NATIONAL HEALTH SERVICE CONTRIBUTIONS

HC Deb 08 February 1961 vol 634 cc533-91

10.25 p.m.

The Financial Secretary to the Treasury (Sir Edward Boyle)

I beg to move,

1. That the rates of National Health Service contributions be increased by substituting the rates specified in the Table set out below for the rates set out in the Schedule to the National Health Service Contributions Act, 1958.

2. That it is expedient to amend the National Health Service Contributions Act, 1957—

1. (a) so that enactments relating to national insurance passed subsequently to the National Insurance Act, 1956, shall be deemed to have been included among the National Insurance Acts referred to in the said Act of 1957;
2. (b) so that the provisions of the said Act of 1957 as to the expenses of the Minister of Pensions and National Insurance shall be deemed to have applied to the expenses of other government departments and to have included provision in respect of accruing liabilities for pensions and other payments and in respect of the use of premises belonging to the Crown; and
3. (c) so as to authorise the Treasury, instead of the Minister of Health and the Secretary of Stale, to make regulations under the said Act of 1957.

3. That there be paid into the Exchequer any increase in the sums so payable by virtue of the said Act of 1957, being an increase attributable to the increases in rates of contributions and the amendments referred to in the preceding provisions of this Resolution.

4. That it is expedient to make provision for other matters incidental or supplementary to the matters aforesaid.

TABLE
Description of person	Weekly rate of contribution
	s.	d.
1. Employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment	2	8½
2. Employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment	2	0½

Description of person	Weekly rate of contribution
	s.	d.
3. Employed boys and girls under (he age of 18	1	4½
4. Employers		7½
5. Self-employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment	2	10
6. Self-employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment	2	2
7. Self-employed boys and girls under the age of 18	1	6
8. Non-employed men between the ages of 18 and 65	2	10
9. Non-employed women between the ages of 18 and 60	2	2
10. Non-employed boys and girls under the age of 18	1	6

We now come to the increase in the National Health Service contribution of 1s., and I hope that it will be with the agreement of the Committee, after a not Wholly uncontroversial debate earlier this evening, if I confine myself in this speech to an exposition of the Government's proposals and do not indulge in a great deal of argument or justification. [Interruption.] There will be plenty of opportunity for more argumentative discussion in which I and others will be delighted to take part, but, solely from the point of view of the convenience of the Committee, I think that on this occasion hon. Members would prefer a speech mainly of exposition. [HON. MEMBERS: "No."] The Government have always accepted—

Mr. Richard Marsh (Greenwich)

On a point of order. Is it in order for the Financial Secretary to rise to speak on a controversial issue and to inform the Committee as he starts that he has no intention of putting the Government's argument in justification?

The Chairman (Sir Gordon Touche)

He can make a speech as he wishes.

Sir E. Boyle

The Government have always accepted the principle, embodied in the original National Insurance Act, which hon. Members opposite—

Mr. William Ross (Kilmarnock) rose —

Sir E. Boyle

—including the hon. Member for Kilmarnock (Mr. Ross)—

Mr. Ross

On a point of order. In his opening remarks the hon. Gentleman said that he intended to present his case in some way which was convenient to the Committee. It was obviously not convenient to this side of the Committee. Can the hon. Member be permitted to continue in that way?

The Chairman

That is not a point of order.

Mr. Sydney Silverman (Nelson and Colne)

Further to that point of order. In defence of the hon. Gentleman, if he has no argument in justification, how, as a matter of order, can he possibly advance one?

The Chairman

The hon. Member knows perfectly well that that is not a point of order.

Mr. Emrys Hughes (South Ayrshire)

On a point of order. May I ask for your guidance, Sir Gordon? Do these proposals apply to Scotland? If so, where are the Scottish Ministers?

The Chairman

That is not a matter for me.

Sir E. Boyle

The Government—

Mr. A. C. Manuel (Central Ayrshire)

On a point of order. My hon. Friend the Member for South Ayrshire (Mr. Emrys Hughes) asked whether this increase in contributions would apply to Scotland. I think that we must have an answer to that and have a Scottish Minister on the Government Front Bench, and—

The Chairman

Order. That is not a point of order.

Sir E. Boyle

The Government have accepted the principle, to which both parties are committed—

Mr. Emrys Hughes

On a point of order. I asked for your guidance, Sir Gordon. I asked only whether this increase applied to Scotland.

The Chairman

That is not a matter for me.

Sir E. Boyle

—that it is reasonable to make some contribution income available for financing a part of the Health Service. As the Committee will be aware, under the 1946 Insurance Act the contribution towards the Health Service was £40 million. In 1957, and again in 1958, rather than reduce the Service, the Government decided to raise the contribution. In 1957, the total contribution was raised to 1s. 8d. and, in 1958, to 2s. 4d. It will have remained at that higher level for three years, and during this period the gross cost of the National Health Service has increased from £675 million, which was the estimate for 1958–59, to approximately £850 million, which is the estimate for the forthcoming financial year.

10.30 p.m.

The annual yield after the 1958 increase was £112 million. We propose further increases in contribution, as I will explain in a moment, which will raise the total net yield, after allowing for the expenses of collection, to £161 million in a full year, which means an increase of £49 million. It is the Government's proposal to bring the new rates of contribution into effect on 3rd July, if these proposals are approved by Parliament, so that the yield in the first year will be £148 million.

This increase of £49 million in the contribution over three years must, in all fairness, be contrasted with the increase of £175 million in the gross cost of the Service, and I must make this point for comparison, that we are aiming to cover, as a result of increasing the contribution, less than one-third of the rise in total expenditure since the last contribution increase.

Now I come to the details of the Government's proposals. The proposals are, first to increase the contributions by 10d. for an employed man, 8d. for a woman and 6d. for a boy and girl, with 2d. on all contributions from employers. The result will be that the employed man will pay a total of 2s. 8½ d, a week and his employer 7½ d. The total new contribution rate will be £7 a year. In fact, the employed man will have to pay only 2s. a week more than in 1948.

The increases for the self-employed and non-employed will be 8d. for a man, 6d. for a woman and 4d. for a boy and girl. As a result, for example, the self-employed man will pay 2s. 10d. At this level the self-employed man will be paying rather more—1½ d. more, in fact—than the man in employment, but rather less than the total contribution for the employed man when we take into account the employer contribution as well, and the Government feel that this is about right. When the scheme was originally started, the self-employed man paid as much as a total contribution on behalf of the employed man. If that principle had been continued a self-employed man would, under our new proposals, be paying 3s. 4d. instead of 2s. 10d.

We think that there is a case for affording some marginal relief to the self-employed man, but the relief should not be such that his level of contribution is reduced to that borne by the employed man personally. We do not want to get too far away from the original concept of the 1946 National Insurance Act, that the Health Service was entitled to receive as much altogether in respect of a self-employed person as in respect of an employed person since it provided the same benefits for all. Furthermore, the employer's contribution is part of what have come to be called "fringe benefits", and the payment of this contribution may have a marginal effect on an employer's ability to pay a higher wage.

We also propose, by the terms of this Resolution, and in the Bill which the Government hope will be founded on it, to take the opportunity to make one or two amendments to the 1957 Act, notably to substitute an up-to-date definition of liability to pay the contribution, for a definition which, with the passage of events, has now become out of date, and to make the position clear on this question of expenses of contribution, so that as from the passing of the 1957 Act the full costs of collection—for instance, including charges for staff superannuation and accommodation—are to be treated as properly deductable from the yield before the net amount is paid over in aid of the Health Service Votes.

This is only an accounting detail. I should like to emphasise that it has no effect at all on the contribution levied from the contributor, nor on the total expenditure of the Health Service. But we are assured by our legal advisers that this is putting right a matter which has become wrong.

Mr. Eric Fletcher (Islington, East)

Is this proposal intended to be a retrospective operation?

Sir E. Boyle

Yes, it is. This is exactly the form of retrospective operation to which during our discussions on the last Finance Bill the Government said they had no objection. It is stating the law as everyone had hitherto supposed it to be. It is ensuring that the law is in fact what it had been supposed to be.

Mr. Hector Hughes (Aberdeen, North)

The hon. Gentleman is galloping through his speech on this important subject as though it did not matter. Will he treat it with more respect and proceed more slowly so that we can follow what he is saying?

Sir E. Boyle

I had completed what I had to say, and I was about to resume my seat. I apologise if I have gone too fast for the hon. and learned Gentleman. The House heard from me earlier this evening, and we shall have many more opportunities to discuss this. I therefore thought that I would content myself with a relatively brief explanation.

Mr. Douglas Houghton (Sowerby)

The hon. Gentleman was much more at ease in explaining these proposals than he was a few moments ago in defending them. I am sure that he need not hesitate to give the Committee the justification for these proposals. It is very considerate of the hon. Gentleman to study the convenience of the Committee, but I assure him that my right hon. and hon. Friends are entirely at his disposal. If a little later he feels moved to return to that part of his speech which he omitted, we shall be very glad to hear it.

What the hon. Gentleman did for the most part of his speech was to explain some of the detail which would be more suitable to the Committee stage of the Bill. What we wish to do in the time available is to consider some of the fundamental aspects of the proposals. We on these benches deeply regret that this House rejected the Motion of censure on the Government for introducing these proposals along with others connected with the Health Service. Had that Motion been carried, it would have swept away the whole apparatus of charges and contributions, and, of course, the Government would have been swept away with it. But the House has decided that we must now give attention to the legislative mechanics of the proposals which the Minister of Health announced the other day.

This Motion is a sort of slipway down which the Bill will be launched, we expect next week. We are against the Bill, so we are against the slipway. We shall oppose this, and we shall oppose the Bill. We shall pray against Orders; we shall, in fact, oppose the whole lot from beginning to end. That gives the benches opposite fair warning of what is coming to them.

An important question which the Committee ought to consider for a few moments is whether taxation should be introduced in this way and at this time before the Budget. There will be no dispute now that these contributions are a tax. The Minister this afternoon referred to them as a sort of poll tax. In any case, we have the authority of the Sunday Times, and we also notice in the Motion that the proceeds of these contributions will not go into the National Insurance Fund but will be paid over to the Exchequer. So these contributions have every appearance of being a tax.

The proceeds of this tax amount to almost £50 million in a full year, and we are entitled to ask the Government whether additional taxation should be levied in advance of the Budget, when we can see the whole conspectus of the national economy and the outturn of the year's revenue and expenditure, and see how the Chancellor proposes to meet the Exchequer obligations for the coming year. Before we even consider the proposed increases in National Health tax, we should like to know, for example, what the Chancellor is going to do about Surtax. We should also like to know whether he will give concessions on Schedule A Income Tax amounting to about £30 million. How is the Chancellor going to deploy the national finances? That is a very important question in considering this form of taxation.

I submit that no one would think of imposing additional taxation on motor vehicles in advance of the Budget on the ground that the cost of road building was proving too much for the Exchequer to bear, yet that principle is followed in connection with these proposals. This has happened twice before. In 1958, the proposed increases in National Health contributions were announced in March, before the Budget. In 1957, the Government announced their intention of imposing charges for the first time before the Budget, although it so happened that the Second Reading of the Bill took place on 8th May—on the day following the Second Reading of the Finance Bill. It is a coincidence that the right hon. Gentleman who was then Financial Secretary moved the first Ways and Means Resolution imposing the National Health contributions in 1957.

