§ 7.4 p.m.
§ Mr. Ness Edwards (Caerphilly)
I beg to move,That this House, believing that similar disability whether arising from war service, industrial employment or other causes, should be assured equal treatment, calls upon the Government to provide two-seater cars for paraplegics and other persons now qualifying for tricycles under the National Health Act, 1946.Before I proceed with my speech, Mr. Deputy-Speaker, I should like to ask whether it is your intention to call the Amendment in the name of the right hon. Gentleman the Home Secretary.
§ Mr. Ness Edwards
I want to deal with some of the background to this subject in some detail. As the House is aware, we have already had an Adjournment debate on this matter, when the Parliamentary Secretary to the Ministry of Health made a very unsatisfactory reply. It was unsatisfactory not in the form of delivery, but in the conclusions which it contained. I take it that those conclusions were conveyed to us as being those of the Minister. It is useful that we have the Minister of Health with us this evening, for he can answer for the decisions he has taken.
We are dealing with about 13,000 men and women who, by their disability, have qualified for the Government-provided, power-propelled tricycle. I do not propose to repeat any of the arguments about the unsatisfactory nature of this provision which were brought forward in the Adjournment debate, but I am pleased to see that the Government themselves regard the present tricycle as being entirely inadequate for wounded ex-Service men. That, in itself, is a recognition which we welcome, and the provision that is being made for them by the Government is welcomed by all of us. But does not it contain a condemnation of the tricycle that is available for non-Service people?
It seems rather ridiculous that, on the one hand, a person with a disability that has been acquired in the Armed Forces will have a two-seater car—
§ Mr. Ness Edwards
That a disabled person who qualifies for a tricycle should have a two-seater car—
§ Mr. Ness Edwards
That is the Government's promise. [Interruption.] We shall see as we proceed. I am talking about those who have qualified, and I understand that the undertaking given by the Government is as I have expressed it. Those who have qualified—[Interruption.] My hon. Friend had better wait. Those who have qualified for power-propelled tricycles are now to be provided with two-seater cars if their disability occurred in the Armed Forces. Whether there are any qualifications about that we shall see later.
Let us consider the categories of persons involved in the provision of the power-propelled tricycle. I have gone to some trouble to track them down. Let us regard the qualifying conditions as agreed. The first category consists of members of Her Majesty's Forces; the second, members of Civil Defence; the third, members of fire brigades; the fourth, civilian victims of the war; the fifth, the industrially disabled—many of them miners—and the sixth, victims of illness and disease—the poliomyelitis sufferers. Those are the six categories, and hon. Members on both sides of the House have pressed for the provision of something better than the present tricycle for them.
It is against this background that the right hon. Gentleman and his colleagues gave an election pledge, which I shall deal with in the light of some of the contentions made by the Parliamentary Secretary in the Adjournment debate. Paragraph 4 of the Conservatives' General Election manifesto, under the heading "Security and Retirement", contains two sentences which I wish to quote, and I am not tearing them out of their context. They are:Those disabled in the service of their country will remain the subject of our special care. Particular attention will be given to providing more suitable vehicles for the badly disabled.That is the end of it. That is not torn out of its context. Here it is, without qualification. I will repeat it: 1630Particular attention will be given to providing more suitable vehicles for the badly disabled.That comes right in the middle of a block of sentences dealing with the National Health Service.
§ Mr. Ness Edwards
Very well, we will deal with that point, I am glad that the hon. Gentleman has raised it. What is meant by "disabled in the service of their country"? If the hon. Gentleman is right, the provision of the Government should be for those who are disabled in the service of their country. Is it only those in the Armed Forces who were disabled in the service of their country? Surely that is the point.
The second sentence eliminates any qualification. If it was intended to be qualified why was not the election pledge contained in more precise words? Let me deal with how the right hon. and learned Gentleman regards what the Government are now doing as a redemption of the promise. In answer to one of his hon. and gallant Friends, on 4th April, he said:My right hon. Friend the Secretary of State for Scotland and I have decided to implement the promise to provide more suitable vehicles by providing small cars for those war pensioners disabled in the service of their country who are eligible for Government power-propelled tricycles."—[OFFICIAL REPORT, 4th April. 1960; Vol. 621, c. 11.]Apparantly, this is to be done under the Royal Warrant, or so we were informed by the Parliamentary Secretary. It is not to be done under the National Health Service. But all war pensioners do not come under the Royal Warrant.
I hope that the hon. Member for Hertford (Lord Balniel) will bear that in mind. There are war pensioners who have been taken in by the National Health Service. There are civilian injuries pensions still paid by the Assistance Board. So what we have is not a fulfilment of the promise on the narrowest basis that the right hon. Gentleman places on these words. All we have are the war pensioners disabled in Her Majesty's Forces. That was not the pledge. The pledge was not on the narrow basis of war pensioners. Let me repeat it again:Those disabled in the service of their country will remain the subject of our special care1631 If that is to be regarded as a qualifying phrase it means that the war pensioners who were not disabled in the Armed Forces are now to be excluded under the terms of the arrangement which the right hon. and learned Gentleman has made.
We have the position that of all the six categories of persons who qualify for power-propelled tricycles, only one category, the smallest, is to be provided with two-seater cars. That was not made plain in the Conservatives' election pledge. It did not say that this would be done only for those in the smallest category. It was said, without qualification, that all those disabled in the service of their country would be the subject of special care.
Let us consider some of them. I know that this is taking the House back to a time before many hon. Members present were in the House, but the civil injuries scheme provided for equal benefit for all who were injured in the war provided that they sustained what was called war service injuries. The pamphlet, "War Pensions for Civilians" was published. There were official leaflets relating to war pensions for civilians and members of the Civil Defence services. They were disabled in the service of the country, but they are excluded from this improvement. Is that redeeming the promise contained without qualification in the Conservative election manifesto? There were two official pamphlets, issued by the Ministry of Pensions and National Service, laying down the categories of war pensioners injured in the service of their country who, on the interpretation of the right hon. and learned Gentleman, should be looked after under the terms of this pledge.
Let me go a step further. What other classes are excluded? Let us take the disability for granted.In the service of their country.Is that to be a qualification? Should not this apply to the Bevin boys, who had no option? Should not it apply to persons who were directed and to those who were called out of the Army and sent back to the mines? The justification for taking them from the Army and sending them to the mines was that they would be of greater service to the country in the mines than in the Army. But the right hon. and learned Gentleman 1632 says that they were not disabled in the service of their country. How can he justify that? It really is beyond me.
What about the men directed from the Army back to the Fire Service in London, during the blitz? Some of them were war pensioners. They received a war service pension. But the right hon. and learned Gentleman does not propose to do anything for them. What about the police? During the blitzes some policemen were drafted out of the Army and sent back to serve in London, in Coventry and in other places. Some of them were disabled in the service of their country and are war pensioners. I say to the right hon and learned Gentleman that he is playing ducks and drakes with the pledge placed before the people by himself and his colleagues during the election.
I think that the Tory pledge was very narrow, accepting the interpretation placed on it now. When it was placed before the people during the election it was assumed to mean what was said, that the badly disabled, without qualification, would be looked after in this respect. I take the view that we ought to say that equal treatment shall be available for all those people with equal disablement.
I do not complain about an order of priority in the provision of the two-seater cars. I can understand the more or less sentimental case for some distinction in the order of getting the cars by those who sustained their injuries in the fighting services and those who acquired their disability by other means, although, for the life of me, I cannot see the Government's justification for distinguishing between the war pensioner who acquired his or her disability in the London blitz and the men and women who acquired their disability in the Armed Forces. They were all part of the fighting Services. This is a ridiculous distinction and the right hon. and learned Gentleman, who has great experience in these matters, legally and otherwise, ought not to put that sort of case before the House.
§ The Minister of Health (Mr. Derek Walker-Smith)
Is the right hon. Member suggesting that the Civil Defence personnel covered by the personal injuries scheme of 1949 are not war pensioners and are not being given this either? Is that what he is suggesting?
§ Mr. Ness Edwards
What I am saying is that the civilians under the civilian injuries scheme who do not come under the Royal Warrant, in so far as we accept the interpretation placed on this concession by the Parliamentary Secretary, do not come under the terms of the announcement the right hon. and learned Gentleman has made. If he is now going to say that war pensioners of any category, whether the pension is paid under the Royal Warrant as his hon. Friend said, or through the Assistance Board, or through the National Health Service, are all to be eligible, he is extending it far beyond the provision that the hon. Lady indicated to the House in answering the Adjournment debate. I hope that he will say that it is not limited in the sense his hon. Friend suggested.
I come to the paraplegics generally, and, first, to the men in the mining industry. Here is a very serious position. I hope that the right hon. and learned Gentleman will nay regard to it. He ought not to hide behind the ambiguity of his election pledge. He ought to do the decent thing. He ought to accept the terms of this Motion. The Amendment really concedes the intention of the Motion. We do not condemn the Government for having done what they have done. What we ask is that they should do more: that they should apply this concession to all who from the point of view of their disablement require it.
According to the terms of the Amendment, which are very much the terms in which the hon. Lady spoke in the Adjournment debate, we are told that it cannot be done because of cost. Let us see what is being done. The right hon. and learned Gentleman says that we are doing a great thing and that it is to cost £200,000. The concession is to be given to only 1,700 yet for £2½ million he could apply it to 13,000. Are we now to be told that because the election pledge will cost £2½ million it is not to be implemented? That is the question the right hon. and learned Gentleman has to answer.
Yesterday, the House was under the shadow of a very great tragedy. Yesterday, 45 men were brought up from a pit, dead. That shook everybody. I was pleased to see the generous rush of human emotion which spread over this House at the news, but in practically every mining village in South Wales there is a man who has lost half his life. He 1634 has a wretched tricycle with which he waits at street corners, afraid to go too far because, if something happened to the tricycle, there would be no one to help him with it. If he goes anywhere he has to go on his own. There is no one to help him out or into the machine. We are entering into a great crisis of manpower in the mining industry. These tricycles can be seen in the streets of the mining villages and are not a great encouragement for recruitment of the young men we want to enter the industry.
I ask the right hon. and learned Gentleman to bear this very much in mind. We had a debate earlier today about training. How many of the paraplegics who have been trained depend on the charity of their employers to take them back and forth to work? They ought to be going under their own steam, someone going with them to see that everything is all right.
I say this to the right hon. and learned Gentleman. I have not discussed it with my hon. and right hon. Friends. Take this Amendment off the Order Paper. We will take our Motion off on one condition, that the Minister will undertake to extend this concession, this new provision, to all the rest of those disabled in the same way as he has satisfied the need of the ex-soldier. We want something to be done. We want to encourage the Government into a little bit of extra virtue than they have so far shown. I hope that when the Minister replies he will bear in mind that there are 13,000 people who could be very much convenienced. Their lives could be filled to a much greater extent if they could be given the convenience he has provided for a very narrow category.
