HC Deb 06 March 1961 vol 636 cc195-219

10.35 p.m.

Miss Margaret Herbison (Lanarkshire, North)

I beg to move, That an humble Address be presented to Her Majesty, praying that the National Health Service (Hospital Charges for Drugs and Appliances) (Scotland) Regulations, 1961 (Si., 1961, No. 186), dated 1st February, 1961, a copy of which was laid before this House on 3rd February, be annulled. I take it, Mr. Deputy-Speaker, that it will be in order to discuss with these Regulations the similar ones for England and Wales: That an humble Address be presented to Her Majesty, praying that the National Health Service (Hospital Charges for Drugs and Appliances) Regulations, 1961 (S.I., 1961, No. 183), dated 1st February, 1961, a copy of which was laid before this House on 3rd February, be annulled.

Mr. Deputy-Speaker (Sir Gordon Touche)

Yes, if that is for the convenience to the House.

Miss Herbison

Thank you, Mr. Deputy-Speaker. This is one further attempt by the Opposition to salvage something from the repeated and disgraceful attacks of this Tory Government on the National Health Service. The Regulations are limited to an increase in charges for prescriptions to hospital outpatients. In a previous debate on other prescription charges sound, cogent and very humanitarian reasons were advanced why no prescription charges at all should be asked for, far less this shocking increase that the Government are determined to impose.

No one wishes to be ill, and certainly no one desires to be chronically ill. How fortunate are those of us who have good health and who never, or only rarely, have to use the health services. These prescription charges, which we discussed previously, hit men and women when they are ill. This is indeed hitting below the belt, and the Tories have shown very clearly in many of their Measures concerning the Health Service that they are masters of that despicable blow.

Added to the worry and strain of illness there will be this great added worry of where the money is to come from to pay for the prescriptions. In the pre- vious debate the Secretary of State for Scotland made the second speech. He said this: No responsible Goverment can take direct taxation to the point at which it begins to have an adverse effect on the whole economy of the country and the prosperity upon which, among other things, the yield of taxation ultimately depends."—[OFFICIAL REPORT, 16th February, 1961; Vol. 634, c. 1856.1 That doctrine has been repeated time and time again by the Secretary of State or by the Minister of Health in those or similar words. Such a statement might go down very well at a Tory women's conference attended by comfortable Tory women lapping up everything that the Tory Ministers tell them. Amongst reasonable thinking people with any social conscience at all the argument can be easily demolished.

Fortunes have been made under this Government in take-over bids alone. By a capital gains tax on these huge profits the Government could have found the money for a much larger hospital building programme than they have announced, which is one of the reasons why these charges must be increased, according to them. They could by that means have found the money not only for the hospital building programme but also for a much larger school building programme than is being undertaken at present.

The Government have announced that for hospital building we are to have an increase over the next five years of £5 million a year, but if we take all these charges on prescriptions, the charges on medical appliances, and the charges under the poll tax in respect of contributions, we find that the Government will get £65 million a year. Some of us want to know what they will do with that money, apart from these mythical hospital buildings about which we have heard so much in the last ten years.

These, of course, are not the real reasons for these charges being put on the sick: they are only attempts to cloak the real reasons. The Government's first reason is a determination, when April comes, to be generous to the Surtax payers and to those who take part in take-over bids. Their second reason is completely in line with the whole social philosophy of the present Minister of Health—and our Secretary of State for Scotland just follows him like a lamb to the slaughter. And from what I hear in Scotland about these charges, it will be a slaughter for the right hon. Gentleman at the next election.

We have a policy pamphlet produced by the Minister of Health—though he was not Minister then——jointly with the present Colonial Secretary, and it gives his whole philosophy. In that pamphlet, the right hon. Gentleman said: The question which therefore poses itself is not 'Should a means test be applied to social services 'but Should any social service be provided without a test of need?'

The Minister of Health (Mr. J. Enoch Powell)

Will the hon. Lady, for the sake of the record—the Colonial Secretary's as well as my own—go on to tell the House that in the rest of the book we went on to say why health and education should be comprehensive and universally available services?

Miss Herbison

That was a very foolish intervention by the Minister. If, in that pamphlet they were trying to get votes and explain why health and education should be comprehensive and full, it seems very strange that the right hon. Gentleman is used as the Government's vehicle for these vicious charges that we are now discussing. No—the Minister's philosophy is like that of some very foolish people who believe that we really must hurt people to cure them—and who are the people he is hurting? They are those who are already sick; those who are already down. That seems to me a cruel and vicious philosophy.

My hon. Friend the Member for Lichfield and Tamworth (Mr. Snow) has spent much time on the subject of drugs, and has made some important statements on it—yet we get this foolish statement from the Secretary of State for Scotland in reply to criticisms about the advertising of drugs: … the whole object of that advertising in the long run is to increase volume and thereby to reduce the ultimate costs. It cannot be done in any other way."—[OFFICIAL REPORT. 16th February, 1961; Vol. 634, c. 1855.] The Secretary of State speaks of increasing the volume of the drugs, whether they are efficacious or not; whether they are far too expensive or not. He makes an excuse for the pharmaceutical indus- try for the shocking advertising campaigns it carries out.

Out-patients go to the hospitals because there they get a medical service which their own family doctors cannot provide. Many of them have to travel some distance to get to the hospitals. In scattered constituencies like mine and that of my hon. Friend the Member for Lanark (Mrs. Hart), and in many other parts of the country—and it is even worse in the Highlands—our people have to pay the cost of travel to hospital. On top of all this, they are now going to have to pay 2s. for every item in a prescription. I can envisage quite a number of people stopping their visits to hospital. Many illnesses will be aggravated if the treatment stops, and we shall have our hospital beds full of people who could easily have had the treatment as out-patients. I say to the Minister of Health that if on humanitarian grounds he will not accept our case, perhaps on economic grounds he might be willing to consider it.

