HC Deb 29 March 1961 vol 637 cc1351-481


As amended (in the Standing Committee), considered.

3.59 p.m.

Mr. Kenneth Robinson (St. Pancras, North)

I should like to raise a point of order, Mr. Speaker, in connection with the two new Clauses on the Notice Paper in my name, entitled, "Extension of power to remit charges for dentures": Subsection (1) of section four of the Act of 1952 (power to remit charges for dentures supplied by teaching hospitals) shall have effect with the omission of the words "after consultation with the university associated with any hospital providing facilities for clinical dental teaching" and with the substitution of the words "any hospital" for the words "that hospital". and "Reduced charges for dental treatment": Subsection (2) of section two of the Act of 1952 (Charges for dental treatment) shall have effect with the substitution for the second "or" of the words "less one pound or the sum of". I understand that they have been ruled out of order. This unfortunate situation has arisen directly as a result of the operation of the Guillotine.

Mr. Speaker

Order. I hope that hon. Members who are not taking part in the present discussion will be good enough to make a little less noise.

Mr. Robinson

Thank you, Mr. Speaker.

I was saying that the difficulty we are in over these new Clauses arises directly out of the operation of the Guillotine. I am not, of course, challenging your decision about the Clauses being out of order. I understand that that is because we are no longer bound by the Money Resolution, but by the terms of the Bill as amended in Standing Committee. But it follows that those two Clauses would have been in order during the Committee stage of the Bill and are now out of order on Report.

In Committee, of course, the new Clauses came at the end of the Notice Paper and it was because of the operation of the Guillotine that we did not get that far and did not, therefore, have an opportunity of discussing them. I know that it could be argued that there were ways round this difficulty. We could perhaps have dropped other Amendments to take the new Clauses. We did drop a number of Amendments and we took only those which seemed to us the most important yet we did not reach the new Clauses. In addition, I must plead ignorance. I thought that new Clauses which came first on the Notice Paper on Report could then be discussed without difficulty.

It could also be said that we should move to recommit the Bill to a Committee of the whole House to allow the Clauses to be discussed, but that is a theoretical rather than a practical solution since not only would it take time, and we are once again operating under a very strict Guillotine, but the Government would no doubt oppose such recommittal and we would be left in exactly the same position as we were in before.

I put it to you, Mr. Speaker, that this is an infringement of the rights of the Opposition and of the minority. Because of the operation of the Guillotine we have not been able, and shall not be able, to discuss any new Clauses. I would ask, Mr. Speaker, whether you have any advice to give the House of how the minority can be protected in similar circumstances on a future occasion.

Mr. Speaker

I understand the hon. Member's protest. The difficulty about asking me to rule on it is that the very last part of his inquiry relates to a hypothetical future position about which I should decline to rule. Once the House decides that an Allocation of Time Order should be made, as the House did, the consequences which may necessarily follow will be that certain new Clauses will not be reached during the Committee stage, but that flows from the decision of the House in imposing the Allocation of Time Order.

I am sure that the hon. Member and the House will appreciate my position, because the hon. Member has been stating that the difficulties which stand in his way arise from rules which govern me and the House at the moment. The result is that I can do nothing to help the hon. Member. The fact is that the two new Clauses are at this stage out of order.


Mr. Thomas Fraser (Hamilton)

I beg to move, in page 1, line 5, to leave out subsection (1).

The House will be aware that the subsection which the Amendment seeks to remove relates to the increased charges for dentures. I trust that the Minister of Health will have appreciated that hon. Members, and, in particular, hon. Members on the Opposition benches, have been severely restricted in the Amendments that they would wish to move on this little Bill. My hon. Friends, of course, would have preferred not to have a Bill at all to amend, but we have been severely curtailed in our opportunities by the operation of the timetable, as has been made clear in the point which my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) has just made.

We on these benches are against all charges in the National Health Service. It follows, therefore, that we will be against any increase in existing charges and it is for that reason that we feel able and, indeed, obliged at this time to move an Amendment, which, I should think, will find vigorous support, for the deletion of subsection (1) of Clause 1. It was not my privilege to be a member of the Standing Committee, but I have done my best to keep myself informed by reading the whole of the OFFICIAL REPORT of the Committee.

On the charges for dentures, I observed that the Minister made some play with the fact that there is still a shortage of dentists. If it is the shortage of dentists that has caused the right hon. Gentleman and his right hon. Friends to bring forward this provision, I fail to see how this subsection will solve the problem in any way. As far as I can see, there is nothing in the Bill that is calculated to increase the supply of dentists. One would have thought that if the concern was with the shortage of dentists an effort might have been made to increase the supply. No such effort has been made, but by means of this subsection certain increased charges for dentures are to be imposed. The object would appear to be to reduce the demand upon dentists to provide dentures. This follows fairly logically and, therefore, these increased charges are to be a deterrent on some of our fellow-citizens against their seeking the services of dentists for the provision of dentures and it may be to have the necessary extractions made in the first place.

Who among our fellow-citizens will be deterred? Surely they will be those who are least able to pay the charges. I do not imagine for a moment that any hon. Member would be deterred by these increased charges from making use of the dental service. We shall be able to obtain our new dentures if we need them and we shall be able to meet these additional charges. But some members of our community will not go to the dentist. The purpose of the subsection is to discourage people who would otherwise go. Obviously, therefore, they will be the less well-to-do.

It will be said no doubt that the poorest people in the community are those on National Assistance and that they will have the charges met by the Assistance Board. I need not call attention again to what the Minister said several years ago about the reluctance of people to go to the Board and particularly about those who are just above the National Assistance level and those who qualify for assistance but, for reasons best known to themselves, have not chosen to go to the Board. These are the people who will be deterred.

I fear that many people who are on low wages will be deterred, and many of those will be paying the increased contributions imposed in another Bill. Many women on low wages will be paying the additional 8d. a week and many men the additional 10d. a week. They will be discouraged from making use of the Health Service to get extractions made in the first place and afterwards to obtain the dentures they need.

Do we in the House really wish to discourage these people? Do we not recognise that to have these people's badly diseased teeth removed is desirable in the interest of their health and that, equally, it is desirable that afterwards they should have dentures fitted to replace those teeth? If we do, why do we put this obstacle in the way of their obtaining these services?

Members on both sides of the House will recognise that the health of these people is very important to the health of the community as a whole. It may well be that some rather superior people regard lower-paid workers as just cogs in the industrial machine and not as being of great importance, but in industry those workers are very important. Those cogs in the machine are essential to the proper working of the machine.

I have seen reports of speeches made recently by the Minister of Labour, in which he has compared the loss of employment and production through ill-health with the loss through industrial disputes, and he has begged his Conservative friends who are always talking about loss of production through disputes to keep things in proportion and to put the figures of such losses alongside those caused by ill-health.

The provision we are seeking to delete will not lead to any improvement in the health of the working people, but, rather, to a worsening. We in this House like to think that our democracy is a good one, and that we have Government by consent. No doubt the Minister of Health was satisfied, when he introduced the Bill, that he had the support of the electors. I do not think that he can now claim that they support him in imposing these new charges. All the health charges taken together have had such an effect that the right hon. Gentleman and the Government enjoy the support of only a minority of the electors—substantially less than half.

We have had five by-elections in the past two weeks, by which time the effect of these charges had been brought home to the electorate. The Conservative Party polled 112,033 votes in those constituencies in the General Election, and the anti-Tory vote was 103,976. The Conservatives thus had 51.8 per cent. of the votes. In the recent by-elections, the Tory vote slumped to 69,613, while the anti-Tory vote went up to 110,275. Thus, the General Election majority in these five constituencies of 51.8 per cent. slumped to a minority of 38.7 per cent. in the by-elections.

The right hon. Gentleman has the satisfaction of knowing that if he resists our Amendment he is resisting the will of more than 60 per cent. of the electors. Those five constituencies are not untypical. I do not know what the smirk on his face is meant to convey.

The Minister of Health (Mr. Enoch Powell)

Will the hon. Member give the Labour Party's figures separately?

Mr. Fraser

I have all the figures here for all candidates in all five by-elections. Only one candidate increased his party's General Election majority, and that was the Labour candidate at Birmingham, Small Heath. I thought that the Government would recognise that the people do not wish these new charges to be imposed.

We on this side of the House, being against all these charges but having failed to get the right hon. Gentleman to take this objectionable little Bill away, are now concerned, by this Amendment, to try to delete the most objectionable provision of the Bill. I do not believe for a moment that this subsection would have the support of the electors. It is, therefore, in the belief that I speak not only for my right hon. and hon. Friends but for a majority of the people, that I have moved the Amendment.

4.15 p.m.

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

We did our best during the Committee stage of the Bill to offer arguments to the right hon. Gentleman the Minister of Health and the Parliamentary Secretary whereby he could have met us in our objections to these additional charges. We were not successful.

I note that my hon. Friend the Member for Hamilton (Mr. T. Fraser) said that the Bill is adding to the charges on the National Health Service in order to deter people from procuring dentures when they need them. I think that the right hon. Gentleman will deny that. He may say that he does not expect this to deter anyone, in view of the rise in the standard of wages and incomes in the nation as a whole in the past few years since the original charges were imposed. He will remember that we put the matter to him in our arguments as fairly as possible.

We said that when, in 1951, these charges on teeth were imposed, there were certain criteria in the mind of the then Minister of Health. The question of deterrence and abuse he put aside, because no one believes that people wish to have their teeth pulled out for fun and to wear dentures if they are not necessary. But this was an easy way to get money, and a method of collecting it that would not be expensive, as the overhead charges would not be high. I have always admitted that this, if we have to have charges, is a reasonable argument.

My argument today is that times have changed, and that if there was any excuse in 1951 for imposing limited charges there is no excuse now. The very fact that the nation is more affluent is surely an argument that we can afford to remit all Health Service charges altogether.

We have heard interesting figures, some of which we produced and others which were produced by the right hon. Gentleman. He told us that in 1959 the gross cost of dentures was £13¾ million and the net cost, therefore, was roughly £7½ million, but that for treatment it was apparent that the cost to citizens of putting their hands into their pockets was a much smaller percentage than the 50 per cent. they must find in obtaining dentures. The gross cost of treatment, he said, was £38,700,000, and the net cost £35,300,000.

It is a specious and, on the surface, an excellent argument to say that we are making the charges in such a way that people will be moved, or impelled, or driven to care for their teeth and to conserve them, because it will be cheaper for them to have conservation treatment rather than wait and have to wear dentures. The difficulty in this argument and why I find it specious is that men and women, particularly young people, do not think about these matters, nor do they know what they should do to conserve their teeth and gums. The Minister knows that we are still a long way from taking preventive action on a national scale. We therefore fall back on the argument that if the nation is wealthier than it was in those earlier days when the charges were first imposed—and they were imposed at a time of great national crisis, the time of the Korean War—this is now the time when the charges should be removed.

Let the Minister consider the figures which he gave us. In 1950, the cost of the dental service was about £48 million. That fell in 1953 to below £30 million and in 1959 the figure was £52½ milion. I know that the first figure includes the higher remuneration which dentists were then getting and that the fall to below £30 million in some respects represents the effect of cuts in that remuneration. However, the latest figure of £52½ million for 1959 does not have the value in terms of goods and services of half what the same amount would have brought ten years ago.

That suggests that, in reality, we are not spending anything like as much on the general dental service as we did in the first years of the service. There is ample evidence to show that not nearly so many people require dentists now as was the case in the early years. The figures are that 3.3 million dentures were supplied in 1950, 1.2 million in 1953 and 1.6 million in 1959. We know that there was a great backlog to be made up in the early years and that a tremendous number of people then required treatment for dental diseases. Many people were then dentureless because they could not afford them and did without them. That was a national scandal as well as being to the disadvantage of those people.

I am delighted that the number of treatments is now increasing and, according to the evidence, is going still higher. When one considers the evidence dispassionately, it seems that we can well afford to turn our backs on these extra charges. It would be out of order to plead for the removal of all the charges, but I maintain that there is no need for this extra charge of 5s. In Committee, we put forward an Amendment suggesting an increase of 6d. instead of 5s. and there is no need to repeat the arguments which we then made which were rebutted and refused by the Minister. However, I hope that even at this late stage the right hon. Gentleman will accept that there is no need for this further charge and that he will give further consideration to it.

Mr. Powell

The Amendment deals with one of two classes of adjustment of charges which the Bill will bring about, and thus brings us to the major arguments for the Bill which have been canvassed since the beginning of its course through the House. I repeat that the ground on which I recommend these adjustments to the House is that the yield of the increases proposed in these charges can be much better applied within the National Health Service by bringing them back to the proportion of the cost of the appliance which they bore when they were first introduced in 1951, rather than by keeping them at their present level.

The hon. Member for Stoke-on-Trent, Central (Dr. Stross) said that times had changed, but the fact that we are more affluent than we were ten years ago does not necessarily mean—and I say that it carries the opposite implication—that the most urgent application of the £1 million or so involved is to keep the charges at their present level. The argument for applying that money elsewhere in the Service is strengthened by the change which has taken place.

Nevertheless, it is true to say, as the hon. Member for Hamilton (Mr. T. Fraser) said, that the shortage of dentists is relevant to our consideration. For as long as the total supply of dental work does not equal the total demanded, we have to consider how the available dental work is shared among the different classes exerting the demand upon it, and we have to determine the influence of the present and future patterns of charges in the distribution of the dental effort as among the different classes of work.

The hon. Member for Stoke-on-Trent, Central reminded the House that since 1951 there has been a welcome shift from general dentistry to conservation work and that of the total of dental work we are securing about half is devoted to the priority classes. As long as there is a net shortage of dental effort, it cannot be denied that anything which reduces the differential between the free treatment for the priority classes, the treatment fee for conservation work and the charge for dentures is bound to react to some degree unfavourably upon that distribution and upon that trend which I know we all wish to maintain and encourage.

To that extent, the undoubted fact that we have not yet got the full dental manpower we require is relevant and supports the arguments which I have made from the beginning—that we ought so to revise these charges that they again bear their initial ratio to the cost of the appliances in question.

Finally, the hon. Member drew attention to the variation in the money cost of the General Dental Service. I have no reason to dispute his figures; but he will agree that it is in terms of volume of work done that we should measure the progress of the general dental service. Not only does the variation in fees over the period vitiate the money comparison, but there is also the fact that with improvements in techniques the same amount of dental manpower is able to do a substantially increasing amount of dental work.

Looking back at those ten years, we see a steady increase in the volume of dental work done. We see a trend towards a better distribution of that work, in particular in favour of the priority classes. In the light of all those facts, the adjustments of these charges to their initial ratio seem thoroughly justified, and the yield which will accrue to the gross revenue of the National Health Service can be much better laid out in other ways.

4.30 p.m.

Mr. James Dempsey (Coatbridge and Airdrie)

I am very surprised to hear the Minister say that the mere fact that there is a shortage of dental officers is ample reason why these charges should be increased.

According to the Bill, we are proposing to increase charges for one denture by 5s., and, where more than one denture is supplied, by 15s. It seems to me that the Minister is arguing, on the one hand, that owing to the shortage of dentists—and he hangs his hat on the Guillebaud Report on this issue—the charges should be increased, and on the other, that over the past few years there have been increases in the number of treatments, the number of dentures supplied, and the number of people attending dental surgeries.

That there have been increases obviously means that there are more dental officers and dental staff available. The Minister argues that the reason for the increases is the shortage of staff. He concedes that more dental work is being done than ever before, but that it can only be accomplished by increasing the dental staff. That appears to me to be contradictory. If we have been able to accomplish this increase in service to the nation during the past few years because the staff has been increased, there is no legitimate argument for increasing dental charges because of the lack of staff. I am at a loss to follow the Minister's reasoning.

The figures show—and this appears to be generally consistent in other services—that as soon as charges are increased the number of people taking a service automatically drops. That is what is happening in the case of dentures. Similarly, every time the price of school meals is increased, there is a decided drop in the number taking school meals, and it takes years to restore the equilibrium. The Minister should explain to the House why he thinks that a level will be reached in the supply of dentures which will enable us to reduce the charges.

All the right hon. Gentleman's arguments are based on the question of supply and demand. He cited my hon. Friend the Member for Hamilton (Mr. T. Fraser), who referred to the dental figures quoted in the Guillebaud Report. But those figures date from between 1949 and 1954. A great deal of water has run under the bridges since 1954. From that period to date, there has been an increase in the number of dental clinics and dental officers.

The Minister cannot dispute that. If we have increased the numbers of dental staff, and if there has been an increase in the numbers attending dental surgeries, it is not reasonable to say that we have to increase the charges because of the shortage of dental officers. If we had been able, over the past five, six or seven years, to contain the demand on the basis of the present charges, there is no validity in suggesting that the charges should be increased.

The Minister should be honest about this matter. It is part of the Government's policy. They intend to redistribute income in many ways. One of the ways is to ensure that consumers, whether they can afford it or not, have to pay extra charges. It would appear that the Minister is misleading the House when he seeks to convey that the main consideration is shortage of dental staff. The fundamental consideration is the economic policy of the Minister, of his Department and of his Government. I honestly believe that the introduction of charges of this nature is a very mean attitude to adopt towards people who may be in pain. I have often said that it takes sufficient courage to go to the dentist without having to pay for treatment. It is obvious that people will only be driven to a dental surgery when they are in excruciating pain.

I ask the Minister to realise that this is not merely 15s. when a person requires more than one denture; it means a £5 contribution. That is the price stated in the Bill. In the light of experience the professional associations and the British Dental Association, which is not an association which one could identify with the British proletariat, but which can be identified with other political interests which are widely represented on the Government benches, have condemned charges of all sorts because of their deterrent effect on persons in need of dental care and treatment, extractions and replacements.

It is our duty to remove that deterrent to the best of our ability. The only effective way is to get the Government to accept the Amendment. We have been asking the Minister for several weeks to accept our Amendments, but he does not seem to be receptive to our appeals. There is no doubt that if he is not receptive the general public are, because they have been protesting since the Bill received its First Reading. The general reaction is that the dental charges proposed are exorbitant.

One should remember that not long ago dentures and treatment were available for 8½d. a week, but from 1st April this year the contribution will be 2s. 8½d. a week. The Minister has insisted throughout the Committee stage that these charges must stand, but we on this side frankly believe that they are unnecessary, unjust and put an unfair burden on millions of wage earners and pensioners. A disproportionate amount of the income of these citizens will have to be used for these purposes. We have tabled the Amendment to indicate not only our opposition to the Government's proposals, but our detestation of the mean and callous disregard which they have for human values.

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

I hoped that the Minister would have said something about the difficulties of women in the home in relation to this matter. We have been told that people are better off now; but, although everybody else in the home may be looked after, although everybody else may make it his or her business to obtain the services required, the mother of the family, who needs the services most of all, has to look into her purse, and she often discovers that she has not sufficient money to pay for the services she requires. Since the introduction of the Bill I have had the opportunity of talking to many women who are very concerned about this matter. I have also spoken to many persons in the medical profession, who have told me that if our women—especially those who are not insured—fail to have their teeth attended to when they should there is a greatly increased possibility of their being admitted to hospital suffering from stomach complaints.

These higher charges will impose an added burden on the mother and the woman in the home. I should like to know whether the Minister has any figures referring to the number of treatments given to women who are not working and therefore not paying insurance, but who are part of a household. Have we any figures to indicate the scope of this matter? I should be interested to hear them if they are available. I should like to be able to compare them with other figures relating to persons in all age groups, whether single or married, who have had attention, and follow up and see whether I can get some more figures from the hospital service or general practitioners, relating to the number of women who attend for some kind of stomach complaint and in respect of whom the general practitioner or the hospital doctor finds that the complaint may well have arisen because of their not having had proper dental treatment.

Many women have told me, "It was difficult enough before to obtain treatment, but where in the name of goodness are we to find £5 if we need dentures?" They will be the ones to suffer. The Ministry should investigate this point very carefully. Older people are able to obtain supplementation from the National Assistance Board to help pay the charges, but the women for whom I am speaking, in the middle age groups, have no opportunity for being treated unless they can find the money. If the Minister has any relevant figures I hope that he will let us have them. Mothers in the home, who have to look after a family, cannot afford to be away from it for any length of time, or be ill for any length of time, because of the difficulties this would cause in their families.

4.45 p.m.

I do not suppose that the Minister can be persuaded to accept the Amendment, but he should bear all these factors in mind. It may be necessary to amend these provisions later on in order to ensure that the thousands of women who are in the position I have indicated are not prevented from obtaining proper dental treatment.

I have always been opposed to charges on the National Health Service. I opposed my own party when it suggested them. I believe that I was the only person in this House who opposed the charges when my party first suggested them. I said that I would not go on to any platform in support of charges; in fact, I said that I would take every opportunity to oppose them. I repeat my opposition now, with added emphasis because the charges have risen and more people find themselves in difficulty.

This is a very bad step. We should not make people pay for dentures when the very thing we have been trying to do is to get them to have early dental treatment so that they can avoid having to have their teeth removed.

Mr. Emrys Hughes (South Ayrshire)

I support the plea made by my hon. Friend the Member for Liverpool, Exchange (Mrs. Braddock). I should be very much obliged if the Joint Under-Secretary of State for Scotland could supply the relevant figures for Scotland in general and Ayrshire in particular. The hon. Gentleman happens to be a constituent of mine, and I should very much like to hear him speak from the Dispatch Box and try to convince the young Unionists of Ayrshire that these charges are justified. Those people are a very progressive section of the community, and are at present expressing alarm about the proposal to reduce the expenditure on a certain hospital. I should like the Minister to tell us how he justifies this mean, miserable imposition, which we seek to modify by the Amendment.

Like my hon. Friend the Member for Liverpool, Exchange, I opposed these charges in 1951. I recently reread the report of the proceedings of the Committee at that time, and I found that I made a very interesting speech. When we look back and read, in HANSARD, what we said perhaps ten years ago, we sometimes find that we said something which we now wish we had not said, but I find that I made a very relevant speech, which could be repeated almost word for word now. I opposed the Labour Government at the time. In speeches here and in the country I warned the Labour Government that if they proceeded with the proposal to charge for dentures and spectacles the time might come when a Tory Government would go through the door which the Labour Government had opened.

Not only that. Three of my hon. Friends and I went into the Lobby to vote against the Clause. They were Mr. McGovern, my hon. Friend the Member for Glasgow, Bridgeton (Mr. Carmichael), and my hon. Friend the Member for Central Ayrshire (Mr. Manuel). I do not regret having voted against the Government on that occasion, because I believed that it was a retrograde and reactionary Bill and a retrograde and reactionary proposal.

Now, ten years later, in following the example of the Labour Government, the Tory Government have done something equally reactionary and retrograde.

Dr. Stross

My hon. Friend will no doubt remember that the Labour Government put a term on the charges—that they should cease after two budgetary years.

Mr. Hughes

I am aware that that was the orthodox explanation, but I believe that any attempt to make any inroads into the Health Service is a technical and political mistake and a great human blunder.

The real excuse made at the time was that this charge would be necessary for only three years. It was said that the Labour Government were having difficulty in finding money for the rearmament programme. We were told that we were at war with Korea, that the rearmament programme would last only three years, and that at the end of it, the Labour Government, having successfully won the war in Korea, would proceed to abolish the charges which they had imposed. Unfortunately, after three years, a Tory Government were in power, and now we have the Government continuing the bad work unfortunately started by the Labour Government in 1951.

I do not want to recall past history for the sake of recalling it, because it is said that the lesson we learn from history is that we learn nothing from it. The right hon. Gentleman has evidently learnt nothing from history. As my hon. Friend said, the charge on dentures has been opposed at every stage of the Bill, and I repeat that when the Labour Government get back to power. as I believe they will, these charges will go. We have abundant evidence to show that the Labour Government will abolish this tax on false teeth.

What a mean miserable thing it is. I should like the Minister whom I am supposed to represent to come to the Dispatch Box and explain his attitude. How will he be able to walk through the streets of Mauchline and say to the toothless old woman, "I am the person who put the tax on your false teeth"? If he does not come to the Dispatch Box and explain what he means, it will be because he is ashamed to do so. Will he tell the old lady in the streets of Mauchline: "It will be all right. You can go to the Public Assistance Committee in Cumnock and, after a declaration of income, you will be able to have 10s. refunded because we are really anxious for you to have false teeth"?

I should also like him to explain how, after the proposal yesterday that the salary of the Secretary of State for Scotland should be increased to £10,000 a year, he can justify this mean miserable economy. I await with interest his advance to the Dispatch Box to hear what he will tell the old woman who needs false teeth and what he will tell the young Unionists who are anxious about dentures being supplied to old people. I hope that he will give us some explanation of his attitude and tell us why he opposes the Amendment.

Mr. Raymond Gower (Barry)

Even accepting the case made by several hon. Members opposite that these charges are objectionable and that they should not be imposed, if I were asked which was the least objectionable charge of all I would say that the charge we are now discussing could be so described.

Mr. Dempsey

They are all objectionable.

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

Does that mean that the hon. Gentleman thinks that there are some which are more objectionable?

Mr. Gower

The average person in his or her lifetime is not always buying dentures. It is true that a friend of mine has more than one set. One set is called "smilers" and the other "eaters", but he is an exception. The average person does not have to undertake this expenditure very frequently.

I thought that the tone of the speech of the hon. Member for South Ayrshire (Mr. Emrys Hughes) suggested that we were now considering the imposition of a very large sum, but surely in the case of a single denture it is an extra charge of only 5s.

Mr. Emrys Hughes

That is a lot to poor people.

Mr. Gower

It is a charge of 5s., we hope once in a long time. For more than one denture the maximum charge is the difference between £4 5s. and £5. People who have false teeth need to replace them infrequently. The maximum charge under the Bill will be an extra 5s. for a single denture, and 15s. for more than one.

Mr. Dempsey

Does not the hon. Gentleman agree that the total charge for one denture will be £2 5s., and £5 for more than one? Does he not regard that as a considerable imposition?

Mr. Gower

I accept what the hon. Gentleman says, but even if the Amendment were accepted the person in question would still be paying 5s. less for a single denture and a maximum of 15s. less for more than one denture.

Dr. Stross

I am following the hon. Gentleman's argument carefully. Does he agree that in the course of the dental adventures which people undertake, ending with a complete set of false teeth, the process starts with one or two false teeth, then another couple of teeth, and that this process goes on for a long time? If one starts at, say, 35 or 40, before one dies one will have had anything up to 10 or 12 different appliances, on all of which one must pay the extra charge.

Mr. Gower

The hon. Gentleman is quoting the extreme case, but even in that case in the course of a lifetime the extra charge would be only £3.

Mrs. Slater

That is £3 on top of the other charges.

Mr. Gower

We are not arguing whether there should be a charge, but whether there should be this increase, and that is the point I wish to emphasise.

Mr. K. Robinson

Is the burden of the hon. Gentleman's argument that, because the initial charge is a substantial one, there can be no argument against increasing it?

Mr. Gower

That is not my argument. I was referring to the arguments advanced by hon. Members opposite that the Bill was imposing the whole weight of these charges. What we are arguing about is the comparatively small increase which is not normally an item of expenditure in the average person's budget. That is why I said at the beginning of my speech—this is a reply to the hon. Lady the Member for Stoke-on-Trent, North (Mrs. Slater)—that this might be deemed by many impartial judges to be less objectionable than many other charges of this kind.

5.0 p.m.

A person who has a denture today gets an extremely good bargain. Fortunately, I have not so far found it necessary to obtain a denture for myself, but I have seen those of relatives and friends. I know that in some cases they cost a large sum of money and even if this charge is increased, I submit that the average person obtains an extremely good bargain.

I do not wish to labour the point too much, but there is another aspect of the matter. I do not want to appear dogmatic about this, but it might be submitted that in some cases—not in all, I accept some of the points made by the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock)—in some marginal cases it is possible that the imposition of these charges would make people a bit more careful of their dentures than they might otherwise be. I know that if I had to pay a charge for dentures I should take care of them——

Mrs. Alice Cullen (Glasgow, Gorbals)

Will the hon. Gentleman explain what he means by persons taking care of their dentures? Who would not take care of their dentures?

Mr. Gower

Whether it be a pair of spectacles or dentures, it is possible that, if they are obtained free, people may be careless about them——

Mr. James H. Hoy (Edinburgh, Leith)


Mr. Gower

The hon. Gentleman may groan, but if a charge is made, however modest, the probability is that people will take more care of these things.

Mr. Emrys Hughes

Does the hon. Gentleman mean that if he were put to greater expense for his dentures he would swallow them?

Mr. Gower

The hon. Gentleman may be facetious about this, and I appreciate the joke. But if he cannot understand the point I am making, I have overestimated his reasoning power.

Giving myself as an example, I think that if one has to meet some form of expenditure one is more likely, in normal circumstances, to take care of the thing for which the charge is made. That is my point, and in making it I hope that I have not taken up too much of the time of the House.

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

The pitiful level to which the Government supporters have fallen in defence of this Bill is shown when we are treated to the sort of nonsense to which we have been listening, about the way people take care of their teeth. I have not heard so much nonsense in all my life. When I was in the Navy—and if one is in the Services one gets these things for nothing—I saw thousands of men who got their false teeth free, but I never saw any of them kicking their teeth about the mess deck or being careless with them in other ways. I have never heard so much rubbish in my life. In the first part of his speech about the smallness of the charge the hon. Member for Barry (Mr. Gower) repeated remarks which he has made about six times already in respect of other charges. It is the same as the argument about the girl's baby—it is just a small one. We have had that argument on every occasion.

The trouble is that all these small amounts add up. If one child in a family is to get one thing, and another wants something else, and the father has to pay more on his health contribution, it all amounts up to a considerable sum. Hon. Members opposite do not seem to be aware of that. They do not appreciate that all these sums add up and make a considerable inroad into the funds at the disposal of the ordinary person. That, however, is not really the question at issue. The fundamental question is whether these services, which promote good health among the people and enable them to contribute to the community in a proper way, should be free of charge. Hon. Members on this side of the House differ from hon. Members opposite in their attitude to that question.

I wish to reinforce the plea of my hon. Friend the Member for South Ayrshire (Mr. Emrys Hughes) that the Joint Under-Secretary of State for Scotland should say something about this Bill. I have been examining the Committee stage discussions and I think it a shameful disgrace that hon. Members representing Scottish constituencies should be dragged along and have everything explained to them by an English Minister who knows little about Scotland and Scottish affairs; and that the Minister responsible for these services in respect of Scotland should sit mum. It is not good enough. We shall try to get some explanation from the hon. Gentleman about the way in which this Bill relates to Scotland.

What have been the reactions of the people of Scotland to this increase? What representations has the hon. Gentleman received that this charge should be levied? Are we to be told that we can have a new hospital in Edinburgh or Glasgow only if people who want new false teeth pay for them? I am not concerned with England. Hon. Members who represent English constituencies can look after that——

Lady Megan Lloyd George (Carmarthen)

And Wales.