§ 7.29 p.m.
§ The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt)
I beg to move, to leave out from "House" to the end of the Question and to add instead thereof:congratulates Her Majesty's Government on the provision of cars for disabled war pensioners in place of power-propelled tricycles and on the speedy fulfilment of their pledges in regard thereto; records its awareness of their desire further to improve the vehicles provided for disabled National Health Service patients; but recognises that regard must he had to all relevant circumstances including cost and competing claims on the resources of the nation".1635 The right hon. Gentleman the Member for Caerphilly (Mr. Ness Edwards) spent some little time when moving his Motion in explaining for his own purposes what he regarded as defined by the terms "war disabled" and "war pensioner". I thought he got quite a long way from the wording of the Motion, which refers to the proposal that persons with asimilar disability whether arising from war service, industrial employment or other causes,should be assured of equal treatment.
I hasten at this stage to assure him that my right hon. and learned Friend will wind up the debate, so he will have a further opportunity of pursuing the matter with my right hon. and learned Friend. In replying to the speech of the right hon. Member, I need to go back into history for a while in order to get the position quite clear about the supply of vehicles for disabled persons.
When hon. Gentlemen opposite were the Government of the day, they gave cars to war pensioners but not to National Health Service patients. Until 1948 the only powered vehicles issued to war pensioners were tricycles of a somewhat antiquated type and very different from the tricycles issued today. They were open vehicles and, in effect, motorised invalid chairs. I stress that the categories of eligibility were very broadly the same as they are today, or have been until my right hon. and learned Friend's announcement.
It was in July, 1948, that the right hon. Member for Middlesbrough, East (Mr. Marquand) announced to the House his intention to provide cars. He said:… a limited number of small cars, not exceeding 1,500, will be made available over the next two years for supplying … to certain classes of very seriously disabled war pensioners who may elect to receive a car in place of the motor propelled tricycle to which they are entitled under existing regulations".The right hon. Gentleman said also:When the needs of these classes have been satisfied, any balance … within the number stated will be distributed … to other very seriously disabled war pensioners at present supplied with motor propelled tricycles to enable them to obtain or retain employment",—[OFFICIAL REPORT, 27th July, 1948; Vol. 454, c. 1103.]The right hon. Gentleman said that he hoped to include also the blind war pensioner.
1636 In the event, no cars were issued to the less seriously disabled who required them for employment purposes, because a ceiling figure of 1,500 was insufficient for the rest, and it was in fact raised by stages, again by a Socialist Government, to 1,950 cars.
In introducing the car scheme, as in many other matters in the treatment and rehabilitation of war pensioners, hon. Gentleman opposite, then the Government of the day, recognised the principle of preference and priority for war pensioners in our social services. I am sorry to see from the Motion that they appear now to have departed from this principle, because the Motion attacks the preference given to war pensioners, whereas it has always been held that the country owes a debt of generosity to those who have been disabled in the service of their country.
Continuing with the history of the cars, in April, 1952, the ceiling was raised to 2,000 by a Conservative Government. In 1955 it was raised to 2,100. Then there was the statement in the Conservative election manifesto last year, which the right hon. Member for Caerphilly saved me quoting, because he quoted from it. This statement has been misinterpreted by many, as I said in the Adjournment debate. It is quite clear in its wording. Following that promise given at the General Election, a decision was quickly made. On 4th April, 1960, my right hon. and learned Friend announced his intention to provide small oars for those war pensioners disabled in the service of their country who are eligible for Government power-propelled tricycles.
The implication that this is any kind of new scheme is not correct. What is happening is that we are carrying on and extending an existing scheme introduced by a Socialist Government and beginning to run down because the number of war pensioners is diminishing.
§ Mr. Willis
Is it not true that people who are at present entitled to tricycles are not all going to receive them?
§ Miss Pitt
They are. We have said that it will be by stages. We shall deal with the most severely disabled first. Perhaps I shall be able to make it a little clearer as I go on. In his statement my right hon. and learned Friend said 1637 that it would necessarily be some months before cars were available and we would deal with the most severely disabled first. In fact, we hope to begin issuing cars next month. They will be Mini-Minors, in case hon. Members wish to know what type of car will be available.
So far from playing ducks and drakes with the pledge, as the right hon. Gentleman announced, I think that we have honoured the pledge which we gave at the General Election and have indeed followed the principle of maintaining preferential treatment for war pensioners.
The Opposition Motion calls for cars for all disabled persons who qualify for tricycles. I said in the Adjournment debate on 17th May that I was not without sympathy for this plea. The tricycle is not designed to carry a passenger, and I understand the desire of those who have tricycles both for companionship and, on occasions, help.
In the Adjournment debate the right hon. Gentleman said that the cost should not be insuperable. In capital at least an additional £2½ million would be required and, when the supply was complete, there would be an additional maintenance cost of about £1 million a year.
§ Mr. R. T. Paget (Northampton)
Is the figure of £2½ million upon the basis of replacing them all at once or as and when they have to be replaced? All my information is that, unless one Ministry insists upon adding Purchase Tax and claiming it from another, cars can be made available at a prime cost which is almost the same as the cost of tricycles.
§ Mr. Paget
The hon. Lady has not answered my question. Does the figure of £2½ million take in Purchase Tax? The problem I have had with various Ministers when I have tried to negotiate on this is that they say that to have cars is more expensive than to have tricycles because of Purchase Tax. That seems to be an odd point of view for one Government Department to take against another. I think the hon. Lady will find that most of the £2½ million is Purchase Tax.
§ Miss Pitt
I am not sure, but I think that it does not include Purchase Tax. If I am incorrect, I will ask my right hon. and learned Friend to amend that statement when he winds up.
It would be a major development to provide cars for all National Health Service patients. It would be a continuing and growing commitment for the future, because the number of patients in the National Health Service, unlike the number of war pensioners, will rise, not fall, and we would always have the problem of replacing the cars when they became old.
The figures which I gave to the House in the Adjournment debate and have repeated tonight are broad estimates. They take no account of future returns on sales of the old cars if they were saleable. They are also based on the assumption that a scheme introduced now would be spread over eight years to give full value to existing tricycles.
The capital cost would be much greater if the period were shortened and usable tricycles had to be scrapped. We have also assumed in giving these figures that over the years the annual rate of increase would be the same as at present. We have assumed that eligible applicants would increase by about 550 a year. It might well be greater.
There are about 5,000 disabled persons eligible for tricycles who have not got them because they are unable to control them for one reason or another, and these people would get cars with nominated drivers if such a scheme were introduced. Again, we think that this may well be a considerable under-estimate.
Therefore, however sympathetic one feels, the suggestion made by hon. Members opposite must be considered in the context of costs against all the other claims. The tricycles have been improved over the years, and the vehicles are very good for their purpose—as, again, I explained in the Adjournment debate. I do not accept the right hon. Gentleman's word "wretched". They are considerably improved and do a good job. From all the contacts I have with those who drive in them, I find that they are happy to use them, although, of course, there is the point that they would like companionship.
I do not rule out further improvements in the design of the tricycle, but we 1639 have made no commitment about introducing larger vehicles for the disabled generally. I must remind the House of the words appearing at the end of the Amendment:… regard must be had to all relevant circumstances including cost and competing claims …on our resources.
For that reason, I have to say that the Motion standing in the name of the right hon. Gentleman and his friends is not acceptable.
§ 7.42 p.m.
§ Mr. Tom Brown (Ince)
It is always difficult not to be misunderstood when debating a subject like this, particularly by those who have only a superficial knowledge of what is in the minds of those who have put down this Motion. Disabled ex-Service men, and those getting the advantages of the amenities under the Royal Warrant, may misunderstand, so I should like to tell them and others just what we have in mind.
Our desire, and I think that it is a righteous desire, is to broaden the principles and application of the Royal Warrant to give to those who have been crippled in industry the same treatment as, or treatment similar to, that given to those injured in the two world wars. I knew that the Ministry would approach the question strictly on the cost basis, but I hope that that idea does not figure very largely in the Minister's mind, because the cost of our proposal is not so great that it cannot be met by a gradual process. We do not ask for this to be done at once, but that a start should be made as quickly as possible, and the aims pursued as fast as our economic resources will permit.
As long as we have wars we shall have sick, 'broken, bruised and crippled men. That cannot be avoided. As long as we have industry, we shall have sick, broken, bruised and crippled men. No legislation can prevent accidents. They will happen. Only a few days ago we heard of the terrible disaster in Wales. We are given to understand that all precautions were taken there to prevent an accident of that type—but it happened, and killed 45 men and boys.
We cannot avoid accidents by legislation, but we can minimise them and their 1640 effects. Once they have happened, we have to provide for and protect the unfortunate victims. Our job here today, as it has been in the past, is to do all that we can to make the lives of these unfortunate people as comfortable and as pleasant as we can, with all the facilities that are now at our disposal. This is the age of science, of affluence, of qualified men. We have men, we have money, and we have machines in the form of two-seater cars for the unfortunate cripples of war and industry.
I hope that the Minister will not think that we are unduly criticising him. Far be it from me to criticise a Minister or a Department from whom I am asking something—I am too old a negotiator for that. We are not criticising the Minister. We are asking him to broaden and quicken the distribution of two-seater cars. Our intention is to extend the provision of these vehicles to the unfortunate victims of industrial accidents, namely, paraplegic cases.
Accidents happen in all industries, but one cannot help but think of the scenes in our mining villages. During the last day or two I have been thinking very seriously about a number of cases in the little village in which I was born, and in which I still live—all paraplegic cases, crippled in industry. I think of Peter Armstrong, 6 ft. in height, of Peter Winstanley, and of William Cunliffe. They all lived in the same roadway as myself.
All were crippled in industry. One has gone to his reward, another gets about the village roadway in a hand-propelled wheel chair, and the third cannot get into a propelled wheel chair. Cases like that strike the heart of one who lives in a mining village. I make no apology at all for singling out the mining industry, because there are more paraplegics in it than in any other industry and one's mind travels naturally to those who have been injured in the pits.