The impression that the Government have been giving during these last few weeks is that no hardship at all will be entailed by these charges, and that where there is hardship it will be dealt with by the National Assistance Board. The Secretary of State and the Minister of Health took quite a time in the debate on the previous Prayer explaining the arrangements. We find in the explanation of the arrangements these words uttered by the Secretary of State—and remember, this relates to someone who is ill, who has had a prescription from the doctor but has not got the money: If, exceptionally, he has no money to pay the chemist, he can get it in advance by applying at the Board's local office. What nonsense. Take the village in which I live. Someone is really ill. He has not the money for the prescription. He has got to get on a bus, undertake a journey for three quarters of an hour to Motherwell, get the money, take it to the chemist and get the medicine which he so desperately needs. What about the old-age pensioner on a Thursday afternoon, the day before he gets his pension? Will it be something "exceptional" if that man has not got 2s., 4s., 6s., or even 8s.? It just shows that the Government have no idea how these people have to live and how they have to look at every side of a penny before they spend it. Not only have they no idea how these people live, but they just do not care.

The Joint Under-Secretary of State for Scotland (Mr. T. G. D. Galbraith)


Miss Herbison

The Joint Under-Secretary says "Shame." I say to him that the actions of this Government show that they do not care at all for these old people, the chronic sick and those who are going to be worried almost out of their lies by these charges which the Government are imposing.

The Government say that those who are not in receipt of National Assistance may get their prescription charges refunded. But, as one of my hon. Friends has said before, only a quarter of 1 per cent. have been able to get these facilities. Someone may be desperately ill. He is not in receipt of National Assistance. He is given a prescription. If he is able to go to the chemist he will get his medicine, and he is given a form. Then, says the Minister: if they post the form, an officer will visit the applicant at his home within the next few days and make a payment if one is needed."—[OFFICIAL REPORT, 16th February, 1961 Vol. 634, c. 1859.] If that is not administration run riot, I would not know what is.

This message that the Tory Party have been trying to put over to the country—that cases of hardship are taken care of—is one which, on examination, our people will realise is just nonsense. Again, of course, the Government know that this is so.

The increased prescription charges will cause great distress to out-patients of hospitals. There is every likelihood that they will lead to great aggravation of illness. All the medical profession is against the charges. Quotation after quotation could be given. I will give just one example of what is happening and will happen. In the town of Lanark, an old lady, on going to the chemist on the first day that the charges were raised, discovered that she would have to pay 2s. for each item. There were several items on her prescription, and she walked out without a single item of the medicine that the doctor knows that she needed.

There is no shame in this Government. There is no humanity in this Government. They insist not only that these charges shall be made, but they insist also on trying to gag this side of the House when we wish to make a case on behalf of those who will be affected.

10.51 p.m.

Lord Balniel (Hertford)

I do not suppose that anyone leaps into this debate warmly and passionately welcoming any increase in charges. On the other hand, it is only right, if one supports the proposals of my right hon. Friend, that one should say that one supports them in principle. Indeed, I support not only the broad context of the proposals which we have been discussing for the past few weeks but I support these Regulations in detail.

What staggered me about the speech of the hon. Lady the Member for Lanarkshire, North (Miss Herbison) was that she said not a single word about the background of the Regulations. She said nothing about the increasing cost of prescriptions, except in relation to advertising, and she said not a word about the increasing part which prescriptions and drugs are playing in the Health Service.

Miss Herbison

One cannot in a short debate say all that one would like. If the noble Lord reads the speech I made when the Minister made his announcements, he will find that I had a good deal to say about the increased cost of prescriptions.

Lord Balniel

I shall certainly read the speech the hon. Lady made. One must remember that this debate is concerned with drugs, and these Regulations are at least in part necessary because of the increasing cost of drugs. It would have been relevant in her speech, which was not as short as all that, to refer to the increasing cost.

I propose to remedy the deficiency. The rise in the cost of prescriptions has been quite dramatic. Looking back to the introduction of the Health Service, the average cost of——

Mr. E. G. Willis (Edinburgh, East)

Look at the profits.

Lord Balniel

I shall refer to that. The average cost of a prescription then was only 3s. ld. By 1954 it had risen to 4s. 2½c1. By 1959, it was 6s. 101d. [An HON. MEMBER: "We never had it so good."] One must recognise that this increase has arisen not only because of higher wages being paid in the pharmaceutical industry—[Interruption.]—if hon. Members interrupt repeatedly, I am quite willing to continue speaking until 11.30.

I was trying to say that we must recognise that the increasing cost of this part of the Service means that the cost per prescription has reached 7s. 3½d. on average. This is largely due to the increasing cost, and increasing quality, of the drugs being prescribed.

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

But will the noble Lord tell us the whole truth, namely, that they represented 10 per cent. of the total cost of the Service, and still represent 10 per cent.?

Lord Balniel

No. If the hon. Gentleman looks at the Hinchliffe Report he will see that it was 8 per cent. at the beginning, but it is now a little over 10 per cent. The cost of drugs has been increasing, and as the right hon. Gentleman the Member for Clackmannan and East Stirlingshire (Mr. Woodburn) elicited in an answer to a Question which he tabled recently in the House, the cost of the pharmaceutical services has increased to literally double the rate of expenditure on other facets of the National Health Service. For the purposes of his Question, he took 100 as the basic figure for 1950–51 and, using that figure, one sees that today, while the comparable figure for the National Health Service cost as a whole is 124, the cost of the pharmaceutical services is 148.

I realise—and I think all hon. Members must realise if they are honest about it—that many of these drugs are virtually life savers. Many people are relieved of suffering and misery and for that we are all very glad. Indeed, one has only to look around, not only to see that these drugs are serving this humane purpose, but that they are also a financial economy in many ways to the country. One has only, for instance, to look at the time when hon. Members opposite were in office in 1948 to remember how regional hospital boards were struggling desperately to provide help for people suffering from tuberculosis; but these hospitals and sanatoria are today being converted to other uses. One recollects operations for mastoid; a disfiguring operation very often, but today it is most unusual. Let hon. Members think of pneumonia which, until recently, was treated in hospital over a period of weeks but which is now often treated at home over only one or two weeks.

Yet, while one recognises all this, one cannot but feel worried about the cost of the pharmaceutical services spreading and taking an increasing part of the cost, and I have not heard hon. Members opposite tell us what part of the National Health Service they would cut in order to allow of this expansion of the pharmaceutical services to take place. [Interruption.] Hon. Members may jeer, but when they were in office they were faced with exactly a similar difficulty to that which is prompting my right hon. Friend to follow his course of action which, I would remind them, was started by Earl Attlee when he was leader of the Government.

