Commons Sitting of 5 April 1963

Preamble
The House met at Eleven o'clock
PRAYERS
[Mr. SPEAKER in the Chair]

CIVIL LORD OF THE ADMIRALTY (STATEMENT)
11.4 a.m.
The Civil Lord of the Admiralty (Mr. C. Ian Orr-Ewing): Mr. Speaker, I observe from HANSARD of 3rd April, Column 439, that during Question Time shortly before the Budget, when the noise level in the House was very high, I misheard a supplementary question put by the hon. Member for Motherwell (Mr. Lawson). I was under the impression that he said "proportionately", whereas he is recorded as having said "disproportionately". I would like the opportunity of setting this matter right. If, amongst the hubbub, I had heard him correctly I would not have replied "Yes, Sir": I would have replied, "I will bear in mind Scotland's special position, but the amount of naval shipbuilding orders firms win, outside the submarine field, must depend primarily on the prices they quote in reply to Admiralty tenders."

ORDERS OF THE DAY

  NURSING HOMES BILL
  As amended (in the Standing Committee), considered.
  11.7 a.m.
  Mr. Alan Brown: I beg to move, That the Bill be now read the Third time.
  The purpose of the Bill is to permit the Minister to make regulations governing the conduct of nursing homes and to remove the present exemption from registration, and consequently inspection, of non-profit-making nursing homes. Before I explain the Clauses and subsections of the Bill, I would crave your
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  indulgence, Mr. Speaker, and that of right hon. and hon. Members while I endeavour to make known to the House the precise reasons, however unwelcome, which together have served to convince me that the measures contained in the Bill represent legislation which is long overdue. I seek this indulgence because, unlike the vast majority of Bills intimately affecting the public, which invariably and rightly are made the subject of a full measure of learned speeches and searching questions on Second Reading, such was not the case in relation to this Bill.
  The Bill was given an unopposed Second Reading by the House on Friday, 7th December, 1962, and such an event, as far as a Private Member's Bill is concerned, provided what may reasonably be called a fairly unique Parliamentary occasion. I describe it thus because one hon. Member who accusted me in the Members' Cafeteria some ten minutes after that memorable event said, "This is the first one in nearly 200 Bills that a private Member has tried to slip through on the nod to which I have not objected." Clearly the hon. Member concerned was in the category of being a professional sinker of Private Members' Bills. Certainly he was a man with a mission.
  At the same time I could not but sympathise with the phobia to which he so willingly confessed. I also take the view, which I think is fully shared by hon. Members on both sides of the House, that it is altogether right and proper and wholly in keeping with the long-established tradition of the House that every piece of legislation, whether its implementation be desired by the Government of the day or by a humble back bencher, should never be allowed to pass into law quietly, like a thief in the night. We must, as did our illustrious predecessors in Parliament, ever have it in our minds that each and every law which will affect the lives of the people must be brought openly to the floor of this great democratic institution; and here in this place, which is the forum for discussion by the people, should the proposed law be fully dissected, debated and made subject to the full glare of publicity. Such is the democratic right of the British people. It is one which I would at all times be prepared to defend, for it is a necessary safeguard

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  to freedom. To me and to most of us, the freedom of the individual member of our society is his birthright.
  It was on 16th November, 1962, that the national newspapers first mentioned that a document produced by a dedicated and brilliant young man, a sociologist by the name of Peter Townsend, had just been published. It so happens that once in a while the public conscience receives a severe jolt. Once in a while, some unwelcome and quite unexpected feature of our national life becomes revealed for all the world to see. Caught in the brilliant glare of Press publicity, an astonishing defect somehow stands starkly revealed in the midst of this Welfare State in which we all take just pride.
  One such rare example was brought home vividly to the public in the report by Mr. Townsend to which I have referred. He reported on the plight of old folk in institutions. His book was entitled "The Last Refuge" and it was based on the result of a four-year survey of institutions and—
  Mr. Speaker: Order. I do not know anything about that report, but this is Third Reading, an occasion on which we discuss the contents of the Bill. Discussion cannot be as wide as we have on Second Reading.
  Mr. Brown: I will say no more about that report, Mr. Speaker. I did, however, think that with your indulgence it might be brought in as it in some way affects the subject which is before the House.
  I mention it, however, for this reason. Many of the newspapers, not unexpectedly, were shocked at certain revelations. Knowing full well that a Private Member's Bill was before this House calling for an end to be put to certain scandalous aspects of the treatment of our old and infirm folk, they not unnaturally connected the two stories. The effect was beneficial because it resulted in my receiving a large number of letters asking me what Parliament was doing about this shameful state of affairs. So far as that question has been posed, it is for hon. Members themselves to say.
  I am hopeful, Mr. Speaker, by virtue of your indulgence, which, I assure you, I will not attempt to abuse, that the debate which takes place here today will, per-
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  haps, be wide enough and will contain sufficient information. I am well aware that my right hon. Friend the Minister of Health is very conscious that for reasons I have already mentioned relative to Second Reading, a gap exists in the public mind which can only be adequately filled by imparting to the public, not only full details of the defects which have been brought to light, but also the remedial action which, if the House passes the Bill, the Minister will be empowered to take.
  I now wish to lay before the House some evidence both by way of named cases of persons who have complained and whose next of kin have written to me exposing the scandalous treatment which has been meted out to deceased relatives, and I shall recount examples of treatment of a nature which, I think hon. Members would agree, is so pitiless to old folk that many hon. Members here today may find it difficult to believe that such things could happen in England in this day and age.
  It so happens that the first letter was given to me last November by the late Hugh Gaitskell, whom I never saw again. He stopped me in one of the corridors of the House and told me how glad he was that this Nursing Homes Bill was to be introduced.
  Mr. Speaker: Order. The hon. Member asks for my indulgence, but however indulgent I may be I am bound by the rules of the House. The rules of the House relating to Third Reading are that we then discuss the contents of the Bill. We cannot have as wide a debate as on Second Reading.
  Mr. Brown: Of course, I accept your Ruling, Mr. Speaker.
  I turn now to the contents of the Bill. Its purpose is to permit the Minister to make regulations governing the conduct of nursing homes—I ask him at this stage whether they may be roughly similar to the regulations already made in respect of homes for disabled and old persons—and to remove the present exemption from registration and, consequently, inspection of non-profit-making nursing homes. In that connection, perhaps my hon. Friend the Joint Parliamentary Secretary would care to make a statement.