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

The hon. Member for Edinburgh, East (Mr. Willis) has asked an interesting question. According to the OFFICIAL REPORT of 2nd May, 1951, the late Hector McNeil replied on precisely the same point to the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock). He said that the Health Service had to be reorganised in this way since, if more hospital beds were to be provided, charges would have to be made for the provision of other services.

Mr. Willis

Unfortunately, I was enjoying a compulsory "retirement" at the time when that speech was made. But I am not much concerned about what happened in 1951, 1941 or 1931. I have always argued that because something happened on one occasion—in this case ten years ago, or it may be that something happened twenty years ago—it is no argument for allowing it to happen again. Every time we examine this matter we should approach it from the point of view of what we ought to do now, not what happened twenty years ago. If we followed that sort of argument and went back far enough, we should now be nude and painting ourselves with woad. That argument is so fantastic, and is accepted so solemnly, particularly by hon. Members opposite, that it grieves me to see the ease with which it is put across.

Mr. Cooper

The hon. Gentleman really should not rack himself with so much synthetic indignation. I also have here the Division record in 1951, and I notice that nearly every hon. Member opposite voted in favour of the charges then.

Mr. Willis

The same argument applies. I was not being indignant. I was feeling sorry that hon. Members opposite should fall for the argument that because something happened ten years ago we ought not to do anything different today. The degree to which a Tory Government and Tory supporters think that everything the Labour Party did is good is almost pathetic. They think that everything the Labour Party did was so excellent that we must not do anything else. Although I am one of the most loyal members of the Labour Party, I would hardly claim that for a Labour Government or for the things they did. That is a most pathetic argument to come from any Government—that because it was done ten years ago it must be right. Is that the touchstone of all that is best and good in the country? It is a great tribute to the Labour Government, but it is not merited.

Mr. Gower

Surely, it is not a matter of what the Labour Government did, but the fact that the Labour Party seems to take a different view about these charges when in Opposition than when it is the Government?

Mr. Willis

I do not want to prolong these arguments about what happened in 1951. I think that they are phoney and that it is rather pathetic that people should have to depend on them today to bolster up a very weak case indeed for what, after all, is a very mean Bill. In effect, the person who, because of ill health or for other reasons, requires false teeth, is told, "You need false teeth and because you need them you must contribute towards the hospital service". That is what the Bill provides. I can see neither rhyme nor reason in that.

Why should we select the man with toothache to be the contributor towards the building of hospitals in England or Scotland? All that we have suggested, and I should have thought that there was a certain amount of justice in it—indeed, the right hon. Gentleman himself was almost agreeing with us previously—is why not ask people to pay in accordance with their ability to pay. What is wrong with that? Is there something terrible in asking people to pay for the social services and hospitals in accordance with their ability to pay?

Mr. Richard Marsh (Greenwich)

Let us have an answer.

Mr. Willis

We have never had an answer.

Mr. Deputy-Speaker (Sir Gordon Touche)

I would point out to the hon. Member that we are discussing the Amendment.

Mr. Willis

I want these charges eliminated. If they were eliminated, then the additional money would have to be found in the way that I am suggesting. Therefore, Mr. Deputy-Speaker, I would suggest with very great respect that it is in order for me to say that. All I am asking is why is our proposal to delete this subsection and to let people pay in accordance with their ability to pay a bad suggestion? Is there something un-Christian or something evil, or something not good about the suggestion? Does it not fit in with the right hon. Gentleman's economic ideas? I do not think that it does, because he has the queerest economic ideas. What is wrong with the proposition?

I should have thought that what we propose was the just method of paying for these things and that we should not just select someone who happens to be unfortunate and tell him that he must pay. We might just as well pick out a person with a pimple on his left ear and say that he has to pay. It is just as reasonable. There is as much logic in saying that a man with a pimple on his left ear should pay for the hospitals as there is in saying that a man who has to have a tooth out should pay for it.

I do not expect that the Government will have second thoughts, but I hope that they will realise how ridiculous is the proposition which they are putting before the House. I certainly hope that the Joint Under-Secretary of State for Scotland will play a part becoming to a Scottish Minister in these debates, and that he will not just sit there like a messenger boy letting the English Minister do all the dirty work. That is not good enough. I want to see Scottish Ministers playing their proper part in these debates and not acting as menial scribblers behind the Box.

5.15 p.m.

The Joint Under-Secretary could probably answer the questions that I have asked and give us the figures for which my hon. Friend asked. He could no doubt tell us to what extent this will affect Scotland, how much it would cost Scotland if the Amendment were accepted and how much Scotland would lose if it were accepted. The real test is how many hospitals would not be built if it were accepted. How much, for instance, would the work in Edinburgh be held up? We have a lot of work going on in Edinburgh. There is the Royal Infirmary to be rebuilt. To what extent would that be held up if the Amendment were accepted?

I think that before we leave the Amendment we ought to be told something about these things, and I sincerely hope that the hon. Gentleman will treat his office in a serious manner. It is an important office and I want it treated as an important office. As I say, I hope that the hon. Gentleman will play his proper part in these debates.

Mrs. Slater

I am sorry that the hon. Member for Barry (Mr. Gower) has left the Chamber, because at the beginning of his speech he said that this was perhaps the least objectionable part of the National Health Service Bills. I wanted to point out to him that he apparently thought that there were some objectionable parts to these Measures although he voted in favour of every one of them and for every part of them. The fact is always thrown back at us that in 1951 the Labour Government introduced the charges. Many of us feel very strongly indeed that they ought never to have been introduced. As the hon. Member for South Ayrshire (Mr. Emrys Hughes) said, their introduction opened the door for continued increases in the charges to be made by the Tories.

It has been pointed out, and this is something which needs to be very strongly pointed out, that initially the charges were put on for a limited period. Since then that part of the Act has never been dealt with, and instead we are now faced with the situation where the charges continue to rise. The fact is that in an age when the Tories are constantly telling us that we are better off, that we are living in much better circumstances and that we are better off because the Tories care, we ought to be taking the charges off. We certainly ought not to be putting extra charges on.

By putting on extra charges we are not really facing up to the question of whether it is true that people are better off, and neither are we facing up to the claim which we on these benches make that in spite of many people being better off there are many thousands whose standard of life has risen very little, if at all.

Mrs. Cullen

I wonder if the Minister is aware that dentists, knowing what is going to happen, especially in working-class districts, will allow working-class men and women to pay for their dentures by hire purchase?

Mrs. Slater

I agree that that is a shocking state of affairs.

The point I was making was that many thousands of people are still living on the border, and in some cases below the border, of a decent standard. It is these people who will find these extra charges most objectionable and most difficult to pay. This is another instance of where at this stage in our history we have the priorities wrong. Instead of considering how best we can care for the people's health, we are putting on extra charges, thus making it very much more difficult for some to attain the standard of health which they ought to have.

Whenever we point this out, the Tories always say, "Well, there is the National Assistance Board to which these people can go." It is either National Assistance or, as my hon. Friend the Member for Glasgow, Gorbals (Mrs. Cullen) suggests, hire purchase. The woman in the house, in particular, has to worry about whether or not she can afford these extra charges.

In the original National Health Service Bill we saved the woman in the house from the worry and misery she had always to bear about her health. The extra charges will take many ordinary mothers back to those circumstances. They will have to reckon up their pennies before deciding whether they can afford to pay the cost of dentures. This again is a case of the priorities being wrong. It is a disgraceful situation that, faced with the arguments of hon. Members opposite, many hundreds of our people are put into this appalling situation in 1961.

Mr. K. Robinson

It does not seem that the Joint Under-Secretary of State for Scotland is to respond to the appeal made by my hon. Friends. When I sit down, of course, he will have an opportunity of speaking if he wishes. As no doubt there are other hon. Members who might wish to take part in the debate, I must remind them of the Guillotine and the fact that we have further important Amendments which we wish to discuss. The Report stage must come to an end at 7.30.

Perhaps it was too much to expect at this stage of the Bill that the Minister would be able to adduce new arguments in support of these increased charges. He rested on the arguments which we have heard several times before. The

first was that it is necessary to keep price levels in line with what they were when the charges were originally imposed in 1951. We have to keep price levels in line with charges which were imposed—whether that was a good or bad thing—at a time of grave economic difficulty and considerable national peril, charges which would have come to an end automatically after three years had there not been a change of Government.

We have had the second argument, that somehow this increase of charges would keep in balance the relationship between conservation treatment and the provision of dentures. The Minister has told us again and again that we must do nothing which would have the effect of discouraging conservation treatment. That is a very hollow argument indeed. If the Minister wants to do anything to encourage conservation treatment he has a very simple method at hand. He could cut or eliminate the charges for dental treatment. It is ludicrous to suggest that the appropriate way of keeping the balance is to increase the charges for dentures. In fact, of course, it makes no difference whatever to the relationship between conservation and dentures.

Finally, the Minister says that, at any rate, we must keep these charges while the supply of dentists is not equal to the demands made upon them for dental treatment. That is after ten years of Conservative Government. We still have not got anything like the number of dentists we need to provide a proper dental service for our people. We are still not getting the dental students in the numbers required. A communication I have had from the dental profession shows that dentists believe that one very considerable contributory cause of the present situation is the way in which the Government have treated the profession. We are wholly opposed, not only to this subsection, but to every aspect of the Bill, and I hope my hon. Friends will now divide on this Question.

Question put, That the words proposed to be left out stand part of the Bill:—

The House divided: Ayes 266, Noes 196.

Division No. 126.] AYES [5.24 p.m.
Agnew, Sir Peter Arbuthnot, John Beamish, Col. Sir Tufton
Aitken, W. T. Ashton, Sir Hubert Bell, Ronald
Allan, Robert (Paddington, S.) Atkins, Humphrey Bennett, F. M. (Torquay)
Allason, James Barlow, Sir John Bennett, Dr. Reginald (Gos & Fhm)
Amery, Rt. Hon. Julian (Preston, N.) Batsford, Brian Berkeley, Humphry
Bidgood, John C. Harvey, John (Walthamstow, E.) Noble, Michael
Biggs-Davison, John Harvie Anderson, Miss Nugent, Sir Richard
Bingham, R. M. Hastings, Stephen Oakshott, Sir Hendrie
Birch, Rt. Hon. Nigel Heald, Rt. Hon. Lionel Orr-Ewing, C. Ian
Bishop, F. P. Heath, Rt. Hon. Edward Osborn, John (Hallam)
Bourne-Arton, A. Henderson, John (Cathcart) Osborne, Cyril (Louth)
Box, Donald Henderson-Stewart, Sir James Page, John (Harrow, West)
Boyd-Carpenter, Rt. Hon. John Hendry, Forbes Page, Graham (Crosby)
Boyle, Sir Edward Hiley Joseph Pannell, Norman (Kirkdale)
Brewis, John Hill, Mrs. Eveline (Wythenshawe) Partridge, E.
Brooke, Rt. Hon. Henry Hill, J. E. B. (S. Norfolk) Pearson, Frank (Clitheroe)
Brooman-White, R. Hinchingbrooke, Viscount Percival, Ian
Browne, Percy (Torrington) Hirst, Geoffrey Peyton, John
Bryan, Paul Hobson, John Pickthorn, Sir Kenneth
Buck, Antony Hocking, Philip N. Pike, Miss Mervyn
Bullard, Denys Holland, Philip Pilkington, Sir Richard
Bullus, Wing Commander Eric Hollingworth, John Pitt, Miss Edith
Burden, F. A. Hopkins, Alan Pott, Percivall
Butler, Rt. Hn. R. A. (Saffron Walden) Hornby, R. P. Powell, Rt. Hon. J. Enoch
Campbell, Gordon (Moray & Nairn) Hornsby-Smith, Rt. Hon. Patricia Price, David (Eastleigh)
Carr, Compton (Barons Court) Howard, Hon. G. R. (St. Ives) Prior, J. M. L.
Cary, Sir Robert Howard, John (Southampton, Test) Prior-Palmer, Brig. Sir Otho
Channon, H. P. G. Hughes Hallett, Vice-Admiral John Profumo, Rt. Hon. John
Chataway, Christopher Hughes-Young, Michael Proudfoot, Wilfred
Chichester-Clark, R. Hulbert, Sir Norman Pym, Francis
Clark, William (Nottingham, S.) Hurd, Sir Anthony Quennell, Miss J. M.
Cleaver, Leonard Hutchison, Michael Clark Ramsden, James
Cole, Norman Iremonger, T. L. Redmayne, Rt. Hon. Martin
Cooper, A. E. Irvine, Bryant Godman (Rye) Renton, David
Cooper-Key, Sir Neill Jackson, John Ridsdale, Julian
Cordeaux, Lt.-Col. J. K. James, David Robinson, Sir Roland (Blackpool, S.)
Cordle, John Jenkins, Robert (Dulwich) Roots, William
Corfield, F. V. Jennings, J. C. Ropner, Col. Sir Leonard
Costain, A. P. Johnson, Dr. Donald (Carlisle) Russell, Ronald
Coulson, J. M. Johnson, Eric (Blackley) Sandys, Rt. Hon. Duncan
Courtney, Cdr. Anthony Johnson Smith, Geoffrey Sharples, Richard
Craddock, Sir Beresford Joseph, Sir Keith Shaw, M.
Critchley, Julian Kaberry, Sir Donald Simon, Rt. Hon. Sir Jocelyn
Crosthwaite-Eyre, Col. O. E. Kerans, Cdr. J. S. Skeet, T. H. H.
Crowder, F. P. Kerby, Capt. Henry Smith, Dudley (Br'ntf'rd & Chiswick)
Cunningham, Knox Kerr, Sir Hamilton Smyth, Brig, Sir John (Norwood)
Curran, Charles Kershaw, Anthony Spearman, Sir Alexander
Currie, G. B. H. Kitson, Timothy Speir, Rupert
Dalkeith, Earl of Lancaster, Col. C. C. Stanley, Hon. Richard
Dance, James Leather, E. H. C. Stodart, J. A.
d'Avigdor-Goldsmid, Sir Henry Leavey, J. A. Storey, Sir Samuel
Digby, Simon Wingfield Leburn, Gilmour Summers, Sir Spencer (Aylesbury)
Doughty, Charles Legge-Bourke, Sir Harry Talbot, John E.
Drayson, G. B. Lewis, Kenneth (Rutland) Taylor, Sir Charles (Eastbourne)
Duncan, Sir James Lilley, F. J. P. Taylor, Edwin (Bolton, E.)
Duthie, Sir William Lindsay, Martin Teeling, William
Eden, John Linstead, Sir Hugh Temple, John M.
Elliot, Capt. Walter (Carshalton) Litchfield, Capt. John Thatcher, Mrs. Margaret
Elliott, R. W. (Nwcstle-upon-Tyne, N.) Lloyd, Rt. Hon. Selwyn (Wirral) Thomas, Leslie (Canterbury)
Emery, Peter Longden, Gilbert Thomas, Peter (Conway)
Emmet, Hon. Mrs. Evelyn Loveys, Walter H. Thompson, Richard (Croydon, S.)
Farey-Jones, F. W. Lucas-Tooth, Sir Hugh Thornton-Kemsley, Sir Colin
Fell, Anthony McAdden, Stephen Tiley, Arthur (Bradford, W.)
Finlay, Graeme MacArthur, Ian Tilney, John (Wavertree)
Fisher, Nigel McLaren, Martin Turner, Colin
Fletcher-Cooke, Charles McLaughlin, Mrs. Patricia Turton, Rt. Hon. R. H.
Foster, John Maclay, Rt. Hon. John van Straubenzee, W. R.
Fraser, Ian (Plymouth, Sutton) Maclean, Sir Fitzroy (Bute & N. Ayrs.) Vaughan-Morgan, Sir John
Galbraith, Hon. T. G. D. MacLeod, John (Ross & Cromarty) Wakefield, Edward (Derbyshire, W.)
Gammans, Lady McMaster, Stanley R. Walder, David
Gardner, Edward Macpherson, Niall (Dumfries) Walker, Peter
Glover, Sir Douglas Maddan, Martin Walker-Smith, Rt. Hon. Sir Derek
Glyn, Sir Richard (Dorset, N.) Maitland, Sir John Ward, Dame Irene
Godber, J. B. Manningham-Buller, Rt. Hn, Sir R. Watts, James
Goodhart, Philip Markham, Major Sir Frank Webster, David
Goodhew, Victor Marlowe, Anthony Wells, John (Maidstone)
Gough, Frederick Marples, Rt. Hon. Ernest Whitelaw, William
Gower, Raymond Marshall, Douglas Williams, Dudley (Exeter)
Grant, Rt. Hon. William Matthews, Gordon (Meriden) Williams, Paul (Sunderland, S.)
Green, Alan Moulding, Rt. Hon. Reginald Wills, Sir Gerald (Bridgwater)
Gresham Cooke, R. Mawby, Ray Wilson, Geoffrey (Truro)
Grimston, Sir Robert Maxwell-Hyslop, R. J. Wolrige-Gordon, Patrick
Grosvenor, Lt.-Col. R. G. Maydon, Lt.-Cmdr. S. L. C. Woodhouse, C. M.
Gurden, Harold Mills, Stratton Woodnutt, Mark
Hall, John (Wycombe) More, Jasper (Ludlow) Woollam, John
Hamilton, Michael (Wellingborough) Morgan, William Worsley, Marcus
Harris, Reader (Heston) Morrison, John
Harrison, Brian (Maldon) Mott-Radclyffe, Sir Charles TELLERS FOR THE AYES:
Harrison, Col. J. H. (Eye) Nabarro, Gerald Mr. Gibson-Watt and
Harvey, Sir Arthur Vere (Macclesfd) Nicholson, Sir Godfrey Mr. Peel.
Allaun, Frank (Salford, E.) Hayman, F. H. Pearson, Arthur (Pontypridd)
Allen, Scholefield (Crewe) Henderson, Rt. Hn. Arthur (Rwly Regis) Peart, Frederick
Awbery, Stan Hill, J. (Midlothian) Pentland, Norman
Bacon, Miss Alice Holman, Percy Plummer, Sir Leslie
Beaney, Alan Holt, Arthur Popplewell, Ernest
Bence, Cyril (Dunbartonshire, E.) Houghton, Douglas Prentice, R. E.
Benson, Sir George Howell, Charles A. Price, J. T. (Westhoughton)
Blackburn, F. Hoy, James H. Probert, Arthur
Blyton, William Hughes, Cledwyn (Anglesey) Proctor, W. T.
Boardman, H. Hughes, Emrys (S. Ayrshire) Pursey, Cmdr. Harry
Bowden, Herbert W. (Leics, S. W.) Hughes, Hector (Aberdeen, N.) Randall, Harry
Bowles, Frank Hunter, A. E. Rankin, John
Boyden, James Hynd, H. (Accrington) Redhead, E. C.
Braddock, Mrs. E. M. Irvine, A. J. (Edge Hill) Reid, William
Broughton, Dr. A. D. D. Irving, Sydney (Dartford) Reynolds, G. W.
Brown, Rt. Hon. George (Belper) Jay, Rt. Hon. Douglas Roberts, Goronwy (Caernarvon)
Butler, Herbert (Hackney, C.) Jeger, George Robinson, Kenneth (St. Pancras, N.)
Butler, Mrs. Joyce (Wood Green) Jenkins, Roy (Stechford) Ross, William
Chapman, Donald Jones, Rt. Hn. A. Creech (Wakefield) Royle, Charles (Salford, West)
Chetwynd, George Jones, Elwyn (West Ham, S.) Shinwell, Rt. Hon. E.
Collick, Percy Jones, Jack (Rotherham) Silverman, Julius (Aston)
Corbet, Mrs. Freda Jones, J. Idwal (Wrexham) Silverman, Sydney (Nelson)
Craddock, George (Bradford, S.) Jones, T. W. (Merioneth) Slater, Mrs. Harriet (Stoke, N.)
Crosland, Anthony Kelley, Richard Slater, Joseph (Sedgefield)
Crossman, R. H. S. Kenyon, Clifford Small, William
Cullen, Mrs. Alice Key, Rt. Hon. C. W. Smith, Ellis, (Stoke, S.)
Darling, George King, Dr. Horace Snow, Julian
Davies, G. Elfed (Rhondda, E.) Lee, Frederick (Newton) Sorensen, R. W.
Davies, Harold (Leek) Lee, Miss Jennie (Cannock) Soskice, Rt. Hon. Sir Frank
Davies, Ifor (Gower) Lever, L. M. (Ardwick) Spriggs, Leslie
Davies, S. O. (Merthyr) Lewis, Arthur (West Ham, N.) Steele, Thomas
Deer, George Lipton, Marcus Stewart, Michael (Fulham)
de Freitas, Geoffrey Loughlin, Charles Strauss, Rt. Hn. G. R. (Vauxhall)
Dempsey, James Mabon, Dr. J. Dickson Stross, Dr. Barnett (Stoke-on-Trent, C.)
Diamond, John McCann, John Swain, Thomas
Dodds, Norman MacColl, James Swingler, Stephen
Donnelly, Desmond McInnes, James Sylvester, George
Driberg, Tom McKay, John (Wallsend) Taylor, Bernard (Mansfield)
Dugdale, Rt. Hon. John McLeavy, Frank Taylor, John (West Lothian)
Ede, Rt. Hon. C. MacMillan, Malcolm (Western Isles) Thomas, Iorwerth (Rhondda, W.)
Edelman, Maurice MacPherson, Malcolm (Stirling) Thomson, G. M. (Dundee, E.)
Edwards, Rt. Hon. Ness (Caerphilly) Mallalieu, E. L. (Brigg) Thornton, Ernest
Edwards, Walter (Stepney) Mallalieu, J. P. W. (Huddersfield, E.) Timmons, John
Evans, Albert Manuel, A. C. Tomney, Frank
Fernyhough, E. Mapp, Charles Ungoed-Thomas, Sir Lynn
Finch, Harold Marquand, Rt. Hon. H. A. Wade, Donald
Fitch, Alan Marsh, Richard Wainwright, Edwin
Fletcher, Eric Mason, Roy Warbey, William
Foot, Dingle (Ipswich) Mayhew, Christopher Watkins, Tudor
Foot, Michael (Ebbw Vale) Mellish, R. J. Weitzman, David
Forman, J. C. Mendelson, J. J. Wells, Percy (Faversham)
Fraser, Thomas (Hamilton) Milne, Edward J. White, Mrs. Eirene
Gaitskell, Rt. Hon. Hugh Mitchison, G. R. Whitlock, William
Galpern, Sir Myer Monslow, Walter Wilkins, W. A.
George, Lady Megan Lloyd (Crmrthn) Moody, A. S. Willey, Frederick
Ginsburg, David Morris, John Williams, Ll. (Abertillery)
Gourlay, Harry Moyle, Arthur Williams, W. R. (Openshaw)
Greenwood, Anthony Mulley, Frederick Willis, E. G. (Edinburgh, E.)
Grey, Charles Oliver, G. H. Wilson, Rt. Hon. Harold (Huyton)
Griffiths, Rt. Hon. James (Llanelly) Oram, A. E. Winterbottom, R. E.
Gunter, Ray Oswald, Thomas Woodburn, Rt. Hon. A.
Hale, Leslie (Oldham, W.) Owen, Will Woof, Robert
Hall, Rt. Hn. Glenvil (Colne Valley) Paget, R. T. Wyatt, Woodrow
Hamilton, William (West Fife) Pannell, Charles (Leeds, W.) Zilliacus, K.
Hannan, William Parker, John (Dagenham)
Hart, Mrs. Judith Parkin, B. T. (Paddington, N.) TELLERS FOR THE NOES:
Mr. Lawson and
Mr. Rogers.
Mr. Deputy-Speaker

The next Amendment is in page 1, line 6, to leave out "five" and to insert "two". It would be convenient to discuss with this Amendment the Amendment in line 11, to leave out "five pounds" and to insert "four pounds nine shillings".

Mr. K. Robinson

In view of the fact that we are operating under a Guillotine and have less than two hours left for the whole of the Report stage, I propose to move neither the Amendment in line 6 nor the Amendment in line 11.

Lady Megan Lloyd George

I beg to move, in page 1, line 12, to leave out subsection (2).

This relates to charges for spectacles. During the debates on the Bill the Government have often called in aid the Guillebaud Committee, but on this point the Guillebaud Committee made its position very clear. It said: It seems to us that the level of the charge for spectacles is such as to constitute a barrier to a proportion of the people who need to make use of the Service; and we recommend that, when the resources become available, a fairly high priority (second only to an adjustment of the dental treatment charge) be given to a substantial reduction in the amount of the charge for spectacles. There is no suggestion of an increase and no comfort for the Government in the Guillebaud's Committee's recommendation. There is not one word about an increase. The only recommendation which the Committee makes is that there should be a substantial reduction on present charges. It is hardly necessary to say that we on these benches agree with that recommendation. Obviously, if the old rate constituted a barrier to a proportion of the people who need to make use of the service", there will be a very much larger barrier under the new rates.

We have had unexpected support for our view from The Times in the two articles contributed recently by a correspondent, who wrote: Not only are the dimensions of the extra revenue … far from assured but the Minister's assertion that there will be no hardship is, to put it mildly, unconvincing. That is substantial if not enthusiastic corroboration from an unexpected quarter.

During the earlier discussions some very strange arguments were advanced in support of these charges. One hon. Member who is not at the moment in his place, one of the few hon. Members opposite who broke the conspiracy of silence upstairs, the hon. Member for Rutland and Stamford (Mr. K. Lewis), produced some remarkable calculations, which I mention because this probably represents the view of other hon. Members opposite who were not so vocal and who, indeed, were not vocal at all, having taken the Trappist vow. The hon. Member said that the need for spectacles would arise for an individual only once, or at most twice, in a lifetime and that therefore the average person would have to pay about £8 in a forty-year working life. He said that the payment of £8 for his spectacles would thus represent about 4s. a year. Very generously he said that even if this were doubled, it would not amount to much. If the hon. Member, the Minister and the Government believe that, they will believe anything.

Do hon. Members opposite really believe that it is only once in a lifetime? Does their experience of life confirm them in that belief? Their practical experience should lead them to believe that tests for those who have even the slightest defect of sight have to take place every two or three years. That assumes reasonably normal sight. There may be a slight change necessitating adjustments, which means new lenses. A means test cannot be applied to these needs. Some people have more serious defects—astigmatism and such defects—and have to wear glasses from a very early age, from their twenties right through their lives. Adjustments will be needed constantly, which means new spectacles. Some people need two pairs of spectacles, one for long sight and one for short sight. These needs are sometimes met conveniently by bifocals. That involves an extra 10s. per lens.

We have many times been faced with the argument that it is only a small increase. We have heard the argument on other occasions, because we are discussing a part of only one Measure in a series of Measures. We are told that this is only a very small contribution. We start with the 2s. prescription charge. The Tories argue that that is not much. Then there is the 10d. increase in the health contribution. Then there is the 5s. increased charge for dentures, which we have already had this afternoon. Then there is the charge for spectacles. We are told that these are very small items indeed and that they do not add up to very much. One of my hon. Friends made the telling comment on the last Amendment that these "small sums" add up to a burden on what are virtual necessities.

We are now discussing the Bill as amended in Standing Committee. In fact, only five words were accepted as an Amendment. Getting an Amendment out of the Minister of Health is like getting blood from a stone. We got only one measly, miserable little drafting Amendment in all the discussions we had in Standing Committee.

I appeal to the Minister, even at this last hour, to accept the Amendment. I know that it would be against the grain for him to do so, because he believes that these charges are fair in themselves. He has said so. He does not believe in a free Health Service. He is sea-green incorruptible. He is the Robespierre of the Right. I am sure that the right hon. Gentleman will remember what happened to him. I am reminded of the words of the Tory cartoonist who said that the Guillotine has fallen into the right hands at last. However, I still move the Amendment, in the belief that the age of miracles is not past.

Dr. Stross

I am not sure that it is reasonable to compare the Minister of Health with Robespierre. For all we know, he would prefer to be likened historically to Marat, who had an interesting time in his bath.

When we discussed subsection (2) in Committee the Parliamentary Secretary fended off our attacks upon what we felt was so wrong with the subsection. We argued that by increasing the cost of each lens for bifocals by 10s. a new tax was being created. The hon. Lady said that that was not right; a mistake had been made in the past; an anomaly existed because people had been getting their bifocal lenses too cheaply; they are expensive, and the Government are now bringing them into line with the situation for ordinary lenses ordinary glasses. That is what the hon. Lady said, and if anyone wishes to read it he will find it at column 183 of the OFFICIAL REPORT of Standing Committee A.

5.45 p.m.

The Parliamentary Secretary gave us some further information on this point. She said that the cost of bifocal glasses, including the frame and spectacle case, is about 75s. today, whereas the cost of similar National Health Insurance glasses, I presume with a case, is about 40s. The hon. Lady argued that a person getting bifocal lenses gets two pairs of glasses in one, because 75s. is less than twice 40s., which is 80s. She went on, using an unguarded phrase, to say that it was unfair to those who had to buy two pairs that other people should at a similar price get the equivalent of two pairs in one.

In reply to one of my hon. Friends who asked her how many people had written to her and complained she said, "None". That was at least utterly and absolutely honest, but she should never have brought forward the pretext in the way she did. No one in this country would dream of complaining in the way she envisaged. No one would say, "Because we need only ordinary glasses with ordinary lenses, merely for reading or merely for distance, we complain that other people at a similar price can obtain bifocals, the lenses of which are more expensive than those in our spectacles".

I accuse the hon. Lady of having missed the whole point of our arguments. We pointed out that this was not only a new tax. Whatever excuse is used, it is a new and grievous imposition. We contended that the Government will lose money by doing this. If they drive people to wearing two pairs of spectacles rather than a single pair of bifocals, there will be more breakages and more spectacles will be lost. I mentioned at the time, as the hon. Lady will remember, that people like myself wear spectacles all day long. We cannot, and do not, take them off except when we go to bed. People with two pairs of spectacles change them over. One pair is on while the other pair is in their pocket or someone is sitting on it. Sometimes they sit on the other pair themselves. Sometimes they lose it. Therefore, from the point of view of replacement we were right in saying that it is an economy to encourage people to wear bifocals if they want them. A disincentive of a financial nature should not be used. We know from the Guillebaud Report that in 1953–54 users of this part of the Service found 38 per cent. of the cost. That means that a substantial amount is still found by the State. This adds real point to my argument.

Subsection (2) refers to children's glasses, which are exempt from charges if the subsection is read superficially. I must, however, warn hon. Members that that is only if the children wear frames made of metal—the cheapest possible frame; the type a child does not want to wear. It is bad enough in any case to have to wear spectacles and to go to school wearing them for the first time, especially for little girls.

If they wear those frames, and if the lenses are fragile and breakable—not unbreakable—then and then only are the spectacles provided free. If a parent says "You shall have spectacles like mine—they are National Health Service ones," the lenses are free but the parent must pay for the frame. If people go outside the Service they do not get any allowance for the lenses at all, but pay the full economic price asked of them by the optician. It is particularly wrong that unbreakable lenses should not be supplied and that children should not be provided with spectactles that will not humiliate them when they go to school.