One should get the history of this subject right. We must be correct about this. Earl Attlee's proposals had nothing whatever to do with the Korean War, as has been suggested by the hon. Gentleman the Member for St. Pancras, North (Mr. Kenneth Robinson); and, incidentally, they had very little to do with economics. The truth is that Earl Attlee and the then Minister of Health believed that there was considerable wastage in the pharmaceutical services.

Perhaps I might quote the words of Earl Attlee at that time: We propose"——

Mr. Ellis Smith (Stoke-on-Trent, South)

It does not matter what he said. It is what we did that counts.

Lord Balniel

—"to make a charge of not more than ls. for each prescription under the National Health Service.

Hon. Members

That was never introduced.

Lord Balniel

The purpose is to reduce excessive and, in some cases, unnecessary resort to doctors and chemists, of which there is evidence which has for some time troubled my right hon. Friends the Minister of Health and the Secretary of State for Scotland. The resultant saving will contribute about £10 million, although this is not the primary purpose of the charge."—[OFFICIAL REPORT, 24th October, 1949; Vol. 468, c. 1019.] What is interesting when one looks at that debate which initiated the charges—[HON. MEMBERS: "No."]—or initiated the intention of the Government at the time to introduce charges, is that these proposals were welcomed by hon. Members opposite.

Mrs. E. M. Braddock (Liverpool, Exchange)

Has the hon. Member read my speech at that time?

Lord Balniel

I have not read it yet. For the moment, perhaps, I may read a speech which I should have thought was the most uncontroversial one of that debate. I see the hon. Member for Leeds, West (Mr. C. Pannell) present. Not only was it uncontroversial because it was his maiden speech, but it was clearly a speech which he had thought over a great deal before delivering. He said: In regard to the shilling on National Health prescriptions, I welcome it. He went on: If it is a fact that certain prescriptions have cost a lot of money, then this tax will keep the expenditure down I hope, if necessary, even something more will be done, because if we have to build this thing properly we shall have to face up to the position. So I am sure that we shall welcome the hon. Member for Leeds, West when he supports us in the Division Lobby tonight.

Mr. Charles Pannell (Leeds, West)

I make no complaint that the hon. Member has had to rely on a maiden speech, which is traditionally not interrupted and not referred to in later debates—[HON. MEMBERS: "Nonsense."]—but what I do complain of is a reference from the end of the speech, torn from its context, when I was arguing between the maintenance of full employment as against hypothetical cuts in the social services at a time when the Conservative Party was pleading not only for greater social services but cuts in taxation at the same time. I suggest that the speech does not stand merely on that excerpt. In any case, if the hon. Gentleman had been here this afternoon he would have known that I referred to the speech and explained it in relation to its time factor. Therefore, I do not necessarily accept his interpretation at the eleventh hour twelve years afterwards. If that is the best he can do, the Tory Party is rather hard up.

Lord Balniel

What was so interesting about the hon. Gentleman's speech—which, as I said, was a carefully delivered one and not off the cuff—was that he did not defend his action on the ground that it was a choice between unemployment and prescription charges. This is how he defended his support for Lord Attlee's proposals: As a decent standard of life by means of full employment is built up over the years. a certain sturdy spirit of independence is created, which turns aside from Public Assistance and even from the Welfare State."—[OFFICIAL REPORT, 26th Oct, 1949; Vol. 468, c. 1386.] That seems to me to be a philosophy which we can support wholeheartedly from these benches.

What my right hon. Friend has done is to introduce, and strengthen, an element of consumer resistance into the pharmaceutical service. People so often say that because my right hon. Friend is a monopoly payer for the pharmaceutical service he is in a strong bargaining position. That is exactly what is not the position. The doctors prescribe the pharmaceutical services, the drugs, but they do not pay for them. So there is no consumer resistance on the part of the doctors. My right hon. Friend pays for all the pharmaceutical services prescribe under the National Health Service but he does not prescribe them, and so there is no consumer resistance so far as he is concerned.

Mr. Maurice Edelman (Coventry, North)

The hon. Member talks about consumer resistance from the sick and the ill. Will he say what sort of consumer resistance the Minister of Health is putting up on behalf of the captive National Health Service against the drug companies, which have been making, for years, profits which are the direct cause of the steady increase in the prescription costs? In these circumstances, would not he agree that it would be better to cut the profits of the drug companies than to impose new burdens on those who are already sick and suffering?

Lord Balniel

I shall deal with the drug companies. My right hon. Friend, in these proposals, has strengthened the course of action initiated by Members opposite—has strengthened consumer resistance so far as the patients, as customers, are concerned.

Mr. A. Woodburn (Clackmannan and East Stirlingshire)

On a point of order, Mr. Deputy-Speaker. Perhaps the Minister would like a little time to conclude this debate, and presumably my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) will speak before him. I take it that the noble Lord is to conclude his speech before 11.30, when this debate must end.

Mr. Deputy-Speaker

That is not a point of order for me.

Lord Balniel

I have listened to many long speeches in the last few weeks from Members opposite, and I have no intention of curtailing my own to please the right hon. Member for East Stirlingshire.

I now turn to the pharmaceutical services. I urge my right hon. Friend to look with increasing emphasis at the other side of the coin. I realise the dangers of interfering with the prescribing of the doctors, and I do not see how he can introduce, on the doctors' side, much consumer resistance. On the other hand, he should look with increasing attention to the pharmaceutical industry.

Here I realise the dangers of interfering too much and so damaging the export trade, of which the pharmaceutical industry is an integral and important part, and the research element. Members opposite have, in past debates, argued ad nauseam that many of the pharmaceutical companies, which are subsidiaries of United States concerns, are making unnecessarily large profits. They must recognise that there is a danger, if we interfere too directly, of damaging the research programmes of these companies.

Members opposite jeer at American subsidiaries. They should call to their minds references in the Hinchliffe Committee's Report on the Cost of Prescribing, about United States companies: The discovery of the first antibiotic, penicillin, opened the way to a vast volume of research into other natural sources of antibacterial agents. The most important development after penicillin was the discovery of streptomycin … by Waksman … in the United States. This was the first effective drug for the treatment of tuberculosis and, in conjunction with other drugs, still forms the basis of chemotherapy for this disease. All subsequent antibiotics have been discovered by scientists working in the laboratories of pharmaceutical firms, almost all in the U.S.A. When one remembers that those drugs included aureomycin, terramycin, achromycin, and spiramycin—all great antibiotic discoveries of the post-war era—Members opposite should be very careful in attacking these American firms.