I should like to read an extract from a letter to show to the House and to the country what these men undergo when they are struck down by accidents to the spine and become paraplegics. I have permission to use this letter, and I shall use it with the full force of the argument used by the man who has 1641 written it. He lives at 223, High Street, Alsagers Bank, Stoke-on-Trent, and he writes:Regarding my disabilities and accident, I met with my accident on 22nd April, 1938–22 years and two months ago last Friday. My spine was fractured seriously, and in consequence, during the whole of that period I have had the loss of control of all bowel movements and have been under the necessity of wearing a surgical appliance for the urine, and when I have been dressed one can visualise what such conditions have entailed, not only for myself but all the unpleasant and disagreeable tasks over that long period for my dear wife, slaving at the washtub. But I have been richly blessed, for I have had a heroine for a wife whose loving and devoted nursing care and attention at all hours of the day and night have contributed so much towards prolonging my life.Furthermore, and this is the point I want to emphasise, he says:In July, 1954, I had an operation for the removal of a cataract on the right eye which, I am pleased to say has been of great benefit to me, for I have … lost the vision of my left eye. In 1955 I was further certified to be suffering from silicosis.There it is—paraplegic case, loss of an eye, and now certified to be suffering from silicosis:It may interest you, Mr. Brown, to know that I have been an in-patient in one of our local hospitals for treatment … on 25 different occasions between 13th February, 1954 and 9th April, 1960.I want the Minister to note the following—I shall not enlarge on it, but I want him to note it:… since prescription charges were introduced, I have paid a sum of over £16, and a sum of £7 2s. for prescriptions as an old-age pensioner since 27th February, 1959—and he adds these words:the greater the adversities the greater the burdens.That is a paraplegic case, and one which, in my judgment, would be well served by the provision of a two-seater car, with, as the Parliamentary Secretary said, a nominated driver. Here is a man who has never left his home except to travel to and from the hospital, a man who is suffering from a disease which, as the Minister will know, requires all the fresh air that can possibly be given to him. Yet, because he is not provided with a means of transport, he has to stay indoors, or sit in a chair just inside the house or in the small garden. That is just one case. One could go on for the next hour or more telling the House of the hardships of paraplegics who have no means of transport.
1642 The present position is that the Ministry of Health supplies single-seater motor tricycles to civilian disabled whose disability involves total or considerable loss of use of both legs, and who are otherwise capable of handling a suitable machine. The Ministry supplies a storage shed, and meets the cost of repairs, including replacement of tyres. Seven gallons of petrol are supplied free every six months. No road tax is payable and the Ministry arrange for third party insurance cover. That is what the Ministry is doing now.
War pensioners—and, again, I preface my remarks by saying that I hope that I shall not be misunderstood—who are 100 per cent. disabled are issued, under the same Royal Warrant, with cars. Road tax and third-party insurance are met by the Ministry of Pensions and National Insurance, and an annual grant of approximately £70 is made towards running and repair costs. That comes from the Ministry of Pensions and National Insurance. The cars, which are adapted for hand control, may be driven by the disabled person or by a nominated driver.
I now come to the point which we mentioned in the Motion. In the coal mining industry there are 500 to 600 men who have suffered paralysis of the lower trunk and both legs due to industrial accident, in the service of their country. A large number of these are young men and the great proportion are married men with children. Whereas the war disabled are provided with cars, the men disabled in industrial service to the nation are provided with single-seater tricycles. That provision does not reflect any credit on the nation.
The coal industry's social welfare organisation has done a great deal for the welfare of disabled mineworkers in the provision of better housing accommodation and holidays. Incidentally, I would say that houses for paraplegics are not the same as houses for ordinary civilians. Everything is different. I have visited bungalows which we have built in Lancashire for these men. We have recently built three bungalows for paraplegics at Blackpool. Everything—windows, doors and toilets—is different in form from those in ordinary houses. We are doing a great service for paraplegia men so far as our money will allow. In cases of breakdown a paralysed man is unable 1643 to go for assistance. He has to move about the village and towns in a tricycle. Normal family relationships are already impaired in many ways and any enforced separation when paraplegia patients go out in their tricycles is an added burden.
Therefore, we contend that what we ought to do as a country—I am not speaking from a political point of view—is to make provision for these men. It can be done, it should be done, and it should be done as quickly as possible. I hope that the Minister and the Department will not advance the argument that the nation cannot afford it. The nation can afford it if it has the will and determination to do it. Let us see that it is done and that we provide comforts, amenities and pleasantries for those unfortunate men who have been overtaken by adversity.
§ 7.59 p.m.
§ Lord Balniel (Hertford)
Every hon. Member will share the feeling which the hon. Member for Ince (Mr. T. Brown) expressed in his speech and will share the feeling which moved hon. and right hon. Members opposite to put down this Motion. I do not suppose there is anyone in the country who, having the blessing of good health, would not do everything in his power to enhance the happiness of these unfortunate people and provide for their well-being, or who would not do anything he could to make it possible for those who have not many blessings to share a wider life with their wives, families and friends and do something to bring them within the ordinary community in its everyday activities. Those are feelings shared, I am sure, by everyone in the country.
I hope that it will be possible before long for my right hon. and learned Friend to accept what is outlined in the Motion. I believe that that was the tenor of the speech of my hon. Friend the Parliamentary Secretary in speaking to her Amendment. I gather that it is the intention of the Government to accept as soon as practicable the terms of the Motion.
§ Mr. Ness Edwards
Do I understand from the Front Bench that the noble Lord's statement is in accord with their will?
§ Lord Balniel
The right hon. Gentleman has interrupted my speech. I speak for myself, of course, and my right hon. and learned Friend will speak for the Government. We have had a clear exposition of the Government's view from my hon. Friend the Parliamentary Secretary. I, of course, speak entirely on my own account.
I hope that we may set as an objective to strive towards the widening of the present allocation of the two-seater vehicles. I say that, associating myself with the hon. Member for Ince in his very special interest in the mining industry in his part of the country.
It will be accepted by hon. Members on both sides that, when we have to allocate the rather limited resources of the State, it is understandable that we should give priority to those who have served and suffered in the service of the country. This is a priority which is generally accepted. On the other hand, it is very difficult to differentiate in logic between a person who is a paraplegic, a person who has suffered industrial injury, or a person who has been injured in a road accident or something of that kind, and a person who has suffered during war.
It is very easy for us to put on the Order Paper these rather warm-hearted Motions calling for an improvement in one section of the National Health Service. This is particularly easy—I say this in no party sense—for those who have sure knowledge that they will not be called on for several years to implement the terms of them. It is very easy for people to put on the Order Paper a Motion such as the one now before us in the sure knowledge that they are not the ones called on to determine the priorities. The determination of priorities is very difficult. It is rather difficult to justify to the country the provision of transport for persons who are in good health and give that a priority above cancer research, hospital building or the many other very important matters coming within the Health Service.
I have this question to put to my right hon. and learned Friend. I understand that the provision and allocation of tricycles under the National Health 1645 Service Act is made under Section 3 (1, b), which provides that the Minister has power to providemedical, nursing and other services required at or for the purposes of hospitals".Has my right hon. and learned Friend power under the existing law to provide these two-seater vehicles to paraplegics who are receiving their benefits under the National Health Service and not under Royal Warrant? I may be wrong in my interpretation, but I am by no means certain that legislation is not needed if we are to implement the purport of the Motion now before us. Of course, I am not averse to such legislation if it be necessary.
I congratulate my right hon. and learned Friend on the very liberal way he is interpreting the Act as it is now. His is a far more liberal and generous interpretation than hon. and right hon. Members opposite were able to adopt. They will recall very well that their interpretation resulted in only 4,800 persons being allocated tricycles, whereas my right hon. and learned Friend has stretched his interpretation of the law and over 11,000 persons now have tricycles.
It is notable that there is absolutely no mention in the Motion of the cost. My hon. Friend mentioned that the cost, according to present calculations, would be £2,500,000 spread over eight years, with an additional yearly cost of £1 million.
§ Mr. Paget
As the Minister and his predecessor know, I have negotiated with several Ministers on this. If the Department used the Isetta car which I myself drive, the price at which each vehicle, without Purchase Tax, could be made available would be about £220. I believe that what is being paid for the tricycles today is over £300.
§ Lord Balniel
I am perfectly happy to accept what the hon. and learned Gentleman says. I understand that my hon. Friend has already given an undertaking to look into the matter of cost and no doubt at the end of the debate we shall hear an answer on that point.
I very much hope that, after the two years necessary for allocating these two-person vehicles to war pensioners, my right hon. and learned Friend will have it within his power to extend and 1646 broaden the existing provisions so as to bring within their scope all persons who are in need of two-person vehicles.
§ 8.8. p.m.
§ Mr. R. T. Paget (Northampton)
I have been very concerned with this problem for many years. I entirely agree with the proposition that a man who received his injury in war should have an automatic priority, if priorities are necessary at a time when we have never "had it so good" and if priorities for these basic needs are necessary in a community as rich and productive as ours.
I will take one case I have in mind. This is a man I know who was born in a room in Northampton. He was thirty-two years in that room. He heard people bringing his food up the stairs, and he wondered what stairs were like. Suddenly, a tricycle was provided. I certainly will not call these tricycles "wretched" by any means. They have been a miracle and a wonder to many; they have opened the whole world to people who were cut off from it. Suddenly, with the provision of a tricycle, the whole world was opened for that man. What joy he experienced! Never have we provided money which has brought more happiness than the money which has been spent on these tricycles has brought.
Hon. Members will know of the clubs which exist and of the expeditions which the members have. There is a special place for them at the Cobblers' football ground, at Northampton. British Railways make provision for them so that these men can be brought into the guards' vans and travel on the trains. There is one man who has attended every away match of the Cobblers during the last fifteen years, a man for whom life had previously meant no more than a single bed. These people who were once useless and a burden suddenly become useful members of society because of these tricycles.
The man to whom I have referred has a job with British Timken Ltd. That is a firm with which I often disagree and I have on occasion had controversies with its somewhat Americanised and extremely Tory manager, Mr. Pascoe. But I always remember something which this man once said to me. He said, "People are really kind to us to start with, but we become a nuisance. But 1647 this firm never tires of being kind". That was a wonderful tribute and I am happy to repeat it.
Now let me return to my point. It may come as a surprise to some of my hon. Friends, but I am profoundly a Socialist and because I am a Socialist I believe that the first thing for which one should look is need. It is only when needs become equalised that we can ration or distribute by money. For instance, if there are not enough radios to go round, the blind should have the first supply and no one should be allowed to have a radio until all blind people have been supplied.
What I am now about to suggest will be very much more controversial. Old people whose lives are constricted by age and by the old-age pension, who cannot get about very much and do not read because they have not been in the habit or knowledge of reading, and whose eyes, perhaps, are not used to it, should have priority within our pension system for television sets because they have a much greater need for them. The difference which a television set makes to an old person's life is amazing.
That is what I mean by priorities of need. People in our society who have lost their legs and thereby the power to move have a priority of need for the mechanical means of movement. We should not be talking about priorities within a group. We should be talking about priorities within the nation. There are cars for those who can walk and take public service vehicles and anything else. Therefore, there ought to be cars for those who need them and whose need is so great. That is where priority in our society should lie.
