§ The Registration of Births, Deaths and Marriages (Scotland) Act, 1854 (17 & 18 Vict. c. 80)
§ In section seventy-six, in the definition of "occupier" the words "lunatic asylum" shall be omitted.
§ This Amendment deletes the obsolete term "lunatic asylum". No substitute is necessary as the word "hospital" covers hospitals providing treatment for persons suffering from mental disorder.
§ Amendment agreed to.
§ The Lord Advocate
I beg to move, in page 95, line 18, at end insert:In section three, for the words "General Board of Control" there shall be substituted the words "Mental Welfare Commission".771 The effect of this Amendment is to make it the duty of the Mental Welfare Commission to take over what were previously the duties of the General Board of Control in divorce cases on the grounds of incurable insanity.
§ Amendment agreed to.
§ Mr. Galbraith
I beg to move, in page 97, line 3 leave out "as it applies to Scotland".
This Amendment should be read with the next Amendment. The effect is to apply the Amendment of the Recall of Army and Air Force Pensioners Act to England and Wales as well as to Scotland. The Fifth Schedule to the Bill repeals the Amendment to the Act made by the Mental Health Act, 1959 for England and Wales only.
The Recall of Army and Air Force Pensioners Act, 1948, makes provision for the recall for service of Army and Air Force pensioners. Paragraph 2 of the Schedule to the Act exempts certain classes of mentally disordered persons from liability for recall. As originally enacted, the Schedule in error identified these persons only by reference to the English statutory provisions. The Bill, as now amended, replaces this by reference to the new English and Scottish legislation.
The next Amendment also has the effect of excluding from the exemption from recall patients receiving treatment in a private hospital, unless they are receiving it at the expense of a regional hospital board. The reason is to prevent the possibility of anyone evading recall to service by arranging to receive, at his own expense, treatment which he does not really need.
§ Amendment agreed to.
§ Mr. Galbraith
If they did need treatment they would not automatically be given exemption which they would be given if they were in a State hospital. Doctors would have to certify and prove that they were really ill. In a State hospital that would not be necessary.
§ Amendment agreed to.
Further Amendment made: In page 100, line 30, at end insert:
In the Seventh Schedule, in Part II, in the amendments to the Army Act, 1955, and the Air Force Act, 1955, there shall be inserted after the word "Wales" the words "and Scotland"—[Mr. Galbraith.]
§ 8.10 p.m.
§ Mr. Maclay
I beg to move, That the Bill be now read the Third time.
I wish to say straight away how grateful I am for the immense amount of work which has been done on this Bill, not only by hon. Members but by people outside the House who took a great deal of interest in the Measure many months before it reached the Floor of the House. It is an important Bill to the future of this part of our social life in Scotland. I am grateful to my right hon. and learned Friend the Lord Advocate and to my hon. Friend the Joint Under-Secretary of State for the detailed painstaking and unrelenting work which they have carried on for many weeks in connection with this Bill.
Fundamentally, the Bill we have today is that which this House sent to the Standing Committee. It is clear that its general structure has met with warm and wide approval. A number of the features to which I drew attention at an earlier stage have been retained without question. For example, the fundamental principle of having for Scotland an independent body to protect the person and property of mentally disordered persons and the retention of the sheriff in the procedures for the use of compulsion have been fully endorsed.
Nevertheless, a lot of hard work has been done on the Bill and it emerges, as I say with gratitude, with numerous improvements. I said that the independent central body has not been questioned, but hon. Members have shown a great deal of interest in its name, its precise constitution and functions, and we have been able to make changes in the light of these deliberations to the general improvement of the Bill. We have provided for a medical review and report 773 on each patient before he can be kept subject to compulsion for more than twenty-eight days. We have also strengthened the periodic review of patients subject to compulsion by introducing a second medical opinion. In each of these changes and in other points of detail everything that has been done as the Bill has passed through the House has been aimed at protecting still further the interests and wellbeing of the mentally disordered.
Hon. Members showed some anxiety about the development of the community services which the Bill is designed to facilitate. There has been no difference of opinion about what is the desirable object here, but we have not all been agreed on the best moans of achieving it. The Bill employs the machinery of the National Health Service (Scotland) Act, 1947, and I think it may assist the House if I show how that machinery, supplemented by the provisions in Clause 7 of the Bill, will enable us to bring about in as good time as possible the developments which we should all like to see.
Hon. Members will have noted that Clause 117 of the Bill makes a special reference to the power to give directions under Section 27 of the 1947 Act for defining the duties of local health authorities, enabling that power to be exercised at any time after the Bill is passed. As soon as possible after the Bill is passed, therefore, I propose to direct local health authorities to make arrangements to provide services for the prevention of mental disorder and the care and after-care of persons who are or have been suffering from mental disorder.
I propose that this direction will be in general terms. During the Committee stage reference was made to our intention to ask the Scottish Health Services Council to advise on this matter. I am glad to be able to tell the House that the Council's Standing Advisory Committee on Local Authority Services already has before it, and has begun work on, a remit on this subject. It is due to meet again tomorrow. The Committee has had impressed upon it the importance we attach to having early advice on the kind of arrangements which local authorities should make with a particular emphasis on the things that can be done quickly.
As soon as this advice is available local health authorities will be told what 774 matters to cover in their proposals. Once this has been done I should expect, subject to consultation with the local authority associations, that the authories' proposals could be submitted to me within six months. I am quite clear that by proceeding in this way we shall be enabled to get appropriate detailed advice on what is practicable, and to secure the flexibility that is essential, without any risk of any local authority falling short of its proper responsibility.
During the consideration of the Bill in Committee great interest was shown in the arrangements by which at present I am advised of the discharge of patients who have been ordered to be detained during Her Majesty's pleasure—a phrase which I hope will disappear in the future. My right hon. and learned Friend the Lord Advocate explained to the Committee haw some of these patients were in State hospitals, some in ordinary mental hospitals, and some on conditional liberation in the community. The Bill provides for the appointment of a committee to manage the State hospitals on my behalf. These State hospitals, as Clause 89 provides, are to be for persons who require treatment under conditions of special security on account of their dangerous, violent or criminal propensities.
The committee which I propose to appoint to manage the State hospitals will be directly responsible to me and will not be part of the regional hospital arrangements. It will be so constituted as to include a very strong psychiatric element. As I envisage the committee at the moment, it will consist of a chairman, three consultant psychiatrists of standing, of whom one will, I hope, be of senior university status, a lawyer, and someone with local authority experience. If none of these persons is a woman, I propose to add one to the committee. I shall lean heavily on the committee for regular review of all the patients who are or have been in the State hospitals, since continuity of knowledge of these patients is important.
I hope that what I have said on the standing of the medical people whom I propose to put on the committee will assure the House that there is no need to look elsewhere for my main advice on these matters. I know that my predecessors in this office who have had to apply 775 their minds to some of the very agonising and difficult decisions which arise in these cases will agree that we have done everything we can to obtain the best possible procedure. It is a part of my duties which weighs most heavily on my mind and conscience as a Minister.
§ Dr. Dickson Mabon
May I ask the right hon. Gentleman a question about the management of the State hospitals? Is it correct to state, particularly in view of what was said earlier about the commissioners, that no member of the State Hospital Board which he is thinking of appointing will also be on the Mental Welfare Commission?