Subsection (2) is an extremely bad part of a very bad Bill—a very bad Bill. In order to keep our tempers in the Standing Committee, we sometimes made light-hearted arguments about Romeo and Juliet, Griselda and so on. We argued that it would have been very difficult for Juliet to have been Shakespeare's heroine had she had to wear spectacles at 14 years of age—and she was only 14 years of age—of the type that the Minister says should be free.

I was asked by an hon. Member what evidence there was that she wore spectacles at all, and it was my hon. Friend the Member for Carmarthen (Lady Megan Lloyd George) who pointed out that, love being painted blind, Juliet must have worn them. In that way we kept our tempers and did not allow the Committee to fall into disrepute, but the House must understand that we feel deeply about this and hope, if it is not too late, that sanity will return.

Commander Harry Pursey (Kingston upon Hull, East)

I oppose these charges. It is not only a matter of increased charges on spectacles but of increased contributions, increased prescription charges, increased charges for dentures——

Mr. Deputy-Speaker

We are dealing with this Amendment.

Commander Pursey

I was only cataloguing, very much in passing, Mr. Deputy-Speaker, all the Government's omissions. This is a definite attack by the Tory Government on the living standards of the lower income groups, and the Minister need not try to argue that the standard of living of the average wage earner is such that he can afford to pay these increases. Not all of these people earn £14 a week. The wage of a farm labourer, and of other lower paid workers, is under £8 a week.

When we had the previous charges, hundreds of thousands of people in the lower income group were not getting their eyes tested at proper intervals and were not getting spectacles when they should, and there is no question at all that their numbers will now be greatly increased. In each of the twelve years since the National Health Service was introduced over a quarter of a million people requiring glasses have failed to get them.

Neither the hon. Lady the Parliamentary Secretary nor the Minister can write that off, as they tried to do in our previous debate on spectacles, by saying that millions of people have been tested and millions have been provided with spectacles. What about the quarter of a million people requiring spectacles every year who have not availed themselves of the Service because of the cost, but who go to Woolworths and, without any proper test, pay 6s. 9d. for a pair of spectacles? Now that the prices are to be pushed up, what are those people likely to do in future?

Further, what about the older people who are not old-age pensioners with supplementary pensions but who are still using large magnifying glasses? They have never had proper spectacles. They were probably foolish enough not to get them when they were free, or the spectacles they got have long since passed into disuse. They now have to use these large magnifying glasses that are not calibrated to the eyes. Anyone with any sense knows that one should not use a magnifying glass as these people do, because the condition of the two eyes may be different.

Again, I challenge the Minister's argument about bifocal glasses by telling him that bifocals can be manufactured at much less than the price at which they have been previously sold. The Minister is simply in the grip of the opticians. An unqualified optician in Uxbridge manufactured these glasses for years at half the usual price. It is no good anyone saying that that man was a crook and was not producing proper glasses—he was supplying them to the United States Air Force, and they are not lunatics. The savings the Minister requires on spectacles could have been obtained by reduced cost of production and reduced fees and charges to the opticians, who are in one of the biggest rackets there is in the National Health Service.

If it is argued that bifocals are the equivalent of two pairs of glasses, the answer is that they can be manufactured more cheaply. A pair of bifocals does not cost as much as two pairs of glasses and two pairs of frames. The Minister is talking arrant nonsense. Moreover, some people require three pairs of glasses and are entitled to get them under the Scheme if they can prove their need of them to the ophthalmic surgeon.

One cannot laugh off these increased charges in terms of pennies or shillings. Instead of being a guinea trade, the opticians' should be only a shilling trade. Their prices should be reduced, but, as it is, for the patients it is a question of guineas, guineas, guineas. It cannot be questioned that the Guillebaud Committee recommended substantial reductions in the cost of lenses and of frames. As testing is still free, the rest must be represented largely by the opticians' profits.

What about the double prescriptions and the other rackets worked by the opticians? I will repeat an example that I have already given. A man broke his glasses and had to get another pair quickly because he could not see to go to work. The optician told him, "I can get you a pair in twenty-four hours, but not under the Scheme." He was a liar, because what can be done outside the Scheme can be done inside it. The optician produced a pair of glasses privately. If such a job is done privately, the testing, the lenses and the frames should be charged privately. In other words, that should have been a job completely outside the Scheme. If it had been, it would have been an even worse racket; as things turned out, it was bad enough.

The point is that when the optician produced the private spectacles at four guineas—instead of 30 bob under the Scheme—he also produced a National Health Service prescription form. He said, "I think you had better sign this form." The man asked why, and he replied "You may want another pair." The man said "I do not want another pair. I have already paid four guineas for these spectacles." "Never mind", said the optician "you had better sign it." So the man, taking the line of least resistance, signed it.

6.0 p.m.

The optician was charging twice for the examination. I defy anyone to tell me that I am talking nonsense. The optician gave the man ordinary spectacles but on the prescription form he wrote "bifocals". The man should either have had ordinary spectacles or bifocals, but by charging for bifocals the optician is able to get an extra fee if the prescription form is ever cashed. There are thousands of these prescription forms on which the Minister is paying opticians' fees. It is no good saying that the matter can be explained by the fact that the test has been bona fide, that it has shown that glasses are not required and that therefore there is no need to provide the spectacles.

That is the sort of case into which the Minister should inquire and find out where the money is being misappropriated, and so cut down the opticians' receipts rather than increase the charges on the lower income groups. The opticians try as much as possible to get people out of the National Health Service Scheme. They say, "There is a nice pair of glasses with non-Service frames." They are probably non-Service lenses as well. The result is that people not only pay through the nose for their spectacles but they lose the opportunity of getting the reduced rates for repairs.

Then there is the question of children's spectacles. Last year the Parliamentary Secretary promised, not only on children's glasses but on a wide range of glasses, that there would be a revision of the arrangements. I asked for a new set of frames to be produced. I understand that the only revision has been that some of the old ones have been thrown out. What about producing some new frames suitable both for children and for adults at a price of 30s. instead of people being rooked to the extent of four guineas and five guineas by the opticians?

There are thousands of people whose eyes require to be tested at least every two years. There are some for whom it is essential that they should be tested every twelve months. The Ministry has agreed that that can be done under the Scheme because there has never been any regulation stating that tests should be carried out only at two yearly intervals. Take the case of a family of four—father, mother and two children—requiring spectacles. What is the total cost, in view of the increased charges? The lower income group are providing the money which could far more easily have been saved on armaments.

I shall now conclude to enable other hon. Members on this side of the House to speak before the Guillotine falls, but I want to make this point quite clear. There has never been any reason why the extra money required, in relation to spectacles and the other items, could not have been obtained by means of bona fide savings in other directions where there has been a waste of money. Consequently, I hope that we shall oppose this and the other charges by going into the Division Lobby and voting against them.

Mrs. Cullen

I should like to speak on the subject of glasses for children. The Parliamentary Secretary said that steel frames were provided on expert advice. I wonder whether she has ever been to an ophthalmic clinic attended by mothers with their children. I have had this experience. I have seen a child who has been taken to have her eyes tested pulling at the tails of her mother's coat. The optician said, "What is the matter? Is she afraid?" The mother replied, "No, she is not afraid, but she is pleading that she shall not be given steel frames". The mother was embarrassed because she did not have the money to enable her to buy any other type of frame.

Many children are miserable at school if they have to wear steel frames. There are some children whom steel frames suit, but others look rather stupid with them. The Minister should do something about this. If a child wants steel frames, by all means let him have them, but it should be possible to provide the other type for children who want them.

I know of one case in which a mother had to pay an extra 8s. This was a sacrifice for her because her husband was unemployed, but, rather than break her child's heart by accepting steel frames, she was determined to find the 8s. by hook or by crook to make the child happy. The Minister is a father, and I am sure he would not like his child to be miserable at school through wear- ing steel frames. I ask him to have second thoughts about this charge.

Mr. Scholefield Allen (Crewe)

This is, unfortunately, the first opportunity that I have had of protesting to the Minister against these charges.

I feel that, sitting as I do, near the benches occupied by hon. Members of the Liberal Party, I should state a very old Liberal principle, that fair taxation places the heaviest burden on the broadest backs—on the backs of those who are best able to carry it. The Chancellor of the Exchequer, who is really the person who will benefit from most of this legislation which has been forced upon us, is extracting from the pockets of the sick and the poor £65 million, and I am not sure whether the public yet appreciate the sleight of hand business that is being carried on. However, they will know in due course, as they will know quite shortly how much they will have to pay for the latest pensions increases.

It may not be well known that the Chancellor of the Exchequer was once a prospective Liberal candidate for Macclesfield. That is a long time ago, when he and I were practising law at Liverpool. He was for many years a Liberal. He came from a Wirral Liberal family, and I think that it is a shame that he should have forgotten that elementary and just liberal principle of placing these burdens on the backs of those who are best able to bear them.

We can never get a blush of shame from the cold face of the Minister of Health. I have noticed the Parliamentary Secretary raising her handkerchief to her face, so it may be that she is blushing. But there is no blush on the face of the Minister of Health. He knows full well what he is doing and why he is doing it. Two or three years ago, he tried to shift the burdens on to the poor, and at that time the Prime Minister allowed him to go. But back he came. No series of Measures has ever had the Press that this series of Measures introduced by the Minister——

Mr. Deputy-Speaker

I hope that the hon. and learned Member will confine himself to the Amendment.

Mr. Scholefield Allen

This is one of the taxes that are being put upon the poorest people——

Mr. Deputy-Speaker

We are discussing simply one Amendment, not the others.

Mr. Scholefield Allen

I am discussing that Amendment. When all the taxes put upon the poor people are condemned in the Press, surely the greater includes the less.

Mr. Deputy-Speaker

We are discussing only one Amendment.

Mr. Scholefield Allen

I entirely agree, Mr. Deputy-Speaker. Surely, however, I am entitled to say that these Measures have been criticised by the Guardian, The Times——

Mr. Deputy-Speaker

The hon. and learned Member is not entitled to say that. We are discussing only this particular Amendment.

Mr. Scholefield Allen

This is one of the iniquitous charges which is being placed upon poor people. This is an opportunity of protesting about it, and that is what we are endeavouring to do.

I do not know whether the Minister of Health has any contact with really poor families, or whether he has read the pamphlets produced recently by the Fabian Society, in which example after example is given of people who are really in poverty. It is true that there are people in affluence, but we still have a submerged tenth. It is on their behalf that we are protesting. They are the people who find it difficult to provide £1 out of their pockets to go to the dentists. These are the people who are in dire need of dental treatment.

Mr. Deputy-Speaker

We are not discussing dental treatment.

Mr. Scholefield Allen

I quite agree, Mr. Deputy-Speaker, but I am pointing out that these sums of £1 have to be produced, and so have the 5s. and the 10s. The right hon. Gentleman must be well aware that there are many families to whom the production of such a sum is a real burden and charge upon the family budget.

To say that one needs a pair of glasses only twice in the course of a lifetime is ridiculous. I do not have really bad sight, but I must have visited an ophthalmic surgeon at least fifteen times. I have not been for three or four years, but I should have been.

Mr. John McCann (Rochdale)

My hon. and learned Friend cannot afford it.

Mr. Scholefield Allen

Not on the salary of a Member of Parliament. Fortunately, some of us are not in that position, but many people cannot afford it.

There are hon. Members on these benches who will benefit by these measures. I have no doubt that my hon. and learned Friend the Member for Leicester, North-East (Sir L. Ungoed-Thomas), for example, will benefit from the Budget. This money for spectacles is being provided so that Surtax can be reduced. We on this side are not here for that purpose. Many of us are here because we were born in poverty. We know poverty, we know where the shoe pinches, and that these charges will be another pinch to a foot which is already bruised.

It is for these reasons that we appeal to the Minister, if he has any heart, to give us something. If he cannot give us much, let him give us this petty little thing for which we are now asking. Surely he will realise that many people have to forgo getting spectacles and forgo prescriptions. When they are in difficulty, they will go to Woolworth's and to other places which they should not visit. It is a constant difficulty for them suffering, as they do, from defective eyesight.

I do not know whether the right hon. Gentleman wears spectacles. Perhaps he is fortunate and does not need them. If he can stand at the Box and say that he needs to go to an ophthalmic surgeon only twice in the course of his lifetime, I shall be surprised. Those who can afford to pay for these services take them when they are necessary. Those who cannot, have to do without them, even when they need them most.

6.15 p.m.

Mr. Willis

I must congratulate the Government side on having managed to gather together the enormous attendance of three Government back benchers for this important debate. I hope that on this Amendment we will be treated with a little more courtesy than on the last one, when we asked a number of questions, to which we did not get answers.

I have one or two questions to ask the Government on this Amendment. I am sorry that the Joint Under-Secretary of State for Scotland is not present, because I wanted to address a few remarks to him. I want to know from the Government what the acceptance of our Amendment for Scotland would cost. We are entited to have information about this. We should know what it would cost the Government for the whole of the United Kingdom if our Amendment was accepted. This information would enable us to judge the position. What is the extent of this burden that is being placed upon the people? Is it large, small, or what? I had hoped that we might have that information in respect of Scotland.

We have had no word yet from the Joint Under-Secretary. Now that he is absent, he has deprived me of half the things I wanted to say to him. I must protest against this treatment. One of the sponsors of the Bill is the Secretary of State for Scotland, who holds a most important office. During consideration of these Amendments, he has been treated in a manner fit only for an office boy.

Mr. J. T. Price (Westhoughton)

Sorting out the white fish.

Mr. Willis

His is an office of great status, much higher than that of the Minister of Health. Why the Secretary of State should be treated in this matter like an office boy, to come in when the Minister of Health says that he can come in, I do not know. That is most discourteous to the Scottish Members.

Dr. Stross

Surely my hon. Friend has had it whispered to him that the Secretary of State may have had a dental mishap. He cannot articulate and cannot afford to go to the dentist.

Mr. Willis

I was told that he had either lost his glasses, or that his teeth were not fitting, and that he could not afford the new charges. I do not know whether that is true.

This is another mean subsection of a Bill to add 2s. 6d. to the authorised charge of 10s. per lens for glasses and to add 10s. in the case of bifocal or multifocal lenses. As my hon. and gallant Friend the Member for Kingston upon Hull, East (Commander Pursey) pointed out in his breezy manner, the result will be that a large number of people who are not well off, living on small incomes, delay facing the charges and meanwhile go to Woolworth's or elsewhere to buy a pair of glasses. Surely that cannot be a good thing for the Government to encourage.

In an age of affluence, why should the Government drive people to do without such things as glasses? What a tribute to the Government! What a testimony of the affluence in which we live that poor people must go to Woolworth's to buy the glasses which they need! It is a shocking and disgusting state of affairs. That Ministers should come to the Dispatch Box and try to justify this imposition is almost beyond belief. To take themselves seriously in the process of justifying it is even worse. I think that they really believe half the things which they tell us from the Dispatch Box.

My hon. Friend the Member for Glasgow, Gorbals (Mrs. Cullen) made out the case for children in what I thought was a rather touching speech. She spoke of a child in the Gorbals whose mother had gone to her and said that she could not afford to buy glasses for her child and therefore her child went to school with steel-framed glasses looking rather ugly and feeling uncomfortable and rather ashamed.

Mrs. Cullen

She did not go to school with steel-framed glasses. Her mother paid for other glasses at great sacrifice to herself.

Mr. Willis

But there are children who do wear steel-framed glasses and suffer from a sense of inferiority, believing that they are not as good as other children. My hon. Friend has vast experience of how ordinary folk in Glasgow live. The right hon. Gentleman must realise that his proposals will affect thousands of families. The problems in my constituency are not as great as those in the constituency of my hon. Friend the Member for Gorbals, but many people have come to me since it was proposed to make these extra charges, including that for spectacles. They have said that it was a very bad thing and that they did not know how they would meet it. These were level-headed, sober-minded people, the backbone of Britain, who have built up its wealth and have come to its aid in times of struggle and strife.

In view of the small amount that he will gain from his proposals, the right hon. Gentleman should think about the matter again, and not increase these charges. Surely it would be better to leave things as they are and to let us pay what we are paying at present. We cannot move to abolish the charges altogether, which is what we on this side would like to do, but at least we can try to prevent them from being increased. If I were the right hon. Gentleman, I would feel rather ashamed of myself, but obviously he does not. He justifies his proposals in his intellectual manner. As I have said on a previous occasion, his trouble is that he has too much intellect and not enough humanity. If he had a little more humanity and considered the matter from the point of view of the people who will suffer as a result of his proposals, he would accept our Amendment.

I wanted to say something about the Joint Under-Secretary of State for Scotland. I understand that he will appear in a sort of solo effort by kind permission of the Minister of Health when we come to the Third Reading. I think that this is a shocking way to treat Scottish Ministers. The fact that they allow themselves to be treated in this way shows what a spineless set of Scottish Ministers we have. This is the way the great and historic Scottish Office is treated by the Government. We shall expect to hear from the Joint Under-Secretary of State before we finish these proceedings.

Mr. A. Woodburn (Clackmannan and East Stirlingshire)

When the. Health Service was introduced, one of the astonishing things which we discovered was the number of people, especially old people, who had not had teeth in their head for years and had never had spectacles with which to see. As my hon. and gallant Friend the Member for Kingston upon Hull, East (Commander Pursey) said, many of them were saved by Woolworth's at 6d. a time.

Commander Pursey

No—6s. 9d.

Mr. Woodburn

It used to be 6d. As a result of the Health Service charges, the cost has increased even in Woolworth's. This has become a very expensive racket.

The supply of free spectacles was originated by my predecessor, Tom Johnston. He was a director of a Glasgow friendly society which gave a large number of benefits to its members. One of them was free spectacles. For years, people had free spectacles from that society. It is true that they were not very elegant, but they were free. The society obtained them by contract at a very cheap rate. It did not cost the society very much. When we were introducing the National Health Service, Tom Johnston thought that the nation could do for the people what a friendly society had been doing for years for its members in Glasgow. One of his great passions was to give the people free spectacles.

Dr. Stross

I wonder whether my right hon. Friend knows that the Minister of Transport came into the Chamber, not because he wanted to listen to us, but because he had forgotten his spectacles. This adds point to the argument concerning saving costs to the Minister of Health.

Mr. Woodburn

If the right hon. Gentleman had free spectacles, he might have seen them lying on the chair before he went out.

Of all the charges, the one against which I feel most passionately is the stupid prescription charge which prevents people getting treatment. I realise that spectacles and teeth are in a different category because they are not things that people want regularly. They want them only once in a while and it is probably possible for them to make this sacrifice. As with all other charges, fairly well-to-do people will not suffer in any way.

I confirm what my hon. Friend the Member for Glasgow, Gorbals (Mrs. Cullen) said, namely, that those who will suffer most in this matter are the children. Children go to school with steel-rimmed spectacles, but they keep them in their pockets. By not wearing them, they injure their eyes. Their mothers do not know that they are doing this, because in most cases children are little snobs. They hate to be different from their colleagues. They do not like to wear Health Service spectacles if their colleagues are wearing fancy-rimmed spectacles.

The same thing applies to school milk. When the fact that children were getting school milk had to be registered the children did not take it because they did not want to be pointed out as being different from their colleagues. The greatest injury emanating from these charges will be done to the children. Whatever else the Minister may do, I hope that he will ensure that children have spectacles with rims which do not give the impression of poverty, or which are distinct from other spectacles. He should ensure that they have a choice in the matter. Children are probably far more conscious about what they wear than adults. Old-age pensioners do not care tu'pence about what they wear as long as they can see.

Mr. Dempsey

Why not?

Mr. Woodburn

Even Members of Parliament are not concerned about whether they look respectable.

Mr. Dempsey

What about the Parliamentary Secretary?

Mr. Woodburn

The hon. Lady is different.

When people get older, they do not bother about these things nearly as much as children, who are sensitive, especially girls. I am sure that the Parliamentary Secretary will agree that girls are very touchy about their appearance. What I fear is that if children are handicapped by these charges, or by the new regulations in any way, they will not use the spectacles they are given, their mothers will not know about it, and their eyesight will be damaged. People will go without, sometimes, to the detriment of their eyesight.

Of course, when spectacles are first prescribed, all sorts of warnings are given by the optician that the patient must come back and be examined again in six months, not just once or twice in his lifetime. One of the difficulties affecting us years ago was not that patients were misusing the Service, but that they were told to come back for further examinations at intervals of six months because there would be another fee for the person who was doing the examination. I had to call attention to the fact that certain unscrupulous practitioners were requiring patients to come back for further examinations and new spectacles every six months because there was a profit in it for them.

This is one of the handicaps inherent in having a scheme like this, which makes a profit for the people who prescribe spectacles. It should be done as a public service by practitioners who are paid a salary so that unscrupulous persons may not manufacture jobs in order to earn profits for themselves. It should be done by specialists dealing with the matter as a public duty. No one should be in a position to prescribe spectacles in great numbers simply because the more he prescribes the more he gets.

If an economy were made at that end of the Service there would be no need for economy by penalising the people who need the prescriptions, the spectacles and the dentures. Throughout his new charges, the Minister has started at the wrong end. The patient is not responsible for prescribing. The responsibility is on the doctor or the oculist. The patient is not the one to be circumscribed and punished. The patient should not be deprived of benefits under the Health Service. The Minister should control the Service in such a way that the work is done for proper purposes, not so as to enable someone to make a profit for himself merely by multiplying prescriptions. In that way, the Minister could make his economies and probably improve the Service as a whole.

6.30 p.m.

Mr. Powell

What the subsection which it is proposed to delete effects is the adjustment of the existing charge for lenses so that the charge bears approximately the same ratio to current costs as it did at its inception ten years ago. Broadly speaking, the cost of lenses, case and dispensing fee has risen by about 25 per cent. in the last ten years, and, accordingly, this subsection is intended to increase the charge per lens by 25 per cent.

In reply to the inquiry by the hon. Member for Edinburgh, East (Mr. Willis), of the total gross yield of the addition of £1.9 million for Great Britain, £200,000 is estimated to be attributable to Scotland.

During the last ten years, we have had experience of the movement of sight testing and of the dispensing of spectacles with the existing charge for lenses and, as the Committee noted when it studied the matter, during those ten years the annual number of sight tests has been steadily increasing and so also, in almost exactly the same ratio, has the number of spectacles dispensed under the National Health Service. So it would not appear that the existence of a charge has interfered with a steady increase in the access to and the use which is being made of the Service by the public, nor, in view of the fact that any kind of remuneration or benefit which one cares to take has in those ten years increased by far more than that proportion, need it be apprehended that that thoroughly desirable trend will not continue.

The Clause makes a further alteration in that, for the first time, it separates bifocal lenses from other lenses for the purpose of charge. I am advised that, nowadays, about 30 per cent. of those who wear spectacles require a double correction and that of that 30 per cent. approximately half meet the need by having two pairs of spectacles and half by having a bifocal pair. The House will know that under the National Health Service one cannot have both a bifocal pair and two separate pairs for the same double correction. Therefore, we have here a genuine alternative.

I think we should all agree that in the decision by the optician whether to advise bifocals or two pairs and the decision by the patient which to accept there should not be any undue financial factor entering into the matter. We would wish to hold the scales as nearly as possible evenly. That is the result of the change which the subsection brings about. There is still some financial advantage in the bifocal pair in that the charge for a pair of bifocals will be £2 as against £2 10s. for the two separate pairs of spectacles, but, broadly speaking, the revision eliminates, or largely eliminates, the present big financial difference between the acceptance of two pairs of spectacles as against a bifocal pair.

Dr. Stross

If that be so, and if the argument be logical that it is merely holding the balance by imposing this new tax on those who wear bifocals, what is the justification for charging for multifocal lenses only the same amount as the Minister does for bifocal lenses? They are much more expensive.

Mr. Powell

The answer is that while there is a substantial use of an item it is right that we should separate its cost and treat it on its own. Multifocals, although, as the hon. Members says, they are more expensive than bifocals, have a great variety and the number of them is extremely small in comparison with bifocals, let alone the total number of lenses. On the other hand, when dealing with bifocals we are dealing with a type of spectacle which is worn in considerable and, indeed, increasing numbers, and it would have been wrong for the financial balance to be so severely weighted as it was hitherto.

I think hon. Members missed the point when my hon. Friend the Parliamentary Secretary said that the present situation was unfair to people who had to wear two pairs of glasses. That is a valid point. It is a clinical decision so to speak, a decision which depends upon people's circumstances, whether it is better for them to go in for bifocals or for two separate pairs of spectacles. My hon. Friend was quite right in saying that it is unfair that a person who has good reason to prefer or to need two separate pairs should be so severely penalised financially as at present.

I find it, therefore, not at all surprising that the profession concerned, in commenting on the proposals in the Bill, has approved the proposal to treat bifocals separately and has pointed out that this was something that the profession itself has for some time past been recommending.

Several references have been made in the debate to the position of children. It seemed to me that some of them might have been based on a misapprehension. Of course, nothing which the subsection does increases in any way any charge which relates to children. What the Clause does is very much to improve the position of a parent such as the hon. Lady the Member for Glasgow, Gorbals (Mrs. Cullen) mentioned. At the present moment where such a parent decides to choose for her child a pair of frames other than the steel frames, one of the N.H.S. range, for example, she not only has to meet the cost of the frames but has to meet the cost of the lenses.

What this Bill does—and I should have thought that it would have been generally welcomed—is to ensure that the lenses are free for a child even though those lenses are fitted into a National Health Service frame. I am referring to children over the age of 10. I think it is generally accepted that it is over the age of about 10 that these considerations begin to apply. Therefore, as far as children are concerned, a very substantial improvement is made by the provisions in this Clause.

Mrs. Slater

Could not the Minister give the little bit of improvement we seek, and give to the children under 10 this facility, so that they need not have to wear steel frames?

Mr. Powell

I have taken advice on this matter with my Standing Ophthalmic Advisory Committee to see where it would be right to make the change, and the advice I am given is that it is about the age of 10 that this freedom of choice becomes a significant factor from the point of view of a child and is likely to begin to affect its readiness to wear spectacles; but it has been hitherto, in my view, unfair that a parent who chose to go outside the steel frames not only incurred the additional charge for the frames—and that is common to the arrangements throughout the supplementary ophthalmic service—but was also penalised by having to pay for the lenses. I think it should be put clearly on the record that that anomaly is removed by this Clause and that, therefore, the position of the children is substantially improved by this Clause.

Mrs. Cullen

Why was this advice given? Was there any particular need for this advice to use the steel frame?

Mr. Powell

Yes, the advice is that it is only from about the age of 10—clearly one could not be precise because cases vary—that considerations of appearance begin to be a deterrent to a child's wearing spectacles.

Mr. Woodburn

Could the right hon. Gentleman tell us what it would cost if this concession were extended to all children and steel frames were done away with?

Mr. Powell

Not without notice. But I think that this is a matter in which we ought to see how we get on, and certainly it is a matter in which the Government ought to be guided by the advice of those who are dealing with children from the optical paint of view.

Finally, the general question has been raised again of priorities and of the application of the sums which these charges will yield, and, once again, the Guillebaud Committee, which the noble Lady the Member for Carmarthen (Lady Megan Lloyd George) quoted, makes it perfectly clear that all these considerations in regard to these individual charges are subject to the overriding question of priority. Once again we are deciding whether the sum of approximately £2 million which is here involved—just under £2 million—is better applied in the National Health Service by maintaining these charges at their present level instead of bringing them up to the proportion which they originally bore to the cost of the appliances, or is better applied elsewhere in the Service.

It is to that question, with respect, that the House has to direct its attention, and I believe that against the experience of the last ten years of the growing use of this service and against the whole economic background there can be no doubt that this increase in the yield can be better applied than by keeping the charges at the present value.

6.45 p.m.

Mr. K. Robinson

The case against the spectacle charges and the increases which are imposed by this subsection has been made so effectively by my hon. Friend the Member for Carmarthen (Lady Megan Lloyd George) and other of my hon. Friends that there is really very little for me to add to it. These are severe charges. It is no good the Minister's saying, on the one hand, that they are not very substantial charges and then, on the other, by a slip of the tongue perhaps, admitting that the difference between the cost of a pair of bifocals and two pairs of ordinary spectacles which represents £1 is not a severe penalty.

Mr. Powell

That is the entire existing cost plus 25 per cent.

Mr. Robinson

I am talking about the entire charge, and the entire charge will now be 25s. for an ordinary pair of spectacles. The right hon. Gentleman produced the additional argument that the number of sight tests has gone on steadily increasing and that the provision of spectacles has gone on steadily over the last ten years, and that, some- how, that proves that these charges are no disincentive. It proves nothing of the kind. It is no evidence whatever.

The very existence of the Health Service is in itself an educative process for people in health education and one would expect that, ten years after the Service was introduced, more people would be looking after their teeth and their eyesight. Anyhow, the fact is that the increase ought to have been in a greater degree than that which we have had, and it is just not true to suggest that these charges cause no hardship.

I do not want to detain the House, because we have other Amendments to debate, but I should like to read to the House a concrete case about spectacles, of a woman who wrote to her trade union branch. Her letter was given to me by one of my trade union colleagues. She wrote: Sorry I have to write to you like this. I wonder if you could help me as I am broke. My husband has been in bed for four weeks and I had to stay at home from work and now when I am ready to go back to work I have gone down with the 'flu. The reason I write to you is I have got two pairs of glasses on order, one for long distance and

one for reading and I can't afford to get them as I have got no money. It takes a long time to pull up again after being home from work. My husband has been home sick for three years … Hope you will do your best for me. …

I am glad to be able to tell the Minister that the trade union did its best for them and provided the requisite funds to enable that woman to get her spectacles. This was not a woman such as my hon. Friend the Member for Liverpool, Exchange (Mrs. Braddock) mentioned, but a woman who was at work who had glasses on order and, because of her circumstances, could not pay for them and had no chance whatever of paying for them without some help from somebody.

It is untrue that these charges are small charges and that these charges are not a deterrent. They are. It is because of that that I hope my hon. Friends will divide on the Amendment.

Question put, That the words proposed to be left out, to "two", in line 14, stand part of the Bill:—

The House divided: Ayes 271, Noes 198.