It is not without interest that in 1957, when additional revenue from National Health contributions was being obtained—

Mr. E. Fernyhough (Jarrow)

On a point of order, Mr. Deputy-Speaker. Can you ask the Patronage Secretary to conduct his conversation outside the Chamber?

The Chairman

That is not a point of order for me.

Mr. S. Silverman

Are you really ruling, Mr. Deputy-Speaker, that if hon. and right hon. Members conduct private conversations in the Chamber in so loud a voice as to prevent us from hearing the pearls of wisdom coming from either side of the House, it is not a point of order for you?

The Chairman

That situation did not arise. I did not hear the Patronage Secretary's voice at all.

Mr. Houghton

I was saying that in 1957, when the first National Health Service contributions were introduced on the ground that the cost of the Health Service was growing too heavy for the Exchequer to bear, at the same time one Income Tax concession alone was the equivalent of half the imposition then being brought in on the National Health Service. The earned income relief of two-ninths was increased on the higher incomes, from £2,000 to £4,000 a year, a new earned income relief of one-ninth was introduced on earned incomes from £4,000 to £10,000 a year, at the same time as the imposition of the first National Health Service contributions.

10.45 p.m.

In 1958, we had a further increase in the National Health Service contribution. It is true that in the Budget of 1958 no such spectacular concessions were made in the sphere of taxation because 1958 did not happen to be an election year. But in 1959, the year after the introduction of still higher contributions, tax reliefs totalling approximately £300 million were given in the Budget of that year. Naturally, therefore, at a time when we are asked to assent to a very sharp increase in the National Health contribution, we should like to know what tax concessions the Chancellor is going to make in his Budget in a few weeks time. Perhaps the Financial Secretary can give us some assurance that this year's increases in the contributions will not be accompanied by substantial tax reductions.

Sir Hugh Lucas-Tooth (Hendon, South)

Did the hon. Gentleman vote against any of these tax reductions, or did any Members of his party?

Mr. Houghton

What we did do was to vote against the National Health Service contribution increase. Hon. and right hon. Gentlemen opposite voted in favour of an additional contribution and in favour of reduced taxation at the same time, because, apparently, they believed with the then Minister of Health that the growing burden of the cost of the National Health Service was more than the Exchequer could be expected to bear; and, presumably, that is the foundation of the proposals which are before us at the present time.

The first thing we have established is that this is a tax. The second thing we have done is to criticise the imposition of additional taxation before the Budget and without knowing the general contours of the financial situation and Chancellor's intentions.

Sir Douglas Glover (Ormskirk)

The hon. Gentleman has referred about four times to the enormity of doing something before the Budget. I remember that the hon. Gentleman was in favour of the Chancellor altering the rates of Purchase Tax before Budget because it was retarding trade. If a reduction in that way is supported, why is this not supported?

Hon. Members

This is an increase.

Mr. Houghton

The trouble with hon. Gentlemen opposite is that first they see things upside down, and secondly, they are so insensitive that it is necessary to repeat four times the enormities of their conduct, otherwise it does not register with them at all.

Mr. S. Silverman

It does not anyway.

Mr. Houghton

The next thing we have to consider is whether the new contributions are a fair tax. Listening to the Minister of Health earlier, I thought he seemed to stress the fact that the ratio between the flat-rate contributions and earnings in 1946 was very little different from the ratio between the new higher rate of contribution and earnings today. I see no merit in that comparison. What the Minister was surely suggesting was that the 1946 standards of social services taxation should be permanently maintained. That is a curious doctrine, because in no other field of taxation have the 1946 standards been maintained. I really could not understand the force of the point he was making.

He also referred to the proportion which contributions were to find towards the total expenditure of the National Health Service. He said that in 1946 it was 21 per cent. and in 1961 it would be 16 per cent. and there seemed therefore to be some merit in that too. I do not acopt that doctrine either. There is no comfort whatever to the benches opposite, either in the Beveridge Report or what has happened since, to the belief that this kind of ratio should be permanently maintained—none at all. In fact, Beveridge referred in his Report to the provisional nature of his own suggestions and said that obviously they would have to be reviewed in the course and in the light of experience. We cannot see that there is any merit in the Government view that we should maintain the ratio between the flat rate contribution and earnings or maintain the ratio between the total yield of contributions and the gross cost of the National Health Service.

Let us look at another aspect of this as a form of taxation. The new and high flat rate contribution from 3rd July, taking into account the National Insurance contribution as well, will be 10s. 7d. a week for a man. That is £44 4s. a year in tax. The curious thing is that 10s. 7d. in a flat rate contribution of this kind is equivalent and no more than equivalent to the amount of Income Tax that is paid by a single man on £9 10s. a week, or a married man with no children on £12 a week, a married man with one child not over 11 on £14 a week, or a married man with two children not over 11 on £16 a week. In other words, it is levying on the workers a flat rate tax in many cases in excess of the amount of Income Tax we deem it equitable for them to pay. If we look at the graduated contribution on top of the flat rate contribution, we find that the amount which will be paid by workers in the various categories of incomes and differences of domestic circumstances will be several shillings higher than the amount of tax which they are called upon to pay.

In our submission, this form of taxation is likely to be more inflationary than other forms of direct or even indirect taxation. These are a direct stimulus to wage demands, and the first forewarning of them has already been given. We should bear in mind, in looking at this Ways and Means Resolution, that this contribution will have been increased by 100 per cent. since 1957 and doubled in three years. I think that in no other respect has there been a doubling of imposts of this kind.

Finally, in considering this Resolution, we are entitled to ask whether it is really necessary. Time and again throughout this debate and in previous debates which I have heard with care in recent days we have had this choice placed before us as if there were no other. The choice put before us is this, either we limit the Service or adjust the finances. That is the choice every time, and the Minister has defended what he is doing on the ground that it is indispensable to the expansion of the Health Service which he wishes to see.

Brigadier Terence Clarke (Portsmouth, West)

Who started this form of taxation?

Mr. Houghton

This form of taxation was started by the Conservative Government in 1957. When we consider the Bill, we shall go into this question of who started it and how it was started, because, it is about time that that ghost was laid—and it will be laid. When the time comes, I shall be able to quote from the Beveridge Report, going back to the conditions in which Beveridge first suggested that a grant-in-aid should be given from the National Insurance Fund to the National Health Service. But he said nothing about keeping the same ratio between contributions and the total cost, as the Government are apparently suggesting that it should be kept.

Brigadier Clarke

He had no responsibility. Who started the taxation?

Mr. Houghton

We have heard little of the hon. and gallant Member of late. His sepulchral tones have been missed in the House. He will have an opportunity later, for as long as he cares to speak, to elaborate any point which he wishes to raise.

I must come back to the choice which the Government put before the House and the Committee when making proposals such as those contained in the Ways and Means Resolution. I refer to the kind of incantation which was first started by the right hon. Member for Runcorn (Mr. Vosper), then Minister of Health, when he was speaking on this matter on 8th May, 1957. After referring to the rising cost of the Health Service, he said that a rise from 72 per cent. to 80 per cent. of the gross cost falling on the Exchequer was, the Government had decided, too heavy a burden for the taxpayer reasonably to be asked to bear. His words were, more than the taxpayer can reasonably be expected to bear."—[OFFICIAL REPORT, 8th May, 1957; Vol. 569, c. 989]. What is the difference between the taxpayer and the contributor under the National Health Service? They are both people who pay a form of taxation. These are both forms of taxation. The Financial Secretary to the Treasury suggested earlier that if public expenditure is hived off from the liability of the Exchequer, then in some way or other it ceases to be public expenditure. But it is public expenditure all the time. This money is going into the Health Service. It will be spent by the Health Service. It will be just as much for the Health Service as the money which it receives from the Exchequer.

This curious approach to the question of public expenditure shows a split personality. What the hon. Member means is, "We know that it will be public expenditure just the same, we know that it will be taxation just the same, but how differently it will be distributed. It will mean that the lower income groups will pay in this contribution an amount out of proportion to the direct taxation which is levied upon them under the Income Tax system". By that means the Government will be able to lower the charge on the higher income groups and to lower taxation on the very rich and on others who could well afford to continue to pay a full measure to the Exchequer for the National Health Service.

The real test is not the choice between the limitation of the Service and the adjustment of the finances. The real test is whether the expenditure on the Health Service can be accommodated within our national resources and also within the scope of our normal system of taxation, without undue burden upon the taxpayers generally. If the burdens are too heavy for the taxpayers to bear, they are too heavy for the contributors to bear. That is what the Financial Secretary never seems to appreciate.

There will be time enough to pursue these arguments and more when we come to the Bill. My hon. Friends will have more to say. Unlike the Financial Secretary, I have deployed enough of the arguments against the Resolution to justify our voting against it in due time.

11.0 p.m.

Mr. A. Woodburn (Clackmannan and East Stirlingshire)

I welcome the proposals for increasing hospital expenditure and improving hospitals. I wish that those proposals went even further.

As the Financial Secretary said, in measuring capital expenditure one has to divide the capacity of the country by different items. If one item is increased, unless the total capacity is increased it must mean a readjustment in other cases. I do not quarrel with that. It was because of that fact that the hospital programme suffered very sadly in the early years after the war. The hospital building programme had to be restricted because of the demand for housing, schools and other urgent priorities. I have no objection to that. Any Government must obviously take that step.

However, I was rather disappointed when the Financial Secretary confused expenditure by the Government and expenditure by the nation. It is curious reasoning to suggest that, merely because the Government shoves expenditure off their plate on to somebody else's plate, that is economising for the country as a whole.

The difficulty the Minister of Health has is that the overwhelming bulk of the National Health Service expenditure is on items with which he cannot interfere. Salaries, wages, nurses' conditions, and conditions of hours and service, are all negotiated outwith his control. This is where he must vie with his colleagues. If the Government want every Department to make a cut, the Minister of Health has no play in the Service, except in the relatively small items such as prescriptions and odd things on the tail end of the Service.

If every Department were ordered to cut its expenditure by 5 per cent., the Minister of Health would have to cut his expenditure almost entirely by wiping out the free prescriptions and free services for patients. The patient would have to carry the whole burden, because the Minister could not cut salaries.

This is one of the problems the Government sometimes face. My right hon. and hon. Friends and I faced it when we were in office. Every Department wants all its colleagues to share in the economies, but the National Health Service cannot do that, because the main bulk of its expenditure is on salaries and conditions.

During the period the Labour Party was in office the cost of the National Health Service rose. That was because when we took over nurses' conditions were deplorable. Hospital supplies were in a deplorable condition. One of the best hospitals in the country had completely out of date X-ray apparatus. It was only thanks to the disposal of war surplus goods that we were able to give hospitals decent equipment in the early days of the Service. There is, therefore, no question that we had at once to improve the nurses' conditions. As a result, the cost of the Service went up quite rapidly.

Today, the cost of the Service is rising rapidly because the Minister of Health has been compelled to give the doctors a very substantial increase, and the nurses' conditions have had to be improved—their conditions will have to be still further improved if the Service is to justify itself in future. Not even yet are we able to give the nurses the conditions that women in other services get, and if we restrict the Service to a ceiling we shall have to restrict the improvement in the nurses' conditions, and so run the risk of crippling the Service through lack of staff.

This idea of economising on the Health Service is rather curious. As far as I can measure it, every time we shift prescriptions from the free to the paying side their cost rises. The reason is that it leads to waste. Everyone knows that doctors will not compel poor patients to pay these huge prescription charges but will prescribe for more than is necessary in order that those patients do not have to return and pay once again.