§ Mr. Maclay
This is too early a stage to commit myself, but I cannot imagine that that is so. If I am wrong in that, my hon. Friend will correct me when winding up the debate.
The Bill is designed to encourage still further voluntary treatment of mental illness and in doing this may well speed up an interesting recent trend in the population of our mental hospitals. While admissions to and discharges from these hospitals have greatly increased, the period of stay in hospital has been so reduced that the total number of patients resident is tending to decline, after having remained fairly constant for many years. Partly because of this, we have not the same pressing need for additional mental hospital accommodation as we have for accommodation for certain classes of mentally defective patients. We are more concerned with improving the quality of accommodation, and with providing some new types of specialised units which developments in psychiatry require, than in increasing the total number of places.
A major difficulty in expansion of the resources, on which successful fulfilment of the aims of the Bill will depend, will be the rapid expansion of the number of skilled workers of all kinds in this field. I sincerely hope that more of our younger doctors will be attracted to psychiatry, for it must be clear that this is a lively and rapidly developing specialty in which there is ample opportunity for good men and good women. It may interest the House to know that my Department has arrangements in hand for meetings to be held in the autumn with the consultant psychiatrists 776 in Scotland to discuss present trends and the best ways of making use of our medical resources.
But medical personnel alone is not enough. We clearly need more social workers in this field and the devotion of more time by skilled members of the Medical Officer of Health's team if we are to have the improvements we want. We have this need constantly in mind in our consideration of the Young-husband Report, with its recommendations for the training of social workers and the structure of local authorities' health and welfare staffs.
The Bill may be said, I think, to have three main aspects. It encourages the voluntary treatment of mental illness and the development of community services. It encourages the use by the courts of the contribution which the mental health services can make to the regeneration of those who have fallen foul of the law—a contribution which it is possible to exaggerate but which is nevertheless of great importance. Thirdly. it provides a code for the protection of the mentally disordered against unnecessary detention and restriction and against exploitation. Each of these matters is important, and I commend the Bill to the House as a proper instrument for achieving what is best in each of them.
I hope that the House will forgive me if I do not sit through the Third Reading debate. I do not know how long it will last. I have been confined to barracks, as it were, the whole day since 10.15 a.m. and there is a weight of work and a certain feeling that I must get on with it.
§ Mr. J. C. Forman (Glasgow, Springburn)
Before the right hon. Gentleman sits down, will he deal with a question which I raised in Committee? I asked about the standard of guardianship, and the Joint Under-Secretary of State for Scotland gave an undertaking that the Secretary of State would introduce regulations governing the standard of guardianship. Does he still intend to frame such regulations?
§ Mr. Maclay
May I leave that question to my hon. Friend the Joint Under-Secretary of State, who will make a short speech in winding up the debate? He will deal with that point.
§ Mr. Dempsey
Before the right hon. Gentleman leaves, will he give us some more information about the circumstances of the local authorities? He proposes to direct them to submit to his Department schemes in connection with the Bill when it becomes an Act. He will appreciate that he is imposing a formidable financial burden upon local authorities by asking them to undertake their share of the responsibility. Will he give the House an undertaking that, once he has approved these schemes, there will be no niggling about the financial contributions and that provision will be included in the local authorities' allocation of the block grant?
§ Mr. Maclay
I cannot give assurances about sums of money in detail, but I can give an assurance that this matter will be taken into full consideration under the terms of the Act under which the block grant is payable. There is no doubt that it will be dealt with.
§ 8.27 p.m.
§ Miss Margaret Herbison (Lanarkshire, North)
We have reached the Third Reading of the Bill, but before I begin to deal with the issues which I should like to raise I must say that all of us have the greatest admiration for the Chairman of our Committee, my hon. Friend the Member for Edinburgh, Leith (Mr. Hoy), who, in spite of great physical difficulties, travelled from Edinburgh to London so that we might finish the last day of the Committee stage. I think that as a result of that he spent a fortnight in hospital in Edinburgh. We owe him a very great debt of gratitude for what he did.
From the beginning, we on this side of the House have at no time regarded the Bill as a party Measure. I wish that hon. Members opposite had taken the same attitude. This is an important human and social Measure. It seems to me that more thought and study should have been given to it by back bench Members on the Government side. With the exception of three hon. Members—the hon. Members for Galloway (Mr. Brewis), Aberdeenshire, West (Mr. Hendry) and Manchester, Moss Side (Mr. Watts)—little or no interest was evinced during the 19 meetings of the Committee by Scottish Members on the Government side.
778 If Scottish Tories evinced little interest in this great human and social Measure, what about the Leader of the Liberal Party? He is the only Liberal who represents a Scottish constituency. He made no contribution on Second Reading. Had he wanted, he could have been on the Committee. We have not seen pelt or hair of him this afternoon—and this is a Bill which to a great extent deals with the liberty of the individual, of which the Liberals talk so much.
The Joint Under-Secretary of State carried the burden of the Bill from his side of the Committee, and he proved both co-operative and helpful in Committee. Many Amendments were accepted there. The Report stage today has been taken up mainly with Government Amendments to meet points which were raised by the Opposition in Committee. I have no criticism to make of the Minister in his attitude to the Bill. Indeed, on Second Reading the Secretary of State said that he would welcome criticism and would consider any suggestions. The Joint Under-Secretary, who has carried this Bill through, certainly honoured those words of the Secretary of State.
I think that it is a much improved Bill. It is certainly true that the main trends are the same as when the Bill first appeared before us, but it seems to me that by this time it is much improved. There are greater safeguards provided to ensure the liberty of the mentally ill and to ensure their welfare generally.
On the question of finance to local authorities, we have failed to move the Government at all. On the question of ensuring that this duty would be made mandatory on local authorities, we have again failed to move the Government. On those vital matters where our political ideologies are poles apart, we have made no impact whatever on the Government.
The vision which was shown so clearly by the Royal Commission will become a reality, it seems to us on this side of the House, only if the local authorities are given the financial aid which they must have. The Royal Commission, in most of its recommendations, emphasised the need for a trend away from institutional care and placed the emphasis on care in the community.
Under the Bill, local authorities will be asked to provide residential homes 779 and hostels. These residential homes and hostels will need men and women to staff them. Local authorities will be expected to employ psychiatric social workers and other social workers. These workers are needed if we really believe in attempting to fit the mentally ill into the community again. I am sure it was the desire of the Royal Commission that as many people as possible who became mentally ill should be fitted once again into their own community.
When the Royal Commission made its recommendations, it was very conscious of the great financial burden which would be placed on the local authorities. Because of that, it asked that for a certain number of years a high percentage of the cost of these provisions should be borne by the Chancellor of the Exchequer. The Government have not accepted this suggestion. They have not accepted the case which we tried to make on Second Reading and in Committee on Clause 7. In those instances, we received no support from Government back benchers in our fight to ensure that local authorities should have the financial aid that was necessary.
Some local authorities in our country have always been dilatory in providing social and health facilities. They will have no incentive under the block grant system of showing the enthusiasm and the urge which we on this side of the House would like them to show. The picture is even worse. There are other local authorities in Scotland which have been always ready to meet the obligations placed on them. Even these progressive local authorities will find it very difficult under the financial provisions of the Bill, which are contained in the block grant legislation, to do what the Royal Commission wished them to do.