Division No. 127. AYES [6.48 p.m.
Agnew, Sir Peter Channon, H. P. G. Galbraith, Hon. T. G. D.
Aitken, W. T. Chataway, Christopher Gammans, Lady
Allan, Robert (Paddington, S.) Chichester-Clark, R. Gardner, Edward
Allason, James Clark, William (Nottingham, S.) Gibson-Watt, David
Amery, Rt. Hon. Julian(Preston, N.) Cleaver, Leonard Glover, Sir Douglas
Arbuthnot, John Cole, Norman Godber, J. B.
Ashton, Sir Hubert Cooper, A. E. Goodhart, Philip
Atkins, Humphrey Cooper-Key, Sir Neill Goodhew, Victor
Barlow, Sir John Cordeaux, Lt.-Col. J. K. Gough, Frederick
Barter, John Cordle, John Gower, Raymond J
Batsford, Brian Corfield, F. V. Grant, Rt. Hon. William
Beamish, Col. Sir Tufton Costain, A. P. Green, Alan
Bell, Ronald Coulson, J. M. Gresham Cooke, R.
Bennett, F. M. (Torquay) Craddock, Sir Beresford Grimston, Sir Robert
Bennett, Dr. Reginald (Gos & Fhm) Critchley, Julian Gurden, Harold
Berkeley, Humphrey Crosthwaite-Eyre, Col. O. E. Hall, John (Wycombe)
Bevins, Rt. Hon. Reginald (Toxteth) Crowder, F. P. Hamilton, Michael (Wellingborough)
Biggs-Davison, John Cunningham, Knox Harris, Reader (Heston)
Bingham, R. M. Curran, Charles Harrison, Col. J. H. (Eye)
Birch, Rt. Hon. Nigel Currie, G. B. H. Harvey, Sir Arthur Vere (Macclesf'd)
Bishop, F. P. Dalkeith, Earl of Harvey, John (Walthamstow, E.)
Bourne-Arton, A. Dance, James Harvie Anderson, Miss
Box, Donald d'Avigdor-Goldsmid, Sir Henry Hastings, Stephen
Boyd-Carpenter, Rt. Non. John de Ferrantl, Basil Hay, John
Boyle, Sir Edward Digby, Simon Wingfield Heald, Rt. Hon. Sir Lionel
Braine, Bernard du Cann, Edward Henderson, John (Cathcart)
Brewis, John Duncan, Sir James Henderson-Stewart, Sir James
Brooke, Rt. Hon. Henry Duthie. Sir William Hendry, Forbes
Brooman-White, R. Eden, John Hiley, Joseph
Browne, Percy (Torrington) Elliot, Capt. Walter (Carshalton) Hill, Mrs. Eveline (Wythenshawe)
Bryan, Paul Elliott, R.W. (Nwcstle-upon-Tyne, N.) Hill, J. E. B. (S. Norfolk)
Buck, Antony Emery, Peter Hirst, Geoffrey
Bullard, Denys Emmet, Hon. Mrs. Evelyn Hobson, John
Bullus, Wing Commander Eric Farey-Jones, F. W. Hocking, Philip N.
Burden, F. A. Fell, Anthony Holland, Philip
Butler, Rt. Hn. R. A. (Saffron Walden) Finlay, Graeme Hollingworth, John
Campbell, Gordon (Moray & Nairn) Fisher, Nigel Hopkins, Alan
Carr, Compton (Barons Court) Fletcher-Cooke, Charles Hornby, R. P.
Cary, Sir Robert Fraser, Ian (Plymouth, Sutton) Hornsby-Smith, Rt. Hon. Patricia
Howard, Hon. G. R. (St. Ives) Marshall, Douglas Shepherd, William
Howard, John (Southampton, Test) Matthews, Gordon (Meriden) Simon, Rt. Hon. Sir Jocelyn
Hughes Hallett, Vice-Admiral John Maudling, Rt. Hon. Reginald Skeet, T. H. H.
Hughes-Young, Michael Mawby, Ray Smith, Dudley (Br'ntf'rd & Chiswick)
Hurd, Sir Anthony Maxwell-Hyslop, R. J. Smyth, Brig. Sir John (Norwood)
Hutchison Michael Clark Maydon, Lt.-Cmdr. S. L. C. Spearman, Sir Alexander
Iremonger, T. L. Mills, Stratton Spelr, Rupert
Irvine, Bryant Godman (Rye). More, Jasper (Ludlow) Stanley, Hon. Richard
Jackson, John Morgan, William Steward, Harold (Stockport, S.)
James, David Morrison, John Stodart, J. A.
Jenkins, Robert (Dulwich) Mott-Radclyffe, Sir Charles Storey, Sir Samuel
Jennings, J. C. Nicholson, Sir Godfrey Summers, Sir Spencer (Aylesbury)
Johnson, Dr. Donald (Carlisle) Nugent, Sir Richard Talbot, John E.
Johnson, Eric (Blackley) Oakshott, Sir Hendrie Taylor, Sir Charles (Eastbourne)
Johnson Smith, Geoffrey Orr-Ewing, C. Ian Taylor, Edwin (Bolton, E.)
Joseph, Sir Keith Osborn, John (Hallam) Teeling, William
Kaberry, Sir Donald Osborne, Cyril (Louth) Temple, John M.
Kerans, Cdr. J. S. Page, John (Harrow, West) Thatcher, Mrs. Margaret
Kerby, Capt. Henry Page, Graham (Crosby) Thomas, Leslie (Canterbury)
Kerr, Sir Hamilton Pannell, Norman (Kirkdale) Thomas, Peter (Conway)
Kershaw, Anthony Partridge, E. Thompson, Richard (Croydon, S.)
Kitson, Timothy Pearson, Frank (Clitheroe) Thorneycroft, Rt. Hon. Peter
Lagden, Godfrey Percival, Ian Thornton-Kemsley, Sir Colin
Lancaster, Col. C. G. Peyton, John Tiley, Arthur (Bradford, W.)
Leather, E. H. C. Pickthorn, Sir Kenneth Tilney, John (Wavertree)
Leavey, J. A. Pike, Miss Mervyn Turner, Colin
Leburn, Gilmour Pilkington, Sir Richard Turton, Rt. Hon. R. H.
Legge-Bourke, Sir Harry Pitt, Miss Edith van Straubenzee, W. R.
Lewis, Kenneth (Rutland) Pott, Percivall Vane, W. M. F.
Lilley, F. J. P. Powell, Rt. Hon. J. Enoch Vaughan-Morgan, Sir John
Lindsay, Martin Price, David (Eastleigh) Wakefield, Edward (Derbyshire, W.)
Linstead, Sir Hugh Prior, J. M. L. Waider, David
Litchfield, Cant. John Prior-Palmer, Brig. Sir Otho Walker, Peter
Lloyd, Rt. Hon. Selwyn (Wirral) Profumo, Rt, Hon. John Walker-Smith, Rt. Hon. Sir Derek
Loveys, Walter H. Proudfoot, Wilfred Ward, Dame Irene
Lucas, Sir Jocelyn Pym, Francis Watts, James
Lucas-Tooth, Sir Hugh Quennell, Miss J. M. Webster, David
McAdden, Stephen Ramsden, James Wells, John (Maidstone)
MacArthur, Ian Rawlinson, Peter Whitelaw, William
McLaren, Martin Redmayne, Rt. Hon. Martin Williams, Dudley (Exeter)
McLaughlin, Mrs. Patricia Rees, Hugh Williams, Paul (Sunderland, S.)
Maclay, Rt. Hon. John Renton, David Wills, Sir Gerald (Bridgwater)
Maclean, Sir Fitzroy (Bute&N.Ayrs.) Ridsdale, Julian Wilson, Geoffrey (Truro)
MacLeod, John (Ross & Cromarty) Robertson, Sir David Wolrige-Gordon, Patrick
McMaster, Stanley R. Roots, William Woodhouse, C. M.
Macpherson, Niall (Dumfries) Ropner, Col. Sir Leonard Woodnutt, Mark
Madden, Martin Russell, Ronald Woollam, John
Maitland, Sir John Sandys, Rt. Hon. Duncan Worsley, Marcus
Manningham-Buller, Rt. Hn. Sir R. Scott-Hopkins, James Yates, William (The Wrekin)
Markham, Major Sir Frank Seymour, Leslie
Marlowe, Anthony Sharpies, Richard TELLERS FOR THE AYES:
Marples, Rt. Hon. Ernest Shaw, M. Mr. Noble and Mr. Peel.
Abse, Leo Davies, S. O. (Merthyr) Griffiths, Rt. Hon. James (Llaneny)
Allaun, Frank (Salford, E.) Deer, George Gunter, Ray
Allen, Schofield (Crewe) de Freitas, Geoffrey Hale, Leslie (Oldham, W.)
Awbery, Stan Delargy, Hugh Hall, Rt. Hn. Glenvil (Colne Valley)
Bacon, Miss Alice Dempsey, James Hamilton, William (West Fife)
Beaney, Alan Diamond, John Hannan, William
Bence, Cyril (Dunbartonshire, E.) Dodds, Norman Hart, Mrs. Judith
Benson, Sir George Donnelly, Desmond Hayman, F. H.
Blackburn, F. Driberg, Tom Healey, Denis
Blyton, William Dugdale, Rt. Hon. John Henderson, Rt. Hn. Arthur (Rwly Regis)
Boardman, H. Ede, Rt. Hon. C. Hill, J. (Midlothian)
Bowden, Herbert W. (Leics, S.W.) Edeman, Maurice Holman, Percy
Boyden, dames Edwards, Rt. Hon. Ness (Caerphilly) Holt, Arthur
Braddock, Mrs. E. M. Edwards, Walter (Stepney) Houghton, Douglas
Brown, Rt. Hon. George (Belper) Evans, Albert Howell, Charles A.
Butler, Herbert (Hackney, C.) Fernyhough, E. Hoy, James H.
Butler, Mrs. Joyce (Wood Green) Finch, Harold Hughes, Cledwyn (Anglesey)
Castle, Mrs. Barbara Fitch, Alan Hughes, Emrys (S. Ayrshire)
Chapman, Donald Fletcher, Eric Hunter, A. E.
Chetwynd, George Foot, Dingle (Ipswich) Hynd, H. (Accrington)
Collick, Percy Foot, Michael (Ebbw Vale) Irvine, A. J. (Edge Hill)
Craddock, George (Bradford, S.) Forman, J. C. Irving, Sydney (Dartford)
Crosland, Anthony Fraser, Thomas (Hamilton) Jay, Rt. Hon. Douglas
Crossman, R. H. S. Galtskell, Rt. Hon. Hugh Jeger, George
Cullen, Mrs. Alice Galpern, Sir Myer Jenkins, Roy (Stechford)
Darling, George George, Lady Megan Lloyd (Crmrthn) Jones, Rt. Hn. A. Creech(Wakefield)
Davies, G. Elfed (Rhondda, E.) Ginsburg, David Jones, Dan (Burnley)
Davies, Harold (Leek) Gourlay, Harry Jones, Elwyn (West Ham, S.)
Davies, Ifor (Gower) Grey, Charles Jones, Jack (Rotherham)
Jones, J. Idwal (Wrexham) Oliver, G. H. Spriggs, Leslie
Jones, T. W. (Merioneth) Oram, A. E. Steele, Thomas
Kelley, Richard Oswald, Thomas Stewart, Michael (Fulham)
Kenyon, Clifford Owen, Will Strauss, Rt. Hn. G. R. (Vauxhall)
Key, Rt. Hon. C. W. Paget, R. T. Stross, Dr. Barnett (Stoke-on-Trent, C.)
King, Dr. Horace Pannell, Charles (Leeds, W.) Swain, Thomas
Lawson, George Parker, John (Dagenham) Sylvester, George
Lee, Frederick (Newton) Parkin, B. T. (Paddington, N.) Taylor, Bernard (Mansfield)
Lee, Miss Jennie (Cannock) Pearson, Arthur (Pontypridd) Taylor, John (West Lothian)
Lever, L. M. (Ardwick) Peart, Frederick Thomas, Iorwerth (Rhondda, W.)
Lewis, Arthur (West Ham, N.) Pentland, Norman Thomson, G. M. (Dundee, E.)
Lipton, Marcus Plummer, Sir Leslie Thornton, Ernest
Loughlin, Charles Popplewell, Ernest Timmons, John
Mabon, Dr. J. Dickson Prentice, R. E. Tomney, Frank
McCann, John Price, J. T. (Westhoughton) Ungoed-Thomas, Sir Lynn
MacColl, James Probert, Arthur Wade, Donald
McInnes, James Proctor, W. T. Wainwright, Edwin
McKay, John (Wallsend) Pursey, Cmdr. Harry Warbey, William
McLeavy, Frank Randall, Harry Watkins, Tudor
MacMillan, Malcolm (Western Isles) Rankin, John Weitzman, David
MacPherson, Malcolm (Stirling) Reid, William Wells, Percy (Faversham)
Mallalieu, E. L. (Brigg) Reynolds, G. W. White, Mrs. Eirene
Mallalieu, J. P. W.(Huddersfield, E.) Roberts, Goronwy (Caernarvon) Whitlock, William
Manuel, A. C. Robinson, Kenneth (St. Pancras, N.) Wilkins, W. A.
Mapp, Charles Rogers, G. H. R. (Kensington, N.) Willey, Frederick
Marquand, Rt. Hon. H. A. Ross, William Williams, D. J. (Neath)
Marsh, Richard Royle, Charles (Salford, West) Williams, Ll. (Abertillery)
Mason, Roy Shinwell, Rt. Hon. E. Williams, W. R. (Openshaw)
Mayhew, Christopher Short, Edward Willis, E. G. (Edinburgh. E.)
Mellish, R. J. Silverman, Julian (Aston) Winterbottom, R. E.
Mendelson, J. J. Silverman, Sydney (Nelson) Woodburn, Rt. Hon. A.
Milne, Edward J. Slater, Mrs. Harriet (Stoke, N.) Woof, Robert
Mitchison, G. R. Slater, Joseph (Sedgefield) Wyatt, Woodrow
Monslow, Walter Small, William Yates, Victor (Ladywood)
Moody, A. S. Smith, Ellis (Stoke, S.) Zilliacus, K.
Morris, John Snow, Julian
Moyle, Arthur Sorensen, R. W. TELLERS FOR THE NOES:
Mulley, Frederick Soskice, Rt. Hon. Sir Frank Mr. Redhead and
Dr. Broughton


Mr. K. Robinson

I beg to move, in page 2, line 27, to leave out Clause 2.

This is the Clause which gives the Minister and the Secretary of State for Scotland powers to vary, by Regulation, the charges that are dealt with under the Bill and, indeed, the charges for dental treatment. We tabled Amendments to substitute for the word "vary" the word "reduce". I gather that these are out of order for the simple reason that they would have precisely the same effect as would have the carrying of the Amendment which I am now moving.

During the Second Reading debate I was taken to task by the hon. Member far Putney (Sir H. Linstead)—who was here earlier, but is not, unfortunately, present now—for suggesting that the ward "vary" in this Clause was really a euphemism far "increase", and that the Minister used the word "vary" but actually wanted power to increase the charges. The hon. Member said that I was being unfair, and pointed to a provision in the Clause which enables the Minister to direct that a charge shall not be payable. The hon. Member said that this constituted a specific power to abolish a charge.

7.0 p.m.

We now find, however, that the power to reduce all the charges is already in the Minister's hands. He is already capable of reducing or abolishing any Health Service charge by Regulation, subject to the negative Resolution procedure. The reason for this Clause is to give him the power to increase charges which he had hitherto only had the power to reduce. We are not inclined to place that power in the hands of the right hon. Gentleman.

We believe that this kind of tax on the sick and on people who need dental and optical treatment is not the sort of thing that should be imposed by Regulation. The Parliamentary Secretary will no doubt say that, in the one Act imposing charges introduced by the Labour Government, there was Regulation-making power. But that was a power with the affirmative Resolution procedure. We believe that if there comes a time, as we fear there will, when the Government want again to increase the charges, they should at least came to the House and go through the normal procedure of legislation. We are not willing to give power to make Regulations which are merely subject to the negative Resolution procedure.

Judging by the justifications that have been made by the Minister and his colleagues for these increases, we can only assume that, when another situation arises in which the Chancellor of the Exchequer wishes to reduce the net cost of the Health Service to the Exchequer, the first thing that he will turn to is the charges and say, "We can put another 25 per cent. on them, and this time all we need do is to table a Regulation that is subject to the ordinary Prayer procedure".

It is for these reasons that we are unwilling to see this power in the Bill. I want to stress again that the only reason that the word "vary" is introduced is to give the Minister power to increase charges, because he has already all the power that he needs, by Regulation, to reduce any charges which he imposes on patients.

The Parliamentary Secretary to the Ministry of Health (Miss Edith Pitt)

The hon. Member for St. Pancras, North (Mr. K. Robinson) made one point clear, and there is another subsidiary one to which he did not devote time. His main purpose by the Amendment is to try to eliminate the provision enabling the Minister to vary upwards or downwards. As he rightly anticipated, I shall remind him that for other charges under the National Health Service, notably the

prescription charges, there is power to do that by Regulation, subject to the negative Resolution procedure.

It seems to me that if the power exists in the case where the amount involved is much greater—the changes made in prescription charges, for instance, are expected to relieve the Exchequer of £12½ million, whereas the charges under the Bill for dentures and spectacles will relieve it of just under £3 million gross—and if that power is right for the greater amount, it is right for the smaller. I suggest that the House accepts the proposals laid down in the Bill giving this power which, as I say, already exists for certain sections of the Health Service.

The hon. Member made the further point that he and his colleagues were not willing to give power which was merely subject to the negative Resolution procedure. In this case, the power that is being sought would apply to Regulations which would, in themselves, be very simple, because the purpose of any changes, either upwards or downwards, would be to substitute one set of figures for another. For these reasons, I must advise the House not to accept the Amendment.

Question put, That the words proposed to be left out, to "for", in line 31, stand part of the Bill:—

The House divided: Ayes 267, Noes 197.

Division No. 128.] AYES [7.6 p.m.
Agnew, Sir Peter Bryan, Paul Currie, G. B. H.
Aitken, W. T. Buck, Antony Dalkeith, Earl of
Allan, Robert (Paddington, S.) Bullard, Denys Dance, James
Allason, James Bullus, Wing Commander Eric d'Avigdor-Goldsmid, Sir Henry
Amery, Rt. Hon. Julian (Preston, N.) Burden, F. A. de Ferranti, Basil
Arbuthnot, John Campbell, Cordon (Moray & Nairn) Digby, Simon Wingfield
Ashton, Sir Hubert Carr, Compton (Barons Court) du Cann, Edward
Atkins, Humphrey Carr, Robert (Mitcham) Duncan, Sir James
Barlow, Sir John Cary, Sir Robert Duthie, Sir William
Barter, John Channon, H. P. G. Eden, John
Batsford, Brian Chataway, Christopher Elliot, Capt. Walter (Carshalton)
Beamish, Col. Sir Tufton Clark, William (Nottingham, S.) Elliott, R. W. (Nwcstle-upon-Tyne, N.)
Bell, Ronald Cleaver, Leonard Emery, Peter
Bennett Dr. Reginald (Cos & Fhm) Cole, Norman Emmet, Hon. Mrs. Evelyn
Berkeley, Humphry Cooper, A. E. Farey-Jones, F. W.
Bidgood, John C. Cooper-Key, Sir Neill Fell, Anthony
Biggs-Davison, John Cordeaux, Lt.-Col. J. K. Finlay, Graeme
Bingham, R. M. Cordle, John Fisher, Nigel
Birch, Rt. Hon. Nigel Corfield, F. V. Fletcher-Cooke, Charles
Bishop, F. P. Costain, A. P. Fraser, Ian (Plymouth, Sutton)
Bourne-Arton, A. Coulson, J. M. Galbraith, Hon. T. G. D.
Box, Donald Courtney, Cdr. Anthony Gammans, Lady
Boyd-Carpenter, Rt. Hon. John Craddock, Sir Beresford Gardner, Edward
Boyle, Sir Edward Critchley, Julian Gibson-Watt, David
Brewis, John Crosthwaite-Eyre, Col. O. E. Glover, Sir Douglas
Brooke, Rt. Hon. Henry Crowder, F. P. Godber, J. B.
Brooman-White, R. Cunningham, Knox Goodhart, Philip
Browne, Percy (Torrington) Curran, Charles Goodhew, Victor
Gough, Frederick Lindsay, Martin Rees, Hugh
Gower, Raymond Linstead, Sir Hugh Renton, David
Grant, Rt. Hon. William Litchfield, Capt. John Ridsdale, Julian
Green, Alan Lloyd, Rt. Hon. Selwyn (Wirral) Robertson, Sir David
Gresham Cooke, R. Loveys, Walter H. Roots, William
Grimston, Sir Robert Lucas-Tooth, Sir Hugh Ropner, Col. Sir Leonard
Gurden, Harold McAdden, Stephen Russell, Ronald
Hall, John (Wycombe) MacArthur, Ian Scott-Hopkins, James
Hamilton, Michael (Wellingborough) McLaren, Martin Seymour, Leslie
Harris, Reader (Heston) McLaughlin, Mrs. Patricia Sharples, Richard
Harrison, Col. J. H. (Eye) MaClay, Rt. Hon. John Straw, M.
Harvey, Sir Arthur Vere (Macciesfd) Maclean, SirFitzroy (Bute&N.Ayrs.) Shepherd, William
Harvey, John (Walthamstow, E.) MacLeod, John (Ross & Cromarty) Simon, Rt. Hon. Sir Jocelyn
Harvie Anderson, Miss McMaster, Stanley R. Skeet, T. H. H.
Hastings, Stephen Macmillan, Maurice (Halifax) Smith, Dudley(Br'ntf'rd & Chiswick)
Hay, John Macpherson, Niall (Dumfries) Smyth, Brig. Sir John (Norwood)
Heald, Rt. Hon. Sir Lionel Maddan, Martin Spearman, Sir Alexander
Heath, Rt. Hon. Edward Maitland, Sir John Speir, Rupert
Henderson, John (Cathcart) Markham, Major Sir Frank Stanley, Hon. Richard
Henderson-Stewart, Sir James Marlowe, Anthony Steward, Harold (Stockport, S.)
Hendry, Forbes Marples, Rt. Hon. Ernest Stodart, J. A.
Hiley, Joseph Marshall, Douglas Stoddart-Scott, Col. Sir Malcolm
Hill, Mrs. Eveline (Wythenshawe) Matthews, Gordon (Meriden) Storey, Sir Samuel
Hirst, Geoffrey Maudling, Rt. Hon. Reginald Summers, Sir Spencer (Aylesbury)
Hobson, John Mawby, Ray Talbot, John E.
Hocking, Philip N. Maxwell-Hyslop, R. J. Taylor, Sir Charles (Eastbourne)
Holland, Philip Maydon, Lt.-Cmdr. S. L. C. Taylor, Edwin (Bolton, E.)
Hollingworth, John Mills, Stratton Teeling, William
Hopkins, Alan More, Jasper (Ludlow) Temple, John M.
Hornby, R. P. Morgan, William Thatcher, Mrs. Margaret
Hornsby-Smith, Rt. Hon. Patricia Morrison, John Thomas, Leslie (Canterbury)
Howard, Hon. G. R. (St. Ives) Mott-Radclyffe, Sir Charles Thomas, Peter (Conway)
Howard, John (Southampton, Test) Nicholson, Sir Godfrey Thompson, Richard (Croydon, S.)
Hughes Hallett, Vice-Admiral John Noble, Michael Thornton-Kemsley, Sir Colin
Hughes-Young, Norman Nugent, Sir Richard Tiley, Arthur (Bradford, W.)
Hulbert, Sir Norman Oakshott, Sir Hendrie Tilney, John (Wavertree)
Hurd, Sir Anthony Orr-Ewing, C. Ian Turner, Colin
Hutchison, Michael Clark Osborn, John (Hallam) Turton, Rt. Hon. R. H.
Iremonger, T. L. Osborne, Cyril (Louth) van Straubenzee, W. R.
Irvine, Bryant Goldman (Rye) Page, John (Harrow, West) Vane, W. M. F.
Jackson, John Page, Graham (Crosby) Wakefield, Edward (Derbyshire, W.)
James, David Pannell, Norman (Kirkdale) Walder, David
Jenkins, Robert (Dulwich) Partridge, E. Walker, Peter
Jennings, J. C. Pearson, Frank (Clitheroe) Walker-Smith, Rt. Hon. Sir Derek
Johnson, Dr. Donald (Carlisle) Peel, John Ward, Dame Irene
Johnson, Eric (Blackley) Percival, Ian Watts, James
Johnson Smith, Geoffrey Peyton, John Webster, David
Joseph, Sir Keith Pickthorn, Sir Kenneth Wells, John (Maidstone)
Kaberry, Sir Donald Pike, Miss Mervyn Whitelaw, William
Kerans, Cdr. J. S. Pilkington, Sir Richard Williams, Dudley (Exeter)
Kerby, Capt. Henry Pitt, Miss Edith Williams, Paul (Sunderland, S.)
Kershaw, Anthony Pott, Percivall Wills, Sir Gerald (Bridgwater)
Kitson, Timothy Powell, Rt. Hon. J. Enoch Wilson, Geoffrey (Truro)
Lagden, Godfrey Prior, J. M. L. Wolrige-Gordon, Patrick
Lambton, Viscount Prior-Palmer, Brig. Sir Otho Woodhouse, C. M.
Lancaster, Col. C. G. Profumo, Rt. Hon. John Woodnutt, Mark
Leather, E. H. C. Proudfoot, Wilfred Woollam, John
Leavey, J. A. Pym, Francis Worsley, Marcus
Leburn, Gilmour Ouennell, Miss J. M. Yates, William (The Wrekin)
Legge-Bourke, Sir Harry Ramsden, James
Lewis, Kenneth (Rutland) Rawlinson, Peter TELLERS FOR TAR AYES:
Lilley, F. J. P. Redmayne, Rt. Hon. Martin Mir. Chichester-Clark and
Mr. J. E. B. Hill.
Abse, Leo Chetwynd, George Edelman, Maurice
Allaun, Frank (Salford, E.) Collick, Percy Edwards, Rt. Hn. Ness (Caerphilly)
Allen, Scholefield (Crewe) Craddock, George (Bradford, S.) Edwards, Walter (Stepney)
Awbery, Stan Crossman, R. H. S. Evans, Albert
Bacon, Miss Alice Cullen, Mrs. Alice Fernyhough, E.
Beaney, Alan Darling, George Finch, Harold
Bence, Cyril (Dunbartonshire, E.) Davies, G. Elfed (Rhondda, E.) Fitch, Alan
Benson, Sir George Davies, Harold (Leek) Fletcher, Eric
Blackburn, F. Davies, S. O. (Merthyr) Foot, Dingle (Ipswich)
Blyton, William Deer, George Foot, Michael (Ebbw Vale)
Boardman, H. de Freitas, Geoffrey Forman, J. C.
Bowden, Herbert W. (Leics, S. W.) Delargy, Hugh Fraser, Thomas (Hamilton)
Boyden, James Dempsey, James Gaitskell, Rt. Hon. Hugh
Braddock, Mrs. E. M. Diamond, John Galpern, Sir Myer
Broughton, Dr. A. D. D. Dodds, Norman George, Lady Megan Lloyd (Crmrthn)
Butler, Herbert (Hackney, C.) Donnelly, Desmond Ginsburg, David
Butler, Mrs. Joyce (Wood Green) Drlberg, Tom Gourlay, Harry
Castle, Mrs. Barbara Dugdale, Rt. Hon. John Grey, Charles
Chapman, Donald Ede, Rt. Hon. C. Griffiths, Rt. Hon. James (Llanelly)
Gunter, Ray MacPherson, Malcolm (Stirling) Silverman, Julius (Aston)
Hale, Leslie (Oldham, W.) Mallalieu, E. L. (Brigg) Silverman, Sydney (Nelson)
Hall, Rt. Hn. Glenvil (Colne Valley) Mallalieu, J. P. W. (Huddersfield, E.) Slater, Mrs. Harriet (Stoke, N.)
Hamilton, William (West Fife) Manuel, A. C. Slater, Joseph (Sedgefield)
Hannan, William Mapp, Charles Small, William
Hart, Mrs. Judith Marquand, Rt. Hon. H. A. Smith, Ellis (Stoke. S.)
Hayman, F. H. Mason, Roy Snow, Julian
Healey, Denis Mayhew, Christopher Sorensen, R. W.
Henderson, Rt. Hn. Arthur (Rwly Regis) Mellish, R. J. Soskice, Rt. Hon. Sir Frank
Hewitson, Capt. M. Mendelson, J. J. Spriggs, Leslie
Hill, J. (Midlothian) Milne, Edward J. Steele, Thomas
Holman, Percy Mitchison, G. R. Stewart, Michael (Fulham)
Holt, Arthur Monslow, Walter Strauss, Rt. Hn. G. R. (Vauxhall)
Houghton, Douglas Moody, A. S. Stross, Dr.Barnett (Stoke-on-Trent, c.)
Howell, Charles A. Morris, John Swain, Thomas
Hoy, James H. Moyle, Arthur Sylvester, George
Hughes, Cledwyn (Anglesey) Mulley, Frederick Taylor, Bernard (Mansfield)
Hughes, Emrys (S. Ayrshire) Oliver, G. H. Taylor, John (West Lothian)
Hunter, A. E. Oram, A. E. Thomas, Iorwerth (Rhondda, W.)
Hynd, H. (Accrington) Oswald, Thomas Thomson, G. M. (Dundee, E.)
Irvine, A. J. (Edge Hill) Owen, Will Thornton, Ernest
Jay, Rt. Hon. Douglas Paget, R. T. Timmons, John
Jeger, George Pannell, Charles (Leeds, W.) Tomney, Frank
Jenkins, Roy (Stechford) Parker, John (Dagenham) Ungoed-Thomas, Sir Lynn
Jones, Rt. Hn. A. Creech (Wakefield) Parkin, B. T. (Paddington, N.) Wade, Donald
Jones, Dan (Burnley) Pearson, Arthur (Pontypridd) Wainwright, Edwin
Jones, Elwyn (West Ham, S.) Peart, Frederick Warbey, William
Jones, Jack (Rotherham) Pentland, Norman Watkins, Tudor
Jones, J. Idwal (Wrexham) Plummer, Sir Leslie Weitzman, David
Jones, T. W. (Merioneth) Poppleweil, Ernest Wells, Percy (Faversham)
Kelley, Richard Prentice, R. E. White, Mrs. Eirene
Kenyon, Clifford Price, J. T. (Westhoughton) Whitlock, William
Key, Rt. Hon. C. W. Probert, Arthur Wilkins, W. A.
King, Dr. Horace Proctor, W. T. Willey, Frederick
Lawson, George Pursey, Cmdr. Harry Williams, D. J. (Neath)
Lee, Frederick (Newton) Randall, Harry Williams, Ll. (Abertillery)
Lee, Miss Jennie (Cannock) Rankin, John Williams, W. R. (Openshaw)
Lever, L. M. (Ardwick) Redhead, E. C. Willis, E. G. (Edinburgh, E.)
Lewis, Arthur (West Ham, N.) Reid, William Wlnterbottom, R. E.
Lipton, Marcus Reynolds, G. W. Woodburn, Rt. Hon. A.
Loughlin, Charles Roberts, Albert (Normanton) Woof, Robert
Mabon, Dr. J. Dickson Roberts, Goronwy (Caernarvon) Wyatt, Woodrow
McCann, John Robinson, Kenneth (St. Pancras, N.) Yates, Victor (Ladywood)
MacColl, James Rogers, G. H. R. (Kensington, N.) Zilliacus, K.
McInnes, James Ross, William
McKay, John (Wallsend) Royle, Charles (Salford, West) TELLERS FOR THE NOES:
McLeavy, Frank Shinwell, Rt. Hon. E. Mr. Irving and
MacMillan, Malcolm (Western Isles) Short, Edward Mr. Ifor Davies
Mr. K. Robinson

I beg to move, in page 2, line 31, after "appliances", to insert: referred to in the Schedule to that Act". This Amendment is a variation of an Amendment which we moved in Committee and which sought to limit any variation of the description of appliances on which charges could be levied, under regulations made possible by the Clause, so as not to enlarge the category. The Minister told us in Committee that our fears were unjustified and that the only appliances to which the variation could be applied were those referred to in the Schedule of the 1951 Act.