I am quite astonished at the way in which right hon. and hon. Gentlemen opposite talk about this 1s. increase. I was told recently of an old-age pensioner in my constituency who had to leave the chemist's shop because she did not have a shilling with which to pay for her medicine, even though she could recover it from National Assistance. She just had not that shilling, and she had to do without her medicine as a result. Another old-age pensioner had five items—that is 5s. They will now cost him 10s.—

Mr. John McCann (Rochdale)

A fifth of the pension.

Mr. Woodburn

—and that old-age pensioner is not entitled to recover the charge.

How can any old-age pensioner pay these charges? I tell the Minister, quite seriously, that he will have to do something about this, otherwise the people who will be making all the economies will be those who will do without their medicines because they cannot afford to pay for them. I am quite sure that even hon. Gentlemen opposite will not want to economise at the expense of old people who are unable to pay for their medicine—

Mr. McCann

That is what they do want.

Mr. Woodburn

That is the curious thing. If one went to an hon. Gentleman opposite and said that one knew of a person who was in need of £1 or £2, he would probably put his hand in his pocket and produce it at once. That has always been one of the curious things. As Jimmy Maxton said, if a wee waitress were in some sort of trouble, any hon. Gentleman opposite would give her £1 or £2 to help her, but when we introduced the Catering Wages Bill to protect all the wee waitresses the whole Tory Party was organised to "down" the wee waitresses. It is exactly the same in this case. If an old-age pensioner from a constituency told an hon. Gentleman opposite that he needed something, he would get it.

Who is to benefit by this saving? My hon. Friend the Member for Sowerby (Mr. Houghton) is quite right; it may be a so-called reduction in taxation. I remember that when food subsidies were abolished there was a reduction in Surtax and other taxes. One very wealthy man I know got exactly £50 a year, while other people got 6d. a week. In order to give that man £50 a year that he did not want or need, and those other people sixpence a week that made no difference to them at all, the whole economy was upset for years by abolishing the food subsidies. When all this is done, some wealthy person who does not need it will get the price of an extra dinner per week. This is supposed to be an extra inducement to him to work hard. It is such stupid nonsense that I cannot understand why anyone should put the argument forward.

It is quite true that the costs have risen, but why have they risen? I put a Question to the Minister the other day about this, and I understand that the net cost of prescriptions in real terms has risen by 24 per cent. Since 1950, there have been introduced into this country, or there have been discovered, new medicines and cures which, admittedly, are very expensive. They have put up the cost of prescriptions very considerably, but, of course, they have saved a tremendous number of lives. Our tuberculosis hospitals and wards have been practically emptied, for example.

I can give some facts and figures in regard to what has happened in Scotland since 1947. Deaths from acute infectious diseases fell from 338 in 1947 to 29 in 1956. For diarrhoea illnesses, the number fell from 1,281 to 166, and for tuberculosis it fell from 4,095 to 801—practically wiped out. In the case of tuberculosis, of course, now that the disease has almost been wiped out, hospitals about to be built at the cost of millions did not need to be built because of the progress in new drugs and treatment which had been made. The incidence of pneumonia and bronchitis has come down, though, as we know, cancer and heart diseases have grown in importance. In 1855, one out of every 400 persons died of tuberculosis. Now, the rate is one in every 5,000, and it is decreasing.

If the Government want to save expenditure by transferring Government expenditure on to the private individual or to somebody outside, why pick on the Health Service? Why not take the Defence Services? Most of what the Government raises by taxation goes on providing defence. This would be an excellent purpose to provide for by a contribution on a stamp. Why not pick on defence expenditure and make people pay according to the amount of money they are having defended by this country? That would be a very good idea. Let those who need the defence most, who have the most to defend, pay according to their needs. Why put it all the Health Service? We have no objection to having a try at what I suggest. It would save quite a lot of expenditure by the Government, and they would be able to reduce Income Tax tremendously. It could be put on a stamp tax, and I hope that it would be very stiff for the Surtax payer who gets so much out of defence.

Why not stop paying for sanitation? Why not stop paying the high cost of clean water? There are all sorts of things on which the Government could save expenditure. No one really needs clean water or sanitation. The fact is, of course, that these things were introduced into this country because, from the standpoint of real cost, they represent an economy for the nation, not a waste or extravagance.

If we talk of rising costs, we must bear in mind that the Service has been improving and we have had the benefit of the new and expensive drugs. Is the drug bill extravagant? It has gone up by well over 20 per cent. since 1950. We have had the miracle drugs which have reduced tuberculosis by 80 per cent. in twelve years. Also, doctors are able to treat many patients for pneumonia and tuberculosis at home, without having to send them to hospital, as they used to do. I believe that it costs £3 a day to keep some patients in hospital, and, of course, it is great saving if people can be cured at home. When treated with these drugs, however, tuberculosis sufferers may go back to work. As an economist, the Financial Secretry will realise that that is much more valuable than going into their graves. In the economic debate, we were told that we wanted to maintain the labour supply. Every man who can be maintained at work is an economy for the country, and this should be borne against the cost of these extra drugs. If the idea went as far as getting rid of sanitation and the rest to save Government expenditure, the hon. Gentleman would soon find that expenditure because of cholera, plague and the like would wipe out that idea of economy.

11.15 p.m.

I agree that excessive prescribing plays a part, but why should the patient be punished for that? I realise that where the auction sale goes on among doctors for patients, patients go along and persuade the doctor to prescribe for them; and, presumably, a doctor who prescribes more than another doctor collects more patients. That is why the Minister will not introduce free medicines for private patients. That would lead immediately to the auction sale procedure, and every doctor engaged privately would prescribe the "roof" for his patients to attract everybody else into his scheme. That could never be risked.

Over-prescribing is, I agree, a danger, but why punish the patient? That is the responsibility of the medical profession, some of whom may be sinners in this regard, as, I know, they were in my period of office. There is, however, no reason why old people should be deprived of their medicine merely because some people misbehave.

The number of prescriptions dispensed in the United States and in Britain has gone down. In Britain, I understand, it has gone down by about 23 million. In the United States, however, the cost has gone up far more than it has done here. My latest figures show that in the United States, costs had gone up by 49 per cent., whereas in this country they were up by 36 per cent. We are supposed to admire the service in the United States, but the cost has gone up very much more there. The latest figures show that in the United States the average prescription cost for those who want private prescriptions is £16 7s. 7d. against the figure for this country of £4 4s. 1d. Everybody knows that, in the United States, to become ill is a sure way to disaster and ruin.

The question is, how do we measure the cost of the Health Service? Is it merely by the expenditure of the Government, or by the expenditure of the nation as a whole? Does anyone suggest that the nation as a whole would pay the doctors less if we did not have the Health Service? Will people have less medicine if more is charged for prescriptions? With the exception of the old people, I do not think so. The medicines will simply be paid for out of another pocket. The wealthy and the well-to-do will be able to pay for their prescriptions, but they would rather pay for them when they are well than when they are ill. Why should a person who is sick or ill have to be bothered with the cost of prescriptions when he is quite willing to pay for them when he is well? What the public ask the Government to do is to collect this money in the fairest possible way and to arrange for the payment for prescriptions as the doctor prescribes them. It is extraordinary that we should interfere between the doctor and the patient.

My hon. Friend the Member for Sowerby has made quite clear that the Government's method of payment is not the fairest possible way and that taxation according to ability to pay is the way in which it should be done. I agree that if the bill is incurred it must be paid for by the public as a whole, but the public are entitled to have the payment made in the most economical and best possible way. I agree with my hon. Friend that the best way is to make the prescriptions the responsibility of the doctor and to ensure that in case of illness nothing interferes between the patient and the doctor.

The Conservative Party opposed the National Health Service, when the Act was going through the House, on the ground that it would interfere between doctor and patient. Members opposite delivered speech after speech saying that Labour Ministers would prevent doctors prescribing freely for the patients what they required. Their main spokesman at the time, Mr. Richard Law, now in another place, said: But there are two principles to which we attach enormous importance. The first is the principle that the doctor's only loyalty and only responsibility should be to his patients. The second principle is that as far as his judgment is concerned, the doctor should be responsible to nobody else but himself, and certainly he should not be responsible to the State."—[OFFICIAL REPORT, 30th April, 1946; Vol. 422, c. 76.]

While I am not prepared to go all the way with him in that statement, I say that the Conservative Party has now completely deserted even the platform on which it opposed the Naional Health Service. It is now the Conservative Government, not the Labour Government, who are introducing deterrents to the administration of the Service in the best interets of the patients; it is they who are now interfering between doctor and patient—and the responsibility for it must rest upon them.

I ask them, even at this late stage, to think not so much of the cold economics of this but of the human aspect. I hope that the Minister, if he must insist on these increased charges, will take steps to see that people like diabetics and others, who have a large number of items on prescriptions, get some concession, and that old-age pensioners are not deprived of the very meagre increase they have had in their pension by having it transferred to increased charges for prescriptions.

Dr. Barnett Stross (Stoke-on-Trent, Central)

I tried—

Mr. John Stonehouse (Wednesbury)

On a point of order, Sir William. May I seek an assurance from you that, so far as you are able, you will endeavour in this debate to call speakers alternately from each side of the Commitee, in order that we may, if we have the co-operation of Members opposite, have a fair debate?

The Deputy-Chairman (Major Sir William Anstruther-Gray)

It is entirely within the competence of the Chair who catches the eye of the Chair.

Mr. William Warbey (Ashfield)

Further to that point of Order, Sir William. Is it not a fact that since this debate was opened by the Financial Secretary we have had a succession of three speakers from this side of the Commitee and no speaker from the benches opposite? Is that in accordance with the traditions of this Committee when we are concerned with raising taxation affecting 23 million people?

The Deputy-Chairman

As the Committee knows, that is no point of order.

Mr. William Hamilton (Fife, West)

On a point of Order, Sir William. It is true that no Member opposite has risen to take part in this debate, though many of them have written in the Press and elsewhere in defence of these charges. We appreciate your position in that you cannot call people who do not rise. What would be the position if two or three of us on this side of the Committee went across to the benches opposite?

The Deputy-Chairman

As the Committee knows, that is not a point of Order. Dr. Stross.

Mr. Dudley Williams (Exeter)

On a point of order, Sir William. Would it be in order if some Members opposite came to this side of the Committee? They might be on the winning side for a change.

The Deputy-Chairman

Order. The Committee must get back to its business. Dr. Stross.

Dr. Stross

I tried to listen as attentively as possible to what the Financial Secretary said when he introduced the Motion. It was not easy all the time, and if I make a mistake in covering some of the things he said and in asking him some questions, I know that he will correct me, and I shall be delighted if he does so.

I think that he pointed out that the contribution was £40 million in 1946 and that that sum represented a levy of 10d. per head in the stamp. So far I am correct? Of course, in 1946 there was no Health Service. We were merely debating it and we had the Committee stage upstairs. The first full year was 1949–50, and I presume that I am right in saying that at that time the contribution was still 10d. and that it remained at 10d. all through the years until 1957, when it was doubled, and then raised to 2s. 4d. in 1958. Now we have this further rise. Now, instead of £40 million we are to raise £161 million in a full year?

Sir E. Boyleindicated assent.

Dr. Stross

Then I heard correctly, in spite of the Patronage Secretary who was sitting behind the hon. Gentleman at the time.