The Government have a substantial responsibility under this great human social Measure. I want at this stage to warn the Secretary of State that we on this side will be most vigilant. We shall constantly remind the Government of their responsibilities about mental health. We shall constantly draw to their attention the need for greater financial assistance to local authorities if they are to provide the facilities which the Bill asks them to provide.
The Bill is merely a blueprint. It does nothing to solve the difficulties. 780 An immense task lies ahead—a task for the Government, the local authorities, the doctors and nurses, and indeed for all who play any part in Scotland in the treatment of the mentally ill.
I have the greatest admiration for the doctors and nurses who devote their lives to this work. For about two months I was a nurse in a mental hospital in Edinburgh. I found it a very useful experience, but I realised in those two months that I could not possibly make it my life's work. Because of that experience and the experience I have had since from visiting hospitals where mentally ill people are treated, my admiration of those who do this work has been greatly strengthened.
The problems are very great indeed, and they will be solved only by a concerted effort by the Government, local authorities, and the staffs of these hospitals. In moving the Third Reading, the Secretary of State said that we are not so short of buildings for the mentally ill, but there is still a shortage for the mentally defective. We could do with more modern buildings than some of the ones we have in Scotland for the mentally ill. Therefore, for the mentally ill, and especially for the mentally defective, there is a need for accommodation.
The Secretary of State will agree with me that there is a need for increased staff at every level if there is to be the kind of mental health service that the Bill envisages and the Royal Commission wanted. I want to deal shortly with two categories of staff which are required. I shall deal first with occupational therapists. No one can possibly deny the value of occupational therapeutic treatment for the mentally ill. The latest figures which I can obtain reveal that there are almost 21,000 mentally ill people in hospitals in Scotland. There are over 6,000 mentally defective and in institutions. That is a total figure of roughly 27,000.
Some weeks ago, I asked the Secretary of State how many fully qualified occupational therapists there were in Scottish hospitals. His answer was 47 full-time and one part-time. If these were divided equally over the patients in the hospitals, there would be one fully qualified occupational therapist to every 562 patients. That is very wrong. They are not equally 781 divided. There is not one fully qualified occupational therapist in the largest hospital in Scotland, which is in my constituency.
The Secretary of State told me that the Western Regional Hospital Board had been asked by him to make plans for a training school for occupational therapists in the West of Scotland. Has he these plans before him? I hope that the Joint Under-Secretary of State when winding up will be able to give me the latest information. I understand that any man who wants to be an occupational therapist in Scotland has to go to England for the training.
I want to turn to another type of worker Who will be most necessary if we are to get the mental health service we desire. Two Reports have been published on the recruitment and training of personnel for the mental health services, parts of them dealing with other matters. We had the Mackintosh Report in June, 1951, and last year the Younghusband Report was published. In spite of questions, the Government have refused to make any pronouncement on the value of the recommendations of the Younghusband Report. In paragraph 1129 of that Report we find these words:We are greatly concerned that, under the new system".—that is, the block grant;individual authorities may not have the same incentive as previously to undertake and finance a programme of training, and of improvement and expansion in a series of services.That is the fear of the experts, but whether it is the humble folk of the Opposition who make the case or the experts chosen by the Government, the Government have decided to turn a blind eye to all of them and to go on their own way.
The Younghusband Report recommended a National Council for Social Work Training, and very strongly recommended that it should be set up as soon as possible. If there is a continuation of this great dearth of psychiatric social workers it will nullify the provisions of this Bill. so much of which depends on community care outside hospitals.
Edinburgh is the only one of the four Scottish universities that provides a course of study for psychiatric social workers. We know that these univer 782 sities are autonomous bodies, but the whole bulk of the finance comes from the Government sources, either in grants to the universities or grants to the students. Surely, the Secretary of State could influence the other universities to provide comparable courses for the other parts of Scotland.
The Younghusband Committee said:Seven years later we can but echo many of the findings of the Mackintosh Committee. There is still a large unfulfilled demand for social workers in the mental health services. Psychiatric social workers are still a mere handful in relation to demand, and there is still no training for other mental health workers.As the Mackintosh Report has been in the hands of the Government for nine years, those words really are a damning indictment of the Government, which have been shilly-shallying since 1951.
This attitude does not augur well for the future—but perhaps the Joint Under-Secretary will be ready tonight to make some announcement of the Government's decision on the Younghusband Report. He moves his head as if to say, "No", but if he is really serious about what this blueprint can do—or, to put it another way, what this "skeleton" Bill could do if given the flesh—and part of the flesh would be the provision of psychiatric social workers—he would be urging the Government to pronounce on the Younghusband Report.
This Bill has encouraged people in Scotland to hope for a much better mental health service. I have been asked about it in a number of areas. This Measure has certainly interested more people in the subject than were interested in it before. If those hopes are to be realised, we shall need a far greater drive and much more energy from the Government than they have so far shown in the treatment of these various Reports. If we want to strengthen and keep alive in those who are working in our Scottish mental health services their enthusiasm for what might come as a result of the Bill, it can come only from drive and energy on the part of the Government.
A word now about research. Last week, I visited a hospital where I spoke to a biochemist who is doing important research on schizophrenia. Of course, a great many of our mentally ill people suffer from illness of that nature. He 783 said that the answer one always has from the Government, that finance is not the hindrance to research, is quite wrong. This is a man who is in research. I ask Ministers to listen carefully because, time after time, the excuse is trotted out that it is not finance but personnel which is the hindrance. Yet here is a man doing important biochemical research which will have a bearing on the treatment of the mentally ill who is quite convinced that it is finance which in some instances hinders important research work which might be done.
I hope that the Government will, when the Bill reaches the Statute Book, use all their energy in getting local authorities to provide community care. I hope that they will give every financial assistance to local authorities. As I said, we shall be vigilant. We welcomed the Bill when it came before us. We think now that it is a better Bill and, as I said before, we thank the Joint Under-Secretary for his great help. I hope that it will mark the beginning of a real chance not only for the mentally ill but for their relatives, too, to know that something vitally important is to be done for them, to bring them hope, to bring them cure and to bring them happiness.
§ 8.50 p.m.
§ Mr. Forbes Hendry (Aberdeenshire, West)
I shall be very brief, because so many words have been said already on the Bill that there seems to be little left to say in the House about it.
I am sure that the Bill brings a sense of accomplishment to a great many right hon. and hon. Members on both sides. It must give a great feeling of accomplishment to the Secretary of State. He produced the Bill. It has been his "baby". It must give a great feeling of satisfaction to the Joint Under-Secretary of State who shepherded the Bill through 19 meetings of the Committee.
Apart from a sense of accomplishment, it has given a great many of us, I believe, a feeling of relief after devoting much time and work to the Bill. It is not the sort of Bill which hits the headlines, but it is a most important one because it is, in effect, a new charter for an unfortunate section of our people 784 who particularly need help. Through the Bill, we have been able to do something to help them, to give them new hope and, as the hon. Lady the Member for Lanarkshire, North (Miss Herbison) said, to give their friends and relations new hope.
