HC Deb 04 May 1960 vol 622 cc1162-6

7.15 p.m.

The Minister of Health (Mr. Derek Walker-Smith)

I beg to move, in page 1, line 15, to leave out remedial gymnasts and speech therapists and to insert: and remedial gymnasts.

Mr. Speaker

It occurred to me that it might be for the convenience of the House to discuss with this Amendment the Amendment to the First Schedule, in page 14, line 8, in the name of the Minister and all succeeding Amendments down to and including the Amendment in page 17, line 29.

Mr. Walker-Smith

I am grateful to you, Mr. Speaker, for your indication that with this Amendment we may discuss the six other Amendments to which you have referred. It is necessary for me to move this Amendment to provide for the exclusion of speech therapists from the Bill and the consequential arrangements which flow therefrom.

The basic principle in regard to this I stated on Second Reading, when I said: I agree with my hon. Friends that we would not want to compel any organisation to come within the terms of the Bill. If we are not able to persuade the speech therapists of the advantages of remaining covered by the Bill I will take the responsibility of moving an Amendment to exclude them."—'[OFFICIAL REPORT, 30th November, 1959; Vol. 614, c. 917.] I am sure this principle is right. Inclusion should be regarded as a privilege, not as a penalty, and entry should be by way of conviction and not compulsion. I have conscientiously tried to convince the speech therapists. I tried unsuccessfully after the Second Reading. In Committee, several hon. Members expressed themselves strongly on the advisability of the speech therapists coming in, in their own interests, and I undertook to make further efforts. I think that the rest of the story of the efforts that I made perhaps emerge most clearly from my correspondence with the speech therapists which, with the permission of the College of Speech Therapists, I shall read. I wrote to them on 2nd February. I for my part remain convinced that it would be unfortunate, both in general and for your profession in particular, if I had to move amendments excluding speech therapists from the Bill. I hope, therefore, that the College will even now reconsider their position; if a further discussion with me would be of help I should be very willing to meet you again in order to clarify the points which seem to me of major importance and to learn from you whether there are any amendments which can be made, without prejudice to the general scheme of the Bill, to allay the doubts —unnecessary, in my view—at present felt by your members. To that they answered on 8th February: We are, of course, very willing to come and see you, should you so desire. You will appreciate, however, that the decision of the profession was reached after thorough consideration over a period of years, of all the preliminaries leading to the Bill, the Bill itself, the Second Reading, and the reports of the Committee Stage. We are convinced there are no amendments which, without prejudice to the structure of the Bill, would make it acceptable to our profession. The membership of the College of Speech Therapists adheres to the conclusion communicated in my letter of 27th January, and I now finally confirm the request to you to move the amendment to exclude Speech Therapists from the Bill, at the Report Stage. We must appreciate the personal attention you have given us in this matter. I wrote again: I think it is right at this stage to put formally on record my view, and that I think of Members of Parliament generally, that the profession's decision is an unfortunate one. I have no doubt that your fears as to the possible ill effects on speech therapists which might result from the Bill are unfounded; on the contrary, I think that participation in the scheme for statutory registration would bring real benefits to the profession. As I have already indicated, I am unable to accept the argument that speech therapists are not a profession supplementary to medicine, or that their position is essentially different from that of the other professions covered by the Bill. It follows, therefore, that when the amendments you ask for have been made and the Bill has become law, it will be necessary for speech therapists, unlike other supplementary professions, to continue to be subject to regulations on the same lines as the National Health Service (Medical Auxiliary) Regulations, 1954. Courses of training leading to qualifications entitling the holder to employment in the National Health Service will thus continue, as at present, to require the approval of the Minister of Health. I should like to add that I and my officers are at your disposal if at any future time you should feel that further discussions might be of value. To that they replied on 7th March: We welcome your decision to move the necessary amendments at the Report stage to exclude the profession from the Bill. This as you know is the corporate wish of the profession… We note the profession will continue with regulations similar to those existing at present. In due course we shall be very glad to take up your kind offer of further discussions. On behalf of the members of the College, once again I should like to convey to you and your officers most sincere thanks for all the help you have given us. That is the position at which we arrived.

As the House will see, there are no hard feelings between us and the speech therapists about our view as to what is the best course for them and themselves believing in the Tightness of their view. They clearly and unequivocally object to inclusion. I am honouring the undertaking which I gave to move Amendments for their exclusion, without in any way altering my view. If at any time in the future the speech therapists come to take a different view, the machinery of Clause 10 is available to them.

There are no serious, let alone, insuperable, mechanical or consequential difficulties about the composition of the Council. The other Amendments which we are now discussing deal with that aspect of the matter. The basic principle for the composition of the Council is to maintain the numerical equality between the representative Members on the one hand and the medical members on the other. It follows, therefore, that now the number of medical members must be reduced by one to conform to that principle. As the House will see, at present there are eight representative members provided for by paragraph 1 (1, c) of the First Schedule and there are eight medical members comprising two under paragraph 1 (1, b) and six under (d), (e) and (f).

The House will agree that the simple solution is to reduce the number of members appointed by the Minister of Health from four to three and to provide that of those only one instead of two must be a registered medical practitioner. That is the point of the Amendments in page 14, lines 15 and 18.

No other changes are necessary and the total membership of the Council will thus be 21 instead of 23. By these Amendments, we have met the position imposed on us by the unwillingness of the speech therapists to come into the scheme.

Dr. Edith Summerskill (Warrington)

I have listened very carefully to what the Minister has said and I think that he has proved to the House that he has done his very best to persuade speech therapists to come into the Bill. I asked him whether at the eleventh hour he would try again, as on the first occasion he had laryngitis and perhaps could not bring sufficient pressure to bear upon them.

I must confess that if I had not been associated with these negotiations, I would not have believed that any professional body would have refused to have been associated with the Bill. It is astonishing that, having had it carefully explained to them on two or three occasions that it would enhance their professional status—and I have written letters rather similar to those written by the Minister—still the speech therapists have adopted the very bad advice of people who feel that it is better for them to remain outside the Bill's provisions.

The Minister has had no option but to move the first Amendment and, of course, all the related Amendments are consequential. I thank him for trying once again to persuade this group to join the other supplementary professions and I think that we all deplore the fact, that the right hon. and learned Gentleman has not been successful.

Sir Hugh Linstead (Putney)

I thank my right hon. and learned Friend for having so amply fulfilled the undertaking which he gave at an earlier stage that, unless the decision were taken by the speech therapists, he would himself take the initiative to remove them from the Bill. I do not regard their decision as quite so tragic as does my right hon. and learned Friend and the right hon. Lady the Member for Warrington (Dr. Summerskill). Indeed, the measure of the case for bringing them into the Bill and the measure of the arguments which my right hon. and learned Friend has advanced to try to persuade them is a measure of the strength of their case on the other side. They obviously feel, as I do, that the arguments on both sides are fairly evenly weighted. I know that it is only after the greatest care and deliberation that they have come down on the side which they have chosen.

I was particularly glad to hear the very clear reference which my right hon. and learned Friend made to the fact that Clause 10 provides a door which can be opened for them at a later stage. He made it perfectly clear tonight that there would be no grudging acceptance of a proposal from them—it may not be for a period of years—if they decide, on reflection, to change their views.

I am sure that my right hon. and learned Friend is aware of how important is the compromise represented by the Schedule in securing support for the Bill. I hope that when the Bill goes to another place, he will use his influence to make certain that no changes are made in the very carefully balanced composition of the Schedule.

Amendment agreed to.