Why £40 million in a full year when the gross national product was £10,000 million and the gross cost of the Service was £381 'million—10 per cent. of £381 million gives roughly £40 million—and now 16 per cent. taken from the citizens by way of these contributions? On the figures I have received from the Minister this morning, following Questions which I put down for answer last Thursday—and I am grateful for the receipt of these figures which are as authoritative as can be—

Mr. Ross

The hon. Gentleman did not work them out; he got someone else to do that.

Dr. Stross

I know, but a great deal of trouble must have been taken by the civil servants, the workers, in the Ministry to prepare them, and I know that hon. Members will be interested to read them in HANSARD in the morning when they will be able to study them; the copy I have in my hand is the only copy I now have available.

11.30 p.m.

The Ministry gives the figures that in the first full year of its operation the gross cost of the Health Service was 3. 8 per cent. of the gross national product. That figure fell year by year until in 1959–60, the last year for which I have figures, it was 3. 6 per cent.—. 2 per cent. below that at the time when Stafford Cripps is supposed to have economised on the Service. The hon. Gentleman told us that in the last accounting year the figure reached the 1949–50 level, so that in this last year we have reached the figure for the first full year.

That does not seem to be extravagance. When the Guillebaud Committee investigated costs of the Service, it said that between the first full year of the Service, 1949–50, and 1953–54 there was such an improvement by way of economies and streamlining that a true £67 million was saved in terms of goods and services. That was an important announcement. He will remember that the then Minister of Health, the right hon. Member for Thirsk and Malton (Mr. Turton), said some very pleasant things about the Committee and its findings and said how reassuring they were. He pointed out how gratifying it was to the House and to him in particular that the Service was so efficiently organised.

Why this sudden change whereby we are faced with a demand for £161 million which, I am told, is 16 per cent. or 17 per cent. of the total gross cost of the service for this next year, as against the 10 per cent. that we asked from men, women and children throughout these other years until the Conservative Government began to impose this type of charge? I do not think that I am going wide of the rules of order when I ask that we should get some explanation.

We have heard that we could get economies in drugs. Of that there is not much doubt. I was advised by the head pharmacist of one of the greatest teaching hospitals in this country, which is not far from this House, that by purchasing abroad only one drug, Tetracycline, he saved his hospital £1,000 a year; and that is just one item.

The Financial Secretary and the Minister will know that with group buying, or collective buying—and that does not mean bulk buying, which is something different—as is done by the Southwest Metropolitan Hospital Board, on an annual expense of £300,000, there is a saving of 10 per cent.—£30,000. Would it not be pleasant to have a 10 per cent. saving on the cost of drugs throughout the whole of the Service?

That would amount to about £9 million all over the country, a very useful sum of money.

Mr. Julian Snow (Lichfield and Tamworth)

Is my hon. Friend aware that last October, for the first time, there was introduced into the standard contractual terms a clause which specifically prohibited the purchase by hospital groups of drugs from abroad, in flat contradiction to the provisions of Section 46 of the Act? [HON. MEMBERS: "Why?"] In order to prevent importations.

Dr. Stross

I am not sure about that. I rather doubt whether that clause is not common form for some hospital management committees.

Mr. Snow

Yes, it is.

Dr. Stross

I do not think it means a thing. At any rate, we have a right to tell the Minister and the Financial Secretary that they should look at these matters most seriously.

Now that I have been drawn as far as this on the question of drugs, may I say that I have an interest, and I wish to declare it, because for some years I have been a director of a small firm which sells drugs to the hospitals. Perhaps that is why I know something of the subject. I declare my interest frankly and openly.

I beg the Minister and the Financial Secretary to look at the problem to see whether we can get substantial savings, as I have said by encouraging collective buying and not paying extortionate prices. There is evidence that £30,000 a year is saved in one regional group by this means. I think it is possible that if such steps are taken by the Minister a salutary effect will be produced on the industry as a whole. Once we make people careful and make them realise that they must not exploit the taxpayer, all the way down the line we shall get real competition instead of a closed shop. I think that that would be a very good thing in this industry.

Mr. John Diamond (Gloucester)

Can my hon. Friend, with his wide knowledge and experience of this industry, say whether it would be wholly beneficial also if the Government were to take powers to ensure that they knew the cost of manufacture of all goods supplied?

Dr. Stross

The Minister has told us that he will take steps towards achieving this. We urge him to do so as quickly as possible, and as thoroughly as possible. So far as we know he has not yet done it. He has not been Minister of Health for very long, but he must do this if he is to carry out his duties as Minister. He will never be forgiven if he does not act vigorously on this matter.

I mentioned that I had received information from the chief pharmacist at a great hospital. My hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) earlier gave fragmentary but interesting details of what is really happening to the people who have to pay increased charges for prescriptions, and what sort of people they are.

The Minister says that this charge is being imposed to keep the Health Service going and to make sure that hospital development is not impeded. It is therefore fair to mention this briefly. The chief pharmacist to whom I referred tells me that on 7th February he picked up at random a batch of 68 prescriptions and divided them into two groups. In one group he put those that he felt were once-and-for-all prescriptions; prescriptions for those people who would not come again. In the other group he put the prescriptions for patients who required frequent treatment. Of the total number of 68, 32 patients came in the second group. An analysis of those prescriptions showed that five patients required five items each visit; three required four items each visit; three required three items each visit; six required two items each visit; and the remaining fifteen one item each visit. He went on to describe the diseases involved, but I will not at this time of the night trouble the Committee with the details. Everybody knows them—diabetes, thyroid disease, rheumatoid diseases, psychiatric ailments, and so on. People suffering from any of those diseases must return to the hospital for treatment week after week, month after month, year after year, and some of them for a lifetime.

My informant, who is one of the great pharmacists in the country and a teacher of pharmacy at the university, is indignant about this charge. He wants the Minister to know, and we are telling him now, that we are not talking about frivolous people; the people who are supposed to come and ask for their medicines for a bit of fun—like the story we heard earlier that orange juice is used for making cocktails. We were not, however, told whether it was the babies or the parents who drank the cocktails. The Minister will find that not only virtually every doctor but every pharmacist deplores what he has done. Those people know something about this subject. The situation with regard to the dispensing of drugs in our great hospitals is very different from what one finds outside in general practice. In nearly every great hospital the pharmacist receives a prescription from a consultant, but he is not bound by that prescription. He can substitute a suitable alternative.

The Minister of Health (Mr. Enoch Powell)indicated assent.

Dr. Stross

I see that the Minister agrees with what I am saying. He knows that it is in order to supply a suitable alternative.

That is a very proper thing. Why is there not some slight control outside, in family doctoring? I will give one example, which I think is atrocious, of the way in which money is wasted. Soluble penicillin is made by different firms, under different branded names. It is given to babies, and does not have to be injected. There are five or six different branded types. Incidentally, I raised this matter about a year ago, but I had no satisfaction from the former Minister of Health, who was a very gracious holder of that office. I asked him why it was that the chemist was compelled to prescribe exactly according to the trade mark or brand on Form E.C.10.

A mother may go, at night, to her doctor, who prescribes penicillin for her baby, which has pneumonia. She goes with that prescription to the chemist, who has four of the brands but not the fifth, which is the one on the prescription. He is not allowed to give the mother any penicillin. If it is too late at night to do anything he must try to get it in the morning, and she must go to him again then, before which time the baby's condition will worsen without this life-saving antibiotic. What nonsense this is. [HON. MEMBERS: "Is it true? "] Of course it is true.

The right hon. Gentleman will have to find some means of providing cover for the chemist, so that he will not be sued by the owner of the trade mark mentioned on the prescription if he gives such a mother another brand. The doctor may also need to be covered. The right hon. Gentleman has been clever enough to try to force these increases on us, and he can surely try to protect the taxpayers by doing something on the lines I have suggested.

We are bitterly disappointed about the Minister's proposals. The right hon. Member for Woodford (Sir W. Churchill), after the publication of the White Paper of 1944, made a statement describing the sort of Health Service the country would have when victory had been won. He likened it to a great fire brigade, which could be called out by the tenant to the humblest cottage or the owner of the greatest mansion, and which would give equal service to both. But what is happening now? When the fire brigade calls, its members put their hands out and ask the tenant of the cottage and the owner of the mansion for money—and the same amount from both. They say, "We want 2s. 8d., or 2s. 10d. Pay, or we go back without giving you any help."

Mr. A. E. Cooper (Ilford, South)

I would not have made any contribution to this discussion had it not been for the speeches of the right hon. Member for Clackmannan and East Stirlingshire (Mr Woodburn) and the hon Member for Stoke-on-Trent, Central (Dr. Stross). There seems to be a feeling among hon. Members opposite that hon. Members on this side of the House are very hardhearted individuals and that our sole inclination in life is to grind the noses of the poor in the dust. I would like them to realise that in the majority of divisions there is a very substantial working-class element.

Mr. S. Silverman

I bet you did not tell them about this.

Mr. Cooper

Over the period of the last three General Elections, the Conservative Party has increased its majority substantially. Sitting opposite me tonight is the hon. Member for Willesden, West (Mr. Pavitt), who is a resident in my constituency and knows something of my record over the last 26 years. During that time, I have represented the Borough of Ilford as a councillor, alderman or Member of Parliament, and throughout the whole of that time, in an area half of which is strongly working-class—including workers for the Ford Motor Company and similar firms—my majority has consistently increased.

11.45 p.m.

I very much regret that since about seven o'clock tonight hon. and right hon. Members opposite seem to have treated this whole subject in what I think is a very hilarious and utterly irresponsible manner—[HON. MEMBERS: "Oh."]

Mr. Laurence Pavitt (Willesden. West) rose —

Hon. Members

Sit down.

The Chairman (Sir Gordon Touche)

Order. If the hon. Member for Ilford, South (Mr. Cooper) does not give way, the hon. Member for Willesden, West (Mr. Pavitt) must resume his seat.

Mr. Cooper

After the second Division took place—

Mr. Pavitt

On a point of order, Sir Gordon. The hon. Member for Ilford, South (Mr. Cooper) mentioned my name in his speech more or less as a reference for a statement he made. Am I not entitled to challenge that statement?

The Chairman

The hon. Member may be allowed to challenge the statement, but not if the hon. Member for Ilford, South does not give way.

Mr. James Callaghan (Cardiff, South-East)

Further to that point of order, Sir Gordon. Would you remind the hon. Gentleman, who has been a Member of this House for a number of years, that when we are in Committee it is customary to give way. [HON. MEMBERS: "Oh"] it is so long since some hon. Members were here that they do not remember what is the practice of the House. It is usual to give way in Committee, especially when a reference is made to another hon. Member.

The Chairman

That is not a point of order for me.

Mr. S. Silverman

Has not it been the invariable custom of the House, whether we are in Committee or not, that if an hon. Member deliberately misrepresents what another hon. Member has said it is customary for the hon. Member who claims to have been misrepresented to be allowed by the hon. Member who has the Floor to explain what the misrepresentation was?

The Chairman

I do not think that arises on this point.

Mr. Cooper

The hon. Member for Nelson and Colne (Mr. S. Silverman) should know that the hon. Member for Willesden, West (Mr. Pavitt) has not spoken yet and so I have not misrepresented anything he has said. I simply called in aid his knowledge of my service to the borough that I have represented over the last twenty-six years, and—

The Chairman

Order. I think it would be better if the hon. Member returned to the Motion.

Mr. Cooper

Since about twenty minutes past ten certain hon. Members opposite have treated this very important subject with a great deal of irresponsibility. By a number of interruptions they have behaved like children. They have not conducted themselves in the manner of adult people or in a way in which the people of this country are entitled to expect from Members of the British House of Commons.