In my researches into the subject, I have seen clear results of the new thinking on mental health. There is now a new hope. We are moving away from the old ideas about treatment and, as I say, with the new thinking, a new charter has been prepared. I am convinced that all the work we have put into the Bill has been well worth while.
§ Mr. Hendry
I think that the hon. Gentleman himself did a good deal of work. I contributed in my small way to the work of the Committee. As a new Member, I did my best. I assure the hon. Member and the hon. Lady who was, I thought, a little unfair to back benchers on this side of the House in their contributions—
§ Miss Herbison
I said that there were three honourable exceptions, and I said that the hon. Member for Aberdeenshire, West (Mr. Hendry) was one of them. I know that he worked on it. I saw him doing it.
§ Mr. Hendry
I am grateful to the hon. Lady for that. I was thinking in rather wider terms. Although only three back bench Members on this side contributed to the debates in the Committee, there was a great deal of discussion among back bench Members themselves to decide how we could help to improve the Bill. It is probably a very good thing that more of us did not speak; otherwise, instead of having 19 meetings we might have had 25 meetings of the Committee.
§ Mr. Ross
It is very interesting to learn that hon. Members opposite had these back bench discussions and all the rest. Is the hon. Gentleman aware that not a single Amendment was put down by his back bench hon. Friends and not a single idea was contributed for the improvement of the Bill he is now proclaiming on Third Reading?
§ Mr. Hendry
I am sorry that the hon. Gentleman has thought it necessary to 785 interpolate in that way. I was about to say that the Bill has given me a great deal of personal satisfaction, because it showed me something which I did not believe possible before I took part in the work upon it, namely, that Members of the House of Commons and its Committees could get together in a non-political spirit to try to improve the law in a Bill presented to us. That is what happened.
The Bill has given me a great deal of personal satisfaction, because I had the privilege of making my maiden speech on it. That very fact gave me, as it were, a proprietary interest in it and, by the time we had gone through about 10 meetings of the Committee, I felt that the Bill had acquired a proprietary interest in me. The Committee stage afforded evidence of genuine endeavour on both sides to improve the Bill. There was a great deal of earnest and sincere discussion. There was practically no political argument and I think that all of us on both sides were trying to achieve perfection. It is possible that in some cases we tried too hard to achieve perfection, and there were times when we could not agree about various things. But I feel that the opposition, whether it came from the other side of the Committee or from the Government back benches, was designed to try to improve the Bill.
I feel that the Bill has, to a large extent, been improved. A great many things have been added to it to improve it. I should like to remind hon. Members opposite of an Amendment achieved by one of the despised added Englishmen, namely, the hon. Member for Manchester, Moss Side (Mr. Watts). I need not remind the hon. Lady the Member for Lanarkshire, North that the hon. Member for Moss Side was, I think, responsible, along with various hon. Members on this side, for adding a woman to the Commission. I do not think that we should forget that.
§ Mr. Hendry
I agree that it was an Opposition Amendment, but it was supported from this side. Without that assistance, I do not think that it would have come about.
§ Miss Herbison
I do not think that the hon. Gentleman listened to my speech. I was very careful to pick out the hon. 786 Members for Manchester, Moss Side (Mr. Watts), Galloway (Mr. Brewis) and Aberdeenshire, West. I always try to be fair in these matters.
§ Mr. Hendry
I agree very much with what the hon. Lady says, but I have been trying to underline the fact that there was a tremendous amount of friendly feeling in the Committee on the Bill.
I propose to finish what I have to say about what happened in Committee by underlining the generosity of my hon. Friend the Joint Under-Secretary of State who accepted so many Amendments in a friendly spirit with the one and only purpose of trying to improve the Bill. We all ought to be grateful to him for the generosity which he displayed in accepting those Amendments and for producing so many Amendments today on Report.
Before I stop paying compliments, I think that every hon. Member present would wish to pay a very great tribute to the tremendous amount of work put into the Bill by the hon. Lady the Member for Lanarkshire, North. She could be seen day after day and night after night sitting in the Library working on the Bill. She has contributed a tremendous amount to the Bill, and we all ought to be grateful to her.
I think that we have achieved a good Bill. Possibly it is not a perfect Bill, but it seems to me that, in a matter of this sort, perfection is never possible. For one thing, we can never all agree on what is perfection. We have all striven hard to make the Bill as perfect as we could and I think that we ought to wait and see how the Bill works. There is a lot to do in a matter of this kind which cannot be done by legislation.
It seems to me that the first thing that all of us on both sides have to do is to educate the public on the subject of mental health. A stigma has always been attached to the mentally ill, and that stigma must go. There is the possibility under the Bill of people who are mentally ill being treated in hospital as ordinary human beings. The Bill makes it possible to make a tremendous addition to the total sum of human happiness in Scotland. I feel that we ought to do everything we can among those upon whom we have influence to get rid of the stigma against mental health. A lead 787 has been given by the Government which has to be followed by many people, the first being members of hospital boards.
I am not satisfied that hospital boards dealing with mental illness appreciate what can be done. We all have influence with hospital boards, and I hope that each one of us will use his or her influence with them to make sure that they appreciate what can be done. As the hon. Lady said, a tremendous lot depends on the local authorities, and each and every one of us has influence with his or her local authority, and I hope that we shall use it.
The hon. Lady also said that the local authorities may be disheartened because of the financial provisions, or lack of financial provisions, in the Bill. We ought to remember what the Secretary of State said in his final speech, namely, that although he cannot give an exact figure in pounds, shillings and pence, the financial assistance will be given under the Acts which already exist. I believe that, having produced this Bill, we can rely on the Secretary of State to make sure that it will work and will not suffer from the lack of pounds, shillings and pence in the hands of the local authorities.
In any case, quite apart from finance, the local authorities must be educated in this way, and I think that each one of us can do a tremendous amount to educate our local authorities. But we have got to go further than that. Much should be done to educate the friends of the patients and the general public. The hon. Lady said that a great deal of interest—a surprising amount of interest—had been shown in Scotland in the Bill, and I hope that that will continue, and that it will not be interfered with by any discordant talk in the House at the final stage of the Bill.
We have to use our influence to educate two other important groups of people in this new attitude towards mental health. The first group consists of the doctors themselves. To a very large extent, I think that the doctors still look upon mental health and the treatment of mental illness as something not quite up to the mark in the medical profession. The psychiatrists and the doctors working in mental health must have their status improved, but whatever 788 I say about the doctors I must repeat ten times about nurses. The nurses in mental hospitals are, and always have been, the poor relations of the nursing profession, and everything must be done to secure that the status of these mental nurses is improved. The same thing applies to social workers. We can get plenty of social workers in other hospitals, but the medical profession and the hospital boards must appreciate the necessity of getting more and more social workers into these mental hospitals. The local authorities have a great part to play in this, too.
I do not want to say much about Part II of the Bill—the unpleasant part which deals with those people who must be kept under restraint. A great deal of discussion has taken place on that already, and my right hon. and learned Friend the Lord Advocate has achieved a very delicate and very even balance between the safety of the public, who must be protected, and the liberty of those unfortunate people who must occasionally be deprived of their liberty. In Committee and in the House, everything that can be done has been done to make the Bill a success, and we ought to send it on its way to another place with our blessing.