I now turn to the rather absurd question of cost. In a society as rich, prosperous and full as ours, it is ludricous to say that we would impoverish ourselves by providing these vehicles for those who are in great need of them. It has been said that the cost would be about £2½ million. Even if I believed that it would be about£2½ million—and I do not—I should like to know whether that figure includes Purchase Tax. This point has been raised in correspondence with the Minister. Am I right in thinking that the £2½ million includes Purchase Tax?
§ Mr. Paget
That is an advance on the previous negotiations.
Previously, the Ministry has said that it could not carry out this proposal because of Purchase Tax. There are other cars, such as the Isetta and the Heinkel, available. They are on a mass production level. I believe that their price is cheaper than the price which the Ministry is paying for tricycles. That was certainly so a year or two ago. Am I right in saying that the cost of the tricycle today is about £350?
§ Mr. Paget
If the Minister would say whether I am right I would be grateful. I understand that that is about the figure.
Without Purchase Tax it would be possible to provide cars like the Heinkel and Isetta for about £220. No doubt for this special purpose and for many of the clients some special adjustments or adaptations would have to be made. This would put the price up a bit, but I do not believe that, even including the cost of maintenance and perhaps of petrol, there would be very much difference, between the two types of vehicle.
The difficulty has been the sort of Poor Law attitude which has been adopted. It has been felt, "We can supply these people with an invalid tricycle, because that is a medical appliance, but we cannot supply people with luxuries for nothing at the national expense." That has been the attitude of mind and it has been brought on by an interpretation of the National Health Service Act, with which, as a lawyer, I do not agree, namely, that once the vehicle becomes a two-seater it could not be provided. I do not believe that that is a right interpretation of the Act. If it is, I can promise the Minister that the House would pass through all its stages in a day the necessary amending legislation.
These tricycles have been wonderful things. They have brought immense and amazing happiness. But we are a much richer community now. We are not talking about priorities as in the days of rationing after the war. We can choose our priorities on a wider basis for those who need them. Let us do it now.
§ 8.17 p.m.
§ Mr. Ian Fraser (Plymouth, Sutton)
There was a good deal in the speech of the hon. and learned Member for Northampton (Mr. Paget) with which I was not in agreement, as will become apparent in the course of my short speech. I speak as a fairly severely disabled war pensioner and also as a motorist who covers necessarily a very great mileage in the course of the year because my constituency is a long way away. I can, therefore, perhaps claim to speak with a certain amount of practical knowledge of the questions which arise in this debate.
I am not so severely disabled as to qualify for one of these machines, but I am sufficiently disabled to have been among people who live in a different way from those who are not disabled at all and who are for that reason separated by a gulf from the disabled. I have spent several periods in Roehampton. I am a part of that splendid and humorous, if rather grim and macabre, fellowship to which Roehampton is a reality. I know what goes on in the minds of people who are more severely disabled than I am.
The first point that strikes me about this debate is a point of serious principle and a point upon which it has seemed to me that hon. and right hon. Members opposite were hedging a little in the course of what they have so far had to say. It seemed to me that the right hon. Member for Caerphilly (Mr. Ness Edwards), who moved the Motion, implied that the Opposition was not really challenging the principle that ex-Service men should have a definite preference in matters of this kind. The Opposition Motion, however, which is powerfully signed—which would seem to imply that in the event of the Opposition coming into power, this would be its policy—states thatsimilar disability whether arising from war service, industrial employment or other causes, should be assured equal treatment".There is nothing there about maintaining any form of priority or preference for the ex-Service man.
This is no light matter. The priority of the ex-Service man's call upon his country is very deep-seated. It is something which any Government should hesitate long before thinking of abandoning. I believe that if hon. and right hon. 1650 Members opposite were in power, they would not abandon it.
It is true—and the right hon. Member for Caerphilly made a great deal of this—that many civilian disabilities are incurred in circumstances as a result of which they have a moral right to be treated on the basis that they are incurred in the country's service. I have in mind many of the mining injuries, which were so movingly referred to by the hon. Member for Ince (Mr. T. Brown), many of the industrial accidents, and so on. Furthermore, a great number of serious disabilities are incurred not in the country's service, but in circumstances meriting the deepest sympathy from everybody—for example, many congenital conditions which people have from birth. It is, however, the fact that the Service man directly and definitely gives up his own, and, in great measure, his family's, freedom in the service of his country during the time he is serving with the Colours.
It is a principle of real importance that there should be no tendency, springing from good will towards the whole population and not, I recognise, from any ill will towards the Service man, to go back to a condition of things that will be familiar to people who read Kipling and who are familiar with the situation of the Services in the nineteenth century and before, a condition when the Service man felt that he was far more welcome to his country in war than he was in peace. It is of real importance that nothing should be done to impair the principle, which has been accepted for one or two generations at least by Governments of both parties, that there should be a real preference for the Service man in this matter.
§ Mr. Fraser
I am grateful to the hon. and learned Member, because that brings out the point on which we are directly opposed. I am arguing precisely that it is right to maintain a preference and a priority for the Service man under the conditions which obtain. I do not believe that if the party opposite were in power, it would infringe that preference.
1651 The gravamen of the Opposition case relates to National Health Service patients. It seems to me that even within the category of National Health Service patients, it is neither wrong nor harmful to have a considerable degree of discrimination in the way in which cases, all of which are seriously disabled, are treated. I cannot see any real parallel between, for example, a disability incurred while gallantly taking part in a rescue in a mining disaster and a disability incurred while driving recklessly or escaping from the police in a stolen car. There seems to me to be scope for great discrimination in the way which we treat disabilities which in themselves may be equal in nature.
§ Mr. J. J. Mendelson (Penistone)
Does the hon. Member believe that he is giving fair examples by contrasting the extreme cases of a criminal act and a mining rescue? Surely, those are not fair examples.
§ Mr. Fraser
I deliberately chose an extreme case on either side. I maintain—hon. Members opposite need not agree with me on this—that that is an important principle and that on moral and rational grounds there is good cause to discriminate in the treatment of disability cases. This is where I am arguing against the Opposition's case.
§ Mr. Mendelson
My point is that there should be no discrimination. What I complain about is comparing the extreme examples of a criminal act and a rescue. These are not fair examples.
§ Mr. Fraser
Admittedly, one could take two cases which are nearer together. The principle which I am maintaining, however, should be clear to the House, whether or not the House agrees with it.
The opposition Motion proposes the provision of two-seater cars. I am not clear why two-seaters were chosen—surely, the Mini-Minor is not a twoseater—but the two-seater cars are generally the answer. I speak as a disabled person with a good deal of practical knowledge of the invalid vehicles which are issued. On more than one occasion, constituents have brought them to me to inspect. I have been underneath them and poked about inside them. I am a practical motorist and know 1652 something about them. I am sure that in only a proportion of cases among National Health Service patients, as, indeed, among war-service cases, is the two-seater car or the Mini-Minor the best answer.
It is unfortunate that these specialised invalid vehicles which are now in issue in their modern marks are called tricycles. There is something pejorative about the word "tricycle". "Tricycle" is in some sense a term of opprobrium suggesting a simple or even ramshackle vehicle. That is definitely not correct. As my hon. Friend the Parliamentary Secretary claimed, it is not true of the modern issue of this vehicle.
There are things about it which are important. It is very often easy to get into, in a way in which, for example, the bubble car would not be and even the Mini-Minor would not be. In many types of physical disability it is easier to control a vehicle of this kind. A most important point is that it is distinctive on the roads. Other motorists know what it is. It is normal for motorists to treat with particular care and respect on the road an invalid car. It is furthermore less dangerous sometimes if it is driven with less than 100 per cent. skill than would be a car such as the Mini-Minor, which is a car which has passed me on the road at well over 60 m.p.h. Running and maintenance, too, are often more economical than is the case with a full two-seater car.
I am sure for these reasons that it is true that some of the severely disabled, be they war pensioners or National Health Service patients, will always prefer the type of vehicle that the present invalid tricycle is. But, having said all that, I would be the first to admit that the therapeutic value of a car which is a real car, a normal car like other people's, can be very great in many cases. It is not only the point which a number of hon. Members have referred to, the extra capacity of the car to carry a wife or a friend or someone to look after the driver. It is even more the feeling of normal life which goes with that.
On this, I would say to the House that even that feeling of normality, that wish to be completely normal, is not universal among the severely disabled. There is 1653 a form of dignity attached to very severe disability which becomes part of the personality itself, and there are those—I can thank of actual examples in my own experience, some of them perhaps the most memorable people I have met—who are, in this curious and perplexing way, suited by being severely disabled. It becomes part of their personality. They are prepared to go their own way, and among those we should find a number who would have no wish to change from the tricycle to which they are accustomed.
Even in my very short experience of the House, I have found myself on more than one occasion going to my right hon. and learned Friend the Minister of Health and asking him for things for my constituents, and I have certainly never found him anything but a most ready and sympathetic friend, I say in the same spirit that I believe it is absolutely right to maintain the priorities that we have maintained and absolutely essential to have regard for cost. The state of affairs would never arise, including the time when right hon. Members opposite are in power, when one could disregard the cost of a thing like this. But I hope that the Government will move in the direction of extending an option of having these cars on a particularly selective basis among National Health Service patients.
I should like to stress that it should be a selective basis and not in any sense a universal right of issue. Let us be clear about what we are doing if we offer cars to the severely disabled, and this applies to the war pensioners just as it does to National Health Service patients. I speak with real feeling on this, because I know the difference between what is an appliance and what is not. My leg is an appliance which the State gives me. My car is not an appliance. An ordinary car, however modified for somebody who is not 100 per cent. fit to drive, is not of the nature of an appliance, though I think it is true that the special invalid car is of that nature.
If, therefore, we extend the issue of ordinary cars, however they may be modified, we are not issuing therapeutic appliances although they may have a therapeutic effect. We are engaging in a welfare distribution. We are giving a precious possession to that person. Cer 1654 tainly that may be a right thing to do, but that is the nature of the act we are doing. I hope that we shall proceed, as time goes on and resources allow, in that direction, but I hope that we shall proceed with a full regard to all the circumstances, including discrimination in the way in which the injury was incurred, the type of injury, the source of injury, the means of the disabled, and all other circumstances. Given all that, I hope that my right hon. and learned Friend will find himself in a position to proceed in that way.
§ 8.35 p.m.
§ Dr. Horace King (Southampton, lichen)
I speak on behalf of the Invalid Tricycle Association, with which, like the hon. Lady the Member for Plymouth, Devonport (Miss Vickers), I am closely associated.
First, I want to correct an impression which may have been given, quite inadvertently, by the Parliamentary Secretary when she last replied to my right hon. Friend the Member for Caerphilly (Mr. Ness Edwards) in an Adjournment debate on 17th May. In that debate the hon. Lady referred to some remarks that I had made in the House on 14th December last expressing the Association's tremendous appreciation of the benefits conferred by the Minister on its members.