However, in response to some misgivings expressed by my hon. Friends, he undertook to look at the matter again to see Whether any further clarification was necessary. We have tabled the Amendment because, while accepting the Minister's contention that this can be a reference only to appliances in the Schedule to the 1951 Act, we thought that it would be desirable to write in these words.

Mr. Powell

I have given the further consideration to the drafting which I promised in Committee, and my conclusion still is that there can be no doubt that the power here given does not make it possible to apply a charge to any appliances or services for which that charge is not now authorised by Statute.

The construction is as follows. The words … any such charge in line 32 carry us back to lines 29 and 30 to the words … any charge authorised by section one of the Act of 1951 for any dental or optical appliance … That Section authorises charges in respect of the supply … of such dental or optical appliances as are described in the said schedule. Consequently, the addition of the words which the hon. Member proposes could not possibly add anything to the construction which I have explained. Indeed, since there is no alternative to that construction the very fact that they were specified might create a doubt or difficulty.

I ask the House to accept that it is clear from the construction of the Bill, construed with the 1951 Act—and I have again confirmed with my advisers—that there can be no question of variation going outside the appliances and services for which charges are authorised by Statute.

Mr. K. Robinson

I should not have thought that the addition of these words could have had any detrimental effect, and I still think that their addition might have been an advantage. However, the Minister has given a categorical undertaking which I must accept, and in those circumstances I beg to ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.


Mr. T. Fraser

I beg to move, in page 4, line 9, to leave out "seven days" and to insert "six months".

As the House will appreciate, subsection (3) provides that the additional charges will come into operation seven days after the passing of the Act, and the effect of the Amendment would be that the increased charges would come into operation not earlier than six months after the passing of the Act.

I say in passing that it seems disgraceful that not only have we been prevented from moving many most important Amendments, but, owing to the operation of the Guillotine, one of the Scottish Ministers has been so gagged that he has not been able to say a word.

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

indicated dissent.

Mr. Fraser

The hon. Gentleman says that he has not been gagged. It makes it very much worse if we have had a Scottish Minister sitting through these proceedings, which amend a Scottish Act of Parliament, and he has not been in the least disposed to say a word on what is being done to that Act.

When we have improvements in social benefits—in retirement pensions, unemployment benefit, sickness benefit, or in the lot of those who get some assistance from the National Assistance Board—we always provide for a period of some months after the Act goes on the Statute Book before any such improvement is made. In the case of all those insurance benefits, the improvement has not been made until administrative arrangements can be made to take increased contributions from the workers. Now, when there is to be a new tax put upon certain sections of our people who are suffering disability, and the justification for the new tax is that the money should be used to build hospitals, we do not wait until we get the plans for the adjustment of the hospitals programme. The Minister proposes that the increase shall come into operation at once.

The Minister has said in justifying some parts of the Bill, in the inadequate discussion that we have been able to have during the Report stage today, that, in view of the increased prosperity we enjoy as compared with ten years ago, there can be no hardship to anyone as a result of the increased charges. The Joint Under-Secretary of State for Scotland will be well aware that prosperity has not yet come to Scotland. Prosperity for the people there is still "around the corner". Jobs are still in the pipeline, but they have not yet appeared.

If the Minister accepts the Amendment, it will at least give the Government another six months to take some positive steps to see that in Scotland and other parts of the United Kingdom where there is considerable unemployment—in the North East and elsewhere where the economy has not expanded in recent years and the people have not enjoyed the level of prosperity mentioned by the Minister—people get their share of the good things of life and are able to pay the increased charges which will fall equally on all areas, including those with considerable unemployment.

I regret very much that one has to curtail one's remarks on such an important Amendment. I do not think that the Minister need feel that any great concession would be made to the Opposition if he were to accept the Amendment. All that it would mean is that the imposition of the increased charges would be delayed for six months. This would mean that the Treasury would lose about £1½ million. When one compares the way in which the Treasury deal with some people in our society with what we expect to be announced by the Chancellor of the Exchequer on 17th April next, I do not think that it is asking too much of the Government at this time to delay the imposition of these charges until we have had a reasonable time to have a look at the changes proposed by the Chancellor.

Miss Pitt

In moving the Amendment, the effect of which would be to postpone the operation of the Bill, after it becomes an Act, for six months, the hon. Member for Hamilton (Mr. T. Fraser) referred to the charges contained in the Bill as a new tax. They are not a new tax, as has been repeatedly explained. The effect of the Bill is to bring up to date the charges imposed by hon. Members opposite in 1951. That is of great importance in connection with the Amendment, because even if the Amendment were accepted the far greater charges imposed by hon. Members opposite would still be payable forthwith. All that it would do would be to postpone the extra 5s. on dentures and the extra 2s. 6d. on spectacle lenses for six months from the date of the passing of the Bill. For that reason alone, I would advise the House to reject the Amendment.

But there is another reason, to which hon. Members opposite have given no thought whatever. The Bill proposes to make some concessions. These would also be deferred for six months. The concessions are that dentures will be free to expectant and nursing mothers, and to children up to school-leaving age, and there will be no charge for lenses, in the case of children above the age of 10, when fitted into National Health Service frames. It would be a very great pity, in an endeavour to delay the Bill, to prevent these concessions from applying. I advise the House to reject the Amendment.

Mr. K. Robinson

Would the hon. Lady explain to the House that the cost of the concessions to which she refers is almost exactly one-tenth of the cost that is placed on the backs of the sick and needy by the increased charges proposed in the Bill?

Miss Pitt

Yes, but they are concessions, and this is the first time that the word "concession" has come from hon. Members opposite.

Mr. Willis

The hon. Lady's reply is rather ridiculous. She said that if we postponed the Bill for six months, the contributors would still be paying the initial big charge. The way to stop that would be for the Government to introduce a Bill by which those charges would not have to be paid. If the hon. Lady says that this delay would be a great hardship, the logical thing to do would be to introduce a Bill to wipe out the charges altogether. We on this side would push it through in the manner in which we usually push Government Bills through the House—that is, in a very speedy and efficient manner. I am surprised that at this stage the hon. Lady should advance that as an argument for not delaying the operation of the Bill.

Her other argument was that we would be postponing certain benefits. We would be quite prepared to consider putting the benefits into operation within seven days but postponing the charges for six months. On that we would be prepared to go all the way with the hon. Lady—to meet all her arguments and be most amenable in assisting her to help the people to bear these new charges. Why is there all this hurry to rush the Bill through so that it comes into operation within seven days? When the old-age pensioners get a rise they have to wait six months.

There is no equity about it. It is not as though a large sum of money was involved. In the case of Scotland the Joint Under-Secretary has not yet made his debut, but I understand that we are to have the pleasure of his première later tonight, by kind permission of the Ministry of Health.

It being half-past Seven o'clock, Mr. SPEAKER proceeded, pursuant to Orders, to put forthwith the Question already proposed from the Chair.

Question put, That "seven days" stand part of the Bill:—

The House divided: Ayes 265, Noes 194.

Division No. 129.] AYES [7.30 p.m.
Agnew, Sir Peter Gardner, Edward MacLeod, John (Ross & Cromarty)
Aitken, W. T. Gibson-Watt, David McMaster, Stanley R.
Allan, Robert (Paddington, S.) Glover, Sir Douglas Macmillan, Maurice (Halifax)
Allason, James Godber, J. B. Macpherson, Niall (Dumfries)
Amery, Rt. Hon. Julian (Preston, N.) Goodhart, Philip Maddan, Martin
Arbuthnot, John Goodhew, Victor Maitland, Sir John
Ashton, Sir Hubert Gough, Frederick Markham, Major Sir Frank
Atkins, Humphrey Gower, Raymond Marlowe, Anthony
Barlow, Sir John Grant, Rt. Hon. William Marples, Rt. Hon. Ernest
Barter, John Green, Alan Marshall, Douglas
Batsford, Brian Gresham Cooke, R. Matthews, Gordon (Meriden)
Beamish, Col. Sir Tufton Grimston, Sir Robert Maudling, Rt. Hon. Reginald
Bell, Ronald Grosvenor, Lt.-Col. R. G. Mawby, Ray
Bennett, Dr. Reginald (Gos & Fhm) Gurden, Harold Maxwell-Hyslop, R. J.
Berkeley, Humphry Hall, John (Wycombe) Maydon, Lt.-Cmdr. S. L. C.
Bidgood, John C. Hamilton, Michael (Wellingborough) Mills, Stratton
Biggs-Davison, John Harris, Reader (Heston) More, Jasper (Ludlow)
Bingham, R. M. Harvey, Sir Arthur Vere (Macclesf'd) Morgan, William
Birch, Rt. Hon. Nigel Harvey, John (Walthamstow, E.) Morrison, John
Bishop, F. P. Harvie Anderson, Miss Mott-Radclyffe, Sir Charles
Bourne-Arton, A. Hay, John Nicholson, Sir Godfrey
Box, Donald Heald, Rt. Hon. Sir Lionel Noble, Michael
Boyd-Carpenter, Rt. Hon. John Henderson, John (Cathcart) Nugent, Sir Richard
Boyle, Sir Edward Henderson-Stewart, Sir James Oakshott, Sir Hendrie
Brewis, John Hendry, Forbes Orr-Ewing, C. Ian
Brooke, Rt. Hon. Henry Hiley, Joseph Osborn, John (Hallam)
Brooman-White, R. Hill, Mrs. Eveline (Wythenshawe) Osborne, Cyril (Louth)
Browne, Percy (Torrington) Hill, J. E. B. (S. Norfolk) Page, John (Harrow, West)
Bryan, Paul Hirst, Geoffrey Page, Graham (Crosby)
Buck, Antony Hobson, John Pannell, Norman (Kirkdale)
Bullard, Denys Hocking, Philip N. Partridge, E.
Bullus, Wing Commander Eric Holland, Philip Pearson, Frank (Clitheroe)
Burden, F. A. Hollingsworth, John Percival, Ian
Campbell, Gordon (Moray & Nalrn) Hopkins, Alan Peyton, John
Carr, Compton (Barons Court) Hornby, R. P. Pickthorn, Sir Kenneth
Carr, Robert (Mitcham) Hornsby-Smith, Rt. Hon. Patricia Pike, Miss Mervyn
Cary, Sir Robert Howard, Hon. G. R. (St. Ives) Pilkington, Sir Richard
Channon, H. P. G. Howard, John (Southampton, Test) Pitt, Miss Edith
Chataway, Christopher Hughes Hallett, Vice-Admiral John Pott, Percivall
Chichester-Clark, R. Hughes-Young, Michael Powell, Rt. Hon. J. Enoch
Clark, William (Nottingham, S.) Hulbert, Sir Norman Prior, J. M. L.
Cleaver, Leonard Hurd, Sir Anthony Prior-Palmer, Brig. Sir Otho
Cole, Norman Hutchison, Michael Clark Profumo, Rt. Hon. John
Cooper, A. E. Iremonger, T. L. Proudfoot, Wilfred
Cooper-Key, Sir Neill Irvine, Bryant Godman (Rye) Pym, Francis
Cordeaux, Lt.-Col. J. K. Jackson, John Quennell, Miss J. M.
Cordle, John James, David Ramsden, James
Corfield, F. V. Jenkins, Robert (Dulwich) Rawlinson, Peter
Costsin, A. P. Jennings, J. C. Redmayne, Rt. Hon. Martin
Couison, J. M. Johnson, Dr. Donald (Carlisle) Rees, Hugh
Courtney, Cdr. Anthony Johnson, Eric (Blackley) Renton, David
Craddock, Sir Beresford Johnson Smith, Geoffrey Ridsdale, Julian
Critchley, Julian Joseph, Sir Keith Roots, William
Crosthwaite-Evre, Col. O. E. Kaberry, Sir Donald Ropner, Col. Sir Leonard
Crowder, F. P. Kerans, Cdr. J. S. Russell, Ronald
Cunningham, Knox Kerby, Capt. Henry Scott-Hopkins, James
Curran, Charles Kerr, Sir Hamilton Seymour, Leslie
Currie, G. B. H. Kershaw, Anthony Sharples, Richard
Dalkeith, Earl of Kitson, Timothy Shaw, M.
Dance, James Lagden, Godfrey Shepherd, William
d'Avigdor-Goldsmid, Sir Henry Lambton, Viscount Simon, Rt. Hon. Sir Jocelyn
de Ferranti, Basil Lancaster, Col. C. G. Skeet, T. H. H.
Dighy, Simon Wingfield Leather, E. H. C. Smith, Dudley(Br'ntf'rd & Chiswick)
du Cann, Edward Leavey, J. A. Smyth, Brig. Sir John (Norwood)
Duncan, Sir James Leburn, Gilmour Spearman, Sir Alexander
Duthie, Sir William Legge-Bourke, Sir Harry Speir, Rupert
Eden, John Lewis, Kenneth (Rutland) Stanley, Hon. Richard
Elliot, Cant. Walter (Carshalton) Lilley, F. J. P. Steward, Harold (Stockport, S.)
Elliott, R. W. (Nwcstle-upon-Tyne, N.) Lindsay, Martin Stodart, J. A.
Emery, Peter Linstead, Sir Hugh Stoddart-Scott, Col. Sir Malcolm
Emmet, Hon. Mrs. Evelyn Litchfield, Capt. John Storey, Sir Samuel
Farey-Jones, F. W. Llovd, Rt. Hon. Selwyn (Wirral) Summers, Sir Spencer (Aylesbury)
Fell, Anthony Lovevs, Walter H. Talbot, John E.
Finlay, Graeme Lucas-Tooth, Sir Hugh Taylor, Sir Charles (Eastbourne)
Fisher, Nigel McAdden, Stephen Taylor, Edwin (Bolton, E.)
Fletcher-Cooke, Charles MacArthur, Ian Teeling, William
Fraser, Ian (Plymouth, Sutton) McLaren, Martin Temple, John M.
Galbraith, Hon. T. G. D. McLaughlin, Mrs. Patricia Thatcher, Mrs. Margaret
Gammans, Lady Maclay, Rt. Hon. John Thomas, Leslie (Canterbury)
Thomas, Peter (Conway) Walker, Peter Wilson, Geoffrey (Truro)
Thompson, Richard (Croydon, S.) Walker-Smith, Rt. Hon. Sir Derek Wolrige-Gordon, Patrick
Thornton-Kemsley, Sir Colin Ward, Dame Irene Woodnutt, Mark
Tiley, Arthur (Bradford, W.) Watkinson, Rt. Hon. Harold Woollam, John
Tilney, John (Wavertree) Watts, James Worsley, Marcus
Turner, Colin Webster, David Yates, William (The Wrekin)
Tufton, Rt. Hon. R. H. Wells, John (Maidstone)
van Straubenzee, W. R. Whitelaw, William
Vane, W. M. F. Williams, Dudley (Exeter) TELLERS FOR THE AYES:
Wakefield, Edward (Derbyshire, W.) Williams, Paul (Sunderland, S.) Colonel J. H. Harrison and
Walder, David Wills, Sir Gerald (Bridgwater) Mr. Peel.
Abse, Leo Hill, J. (Midlothian) Popplewell, Ernest
Allaun, Frank (Salford, E.) Holman, Percy Prentice, R. E.
Allen, Scholefield (Crewe) Holt, Arthur Price, J. T. (Westhoughton)
Awbery, Stan Houghton, Douglas Probert, Arthur
Bacon, Miss Alice Howell, Charles A. Proctor, W. T.
Beaney, Alan Hoy, James H. Pursey, Cmdr. Harry
Bence, Cyril (Dunbartonshire, E.) Hughes, Cledwyn (Anglesey) Randall, Harry
Benson, Sir George Hughes, Emrys (S. Ayrshire) Rankin, John
Blackburn, F. Hunter, A. E. Redhead, E. C.
Blyton, William Hynd, H. (Accrington) Reid, William
Boardman, H. Irvine, A. J. (Edge Hill) Reynolds, G. W.
Bowden, Herbert W. (Leics, S. W.) Jay, Rt. Hon. Douglas Roberts, Albert (Normanton)
Boyden, James Jeger, George Roberts, Goronwy (Caernarvon)
Braddock, Mrs. E. M. Jones, Rt. Hn. A. Creech (Wakefield) Robinson, Kenneth (St. Pancras, N.)
Broughton, Dr. A. D. D. Jones, Dan (Burnley) Rogers, G. H. R. (Kensington, N.)
Butler, Herbert (Hackney, C.) Jones, Jack (Rotherham) Ross, William
Butler, Mrs. Joyce (Wood Green) Jones, J. Idwal (Wrexham) Royle, Charles (Salford, West)
Castle, Mrs. Barbara Jones, T. W. (Merioneth) Shinwell, Rt. Hon. E.
Chapman, Donald Kelley, Richard Short, Edward
Chetwynd, George Kenyon, Clifford Silverman, Julius (Aston)
Collick, Percy Key, Rt. Hon. C. W. Silverman, Sydney (Nelson)
Corbet, Mrs. Freda King, Dr. Horace Slater, Mrs. Harriet (Stoke, N.)
Craddock, George (Bradford, S.) Lawson, George Slater, Joseph (Sedgefield)
Crossman, R. H. S. Lee, Frederick (Newton) Small, William
Cullen, Mrs. Alice Lee, Miss Jennie (Cannock) Smith, Ellis (Stoke, S.)
Darling, George Lever, L. M. (Ardwick) Snow, Julian
Davies, G. Elfed (Rhondda, E.) Lewis, Arthur (West Ham, N.) Sorensen, R. W.
Davies, Harold (Leek) Lipton, Marcus Soskice, Rt. Hon. Sir Frank
Davies, S. O. (Merthyr) Loughlin, Charles Spriggs, Leslie
Deer, George Mabon, Dr. J. Dickson Steele, Thomas
de Freitas, Geoffrey McCann, John Stewart, Michael (Fulham)
Delargy, Hugh MacColl, James Strauss, Rt. Hn. G. R. (Vauxhall)
Diamond, John McInnes, James Stross, Dr. Barnett (Stoke-on-Trent, C.)
Dodds, Norman McKay, John (Wallsend) Swain, Thomas
Donnelly, Desmond McLeavey, Frank Sylvester, George
Driberg, Tom MacMillan, Malcolm (Western Isles) Taylor, Bernard (Mansfield)
Dugdale, Rt. Hon. John MacPherson, Malcolm (Stirling) Taylor, John (West Lothian)
Ede, Rt. Hon. C. Mallalieu, E. L. (Brigg) Thomas, Iorwerth (Rhondda, W.)
Edelman, Maurice Mallalieu, J. P. W. (Huddersfield, E.) Thomson, G. M. (Dundee, E.)
Edwards, Rt. Hon. Ness (Caerphilly) Manuel, A. C. Thornton, Ernest
Edwards, Walter (Stepney) Mapp, Charles Timmons, John
Evans, Albert Marquand, Rt. Hon. H. A. Tomney, Frank
Fernyhough, E. Mason, Roy Ungoed-Thomas, Sir Lynn
Finch, Harold Mavhew, Christopher Wade, Donald
Fitch, Alan Mellish, R. J. Wainwright, Edwin
Fletcher, Eric Mendelson, J. J. Warbey, William
Foot, Dingle (Ipswich) Milne, Edward J. Watkins, Tudor
Foot, Michael (Ebbw Vale) Mitchison, G. R. Weitzman, David
Forman, J. C. Monslow, Walter Wells, Percy (Faversham)
Fraser, Thomas (Hamilton) Moody, A. S. White, Mrs. Eirene
Galpern, Sir Myer Morris, John Whitlock, William
George, Lady Megan Lloyd (Crmrthn) Moyle, Arthur Wilkins, W. A.
Ginsburg, David Mulley, Frederick Willey, Frederick
Gourlay, Harry Oliver, G. H. Williams, D. J. (Neath)
Grey, Charles Oram, A. E. Williams, Ll. (Abertillery)
Griffiths, Rt. Hon. James (Llanelly) Oswald, Thomas Wililams, W. R. (Openshaw)
Gunter, Ray Owen, Will Willis, E. G. (Edinburgh, E.)
Hale, Leslie (Oldham, W.) Paget, R. T. Winterbottom, R. E.
Hall, Rt. Hn. Glenvil (Colne Valley) Pennell, Charles (Leeds, W.) Woodburn, Rt. Hon. A.
Hamilton, William (West Fife) Parker, John (Dagenham) Woof, Robert
Hannan, William Parkin, B. T. (Paddington, N.) Wyatt, Woodrow
Hart, Mrs. Judith Pearson, Arthur (Pontypridd) Yates, Victor (Ladywood)
Hayman, F. H. Peart, Frederick Zilliacus, K.
Henderson, Rt. Hn. Arthur (Rwly Regis) Pentland, Norman
Hewitson, Capt. M. Plummer, Sir Leslie TELLERS FOR THE NOES:
Mr. Irving and Mr. Ifor Davies.

7.40 p.m.

Mr. Galbraith

I beg to move, That the Bill be now read the Third time.

I shall try to be as brief as possible, because I know that there are many hon. Gentlemen who wish to speak. Before turning to the contents of the Bill, however, I should like, first, if I may, to pay a tribute to the hon. Member for St. Pancras, North (Mr. K. Robinson), who has led for the Opposition. His courtesy and consideration helped to keep our proceedings at a near normal temperature most of the time.

Mr. Charles Loughlin (Gloucestershire, West)

That is the kiss of death.

Mr. Galbraith

Coming as I do from the more tempestuous North, I may say that the humour and classical erudition of many of the other speeches was a real revelation. They made we wonder whether some of my fellow countrymen, who always use the claymore rather than the rapier, may not have something to learn from the hon. Gentleman's velvet glove technique.

Mr. Willis

We get the hon. Gentleman to his feet, anyway.

Mr. Galbraith

The hon. Member for Edinburgh, East (Mr. Willis) who says that he gets me to my feet anyway, is now learning that if he waits long enough he gets a good thing in the end. I will make a bargain with the hon. Gentleman; if he speaks less I will speak more.

The hon. Member for South Ayrshire (Mr. Emrys Hughes), who represents me in this House, was concerned about my relations with the young Unionists in South Ayrshire. I hope that he will take the opportunity tomorrow of circulating my speech to them.

I am only sorry that in spite of the Opposition's persuasive manner we could find no reason for agreeing to more than one minor drafting Amendment, and that was to Clause 3. Apart from this small change, which I am sure the House would not wish me to take up time in explaining, the Bill is the same as that which was originally presented to the House.

I therefore think that it might be right at this stage to emphasise again the reasons which led the Government to propose the small increases—and I emphasise the word "small"—in the charges for dentures and glasses for which the Bill now makes provision. The background to the proposals to increase the charges has been a continuing rise in the cost of the Health Service, which has now reached the very high figure of £867 million in the current year, with an estimated increase on that figure in the forthcoming year of 11 per cent, a very considerable increase indeed. In spite of this, the Government are determined to develop and improve the Health Service still further. This will, of course, require even greater expenditure and it is to help meet this burden that the present proposals have been made.

The interesting thing in this situation is that we on this side of the House are acting in exactly the same way as hon. Gentlemen opposite found they had to act when their ideal notion of the scheme of things clashed with the harsh realities of practical and responsible Government.

Mr. Dempsey

The hon. Gentleman should not look at me.

Mr. Galbraith

The hon. Gentleman should not be so self-centred. I was looking at all his right hon. and hon. Friends. That was why they introduced charges for false teeth and glasses in 1951.

Mr. Tom Driberg (Barking)

Do not say "all".

Mr. Galbraith

There may be one or two exceptions, but as a party and as a Government they introduced the charges in 1951. They took the first step, and this Bill, therefore, introduces no new principle. All it does is to adjust the charges and take account of the increased cost.

When the charges for dentures were first introduced, in 1951, they represented about half the fees payable to dentists for false teeth, that is about 50 per cent. of the cost to the Health Service. By 1960, however, the percentage of the denture bill which was met by the charges had fallen from 50 per cent. to about 43 per cent.——

Mr. William Ross (Kilmarnock)

On a point of order, Mr. Deputy-Speaker. I understood that on the Third Reading of the Bill we were limited to what was in the Bill. I should like to direct your attention to, and ask your advice on, the speech of the hon. Gentleman, who has not yet mentioned what is in the Bill but has given reasons for the rise, which, I should have thought, was relevant to a Second Reading debate, but not to the Third Reading debate.

Mr. Deputy-Speaker (Major Sir William Anstruther-Gray)

The hon. Gentleman's understanding is correct, but I take it that the Minister will very quickly come within the strict confines of a Third Reading speech.

Mr. Sydney Silverman (Nelson and Colne)

Further to that point of order, Mr. Deputy-Speaker. It will not have escaped your notice that the point is of considerable importance, because if, in moving the Third Reading of the Bill, the hon. Gentleman is entitled to attack what the Labour Government did in 1951, presumably, during the rest of the debate, some of us will be entitled to defend them. As the Bill does not deal with 1951, but with 1961, it would seem that that could not be in order.

Mr. Deputy-Speaker

I hope that the House will not go very much further than is appropriate during a Third Reading debate.

Mr. Galbraith

I was trying to give reasons for what was in the Bill. If I have gone beyond the mark, I apologise.

The revised charges now proposed in the Bill merely restore the position to what hon. Gentlemen opposite thought was fair in 1951, that is, back to 50 per cent. of the relevant denture fees.

There is no doubt that experience in Scotland as well as in England and Wales, has shown that the denture charge has encouraged a switch away from false teeth to the conservation of natural teeth. Indeed, the experience of the denture charge is a good example of the way in which it is possible to use charges as a means of developing this service and of guiding it along the right lines so that preventive dental treatment increases and people keep more of their own teeth longer. This is a tendency which I think we would all wish to encourage, and the charge will have just that effect.

Sir Myer Galpern (Glasgow, Shettleston)

Is the hon. Gentleman suggesting that dental practitioners were so mis- guided that they were extracting teeth solely for the purpose of getting the charges which would be payable by patients and by the Health Service rather than conserving teeth, and that this is the only method whereby we can get these dental practitioners to observe the purposes for which they are practising?

Mr. Galbraith

If the hon. Gentleman will wait a minute he will see what I mean.

For example, expenditure on false teeth in Scotland is now less than half what it was in 1950. On the other hand, expenditure on other forms of dental treatment is almost double what it was in that year.

Mr. Emrys Hughes

The hon. Gentleman has asked me to circulate his speech to the Young Unionists. Is he aware that the Young Unionists in my part of Scotland are dentists? How can I circulate that among dentists?

Mr. Galbraith

I shall be delighted if the hon. Gentleman will circulate it. I am willing to take the risk that dentists may not appreciate everything that is contained in it—although I think that they will if they read the whole of it.

As I was saying, it was explained to the House by my right hon. Friend the Secretary of State, during the Second Reading debate, that a substantial proportion of this increase is being used to provide preventive treatment for children. This form of development was not possible in 1951 because a major part of the resources of the general dental service, both in money and in dental manpower, was being used to provide false teeth. I hope that that answers the point raised by the hon. Gentleman.

In the light of past experience, therefore, the Government are confident that the modest—I stress that word again—increases in the denture charges proposed in the Bill will serve to continue to place the emphasis on dental treatment rather than on the provision of false teeth, that is. on prevention rather than cure.

Turning to glasses——

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

As on three or four occasions the Minister has emphasised the modesty of the charges, is that the virtue which he is emphasising in the Bill? Are we to understand that the more modest the charges the more he can commend it to the House?

Mr. Galbraith

I am merely pointing out that the charges are modest. The hon. and learned Gentleman may draw what conclusion he wishes.

It is the view of the Government that it is perfectly reasonable that the charge of 10s. per lens, introduced in 1951 should, ten years later, be brought more into line with current costs. The introduction of the special charge for bifocal lenses is a reflection of the fact that these lenses serve the purpose of two ordinary pairs of glasses for which, at present, an applicant would have to pay separate charges. In themselves, bifocal glasses are often more convenient and there seems no reason why someone who chooses bifocals should pay only half the charge that a person having two pairs of glasses has to meet.

There is one feature of the Bill which the Opposition have welcomed, not very loudly perhaps, but still it has been welcomed——

Dr. Stross

Was the hon. Gentleman in the Chamber when the Minister of Transport came in and gave us evidence of all the arguments we used against this extra charge on bifocals?

Mr. Galbraith

I do not think that the action of the Minister of Transport necessarily proved what the hon. Gentleman seeks to suggest that it did prove.

Mr. William Hamilton (Fife, West)

If it is a logical argument that one ought to pay double for bifocals, what would be the charge for a monocle?

Mr. Galbraith

I must confess that I do not know the answer to that question, but I will try to find out and I will write a letter to the hon. Gentleman.

As I was saying, there are two exemptions provided in the Bill for free service to priority classes which I think the Opposition have welcomed. These exemptions are in Clause 1. They enable expectant and nursing mothers and school children to obtain free dentures, and they also enable children over 10 years of age, so long as they remain at school, to have free lenses in the Health Service frame of their choice, that is, any frame in the complete Health Service range.

There were many eloquent speeches during the Committee stage on the provisions in Clause 2 of the Bill relating to the future variation of charges for dental and optical appliances and dental treatment, and I should like to restate the purpose of these provisions so as to prevent any misunderstanding. They are intended merely to ensure that changes can be made in future in these charges in the same way as changes can be made in other Health Service charges. The powers sought can be used only to vary the amounts of the charges for dental or optical appliances or for dental treatment, or to alter the categories into which dentures or glasses, other than children's glasses, are divided for the purpose of the charges.

The powers do not extend—I should like to emphasise this—to introducing new charges for any other services or appliances, or to varying the circumstances in which, or the categories of persons to whom, the charges apply. In other words, legislation will continue to be necessary for any extension of the charges to new appliances and for any variation in the exemptions from charges for dental or optical appliances or for dental treatment for which the Acts of 1951 and 1952 and the present Bill provide. I hope that this explanation may set at rest some of the doubts of hon. Members opposite.