§ 9.3 p.m.
§ Mr. Hannan
We have just listened to a rather remarkable speech from the hon. Member for Aberdeenshire, West (Mr. Hendry). I should have thought that the number of times on which the Joint Under-Secretary of State has had to get up today and repeat the statement that the Government were making the Amendment because of suggestions made by the Opposition in Committee was proof positive of the source of the improvements in the Bill. My hon. Friend the Member for Lanarkshire, North (Miss Herbison) rightly paid tribute to and mentioned the three hon. Members opposite, but, as my hon. Friend has remarked, the hon. Member for Aberdeenshire, West has said more tonight in his speech than those three hon. Members did in Committee.
§ Mr. Hannan
The answer is that, as the Joint Under-Secretary knows, back benchers did not take part in the Committee proceedings because the Whips 789 were on, and because the more they spoke the greater would have been the length of time that would have been taken. Do not let anyone be hypocritical about it and, in the dying stages of the Bill, try to gain credit from the efforts of a lively Opposition. The hon. Member said that he would have to educate the local authorities, but it is rather the other way round in Scotland, at least, in regard to some of the local authorities. It is they who have had to teach the Government in respect of these services.
I have been provoked to speak longer than I intended, but I, too, want to pay tribute to the Joint Under-Secretary of State despite on occasion in Committee his moments of petulance when he said that he had had enough. At least we were getting to the stage when nerves were beginning to be frayed. The hon. Gentleman was courteous and has shown himself amenable to many of the good suggestions which came from this side of the Committee. Of course, my hon. Friends have worked hard.
One hon. Member spoke earlier about the great and abounding love of people who indulge in this work, and they must be referred to once again. Many of these people, it was said, are inarticulate. I have a school for deaf children in my constituency. There, too, one can see signs of the same sort of abounding affection among the teachers, the nurses and those who care for them. One can see them feeling it when they want to express themselves but are unable to do so. These people give devoted service and are dedicated to their calling. It is certainly not their wages or salaries which encourage them to go on.
In the Bill, we are encouraging people to become voluntary patients and to enter by their own action and seek treatment in that way. The hon. Member for Aberdeenshire, West was quite right in saying that we are passing away from the old days of the institution and the like. Epileptics, the aged and people who suffered from mental disorders have been shut away in institutions. Now the progressive tendency is that they should have community care. At one time even minors were segregated from the community and sent out to isolated places to stay and for that 790 reason were kept away from the rest of the community.
I wish to put one point to the Joint Under-Secretary who, I hope, will be able to confirm my impression concerning Clause 7 which deals with local authorities. Can he confirm that that Clause, react in conjunction with Section 27 (2) of the National Health Service (Scotland) Act, provides that while a local authority establishes, equips and maintains residential accommodation and care for persons, it can recover a charge from people who are in receipt, for example, of National Assistance.
Such people pay £2 to the local authority and receive back 10s. This is by way of encouraging them psychologically to believe that they are independent and are paying at least part of their way. Many old people cannot understand the situation or why they should be asked for money. Will this practice continue under Clause 7? Will a local authority be able to receive the £2 from the National Assistance and refund the 10s. to the old people? I shall be grateful if the hon. Gentleman will confirm my impression. It was on this account that we were uncertain in Committee whether to move an Amendment. If I am wrong I shall be glad if the Joint Under-Secretary will inquire whether under its provisions the National Assistance Board can co-operate with the local authority in continuing the present practice.
I wish the Bill well on its journey. I hope that it will receive due consideration in another place and that we shall receive further suggestions from noble Lords. All of us on this side of the House welcomed the Bill in the first place. We still think that it is a charter and that it will go a long way for many years in setting a new pattern for the treatment of mental illness in modern conditions.
§ 9.10 p.m.
§ Mr. John Brewis (Galloway)
I wish to associate myself with the tributes paid to the hon. Lady the Member for Lanarkshire, North (Miss Herbison) for all the work that she has done on the Bill and also to pay tribute to the work of many of her hon. Friends. It is significant that this year, which is Mental Health Year, is that in which we have a new Mental Health Bill for Scotland. It is not always appreciated what a large 791 number of people in Scotland are involved in this matter of the treatment of mental health and how many beds are occupied by the mentally ill. I very much welcome the system whereby patients can enter mental institutions voluntarily without having to sign any certificate or being afterwards detained compulsorily. I believe that already the percentage of those entering voluntarily is reaching 80 per cent.
We must do all we can to remove fear from this branch of medicine and, as far as possible, to assimilate mental health with physical health, because the sooner the mentally ill patient is out and earning his own living the better for the country. A quick turnover also helps the patient to fit himself once again into his home environment. I am glad to say that the mental institution which deals with patients in my part of the country has now reached a turnover of nearly 100 per cent. every year of the patients attending institutions.
I was glad to hear what my right hon. Friend the Secretary of State said about recruiting more doctors. It seems that glamour really attaches to the curing of the mentally ill. I hope that we shall remember also those who are in the silent world of the mentally deficient, and the devotion of nurses, doctors and guardians who look after people who are in this condition. I welcome what my right hon. Friend said about after-care clinics and the local authorities. A great deal can be done by the leagues of friends of the various mental institutions to bring normal life to the patients and to provide the little comforts which help them so much during their stay in the institutions. I give a very great welcome to the Bill.
§ 9.14 p.m.
§ Dr. Dickson Mabon
There is much with which I agree in the remarks made by the hon. Member for Galloway (Mr. Brewis), and particularly in his concluding comments about leagues of friends. A great deal of lay work is done on a voluntary basis for what he called the silent world of the mentally deficient. One reason why work among the mentally deficient is not as popular or as attractive as it might be to doctors is that it is so bereft of sufficient financial aid for its development.
792 When my hon. Friend the Member for Lanarkshire, North (Miss Herbison) was speaking about biochemists and the need for more research, I was reminded of the time when the theory was put about that, to a large extent, some forms of mental deficiency were due to deficiencies of very minute quantities of various biochemicals, and if we could only discover what the nature of these were, and what their particular forms of construction were, we could actually induce a drug cure for certain forms. That is, perhaps, still in the rarified world of medical speculation. I believe that money should be spent prodigiously and even extravagantly to find out these things.
The drug largactil, often employed in some cases of senile dementia, was often doubted in the initial stages. It was only by adequate research that it was proved to be of such value. It is now used extensively. It and its allied drugs means that the chains and locks need no longer be on lunatic asylum doors.
This Bill just catches up with medical practice. There is a dreaful history of delay which goes back to before the Second World War. A Committee reported in 1946 and, for the good reasons which I explained on Second Reading, it was then obviously not the time to prepare a mental health Bill. The subject therefore languished, in Scotland at least, until the last part of 1957. It has taken all this time finally to get it into shape. We are very glad of this Bill and the Opposition have given it every facility—that cannot be denied.
Members opposite have been kind in their remarks, but not as gracious as I thought would have been. I am glad that the hon. Member for Aberdeenshire West (Mr. Hendry) has had his faith in Parliamentary democracy restored, and reaslises that we are not ogres on this side of the House and are willing to be helpful. I am glad he realises that a democracy is a good place to live in.