Mr. W. Hamilton

On a point of order, Sir Gordon. Will hon. Members on this side of the Committee be entitled to reply to these charges if they get an opportunity?

The Chairman

Hon. Members can make speeches when they are called.

Mr. Hamilton

Will they be in order, as the hon. Member for Ilford, South (Mr. Cooper) is in order, in referring to the behaviour of other hon. Members?

The Chairman

When the speeches are made we shall see whether they are in order.

Mr. Charles Loughlin (Gloucestershire, West)

Further to the point of order, Sir Gordon. It is essential that it should be ruled now whether that would be in order, whether it is possible to make references of this kind, lest the matter should come up again later. If the hon. Member for Ilford, South (Mr. Cooper) is entitled to do so, I assume that we shall be entitled to do so.

The Chairman

What I am dealing with at the moment is the speech of the hon. Member for Ilford, South, which has not been out of order so far. It is desirable, however, that the hon. Member should come back to the Resolution.

Mr. Hector Hughes

The hon. Member talks about irresponsibility. I do not think he was here when the Minister treated the Committee with great disrespect by galloping through his opening statement on the Resolution at such a speed that we could hardly understand what it meant.

Mr. Cooper

I cannot help it if my hon. Friend speaks in English which is not readily understood by Scottish hon. Members. I have been here all the time since seven o'clock and have listened to every word that has been spoken. If I may continue—

Mr. Ross

Is it in order to call an Irishman a Scotsman?

The Chairman

It is not out of order.

Mr. Pavitt

On a point of order, Sir Gordon. Is it in order for the hon. Member for Ilford, South to make statements about the way in which hon. Members on this side of the Committee are treating the debate when hon. Members behind him are exercising a considerable amount of levity?

The Chairman

That is not a point of order.

Mr. Cooper

The exchanges in the last five minutes sufficiently underline all I have previously said. It is deplorable—[HON. MEMBERS: "Hear, hear."]—that hon. Members should behave in this manner.

Mr. George Thomas (Cardiff, West)

Would it be in order for the hon. Member for Ilford, South to refer to the health charges?

The Chairman

I have been trying to encourage the hon. Member to do that.

Mr. Cooper

The hon. Member for Ilford, South would be delighted to get on with his speech if allowed to do so.

What we are thinking about and discussing tonight is how the National Health Service of the future should be financed. I think the right hon. Member for East Stirlingshire was very constructive in the early part of his speech in which he laid down the difficulties with which the Labour Government were certainly faced in seeing how it should be financed. There is no doubt that this Service is developing, perhaps faster than many thought it would, say, ten or fifteen years ago when it was initiated. [Interruption.] I wish hon. Members would pay some attention to the facts and not try to tub-thump as if there were an election three weeks ahead. The facts are—[Interruption.] Hon. Members opposite can shout and scream as long as they like; it will not worry be in the slightest.

The facts are that the Health Service of this country under Conservative Governments in the last ten years has developed out of all knowledge and is the envy of the world. The question we face in this Committee of the House of Commons tonight is how its future development is to be financed. I admit quite frankly that it is a matter for argument whether it should be financed one way or the other. I do not deny the right of hon. Members opposite to their view that it should be financed by direct taxation, but surely in accepting that we have a right to expect them not to deny us the right to a wholly contrary doctrine.

Mr. Scholefield Allen (Crewe)

The Tories have the benefit of their election pledges.

Mr. Cooper

The standard of living in this country has changed substantially in the last ten years, and now is the time when we must consider realignment of the method in which these things are paid for. Let us not think that those who are described as the poorly paid people are being badly treated. They are doing remarkably well.

Mr. Cyril Bence (Dunbartonshire, East)

Come to my constituency and say that.

Mr. James Dempsey (Coatbridge and Airdrie)

How are they doing well?

Mr. Cooper

I wish that hon. Members would listen. I have no desire to detain the Committee for more than a few moments. Hon. Members opposite grumbled because no one on this side of the Committee wished to take part in the debate, but the moment someone makes a speech all they do is interrupt him. What do they want—one way or the other.

The so-called working-class in this country do very well indeed. About 4 million to 5 million pay no Income Tax. Many draw family allowances. They can earn a substantial amount of money before they have to pay Income Tax. Many live in council houses at rents which are subsidised by others. They get many services for which they pay nothing, other than their contributions in indirect taxation. We hear a great deal about the Surtax payers and others in the higher income groups, but let us not forget that £1,000 a year is not a particularly high income these days. In many industries in my area workers earn £20 a week. Moreover, many people earning over £1,000 a year send their children to private schools at no cost to the taxpayer.

The Chairman

Order. I am sorry to interrupt the hon. Member, but he is going very wide of the Motion.

Mr. Cooper

Many things are paid for by the higher income groups which are not a charge on the Health Service or the hospital service. Hon. Members opposite should recognise that these people make a considerable contribution. I sincerely believe that the time has come for a reconsideration of the methods by which the Welfare State is financed. We have reached the limit to which the ordinary contribution can be raised. I do not think that it can be taken any higher than the figures in the Bill without serious social consequences, particularly in wage demands. The figure in the Bill is about the maximum we can ask. We must consider how the Welfare State is to be financed in the future. Unfortunately, at present it is financed on the nation's vices—tobacco and spirits, to a considerable extent.

Mr. S. Silverman

On a point of order. In seeking guidance for those who wish to speak later, I would point out that the hon. and gallant Member has spoken about Surtax, school fees, and a variety of other matters, and now proposes to speak about tobacco and spirits.

Mr. Bence

And vice.

Mr. Silverman

How wide is the debate to be allowed to range?

The Chairman

I have made several attempts to keep the hon. Member for Ilford, South (Mr. Cooper) in order. He is going wide again. If he continues like this, I shall have to ask him to resume his seat.

Mr. Cooper

Sir Gordon, I have endeavoured in the face of considerable provocation to keep in order.

Mr. G. W. Reynolds (Islington, North)

On a point of order. Earlier there were two hon. Gentlemen opposite who wished to speak, but the Patronage Secretary addressed them and they left. I am not sure that that was in order. Is it in order whilst an hon. Member is on his feet for the Patronage Secretary to tell him to sit down?

Mr. Silverman

In any case, why does he not?

Mr. Cooper

I do not know where the hon. Member for Islington, North (Mr. Reynolds) gets his peculiar ideas from. He must have very acute hearing, because my right hon. Friend and I had a quite different conversation. It would be a very good thing if we could have television at this moment.

I am trying to say two things. First, I think that the Opposition tonight have behaved in the most irresponsible manner possible, a fact which will be recorded in the country without any difficulty whatsoever. Secondly, my right hon. Friend is correct in what he has done. Further, I feel that we have now reached the limit in the individual contributions which people must be expected to make.

12 m.

Mrs. Eirene White (Flint, East)

I start my speech by expressing my condolences with the Borough of Ilford, because if the residents there have heard speeches like that for twenty-six years they deserve sympathy. Personally, I feel completely responsible and extremely indignant about this matter. It is a serious matter, on which my hon. Friends and I feel very strongly. If we sometimes seem to the hon. Member for Ilford, South (Mr. Cooper) to be a little hilarious, I assure him that is simply because we feel so strongly about this that we are perhaps a little over-emotional.

The Government have no excuse whatsoever for bringing this proposal forward at present. We have been told that now for the first time the Government are about to take steps to inquire into one of the most costly sections of the Health Service, namely, the supply of drugs. My hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross), who has great experience in this matter, was far too kind, not merely to the present Minister, but to his predecessor, the right hon. and learned Member for Hertfordshire, East (Sir D. Walker-Smith). He may have been a graceful Minister, but he clearly was not an effective one. Why did he not initiate far sooner the inquiries which the present Minister says he is about to initiate into the cost of drugs? The right hon. and learned Gentleman found that he could not earn enough on the Treasury Bench to pay his own contributions.

Sir Derek Walker-Smith (Hertfordshire, East)

If the hon. Lady would display the fairness which is normally characteristic of her and would look at the facts of this subject, she would acknowledge that the three-year agreement with the pharmaceutical industry expired in June of last year. Obviously negotiations were in hand with the industry for the period after the end of the first trial period of three years. My right hon. Friend the Minister has successfully brought those to a conclusion in the new agreement as from the beginning of this year. It is wrong and unfair to say that no action was taken before. I hope that the hon. Lady would not suggest that I or any other responsible Minister would have acted in breach and contravention of an existing agreement.

Mrs. White

All I was saying was that the right hon. and learned Gentleman's agreement was ineffective, and that it is only now, apparently, that what we hope will be adequate investigations are to be made into the costings of these firms.

Surely, the collective responsibility not merely of the present Minister but of his predecessors in office should have led them to have satisfied themselves about the cost of drugs, not after but before they come to us saying that we should ask the public to pay these highly-increased charges and contributions.

Had these increased contributions been part of a package deal, of which we might have approved, I should not be objecting. The Minister might have said to us, "Costs have increased—we must find some extra finance. I do not intend to do anything about prescription charges, I shall not increase the charges for dentures, and the like. I shall ask for some small increase in contribution to be paid by people in employment, but I will not put an extra tax on the sick."

Had he done that, we might have been in a more amenable frame of mind about increased contributions—but not at all. The package deal we are being asked to approve is completely deplorable. We are now being asked to increase taxation—because, let the Government call it what they will, it is no different. We are increasing taxation on a flat rate with complete disregard of the people's capacity to bear that taxation.

Again, the representative of the Treasury might have said to us tonight, "We have been very seriously considering the financing of the social services. We think that the time has now come to give up the flat-rate basis. We think that it should now be placed on a footing in relation to earnings or in relation to income." Had he done that, I think that we could have had a reasonable discussion. There is at least some possible scope for argument there.

The Government, however, are not making any constructive or progressive changes; they are merely saying, "We want more." They have given us this list which is on the Order Paper now, and I ask the Financial Secretary—I will wait for the Patronage Secretary to take his seat—

Mr. Diamond

On a point of order, Sir Gordon. I have hesitated to interrupt my hon. Friend the Member for Flint, East (Mrs. White) until I thought that it might be convenient to her. Now that the Chief Whip has resumed his seat, Sir, may I ask, with deference, whether you propose to disclose the conversation that has just taken place between you and the Chief Whip?

The Chairman

I do not intend to disclose any private conversation with anybody.

Mr. Diamond

Further to that point of order, Sir. May I take it that the normal course as to raising the question of whether you would accept a Motion for the Closure is for the question to be raised in a voice that can be heard throughout the Chamber? Can I take it that the conversation was a private conversation, and had no relevance to any proceedings in this Chamber?

The Chairman

It is not the concern of the hon. Member what the conversation was about.

Mr. Manuel

It is the concern of the Committee.

Mr. S. Silverman

Further to that point of order, Sir Gordon. I am sure you would agree that, if there were a conversation, however privately conducted, between the Patronage Secretary and the occupant of the Chair which had something to do with the conduct of the debate with which the Committee was then concerned, that would be something which the Committee would be entitled to know about.

The Chairman

My understanding of the position is that a private conversation is a private conversation.

Mr. Silverman

So long as it is about private affairs.

Mrs. White

When the Patronage Secretary interrupted the debate, I was about to ask the Financial Secretary to be good enough to explain why it is proposed that the increases in contribution which we are discussing should be 10d. per week for men and 8d. per week for women. I think that is the correct relationship. He will, I am sure, in the course of his duties, have studied the latest figures of average earnings of persons employed in this country. They were published quite recently. He will have observed that the average earnings of men at present are, in round figures, between £14 and £15 a week, but for women the figure is between £7 and £8 a week.