I say this with a special interest, because I have in my constituency one of our great pharmaceutical companies, which is a subsidiary of an American company, and those who work in it resent the allegations and accusations, ignorant and ill-informed, made by hon. Members opposite.

On the other hand, it is right that we should look carefully at the disparity in the prices which are charged for similar drugs in this country and on the Continent. One is worried when one reads that similar drugs are sometimes cheaper in France than in this country. I ask my right hon. Friend to look very carefully into that problem.

There are certain types of illness, such as epilepsy, for which prescriptions have to be made up once every three or four weeks and very frequently these prescriptions contain three or four items. In many illnesses it is possible for doctors to prescribe a considerable amount of drugs in one prescription, but in epileptic cases doctors are unwilling to prescribe in large quantities because of the dangers of accidental or deliberate poisoning or because they wish to alter the dosage frequently. Will my right hon. Friend consider the possibility of some kind of comprehensive charge to cover these multiple prescriptions which have to be made for these rather special kinds of illness?

I welcome these proposals, in the context of the general proposals which my right hon. Friend has made, and I will certainly support the Regulations in the Division.

11.12 p.m.

Mr. A. Woodburn (Clackmannan and East Stirlingshire)

We have just listened to one of the most shameful speeches I have ever heard in the House. The noble Lord—[HON. MEMBERS: "Noble?"] I have used the term, although it is a courtesy term; what he has done tonight includes very little nobility. All that the noble Lord has been talking about has no reference whatever to the facts of the case. Nothing in the past has ever prevented people who required medicines from getting them. By what they are doing tonight the Government will prevent people from getting the medicines which they require.

It is true that people with money or with reasonable incomes will not be prevented from getting medicine. The whole of this economy will be at the expense of the people to whom my hon. Friend the Member for Lanarkshire, North (Miss Herbison) referred—the old and the sick, or those with large families who require a number of prescriptions and who cannot afford to buy the medicine. Nothing done in the past ever prevented doctors from prescribing freely the medicine which the patient required or prevented the patient from getting the medicine. The hon. Member for Putney (Sir H. Linstead) made a speech the other night which showed that the chemists of the country, as well as the doctors, realise that these provisions will prevent people from getting medicine.

Imagine the nonsense of the arrangements which are to be made. The old person goes to the National Assistance Board and has to pay more in bus fare than he will save by the prescription. He collects money from the Government through the National Assistance Board, carries it to a chemist's shop some miles away and hands it over to the chemist, who hands it back to the Government. The right hon. Gentleman is arranging that we should start a noble corps of snoopers again, who will visit, by motor car, the old-age pensioner to see whether he requires medicine.

The right hon. Gentleman should admit that it is nonsense to say that the country's economy depends on depriving people of the medicines which they should have. I am not concerned about people who can afford to pay for their medicines, but the right hon. Gentleman knows that these arrangements are the reintroduction of the workhouse principle—"If you want relief, go to the workhouse "—knowing very well that people would rather starve than go to the workhouse and would rather go without medicines than follow the arrangements he has made.

Even at this late hour, I make a plea for humanity, for those people who are sick, for those who are old, or who have large families and who cannot afford to buy medicines. I ask the Government to bring back the system by which a comprehensive medical service was available to all people.

I cannot understand how the Secretary of State or the Minister can justify saving the country at the expense of depriving some person of the medicines he needs to heal him when he is sick. That is the issue that the noble Lord evaded and about which the noble Lord the Member for Dorset, South (Viscount Hinchingbrooke) had his conscience salved the other day when he was told about this so-called equal treatment.

The right hon. Gentleman knows that the reason for introducing this circumlocution arrangement for old people to get their medicines is that they will not take advantage of it and that he will save money at the expense of having the women and children and old people thrown overboard. A State that saves itself at the expense of the women and children does not deserve to be saved.

11.17 p.m.

Mr. Kenneth Robinson (St. Pancras, North)

The noble Lord the Member for Hertford (Lord Balniel) has taken up nearly half the time which was available for this debate, and if in replying the Minister is not able to have as long as he asked, I hope that he will put the blame where it surely rests—on the shoulders of the noble Lord. I shall divide the remaining minutes between us.

I had hoped that there would be time for me to go in some detail into the arguments adduced by the Minister of Health in support of the increase in prescription charges when we last debated the matter, but I will content myself with dealing with only one. His argument for doubling the prescription charge was that the standard of living had gone up since the charge was originally fixed at 1s. per prescription. However, the Minister's proposals represent a charge of three times the charge introduced in 1952, and I do not think that the Minister would suggest that the standard of living had risen by three times in the last nine years

The Regulations against which we are praying tonight are those relating to the dispensing of prescriptions in hospitals. What will the Government do when hospital management committees decide that they so dislike imposing these charges that they are prepared to make use of amenity funds to mitigate hardship? They have amenity funds at their disposal and I understand that in some hospital management committees proposals have been made for the use of these funds for this purpose. I hope that we shall hear the Government's view.

Mr. Ellis Smith

On a point of order. As you have just returned to the Chair, Mr. Speaker, will you make inquiries to see how many hon. Members have spoken in the debate, bearing in mind that this is an Opposition Prayer and that you have discretion to extend the time for the debate if you think that it has not had sufficient time?

Mr. Speaker

I will consider what the hon. Member has in mind, although, with respect, he has not stated it quite rightly, but do not let us lose more time now.

Mr. Robinson

The Minister told us today that he had had 900 letters protesting about these National Health Service charges and I think that he will agree that most of those have been about the prescription charges. He has had these letters because real hardship is being imposed, particularly by the prescription charge. I wonder whether we can hear whether any steps have been taken to introduce any comprehensive charges, or any further make-up of comprehensive packs for those patients suffering from chronic conditions. We have had some promises from the Ministry in vague terms, but we should like to know whether any action has been taken.