That was, however, only part of what I had said in that debate. On 14th December some of us were pressing the Minister to speed up the inquiry into whether invalid tricycles could be replaced by something better. The hon. and gallant Gentleman the Member for Norwood (Sir J. Smyth) had raised the subject, and the Parliamentary Secretary had told him that the promise made about cars related only to war pensioners. I then intervened and said:Is the Parliamentary Secretary aware that, while the Invalid Tricycles Association appreciates tremendously the benefits the Minister has conferred upon its members, not only the happiness but also the health and the safety of the crippled, to whom mechanical transport is the only means of conveyance, are involved in this inquiry? Will the most earnest consideration be given to the great mass of those cripples? "—[OFFICIAL REPORT, 14th December, 1959; Vol. 615, c. 1031.]Those like myself who are actively associated with the Invalid Tricycle Association and the Association itself 1655 have always held this view. We appreciate what the Minister has done. At the same time, we are asking for much more to be done. There is no doubt that the invalid tricycle has been a boon to the paraplegic and the amputee. Many a cripple who never left his home from one year's end to another has had the joy of getting out into the sunshine, into the country and into human fellowship since we provided him with a mechanical means of conveyance.
It is a joy and inspiration to attend meetings or social gatherings run by the Association. Inside the hall there will be various kinds of invalid tricycles which have brought some who can stumble into the hall or be helped into the hall. Inside the hall itself there will the invalid tricycles still containing the people who have had to be put into them when they got out of bed and can never get out of them until they get back home. They are happy gatherings. Many of these people would have no social existence at all but for the invention of the invalid tricycle and its provision for them by the Minister and his predecessors. I can think of some of my own friends in the Association who, literally, had never left their homes for many years until we first provided them with this wonderful new invention.
I was glad to hear my hon. and learned Friend the Member for Northampton (Mr. Paget) refer to the marvellous Association rallies. Some of these cripples travel hundreds of miles in these mechanical conveyances to rallies which have to be seen to be believed. For some of them the tricycle is a means of getting to work to earn a living. I think of one Southampton man, paralysed down one side, who was told that he would be bedridden all his life. With indomitable courage, he got from his bed and conquered his paralysis sufficiently to be able to struggle to a day's work whenever he could persuade someone with a car to carry him to work. I remember when I persuaded the present Minister of Health to supply him with an invalid tricycle what a revolution of happiness it made in that man's life. The man was a cripple whose courage surpassed almost anything I have ever seen.
We certainly appreciate all that the Minister has done. Hon. Members 1656 appreciate the very friendly contacts which we have with the Ministry of Health. Some of us were afraid when the Government transferred this group of problems from the Ministry of Pensions to the Ministry of Health that we were going to lose some of the warm humanity which has always marked the Ministry of Pensions. I am glad to say that our experience is that the same efficiency and the same kindly humanity pervades the Minister's own Department.
Having said that, I must add that when a cripple goes out in his invalid tricycle he goes out alone. If there is trouble with his tricycle, if there is trouble in starting it, or even if he has trouble in getting in and out of it, if he has to get out because of an accident, if he has the slightest difficulty, he has to face that difficulty alone. In a small car, there would always be someone able to help him. He needs companionship on the road. These people in the invalid tricycles who travel 100 or 200 miles across England to a rally literally travel alone. The driver cannot take his wife with him, and a crippled wife cannot take her husband with her. They cannot take a child or a friend in an invalid tricycle.
Now that the technicians have broken through, now that the invalid tricycle, which has steadily improved during the post-war years out of all recognition, is beginning to give place to the small car, I hope the Minister is going to let civilian cripples share in this new boon which science has brought to us. I think it was right to give the first priority, if priority had to be given, to the claims of the crippled ex-Service men. Disabled ex-Service men hold a special place in the hearts of all of us and the all-party Committee which supports the claims of B.L.E.S.M.A. welcome the Minister's decision to provide Minicars for the acutely disabled ex-Service men, and I know what joy that brought to the annual conference of B.L.E.S.M.A.
But amputation is amputation and paraplegia is paraplegia, whether the victim is a man or a woman, a civilian or a soldier. The handicaps are the same, the hardships are the same, and all these disabled citizens, military, ex-military or civilian, are citizens needing all the help the State can give. They need help to earn their own living, they need help to be able to get about outside their homes, 1657 to enjoy friendship, and particularly they need companionship to enable them to live as full a life as their disability will permit and modern invention can provide.
I know that in an earlier debate the Parliamentary Secretary argued that legislation was needed to bring this about. Some of my hon. and right hon. Friends on both sides of the Committee—because this is a non-party debate on a non-party matter—have advised me that no legislative change is necessary but that it can be done within the compass of the present legislation. Whether it needs a change of the law or merely an administrative change, I hope that the Minister will assure us at the end of the debate that he will do something about it.
The annual conference of the Invalid Tricycle Association shortly to be held has given pride of place on the conference agenda to a resolution which I think answers the speech to which we have just listened from the disabled ex-Service man who addressed the House about priorities. I quote from the resolution:This Annual General Meeting of the invalid Tricycle Association welcomes the decision of the Minister of Health to replace the three-wheeled invalid vehicles at present on issue to the seriously disabled ex-Serviceman with a small motor-car more suited to modern conditions, and requests the Minister to make a similar arrangement for the National Health Service patients.I know the joy that the Minister's first decision brought to this year's annual conference of B.L.E.S.M.A. If as a result of this debate today something similar could be announced at the annual conference of the Invalid Tricycle Association, the Minister would be again adding joy and real happiness to a very worthy and very courageous group of British citizens.
§ 8.45 p.m.
§ Miss Joan Vickers (Plymouth, Devonport)
I am very glad to have the opportunity of joining in the debate. Like the right hon. Member for Caerphilly (Mr. Ness Edwards), I had the opportunity to raise the matter on an Adjournment debate, although mine was rather earlier, on 16th November, 1959. I am very pleased, too, that the hon. Member for Ince (Mr. T. Brown) suggested—and he is always very wise in these things— 1658 that this should be a gradual progress, and I am certain that it is the intention of the Ministry that it should be.
I take exception to what was said about these "wretched tricycles". I lend my house for the meetings of the Invalid Tricycle Association in Devon-port. The members are extremely happy people and at these meetings they arrange their tours. Incidentally, they often go abroad and do not simply tour in this country.
Very good arrangements are made in my area for invalids whose tricycles break down. Passing motorists will always stop, but we have a list of garages which can be telephoned and which will always send out a breakdown van.
§ Mr. Ness Edwards
Does not the hon. Lady realise that in isolated Welsh villages and mining valleys the problem is entirely different from that in the large towns?
§ Miss Vickers
I cannot imagine any place so isolated that there is not someone passing during the day. I gather that Wales is not quite so deserted that there will not be someone coming, at least a lorry driver, on his journey from place to place.
§ Mr. Ness Edwards
That is not the point. In the large towns it is possible to get these people together in groups, but in the isolated villages, where there is only one such invalid, it is impossible to have the sort of association which there is in Northampton, for instance, or in other parts of the country.
§ Miss Vickers
I agree that there are special difficulties. I can drive a car, but I have no knowledge of the insides, and if I am driving alone and have a breakdown, I am equally stranded, although, I admit, I could walk if necessary.
The invalid tricycles have given tremendous service. One of the important things we have to remember is that we must suit the vehicle to the individual, because, however generous the Ministry might be, there will always be those who could not manage a car and who would be infinitely happier and safer in a smaller type of vehicle.
Only last Friday, I had 34 completely disabled people to tea in the House of Commons. This is the fourth year that 1659 the group has come. I arranged for them to be pushed round by Red Cross people so that they could see the House. I mention that because other hon. Members have drawn on their experience in mining districts.
In my constituency, there is a disabled people's home which, I am very glad to say, my right hon. and learned Friend has visited. There are eight flats for disabled people who can look after themselves, there is a recreational hall, and there are 22 flats for people who cannot look after themselves. Because of that home I have been able to make some study of their problems, and I know the difference between those who would be able to manage a Mini-Minor motor car and those who definitely need the other type of vehicle. Whatever happens, I hope that the present vehicle will not be superseded and that we shall always have the invalid tricycles, whether with petrol engines or electrically driven, because their loss would be a great loss to many people. I hope that my right hon. and learned Friend will keep them on the market.
To help the progress and delivery of these cars, it might be found that some people would be prepared to pay for them. I have just had a case of a man who is employed in a railway inquiry office and who, although he does not get a tremendous wage, is able to buy his own car. I should like to see a scheme of loans run by the Ministry so that such people who were in work and who could pay back over a period of months or years could buy their own cars or, if they had a car, could have the gadgets which, I understand, cost about £70 and are renewable about every five years.
I should like to see an extension of such a scheme, particularly of loans given to persons so that they can buy their own cars. The loan could be made on reasonable terms and the Minister might be able to make it without any form of interest. Such a scheme would cut down the waiting list considerably.
I want to make a plea, as I did in my Adjournment debate on 16th November, for less strict differences in the categories of the persons who can obtain cars. Would it not be possible to sell the propelled car—the invalid tricycle—to these people if they could afford it? 1660 These vehicles are not on the market and a number of people I know—some of them single and earning £10 or more a week—would be willing to buy a car but do not come into the category of being allowed one because they can walk. They find it difficult to walk and when they get horn from work after their struggle they are tired and cannot make an effort to go out again. If they could have one of these small vehicles it would minimise their difficulties considerably.
I gather that there are priorities first for the person who has two amputations, one just above the knee. It is very difficult if one has two legs cut off below the knee, for that is a less high category. I believe that that is too difficult a distinction. There is also the question of total loss of use of both legs and limited walking ability. It is difficult to judge the limited walking ability of an individual. Some of them can walk just sufficiently to enable them to get to work but have to give up work sooner than normally because the daily journey gets more tiring, especially, as they may put on weight because they cannot take much exercise.
I also make a plea for the housewife. Hers should be a job which should qualify for this. I know of a woman with five children who has both legs off. She should go shopping but is unable to do so, and her husband has to do it. Before we consider giving out these two-seater vehicles we should make available a larger range of the other vehicles. It is essential to decide whether we are going to specialise in a few or help a greater number of people. I come down on the side of helping the greater number in their disability.
I believe that practically nobody is too badly disabled to take part in the life of the community somewhere, and therefore I think that we can give this benefit over a greater number of people. I understand that in 1951 there was a total of 6,238 cars issued—of the invalid tricycle type—and in 1959 there were more than 13,000. That has been a tremendous step in those few years and of great benefit to many people.