I was surprised by one or two other comments that he made, but I stick to my essential point, which is that we should not be too congratulatory about the Bill. It took a long time. It is better than it was at Second Reading, because the Government have thought about it and have listened to some of the arguments. I would not claim, as apparently do the majority of back 793 bench Conservative Members, infallibility, nor do I believe that the Government or any Government can be infallible. That was the point that my hon. Friend the Member for Kilmarnock (Mr. Ross) seemed to be making tonight. He was not quarrelling or being unpleasant to hon. Members of the party opposite when he recited the facts. The facts are there to be seen.
With three very good exceptions, back benchers opposite came out of this badly. If they had all these private discussions, referred to by the hon. Member for West Aberdeenshire where were the Amendments that should have been proposed? We on this side had a considerable number of Amendments accepted in Committee. To a large extent this was due to the Joint Under-Secretary of State being so willing to consider the arguments and, also, I think, because he had a certain amount of delegated responsibility. Others were not accepted because, I like to think, the Secretary of State could not delegate responsibility for deciding about them. They seemed to remain in this higher immutable sphere.
Of the Amendments we discussed today on Report—I refer to the subject matter and not to the numerical aspect—for many were concerned merely with the substitution of the word "Commission" for the word "Board" thirty-eight were moved by the Government today entirely because of points presented by the Opposition. Many of them had been opposed by the Government in Committee.
Two splits took place in the party opposite during the passage of the Billl. The first was on the question of local authority finance. An English Member—the hon. Member for Manchester, Moss Side (Mr. Watts)—voted with us against the general grant provision. I have no doubt that, as a new Member, he was subjected to a certain amount of remonstration, to put it mildly. Perhaps he will not be tempted to do that again.
The other split was on the question whether we should include a woman on the Commission. I am sorry that the hon. Member for Aberdeenshire, West is not present. This second split in the Tory Party came when the hon. Member for Aberdeen, South (Lady Tweedsmuir) did not quite agree with his argument. 794 She was more inclined to listen to the Joint Under-Secretary, who himself was not sure whether we would find a woman capable enough—I think that was his phrase—to sit on the Mental Health Commission. I do not know whether he will blush deeply when he meets the lady who is ultimately appointed. I wonder if he will think that she is thinking that he is thinking that she is not capable enough to serve on the Commission. Those were the two splits in the party opposite, and I am glad to say they were stimulated by our Amendments.
We take pride in the fact that the Bill as it stands would have been a sorry creature if it had not been amended 38 times on Report and many times in Committee. Unfortunately, there are at least four legislative deficiencies outstanding. Although we are now sending it to another place I hope that the Government will give due consideration to those four points. One seems not to be the responsibility of the Secretary of State at all; it seems almost a Cabinet decision, and the Cabinet seems unsympathetic to the point of view of the Secretary of State for Scotland. I can only assume that the failure to amend the aliens' Clause was due to this. I will not touch upon the others; leave them for the Joint Under-Secretary to consider.
My hon. Friend the Member for Glasgow, Maryhill (Mr. Hannan) made an excellent point about the concern of Glasgow Corporation and other local authorities. I hope that the hon. Member will deal with that point, and also with the one I made to the Secretary of State concerning dual membership of the Mental Health Commission and of a board of a State-managed institution. I hope that dual membership will not occur. My hon. Friend the Member for Lanarkshire, North said that the Bill was a skeleton, and that it ought to be given flesh and blood.
That is perhaps the greatest criticism of the Bill as it stands. The Government have adopted a skeletal approach. It is lacking money, staff and buildings. When the Joint Under-Secretary was being chivvied on the question of money on Second Reading he hid behind the argument that this was just the anatomy and that we ought not to discuss the physiology of it. The living of it was not as important as its bones. That 795 is a foolish point of view, which happily he contradicted later in his own speech.
The hon. Member for Aberdeenshire, West said that he knew that the money was there. In that case, he knows more than anyone, including the Secretary of State. If the money is not provided local authorities will not be able to provide all the facilities required, with the best will in the world, however much we lecture them or educate them. We have argued this before. The powers which the Bill provides add nothing to those Which have existed for the last ten years. In his Second Reading speech the Secretary of State suggested that local authorities were, under this Bill, being given a new and extended list of statutory powers. He said:This part of the Bill, therefore, makes it possible for local authorities as health authorities, as welfare authorities, as children's authorities and as education authorities to provide all the services that may contribute to the wellbeing of the mentally disordered in the cornmunity."—[OFFICIAL REPORT, 9th February, 1960; Vol. 617, c. 257.]I think that he made a mistake there. He should have said, "This makes it permissible, but in many cases impossible."
Many authorities are having so many demands made upon them that they will not find it possible. The proof of this assertion lies in the report of one of the most critical Committees that ever reported on a Government's progress in the silent field of mental deficiency—the Fyfe Report—which said that with the present statutory responsibility, and with the present grant system, the fact was that the community, through local authorities, were not playing their proper part. It said that about 6,000 youngsters were still awaiting admission and facilities for community care and after care in the mental deficiency world alone.
I cannot see how we can expect the Government to convince us that because we are recasting in the same mould the statutory powers which already exist we are therefore suddenly going forward with a new lease of life. I suppose that it is customary, in Third Reading debates, to make glowing perorations. There is no doubt that this is a great reform; the question is whether it will have life breathed into it, and whether the money will be forthcoming. Money 796 is important, and so is staff. My hon. Friend the Member for Lanarkshire, North dwelt on the provision of occupational therapists and social workers generally in regard to this matter.
In a meeting of the Scottish Grand Committee, subsequent to the Scottish Standing Committee which considered the Bill upstairs, we had a debate on the Health Estimates. I asked the Secretary of State for Scotland to make a comment on the Younghusband Report. He said this:I cannot state today when we shall be taking action. I fall back on the statement that it could be shortly, but 'shortly' is to be interpreted in the normal Parliamentary sense."—[OFFICIAL REPORT, Scottish Grand Committee, 31st May, 1960, c. 61.]In the natural inquisitiveness which I have developed towards him after a long association in West Renfrewshire and Greenock, I interrupted and said, "At least two years." He replied—it is the most definitive answer we have had from any Cabinet Minister—"No".
So we know from the Government that the Younghusband Report will apparently be considered by the Government within two years. That is a fact; we know that. Yet this Bill will be implemented very soon. It is high time that the Government recruited advisers from the Conservative Central Office. I mean that, because the Conservative Central Office can seemingly make up its mind more quickly than can the Government. The Government had a Report lodged with them on 6th February, 1959. It is now 23rd June, 1960. According to the Secretary of State the Government have not made up their minds. On 31st May he said that it may be something less than two years before they make up their minds. It may be 1962, perhaps it may be 1961.
Yet there was a manifesto published on 11th September, 1959, by the Tory "research boffins"—if that is what they are called—who tell the Government what to do. On page 3 of the Conservative Party's General Election manifesto it states quite specifically:We shall set up"—please note that, not "we may", but "we shall"—a National Council for Social Work Training to help recruit and train the extra social workers who will be needed.797 That precise title is taken from the Younghusband Report. So there is no suggestion that it is some other council or a variant of the recommendations produced in that Report.