Among the letters the right hon. Gentleman has received there have certainly been some official protests from local authorities. I know that he has had one from Harlow, because I have seen a copy of it. There is a very good reason for that protest. The Minister has told us that steps are taken to see that hardship is mitigated by recourse to the National Assistance Board, but in Harlow—with a population of 52,000—the local office of the National Assistance Board is open for only two hours a week. What earthly use is that as a means of mitigating hardship to people who have to have prescriptions, often in emergencies? The fact is that these hardships are real, and hon. Members on both sides of the House must have evidence that they are real.

I should like to quote from two letters I have received, which are typical of what we have been hearing. The first is from a pensioner aged 76, with a wife of 72 who is suffering from progressive muscular atrophy. She has had this condition for three years. This man is receiving a very modest pension and he tells me that doctors' prescriptions for his wife are made out five or six times a week for sedatives and medicines only, and that the rise now proposed means an increased expenditure from 5s. to 10s. a week, and with local rates to pay for, and day and night sick room, what can they do but refuse the medicinal items and let nature take its course? He says that all his resources have been expended on trying to effect a cure for his wife and that he now has nothing left.

The other letter is from a railway pensioner—and hon. Members know what limited resources most of them have to exist on. He says: I might also say we have never had Public Assistance. My wife said she would rather starve, so we manage as best we can. We know that it is unfortunate that people take this attitude, but the fact is that they do take it, in large numbers, any many people will go without the drugs and prescriptions they need, simply because they will not go for what they regard as charity, namely, National Assistance.

In winding up the debate this afternoon the Minister asked the Opposition to use arguments which had an echo in the country. I believe that of all these deplorable proposals of the Minister the doubling of the prescription charge is the most squalid. That is the view that we have expressed from this side of the House, and shall continue to express. I believe that view is echoed in the country, and that those echoes will go on reverberating until the next election, when they will sweep this Government out of office.

Mr. Hector Hughes (Aberdeen, North)

On a point of order. A few minutes ago, Mr. Speaker, you were asked for your guidance on the question whether you would, in your discretion, allow this debate to be continued beyond half-past eleven o'clock. What you ruled on that occasion was not clear to all of us. For our guidance, would you tell us whether you will exercise your discretion by allowing the debate to continue beyond half past eleven?

Mr. Speaker

I have no power to continue the debate beyond half-past eleven, and considerations which arise on the Standing Order I will consider then.

11.24 p.m.

The Joint Under-Secretary of State for Scotland (Mr. T. G. D. Galbraith)

When we considered, just over a fortnight ago, the Regulations increasing from Is. to 2s. the charge on prescriptions which are provided by family doctors and dispensed by chemists, the House decided, after full consideration, to reject the Prayer which sought to annul the Regulations. Tonight we have before us Regulations which make similar increases in the charges made to hospital out-patients who receive drugs at the out-patient department of the hospital. These are a very small proportion of the total number of prescriptions dispensed in the country.

I had been expecting this evening to hear arguments from hon. Members opposite as to why—[Interruption.]—hon. Gentlemen might as well keep quiet. I hear enough of them in the Scottish Grand Committee and I am not particularly anxious to hear them now. I had expected to hear arguments as to why these few out-patients receiving medicines at hospital should be treated differently from patients— —

Mr. J. T. Price (Westhoughton)

On a point of order. I draw your attention, Mr. Speaker, to the reference just made by the Joint Under-Secretary. He referred to my hon. Friend in reference to something that he says happened in the Scottish Grand Committee. Is it in order for an hon. Member opposite, who is plugging away with his brief, to make disparaging remarks of one of my hon. Friends with reference to something that is in no way connected with the debate? It is most disgraceful.

Mr. Speaker

The reference I thought I heard was not directed to any single hon. Member but to "hon. Members opposite" [Interruption.] I am quite willing to accept correction, but I thought it was directed to hon. Members generally in the Scottish Grand Committee.

Hon. Members


Mr. Galbraith

I am delighted to withdraw if I have said anything that offends the hon. Member for Edinburgh, East (Mr. Willis). If hon. Members will allow me to refer to the notes I have made during the course of the debate, I may be able to answer the points which have been made.

In opening the earlier debate on the subject the hon. Member for St. Pancras, North (Mr. K. Robinson) said that this was the fifth round. I do not know what round we are at now, but it seems to me from the arguments propounded by the Opposition that they at least are punch-drunk. At any rate, I assure them that the Government do not intend to be deflected from doing what they believe to be in the best interests of developing the National Health Service.

Two points were raised by the hon. Lady the Member for Lanarkshire, North (Miss Herbison). One concerned the cost of drugs. The Government are very much concerned to do all they can to keep the cost of drugs to a minimum and have in fact been in close contact with the Association of the British Pharmaceutical Industry on this matter, with recent success.

Secondly, the hon. Lady and other hon. Members said that they were very concerned about whether there might not be hardships falling upon the poorer person. My right hon. Friend on an earlier occasion gave a very full explanation of the Government's concern that hardship should be avoided and indicated how the arrangements for refund would operate. I can only refer hon. Members again to what was said on that occasion and assure the House that we will keep the matter constantly under review; although I should say that our earlier experience—this meets the point raised by the right hon. Member for Clackmannan and East Stirlingshire (Mr. Woodburn)—with the Is. charge leads us to believe that the Board will cope humanely and efficiently with those just above the National Assistance level.

I know that hon. Members opposite do not like being reminded of what they did when they had the responsibilities of Government. The fact remains that under the guidance of the Leader of the Opposition they introduced the principle of charges as a means of helping to finance the Health Service.

Mrs. Harriet Slater (Stoke-on-Trent, North)

Not charges.

Mr. Galbraith

Yes, charges for dentures. The present increased charges—I cannot repeat this too strongly—are not a body blow aimed at the National Health Service, which has advanced by 25 per cent. under the present Government.

Mr. Speaker

Order. The Question is——

Mr. Hector Hughes

On a point of order.

Mr. Speaker

No—no point of order now.

It being half-past Eleven o'clock, Mr. SPEAKER put the Question, pursuant to Standing Order No. 95A (Statutory Instruments, &c. (procedure)).

The House proceeded to a Division—

Mr. Hector Hughes

(seated and covered): On a point of order, Mr. Speaker. I asked you earlier whether you would, in your discretion, allow this debate to be continued after half-past eleven, having regard to the fact there were so many hon. Members on this side of the House who sought to catch your eye, but without success, and also having regard to the fact that the attempted reply by the Minister did not deal with the points made by my hon. Friends.

