that I am hesitant about the Bill proceeding further at this stage. Not only is the White Paper awaiting discussion by the House but, as right hon. and hon. Members know, the whole question of local government finance is under discussion outside the House at the moment and is, I understand, shortly to 1417 be the occasion for a White Paper to be laid before the House. At the moment, of course, the welfare services generally do not attract grant from the Government, but if a general grant were to be introduced presumably they would benefit. It seems to me, therefore, that we must consider what effect the introduction of this Bill would have on other local authority services.
§ Mr. Mitchison
Surely it is the case, is it not, that if a local authority made a contribution to a voluntary organisation under Section 31 of the National Assistance Act, that contribution would rank for Exchequer equalisation grant?
§ Mr. Vosper
It would rank for equalisation grant. It was proposed by the Guillebaud Committee on the Health Service that welfare expenditure should rank for grant from the Ministry of Health. That is not the case at the moment, but a general grant, were it introduced, could have a similar effect.
For that and other reasons, I am not agreeable to the point made persuasively by the hon. Member for Wigan that I should be prepared to authorise a Money Resolution in place of the provisions of Clause 2. I do not think that that would be a practical proposition as long as the general question of local government finance is likely to come before the House in the near future. It is for those reasons—the matter of timing and the possible fragmentation of the domiciliary services—that I am a little hesitant about accepting the terms of the Bill at present.
It is, however, evident from hon. Members who have spoken in the debate that they are in favour of the principle and also in favour of the terms of the Bill. Although I think it would be wiser at least to await the completion of the review of local government reorganisation and finance, I will not ask hon. Members on either side of the House to oppose the Bill. My purpose has been to put before the House the views of the Government. Generally, they are in favour of the principle but are rather hesitant about the timing.
I do not altogether share the view of the hon. Member for Wigan that the delay caused by deferring the Bill pending consideration of the reorganisation of the functions and finance of local Government would cause much hardship. 1418 While I have indicated that there are substantial advantages in my opinion in letting the matter stand over, if the House wishes to give the Bill a Second Reading today I shall not advise my hon. Friends to oppose it, but I shall do my best to improve the Bill in Committee.
§ 2.57 p.m.
§ Mr. G. R. Mitchison (Kettering)
May I first associate my hon. Friends and myself with the kind and well-deserved words which the right hon. Gentleman spoke about my hon. Friend the Member for Bradford, East (Mr. McLeavy)? We sympathise with my hon. Friend. We are very glad indeed that his Bill has reached as far as this, we are very sorry that he is not with us at the moment and we all feel that in his absence his task has been very well supplemented by others.
I have not very much to say about the merits of the Bill. This seems to me to be another case of a social service, which, as so often in the history of this country, has been begun by voluntary effort, has been found a "bit much" for voluntary effort alone, has been recognised as good and necessary by the community and has been subsequently developed by a combination in various proportions of voluntary effort and the work of the local or some central authority. Before holding his present office the right hon. Gentleman was Parliamentary Secretary to the Ministry of Education, and I am sure he will agree that that, broadly, has been the history of education in this country and that what we are seeing here today is something of the same sort in a smaller but very important matter.
After all, the proper sympathetic help which it can give to old folk not only appeals to us individually but on any showing is one of the most important functions of any civilised community— and I am not certain whether it is even necessary to add the word "civilised".
On Clause 1, I would simply say that the points raised seem to be Committee points. Even the question of which authority is, I should have thought, a Committee point. In substance, this is a tolerably simple Bill. There is nothing about it which need take a very long time. If it were restricted a little beyond the original intentions of those who moved it, I should be sorry, for personally I do not think they go too far, but there 1419 would still be room for very much to be done, and very much which, as hon. Members have said, is urgent.
We have to remember that we are dealing with the old people who have perhaps not very many years to live and who find a delay in this sort of thing, particularly when it has attracted a certain amount of attention, very difficult indeed to bear. One approaches the question of time and money with that in mind.
I am sure that the right hon. Gentleman would himself feel that if he could get the Bill through without making it contingent on other matters, he would wish to do so. I assume that he looks at it in that way and that he is more concerned with the human and social value of what we are trying to do than with any question of simultaneous tidiness in the legislative programme.
Looking at the matter in that light, is there any reason why this Bill should wait upon the reorganisation of local government finance? The right hon. Gentleman is well aware—I think it has been stated in the House—'that there is no prospect of legislation about local government functions and finance until the next Session of Parliament. When that legislation is introduced it will obviously involve questions which will need the most careful and the most detailed consideration. The passing of any legislation about it by the House is therefore not likely to occur until next year.