What is the justification for expecting women to pay what is admittedly somewhat Jess than men but considerably more than their proportion if the matter is judged according to their average earnings? Before we are asked to accept the figures put before us, he should explain to the Committee why it is that the man's contribution is to go up by 10d. whereas the woman's is to go up by 8d., when it is perfectly clear, since it is with women in employment and paying their own contributions that we are concerned, that women, according to the figures of average earnings published by the Government, are not in a position to pay as large a proportion in contribution as is suggested.

Mr. W. Hamilton

Will my hon. Friend be very careful about this? The Government might put the man's contribution up still further.

Mrs. White

That may be, but I am standing by the figures of relative earnings, and I want to know what the explanation is for this completely inequitable and disproportionate contribution from employed women in this country. At the other end of the scale, women have their income mulcted in Surtax. At this end of the scale, they have a raw deal by being asked to pay considerably more than they ought to pay, according to the figures.

There has been a good deal of discussion today about the increased cost of the Health Service. We have emphasised again and again from this side of the Chamber that, taken as a proportion of the gross national product—or whatever the economists choose to call it—the amount spent has not until this year even equalled the proportion of the national income spent on the Service ten years ago. Therefore, as my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) so admirably said in his winding-up speech at the end of our earlier debate, this panic Measure is really quite monstrous and unjustified.

I have not heard anyone explain so far that one of the reasons why there is additional cost in the Health Service, naturally enough, is, quite apart from increases of wages and so on, that there have been changes in the structure of the population. No one has, I think, made the closely relevant point that we may properly expect that the Health Service would cost somewhat more today because of the increase in the proportion of young persons in the population as a result of the increase in the birth rate and because people are living longer.

It is precisely these two groups of persons who require most medical attention. Therefore, it would have been quite astonishing if we had not had some increase in the cost of the Service, for that reason alone.

One of the things which I find monstrous about the Government's proposals is that, even granting that they are making some slight concessions for pensioners and the like, the families with children will be most hardly hit. On the figures that are before us, the breadwinner will have to pay extra contributions in addition to the other forthcoming National Insurance contributions. At the same time, if his children are to have proper medical help, he must also pay considerably larger sums than he has been paying hitherto. It is completely unjustified for the Government to come to us tonight and expect us to agree to these figures in view of their lamentable handling of the situation.

Several Hon. Members

rose —

The Chairman

Mr. George Thomas.

12.15 a.m.

Mr. George Thomas (Cardiff, West)

rose —

Mr. Callaghan

On a point of order. Before my hon. Friend begins his speech, may I draw your attention, Sir Gordon, to the fact that twelve of my hon. Friends rose to their feet? In view of the fact that at the end of a speech it is sometimes known for the Chief Patronage Secretary to ask for a Closure Motion to be accepted, will you take into account that if he does that, it would be, in the words of the Standing Order, … an infringement of the rights of the minority … when twelve Members are still rising to their feet?

The Chairman

The hon. Member can rest assured that I shall take every consideration into account.

Mr. Stephen Swingler (Newcastle-under-Lyme)

Further to that point of order, Sir Gordon. May I make a plea on behalf of Members opposite and draw your attention to the fact that, owing to the browbeating by the Patronage Secretary, only one hon. Member opposite has so far had an opportunity to speak in the debate?

Mr. Warbey

Further to that point of order. Is it not perfectly clear, Sir Gordon—it has been obvious to every Member on this side—that the Patronage Secretary has been going round telling hon. Members opposite not to speak in this debate? Is this not a denial of the privileges of hon. Members?

The Chairman

That is not a point of order.

Miss Jennie Lee (Cannock)

Further to that point of order. May we depend upon you, Sir Gordon, to treat us not as two distinct parties? It will be obvious to you that not one Member from the party opposite rose to speak, whereas there were at least twelve of my hon. Friends on this side who were anxious to contribute to the debate.

Mr. G. Thomas

I rise to support my hon. Friends because of the deep feeling among my constituents about the proposals which are now before us. The question of increasing the contribution is one to which the hon. Member for Ilford, South (Mr. Cooper) referred in passing. Because I believe that this contribution is unfairly assessed and leaves gross injustices within the proposals of the Minister of Health, I propose for a moment to tell the Committee of an experience I had in my constituency during the past week.

When it was mooted in the Press that there was a possibility of a charge of 2s. per item per prescription being made, I visited an old-age pensioners' home in Cardiff where both the people concerned were chronic invalids. The week before, out of an income—which is exceptional among working-family old-age pensioners—of £8 a week, they had paid 8s. for their medical prescriptions, 4s. for each of the chronic invalids. They had made representations to their doctor, whom I well know, asking him what he could leave out of the prescriptions, because they could not afford to pay. These people will be faced—

The Chairman

This Financial Resolution does not deal with prescriptions.

Mr. Thomas

I was tempted to refer to them, Sir Gordon, because the hon. Member for Ilford, South went so far. At least, I am talking about health costs. This proposal for increased contributions which the Minister now asks us to approve is an attempt by him to undermine the whole basis of our welfare services. It means that the very rich will be relieved of a burden by the very poor having to pay more. The fact that last year in Wales alone £100,000 was reclaimed from the National Assistance Board by people who had paid 1s. for their prescription—I am using this as an illustration, Sir Gordon—proves that there is a vast army of people who cannot afford to pay the higher contributions the Minister is now asking for.

He should look again at the financing of the National Health Service, because I agree with my hon. Friend the Member for Cannock (Miss Lee) that the Chancellor of the Exchequer ought to be bearing the burden of the Service. The next thing that we will have is Members opposite following their noble Friend the Member for Dorset, South (Viscount Hinchingbrooke), who wants to make a charge on education similar to the health charges. It would be just as logical to levy contributions for education as it is to levy contributions for the Health Service.

The mark of a civilised community should be that we make our contribution to the welfare services according to our ability to pay. Instead, the wealthy, so well represented by the benches opposite, are being asked to make the same contribution every week as the lower-paid wage earners. It is a socially unjust and unfair proposal.

The Minister should, if the costs of the National Health Service are rising and if there is a special problem facing him, tell the better-off section of the community that, through taxation, they must make a greater contribution. After all, we ought to redistribute the national wealth in the welfare services, not take more from the very people who, in our so-called affluent society, find their low standard of living harder to bear.

It is true that for those people earning under £9 a week life is much harder than it was for the lower-paid wage earners ten years ago, when the party opposite came in to office. Now the Government are widening the gap between the poor and the well off. By these proposals they are simply destroying the principle that the rich should help the poor, that the strong should help the weak—a principle embodied in the welfare services of which we have all been so proud.

It is an unhappy fact that, once the right hon. Gentleman was named as Minister of Health, we all knew that these proposals would come. His reputation went before him. I am ashamed to think that a man who comes from Wales—at least his forebears did; he claims the distinction of that—should so far forget the social principles in which we believe that he is prepared to throw on one side that principal which both sides have claimed at successive General Elections—the principle that we all help each other in time of sickness solely according to need. The Minister will find that the trade union movement will resent this proposal. He will inevitably find that he has thrown a spanner into the works of wage negotiations. It is all right for those well-padded hon. Members opposite to say—

Mr. A. R. Wise (Rugby)

While somewhat repudiating the extent of my padding, may I remind the hon. Member that it was not from this side of the Committee that there came the proposal that the starting level for Surtax should be £6,000?

Mr. Thomas

If it is to be in order to discuss Surtax—

The Chairman

It will not be in order.

Mr. Thomas

—I can assure the hon. Member for Rugby (Mr. Wise) that we will be ready to discuss Surtax if those who put this tax on the lower-paid workers of the country relieve Surtax payers later in the year. He will soon find the depth of indignation not only in the House of Commons, but in the country, and we warn hon. Members opposite that they have gone about as far as they can in pushing the workers around in a society in which, they keep reminding us, we have never had it so good.

These proposals will depress the standard of living of the people who can least afford every week to pay more and more out of their wages. Hon. Members opposite have never liked the Health Service and I remember that they used to keep us up night after night going through the Division Lobbies to vote on the Service. There are still hon. Members opposite who then made speeches agitating for the doctors not to co-operate in the Service, and some of them are now sitting on the Government Front Bench.

This proposal to maul a service which has been the envy of the world will not be forgiven. It is in harmony with Tory philosophy and with the Tories' idea that it is somehow wrong for people to have anything in the community without passing money over the counter. They think that there is a greater respectability in tablets being paid for over the counter than in having the community find its own decent way of helping those who are in need.

I know that it is no good to appeal to the better instincts of the Treasury and ask for further consideration to be given to this matter, but I can tell the Government that, so far as lies within my power, I will make it as difficult as possible, wherever I go in the country, for those who support a proposal which will make life harder and less just for the very people who are the producers in our society.

The Chairman

Sir Edward Boyle.

12.30 a.m.

Sir E. Boylerose —

Mr. George Brown (Belper)

On a point of order, Sir Gordon. It must be clear to you that many hon. Members wish to put points to the Government and to get an answer to them. It must also be clear, especially after the private conversation that went on just now, that it could have been in the mind of the Patronage Secretary to prod the Financial Secretary to rise to his feet now with a view to closuring the debate immediately afterwards. Since the Standing Order provides that you are the custodian of the rights of the minority—and we are the minority here—Sir Gordon, any intervention by the Minister at this stage before, many of my hon. Friends have spoken in the debate should not be regarded as a proper occasion on which to closure the debate.

The Chairman

It is quite normal to call upon the Minister to speak.

Mr. Brown

Further to that point of order, Sir Gordon. Since the Financial Secretary has not chosen to wait till the end of the debate, does the fact that he has risen to his feet preclude him from rising again, and does it preclude my hon. Friends who have not yet been called from speaking?

The Chairman

He can speak again with the leave of the Committee.

Mr. Swingler

Sir Gordon, you may not have noticed that back bench Members on both sides of the Committee rose to speak just now. In view of the fact that there has not been a fair balance between both sides of the Committee owing to the reluctance of hon. Members opposite to speak, would it not be fairer to allow the back bench Member opposite who did rise to speak?

The Chairman

That is not a point of order.

Sir E. Boylerose —

Mr. Callaghan

I think that we could get on much faster, Sir Gordon, if the Financial Secretary were allowed to utter one sentence. Could he tell us that it is not his intention to wind up the debate at this stage?

Sir E. Boyle

I can tell the Committee my intention. I have never understood that one has to ask leave of the Committee to rise. It is now about two hours since I last resumed my seat. I rose just now with the intention of answering some of the points which have been raised during the last two hours.

Mr. Callaghan

That is not quite the question I put. I appreciate the hon. Gentleman answering as he did, but I am asking whether he now intends to wind up the debate. Is it his intention to close the debate?

Sir E. Boyle

I cannot possibly know that. I have been in this House for a number of years and it is perfectly well known—

Mr. Fernyhough

On a point of order, Sir Gordon. We have every respect for you, but I want to ask you whether, having regard to the number of Members who have been trying to speak since a quarter-past ten, it is reasonable and fair that the Minister should, within a matter of two hours, be given an opportunity to make a second speech before Members who have been in the Chamber all day have had an opportunity to make a speech?

The Chairman

It is proper for the Minister to address the Committee.