Mr. Speaker, I now repeat my request that you should, in the exercise of your discretion, allow this debate to continue beyond half-past eleven for the reasons I have given. It must be perfectly obvious to you, sitting there and looking at this side of the House, that there are many hon. Members who wish to speak, and it must also be obvious to you that this is a matter of tremendous importance to our people. Therefore, I ask you—I beg you—to allow this debate to continue beyond 11.30.

Mr. Speaker

I heard the hon. and learned Gentleman's intervention previously with great care and respect, as I heard this one, and I had an opportunity to look at the Standing Order on considerations laid down for me; and also to look at precedents, and decided my duty to the best of my ability. I thought that the Standing Order in these circumstances obliged me to put the Question when I did. I did so, and I am afraid that I cannot change the opinion that I have formed.

Mr. Ellis Smith

(seated and covered): Further to that point of order.

Mr. Speaker

No, I am sorry—not now.

Mr. Ellis Smith

Further to that point of order.

Mr. Speaker

No, there is nothing further, I am very sorry; no disrespect to the hon. Member or to anybody else. In the discharge of my responsibility as best I conceive it to be, I have so decided and the moment has now arrived to put the Question again.

Mr. Ellis Smith

I desire, Mr. Speaker, to raise a point of order——

Mr. Speaker

No, I am very sorry.

Mr. Ellis Smith

I desire, Mr. Speaker, to raise a point of order.

Mr. Speaker

I am very sorry; I am on my feet discharging my duty. I cannot hear the hon. Member.

Mr. Ellis Smith

I am in accordance with Standing Orders and with Parliamentary practice, and I desire to raise a point of order.

Mr. Speaker

I appreciate that the hon. Member does, and I would like to hear him if my duty so permitted, but I am on my feet putting the Question, and the Question is, That an humble Address be presented to Her Majesty, praying that the National Health Service (Hospital Charges for Drugs and Appliances) (Scotland) Regulations, 1961 (S.I., 1961, No. 186), dated 1st February, 1961, a copy of which was laid before this House on 3rd February, be annulled.

Mr. Ellis Smith

On a point of order, Mr. Speaker. My point of order is based on my memory of Standing Orders, and I should like to qualify that by saying that I have not recently seen the Standing Order and that you have the advantage. Am I correct, Mr. Speaker, in interpreting the Standing Order as follows: that Mr. Speaker has a discretion, in view of the way that the debate has gone, to postpone putting the Question in order that we can have a democratic discussion on another evening?

If that is so, Mr. Speaker, am I correct in saying that the noble Lord on the opposite benches took at least twenty minutes and that six Members on this side, including five Scottish Members, who have sat here for the whole of the time, have not had an opportunity of speaking at all? If those are the facts. Mr. Speaker, will you be good enough to consider whether the Standing Order should not be interpreted in a way which gives you discretion to postpone the debate until another night?

Mr. Speaker

I am obliged to the hon. Member. The Standing Order is No. 95A. I can refer him to nothing but the terms of the Standing Order. It was in the performance of my duty as I conceived it to be under the Standing Order and in the light of precedents available to me that I put the Question when I did. I cannot add to that.

Dr. J. Dickson Mabon (Greenock)

(seated and covered): Mr. Speaker, may I refer you to Standing Order 95A (2, a)? Why is it that we cannot give consideration to the fact that we did not begin the Prayer until 10.35, that some six minutes were occupied by the Government spokesman and the rest of the time was taken up by an hon. Member opposite and one Member of our Front Bench? Surely it is grossly unfair to exclude seven Members who want to speak, as well as not allowing the Minister time in which to give an adequate reply?

Mr. Speaker

I hear the hon. Member with the greatest interest always, and, without the slightest discourtesy to him or

to anybody else, I cannot add to what I have said. I have considered the Standing Order, and my duty, and I have so ruled.

Mr. William Ross (Kilmarnock)

(seated and covered): Further to that point of order, Mr. Speaker. Do I take it that the Standing Order refers to occasions when the time for the debate has not been adequate, and that in your opinion the time for this debate has been adequate?

Mr. Speaker

No. I referred the hon. Member to the terms of the Standing Order, which he states more narrowly than they are.

Mr. Ross

But surely in view of the terms of the Standing Order, the lateness of the hour at which the Motion was entered upon, bearing in mind that it was moved thirty-five minutes later than the time of 10 o'clock which is mentioned in the Standing Order, and in view of the importance of the Motion—about which there is surely no difference of opinion—the time for debate has not been adequate. Those are factors which should be taken into consideration. I seriously ask you, Mr. Speaker, to consider, in the light of the Standing Order and the conditions arising, that time has definitely not been adequate for the ventilation of points which hon. Members on this side of the House wish to raise.

Mr. Speaker

I appreciate what the hon. Gentleman is putting to me, and the way in which he puts it, but none the less the considerations which arise for the basis of my decision I have considered. I am very sorry. I am not retreating from it in any way. I cannot.

The House divided: Ayes 179, Noes 246.