Throughout the discussions on the Bill, both in the House and in the Standing Committee, the Government have tried to take every opportunity of publicising the arrangements for the charges to be remitted in cases where they may cause financial hardship. Examples have been given by both my right hon. Friends to show the type of case which is eligible for remission. There are two points which I should like to bring out again to make sure that they are fully appreciated. There has, I think, been a mistaken impression in some quarters that remissions are available only to people who are already currently in receipt of regular National Assistance. In fact, remissions are available also to persons who are not currently receiving National Assistance, provided that they are in need according to the standards of the Board, and even if they are in full-time employment.

Perhaps I should explain why I have used the words "remit" and "remission" rather than "refund". I have done so because the normal procedure is that where a patient is eligible the Board makes the payment to the dentist or optician direct. I hope that this further explanation will set at rest any doubts and will assure the country that, according to their need, people will get the financial help that is necessary.

Mr. Emrys Hughes

That will not satisfy the Young Unionists.

Mr. Galbraith

I think that it will. At any rate, if the hon. Gentleman will circulate my speech, it will be interesting to see who is right. Perhaps he will put it to the test in that way——

Mr. W. Hamilton

Will the hon. Gentleman allow me to interrupt him again?

Mr. Galbraith


In conclusion, I should like to say that in spite of the criticism that has been levelled against us over these charges, the Government are confident that in this Bill we are doing the right thing for the Health Service. We have a fine record of development over the last ten years—[HON. MEMBERS: "Where?"]—and it is a record of which we are justly proud. But it is one we intend to improve still further, and the Bill will help us to do just that. I therefore ask the House, in this forward-looking spirit, to give the Bill its Third Reading.

Mr. W. Hamilton

Will the hon. Gentleman clear up one point which troubles me? Suppose a farmer, who is getting subsidies, has a prescription. Does he go to the National Assistance Board and tell the Board precisely how much subsidy he is getting so that the Board can decide whether he is in need of assistance, taking into account his subsidy? I think that we are entitled to an answer. There are farmers who may suffer from ill-health.

8.0 p.m.

Mr. K. Robinson

The House will have listened with interest to the Joint Under-Secretary of State for Scotland, who has broken a very long silence on this Bill. Having listened to him, hon. Members will have understood why he has been keen on maintaining silence hitherto.

Mr. Anthony Kershaw (Stroud)

It was a very good speech.

Mr. Robinson

I do not think that any of the arguments the hon. Gentleman put forward in support of the Third Reading of the Bill were any more convincing—indeed, they were far less convincing—than many of the arguments we have heard before.

We have now come to the last stage of this miserable Bill. I am sure that I am speaking for all my hon. Friends when I say that nothing has happened in any stage of our discussions on the Bill to shake our conviction that this Measure is as unnecessary as it is undesirable. It is unnecessary because we simply cannot accept that at this stage there is any need for cutting the Exchequer contribution to the National Health Service. In previous debates we have quoted figures about these Health Service charges to show that the Service, by the only yardstick one can legitimately use, far from costing more, is not costing as much today as it was costing ten years ago.

If anyone doubted the figures which my hon. Friends and I selected from official Government publications, there is a slightly different set of figures, producing precisely the same result, to be found in the first of two interesting articles which appeared in The Times a day or two ago. They were referred to during the Report stage by my hon. Friend the Member for Carmarthen (Lady Megan Lloyd George). Dr. D. S. Lees, quoting the gross current expenditure on the National Health Service in proportion to the gross national product, produces a figure of 4.19 per cent. for 1950. On exactly the same basis, on the Estimate for 1961 the figure is 4.14 per cent. So, despite the great expansion we have been told about by the Joint Under-Secretary, on these figures—as on any other sets of figures I have been able to discover—the National Health Service is costing a slightly smaler proportion of the gross national product than it was ten years ago.

Now that the right hon. Gentleman has produced proposals for increased contributions and increased charges, the Exchequer contribution to the National Health Service is not slightly down, but very substantially down, on 1950. If one takes the Exchequer contribution, I think the figures that will be produced are 3.85 per cent. for 1950 and 3.22 per cent. for 1961 based on the Estimates. Surely, at a time when we are told that living standards are constantly rising, we should expect both an absolute and a relative rise in expenditure on the nation's health.

That is exactly what has been happening, according to these articles, in the United States of America. There the majority of health expenditure is on a private basis. It is a matter of option to a very large extent how much people there spend on health, but in the United States total expenditure on medical care has risen from 4½ per cent. in 1949 to 5½ per cent. in 1959. That is an overall rise of about a quarter in ten years, when our expenditure in relative terms has fallen and when the Exchequer contribution to the Health Service has fallen by something approaching 20 per cent. in the same period.

We simply cannot see that there is any argument at all for cuts in this Service, still less any argument for placing greater burdens upon the patients and those in need. This article, going on to draw analogies from the American experience, says that in Britain: Over the past 10 years it has declined slightly and, at times in between, sharply. One of the assumptions underlining the Health Service is that, without it, people would not spend enough on medical care. On the contrary, it would seem that public expenditure is less than private expenditure in its place would have been. In this fact and these statistics lies the condemnation of the Government that they are in fact arranging that the nation spends less on health than, by all the evidence we have, it would have been spending if it were left to private individuals, as in the United States, to make their health payments themselves. The article winds up by saying that possibly the Government have different motives in this . Dr. Lees says: Health services have little contribution to make to the growth of future output. I would cross swords with him there. I think that he has under-estimated, and I am quite sure that the Minister and the Government have grossly underestimated, the positive dividends—even in economic terms—which the National Health Service brings in getting people back to work after they have been ill and keeping people in work who would fall ill if it were not for the Health Service looking after them. On the assumption that this is what the Government think, Dr. Lees says that no doubt there has been a deliberate restriction of the Health Service in order to release resources for more production-stimulating services and he quotes higher education.

Dr. Lees concludes by saying: But if this is now the raison d'etre of public health services, then as electors, taxpayers, and frustrated consumers, we have a right to be told. Before we part with the Bill, we should like to know from the right hon. Gentleman if that is the view of the Government, and to what extent there is a deliberate policy of cutting back expenditure on health for reasons of that kind.

In earlier debates, the right hon. Gentleman has spoken a great deal about the alleged ceiling which was put on the Service by Sir Stafford Cripps. Of course, there never was a ceiling. Each year expenditure on the Health Service rose. It rose even in the year to which so much reference has been made when charges for teeth and spectacles were imposed for the first time. The published figures we have today suggest that this Government have now put a ceiling on the Health Service. We should like to know whether that is so.

Net Government expenditure on the Health Service for the coming year is £600 million. Six hundred million pounds is the total expenditure on the Health Service for the year now expiring if one ignores the once-for-all payment of £31 million in respect of the backdated salary increases for doctors. It may be purely a coincidence that these two amounts are almost exactly £600 million, but is looks very much as if a ceiling figure has been put on to the Service. If so, we should like to know for how long this is to be. For how long are we to have a series of additional charges and increased contributions if the gross expenditure of the National Health Service continues to increase as it should?

Perhaps I may now sum up this part of our argument. We feel that no case whatever has been made for the raising of £2.6 million under this Bill. We fear that the right hon. Gentleman, like Oliver Twist, is coming back to ask for more, and that it will be all too easy for him to do so. All he needs to do is to table a Regulation and all we as an Opposition will be able to do is to pray against it after 10 o'clock at night. So much for the necessity, or alleged necessity, of this Measure.

We think that it is undesirable and that is by far the greater burden of our complaint against the Bill, because we think that, far from erecting new barriers, the existing financial barriers between the patient and the treatment he needs should be demolished. When talking about the charges imposed by a Labour Government in totally different circumstances, Ministers might at least acknowledge from time to time that it is clearly and emphatically the Labour Party's policy now to revert to a Health Service which is free to the patient and to the abolition of all health charges. That is our policy, and we have made it abundantly clear.

The right hon. Gentleman and his hon. Friends have made much play of the fact that these are only small increases. As has been said, it is easy to select a particular increase and to say, "This is only half-a-crown. It represents only a packet of "Players". The fact is that the Measures taken together will place an additional burden of £65 million on the public in a year. Under this Bill it is between £2½ million and £3 million. As we have said again and again, and as we should repeat, we believe that this will cause hardship.

The right hon. Gentleman counters by saying that any hardship which might be accidentally imposed by these Measures can be looked after quite satisfactorily by reason of the arrangements for National Assistance Board refunds, or remissions, to use the word used by the Joint Under-Secretary of State for Scotland. The right hon. Gentleman has been under some embarrassment on this, because many of the arguments which we have used against the principle of imposing charges and then leaving it to the National Assistance Board to alleviate them are arguments which he himself used with much eloquence in 1951.

I will not weary the House with the quotations from the OFFICIAL REPORT of those debates, but the right hon. Gentleman is having to defend the very argument which he then attacked with some vehemence and at some length. He moved Amendments to that Bill which sought to take the National Assistance Board out of the picture, but now he says that the arrangements which he then condemned are all right because he happens to be the Minister.

The right hon. Gentleman says that, because of this, there will be no hardship. In an earlier debate he gave us some hypothetical examples of people who would be entitled to a refund of the charges. He quoted figures for a man in full-time employment earning £9 5s. a week—I have forgotten the exact figures—with two children, and with a television set on hire purchase; in spite of, or perhaps because of, these things, this man, he said, would be entitled to refund.

May I give a concrete example of a real couple who have been refused a refund of health charges? It is a couple of old-age pensioners, each 73 years of age. The total available weekly resources—and I am using the National Assistance Board's own figures—are £6 0s. 4d. per week for two people. The rent which they have to pay and their insurance premiums amount to £1 2s. 10d. a week, which leaves this couple with a net weekly income of £4 17s. 6d.

They first made an application six months ago for a refund of the charge. At that time they had a bank balance of £40 4s. 7d. They have now made a further application for a refund, and in the interim the bank balance has been reduced to the pathetic sum of £3, such are their difficulties in trying to make ends meet. On both occasions they have been turned down flat by the National Assistance Board. They appealed, and the Board wrote in its submission, "The appellant is not in need of assistance". The husband has written to me to say that he will soon have to get out of his house because he can afford to keep it going no longer. He also wrote: When you are 73 years and need treatment, you have paid insurance since away back in the Lloyd George days, you find yourself at our age having still to pay to get well. What a heartless mob! Hurry up and get back to power before the country is ruined. That is a concrete case of two old-age pensioners who, from what the Minister said earlier, one would expect automatically to get a refund, but apparently they are not entitled to it; it is assumed that £4 17s. 6d. a week net is quite sufficient to enable them to live and to pay their Health Service charges.

Another impression which was given by the Minister, no doubt inadvertently but nevertheless given to many people, was that totally different arrangements exist for refund of charges from those which exist for entitlement to National Assistance benefit. I have here a reply which the Minister of Pensions and National Insurance gave me which makes it clear that precisely the same scales, disregards and allowances are applied in both types of case. The only difference is that a man in full-time employment can be entitled to a refund of a Health Service charge whereas he is not entitled to National Assistance, but, with that distinction, exactly the same scales apply.

It is, therefore, true to say that in most cases, at any rate, of people who are not in receipt of National Assistance already, if they are entitled to a refund of a Health Service charge then they are probably entitled to National Assistance, too. This is why we have such pathetically small figures of refunds made by the National Assistance Board for the various types of Health Service charge to people who are not in receipt of National Assistance. I want to make it clear that I do not blame the National Assistance Board. We know that the Board's officers act humanely. But they have to act within a framework of inhuman regulations imposed on them by the Government.

We are opposed to the Bill for all these reasons and also because of the profound ideological differences with relation to the Health Service which divide the two sides of the House. Hon. Members opposite do not believe in a Welfare State as we understand it; they believe in a means test State, and they are busy with the process of converting the Welfare State into a means test State, a State in which nobody receives any benefit as of right if he is capable of paying for it out of his own pocket. That is a concept which we reject utterly.

I believe that it is out of this concept that this squalid Bill emerged. It is a Bill which extracts £2½ million out of the pockets of those whose teeth or eyesight is deficient. For all those reasons, we shall be happy to vote against the Third Reading.

8.21 p.m.

Mr. Kenneth Lewis (Rutland and Stamford)

I should like to join those who have expressed their pleasure in having been on the Committee on the Bill. My hon. Friends and I do not see the Bill in exactly the same light as do hon. Members opposite, but at any rate we have learned a great deal by the proceedings. On several occasions I was busy taking notes of many points made by hon. Members opposite, because from time to time we ranged wide on the Bill.

The hon. Member for Hamilton (Mr. T. Fraser) said he was against all charges, and the hon. Member for St. Pancras, North (Mr. K. Robinson) has spoken about the severity of these charges and the hardship which is involved in them. Of all the charges which have been increased in these weeks, I think that these are the least onerous in their effect on the community. Despite protestations by hon. Members opposite, the Bill is just a fallow-up of the 1951 Act. As the cost of the Service has doubled, it is reasonable and fair that these charges should be increased.

The Leader of the Opposition has on one or two occasions said that he did not himself impose the ceiling of £400 million which was fixed by the Labour Government in 1951. That is true. The ceiling was fixed by the late Sir Stafford Cripps. I have looked through the debates which took place then. I was interested to read what the Leader of the Opposition actually said about the ceiling and the charges. He said: We decided that the Health Service estimates must be brought within a total of £400 million, which, for the time being, would have to be a ceiling. He said later in his speech: The Government have, therefore, decided to introduce a modest charge in respect of dental work and optical services."—[OFFICIAL REPORT, 10th April, 1951; Vol. 486, cc. 851–2.] That was said by the present Leader of the Opposition. In 1951 he called the charges modest. That is why we say that they are still modest charges. In fact, the present Government's charges are even more modest.

The hon. Member for Ebbw Vale (Mr. M. Foot) has recently said that a vote is the proper way for a back Bencher to express his views and exercise his rights. In 1951 he opposed the charges. So did the hon. Lady the Member for Cannock (Miss Lee) and the hon. Lady the Member for Liverpool, Exchange (Mrs. Braddock). Although they were against the charges they did not vote against them. The hon. Member for Ebbw Vale, who now says that the right way to express a view is to vote, did not vote against the charges, although, he expressed a view on that occasion.

We have had the Guillotine on the Bill. Right hon. and hon. Members opposite have said that we ought not to have introduced the Guillotine and that, by doing so, we have prevented discussion on the Bill. I have looked up the time-table for the 1951 Bill, on which there was no Guillotine. I discovered that it was introduced on 17th April, 1951.

Mr. Loughlin

On a point of order. May I have your guidance, Mr. Deputy-Speaker? Is the question of the Guillotine in order on Third Reading?

Mr. Deputy-Speaker

It is true that hon. Members should stick to what is in the Bill, but, in fact, the question of the Guillotine has been connected with the progress of earlier stages of the Bill and I do not think that a bare reference to it goes too far.

Mr. Lewis

Thank you, Mr. Deputy-Speaker. The Second Reading of the 1951 Bill was on 24th April. The Committee stage was on 2nd May. The remaining stages were on 7th May. Therefore, it would appear that when the charges were first introduced by the Labour Government the opposers of the Government were not nearly so cross with them as they have been with us. There was no harrying. There was only some sort of apology that the charges had to be made. When the Labour Party has to do anything—whether it is putting charges on or increasing taxes—it says to the country, "This is hurting us more than it is hurting you". When we have to do it, we are told that we are sadists who are slashing the Health Service.

It has been said many times during the discussions on the Bill that since 1951 wages have doubled and, consequently, these charges are in keeping with that situation. Hon. Members opposite object to the use of the average wage as a yardstick. But the basic wage of the lower paid wage earner—for example, the agricultural worker—has also almost doubled and his earnings have certainly doubled since 1951. If it was right for hon. Members opposite to impose these charges on the lower paid wage earner in 1951 then it is clearly not unreasonable for us to do so now.

Mrs. Slater

Is the hon. Gentleman making the deduction that an agricultural worker will not suffer from the imposition of these charges because his wage has doubled and it is therefore adequate to pay these extra charges?

Mr. Lewis

Compared with 1951, that is exactly what I am saying. Has it occurred to hon. Members opposite that one reason why the cost of teeth and spectacles has doubled is that the increased wages of the people who make spectacles and false teeth are included in this increase? Consequently, what is really being imposed upon the average wage earner of the country is part of the wages of his fellow workers.

Dr. Stross

Does the hon. Gentleman admit that his argument, which I am following carefully, also demonstrates why the cost of the Health Service has increased until it has nearly doubled? It is because it is mainly wages.

Mr. Lewis

I do not dispute that. I shall come to it in due course. Once it is agreed that the charges were right in the first place, it cannot be argued that it is not fair and reasonable that charges should continue to march forward with the increase in wages. Hon. Members cannot object to a marking time operation, which is all that this is.

Mr. Loughlin

Will the hon. Gentleman give the House the information on which he bases his estimate that wages in specific instances have doubled? For instance, can he give me the rates of wages applicable to grade 1 dental technicians in 1951 and at present?

Mr. Lewis

No, I have not got exact figures.

Mr. Loughlin

The hon. Gentleman does not know.

Mr. Lewis

I was not, in fact, referring to these wages——

Mr. Loughlin

He referred to the cost of teeth.

Mr. Lewis

The hon. Gentleman must concede this. Although I do not have the particular details, it is obvious that the wages of dental technicians must have gone up in conformity with other wages, otherwise nobody would be working as a dental technician. He knows that very well.

These charges are effective only two or three times in a lifetime. I understand that on Report the hon. Lady the Member for Carmarthen (Lady Megan Lloyd George) suggested that I was wrong in propounding this argument in Committee. In Committee, the hon. Member for Stoke-on-Trent, Central (Dr. Stross) spoke of having had about thirty pairs of glasses in his working life. I can only say that if that is the case, it has been a very expensive operation both for him and the National Health Service. As far as his money is concerned, the eyes have it——

Dr. Stross

That was a little unfair. I was not on the National Health Service when I was ten years of age.

Mr. Lewis

Hon. Members opposite know that people do not get spectacles and false teeth every year. Those who at any time find themselves in hardship can get these appliances through the National Assistance Board. I was rather surprised to hear the example quoted by the hon. Member for St. Pancras, North. I would not dispute his figures. I can only say that someone who had a much higher income than that recently saw me at one of my interviews and I was able to get him a refund. I therefore think that the hon. Member should advise the people concerned to make another application——

Mr. K. Robinson

I will only repeat that this case went to appeal, and the National Assistance Board's refusal was then upheld.

Mr. Lewis

I do not know the details of the income. All I am saying is that, without any appeal whatsoever, I was able to secure for an old-age pensioner, who had a job as well as the pension, a refund of prescription charges.

Assuming that those in need get this assistance, who is it that cannot afford to pay the charge for spectacles and false teeth? Is it the Surtax payer? Are we to say that they should not pay these charges? I am sure that it would be perfectly reasonable to say that they might pay even more. Is it the well-paid manual worker—the steel worker, for example? During a debate the other day, the hon. Member for Rotherham (Mr. Jack Jones), intervening in the speech of my hon. Friend the Member for Weston-super-Mare (Mr. Webster), said: I should like to tell the hon. Gentleman that in the works in which I am employed the savings of the steel workers are the highest in the North-East of Great Britain. They already have every opportunity they wish to invest in a prosperous State, and are encouraged to do so."—[OFFICIAL REPORT, 23rd March, 1961; Vol. 637, c. 643.] Are they unable to pay these charges? Of course they are not——

Mr. Dempsey

Is the hon. Gentleman aware that in the West of Scotland there are thousands of steel workers on a three-day week? It is an utter impossibility for them to save such sums of money and, indeed, well-nigh impossible for them to meet these increased charges.

Mr. Lewis

Well, if they are below a certain income level, they can get a refund. In any case, I am sure that they are on a three-day week for a very temporary period——

Mr. Dempsey

No, for months at a time.

Mr. Lewis

I think that in the present state of our industry they can look forward to having full employment fairly soon.

Mr. Dempsey

I suggest that the hon. Gentleman comes to the west of Scotland and examines the position we have there.

Mr. Lewis

I agree that there are certain less fortunate places, but the longer we keep this Government in office, expanding the economy and generally trying to help the underdeveloped areas, the sooner we shall get rid of that situation in which certain areas are suffering from rather higher unemployment than others. The fact remains that in 1951, the Leader of the Opposition said categorically that these charges were modest. These charges are modest today. They are in a quite different category from either the prescription charges or the increased contributions.

When we were in Committee, the hon. Member for Stoke-on-Trent, Central gave a rather amusing lesson on the Classics. It was all Greek to me, but I am sure that my right hon. Friend the Minister was able to translate it. He told us that Sophocles found himself at the age of 95 beyond the delights of love. The hon. Member said that while Sophocles knew the delights of love, he was wearing rose-coloured spectacles. I was wondering at the time whether the hon. Member hoped that we might be getting rose-coloured spectacles from the National Health Service.

That is not really as far fetched as it sounds. Two or three days ago I cut out from the Evening Standard a report by its science correspondent, who said: British scientists have found out how to make the world look a little better through spectacles by rose tinting the surface of the lenses. The new glasses let in more light and cut out almost all reflection inside and out. They can be ordered from any optician and cost about £1 extra. I want to ask my right hon. Friend the Minister whether he will look at this——

Mr. T. Fraser

On a point of order. The hon. Member's reference to the speech in Committee by my hon. Friend the Member for Stoke-on-Trent, Central (Dr. Stross) would seem to me to have little to do with the Third Reading. My hon. Friend was ruled out of order in Committee in raising the matter. The hon. Member for Rutland and Stamford (Mr. K. Lewis) has not only dealt with the speech which was out of order in Committee—and, therefore, is bound to be out of order on Third Reading—but is going on to deal with other rose-tinted spectacles, which certainly do not come within the provisions of the Bill.

Dr. Stross

Further to that point of order. It is not quite true to say that I was ruled out of order. The Chairman of the Committee merely asked me what Sophocles would have thought about the Clause.

Mr. Deputy-Speaker

There is always a danger, in making any quotation, that it may find itself leading whoever is making the speech rather too far from the exact subject of the debate.

Mr. Lewis

I thought that I was in order, because it seemed to me that if a new type of spectacles is to be available at £1 extra we might know from my right hon. Friend the Minister whether they will be available through the Health Service.

The trouble is that the Opposition have been looking at the Health Service through rose-coloured spectacles for a long time. Over the last ten years, the cost of the Service has doubled. I am in favour of the Health Service. I want to see it working, and working well. The most serious aspect is that the cost of the Service has doubled in the last ten years with too little new development. We have not had many new hospitals built. There has been inadequate development in geriatrics. We are only just starting the new developments in mental health, the Bill for which has been passed by the House.

There is a great opportunity to expand the Service in future. The Minister has decided that, by getting more money in increased contributions and charges, he will have more finance available in order to expand the Service. There is no other way in which we can do it. Hon. Members opposite discovered this when they were in office, and they would discover it again if they were in office tomorrow.

There is one great obligation on any Government. It is one which I had ingrained in me in my youth. I have always believed that Governments should first provide jobs for as many people as possible and that in doing this they should not be afraid to spend money.

Mr. Deputy-Speaker

Order. I hope that the hon. Gentleman will bear in mind that employment does not come within the Third Reading of this Bill.

Mr. Lewis

I will do so, Mr. Deputy-Speaker. I am sorry if I have strayed a little. I was making the point that any Government, having done that as a first charge and having created a reasonably affluent society, should then try, as a second priority, to make available in the social sector services for those who need them and for those who happen to be not so well off. I would not mind a free Health Service, without any charges—prescription charges or anything else—for those who really needed it, even if it were a smaller Service and less all-embracing than it is now. There is a great danger of getting ourselves into a position in which, in seeking to help the lame dog over the stile, we so busy ourselves helping those who are not lame that they get over the stile leaving behind those who are lame.

8.43 p.m.

Sir L. Ungoed-Thomas

I almost feel like apologising to my hon. Friends for speaking. I have been urged to my feet only by two appalling statements made by the hon. Member for Rutland and Stamford (Mr. K. Lewis).

First, he said that, because wages have been doubled—I do not agree that they have been doubled—the Health Service charges should also be doubled. This means that, when people have an increase in wages or any improvement in their standard of living, they must be pushed back to the position which they were in before they had the increase by imposing extra charges on them. In other words, this is the policy of keeping the oppressed permanently oppressed. We are bitterly opposed to this policy. We say that everyone should share in the development and the wealth of the community.

The second point which the hon. Gentleman made was this. He reiterated the ridiculous argument which is always put from Conservative platforms that what we should do is to concentrate the available resources to alleviate the situation of the poor, and that the way to do that is to take the charges away from taxation, and to increase the contributions which are levied on the rich as well as on the poor. We have had that in all sort of ways. We were accustomed to it on family allowances. When contributions are made by members of the community generally, they can all take advantage of the insurance, or whatever it is, that those contributions afford. The poor have the advantage as well as the rich.

The Government's policy, on the other hand, is to relieve the rich by concentrating exclusively on a means test to ensure that none but the very poorest who come within the limits of the means test receive any advantage at all. That, equally, we oppose as a policy. [An HON. MEMBER: "The Poor Law mentality."] The Poor Law mentality, as one of my hon. Friends says.

My hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) referred to the possibility of a ceiling being imposed on the Health Service by the Government, and he cited the two significant figures, the £600 million in one year followed by £600 million in another year. As I understand it, what the Minister has been saying throughout our debates implies that the Government have placed a ceiling upon the Health Service, because his case has been that, in order to enable him to make some improvement in the Health Service at one place, he must exact from the Health Service at another place; in order, for instance, to do something about the hospitals, he must impose the charges provided for in this Bill.

We want an answer, in the terms for which my hon. Friend pressed, to the question whether a ceiling has now been placed upon the Health Service. I hope that we shall have that answer from the Minister tonight. If his answer is that no ceiling has been placed on the Health Service, how can he say that it is only by means of these charges that he can obtain any money for making any improvement at all in any other part of the Service?

Throughout the debates on the Bill, there have been references to what happened in 1951, as we all expected.

Mr. W. A. Wilkins (Bristol, South)

Only to a part of it.

Sir L. Ungoed-Thomas

Only to part, as my hon. Friend says, but, of course, we are not in the least surprised at that. We have been taunted by it all the way through. I say frankly that the imposition of those charges was a mistake, a mistake which I trust will never be repeated by any Labour Government. But, having made my position perfectly clear about that, I emphasise that the imposition of charges as a temporary measure in an extremely difficult economic situation is entirely different from the approach of the Government to the Health Service charges that are being imposed now.

What was done in 1951 was done by the Labour Government as a temporary, exceptional Measure in exceptional circumstances. What the Government are doing here is nothing of the kind. They are erecting the charges into a permanent system of exaction which changes the whole nature of the Health Service itself. What this immensely significant Bill does—very significant when taken in conjunction with other matters, though not enormous in its figures—is to introduce an entirely new approach to the welfare services and an entirely new method of handling them. What we have here, in fact, is the fulfilment of the revolt in which the right hon. Gentleman participated three or four years ago.

The importance of the Bill in principle—it is far more important in principle than in its detail—is twofold. First, it imposes at their moment of greatest need a tax upon those who are least able to bear it and it imposes this tax in relief of general taxation. So that this Measure, as I believe the Minister has frankly recognised, is not really a welfare Measure at all. It is, of course, a taxation Measure. It is nothing but a device for shifting from the richer members of the community on to the poorer members a tax which the Chancellor of the Exchequer does not himself wish to impose, and it is being done under cover of the Welfare State. This is a Treasury Bill and not a Ministry of Health Bill at all.

The second significant thing about the Bill, and the second great element of principle involved in it, is that it is shifting the principle of the Health Service away from providing for everybody in the community a minimum standard of health and meeting the needs of all members of the community who require that service. It is moving from the conception of health as a welfare service in the interests of and available to the community as a whole to the conception of providing charitable relief for only the most needy in the community and after imposing a means test upon them. It is moving back from the whole principle of the Welfare State to the principle of the Poor Law State.

It is because these principles are involved in the Bill that we on this side of the House feel so extremely strongly about it and have done everything in our power to oppose the Measure at every single stage. I hope that my hon. Friends will continue to press upon the Government and urge upon and make clear to the people this enormous and significant attack on the Welfare State and on the whole conception of welfare which we on this side of the House brought into the country in the years when we were in power.

8.52 p.m.

Mr. Charles Curran (Uxbridge)

I am very glad to follow in the debate the hon. and learned Member for Leicester, North-East (Sir L. Ungoed-Thomas). His speech is exactly the sort of speech that a Tory has to challenge as soon as he hears it. The hon. and learned Member has made an attack on the Minister of Health which, in one way, I wish were true. I wish that what the hon. and learned Member was saying was accurate and that my right hon. Friend was seeking to reconstruct the Health Service radically. In fact, he is doing nothing of the kind. What he is doing is taking the Health Service as created by the Labour Party and making certain amendments in it to bring it up to date. But he is not making any essential difference in the basis of it.

To present my right hon. Friend, as he has been presented throughout these debates, as plotting the overthrow of the Health Service and the downfall of the Welfare State as a malevolent mixture of Machiavelli and Mephistopheles is just nonsense. My right hon. Friend is doing none of these things. He is taking the Service as it is left and making it square with the economics of 1961. I wish that it were possible for us, and I hope that before we leave office it will be possible, to go further than this. I hope that this will be the last time that any Tory Government produces this kind of Bill.

I have listened with a great deal of sympathy to the things which have been said by hon. Members opposite about the difficulties of the poor in obtaining access to the Service. I sympathise very warmly with these criticisms. The one factor in these proposals that disturbed me was how far it would be easy for people who are just above National Assistance level to obtain access to the Service. It is a matter on which I and many of my hon. Friends have felt anxiety. I hope that the administrative mechanism which is being provided to enable people who are hard up to get access to the Service will work well. If they do not work well there is at least one Tory Member who will be ready to say so and to criticise them.

We must face the fact that, while we must do our utmost to look after the poor, the sick, the hard-up and people who cannot take care of themselves, there is not the smallest necessity in the England of the 1960s for running the Welfare State on the basis of distributing universal benefits, without reference to income, both to the poor and to the rich.

I will forestall an intervention which I am sure is bound to come from the hon. and learned Member for Leicester, North-East (Sir L. Ungoed-Thomas) by telling the House that I am not advocatting a return to the Poor Law. I decline to descend into anecdotal emotionalism. I am not putting the case in those terms. I am not going to pretend that I was brought up in poverty, because I was not. It would be humbug if I talked as though I had been.

Nevertheless, I come from men and women who came to this country as fugitives from Irish famine and with personal experience of the Poor Law and the workhouse. I have an inbuilt, inherited and ineradicable hatred for the Poor Law. That hatred is not peculiar to me or to one class or to one party. In our open, mobile society this inherited hatred is found at all social levels, and it is just as prevalent on this side of the House as it is on the other.

It is also true not only of this country, but of the other side of the Atlantic. If it were relevant, it would be easy to show that this inherited hatred for the Poor Law and the Poor Law approach to poverty was characteristic of many of the men associated with President Roosevelt and the New Deal. Nor do I think that we need to dig very deep into the psychological luggage of President Kennedy to find it there.