If, at the General Election, the Tory Party can make pledges like this, and, no doubt, catch a few votes of those who know about this and people who want to take up a career in occupational therapy and psychiatric social work, they ought to persuade their Ministers to make a decision. This is not a party point. Unless the Younghusband Report is implemented soon there will not be the training facilities to provide the people to make the provisions of the Bill a reality.
I do not blame the Joint Under-Secretary of State. He is a junior Minister who is unable to move his chief on this matter. I have no doubt that he has been arguing with his right hon. Friend relentlessly behind the scenes to try to persuade him to make a decision about the Younghusband Report soon. Presumably, such a decision will have to be made at Cabinet level. I know that there are other junior Ministers who are getting impatient because the Government have not made a statement of this character.
There is also the question of buildings. I am alarmed at the statement of the Secretary of State in this regard. He was not very worried about accommodation. It seemed that all we had to do was to decorate a few wards and put up a couple of partitions here and there, and everything would be fine. That was the impression I gained from the statement of the right hon. Gentleman about the future of mental hospitals. This is alarming.
We remember that in the debate on the Second Reading, when the Joint Under-Secretary mentioned the provision of about 800 places for mental deficiency, I wanted to know where those are to be contained. The Minister said that the new building programme was based on a very big presumption. He did not know how many mental defectives would as a consequence of the Bill be able to be released from mental institutions.
Well, nobody does know, but it is accepted that there will be a considerable number. The Minister went on to say that since there is a queue of 6,000 798 waiting to get in the Government were to have some 800 new places provided in three years and they expect that that would meet the situation. I wish to know whether the Joint Under-Secretary stands by that in the light of what was said by the Secretary of State today. Is he confident that 800 places is sufficient?
We shall watch the Bill go to another place with mixed feelings. We are glad that it has been improved and that we have had a responsive Joint Under-Secretary even though we have failed in four major items to shift his mentor. We are a little alarmed that no mandatory provision is provided for mental health. No adequate assurance has been given that the best facilities and the money will be available and there is this doubt about the emergence of the staff needed to sustain the whole service.
I do not expect the Joint Under-Secretary to say so, but the Opposition have done a splendid job in arguing their case. We could have had more help from hon. Gentlemen opposite, but for some reason which I do not know, perhaps for internal reasons of Tory Party strife, we did not get the participation in the discussions on the Bill from hon. Members opposite that we ought to have had. We also accept that we cannot expect hon. Members opposite to criticise their own Government in relation to the subsequent provisions of this Bill. I underline what was said by my hon. Friend the Member for Lanarkshire, North (Miss Herbison) on this score. We shall pursue this matter of more money for mental health relentlessly during this Parliament and when we become the Government we shall make sure that the money is provided directly as the Royal Commission recommended.
That was our pledge at the General Election and I hope that after the next election, when we shall be the Government, we shall honour that pledge. We shall pursue this question of the Young-husband Report and seek its implementation as early as possible. I hope that the Joint Under-Secretary of State will continue to fight this battle for us in the knowledge that we are behind him and will try to secure its implementation as early as possible.
I hope that when we are revising the law again, perhaps in the light of great 799 medical strides in the treatment and approach in the next two decades or so, we shall not have to suffer a long decade of Government inaction before, finally, they catch up with medicine. I hope that they will do it more speedily. My hon. Friends and I join in congratulating the Department and others who at last helped to see this Bill reach the light of day.
§ 9.36 p.m.
§ The Joint Under-Secretary of State for Scotland (Mr. T. G. D. Galbraith)
Right hon. and hon. Members who have shared with me the rewarding experience of taking part in the discussions on the Bill at each stage will, I am sure, appreciate that I rise to wind up this evening's discussion with a deep sense not only of relief but also of the importance of the occasion.
I believe this to be an important piece of social legislation. We can all feel pride in having helped to fashion as good an instrument as possible for this great purpose. As the Bill has passed through the various stages to reach its present form, it has been clear that all of us have been guided by the same principle and that the only difference has been as to the best means of achieving the agreed end. In most cases it has been little more than the difference in colour between blush-white and off-white.
This is no occasion for me to repeat at length what has been said, and I therefore propose briefly to deal with one or two of the points which have been raised this evening. The hon. Member For Glasgow, Springburn (Mr. Forman) asked about the standard of guardianship. At various stages of the Bill, he has made attempts to get a satisfactory answer to that question. I am afraid that all I can say is what I have said before—that regulations will be made covering this point under Clause 33.
§ Mr. Galbraith
It may not be very helpful, but I am sure that the hon. Member did not expect a very helpful answer.
§ Mr. Galbraith
I do not want to disappoint the hon. Member. That is what he likes to get, and that is what he has got on this occasion.
800 The hon. Lady the Member for Lanarkshire, North (Miss Herbison) opened the Third Reading debate for the Opposition. I should like to thank her very much for what she said about me. I should like to congratulate her, too, on the phenomenal amount of hard work which she did. I had the official resources of the Scottish Office behind me, and even then I found it quite hard work. She had only her own work and the help of her hon. Friends, and I was most impressed by her contributions to the Bill. I felt a little sorry that at the end of her speech she indulged in a little party political flavour in referring to the fact that some of my hon. Friends did not take as large a part in the discussions as did some of her hon. Friends. She should have thanked them for that, because otherwise we probably should not be dealing with the Third Reading tonight.
The hon. Lady asked about a school in Glasgow for occupational therapy. The Regional Board has been asked to work out proposals for a new school in Glasgow. It has not yet submitted them, but my right hon. Friend regards this as a matter of urgency and he intends to see that there is no avoidable delay. The hon. Lady asked about psychiatric social workers. We are arranging to discuss with psychiatric social workers their own ideas as to how best they can be reinforced, and we will certainly consider the possibilities of extending the facilities for training on the lines which she suggested.
The hon. Lady also asked about research. If she will give me particulars of the allegation that research is being hampered by lack of money, I shall be very glad to look into it for her.
I come to my hon. Friend the Member for Aberdeenshire, West (Mr. Hendry), who unfortunately is not here. I apologise to him. I see that he is here and I am glad to see that he is still on the right side of the House. I was beginning to get a little worried about that at one stage. That is all that I wanted to say to him.
The hon. Member for Glasgow, Mary-hill (Mr. Hannan) asked questions about local authorities and payments. I can give him the assurance that local authorities will be able to recover by way of payments from the National 801 Assistance Board the minimum charge for residents in homes for the mentally handicapped in the same way as they now do for those in homes for the aged. The National Assistance Board has given us an assurance in that sense. That ought to be a help not only to the hon. Gentleman's own local authority but also to other local authorities in Scotland.
My hon. Friend the Member for Galloway (Mr. Brewis) summed up the Bill correctly when he said that its object was to assimilate mental and physical illness. That is what we have been trying to do the whole time.
The hon. Member for Greenock (Dr. Dickson Mabon), who wound up the debate, had a lot to say, as usual, and one of his questions was whether any member of the Mental Welfare Commission could also be appointed as a member of a management committee of a State hospital. The answer is, No; he cannot. I hope that that will satisfy him.
He also asked about buildings and the 800 beds which we said we should provide for defectives. I do not know precisely what the ultimate need will be, but we need at least the 800 beds we estimated, and we intend to provide them.