Then, in addition to that, when we are dealing with matters of this kind, we have to have regard to the financial years of local authorities and, possibly in this matter, to the rating difficulty that house property in this country is at present rated on a 1939 basis and is due in a comparatively short time to be rated on the current basis unless the law is changed. All that makes it probable that the effectual reorganisation of local government finance is a long way ahead. Ought it really to be necessary to wait for this Bill to go through until that can be done?
There are two matters. The first is the recommendation of a direct grant—the Guillebaud recommendation, I think it was. Of course, I do see that that possibly does raise some difficulty. I should not have thought it a very large one, 1420 because the sum involved must be quite small, but there is, of course, and can be no provision in the Bill for that purpose. That would certainly require a Money Resolution.
The other matter is this. Clause 2 provides in effect that the payments by local authorities shall not rank for Exchequer equalisation grant. That is the effect of it. That will mean that if the Bill goes through in that form financially the payments will have to be made entirely out of the rates. I noticed when the right hon. Gentleman was speaking, and when other Members were speaking, too, that there was a considerable measure of national co-ordination among voluntary organisations which have been dealing with this. That seems to me rather inevitable. If we are to try to deal with this form of assistance to old folk purely on a local basis we shall have the usual difficulty of dealing with what is really a national problem on a local basis, that the places where most is needed are very often the least able to deal with it. Of course, it is the general purpose of the Exchequer equalisation grant to deal with that sort of question in a variety of matters. Surely it ought to be applied here?
There is in my own constituency a town which, I think, has about the youngest population in the country—Corby. There are other towns which have the oldest population in the country. As a rule those with the oldest population, as one would expect, are those which have not very prosperous local government finance. They may be cases of whole towns having become centres of retirement where that would not apply so much, but by and large it is true to say at any rate that there are a great many places with a high proportion of old people and with singularly little by way of financial resources to deal with them.
Broadly speaking, it cannot be right that the amount of help which can be given in those cases should depend on the rates. It really is not, I feel sure the right hon. Gentleman will agree, right in principle that that should be done. I would beg the right hon. Gentleman, therefore, to do what he alone can do, and that is to take the necessary steps by way of a Money Resolution to enable Clause 2 to be dropped out of the Bill. It is not the same thing as the Guillebaud 1421 Report, but I ask him this, and I tell him it is not one of those rhetorical questions. I really do not know the answer.
Provision under Section 31 of the 1948 Act must rank for Exchequer equalisation grant. It is pretty illogical if that expenditure is to rank for Exchequer equalisation grant and this expenditure is not to rank for Exchequer equalisation grant. That is indefensible, I think, in practice, but there is one further possibility.
Suppose that a county borough—he gave us instances—has taken power to do this sort of thing itself. Am I wrong in thinking that would rank for Exchequer grants? It would, would it not?
§ Mr. Vosper
The real reason why I was hesitant on that point is that the whole future of the general grant and, indeed, of the Exchequer equalisation grant is at present under consideration.
§ Mr. Mitchison
I quite realise that, but it is not intended that the block grant should be any substitute for the Exchequer equalisation grant. The opposite is intended, and any change made in the equalisation grant cannot possibly hinder the treatment of occasional items of local government expenditure. Apart from legislation, occasions for expenditure on particular matters are happening from day to day, and if we are to be told in relation to every measure of social well-being that we must wait until the whole future of local government finance is settled, we are letting ourselves be dominated by the machinery, and letting our social duties be subordinated to the form of the proceedings in the House and the fragrance of legislation. The substance of the matter is that there is really no earthly reason why that Clause should be allowed to remain in the Bill and this burden put entirely on the rates.
If I have not said much about the substance of the Bill it is because it has been said so very well already by my hon. Friends and the hon. Lady the Member for Devonport (Miss Vickers) who spoke in its support. It is obviously a thoroughly good Measure. I would not wish to take up the time of the House with any criticism of detail today, but I hope that the Minister, who told us so very clearly that his heart was in the right place in the matter, will not let his heart be displaced by the Government's tight purse.
§ 3.7 p.m.
§ Mr. George Craddock (Bradford, South)
I did not anticipate a few days ago that it would fall to my lot to wind up this very important debate on the Bill for which my hon. Friend the Member for Bradford, East (Mr. McLeavy) obtained a First Reading some weeks ago. I am sure that my hon. Friend will be very much impressed by the sympathy expressed in the House in reference to his absence today. Although he left hospital only yesterday, I am glad to say that he is getting very much better.