The annual cost of upkeep is considerable—about £1½ million. One has to take that into consideration. I hope that the Minister will consider those who can be self-supporting within the community and can really take their part in it, as 1661 in the case, quoted by the hon. and learned Member for Northampton (Mr. Paget), of the man who could not get downstairs for 32 years.
I hope that when the two-seater cars are provided more than three hours' tuition will be given. I understand that that is the period which is laid down—and in the Adjournment debate I drew the attention of my hon. Friend to the fact that some people receive only about half an hour's tuition. If these larger cars are supplied I hope that their drivers will have to pass a test similar to that laid down for persons who are not disabled. Disabled people will find it quite different driving the new cars, and I know that disabled people driving ordinary cars fitted with special gadgets have to pass quite a severe test. It will be quite a responsibility for many of these people to drive a car if they take with them their wives and children.
The only other question is that referred to by the Piercy Committee in paragraph 311, namely, the need for closer co-operation between various Government Departments and a clearer definition of the responsibilities of the various Departments. I am thinking mainly of the difficulties which will arise in connection with the two-seater car. One hon. Member said that a garage is provided for the tricycle, and I presume that one will have to be provided for the car. This will take up quite a lot of room. There is considerable delay even in providing an individual with his tricycle because of the difficulty of providing a garage.
The two things are done by different Departments. Whoever decides to deliver the vehicle should ascertain that a garage is available before the vehicle is delivered or is put on the list for delivery. A person may be told that a car is waiting for him but that he cannot have it because there is no garage.
§ Miss Vickers
The hon. and learned Member is responsible for his own car, but these are Ministry cars, and the Regulations provide that garages must be provided. If the hon. and learned Member is not satisfied with his car, I presume that he can change it as and when he requires, but these invalid cars 1662 have to remain the property of the Ministry. It may be that A is told that his car is ready for him but there is no garage, while B who may have a garage will not be able to receive a car because he is not next on the list. I hope that this point will be cleared up, because it has caused considerable difficulty.
Although I sympathise with the need of ex-Service men, and agree with the hon. Member for Southampton, Itchen (Dr. King) that the Invalid Tricycle Association and B.L.E.S.M.A. have welcomed the suggestion that ex-Service men shall have priority, I hope that we shall nevertheless take account of the civilian disabled and make the restrictions upon their obtaining these vehicles a little less stringent.
§ 9.0 p.m.
§ Mr. E. G. Willis (Edinburgh, East)
I wish to speak in this debate not so much because there are a large number of miners in my constituency—those hon. Members who represent mining constituencies will be able to speak for the miners—but because there is also in my constituency a settlement for disabled men, the Thistle Foundation, which has been visited by the hon. Lady the Parliamentary Secretary and by the Minister of Pensions and National Insurance. The settlement houses about 100 disabled men with their families and it is probably one of the finest in Britain. The disabled men there can live with their families and at the same time, obtain the necessary treatment. There are also workshops in which they can work.
I visit this foundation frequently and I have to deal with a large number of Parliamentary cases involving residents there. I always feel rather humble in the face of the tremendous courage displayed by these men. I have a great admiration also for the way in which wives assist them. They have to put up with a great amount of inconvenience and sometimes with the irritability of their husbands, and the need to perform unpleasant jobs, and all the rest of it. That is why I am glad that at last the Minister has recognised the unfairness to a disabled man caused by the fact that he may not have been able to take out his wife or his family for perhaps twenty or thirty years, or even longer.
When dealing with the various cases arising from the Thistle Foundation, I 1663 have been struck by the number of varying circumstances producing differing treatment of what would appear to be almost the same type of disability. It has been said in the debate that a man who has served his country should be given priority, but I find that even among men who have served their country, and who are suffering from the same disability, the treatment is quite different.
Everyone is aware of the notorious difficulty of dealing with cases of disseminated sclerosis. I know of cases of men who get high pensions under the Royal Warrant and others who get nothing. A man who might have been delivering a message from his headquarters may qualify and a man who might have been going on leave might not qualify. They may be both in the Service and perhaps have been driving through the Royal Dockyards, but one qualifies and the other does not. There is an enormous difference between those who qualify and those who do not, but who are both Service men, and the person who qualifies under the National Insurance Acts. There are other people who qualify under the Industrial Injuries legislation and I am puzzled about all this.
The families of these men have exactly the same problems to face yet there are enormous differences in the amounts which they receive. Many of the people living in the Foundation realise this and it often causes niggling criticism. One family thinks, "Fancy, Mrs. So-and-So, next door, has this, that and the other, and her husband has exactly the same disability as mine". That is not a good thing socially.
The Amendment to the Motion "congratulates Her Majesty's Government on the provision of cars for disabled war pensioners in place of power-propelled tricycles …" but I understand that all the war disabled pensioners who have power-propelled tricycles will not get cars. I forwarded a case to the Joint Parliamentary Secretary only last week. War disabled pensioners who qualify by having power-propelled tricycles provided by the Government were under the impression that they would get cars, but apparently a Ministry circular has been sent to them telling a number of them that although they have a power-propelled tricycle to enable them to get to work, 1664 they will not qualify for a car. I see that the Joint Parliamentary Secretary is standing near Mr. Speaker's Chair. He should come into the Chamber to listen, because I am referring to a case which I sent to him.
I think that we ought to be told where the line should be drawn, and who exactly among the disabled ex-Service men at present possessing power propelled tricycles are to have them replaced. There is a general impression abroad that everyone who has a power-propelled tricycle is to have it replaced. That cannot be so if a circular has now gone out telling a number of men that they are not to have their machines replaced. The Government ought to be more frank about this. They should tell these men what the position is, because it is a tremendous disappointment to them if they think they will get a replacement and then find they are not eligible.
A man I know quite well wrote to me last week. I have been trying to get him a car. He has had a power-propelled tricycle for some time. He wrote very bitterly, saying that he never bothered because he thought he would be given a car. He said he had not enjoyed going out in the company of his wife for forty years. I cannot remember the exact wording of the letter, because I sent it on to the Ministry. There must be many other cases like that, because this scheme has only just begun. We ought to be told what the Government are doing and who are to get these cars.
Many seriously disabled persons are disqualified because of the way in which their category is interpreted. I have been told that if a person could walk the distance from where I am standing to the Clerks at the Table he could not get a car, but, if a person could walk only from where I am standing to the Dispatch Box he could get a car. This distinction seems unreal.
What my right hon. Friend the Member for Caerphilly (Mr. Ness Edwards) said in opening the debate was quite fair. The Government are to replace power-propelled tricycles for ex-Service disabled men and my right hon. Friend asked that when that had been done—and it will take two years—the Government should say, "We think it a fair proposition to do the same for civilians, whether they have been injured in the mines or in 1665 any other way." Surely that is not unreasonable. In spite of the speech made by one hon. Member about priority being given to ex-Service men, I am quite confident that ex-Service men themselves would like to see this done. They do not like to feel that they are a privileged community and to see others living alongside them unable to enjoy something which they can enjoy.
Much has been said about the question of cost. We are told that this would cost £2½ million, but, spent over a long time that would be only a few hundred thousands a year.
§ Mr. Willis
Yes, shades of George Buchanan.
Are we at this time to say that we are unable to do this very small thing? I do not want to make a political point by talking about Blue Streak and the £100 million that involved, but there must be many millions of pounds wasted by any Government every year in following up various lines of research and development and such ancillary matters. This is not too small an amount to expect any Government to be able to spend. Putting it very brutally, the Government can afford £100 million on Blue Streak for the purpose of destroying men's limbs, but cannot afford £2½ million to help get the men about after we have tried to destroy them.
These men have served their country. It does not matter whether they are civilians. I say that having been a serving man who has had fifteen years' service in the Navy and in the Army. I am quite sure that the Service man does not want this. Whether a man has injured himself in a pit or fallen down the stairs, thus breaking his back or injuring himself in some other way, the problem for his wife and family and himself is exactly the same as if he had fallen or become injured in some other way. These men, no matter how they came by their injuries, have the same financial problems, the same difficulties with their children, the same difficulties in getting about, and the same human and social problems.
We are not asking that Service men should not get their cars until the industrially disabled men get theirs. Our point 1666 is—I feel that most of the House is with us—that, having made the provision, it is not too much to ask that disabled miners, civilians and others should also get them if they fall within the categories.
§ 9.12 p.m.
§ Mr. Kenneth Lewis (Rutland and Stamford)
There is perhaps a touch of irony in the debate at this time, because if my right hon. Friend the Minister of Transport had been sitting in the place of my right hon. and learned Friend we would have been taking him to task and asking him to take action to prevent motorists from becoming invalids. We are now discussing how we can enable invalids to become motorists. Sometimes when one considers the situation on the roads one wonders whether there is great advantage in having a motor car in these days.
I am sure that we all agree that, when dealing with people who are unable to get about, it is right and proper that if the State is providing general welfare it should do something to help these people. It is right that we should deal with the ex-Service men first and give them priority. Many hon. Members are ex-Service men. Hon Members on both sides will agree that many ex-Service men have no one else to help them. They came out of the Services, and that was the only background they had. They had not worked for a firm. They had not even belonged to a particular community because they were away for so long. They depend entirely and absolutely upon the State. Therefore, if there is to be a priority, it is right and proper that it should be given to ex-Service men. After that it is also a good thing that we should do what we can for the civilian who is in any way incapacitated.
It would be helpful to the House if my right hon. and learned Friend can say what the future holds, without promising anything immediately. Perhaps he will say whether it is possible to deal with hard cases. Perhaps cases might be dealt with in due course where persons are living in country areas and have to go farther than others who are living in towns whose present vehicles are adequate.
I should also like to reinforce the plea of my hon. Friend the Member for 1667 Plymouth, Devonport (Miss Vickers), who asked the Minister to consider making some of these vehicles available for sale. There are people who would buy them, and could make good use of them; who could afford to buy them, and would be independent enough to want to do so. If my right hon. and learned Friend could say something about that, it would be very helpful.
In this debate there seems to be a general feeling that many of the people who have the tricycles want a motor car. I am not sure that all of them necessarily want to have the two-seater. One sees these people occasionally at football matches with their tricycles, and they seem to enjoy going about on their own in these vehicles. That is not to say that there are not others who would like to have two-seaters, but I sometimes wonder whether, nowadays, we are going a little too far in expecting that the State must always immediately fill in this sort of gap, and make changes that increase the charge on the public purse.
I wonder whether we should not ask the country to do this now, today, as a public service quite outside the National Health Service. We live in an affluent society, and the number of motor cars is increasing year after year. The Government are providing these tricycle vehicles, but the Opposition's Motion suggests that they should go further and provide motor cars. The Government do not feel at this moment that they can concede that. Does it have to be left that way?