Division No. AYES [11.30 p.m.
Abse, Leo Butler, Herbert (Hackney, C.) Delargy, Hugh
Albu, Austen Butler, Mrs. Joyce (Wood Green) Diamond, John
Allaun, Frank (Salford, E.) Castle, Mrs. Barbara Dodds, Norman
Alien, Scholefield (Crewe) Chetwynd, George Donnelly, Desmond
Awbery, Stan Cliffe, Michael Dugdale, Rt. Hon. John
Bacon, Miss Alice Coltiok Percy Edelman, Maurice
Bence, Cyril (Dunbartonshire, E.) Corbet, Mrs. Freda Edwards, Walter (Stepney)
Blackburn, F Craddock, George (Bradford, S.) Evans, Albert
Blyton, William Crosland, Anthony Finch, Harold
Boardman, H. Cullen, Mrs. Alice Fletcher, Eric
Bowden, Herbert W. (Leine, S.W.) Darling, George Foot, Dingle (ipswieh)
Bowles, Frank Davies, G. Elfed (Rhondda, E.) Foot, Michael (Ebbw Vale)
Braddock, Mrs. E. M. Davies, Harold (Leek) Forman, J. C.
Broughton, Dr. A. D. D. Davies, Ifor (Gower) Fraser, Thomas (Hamilton)
Brown, Alan (Tottenham) Deer, George Gaitskell, Rt. Hon. Hugh
Brown, Rt. Hon. George (Belper) de Freitas, Geoffrey Ginsburg, David
Gordon Walker, Rt. Hon. P. C. Loughlin, Charles Roberta, Goronwy (Caernarvon)
Gourlay, Harry Mabon, Dr. J. Dickson Robinson, Kenneth (St. Pancras, N.)
Greenwood, Anthony McCann, John Silverman, Julius (Aston)
Grey, Charles MacColl, James Silverman, Sydney (Nelson)
Griffiths, Rt. Hon. James (Llanelly) McKay, John (Wallsend) Slater, Mrs. Harriet (Stoke, N.)
Griffiths, W. (Exchange) Mackie, John Slater, Joseph (sedgefield)
Grimond, J. MacMillan, Malcolm (Western Isles) Small, William
Hall, Rt. Hn. Glenvil (Colne Valley) Mallalleu, E. L. (Brigg) Smith, Ellis (Stoke, S.)
Hamilton, William (West Fife) Manuel, A. C. Snow, Julian
Hannan, William Marquand, Rt. Hon. H. A. Soskice, Rt. Hon. Sir Frank
Hart, Mrs. Judith Mason, Roy Spriggs, Leslie
Hayman, F. H. Mellish, R. J. Stewart, Michael (Fulham)
Healey, Denis Mendelson, J. J. Stonehouse, John
Henderson, Rt.Hn. Arthur(RwlyRegis) Milian, Bruce Stones, William
Herbison, Miss Margaret Milne, Edward J. Strachey, Rt. Hon. John
Hewitson, Capt. M. Mitchison, G. R. Strauss, Rt. Hn. G. R. (Vauxhall)
Hill, J. (Midlothian) Monslow, Walter Stross, Dr.Barnett (Stoke-on-Trent.C.)
Hilton, A. V. Morris, John Swingler, Stephen
Holman, Percy Moyle, Arthur Sylvester, George
Holt, Arthur Mulley, Frederick Symonds, J. B.
Houghton, Douglas Noel-Baker, Francis (Swindon) Taylor, Bernard (Mansfield)
Howell, Charles A. Oliver, G. H. Thomas, Iorwerth (Rhondda, W.)
Hoy, James H. Oram, A. E. Thompson, Dr. Alan (Dunfermline)
Hughes, Emrys (S. Ayrshire) Oswald, Thomas Thornton, Ernest
Hughes, Hector (Aberdeen, N.) Owen, Will Wainwright, Edwin
Hunter, A. E. Padley, W. E. Warbey, William
Hynd, John (Attercllife) Pannell, Charles (Leeds, W.) Watts, James
Irvine, A. J. (Edge Hill) Pargiter, G. A. Weitzman, David
Janner, Sir Barnett Parker, John (Dagenham) White, Mrs. Eirene
Jay, Rt. Hon. Douglas Parkin, B. T. (Paddington, N.) Whitlock, William
Jeger, George Pavitt, Laurence Wilcock, Gruop Capt. C. A. B.
Jenkins, Roy (Stechford) Pearson, Arthur (Pontypridd) Wilkins, W. A.
Jones, Rt. Hn. A. Creech(Wakefield) Peart, Frederick Willey, Frederick
Jones, Dan (Burnley) Pentland, Norman Williams, Li. (Abertilfery)
Jones, Elwyn (West Ham, S.) Plummer, Sir Leslie Williams, W. R. (Openshaw)
Jones, Jack (Rotherham) Popplewell, Ernest Willis, E. G. (Edinburgh, E.)
Jones, J. Idwal (Wrexham) Price, J. T. (Westhoughton) Winterbottom, R. E.
Jones, T. W. (Merioneth) Probert, Arthur Woodburn, Rt. Hon. A.
Kelley, Richard Purser, Cmdr. Harry Woof,, Robert
King, Dr. Horace Randall, Harry Yates, Victor (Ladywood)
Lawson, George Redhead, E. C. Zilliacus, K.
Lee, Miss Jennie (Cannock) Reid, William
Lever, Harold (Cheetham) Reynolds, G. W. TELLERS FOR THE AYES:
Lever, L. M. (Ardwick) Rhodes, H. Mr. Short and Mr. Irving.
Logan, David Roberts, Albert (Normanton)
Agnew, Sir Peter Clark, Henry (Antrim, N.) Gammons, Lady
Aitken, W. T. Clark, William (Nottingham, S.) Gardner, Edward
Allan, Robert (Paddington, S.) Cleaver, Leonard Glover, Sir Douglas
Allason, James Cordeaux, Lt.-Col. J. K. Glyn, Dr. Alan (Clapham)
Ashton, Sir Hubert Cordle, John Glyn, Sir Rlohard (Dorset, N.)
Atkins, Humphrey Corffeld, F. V. Godber, J. B.
Bainiel, Lord Costain, A. P. Goodhart, Philip
Barlow, Sir John Coulson, J. M. Goodhew, Victor
Barter, John Craddock, Sir Beresford Gough, Frederick
Batsford, Brian Critchley, Julian Gower, Raymond
Bearnish, Col. Sir Tufton Crosthwalte-Eyre, Col. O. E. Grant, Rt. Hon. William
Bennett, Dr. Reginald (Gigs &Fhm) Cunningham, Knox Green, Alan
Berkeley, Humphry Curran, Charles Gresham Cooke, R.
Bidgood, John C. Dalkeith, Earl of Grimston, Sir Robert