Mr. Callaghan

Further to that point of order. We all agree that suspicion has been aroused because of the actions of the Patronage Secretary. None of us wants to cast any reflection upon your conduct in the Chair, Sir Gordon, but could we respectfully ask you this. You must be aware of the temper on this side of the Committee, and it would be reasonable to ask that you should not regard the occasion of the answer which the Financial Secretary is now seeking to give as being the end of the expression of opinion from this side of the Committee on this important question, when there are so many Members who have been sitting here for so long and who have been unable to express their views.

You will be aware, better than I, that if the Patronage Secretary should rise to his feet there can be no further debate. Therefore, the only opportunity we have of raising this matter and representing the strong views which are held on this side of the Committee is before he rises to his feet. I do not want to interrupt the Financial Secretary, but I think that his speech could proceed in amity if you could tell us that it is not your intention at the end of his speech to accept a Motion for the Closure.

The Chairman

I cannot accept a Motion for the Closure until it has been moved.

Mr. Callaghan

Further to that point of order, Sir Gordon. I think that we all understand that you cannot accept the Motion until it is moved, but, equally, when it is moved we cannot make any representations to you. Therefore, both you and we are in this difficulty. What would help us in deciding whether the Minister was being reasonable in rising at this moment would be to know whether you consider that the debate has gone on sufficiently long for you to accept the Motion when it is moved. I think that it is reasonable to ask you what is in your mind about the length of the debate.

The Chairman

Sir Edward Boyle.

Sir E. Boylerose —

Mr. Michael Stewart (Fulham)

On a point of order, Sir Gordon. You told us a little while ago that the Financial Secretary would be able to speak yet again by leave of the Committee. Am I not right in supposing that he does not require any such leave; that he can speak as many times as he or the Committee wishes? May we take it, therefore, that his rising now in no way prejudices the proposition that he can rise again to answer the further points which we hope my hon. Friends will make?

The Chairman

Sir Edward Boyle.

Sir E. Boylerose —

Mr. Cyril Bence (Dunbartonshire, East)

On a point of order, Sir Gordon. The Motion says: (c) so as to authorise the Treasury, instead of the Minister of Health and the Secretary"— that is, the Secretary of State for Scotland— to make regulations under the said Act of 1957. Can we, as a Committee, demand that the Secretary of State for Scotland comes to that Box to explain the position in respect of Scotland?

The Chairman

The hon. Member cannot demand the presence of a particular Minister.

Mr. Fletcher

Further to the point of order raised by my hon. Friend, Sir Gordon, in helping you to apply your mind to the position if the Motion for the Closure is moved, might I draw your attention to the fact that there are a large number of highly complicated technical questions of a legal character which appear to me to arise on this Motion and which have not been put before the Committee. As the right hon. and learned Gentleman the Attorney-General is now here, I hope that we shall have an oppor- tunity of ventilating these questions and receiving replies from him before the debate is concluded.

Mr. Rossrose —

Mr. Douglas Jay (Battersea, North)

On a point of order, Sir Gordon. In order to help you and to help the Committee, may I, through you, make this appeal to the Financial Secretary? He said that he rose to answer questions from my hon. Friends. As it is perfectly clear that there are many more questions which many of my hon. Friends wish to put, would it not solve the difficulty and help the Committee if the Financial Secretary refrained from making his answers until he had heard the further questions?

The Chairman

Sir Edward Boyle.

Sir E. Boylerose —

Mr. Ross

On a point of order. Sir Gordon, I know that it is rather difficult for you to answer this kind of question because the possibility of the Patronage Secretary moving the Closure is, of course, hypothetical. You have to decide whether to accept it, and once it is accepted, there can be no debate.

Would I be in order in asking you to bear in mind that this Motion applies to England, Wales and Scotland; that the Motion proposes to alter considerably the present duties and responsibilities of the Secretary of State for Scotland; and that hitherto we have had little or no consideration of the point of view of Scotland in relation to this? Prior to this debate, although the National Health Service in Scotland is represented in the Cabinet by the Secretary of State for Scotland, we did not hear from him the position relating to Scotland. I wish to address certain remarks in relation to this Motion to the Secretary of State for Scotland.

The Chairman

I did not call the hon. Member to make a speech; I thought that he was rising to a point of order.

Mr. Ross

Will you, Sir Gordon, as you make up your mind about any subsequent action you may take, bear in mind that we in Scotland have a point of view and still have not been able to express it?

Mr. G. Brown

I beg to move, That the Chairman do report Progress and ask leave to sit again.

I do so in order to draw attention to what seems to be a most remarkable and unsatisfactory situation. The Financial Secretary seems to be in an absolutely uncontrollable hurry to reply to a debate which clearly is not yet half way through. The issue we are debating is one of major importance to large numbers of our people—leaving out the party bitterness in the House. What we want first, is to be quite sure that my hon. Friends and hon. Members opposite have liberty to put their points of view and to know that the Minister will answer them. We have all been disturbed by the peregrinations of the Patronage Secretary. In the time that I have been in the House I have never seen one who managed to carry out his duties in a more arrogant, ostentatious and contemptuous fashion than this one.

He made not the slightest attempt to save your position. He troubled not a little about the risk of bringing you into conflict with this side of the Committee, by the way in which he quite loudly let everybody hear what he was saying. He walked round to the Chair while my hon. Friend the Member for Flint, East (Mrs. White) was speaking, as if neither she nor anybody else mattered, and then sat down and let everybody know that it was his immediate intention to move the Motion, "That the Question be now put", and then prodded to his feet the up-to-then somnolent figure of the Financial Secretary.

I would not trouble you with this Motion, Sir Gordon, except that it appears to me and to all hon. Members on this side of the Committee that—in the terms of the Standing Order—we are about to have a real infringement of the rights of the minority. My hon. Friend said that twelve Members were standing when the Financial Secretary rose to wind up the debate. That is a magnificent understatement. There were at least twenty hon. Members on this side of the Committee, there was the hon. Member for Heston and Isleworth (Mr. R. Harris) and there may have been others. Therefore the whole Committee has a desire to continue this debate, for perfectly proper reasons.

In moving this Motion I ask that we shall have a statement from the Patronage Secretary. If the Leader of the House were any longer cognisant of his duties he would be here, but such is the contempt every Minister is showing for Parliament at this stage that not one of them is concerned to bother about it at all. Earlier this afternoon we had two Ministers—the Minister of Health and the Financial Secretary—neither of whom answered a single point put in the debate, and both of whom read briefs that had been written before the debate began.

The Chairman

I am afraid that the right hon. Gentleman is going beyond the terms of the Motion he proposes to move. In any case, I do not propose to accept that Motion at this stage.

Mr. Brown

I do not know whether I am in the middle of a speech the conclusion of which you have not heard, Sir Gordon, in support of a Motion which you have accepted—

The Chairman

I am sorry. The right hon. Gentleman has misunderstood me. I have not accepted the Motion.

Mr. Brown

You have called me; otherwise I should not be making a speech. I have been addressing the Committee for five or ten minutes, moving a Motion, "That the Chairman do report Progress and ask leave to sit again". I have not yet finished my arguments. It may be within your competence, when I have finished, to say that you do not accept the Motion, but I submit, with respect, that in the middle of what I am saying you cannot tell me what your conclusion is.

12.45 a.m.

The Chairman

The right hon. Gentleman is going further than the Motion warrants. I was telling the right hon. Gentleman that it is not my intention at this stage to accept the Motion.

Mr. S. Silverman

On a point of order, Sir Gordon. I understood that my right hon. Friend had made it perfectly clear when he rose to his feet that he was moving to report Progress and to ask leave to sit again. The whole of his speech so far has been an argument in support of that Motion. Is not it a little too late for the Chair not to accept it? If the Motion is not to be accepted at all, the usual custom is to reject it at once. It is too late to say that you do not accept it after a speech in support of it is half completed.

The Chairman

The hon. Member is mistaken for once. It is quite usual for an hon. Member to make a speech on a Motion which is not necessarily accepted.

Mr. Brown

Do I understand, since I am in the middle of my speech, that I may take it, Sir Gordon, that while you are not disposed to accept the Motion now, you are open to further arguments which I may put before you? I am submitting to you in support of this Motion that, in view of the contempt which Ministers have shown all through the day, and the arrogance which the Patronage Secretary has disclosed—it was really shockingly bad behaviour—we are entitled to ask for a statement from him, in the absence of the Leader of the House, as to the intentions of Her Majesty's Government. I have moved the Motion, "That the Committee do report Progress and ask leave to sit again." I have appealed to the Patronage Secretary for a statement and I ask that we get that, otherwise we on this side of the Committee must press our Motion.

The Chairman

I am afraid that I cannot accept the Motion at this stage.

Mr. Silverman

May I offer a rather different reason why you might consider accepting the Motion at this stage? I do not think—

The Chairman

Order. I have given my decision.

Mr. Swingler

May we know why?

Mr. Silverman

May I advance some considerations—

The Chairman

Order. I have given my decision on the matter.

Mr. Manuel

On a point of order, Sir Gordon. I think that the whole tension could be relieved if the Financial Secretary would tell the Committee that at a later stage he will answer the further questions which may be put to him.

Sir E. Boyle

I rose because it has always been the custom in debates in which I have taken part that, in a Committee, a Minister rises after two hours to answer some of the points put to him. What happens after I sit down is entirely a matter for you, Sir Gordon, and the Committee—

Hon. Members

Sit down.

Mr. Frederick Lee (Newton)

On a point of order, Sir Gordon. I distinctly heard the Financial Secretary say that it is the custom in the House, or in Committee, that after two hours a Minister rises to answer questions which have been put to him. I suggest that if we let that statement go by default it will be taken as a precedent and, whenever a Committee—

The Chairman

Order. Is the hon. Gentleman rising to a point of order?

Mr. Lee

With great respect, I think that we are discussing something which may establish a very dangerous precedent. My point of order was that the Minister used the expression that, after two hours of debate in a Committee of this type, it is usual for the Minister to reply to the questions which have been addressed to him. I am submitting to you as a point of order that if it is to be accepted as a precedent from now on that, whenever we have had two hours of discussion in any Committee, automatically the Minister will have the right to rise to answer the questions and then automatically the discussion will end—

The Chairman

I am sorry to interrupt the hon. Member, but perhaps I can help him. The Financial Secretary was not giving a Ruling. He was merely making a statement with which hon. Members may or may not agree.

Mr. Lee

I appreciate that, Sir Gordon, but when he made that statement, I put the point to you as Chairman of the Committee that if we allowed that to go by default it could be accepted as a precedent. May I address you on the point of order?

The Chairman

It cannot be accepted as a principle.

Mr. G. Brown

Further to that point of order. The statement made was that in the experience of the Minister it was the custom when there have been two hours of debate for the Minister to rise. The point of order we are putting to you—there is no one else to answer us so long as you are in the Chair and we cannot save you from the responsibility—is, is there such a custom of the House that a Minister is fully entitled and called upon to rise after two hours of debate?

The Chairman

The Minister merely made a statement of what he regards as practice. Of course, as every hon. Members knows, there is no rule about it.

Mr. Brown

I beg your pardon, Sir Gordon, but with respect, I must press this. I heard what the Minister said. You have been good enough to tell me three times since then what the Minister said. I am clear about what the Minister said. We are asking you, is there any practice or custom this House, established or laid down, which either entitles or calls upon a Minister to reply after only two hours of debate? I am not interested in the Minister's views. I am asking you as custodian of the rights of the House of Commons. Is there any such practice or custom?