§ Mr. Galbraith
The hon. Gentleman and the hon. Lady the Member for Lanarkshire, North, and, indeed, a great many hon. Members who contributed from the benches opposite, were concerned about the financing of local authorities. It seems to me that there are three separate questions—first, how local authorities should proceed; secondly, their willingness to proceed, and, thirdly, their financial ability to proceed.
On the first, the procedure is essentially that laid down by the Government in the National Health Service (Scotland) Act, 1947. It has worked reasonably well in other respects, and most authorities have done a great deal since 1947 to justify the arrangements which were then made. The local authorities themselves would certainly prefer that this pattern should be followed. I would agree with the hon. Member for Coat-bridge and Airdrie (Mr. Dempsey), who in the third sitting in Committee said: 802The voice of local authorities should be heard. I believe there is a misunderstanding about the attitude of local authorities…"—[OFFICIAL REPORT, Scottish Standing Committee, 3rd March, 1960, c. 115.]if it is thought that they want a change in the procedure.
§ Miss Herbison
It may be that some local authorities do not want a change in the procedure, but, on that third morning, facts and figures were given from our side, not from the Government side, to my hon. Friend the Member for Coatbridge and Airdrie (Mr. Dempsey) which made him think very seriously afterwards whether this item in Clause 7 should not be made mandatory.
§ Mr. Galbraith
No, the hon. Member for Kilmarnock (Mr. Ross) always takes everything that I say so seriously that it is very risky for me to say anything that is not in my brief. That makes my speech very boring to me and, no doubt, boring to the House as well. Much will depend on the local authorities' awareness of the possibilities of community care and on a full understanding of the part they can play. The Scottish Association for Mental Health is already arranging to discuss the new legislation and its possibilities at its next annual conference, and the Scottish branch of the Royal Institute of Public Administration is also proposing to hold a three-day conference next year on this subject. My right hon. Friend's Department will give all the help it can to ventures of this kind, and the medical officers of the Department will be giving increasing attention to the local authority health services in this field.
Against this background, I expect that, when the Standing Advisory Committee produces its recommendations as to the first steps which local authorities should take, most local authorities will welcome its guidance and will be anxious to go ahead.
This leads to the third problem, namely finance and whether local authorities will have the resources to go 803 ahead. The Opposition during the preceding stages of the Bill and again tonight have shown that they do not like the Government's method of assisting local authorities by way of general grant, but my right hon. Friend the Secretary of State intends to make provision in the general grant on a scale which will enable local authorities to move forward as rapidly as they can make the necessary plans, provide the necessary buildings, and recruit the necessary staff.
§ Mr. Galbraith
I am glad the hon. Gentleman admits that he has heard it before. He accused us earlier of saying one thing in Committee and another thing tonight. I am merely saying now that we are sticking to our guns. There is no reason to expect that local authorities will be short of money or that they will have difficulty, because of any restrictions on capital expenditure, in providing the necessary buildings to which the hon. Lady referred.
§ Mr. James McInnes (Glasgow, Central)
If this money is to be included within the general grant, will there be a specific entry when the orders in relation to the general grant are laid before the House so that we can see the precise amount included for this purpose?
§ Mr. Galbraith
I am surprised at the hon. Gentleman asking that question, because the answer is, as he must know, "No".
§ Mr. Thomas Steele (Dunbartonshire, West)
Will the hon. Gentleman arrange that in another place the definition of "adequate" is inserted into the definition Clause?
§ Mr. Galbraith
No, I shall not arrange for that.
The hon. Lady the Member for Lanark (Mrs. Hart) said in Committee that the timing will have to be considered in relation to the supply of workers and the efforts made for the training and recruiting of workers to 804 carry out the service rather than money. I think that the hon. Lady is right. My right hon. Friend has already taken steps with a view to setting up another school in Scotland for occupational therapists. Discussions are taking place with psychiatric social workers, and the hon. Member for Greenock will be interested to hear that the position of social workers in general is under very active consideration by the Government in the context of the Younghusband Report.
§ Dr. Dickson Mabon
I am beginning to wonder about that answer. When it was given, I interrupted the Secretary of State and said, "At least two years?" The right hon. Gentleman said, "No". From that answer, it could be ten years. I should like the hon. Gentleman to tell me that it will be very soon.
§ Mr. Galbraith
The hon. Gentleman must interpret the answer of my right hon. Friend in his own way.
§ Miss Herbison
The Joint Under-Secretary must be aware that unless action on the recommendations of the Younghusband Committee is taken very soon local authorities will not have to worry about money, because they will not have the workers. That should be worrying the Government and the Minister. How soon does he mean? Does he mean two years, ten years, or six months?
§ Mr. Galbraith
With regard to the actual timing, the hon. Lady must be satisfied with my right hon. Friend's Answer, and to supplement that I would repeat what I have said tonight, which is that the position of the social workers in general is under very active consideration by the Government in the context of the Younghusband Report, and I really would ask—
§ Mr. Galbraith
I am trying not to be obscure.
These are the separate aspects of the problem. Given the financial resources—and the Government do not believe 805 that there will be any real difficulty on this score in regard to their share—there is no reason to suppose that Scottish local authorities will not be anxious to move forward as rapidly as they can recruit the skilled staff for these services.
There are difficulties, but they are not to be resolved by procedural changes, and there is no reason to depart from the well-tried procedure of the 1947 Act, or to put anything into this Bill that might imply that local authorities generally would have to be compelled from the outset to play their part under this new legislation.
In conclusion, this Bill can only lay down a sound legislative framework. Its success in practice will largely depend on the action taken by the hospital authorities and the local health authorities and, above all, on the attitude of the public themselves to mental illness and the problems associated with it. There are already many signs of a considerable change in this attitude, a change that has been stimulated by the work of the B.B.C., the enlightened attitude of the Press, and the growing activities of voluntary bodies like the Scottish Association for Mental Health. My right hon. Friend the Secretary of State intends to do what he can to foster this climate of opinion, and it will help that in this year, which is World Mental Health Year, we shall have the World Federation holding its conference in Edinburgh.
The public's attitude means a very great deal to the work of our mental hospitals. They can help, as my hon. Friend the Member for Galloway recognised, with the visiting of patients, and with the acceptance of patients coming out on visits, or on trial periods for resettlement in the community. They can help, again, by adopting a tolerant and kindly attitude to mentally-handicapped people who are able, with some assistance of this kind, to make their own way in the community and earn their own living in employment.
They can help as citizens by stimulating their own local representatives to undertake, as a local authority, the different types of provisions which this Bill envisages in order to assist the mentally ill and the mentally handicapped to come back into the ordinary community or to remain in the community without having to go to hospital.
806 To some extent, it is because of the public's changing attitude that some of these new possibilities of treatment and care have opened up. I feel confident that these encouraging tendencies will continue, and that the responsible authorities and the public between them will take the opportunities which this new legislation offers and make a real success of it.
It is in this hopeful spirit, and also, if I may say so, thankful spirit to the Opposition and to my hon. Friends for their help, that I wish this Bill well as it leaves our Chamber this evening on a further stage of its journey towards the Statute Book.
§ Question put and agreed to.
§ Bill accordingly read the Third time and passed.