Biggs-Davison, John Dance, James Grosvenor, Lt.-Col. R. G.
Bingham, 'R. M. d'Avigdor-Goldsmid, Sir Henry Gurden, Harold
Bishop, F. P. Deedes, W. F. Hall, John (Wyoombe)
Black, Sir Cyril Digby, Simon Wingfield Hamilton, Michael (Wellingborough)
Box, Donald Donaldson, Cmdr. C. E. M. Harris, Frederic (Croydon, N.W.)
Boyd-Carpenter, Rt. Hon. John Doughty, Charles Harris, Reader (Heston)
Boyle, Sir Edward du Cann, Edward Harrison, Col. J. H. (Eye)
Brewis, John Eden, John Harvie Anderson, Miss
Bromley-Davenport, Lt.-Col.Sir Walter Elliot, Capt. Walter (Carshalton) Hastings, Stephen
Brooman-White, R. Elliott, R.W. (Nwostle-upon-Tyne,N.) Heald, Rt. 'Hon. Sir Lionel
Browne, Percy (Torrington) Emmet, Hon. Mrs. Evelyn Hendry, Forbes
Bryan, Paul Farr, John Hicks Beach, Mal. W.
Bullard, Denys Fell, Anthony Hill, Dr. Rt. Hon. Charles (Luton)
Bullus, Wing Commander Eric Finlay, Craeme Hill, Mrs. Eveline (Wythenshawe)
Butcher, Sir Herbert Fisher, Nigel Hill, J. E. B. (S. Norfolk)
Butler, Rt.Hn.R.A. (Seffron Walden) Fletcher-Cooke, Charles Hinchingbrooke, Viscount
Campbell, Sir David (Belfast, S.) Forrest, George Hirst, Geoffrey
Campbell, Cordon (Moray & Nairn) Foster, John Hobson, John
Carr, Compton (Barons Court) Fraser, Hn. Hugh (Stafford & Stone) Holland, Philip
Carr, Robert (Mitcham) Fraser, Ian (Plymouth, Sutton) Hollingworth, John
Channon, H. P. G. Freeth, Denzil Hope, Rt. Hon. Lord John
Chataway, Christopher Galbraith, Hon. T. G. D. Hopkins, Alan
Hornsby-Smith, Fit. Hon. Patricia Marten, Neil Smyth, Brig. Sir John (Norwood)
Howard, Hon. G. R. (St. Ives) Mathew, Robert (Honiton) Spearman, Sir Alexander
Howard, John (Southampton, Test) Matthews, Gordon (Meriden) Stanley, Hon. Richard
Hughes Hallett, Vice-Admiral John Mawby, Ray Stevens, Geoffrey
Hughes-Young, Michael Maxwell-Hyslop, R. J. Steward, Harold (Stockport, S)
Hulbert, Sir Norman Maydon, Lt.-Cmdr. S. L. C. Stoddart-Scott, Col. Sir Malcolm
Hutchison, Michael Clark Mills, Stratton Studholme, Sir Henry
Iremonger, T. L. More, Jasper (Ludlow) Summers, Sir Spencer (Aylesbury)
Jackson, John Morgan, William Talbot, John E.
James, David Cleave, Airey Taylor, Edwin (Bolton, E.)
Jennings, J. C. Nicholls, Sir Harmar Taylor, W. J. (Bradford, N.)
Johnson, Dr. Donald (Carlisle) Noble, Michael Teeling, William
Johnson, Eric (Blackley) Oakshott, Sir Hendrle Temple, John M.
Johnson Smith, Geoffrey Orr, Capt. L. P. S. Thomas, Leslie (Canterbury)
Jones, Rt. Hn. Aubrey (Hall Green) Orr-Ewing, C. Ian Thomas, Peter (Conway)
Joseph, Sir Keith Osborn, John (Hallam) Thompson, Kenneth (Walton)
Kaberry, Sir Donald Osborne, Cyril (Louth) Thompson, Richard (Croydon, S.)
Kerans, Cdr. J. S. Pannell, Norman (Kirkdale) Thornton-Kemeley, Sir Colin
Kerby, Capt. Henry Partridge, E. Tiley, Arthur (Bradford, W.)
Kerr, Sir Hamilton Pearson, Frank (Clitheroe) Tilney, John (Wavertree)
Kershaw, Anthony Peel, John Turner, Colin
Kimball, Marcus Percival, Ian Turton, Rt. Hon. R. H.
Kirk, Peter Pickthorn, Sir Kenneth Tweedsmuir, Lady
Lambton, Viscount Pike, Miss Mervyn van Straubenzee, W. R.
Leavey, J. A. Pilkington, Sir Richard Vane, W. M. F.
Legge-Bourke, Sir Harry Pitman, I. J. Vaughan-Morgan, Sir John
Lewis, Kenneth (Rutland) Pitt, Miss Edith Vickers, Miss Joan
Lilley, F. J. P. Pott, Percivall Vosper, Rt. Hon. Dennis
Lindsay, Martin Powell, Rt. Hon. J. Enoch Wakefield, Edward (Derbyshire, W.)
Litchfield, Capt. John Price, David (Eastleigh) Walker-Smith, Rt. Hon. Sir Derek
Lloyd, Rt. Hon. Selwyn (Wirral) Price, H. A. (Lewisham, W.) Wall, Patrick
Loveys, Waiter H. Prior, J. M. L. Ward, Dame Irene
Low, Rt. Hon. Sir Toby Quennell, Miss J. M. Watts, James
Lucas, Sir Jocelyn Ramsden, James Webster, David
Lucas-Tooth, Sir Hugh Redmayne, Rt. Hon. Martin Wens, John (Maidstone)
McAdden, Stephen Rees, Hugh Whiteraw, William
MacArthur, Ian Renton, David Williams, Dudley (Exeter)
McLaughlin, Mrs. Patricia Ridley, Hon. Nicholas Williams, Paul (Sunderland, S.)
Maclay, Rt. Hon. John Ridsdale, Julian Wills, Sir Gerald (Bridgwater)
Maclean, Sir Fitzroy (Bute & N.Ayrs.) Rodgers, John (Sevenoaks) Wilson, Geoffrey (Truro)
McLean, Neil (Inverness) Wise, A. R.
Macleod, Rt. Hn. lain (Enfield, W.) Roots, William Wolrige-Gordon, Patrick
McMaster, Stanley R. Ropner, Col. Sir Leonard Woodhouse, C. M.
Macmillan, Rt.Hn.Harold (Bromley) Russell, Ronald Worsley, Marcus
Macmillan, Maurice (Halifax) Scott-Hopkins, James
Macpherson, Niall (Dumfries) Sharpies, Richard TELLERS FOR THE NOES:
Maddan, Martin Shaw, M. Mr. Gibson-Watt and
Markham, Major Sir Frank Skeet, T, H. H. Mr. Chichester-Clark.
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