Is it not possible for those who now have one-seater vehicles to be assisted in the acquisition of two-seater vehicles by local organisations and local people coming to their aid? Would it not be possible for Rotary clubs, or even for private individuals to think about this—as I believe many do now for old people—as an individual service that they are prepared to give? In many cases these people have sons and daughters who could do just that. Others have not, and I think that we in this House have a right to say, "Here is a service that can be given quite outside the Health Service, something that individuals can do to help those who have the minimum requirement—the one-seater vehicle."
1668 We happen to be a bit better off. We are not incapacitated. We are working, and earning good money. We are prepared to give up a day or so a month to assist these people. This kind of Christian charity is something that is quite non-political. When one gets a request in a Motion like this, one sometimes feels that all the emphasis is laid on Government action, and nothing is left for the individual. It may be possible for the Government to deal with this problem stage by stage but, quite apart from what the Government can do, the country itself will, I am sure, recognise that it has a responsibility in the matter.
§ 9.20 p.m.
§ Mr. J. Hill (Midlothian)
I regret some of the speeches that have been made, because in them there has been a tendency to place the ex-Service man against the man broken in industry. I would remind the House that many of the men broken in the pits would have been in the Services had they been allowed to join. They were not allowed to join, because at that time they were considered more essential in getting the coal in order to conduct the war. That is why I regret the comparison—and I take second place to no one in my admiration for and sympathy with these men who were broken in the war.
What are we asking? We are asking that the man who has the motor-propelled tricycle should be provided with a two-seater car. The hon. Member for Rutland and Stamford (Mr. K. Lewis) asked whether there were not charitably-minded persons prepared to help, but the people about whom we are concerned are asking not for charity but for what we think is a right from the Government of the country—
§ Mr. K. Lewis
But, surely good neighbourliness cannot in any circumstances be described as charity. It is just good neighbourliness.
§ Mr. Hill
I agree with the hon. Gentleman about good neighbourliness, but I am not prepared to agree that the good neighbour should have to spend his money on what, in my opinion, is a Government responsibility.
It is less than a year since I left the coal pits. There I had the unhappy experience on various occasions of 1669 helping to carry out men with the lower part of the body destroyed for all time. Their courage had to be seen to be believed. As a trade union official, it was my custom to follow up the cases to the hospital, and to visit them there.
We have the Edenhall Hospital in my constituency, where these cases are now dealt with, and I visit that hospital periodically. It is perfectly true to say that although these men are very happy with the tricycles, they would be much happier had they two-seater cars so that their wives could accompany them on many a run that they have to take by themselves.
I do not think that we are asking anything unreasonable when we ask for a two-seater car for that type of case. Even Billy Butlin is as generous as the Government 'because in Scotland he gives these cases of paraplegic miners a free holiday at holiday camps. That is something in line with what the hon. Member for Rutland and Stamford has suggested. Not only does he give the men a holiday, but he gives their wives and families a holiday, too. If a firm like that can give this help, what is to prevent the Government from supplying two-seater oars?
I understand that recently my organisation, the Scottish Area of the National Union of Mineworkers, sent a resolution along these lines to the Ministry asking that these cars should be provided. I do not want to repeat what has already been said, but I hope that the Government will think again and will consider giving these people something which, although it will not restore the power in their legs, will at least give them the pleasure of having their wives accompanying them at all possible times.
§ 9.25 p.m.
§ Mr. J. J. Mendelson (Penistone)
I wish to address myself briefly to two points made by the hon. Lady the Parliamentary Secretary. I think that we must all accept that finance comes into this matter. That is common ground and, throughout the debate, it has been recognised. I submit to the Minister, however, that we are not here dealing with the problem of establishing priorities only within a narrow compass, but are obliged, as a House of Commons to look at social priorities beyond the immediate problem we are discussing. 1670 There is really no contradiction here at all.
I have had many conversations with colleagues, ex-Service men like myself, miners and people in industry whom I represent when we have discussed this whole matter. Our joint conclusion—this is the real case the Minister has to answer—can be put in the form of question. Is it not shocking that, in the second half of the twentieth century, we cannot so arrange our social priorities that we have our ex-Service men, those who have given service to the nation in the coalfields and suffered injury, and those who have been seriously injured in the steel industry and in other industries, all included within the comparatively small group of people who can be given this aid today?
I appeal to the Minister to address himself to that case. Administratively, of course, no one is asking for everything to be done overnight. It is a gradual process. There is no difficulty at all in the Government announcing tonight that this gradual process will include those categories of people mentioned in our Motion.
Secondly, as the hon. Lady the Member for Plymouth, Devonport (Miss Vickers) said, we have a duty to widen the circle of people who can be helped in this way. Everyone will accept that. But, of course, we understand that, in widening the circle, we must always keep in mind categories where the incidence of injury is higher than in others. That is the meaning of the reference to industrial injuries in the Motion, and that is why I, together with others, have mentioned miners in particular. We are not impractical enough to suggest to the Minister that he must have no regard for the incidence of injury in various categories. Therefore, while accepting fully the principle enunciated by the hon. Lady, I say that, in interpreting and applying it, categories must be considered.
My last point goes a little beyond the immediate substance of the debate. This debate has been comparatively free from political disagreement, and I want to keep it that way. There have been many occasions on which the general problem of social advance has been discussed between the two sides, but I have always taken the view that there are several problems on which, with the practical 1671 approach of hon. Members and the various associations whose interests have been represented in the debate and of those who give advice to the Minister, common ground can be reached.
It is perfectly possible, because the chances are there with the available practical means of doing what is required, to reach an agreement which can do justice to the categories of people concerned and which can be carried and justified in the country by those who have particular interest and knowledge in the matter. I appeal to the Minister to treat the problem in that spirit when he replies.
§ 9.30 p.m.
§ Miss Margaret Herbison (Lanarkshire, North)
During this debate we have heard a great deal about priorities from the Minister and from every hon. Member opposite who has spoken. I am glad that my hon. Friend the Member for Penistone (Mr. Mendelson) dealt with this point. It seems to me that the Government are basing their case on priorities.
The Parliamentary Secretary recalled that it was a Labour Minister who first set these priorities. She said that the Socialists gave preference and priority to war pensioners. We do not deny that. We are not ashamed of it. That was 1948, four years after a dreadful war. But this is 1960, twelve years later. Our Motion does not ask that anything should be taken from the war pensioner. We are delighted that he gets what he is getting today. It merely asks that what is enjoyed, if one can call it "enjoyed", by the war pensioner should be enjoyed by others who are disabled, not for the same causes, but in the same way.
The first page of the Tory Party's manifesto—and I have quoted this often in the last few months—asksDo you want to go ahead on the lines which have brought prosperity at home?"—not the lines that perhaps at some time in future will bring prosperity. So that only a few months ago the Government were telling the people that we were a prosperous nation.
The sole reason given for the Amendment is that we cannot meet what is 1672 being asked for in the Motion because of cost. The Amendment states:but recognises that regard must be had to all relevant circumstances including cost and competing claims on the resources of the nation.What a different picture this is from that painted in the manifesto. Judging from the Amendment and from the Minister's speech, one would think that our country was living in miserable poverty, not prosperity.
I now turn to the part of the manifesto which was brought to the notice of the Government by my right hon. Friend the Member for Caerphilly (Mr. Ness Edwards). I am certain that many disabled people who have tricycles on reading that manifesto took it that it applied to them. It refers toThose disabled in the service of their country"—"service" with a small "s". If the Government had been honest and if what they said was what they meant, they would have said "in Her Majesty's Services", but they did not. They merely said:Particular attention will be given to providing more suitable vehicles for the badly disabled.The paraplegics in my constituency—and in my constituency they are mainly miners who have been disabled in the mines, but there are those who have been disabled in the steel works and every type of heavy industry—had a right to expect on reading that manifesto that it applied to them.
Both the Amendment and the Parliamentary Secretary's speech are mean, miserable and complacent. All the back benchers who have spoken from the Government side have said that we cannot afford this concession. The hon. Member for Hertford (Lord Balniel) said that we all wanted to help these people. He went on to say, however, that when we have to allocate limited resources of the State we have to choose our priorities. I will deal with that later.
I listened carefully to the speech of the hon. Member for Plymouth, Sutton (Mr. I. Fraser), according to whom, apparently, even if we were not able to afford this concession, we should set up an artificial barrier to maintain priority for the ex-Service man. That is very 1673 foolish. In my constituency, there are disabled miners side by side with disabled ex-Service men. I know men of both categories, and I know that the disabled ex-Service man would want his comrade who had been disabled industrially to have everything that he has himself.
§ Mr. I. Fraser
The hon. Lady will remember that I said there were a number of categories of disabled National Health Service patients who on moral and rational grounds had a perfectly equal claim with the ex-Service man to sympathetic treatment in this way. I was maintaining, however, that in that class there should continue to be priorities and preferences. I claimed the first for the ex-Service man, and I suggested that among the National Health Service patients there should be priority according to the way in which the disability was incurred and the need of those affected.
§ Miss Herbison
I thank the hon. Member for his intervention. I do not believe that he is out of sympathy, but I think that when he reads the whole of his speech he will understand why it gave me the impression that, whether or not priorities were necessary, he still feels that there should be priority for the ex-Service man.
What kind of priorities are we talking about? What is the scope of this problem? The cost to meet what we ask in the Amendment is £2½ million, not in one year but spread over eight years, with £1 million for maintenance. Let us consider what is happening under the fiscal policy of the Government, who cannot afford £2½ million spread over eight years. By the initial allowance for motor cars, the Chancellor loses £50 million annually, as against £2½ million over eight years—£50 million to people who are much better off than those about whom we are talking. Indeed, the hon. Member for Kidderminster (Mr. Nabarro), who boasted that he has never paid anything under Schedule A, will be given the initial allowance for his car.
Reputable sources have estimated that the Government lose £100 million a year through tax evasion. To these two items of £50 million and £100 million a year my hon. Friends could add others. Against these, however, the Government 1674 quibble about an additional £2½ million spread over eight years.
By the Amendment and the speech of the Parliamentary Secretary, the Government have shown that they are trying to set one group of citizens against another. I was glad to hear the speech of my hon. and learned Friend the Member for Northampton (Mr. Paget), who made it clear that we should not be discussing priorities between these two classes of people.
The priorities today are the priorities in the nation as a whole, and if that were accepted by the Government they would have no hesitation in accepting our Motion. We ask that all who need a car in the special categories, the industrially disabled and the paraplegics, should have the same benefits as the war pensioners. We are delighted that the war 'pensioners have these benefits. We know how great the benefits are, and it is because we know it that we want them for other people who are similarly disabled.
Much has been said about companionship, and letters have been quoted. My hon. Friend the Member for Edinburgh, East (Mr. Willis) with his intimate knowledge of this matter from the institution in his own constituency, gave examples. There are paraplegics whom I know well in my own constituency. It is not only companionship that they need on their outings. These men have to have their wives perform the most intimate personal services for them.