This is a very useful Bill. After the debate, it would be best if I pointed out what I think is its principal feature and described what Clause 1 seeks to do. The words, amending Section 31 of the National Assistance Act, 1948, are:and shall have power to make such arrangements as the authority may from time to time determine for providing (through a voluntary organisation or otherwise) old people ordinarily residing in the area of the authority with meals, domiciliary services and recreational and other facilities in their own homes or elsewhere…That is most important. It is within the knowledge of many people that with better medical services, and therefore more efficient treatment, people are living longer.
The Minister is of the opinion that old people should have such services as will enable them to stay in their own homes and not have to go into old people's homes. I understand that the Minister has had to leave to keep a pressing appointment, but the Parliamentary Secretary is here, and I want to say at this stage how much I appreciate many of the remarks which the right hon. Gentleman made about the Bill of my hon. Friend the Member for Bradford, East.
I feel sure that we can now look much deeper into this matter, and I am certain that the concern expressed about domiciliary facilities and on the financial aspect of the Bill are points which can be dealt with easily in Committee, together with other minor matters. The Bill is supported by the three hon. Members representing Bradford, West (Mr. Tiley), East and South, and we know from contacts in this House that a number of hon. Members on both sides also give it their support.
Old people become less able to perform their domestic functions and to keep 1423 themselves fit in advancing years. We have known through local authority contacts that one of the great difficulties to be overcome concerns old people who have to cook for and feed themselves. They do not seem able to do that. They are far too casual in cooking meals and in looking after that important aspect of health, so that in that respect there is an important service which we could give them. If we can get the "meals on wheels" service there will be less demand by people to go into old people's homes. Here we are trying by Act of Parliament, to enable local authorities to set up the necessary machinery and to make use of the local authority associations of which we have heard so much in this debate.
My hon. Friend the Member for Wigan (Mr. R. Williams) gave stronger and broader reasons for supporting the Bill. He mentioned two important and sad points, and referred to people being found dead in their homes, perhaps two or three days after their death, because they had not been visited. Another important point is that of loneliness. Therefore, it is important to give power to the local authorities to supply these necessary services in localities where there is a demand for them.
I would also refer to the most interesting and delightful speech of the hon. Lady the Member for Devonport (Miss Vickers). She paid a very special tribute to the many voluntary organisations such as the British Red Cross Society and the Church organisations, making it clear that the Bill in no way seeks to interfere with their work. That was very much in the mind of my hon. Friend the Member for Bradford, East when I spoke to him about the Bill a fortnight ago, when he said that we must make all possible use of voluntary bodies.
The hon. Lady also spoke about extra-domiciliary care, and made a special plea for more clubs. It has today been stated that many people up to the age of about 75 are capable of looking after themselves. Many retired people can go to clubs in the neighbourhood and interest themselves in what goes on there.
The hon. Lady also mentioned handicraft work, and that is very important. The most important thing for us all to do is to take an intelligent interest in something or other. We ought to go more deeply into the ways in which we 1424 can help old people to interest themselves in the many aspects of social life which they are still capable of following.
We heard an interesting speech by the hon. Member for Central Ayrshire (Mr. Nairn), who referred to matters which are worth emphasising—the need to visit old people in their homes and the need to provide meals. I think he felt that what was most important of all was that the old people should be visited, and I believe that we ought to do all that we possibly can to help in that way. These people have worked hard for the State and for society for upwards of fifty years, and during their last ten or fifteen years facilities ought to be provided to enable them to enjoy their well-earned retirement. I do not think that the financial aspects of the problem are quite so large as they appear to be and as the Minister posed them.
My hon. Friend the Member for Leicester, North-West (Mr. Janner) made a valuable contribution to the debate which made apparent the human qualities that he possesses and the human feeling and understanding that we ought to have in respect of our old people who have done so much for society.
I was very gratified that my hon. and learned Friend the Member for Kettering (Mr. Mitchison) made one of his usual interesting and clever speeches. He talked about the timing and money points and the effect of direct grants. Those are the considerations which this afternoon have prevented the Minister from giving an all-out "Yes" to the Bill. Notwithstanding that, we have had a first-class debate.
We have had a most interesting reply from the Minister himself, and in the talks which I and my colleagues have had with him we have felt that he has the right approach to the matter. I hope that he will be able to play a very large part in Committee in making it possible for us to have this amendment of the 1948 Act, so that we may be able to extend this special provision to old people. I have the greatest pleasure in commending the Bill to the House.
§ Question put and agreed to.
§ Bill accordingly read a Second time.
§ Bill committed to a Standing Committee pursuant to Standing Order No. 38 (Committal of Bills).