Mr. Deputy-Speaker

Order. The hon. Member is going far beyond the scope of a Third Reading speech.

Mr. Curran

I appreciate that, Mr. Deputy-Speaker. I merely wanted to dispose of the assertion that, when I say that we should help people who need help and not the others, I am advocating a return to the Poor Law. It is not beyond our administrative ingenuity to find ways of seeing which people are poor and in need, and help them, without going back to the Poor Law and without introducing a degrading system of domestic inquisition in people's homes before they can get help.

Mr. T. Fraser

On a point of order, Mr. Deputy-Speaker. Is it possible for you to convey to the hon. Member that there is nothing in the Bill about ways and means of assisting the poor?

Mr. Curran

Exactly. The hon. Member for Hamilton (Mr. T. Fraser) is taking the words from my mouth.

Mr. Deputy-Speaker

The point of order raised by the hon. Member for Hamilton (Mr. T. Fraser) was justified, and I invite the hon. Member for Uxbridge (Mr. Curran) to try to keep his remarks within what is being discussed—that is, the Bill before the House.

Mr. Curran

I will do my best to do that, Mr. Deputy-Speaker. These charges are part of the framework of the Health Service which we inherited from the Labour Government. I believe that in the near future we must reconstruct the Welfare State in such a way that it will not be necessary to make this kind of charge in future, and I hope that this is the last time we shall introduce a Bill like this. [HON. MEMBERS: "Come to the Bill."] I have listened very attentively to a great many speeches from Members opposite.

Mr. John Rankin (Glasgow, Govan)

They were about the Bill.

Mr. Curran

I have listened for hours to ritual caterwauling about this matter. Since I have listened to all this oratory, with Labour Member after Labour Member painting his face with rage about the Tory Party, I ask Members opposite to listen for once to a Member from this side of the House.

Mr. Loughlin

I was enjoying the hon. Member's speech. Indeed, I enjoyed it the last time he made it. We want him to devote his attention to the Clauses in the Bill which ensure that those people who cannot afford to pay the charges should have provision to enable them to get prescriptions without having to pay the charges.

Mr. Curran

I am saying that I am satisfied with the arrangements which the Minister has made for giving help to the marginal cases, not only the hard-up people who are getting National Assistance, but those who are just above that level. Those arrangements, I believe, will work well. I have carefully examined the arrangements which my right hon. Friend has made, and they seem to be capable of working well. Although I recognise the uneasiness which many people feel, I have satisfied myself that there does not seem to be any ground for that uneasiness. If it should turn out that I am wrong, I shall be very willing to come here and say so.

Mr. Norman Dodds (Erich and Crayford)

But would the hon. Gentleman vote against the Government?

Mr. Curran

I am not here in bond to anybody. If I believed that the Government were wrong, I would not vote for them.

Mr. Dodds

Would the hon. Member vote against them?

Mr. Curran

I would vote against them if I did. If I were to find that the arrangements which have been outlined for giving help to the marginal cases did not work properly, nothing would prevent me from saying so, both in the House and outside.

I repeat that we have to look further than the Bill. We have to recognise that the Bill spotlights the urgent necessity for getting away from the concept of the Health Service as something which must be made available, without reference to income, to both the well-off and the hard-up. Sitting behind the benches opposite throughout these debates I have seen a long line of ghosts—the rich people who would benefit from the Socialist attack on the charges. If the Socialist Party has its way, and abolishes the charges, it is true that that would help the poor, but that is only half the truth, for it is also true that it would also help many people who are not poor. [Interruption.] The policy hon. Members opposite are advocating——

Sir L. Ungoed-Thomas

Will the hon. Gentleman recognise that if, instead of charges, the costs were paid out of taxation by everyone according to his means, everyone would obviously be entitled to receive the benefits of the Health Service? Would not that effect precisely what the hon. Member has in mind?

Mr. Curran

That interruption proves the point I was making. That is exactly the trouble. That illustrates the need for a radical reconstruction of the Service so that in future it will be possible to finance it differently.

Sir L. Ungoed-Thomas

Out of taxation?

Mr. Curran

If the hon. and learned Gentleman likes——

Mr. Dodds

That is on the record.

Mr. Curran

Let me finish my sentence. It will be possible to finance it out of taxation if free access to the Service is limited to the people who need help and not distributed to the others. That is exactly the point. Then we can finance it out of taxation——

Hon. Members

Where is the line drawn?

Mr. Curran

As it is——

Mr. Dodds

The hon. Member is making the point, which he has made many times, about those just above the marginal line of assistance. Some of my hon. Friends asked him where he would draw the line. Does he not appreciate that there are many cases where a man has a good wage, his wife has bad health and has to spend 10s. a week on prescriptions, and that over and above that a home help is needed, and that all that expenditure is a terrible drain on a man who would not qualify for free access to the Health Service, as the hon. Members calls it? What would he do about cases of that kind?

Mr. Curran

Of course there are cases—[Interruption.] Let me answer the question, which is very fair and which exactly illustrates how it is impossible to draw a hard-and-fast line. The line has to he drawn recognising that there will be hard cases needing special consideration, and the case which the hon. Member has cited is one of them. That shows the impossibility of arbitrarily deciding that anybody with an income of £X a week should not have free access to the Health Service. But it is surely not impossible to devise administrative methods of ensuring that people who need help and who can show that they need it will get it without difficulty, without, at the same time, supplying free of cost social services to Surtax payers, or to capital gains artists.

I wonder that on the other side of the House there should be so much enthusiasm for the principle of supplying social services free of cost to the people who pay Surtax, to the people who make money on capital gains, to the people who live on expense accounts, to the people who draw top hat pensions. In our increasingly prosperous society there are more and more people who, by any method of assessment, do not need to be given free access to the Health Service. So long as we go on distributing these benefits without reference to need, we are putting the poor at the end of the queue. We are using to help the rich money which should go to help the poor.

Mr. Dodds

It is the rich who are getting the farm subsidies.

Mr. Thomas Swain (Derbyshire, North-East)

The hon. Member says that we have an increasingly prosperous society. Does he consider that we have an ever increasingly prosperous society when we have 7 million workers earning less than £10 a week? How does he reconcile the two statements?

Mr. Curran

The two statements are not in conflict. It is true that in our society a great many people are well off, but it is also true that there are many who are not. Supposing what the hon. Members says is true——

Mr. Swain

It is true.

Mr. Curran

—it means that 20 per cent. of our population are hard up and we should help them generously. But why should we dispense to the other 80 per cent., who are not hard up, money which ought to go to the 20 per cent. who are? That is what the Labour Party will not face up to. Instead, it goes on with the old claptrap about the Poor Law.

Mrs. Slater

This is just too bad. Does the hon. Member ever read Tory publications? Does he not realise that this is exactly the philosophy that the Tory Party is putting forward—that the time has come when we must apply the means test? If he does not believe that to be true, let him read the Bow Group pamphlet, page 69.

Mr. Curran

It is not necessary, in order to concentrate help on the people who need it, to introduce a household means test. It is right to help the people who need it, but to say that we cannot distinguish between the well off and the hard up without the Poor Law is a complete non sequitur. We can do it by referance to Income Tax codings. We can say that people whose incomes are below a certain figure shall have automatic access to the social services, with no questions asked.

Mr. Ross


Mr. Deputy-Speaker

The debate is tending to range too widely. I hope that the hon. Member will bring his speech back to the Third Reading of the Bill.

Mr. Curran

I ask the House to agree that the debates on the National Health Service to which we have listened for so many days and nights demonstrate conclusively the necessity for a new approach to the problem of helping people who are hard up, whether they require help from the Health Service or any other social service. We cannot go on distributing benefits universally. I should not think that it would be administratively difficult to provide that those people who need help shall receive it generously, without any question of domestic inquisition. I believe, further, that while we must do this, what we must also do in the long run is to get rid of poverty altogether.

The ultimate purpose of Tory policy must be the abolition of poverty. So long as there are poor, however, we must concentrate upon helping them. But that is only a stop-gap; it is not a terminus. It is only a step along the path towards getting rid of poverty. That is the moral we must draw from the debate. At the moment, in our present state of society, we must have universal social security, but I want to see an England in which poverty has been abolished, in which everybody is well off, and universal social security is replaced by universal personal security. Until we have reached that stage we must take care of the hard-up, and I believe that the Bill does this inside the framework of the Health Service. I do not accept it with enthusiasm, but we inherited the Welfare State structure from the Socialists and we must do the best we can with it.

I hope that before the next General Election, however, we shall be able to go much further towards getting rid of poverty and be able to concentrate all the help we can on the steadily diminishing minority who cannot take care of themselves.

9.13 p.m.

Dr. Stross

The Minister of Health now knows where to go for advice. He has heard it at great length tonight, as we all have. But if he ever goes there for advice he will not be the type of man I think he is. What did the hon. Member for Uxbridge (Mr. Curran) tell us tonight, in the great spate of words he uttered? He said only two things. First, that in this small Bill there were only minor adjustments, bringing up to date the Health Service as the Minister had found it. He forgot to tell us that when the Tory Party took over the Health Service in 1951, only 8½ per cent. was being contributed directly by the public, whereas today the public contributes 20 per cent. This is the minor adjustment that is being made—the small effort required to bring the Health Service up to date—a mere bagatelle, a mere nothing.

I shall refer to one other thing which the hon. Member said and then leave him alone, for I have better things to speak about. The hon. Gentleman made it clear in his advice to the Minister and to the House that what we need now is not the Health Service which we are discussing but two health services, one for the rich, for which they will pay when they need it, and the other a miserable health service open only to the poor, and that we should support only the latter. The hon. Gentleman made that clear at least twenty times.

Mr. Curran

If I gave that impression, I misled the hon. Gentleman. Perhaps I might put it more plainly. Might I be allowed to clear that obscurity by a simple analogy? There are buses avail- able outside the House. Some people can use them without paying fares. Why should not we run a Health Service on the same lines as public transport—make it available to all, and to those who cannot pay make it free?

Dr. Stross

The House heard the hon. Gentleman's speech and will judge what he said. I thought he suggested that we on this side of the House pandered to the rich and to the Surtax payer, and that we had some strange idea that we must support a free Health Service so that the rich could use it. That was sheer nonsense, and we do not want to hear it again.

I would rather deal with the speech of the Joint Under-Secretary of State for Scotland who I thought opened in a most subtle and clever fashion by very properly paying a compliment to my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) who has led us in these debates and during the Committee stage. If I disagreed with anything that followed, I certainly agreed with that part of the Minister's speech.

The Minister then said that he had enjoyed the Committee stage, and he attempted to cause a rift on this side of the House between English, Welsh and Scottish comrades by using the technique of divide and rule. He suggested that the claymore was used in a somewhat ruffian-like fashion by Scottish hon. Members, and that they ought to take note of the way the rapier was used and the way in which English hon. Members had handled matters during the Committee stage.

That was a charming compliment, but what did the hon. Gentleman go on to say? He said nothing convincing. He emphasised—and this is a typical Tory argument—that the Service is costing a great deal now, £867 million, and that the cost is still rising. Why did he not give us the facts so that they could be understood by people outside the House? When people outside the House are considering sums of money, whether it be the salary of a Member of Parliament at £1,000 a year, as it used to be—a vast fortune—or £1,300 a year—another vast fortune—or the £24,000 a year which Dr. Beeching is to receive, they look at the figure involved rather than what is left and what the money will buy.

What is the cost of the Health Service? The Minister has given the figures. We know what they are, and however one computes them the truth is that in the first full year of the Health Service, in terms of a percentage of our national income, it cost more than it has done every year until this year. It was 3.8 per cent. in the first full year. That figure has been reached again only this year. In the intervening years it represented a lower proportion of the national income. The Minister said that next year the cost will represent 4 per cent. of the national income.

Everybody knows that in every modern Western European country—and in the United States of America—where there is a highly industrialised population the cost of the health service in terms of the national income is between 4 and 4½ per cent. The percentage in Britain is lower than that in any other country. Therefore, there is plenty of room for improvement. The hon. Member for Uxbridge—I hope sincerely—said that he thought there was need for improvement and for the expenditure of more money. There were times during his speech when I thought he was trying to say that, and if so I agree with him.

There is such a need for a number of reasons. One is that no one knows exactly how much we save by having a Health Service which is freely available. Before the war we used to estimate that there were about 800,000 people sick—that was before the war, with a smaller population than we have now—and that if we could cut this figure down and have, say, only 600,000 sick at any one time, there would be a great saving. I am not speaking of pain or suffering but from the point of view of the economy of the country.

There is another way of looking at it. Before the war we used to try to estimate the cost of illness in terms of cash. We thought of it as a little over £300 million a year. That was the cost of ill health in terms of wages lost and what the country paid out, and so on. Now the figure would be about £1,000 million a year. That is an easy figure to remember. Anything that we can do by way of a universal, freely available Health Service, without charge at the time of use, whether to a Surtax payer, a prince of the blood or the poorest person in the country, is well worth while, not only on moral but on practical grounds. I apologise if I speak with some heat, but I was disturbed at hearing some of the things which were said by the hon. Member for Uxbridge.

The Minister knows that we feel passionately about this matter and we accept that the right hon. Gentleman feels sincerely about his own point of view. We are locked in an ideological struggle. We cannot both be right; that is not possible. The right hon. Gentleman realises that things like deaf aids should be provided free because the cost of administering them by using a means test might be as great or greater—apart from the immorality of that course of conduct—as a charge for the appliances. This was always the view of the late Aneurin Bevan and I think he justified it and proved it to the hilt.

I am sorry that the present Minister of Health was not a Member of this House in 1946, and did not take part in the Committee stage discussions on this subject at that time, because I know that he would have enjoyed doing so very much. It was a great privilege to listen to Aneurin Bevan arguing and to appreciate his attitude in these matters. I thought about this question for years and I tried to think about it even before 1946, during and before the war. In the early days before the war when I was in practice, I had practical experience of what the medical service was like. Then I had a liberty which doctors have not now; I could refuse to charge patients. I could give them medicine and appliances free. Indeed, many of us did.

In order to be able to live, I made the rich pay for it—that is a proper social principle—and, of course, they paid for it and they did not mind. They asked me to give more of my time to them than I could give to the individual poor, but I gave my services to the poor for nothing if they could not pay. Doctors are prevented from doing that now, because the Minister imposes a charge. The imposition of a charge is wicked.

Reference has been made to 1951 and the time of the Korean war, when we imposed charges, but they were regulated in such a way that they could be varied downwards but never upwards. When hon. Members make their speeches I cannot see why they should not tell the whole truth. I try to and my hon. Friends try to. We do not deny that we did wrong in 1951, but we have a perfect right to say that if what we did was evil, why do hon. Members opposite always praise that evil? If what we did was good in the rest of the Service in 1946, why was it decried by hon. Members opposite? Why did they vote and speak against it? They hated the Service. I believe that they still hate it.

9.26 p.m.

Mr. Kershaw

I heard with some degree of relief the remarks of the hon. Member for Stoke-on-Trent, Central (Dr. Stross) when he said that both sides of the House are intent upon improving the Service. Both hold their own opinions sincerely on how that can be done. I think that sometimes in these debates we on this side have been rather led to think that the Socialists, through their determined, wild extravagance, indulged in for ideological reasons, wish to wreck the Health Service, while hon. Members opposite believe that the hard-faced, grim Tories also desire to wreck the Service.

I think the hon. Member was led into an error in suggesting that, in fact, ideology itself separates us at present. I wonder how true that is. I know it is not particularly a recommendation to this side of the House for any policy to say that it is a policy formerly followed by the Socialist Government. I have never quite swallowed that. Like my hon. Friend the Member for Uxbridge (Mr. Curran), I rather hope that in future, at any rate, some further thinking about these things will become necessary, and indeed desirable.

But certainly the argument that it has been done before is, if I may say so, a certain argument against the show of enthusiasm which the Opposition have maintained tonight and in other debates during the passage of this Bill. They get very hot now, and would have it that there was not a single hon. Member opposite, including the hon. Member for Stoke-on-Trent, Central, who did not at the time hate those charges in 1951 and drag himself with leaden feet through the Division Lobby. It is rather like Germany where one cannot find a Nazi now.

I think the truth, as the Minister said in one of our debates is that in 1951 the Socialist Party "breached the principle" by imposing, in the words of the Leader of the Opposition the "modest charges" which they then imposed. The hon. and learned Member for Leicester, North-East (Sir L. Ungoed-Thomas) said that the circumstances were entirely different and that the charges were imposed only for a short time. Perhaps that was a Parliamentary device at the time in order to get unwilling hon. Members to vote for them.

Mr. Walter Monslow (Barrow-in-Furness)


Mr. Kershaw

If I may finish this point, I shall then gladly give way to the hon. Member.

The hon. and learned Member for Leicester, North-East said that the financial circumstances were so very different that it was hardly fair to compare them with the circumstances of today. That came near to saying that the financial policies and economic incompetence of the Socialist Government landed them in a position in which they were quite unable to take any other action than that which they took.

Mr. Monslow

The hon. Member must recognise that a number of us voted against the 1951 charges. In fairness to hon. Members on this side of the House, I should tell him that we also made it perfectly clear that, had we been returned in a subsequent election, we would have returned to a free Health Service.

Mr. Kershaw

As I say, these are handy speeches to be able to make just before an election. The fact is that the charges were introduced. The hon. Member for Stoke-on-Trent, Central said that the Korean war was the reason for these charges. [HON. MEMBERS: "Was it not?"] I hear that echoed on the benches opposite. Nothing of the sort. The Korean war broke out three months after steps had been taken to increase the charges.

Mr. T. Fraser

Surely the hon. Member is aware that these charges were introduced in the Budget of 1951 and that the Korean war started in July, 1950.

Mr. Kershaw

It is clear that when the powers were taken Korea had nothing to do with it. One has only to look up the records.

Mr. George Brown (Belper)

The hon. Member has just accused us of inventing this argument about the Korean war. My hon. Friend has put to him the point that the Korean war started more than six months before the charges were imposed. Does he accept that? If he does, does it not destroy the point which he has tried to make?

Mr. Kershaw

The right hon. Gentleman knows that that may be when the charges were imposed but the powers had been taken in legislation before then.

Mr. K. Robinson

The hon. Gentleman is quite wrong about that. The charges were introduced in a National Health Service Bill which arose out of the Budget of 1951. There were no powers to impose charges in respect of spectacles and dentures before that.

Mr. Kershaw


Hon. Members


Mr. Kershaw

I will withdraw, because I have not the facts in my mind, but I am certain that when I look them up in the Library I shall see the legislative reason. The charges were imposed, and however good or bad it may have been, it is clear that the ideological differences between the two sides of the House cannot be erected at this late date.

It has been repeatedly said by hon. Members opposite that these charges will undermine the Health Service. The figures which my right hon. Friend gave in introducing the Bill are relevant and have not been repeated often enough. The Service which we are said to be undermining shows an increase in activity in every possible department. There has been an increase in the number of doctors, of dentists and of nurses, an increase in the number of buildings and in the number of patients who are treated. How can it possibly be said that a service which enjoys those advantages is being undermined by the Government which is administering it?

The buildings which are necessary and which we all agree will become more necessary in the future are extremely expensive, but we must have them. These new buildings are the most expensive this country has ever had in the Health Service. We know that the new treatments for mental health will cost a great deal of money. The House is aware no doubt that 10 per cent. of the population of this country suffer from some mental breakdown at some time or another. One in twenty of the population of this country have at some time or another to go into a mental institution. Looking at the benches opposite, I would point out that three or four of the hon. Members opposite either have been, will be or at the moment should be in a mental institution, according to the average.

Mr. W. Hamilton

Who let you out?

Mr. T. Fraser

What about the hon. Member's side of the House?

Mr. Kershaw

Surely it will be conceded that it is reasonable that this very large financial burden required for these buildings is such that we should lay the foundations not only in material but also in the financial sense. The Opposition say that if they are given the opportunity they will have a Health Service with no charges and presumably no contributions, although I am not sure about that.

Mr. G. Brown

Why not?

Mr. Kershaw

It is difficult to know what the Opposition's policy is. They have a policy now, but the closer we come to an election, perhaps the more likely it is that more sober counsels will prevail and they will realise that if the Health Service is to be financed entirely by the taxpayer it will be adding, for example, £270 million to the Bill this year, which is about 2s. 6d. on the Income Tax.

Mr. T. Fraser

No, it is not.

Mr. Kershaw

It is something very close to that. We shall see the usual gyrations of the Opposition. They will say that they will spend much more money on this, that and the other, but before the election they will also say that they do not propose to raise any taxes. This will be one of the hoops through which they usually go.

Assuming that this meant a steep rise in Income Tax, it does not necessarily mean that in the eyes of the Opposition it is a drawback. I know that, but no doubt they will also consider the problem of inflation and the limit to which taxation can be allowed to rise. This is only one item to be added to taxation, as well as others which they have promised. They will consider how far they will be able to achieve their purposes by allowing inflation or starting an inflationary frame of mind in this country.

The hon. Member for St. Pancras, North (Mr. K. Robinson) told us of one of the very sad cases which he always manages to have for these debates.

Mr. G. Brown

There are many of them.

Mr. Kershaw

They are very sad, but he always has a new one. Mathematically speaking, I can understand how the decision was arrived at in that case, but it must have left nobody very happy about the situation.

What I object to about the hon. Gentleman's solution to the problem is that in order to relieve the poverty of that married couple who had 97s. 6d. a week he wishes to raise the pension of everybody else who does not need it. This would lead to the same difficulty which my hon. Friend the Member for Uxbridge mentioned. If everybody is relieved in order to get the couple about whom the hon. Gentleman talked on to a reasonable standard of living, the consequence would again be an inflationary one. That is the difficulty. Before long the couple, although they would have a higher mathematical income, would be in the same state of life as they are in today.

The hon. Member crowned his argument on this point by saying that it was "the inhuman regulations" of this Government which condemned this couple to the position they are in. I wonder what adjectives the hon. Gentleman used in the days of his own Government to describe what they did to people in similar circumstances. It is rather difficult to imagine what adjectives he might have fallen back on when the retirement pension was 26s. a week and 30s. for some. That is where the Party opposite left it. What about their inhuman Regulations?

Mr. Scholefield Allen

When the Labour Government increased retirement pensions from 10s. to 26s. a week, the late Lord Waverley, formerly Sir John Anderson, said in this House that it was too much and too hasty. Those were his words. He condemned us at the Dispatch Box for doing it.

Mr. Kershaw

I am not responsible for what went on in those days. [Interruption.] I gather it is said that my party was responsible. My party has also been responsible for ensuring that pensioners have had a rise in real value of 20 per cent. above the condition in which they were left by the Labour Government. No one doubts that hon. Members of the party opposite have good hearts. They lack good heads. Their financial policy puts it out of their power to raise pensions to the degree they want.

A certain amount of play has been made about the amount of public outcry and opposition which the Measure has caused. I have not come across any very sustained public opinion about it. I have received a number of letters from Socialist organisations in my constituency which have protested about it. I have asked them—I daresay I shall receive replies—whether they protested in exactly the same terms when the same sort of thing was done in 1951. I am certain that the answer, if I receive one, will be that they never thought to write to the then Chancellor of the Exchequer.

No one can have any particular enthusiasm for imposing charges which may fall upon those who are not well able to afford them. However, if this is the price which we have to pay for an extension and an expansion of the Health Service, for the extension of the buildings which we know are so necessary and for securing the future progress of the Health Service, this is a price which the House should pay, and that is progress which the House should purchase.

Mr. Ross

Before the hon. Gentleman sits down, will he say something about the Bill before the House?

9.40 p.m.

Mr. Dempsey

This is a very bad Bill, full of iniquity. It suggests that one method of raising about £2½ million should be a tax on dental sufferers and myopics, and it stigmatises our school children by asking them to wear metal-framed spectacles. That is the purport of the Bill, and those are the items on which the charges are being increased.

After listening to the lamentable attempt by the Joint Under-Secretary of State for Scotland to defend this Measure, one is impelled to comment on it. The hon. Gentleman did not seem to be so much delivering a speech as delivering a civil servant's monologue. There was no question of his making a statement from the Scottish point of view, or from his own, on this very important topic.

The way in which he read his address reminded me of the delegate who, after listening to a speaker at a conference, rushed to the rostrum and said, "I object to that speech for three reasons: first of all, it was read; secondly, it was read very badly; thirdly, it was not worth reading at all." It is to that kind of speech that we have been treated this evening.

The hon. Gentleman sought to defend, above all things, an improper, unfair and disproportionate tax on those suffering from an ailment of one kind or another, whether it be toothache or defective eyesight; and the arguments he used in justification of the increased charge for bifocal lenses were also unsound. I can assure the Government that no one wears spectacles, bifocal or any other type, for the pleasure of wearing them. Most of those who wear spectacles are unable to manage without them. The party opposite should remember that the cause of most of these troubles in inherited. Many of these people contracted ailments such as this from infant illness, and many now have defective eyesight as a result of malnutrition during the hungry 'thirties. Ministers should bear those factors in mind before they decide to impose these charges on millions of people who cannot very easily afford to pay for them.

To say that these charges are vitally necessary in order to raise the money so much needed to continue our hospital building programme is nonsense. To suggest that, for that purpose, we should tax people who suffer from defective eyesight, is ludicrous. It might as well be said that we should also tax the deaf. The Government's approach to this problem is not sensible, logical or sound, and we did our very utmost to impress that on the Minister and on the Under-Secretary of State in Committee.

What really surprised me was that the hon. Gentleman, in an interjection, referred to the fact that Scotland was being treated as a region—not as a country at all. It has no nationhood attached to it but is simply a region, like a corner of England and Wales. That statement was most regrettable. We understand that the Secretary of State for Scotland is the Minister of Health in Scotland, yet in Committee the Scottish Office stated that Scotland is merely a region. I am sure that the Unionists of Ayrshire will not enjoy that aspect of the speech of the Joint Under-Secretary. I should be delighted if my hon. Friend the Member for South Ayrshire (Mr. Emirys Hughes) would circularise that with the Joint Under-Secretary of State's speeches. Then, we would see how the Conservative Party treats such a nefarious reference to a country with such a proud nationhood as Scotland.

I was hoping to refer to the cumbersome procedure in the Bill dealing with replacements. I am sorry that time does not permit me to do so. I should, however, like the Minister and the Joint Under-Secretary to consider this cumbersome procedure. According to the words of the Bill, no charge shall be made under this section in respect of the replacement of dentures or lenses where the replacement is required in consequence of loss or damage". That Section from the 1951 Act is followed by a reference in the 1954 Act, in which the procedure is laid down for adjudicating on applications for replacements. I notice that the applicant may appear and give oral evidence why he has lost his teeth, or why a lens has jumped out from his glasses or some other incident has occurred. It seems fatuous for a person to attend a meeting of a committee, probably losing a day's work in doing so, to convince its members that he legitimately lost a lens from his spectacles. That is the sort of thing which is happening as a result of this cumbersome procedure in adjudicating upon questions of whether dentures have been kicked out or have fallen out. The Minister should examine this provision and modify it. He should make the procedure as simple as possible for persons who find themselves in such circumstances.

I recall, for example, the wording about whether the replacement is necessitated by lack of care on the part of the applicant. Some very strange decisions are arrived at in this respect. A miner coming home from work late runs for his bus, misses it, falls and breaks his teeth. He claims that there was no negligence on his part, but, apparently, it was decided by some pearls of wisdom that he was careless in running for the bus, and he had therefore to pay for his dentures.

Then, there was the lady who, leaving a shop with her basket of messages, ran into a pedal cycle, got a fright and, as a result, fell and broke one of her lenses. Some people might take the view that that was a legitimate accident. Others have taken another view and said that she should have more road safety sense, that she was careless and that the accident was due to her negligence, with the result that in addition to a tumble and shock for two or three days, she has had to meet the cost of the lens.

One need only quote the case of the small child——

Mr. Speaker

I have tried not to interrupt owing to the Allocation of Time Order, but I have great difficulty in understanding how I can allow the hon. Member to say this on Third Reading.

Mr. T. Fraser

The reference is Clause 3 (2), Mr. Speaker. I assure you that my hon. Friend is one of the few hon. Members who have been in order during this Third Reading debate.

Mr. Speaker

If that is so, then I am sorry. I have great difficulty in understanding what a lady hitting a bicycle has to do with the Third Reading of this Bill.

Mr. Dempsey

I was referring to subsection (2) to which I tabled an Amendment and which refers to replacements of spectacles, dentures, etc., but I will leave that matter if the Minister says that he will consider the procedure.

I want to say something about the attitude of the Minister towards those in need. In Committee we had a great harangue about how the National Assistance Board can assist persons in need. I have gone to the trouble of finding out how the Board will assist persons who are ineligible to receive National Assistance. The Board has issued a leaflet which deals with persons who are eligible and ineligible to receive National Assistance. Paragraph 7 of it states: Other persons who cannot reasonably meet the charge from savings and whose available income, after paying rent and rates (or owner-occupier outgoings), is not very much above the standard in paragraph [...] above will probably"— it is not definite; the word is "probably"— be able to get a grant for part or all of the charge, depending on the charge and on the resources available. There is no assurance there that they will receive a refund. It merely states that they will probably do so.

I went to the trouble of writing to my own area officer for amplification of this leaflet. This is what he said to me in a letter dated 20th March: Broadly, assistance with these charges can be given to any person over the age of 16 years (including persons in full time work) who, after paying the full charge for himself, wife or children, will be left without enough to meet his needs as assessed by the Board. In deciding whether assistance can be given the usual disregards on capital and certain forms of income are applied and in the case of earnings the first 30s. plus half the next 20s. are disregarded. Let us consider some of the people who are regarded as being in full-time employment and who are likely to apply for a refund of the dental or ophthalmic charge. In the case of a husband and wife whose National Assistance allowance is 90s. with a rent allowance of 15s., if the husband is working his first 30s. is disregarded and half of the next 20s. is disregarded. The husband and wife are allowed to earn £7 5s. Beyond that they are required to pay the charge for the ophthalmic or dental appliance. A single person with a National Assistance rent allowance of 10s. is allowed to earn £5 10s. In what part of the country do the Ministers think that a single man who is working full-time is likely to be earning less than £5 10s. a week? Generally speaking, it means that any person who is gainfully employed in full-time employment will not be eligible for these refunds.

It is morally wrong for the Minister to try to mislead the House on an issue of this nature. He attempted to do so in Committee. I hope that he will challenge my figures and contradict them if they are wrong. If he does not contradict them, he will be bound to apologise to hon. Members of the Committee for misleading them into believing that people in full-time employment, as a result of the application of the complicated system of disregards and calculations in the National Assistance Board, will be likely to receive relief if they are asked to meet any of these charges. I do not believe that they will.