The Chairman

There is no particular rule.

Mr. S. Silverman

I want to put to you this point, Sir Gordon. Some questions have been put to you as to whether there is any customary practice when the House is in Committee for a Minister to reply to a debate after two hours. I want to submit to you that that question cannot arise here. Certainly there have been a number of speeches in the past two and half hours, but they have all been made from one side of the Committee.

The Chairman

Order. If the question does not arise, there is no point in discussing it.

Mr. Silverman

On a point of order.

Mr. Swingler

In order that we may have a democratic procedure, may I say that any suspicion of collusion between the Chair and the Government Whips can do great harm?

The Chairman

I did not hear the hon. Member.

Mr. Swingler

I wanted to ask you, Sir, whether you would give a straightforward assurance which, with respect, it is within your power to give, that, as you know that many hon. Members, some on each side of the Committee, wish to put further points to the Financial Secretary, you will give those hon. Members an opportunity to put those points after the Financial Secretary has concluded?

The Chairman

It is quite improper for me to give such an assurance about some future Motion. I understand that the Committee wishes to discuss the Financial Resolution. Hon. Members seem to be a long time discussing points of order.

Mr. Callaghan

I rise because I think that all my hon. Friends would regret it if there were a collision between the Chair and hon. Members on this side of the Committee. Many of us are anxious to avoid that. The Financial Secretary has risen a dozen times to make his speech and each time he has been prevented by a point of order—

The Chairman

Is the hon. Member speaking to a point of order?

Mr. Callaghan

Yes, Sir Gordon. If I may reassure you, I am trying to expedite the business of the Committee. I am pointing out that it is not expedited if, every time the Financial Secretary rises to make his speech, he is interrupted by dissastisfied hon. Members raising points of order. As you have said that you are not free or able, or have not yet made up your mind, to take a decision about the ending of the debate, would not the Financial Secretary's reply be expedited if the Patronage Secretary gave an assurance that he does not propose to move the Closure?

The Parliamentary Secretary to the Treasury (Mr. Martin Redmayne)

The Committee will realise that this is a rare treat for them. The right hon. Member for Belper (Mr. G. Brown) accused me, in fairly broad terms, of discourtesy to the Committee in a variety of ways. First of all—

Mr. S. Silverman

Is this a point of order?

Mr. Redmayne

I think I should be permitted to reply.

Mr. Silverman

On a point of order. What is the Patronage Secretary doing? Is he speaking to the Motion or raising a point of order?

Mr. Redmayne

I am speaking further to the point of order raised by the hon. Member for Cardiff, South-East (Mr. Callaghan). I will be brief, but I think that the Committee should be fair to me in this matter. I was accused of personal discourtesy to the hon. Lady the Member for Flint, East (Mrs. White). All I did was to walk from the Bar of the House, as any hon. Member might, to the place where I normally sit, without passing between the hon. Lady and you, Sir Gordon. That accusation is therefore quite unjustified. As for my other movements about the Committee, these are common form in the House. I have certain duties to perform on this side of the Committee, just as the hon. Member for Leicester, South-West (Mr. Bowden) has certain duties on the other side of the Committee. If we were not so heated, I think that no exception would have been taken.

1.0 a.m.

My hon. Friend the Financial Secretary, in accordance with ordinary procedure, proposes to answer some of the points which have so far been put in this rather complicated debate. As he said, in Committee that is a procedure which is normally followed. If, after that, I, as Patronage Secretary, choose to move the Closure in my own poor wisdom, it is entirely up to the Chair whether it is accepted. I move it at my own risk. If the Chair does not accept it, I look a precious ass. That is my business. Perhaps the Committee will now be good enough to let my hon. Friend reply to the points which have been made. We can then see what happens.

Sir E. Boylerose —

Hon. Members

No.

Mr. G. Brown

Sir Gordon, we are very grateful to the Patronage Secretary for what he said. If I misinterpreted his movements earlier, I withdraw my remarks completely. But the right hon. Gentleman could have expedited affairs if he had chosen—it would not have cost him much to do it—to give us the assurance for which my hon. Friend asked. We shall be delighted to hear the Financial Secretary at this stage if it is more convenient to him to deal with the points which have been raised so far, other points being raised by other hon. Members afterwards. If that is for his con- venience, we are delighted to hear him and to facilitate that course.

It would make it so much easier for us, as the Patronage Secretary can clearly now see the misunderstanding which has arisen, if he will make it absolutely plain that he has not already made up his mind to close the debate afterwards. In the absence of such an assurance, some of the words he used sounded to us very ominous. It sounded to us as though he were a man whose mind was already closed. He and I have not been in the House of Commons a long time; we do not rate as old hands. However, we have been here long enough to know that on an issue of this kind, with this kind of temper and mood abroad, there has not been in our time a Government strong enough or powerful enough to over-ride it, except at tremendous additional inconvenience to themselves and everybody else.

There are many Bills to come. There are many Orders to come. There will be many opportunities. I suggest to the Patronage Secretary that in his own interests and those of his own side he might as well begin by being generous and let the Committee say its piece. Let hon. Members raise their points and allow an opportunity for discussion. It is already one o'clock in the morning. It cannot be a matter of great moment whether the Closure is moved now or the debate is allowed to continue.

I therefore ask the Patronage Secretary, speaking now as a House of Commons man and not as a partisan—[HON. MEMBERS: "Oh."] If hon. Gentlemen want the other mood, it can be obtained without any difficulty. That is the point of what I am saying. I appeal to the Patronage Secretary as a House of Commons man on a House of Commons matter, on a Bill the content of which could not be more telling, more important, or to many people more moving, to rise again and go a little beyond what he said just now. I ask him to assure us that, if we hear the Financial Secretary, as we shall gladly do, he will not then seek to use that as an occasion for closing the debate and shutting out the large number of Members on both sides who still want to continue the debate. I appeal to the Patronage Secretary to give us a second treat, and we will not ask him for any more too soon.

Sir E. Boylerose —

Hon. Members

No.

Sir Lynn Ungoed-Thomas (Leicester, North-East)

Sir Gordon, you told my hon. Friend the Member for Newcastle-under-Lyme (Mr. Swingler) that it would be improper for you to give an assurance to the Committee about the Closure. May we be assured that what would obviously be an improper assurance, according to you, has not been given to the Patronage Secretary?

The Chairman

No application has been made to me for the Closure, and I have given no assurance.

Mr. Longhlin

Further to that point of order. In view of the Patronage Secretary's statement, from which we can gather that immediately the Financial Secretary sits down he intends to move the Closure, may we now revert to the question whether you are prepared to give us an assurance that you will not accept the Motion at this stage, as so many of us want to speak on these issues?

The Chairman

I cannot give any assurance about hypothetical circumstances.

Sir E. Boylerose —

Hon. Members

No.

The Chairman

I hope that the Committee will conduct its proceedings in a reasonable fashion.

Mr. Loughlin

On a point of order, Sir Gordon. With due respect to you, Sir, I cannot at this stage conduct myself in a Parliamentary manner in view of the conduct of the right hon. Gentleman opposite, and I will risk being named—although with no disrespect to yourself, Sir Gordon.

Sir E. Boylerose —

Hon. Members

No.

The Chairman

I hope that hon. Members will allow the debate to be conducted.

Sir E. Boylerose —

Hon. Members

No.

Mr. Redmayne

Sir Gordon. This is a most difficult situation, and I am sorry that we find ourselves in this difficulty. The fact of the matter is that this debate is only, as it were, a paving stage for a Bill which will have a Second Reading and a Committee stage on the Floor of this House. It is, therefore, in a different set of circumstances from many of our stages of procedure.

As Patronage Secretary, I am in an awkward position. I said before that responsibility for moving the Closure is entirely mine, and that it is up to me to risk whether or not it will be accepted. As it is obvious that at this moment we shall not make any progress in this way, I must put the matter to the test.

I therefore beg to move, That the Question be now put.

Hon. Members

No.

The Chairman

The Question is, That the Question be now put.

Mr. Callaghan

Sir Gordon—[Interruption.]—I beg to move, That the Chairman do now leave the Chair.

Hon. Members

Send for Mr. Speaker.

Question put, That the Question be now put:—

The Committee proceeded to a Division —

Mr. Callaghan(seated and covered)

On a point of order, Sir Gordon. Many minutes ago, you called the Financial Secretary to speak in this debate. He was then interrupted by several points of order, some, perhaps, more irregular than others, and at the end of one of them the Patronage Secretary rose, as he said, to reply to a point of order which I had raised. I think we all appreciated that, but is it not an abuse of the procedure—indeed, I go further—is he in order in actually rising at that moment, when the Financial Secretary had been called, in order to move "That the Question be now put"? It may be that he is within order, Sir Gordon, but do you not think that it is an abuse of the rules of order? In the circumstances, I beg to move that you do leave the Chair.

The Chairman

The Question is, "That the Question be now put."

Mr. GIBSON-WATT and Mr. CHICHESTER - CLARK were appointed Tellers for the Ayes; but no Member being willing to act as Teller for the Noes The CHAIRMAN declared that the Ayes had it.

Mr. G. Thomas

(seated and covered): On a point of order, Sir Gordon. May I ask whether I heard you announce Tellers for both sides? Also, may I ask whether you will allow us to pursue the matter of whether the debate is to be continued?

The Chairman

That matter has already been decided.

Hon. Members

When?

Question put accordingly.

The Committee proceeded to a Division —

Mr. BRYAN and Mr. J. E. B. HILL were appointed Tellers for the Ayes; but no Member being willing to act as Teller for the Noes The CHAIRMAN declared that the Ayes had it.

Resolved,

National Health Service Contributions

1. That the rates of National Health Service contributions be increased by substituting the rates specified in the Table set out below for the rates set out in the Schedule to the National Health Service Contributions Act, 1958.

2. That it is expedient to amend the National Health Service Contributions Act, 1957—

1. (a) so that enactments relating to national insurance passed subsequently to the National Insurance Act, 1956, shall be deemed to have been included among the National Insurance Acts referred to in the said Act of 1957;
2. (b) so that the provisions of the said Act of 1957 as to the expenses of the Minister of Pensions and National Insurance shall be deemed to have applied to the expenses of other government departments and to have included provision in respect of accruing liabilities for pensions and other payments and in respect of the use of premises belonging to the Crown; and
590
3. (c) so as to authorise the Treasury, instead of the Minister of Health and the Secretary of State, to make regulations under the said Act of 1957.

3. That there be paid into the Exchequer any increase in the sums so payable by virtue of the said Act of 1957, being an increase attributable to the increases in rates of contributions and the amendments referred to in the preceding provisions of this Resolution.

4. That it is expedient to make provision for other matters incidental or supplementary to the matters aforesaid.

TABLE
Description of person.	Weekly rate of contribution.
	s.	d.
1. Employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment	2	8½
2. Employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment	2	0½
3. Employed boys and girls under the age of 18	1	4½
4. Employers		7½
5. Self-employed men between the ages of 18 and 70, not including men over the age of 65 who have retired from regular employment	2	10
6. Self-employed women between the ages of 18 and 65, not including women over the age of 60 who have retired from regular employment	2	2
7. Self-employed boys and girls under the age of 18	1	6
8. Non-employed men between the ages of 18 and 65	2	10
9. Non-employed women between the ages of 18 and 60	2	2
10. Non-employed boys and girls under the age of 18	1	6
Resolution to be reported.
Report to be received this day; Committee to sit again this day.