The hon. Member for Rutland and Stamford (Mr. K. Lewis) said that perhaps other people would take them out in a car. That is a good thing, but many will not go out in anybody else's car. They want their wives with them not only for companionship, although that is important, but because of these personal attentions which they must have from them. I know that from friends of my own who are in that position. My hon. Friend the Member for Ince (Mr. T. Brown), in the letter which he quoted, also showed this very clearly. It has been said that the tricycle has opened new vistas for many of these people. It has and we are glad of that, but these vistas are still limited. Many of these men cannot go very far because they need somebody with them, and there is strong reason for that.
1675 It seems to me that the Government often appeal to what I would call the lowest in our people, the sort of "I'm all right Jack" philosophy, but I would say to the Minister, who seems to think that a joke, that the British people in the main are decent, generous people and that if we were to put this matter to them this evening they would say to the Government, "Find that £2½ million over these years." There would be no vestige of hesitation. The Government talk a great deal about prosperity and in the next breath tell us that they cannot find £2½ million for these humane purposes over eight years.
We on this side of the House believe in priorities, and we regard what we ask for this evening as an important priority. It has always seemed to us that in a civilised, Christian country the strong and able amongst us ought to take care of the sick, the weak and the disabled. That is all we ask for in the Motion. I hope that the Minister has listened carefully to the debate. I am sure that if they had not felt that they had to back the Government, his hon. Friends would have been much stronger in their speeches. Let the Government be as generous as I am sure the British people would want them to be. Let them give us what we ask for in the Motion and withdraw their Amendment.
§ 9.44 p.m.
§ The Minister of Health (Mr. Derek Walker-Smith)
We have had a very interesting debate with some very constructive and moving speeches. We had particularly good speeches from my hon. Friend the Member for Plymouth, Sutton (Mr. I. Fraser), my hon. Friend the Member for Plymouth, Devonport (Miss Vickers) and my noble Friend the Member for Hertford (Lord Balniel) and, among hon. Members opposite, the hon. Member for Ince (Mr. T. Brown), the hon. Member for Southampton, Itchen (Dr. King) and the hon. and learned Member for Northampton (Mr. Paget). On the whole, they have been speeches reasonably free from party or political controversy. The right hon. Member for Caerphilly (Mr. Ness Edwards) will not, I am sure, expect me to put him in quite that category.
§ Mr. Walker-Smith
The right hon. Gentleman is by temperament combative, and it is a very attractive quality. I know that he will not mind if, from time to time, I pick up his points; I am sure that he will certainly not take it amiss. However, I do not want, on the whole, to make that sort of speech, at any rate not more than I can help, because I do not feel that this is the appropriate occasion.
We are concerned here with a subject of great importance and much human interest. We are concerned with disabilities which are tragic however they are sustained—disabilities borne, as we all know, bravely and cheerfully by those who have sustained them, and these people are, of course, entitled, and indeed receive, the constructive and compassionate interest of hon. Members on all sides of the House.
This subject throws into particularly sharp relief two complementary, if not conflicting, considerations which I have encountered very much in three years of dealing with health and welfare matters. In the first place, in all these health and welfare matters we are, of course, dealing with people who, in the words of Bishop Gunning's prayer, are afflicted or distressed in mind, body or estate. For that reason, we have a special duty and natural impulse to do our best for them. But our natural impulse is inevitably conditioned by our means.
The hon. Member for Ince said he hoped that cost was not in my mind. I wish that it was not. I think that anybody who has been Minister of Health would wish that it was not in his mind. But, unfortunately, it has to be in my mind, because the cost of the National Health Service is high. The Exchequer share of the Service is a quarter of the whole of our Income Tax yield, and perhaps an even more striking thing, it alone is more than five times the total Budget that Mr. Gladstone introduced for the country only 100 years ago.
§ Mr. Walker-Smith
I should have thought that it was fairly obvious. It was obvious to one or two of the right hon. Gentleman's hon. Friends, even if it is not as yet to him. It is obvious that there will be times when our will is not matched by our means, and there 1677 will inevitably be times when our purse does not allow us to go as far as our hearts would take us.
I agreed with my hon. Friend the Member for Sutton when he said that we shall never get a time when we can disregard costs in this matter. I think that that was not dissented from in the short but interesting speech of the hon. Member for Penistone (Mr. Mendelson). I see that the right hon. Member for Caerphilly seeks to intervene, but I rather hope that I may be allowed to proceed without interruption, not that I would shrink from it, as the right hon. Gentleman knows.
So we start from that basic position. Indeed, so far from its being a paradox, I would say that it is a platitude, and none the worse for that because most human wisdom is by now enshrined in platitudes. However, it is the sort of platitude that we all realise quickly enough in our private affairs, though in our public affairs we are less likely to take account of it, at any rate all those who are not charged with the immediate responsibility for finding the means.
It is this inescapable point, unwelcome though it may be, which our Amendment is designed to bring out. If the right hon. Gentleman's Motion had contented itself with saying that, although we provide a good service, we should seek to improve it and provide a still better one as and when circumstances and resources allow, he could have initiated a useful debate, and I do not suppose that he would have found a single dissenting voice.
Of course, that is not what the right hon. Gentleman has done. He has largely disregarded the economic aspect. Indeed, he, though not all his hon. Friends, rather based his case on a repetition of his attack on the vehicle. I am glad to think that I do not really need to answer that, because there has been a general concensus of opinion in the House that these are good vehicles. That does not mean that the Mini-Minor car is not a better vehicle, but these are good vehicles and very different vehicles from the early motorised wheeled chairs with which this system started.
The hon. and learned Member for Northampton and the hon. Member for Itchen referred to the Invalid Tricycle Association rallies. I attended the last annual one at Whitsun and saw what 1678 they can do, appreciated the distances they had come, and so on. The right hon. Gentleman ought to have been there, for then he would not have made the speech he made on 17th May decrying these vehicles, because they are good vehicles. Indeed, we are leading the world in the provision of vehicles for the disabled. These are not my words. They are the words of the chairman of the Invalid Tricycle Association, who wants cars. Certainly, he does, but he is candid enough to say that we are leading at the present time.
When we have debates on economic affairs in the House, the right hon. Member for Huyton (Mr. H. Wilson) very often talks about league tables. We have not heard anything about an international league table in this debate, because we are top of the league. We have not heard any comparisons, we have not had suggested in a single speech the name of any other country which is doing more than we are in this matter.
Having said that, I freely concede that it is a disadvantage that these vehicles—I agree with my hon. Friend who said that we should not call them tricycles—do not carry a passenger. So it is natural that we should cherish the wish to move towards the provision of cars which do so, but we did not feel that, together with all the other advances in the social services that we are making, and having regard to the economic questions to which I have referred, we could do this for all, and so the question was could and should we do it for any.
We thought that one category stood out—the category which we had singled out in our election manifesto.
§ Mr. Walker-Smith
Certainly; it is dealt with in one short paragraph of two sentences which have to be read together. The first sentence makes it quite clear that the reference here is to war pensionersdisabled in the service of their country"—a well-understood phrase. It does not imply any lack of appreciation of those who are injured in peace-time; of course, it does not, because peace has its casualties no less than war, but the phrase is well understood. We were following a traditional preference and priority started, 1679 as is admitted, by the Labour Government and given effect to, not only in the matter of vehicles but in various other matters like priority of admission to certain hospitals, and so on.
These war pensioners are a clearly defined category for whom this traditional preference already existed. I am sorry that there has been some misunderstanding about Civil Defence. They come in—the policemen, firemen, etc. The right hon. Gentleman referred to the Police War Reserve and the National Fire Service, and they come in. We have written to some of the Civil Defence people already in regard to their vehicles. We felt that this category could be dealt with now, and we have dealt with it, but I do not think it is so easy to divide up any other categories. My hon. Friend suggested a selective basis, and so did the hon. Gentleman, but I think that when we pass from the war pensioners to the National Health Service patients any splitting-up of the categories will lead to great difficulties. They are all very deserving categories, but we cannot give one priority against another within the context of the Health Service.
§ Mr. Walker-Smith
I am sorry, but I have only five minutes, and I cannot give way.
We cannot divide up National Health Service patients, because we would find great difficulty in balancing the claims of one deserving category against another and with them it is rather, as in the case of Wordsworth's clouds, we move together if we move at all. In effect, we have our two categories—the war pensioners, with whom we have dealt, and the National Health Service pensioners, who are about eight times as numerous and who make a much bigger cost problem. We have worked out the cost figures as fairly as we can and I believe that, so far as estimates can be, they are the right figures.
As the hon. and learned Member for Northampton knows, I cannot give detailed figures because they are the subject of Government contract and in the ordinary way one cannot do that, but I can tell him that the cost is based on the Mini-Minor, does not include a Purchase Tax element, is much more than 1680 the petrol tricycle to which he referred and on which he put too high a price, and that it does include, among other things, the annual increment of new patients which is not the case with the war-pensioner category.
§ Mr. Walker-Smith
I am sorry. I cannot give way. I have only three minutes left in which to say what I want to say.
§ Mr. Walker-Smith
I am sorry, but I cannot give way.
We have been left in some difficulty about the attitude of the Opposition in this matter, because we do not know whether they think it wrong now that there should be the traditional priority, or whether they think that if we could not do it for all, for economic reasons, we should not have done it for the war pensioners, as we did.
§ Mr. Walker-Smith
The hon. Lady objects, but we are in some difficulty about knowing what the Labour Party's policy is in this respect, because its election manifesto made no reference to the subject, so we are left in some difficulty about the views of hon. Members opposite.
§ Miss Herbison
If the right hon. and learned Gentleman would give way, there would be no difficulty.
§ Mr. Walker-Smith
We believe that our Amendment presents the facts of the situation accurately and in proper perspective. I submit that the House can be confident that we will pursue the well-being of these deserving people in all categories conscientiously, constructively and compassionately. I believe that the progress which we have made in the vast and varied field of the health and welfare services shows that that confidence is well founded and I ask the House now to endorse that view.
§ Question put, That the words proposed to be left out stand part of the Question:—
§ The House proceeded to a Division; but no Member being willing to act as Teller for the Ayes, Mr. SPEAKER declared that the Noes had it.1681
§ Proposed words there added.
§ Main Question, as amended, put and agreed to.
That this House congratulates Her Majesty's Government on the provision of cars for disabled war pensioners in place of power-propelled tricycles and on the speedy fulfilment of their pledge in regard thereto; records its awareness of their desire further to improve the vehicles provided for disabled National Health Service patients; but recognises that regard must be had to all relevant circumstances including cost and competing claims on the resources of the nation.