I have from the start opposed the Bill. It is interesting to note that even sections of the Press with a Conservative bias oppose the increased charges. It is interesting to note also that professional bodies condemn the Government. Indeed, most responsible organisations condemn the Government for introducing charges of this kind. Even the comedians in our music halls now are using the Minister as a butt to entertain the public. In a little sketch, as we call it in the North, or comic strip, as it is called down here, we see three of the Ministers, under different names, of course to prevent embarrassment, in which one of them receives dental treatment. He goes to the Assistance Board for his refund, and as he arrives at the Board's office, he is asked to raise his right hand and say either, "I have" or "I have not". He is then asked these questions? Are you married, widowed, separated or divorced? Have you views of work or registering at the bureau? Have you any private income or money at the Co-op; And is your Granny's jumper red, white or blue? That is what the National Health Service has been reduced to under the Tories. Our comics in our music halls North of the Border are using the Bill as a butt for fun. The Government have still time to retrieve themselves, to try to save their face. They have still time to show some respect if not for themselves then for the people who foolishly sent them here.

This is an iniquitous Bill. I said in Committee that, as a result of the axing of the Service, the Minister would go down in history as the "Hatchet man". The Health Service is one of the most important services upon which humanity depends, and it has been axed severely. What worries me is that this may be the thin end of the wedge. No doubt, there will be further inroads into the Health Service unless there is sufficient agitation on the part of the Labour movement and the general public to reverse the Government's policies.

It is surprising how often Reports are referred to and certain parts are selected and used by the Government while the rest is shelved. I paid close attention to the Guillebaud Report, but, after I heard the Minister, I was convinced that, from his point of view, it was like the proverbial curate's egg, good in parts, because he rejected many salient features of the Report which showed quite plainly that charges are a deterrent to people anxious to use the dental or ophthalmic services.

The Bill is disgraceful in many respects. I sincerely believe that if the Minister and his party had promised the electors a Bill of this nature before the election, there might well have been a different result.

The Tories intended to introduce a Bill of this nature but they deliberately concealed it from the electorate, and then took advantage of their majority to impose it on the country. The Bill shows that there is a difference between Tory promises on the one hand and Tory performance on the other. I hope that when we enter the Division Lobby we shall inaugurate a crusade which will not only reverse the iniquities of the Bill but also reverse the Government at the next election.

10.0 p.m.

Mr. T. Fraser

I should like to apologise to my hon. Friends, so many of whom would still like to contribute to the debate. I should have preferred to listen to them rather than cause them to listen to me. The Joint Under-Secretary of State for Scotland broke his silence on the Bill by moving the Third Reading. I thought that it was a disgraceful speech. As my hon. Friend the Member for Coatbridge and Airdrie (Mr. Dempsey) has said, it was a speech well prepared in the office. The hon. Gentleman read every word of it and he did not read it very well, and, as my hon. Friend also said, it was hardly worth reading.

The hon. Gentleman made some assertions in the course of his speech which he seemed to regard as declarations of great profundity. He said that he was hoping that he would have convinced hon. Members on this side of the House that there was justification for the Bill, but there was nothing that he said in his speech that had not been said time and time again during proceedings on the Bill, and, I should have thought, had been said much better. He made the same old case again that one has become accustomed to hear about the way in which, according to him, the amount of conservation treatment in the dentists' surgeries has increased and the demand for dentures has gone down, and he compared the "pick-up" of dentures and spectacles today with what it was in the early years of the Health Service.

Surely the hon. Gentleman knows, or at least if he does not know, it is high time that he found out and convinced himself, that in 1948, when the Health Service was introduced, there were millions of people who had a great need for dentures and spectacles, but that until these things became freely available under the Health Service they had perforce to do without them. This is so obviously true, and must be known to any thinking person, that it is disgraceful that a Minister can make a speech and completely ignore the fact.

It is not the imposition of charges alone, therefore, that has caused the rundown in demand. I admit that the charges will cause a diminution in demand. That is why they are wrong, but even if there had been no charges the number of our fellow-citizens who would be claiming false teeth today would be substantially less than the number immediately after the introduction of the Health Service. It may well be that the greater attention that has been given to dental health over the years, together with the improvement in the standard of living today compared with what it was in the inter-war years and the time before the First World War, has led to the decrease in demand.

Many of the people who were in need of dentures in 1948 were people whose teeth had been decayed due to negligence and, in some cases, due to very serious malnutrition many years before. Therefore, one would expect that today, in more enlightened times than we had to endure under a Tory Government before the last war, the dental health of our people would be rather better. One would expect there to be an increase in the conservative work done in the dentists' surgeries, unless there is a time devoted purely to extraction and the fitting of false teeth.

The reason for the run-down in the demand for false teeth is that we had the backlog which had to be satisfied in 1948, but that can hardly be applied to spectacles. The Minister cannot give the same evidence of conservative treatment to the eyes that he can of conservative treatment to teeth. But there has been a run-down in the demand for spectacles. Millions of people could not afford spectacles until they became freely available through the Health Service, and the Minister knows well that there are still hundreds of thousands who are discouraged from obtaining false teeth or spectacles because of existing charges, and who will be even more discouraged by the increased charges imposed by the Bill.

The Minister has said time and again that the new total charges will be of the same ratio to total cost as were the charges imposed ten years ago. The Parliamentary Secretary made the same point today. She said it with charm and sweetness that were calculated to convince us that, because the ratio would be the same, that was the end of the argument.

Do not the Minister and the Parliamentary Secretary realise that we on this side of the House do not want any charges at all on the Health Service? The Labour Government introduced charges in 1951, but the Act giving effect to them provided for a limit of three years, and that Regulations could be introduced at any time before then to reduce the charges, but never to increase them. Thus, comparison between these proposals and what was done when the Korean War had been raging for nine months and when this country was in serious difficulties is not valid.

I admit that we made a mistake in introducing charges in 1951. We were wrong, but at least we had the defence that we were involved in war and did not know how far it would spread. The country was getting into balance of payments difficulties because world prices were rising, and we were increasing taxation. Those were the circumstances in which charges were first imposed for a temporary period in 1951. It was wrong to impose them, even so.

The Minister is often praised for his sincerity in this matter. How can he say that the justification for these charges is that they bear the same ratio to the total cost of the appliances as did the 1951 charges, and pretend that the Labour Government, in imposing those charges, meant them as a permanency? He knows that they were never intended to be a permanent feature of the Service.

Th Minister has said, and it has been said on his behalf by others, that the money saved by these increases can be better spent in other sections of the Health Service, in other words, on hospital building. He may be convinced that it will be spent on hospital building, but no hon. Member on this side is so convinced. When we ask about hospital building we are always told that the building resources and the technical resources are not available.

In any case, if this is a tax for the purpose of building hospitals, why is it imposed only on the people who need dentures and on those who need spectacles? Why is it not imposed on the millions of people who do not need dentures or spectacles, but who frequently need hospital services just the same? Why do those needing dentures and spectacles have to pay a bigger share of the cost of hospitals than others? Will the Minister tell us why there is to be that discrimination in the imposition of a tax on people who have the misfortune to need dentures or spectacles?

Incidentally, during an earlier discussion the Minister justified the increased charge for bifocal lenses—I think that I have taken down his words fairly accurately—by saying that those who needed two pairs of spectacles instead of a pair of bifocal glasses should not be so severely penalised financially. Persons who decided to have two pairs of spectacles had to pay substantially more than those who could make do with a pair of bifocals and the Minister thought that the former should not be so severely penalised.

The way to have corrected that would have been to have removed the severe penalty, but instead he also severely penalised the person who got a pair of bifocals. That is not a very logical process. We want the severe penalties removed altogether and not increased. It would have been easy for the Minister to have put the two on exactly the same basis and made the provision of these appliances free to all patients, as was the case when the Health Service was introduced in 1948.

Those hon. Members opposite who have related their remarks to the Bill have said in the course of these discussions that these increases were the least objectionable of all the charges. It was very nice of them to say so. It is clear that they regard these increases as objectionable. If they are the least objectionable, they are objectionable. All the other charges are, therefore, more objectionable, but hon. Members opposite voted for all of them and tonight will vote for these increases. I cannot understand hon. Members opposite.

Will the Minister consider the position of some of those who are most likely to be discouraged by the increases in the charges, those who are already strongly discouraged by the present charges? Leaving aside some of the other categories which have been mentioned, I return to that mentioned by my hon. Friend the Member for Liverpool Exchange (Mrs. Braddock), who spoke of the married woman, the mother who was not at work and who was not an insured person, the woman who was usually a middle-aged mother and who had brought up a large family and whose husband earned a small wage.

Hon. Members on both sides who have "surgeries" know perfectly well from their experience that the person who is most likely to come to their "surgeries", toothless and without dentures, and who needs dentures, is the midle-aged mother. Her husband may be earning £9 or £10 a week, but be unable to find the £4 5s., now to be £5, needed to get her dentures. In many cases she will not be able to find the money out of her housekeeping to pay for them. There may be many other demands on her all too inadequate resources. Since she always puts herself at the end of the queue she will not be able to find £5 for dentures.

It is the same type of person who is most likely to be without spectacles. She may not be able to ask the National Assistance Board to remit the cost of spectacles. If her husband has £9 or £10 a week she would not qualify, but if she cannot get the money required for the spectacles which she needs she goes without them. The Minister must know that himself.

A lot has been said in these discussions about arranging for the Assistance Board to help the needy. The hon. Member for Uxbridge (Mr. Curran) made a long speech about it. He said that he would wait and see how these new arrangements would work out. There are no new arrangements at all. We are working under the arrangements that we have had for many years. They are not dealt with in the Bill. From that point of view, it may be out of order to discuss that, but I assure you, Mr. Speaker, that the hon. Member for Uxbridge did not discuss anything else.

The case cited by my hon. Friend the Member for St. Pancras, North (Mr. K. Robinson) is one known to all of us who pay attention to the complaints brought to us by our constituents and who believe that they should be getting some assistance from the Assistance Board for the charges imposed upon them, although they are not in receipt of National Assistance week by week. No hon. Member opposite would not justify the figures given by my hon. Friend in relation to the two people 73 years of age with a net spendable income fo £4 17s. 6d.

No hon. Member opposite would have said that such a person should pay for his prescriptions or false teeth and spectacles. Hon. Members would say that they should get them gratis, or have the charges remitted, but under the so-called new arrangements these charges will not be remitted. Hon. Members opposite should clearly know that that is so, and if they knew they were deceiving themselves and were guilty of humbug.

I must make way for the Minster.

Hon. Members


Mr. Fraser

I know that he has only 10 minutes in which to reply. I did not seek to curtail the debate. There is no one on this side who wanted to curtail discussion on the Bill. It was the Minister and his right hon. Friends who imposed the timetable. They decided that the Guillotine could fall at 10.30 tonight to terminate the discussion on the Bill.

If the Minister has chopped his own head off and given himself less time than he desires he must not blame the Opposition. We have had to listen to a lot of nonsense from hon. Members opposite during this Third Reading debate. The hon. Member for Stroud (Mr. Kershaw) discussed the origin of these charges. He said it was three months before the Korean War started. He then submitted that he may have got things slightly wrong.

Mr. Kershaw


Mr. Fraser

Hon. Members opposite must know by now that these charges were first introduced in the course of a Budget speech made in the spring of 1951. Provision was made for those charges in the Bill passed thereafter, in the summer of 1951, whereas the Korean War started in the summer of 1950. The Korean War started nine months before there was any intimation of charges being made under the Health Service. Those charges, when incorporated in the Bill that became the Act of 1951, were specifically limited to a period of three years.

It is agreed that it was right to impose the charges at that time, and it is obviously wrong, and obviously humbug on the part of hon. Members opposite, to try to justify the present increases by relating them to what was done in 1951. In that year the Act was passed by a Labour Government which went into a General Election a few months later. [HON. MEMBERS: "And they lost."] Yes. We will not catch the Tories out that way. A few months after they got in in the General Election of 1951 we found that we had a Bill imposing additional charges on the Health Service. They did not tell us before the election that they would do that. They did it after the election.

In 1955, they denied that they would introduce any kind of Rent Act, but within a few months of the election we had the Rent Act. In the last election there was no word of any increase in the charges on the Health Service, but we have had legislation doubling the prescription charges. All these actions are carried out immediately after an election or, as the Government expect, a good time before the next election. The electors may have forgotten what the Government have done, or may have other things on their minds, immediately before the next election takes place.

This is a disgraceful little Bill. It increases charges where no increases are needed. The purpose of the Bill is to discourage people from going to dentists for dentures, or to opticians for spectacles. It disregards the fact that people would go for one or the other only if they were needed for the improvement or maintenance of their health. The Bill will succeed in discouraging many people from taking full advantage of the Health Service. It will be the poorest people—the people for whom the hon. Member for Uxbridge shed his crocodile tears this evening—who will suffer, and I hope that an increasing number of people outside the House will realise just what the Government are doing to the Welfare State which our people want and love so much.

10.24 p.m.

Mr. Powell

In the last ten years, during which the charges which the Bill increases have been in force, they have added to the money available for the National Health Service about £16 million or £17 million a year. They have resulted, in the General Dental Service, in the concentration of no less than half the total effort upon the priority classes and, for the rest, in a greatly increased concentration of dental work upon conservation. They have done this in circumstances in which no hardship has resulted to those concerned; in which no less than 20 per cent. of the total amount remitted through the National Assistance Board has been remitted to people who were not in regular receipt of National Assistance.

These charges have been to the benefit of those whom we desire to benefit most—the priority classes—and they have strengthened the finance of the National Health Service. Hon. Members opposite prate about priorities. One sometimes wonders whether they know what that word means. My hon. Friend this afternoon pointed out the value of the exemptions which the Bill makes, and it was made a matter of scorn that the cost of those exemptions was only £250,000 or £300,000. What hon. Gentlemen cannot appreciate is that those exemptions are deliberately concentrated on the priority classes, so we are carrying on the good effect which these charges have had within the National Health Service in the last ten years.

This is what my predecessor said almost exactly ten years ago: … the decision to ask for authority to impose charges is not a tax on the Health Service; it is a readjustment within it"—[OFFICIAL REPORT, 24th April, 1951; Vol. 487, c. 239.] It has been a readjustment in favour of precisely those to whom we most wish to bring the assistance of the National Health Service.

We are, of course, conducting this debate upon a comparatively narrow financial basis. The sum involved is only about £3 million a year. Nevertheless, and this has been recognised on both sides of the House, there is an important principle involved although we are debating a narrow application. The principle is precisely that principle of priorities which the Guillebaud Committee in its study of these charges emphasised over and over again. It is a question of whether the yield of these charges can be better used by retaining them at their present level than by application elsewhere in the National Health Service.

The hon. Member for St. Pancras, North (Mr. K. Robinson) referred to the rate of expansion of the Health Service. Although we are dealing with a sum of only £3 million, I think that it is pertinent to remind the House of the rate at which the gross expenditure upon this Service has been increasing. I will give the figures for the last four financial years. In 1958–59 it was £711 million; in 1959–60 it was £753 million. In the year now coming to an end it will be £807 million, and next year on the original estimate it will be £886 million, and that figure will represent a higher proportion of the national income than has ever been applied in this country to health services.

I am coming now to the net figure because it is this figure—it is the Exchequer contribution—which controls the extent to which we are able to expand the Service. The net figures expanded by 6½ per cent. the year before last; last year by 8½ per cent.; and next year they will still. even after all these charges, be up by a further 3 per cent. Hon. Members on both sides of the House realise that given that there is a limit—and inevitably there must be a limit—to the net cost of the Service the extent to which we can go forward in the expansion of it depends on the sources of finance which we can obtain from elsewhere, and I challenge any hon. Member to say that it is more important, more in the interests of the National Health Service, more in the interests of

the nation, that this sum of £3 million, or the sum of £65 million which emerges from all these changes, should be devoted to maintaining the status quo rather than to carrying forward the expansion of this Service.

Question put, That the Bill be now read the Third time:—

The House divided: Ayes 287, Noes 210.

Division No. 130. AYES [10.30 p.m.
Agnew, Sir Peter Deedes, W. F. Hurd, Sir Anthony
Aitken, W. T. de Ferranti, Basil Hutchison, Michael Clark
Allan, Robert (Paddington, S.) Digby, Simon Wingfield Iremonger, T. L.
Allason, James Doughty, Charles Irvine, Bryant Godman (Rye)
Arbuthnot, John du Cann, Edward Jackson, John
Ashton, Sir Hubert Duncan, Sir James James, David
Atkins, Humphrey Duthie, Sir William Jenkins, Robert (Dulwich)
Barber, Anthony Eccles, Rt. Hon. Sir David Jennings, J. C.
Barlow, Sir John Eden, John Johnson, Dr. Donald (Carlisle)
Barter, John Elliot, Capt. Walter (Carshalton) Johnson, Eric (Blackley)
Batsford, Brian Elliott, R. W. (Nwcstle-upon-Tyne, N.) Johnson Smith, Geoffrey
Beamish, Col. Sir Tufton Emery, Peter Joseph, Sir Keith
Bell, Ronald Emmet, Hon. Mrs. Evelyn Kaberry, Sir Donald
Bennett, F. M. (Torquay) Farey-Jones, F. W. Kerans, Cdr. J. S.
Bennett, Dr. Reginald (Gos & Fhm) Finlay, Graeme Kerby, Capt. Henry
Berkeley, Humphry Fisher, Nigel Kerr, Sir Hamilton
Bevins, Rt. Hon. Reginald (Toxteth) Fletcher-Cooke, Charles Kershaw, Anthony
Bidgood, John C. Foster, John Kimball, Marcus
Biggs-Davison, John Fraser, Ian (Plymouth, Sutton) Kitson, Timothy
Bingham, R. M. Freeth, Denzil Lagden, Godfrey
Birch, Rt. Hon. Nigel Galbraith, Hon. T. G. D. Lambton, Viscount
Bishop, F. P. Gammans, Lady Lancaster, Col. C. G.
Bourne-Arton, A. Gardner, Edward Langford-Holt, J.
Box, Donald Gibson-Watt, David Leather, E. H. C.
Boyd-Carpenter, Rt. Hon. John Glover, Sir Douglas Leavey, J. A.
Boyle, Sir Edward Glyn, Sir Richard (Dorset, N.) Leburn, Gilmour
Braine, Bernard Godber, J. B. Legge-Bourke, Sir Harry
Brewis, John Goodhart, Philip Lewis, Kenneth (Rutland)
Brooke, Rt. Hon. Henry Goodhew, Victor Lilley, F. J. P.
Brooman-White, R. Gough, Frederick Lindsay, Martin
Browne, Percy (Torrington) Gower, Raymond Linstead, Sir Hugh
Bryan, Paul Grant, Rt. Hon. William Litchfield, Capt. John
Bullard, Denys Green, Alan Lloyd, Rt. Hon. Selwyn (Wirral)
Bullus, Wing Commander Eric Gresham Cooke, R. Loveys, Walter H.
Burden, F. A. Grimston, Sir Robert Lucas, Sir Jocelyn
Butler, Rt. Hn. R. A. (Saffron Walden) Grosvenor, Lt.-Col. R. G. Lucas-Tooth, Sir Hugh
Buck, Antony Gurden, Harold McAdden, Stephen
Campbell, Gordon (Moray & Nalrn) Hall, John (Wycombe) MacArthur, Ian
Carr, Compton (Barons Court) Hamilton, Michael (Wellingborough) McLaren, Martin
Carr, Robert (Mitcham) Harris, Reader (Heston) McLaughlin, Mrs. Patricia
Cary, Sir Robert Harrison, Brian (Maldon) Maclay, Rt. Hon. John
Channon, H. P. G. Harvey, Sir Arthur Vere (Macclesf'd) Maclean, Sir Fitzroy (Bute & N. Ayrs.)
Chataway, Christopher Harvey, John (Walthamstow, E.) MaoLeod, John (Ross & Cromarty)
Chichester-Clark, R. Harvie Anderson, Miss McMaster, Stanley R.
Clark, William (Nottingham, S.) Hastings, Stephen Macmillan, Maurice (Halifax)
Cleaver, Leonard Hay, John Maopherson, Niall (Dumfries)
Cole, Norman Heald, Rt. Hon. Sir Lionel Maddan, Martin
Cooper, A. E. Henderson, John (Cathoart) Maitland, Sir John
Cooper-Key, Sir Neill Hendry, Forbes Manningham-Buller, Rt. Hn. Sir R.
Cordeaux, Lt.-Col. J. K. Hiley, Joseph Markham, Major Sir Frank
Curdle, John Hill, Mrs. Eveline (Wythenshawe) Marlowe, Anthony
Corfield, F. V. Hill, J. E. B. (S. Norfolk) Marples, Rt. Hon. H. A.
Costaln, A. P. Hirst, Geoffrey Marshall, Douglas
Coulson, J. M. Hobson, John Matthews, Gordon (Meriden)
Courtney, Cdr. Anthony Hocking, Philip N. Maudling, Rt. Hon. Reginald
Craddock, Sir Beresford Holland, Philip Mawby, Ray
Critchley, Julian Hollingworth, John Maxwell-Hyslon. R, J.
Crosthwaite-Eyre, Col. O. E. Hopkins, Alan Maydon, Lt.-Cmdr. S. L. C.
Crowder, F. P. Hornby, R. P. Mills, Stratton
Cunningham, Knox Hornsby-Smith, Rt. Hon. Patricia More, Jasper (Ludlow)
Curran, Charles Howard, Hon. G. R. (St. Ives) Morgan, William
Currie, G. B. H. Howard, John (Southampton, Test) Morrison, John
Dalkeith, Earl of Hughes Hallett, Vice-Admiral John Mott-Radclyffe, Sir Charles
Dance, James Hughes-Young, Michael Heave, Airey
d'Avigdor-Goldsmid, Sir Henry Hulbert, Slr Norman Nicholson, Sir Godfrey
Noble, Michael Robinson, Sir Roland (Blackpool, S.) Thornton-Kemsley, Sir Colin
Nugent, Sir Richard Rodgers, John (Sevenoaks) Tiley, Arthur (Bradford, W.)
Oakshott, Sir Hendrie Roots, William Tilney, John (Wavertree)
Orr-Ewing, C. Ian Ropner, Col. Sir Leonard Turner, Colin
Osborn, John (Hallam) Russell, Ronald Turton, Rt. Hon. R. H.
Osborne, Cyril (Louth) Sandys, Rt. Hon. Duncan van Straubenzee, W. R.
Page, John (Harrow, West) Scott-Hopkins, James Vane, W. M. F.
Pannell, Norman (Kirkdale) Sharples, Richard Vaughan-Morgan, Sir John
Pearson, Frank (Clitheroe) Shaw, M. Vosper, Rt. Hon. Dennis
Peel, John Shepherd, William Welder, David
Percival, Ian Simon, Rt. Hon. Sir Jocelyn Walker, Peter
Peyton, John Skeet, T. H. H. Walker-Smith, Rt. Hon. Sir Derek
Pickthorn, Sir Kenneth Smith, Dudley (Br'ntf'rd & Chiswick) Ward, Dame Irene
Pike, Miss Mervyn Smyth, Brig. Sir John (Norwood) Watkinson, Rt. Hon. Harold
Pilkington, Sir Richard Spearman, Sir Alexander Watts, James
Pitt, Miss Edith Speir, Rupert Webster, David
Pout, Percivall Stanley, Hon. Richard Wells, John (Maidstone)
Powell, Rt. Hon. J. Enoch Stewart, Harold (Stockport, S.) Whitelaw, William
Price, David (Eastleigh) Stodart, J. A. Williams, Dudley (Exeter)
Prior, J. M. L. Stoddart-Scott, Col. Sir Malcolm Williams, Paul (Sunderland, S.)
Prior-Palmer, Brig. Sir Otho Storey, Sir Samuel Wills, Sir Gerald (Bridgwater)
Profumo, Rt. Hon. John Summers, Sir Spencer (Aylesbury) Wilson, Geoffrey (Truro)
Proudfoot, Wilfred Talbot, John E. Wolrige-Gordon, Patrick
Pym, Francis Taylor, Sir Charles (Eastbourne) Woodhouse, C. M.
Quennell, Miss J. M. Taylor, Edwin (Bolton, E.) Woodnutt, Mark
Ramsden, James Teeling, William Woollam, John
Rawlinson, Peter Temple, John M. Worsley, Marcus
Redmayne, Rt. Hon. Martin Thatcher, Mrs. Margaret Yates, William (The Wrekin)
Rees, Hugh Thomas, Leslie (Canterbury)
Renton, David Thomas, Peter (Conway) TELLERS FOR THE AYES:
Ridsdale, Julian Thompson, Richard (Croydon, S.) Mr. Edward Wakefield and
Roberts, Sir Peter (Heeley) Thorneycroft, Rt. Hon. Peter Colonel J. H. Harrison.
Abse, Leo Fernyhough, E. Key, Rt. Hon. C. W.
Allaun, Frank (Salford, E.) Finch, Harold King, Dr. Horace
Allen, Scholefield (Crewe) Fitch, Alan Lawson, George
Awbery, Stan Fletcher, Eric Ledger, Ron
Bacon, Miss Alice Foot, Dingle (Ipswich) Lee, Frederick (Newton)
Beaney, Alan Foot, Michael (Ebbw Vale) Lee, Miss Jennie (Cannock)
Bence, Cyril (DunbartonShire, E.) Forman, J. C. Lever, Harold (Cheetham)
Benson, Sir George Fraser, Thomas (Hamilton) Lever, L. M. (Ardwick)
Blackburn, F. Gaitskell, Rt. Hon. Hugh Lewis, Arthur (West Ham, N.)
Blyton, William Galpern, Sir Myer Lipton, Marcus
Boardman, H. George, Lady Megan Lloyd (Crmrthn) Loughlin, Charles
Bowden, Herbert W. (Leics, S. W.) Ginsburg, David Mabon, Dr. J. Dickson
Bowles, Frank Gourley, Harry McCann, John
Boyden, James Greenwood, Anthony MacColl, James
Braddock, Mrs. E. M. Grey, Charles McInnes, James
Broughton, Dr. A. D. D. Griffiths, Rt. Hon. James (Llanelly) McKay, John (Wallsend)
Brown, Rt. Hon. George (Belper) Gunter, Ray McLeavy, Frank
Butler, Herbert (Hackney, C.) Hale, Leslie (Oldham, W.) MacMillan, Malcolm (Western Isles)
Butler, Mrs. Joyce (Wood Green) Hall, Rt. Hn. Glenvil (Colne Valley) MacPherson, Malcolm (Stirling)
Castle, Mrs. Barbara Hamilton, William (West Fife) Mallalieu, E. L. (Brigg)
Chapman, Donald Hannan, William Mallalieu, J. P. W. (Huddersfield, E.)
Chetwynd, George Hart, Mrs. Judith Manuel, A. C.
Cliffe, Michael Hayman, F. H. Mapp, Charles
Collick, Percy Healey, Denis Marquand, Rt. Hon. H. A.
Corbet, Mrs. Freda Henderson, Rt. Hn. Arthur (Rwly Regis) Marsh, Richard
Craddock, George (Bradford, S.) Hewitson, Cant. M. Mason, Roy
Crosland, Anthony Hill, J. (Midlothian) Mayhew, Christopher
Crossman, R. H. S. Holman, Percy Mellish, R. J.
Cullen, Mrs. Alice Holt, Arthur Mendelson, J.J
Darling, George Houghton, Douglas Milne, Edward J.
Davies, G. Elfed (Rhondda, E.) Howell, Charles A. Mitchison, G. R.
Davies, Harold (Leek) Hoy, James H. Monslow, Walter
Davies, Ifor (Gower) Hughes, Sledwyn (Anglesey) Moody, A. S.
Davies, S. O. (Merthyr) Hughes, Emrys (S. Ayrshire) Morris, John
Deer, George Hughes, Hector (Aberdeen, N.) Moyle, Arthur
de Freitas, Geoffrey Hunter, A. E. Malley, Frederick
Delargy, Hugh Hynd, H. (Accrington) Oliver, G. H.
Dempsey, James Irvine, A. J. (Edge Hill) Oram, A. E.
Diamond, John Jay, Rt. Hon. Douglas Oswald, Thomas
Dodds, Norman Jeger, George Owen, Will
Donnelly, Desmond Jenkins, Roy (Stechford) Paget, R. T.
Driberg, Tom Jones, Rt. Hn. A. Creech (Wakefield) Pannell, Charles (Leeds, W.)
Dugdale, Rt. Hon. John Jones, Dan (Burnley) Pargiter, G. A.
Ede, Rt. Hon. C. Jones, Elwyn (West Ham, S.) Parker, John (Dagenham)
Edelman, Maudice Jones, Jack (Rotherham) Parkin, B. T. (Paddington, N.)
Edwards, Rt. Hon. Ness (Caerphilly) Jones, J. Idwal (Wrexham) Pearson, Arthur (Pontypridd)
Edwards, Robert (Bilston) Jones, T. W. (Merioneth) Pearl, Frederick
Edwards, Walter (Stepney) Kelley, Richard Pentland, Norman
Evans, Albert Kenyon, Clifford Plummer, Sir Leslie
Poppiewell, Ernest Smith, Ellis (Stoke, S.) Warbey, William
Prentice, R. E. Sorensen, R. W. Watkins, Tudor
Price, J. T. (Westhoughton) Soskice, Rt. Hon. Sir Frank Weitzman, David
Probert, Arthur Spriggs, Leslie Wells, Percy (Faversham)
Proctor, W. T. Steele, Thomas Wells, William (Walsall, N.)
Pursey, Cdr. Harry Stewart, Michael (Fulham) White, Mrs. Eirene
Randall, Harry Stonehouse, John Whitlock, William
Rankin, John Strauss, Rt. Hn. G. R. (Vauxhall) Wilcock, Group Capt. C. A. B.
Redhead, E. C. Stross, DrBarnett (Stoke-on-Trent, C.) Wilkins, W. A.
Reid, William Swain, Thomas Willey, Frederick
Reynolds, G. W. Swingler, Stephen Williams, D. J. (Neath)
Roberts, Albert (Normanton) Sylvester, George Williams, LI. (Abertillery)
Roberts, Goronwy (Caernarvon) Taylor, Bernard (Mansfield) Williams, W. R. (Openshaw)
Robinson, Kenneth (St. Pancras, N.) Taylor, John (West Lothian) Willis, E. G. (Edinburgh, E.)
Rogers, G. H. R. (Kensington, N.) Thomas, lorwerth (Rhondda, W.) Wilson, Rt. Hon. Harold (Huyton)
Ross, William Thomson, G. M. (Dundee, E.) Winterbottom, R. E.
Royle, Charles (Salford, West) Thornton, Ernest Woodburn, Rt. Hon. A.
Silverman, Julius (Aston) Timmons, John Woof, Robert
Silverman, Sydney (Nelson) Tomney, Frank Yates, Victor (Ladywood)
Slater, Mrs. Harriet (Stoke, N.) Ungoed-Thomas, Sir Lynn
Slater, Joseph (Sedgefield) Wade, Donald TELLERS FOR THE NOES:
Small, William Wainwright, Edwin Mr. Short and Mr. Irving.

Bill accordingly read the Third time and passed.