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  Clause 1(1,a) empowers the Minister of Health to make regulations as to the conduct of nursing homes which may, in particular, specify the facilities and services provided in such nursing homes as defined in Part VI of the Public Health Act, 1936, or where a home is in London, the Public Health (London) Act, 1936, which include maternity homes. The regulations may also, under subsection (1,b), empower the local authority responsible for the registration of the home under those Acts—normally the county council or the county borough council—to specify the maximum number of persons, or 'the number of persons of any description, who may be received in the home as patients. Thus it would be possible for the registration authority to ensure both that a home was not overcrowded and that it did not receive patients of types for which it did not have the staff, accommodation or facilities to cater. A home could, for example, be registered "for twenty-five geriatric or chronic sick patients only". The regulations I am asking for may also provide that contraventions of or failure to comply with any specified provision of the regulations shall be an offence. Clause 1(1,d) empowers registration authorities to institute proceedings in respect of an offence. I think it will be thought these are normal enforcement provisions.
  Clause 1 (2) prescribes maximum penalties on conviction before a magistrates court of £5 for the first offence and £20 for subsequent' offences. These penalties are the same as those prescribed for similar offences in respect of mental nursing homes under Section 16 of the Mental Health Act, 1959, and in respect of homes for the disabled or old people under Sections 40 of the National Assistance Act, 1948. The subsection also enables the registration authorities to cancel the registration of a person in respect of a nursing home on the ground that he or she has been convicted of an offence against the regulations. This power supplements the powers to cancel nursing home registration in the existing provisions of the Public Health Acts and gives the registration authority the effective sanction in reserve for particularly frequent or serious contraventions of the regulations, as well as having what, we hope, will be a deterrent effect.
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  Clause 1 (3) provides that where an offence against the regulations has been committed by a body corporate and the offence can be shown to have been committed with the consent or connivance by or can be attributed to the neglect by any director, manager, secretary, or similar person of that body, that officer as well as the body itself is to be guilty of the offence. Slightly different versions of this provision which place the onus of proof more on the officers of the company or body to show that the offence was committed without their knowledge or consent are in the existing Public Health Acts and in the National Assistance Act provisions for the registration of homes for disabled or old people, but the formula used here is that used under all recent enactments in which offences by companies or bodies corporate are dealt with.
  Clause 1 (4) provides that regulations made under the Bill shall be subject to the negative procedure in Parliament in the same way as are regulations made under the corresponding provisions of the National Assistance Act and the Mental Health Act.
  Clause 2 repeals 12 months after this Bill becomes law, if it pleases the House today that it should, the existing provisions in Section 192 of the Public Health Act, 1936, and the corresponding Section 246 of the Public Health (London) Act, 1936, which enable registration authorities to exempt any hospital or institution not carried on for profit from the operation of the provisions of those Acts relating to the registration and inspection of nursing homes. The original intention of those Sections seems to have been to exempt voluntary hospitals from registration and, of course, from inspection, but nowadays, since the coming into force of the National Health Service Act, 1946, their main effect is to exempt nursing homes run by voluntary organisations and charities. In the interests of their patients it seems desirable that the distinction between profit making and non-profit making nursing homes which does not exist under the National Assistance Act, 1948, nor under the Mental Health Act, 1959, should cease, and that the same standards and the same requirements should apply to voluntary as to privately run nursing homes.

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  I should like to stress, if I may for one moment, while mentioning standards, voluntary organisations, and so on, that in so far as voluntary organisations or voluntary nursing homes are concerned the vast majority of them are well up to the agreed standard. We are really trying to cope with those which I would have mentioned had I been able to, those which do not maintain such standards and have no intention of maintaining such standards, but purely and simply take old, infirm and other people into the homes where it is purported that nursing and medical attention is given, but where in fact it is not given and where the standards are very bad.
  Clause 2 would apply the provisions of the Public Health Acts as to registration and inspection to some 114 voluntary nursing homes and organisations running them. They will be given a year to arrange for registration and to make any structural alterations or other alterations which my right hon. Friend in his wisdom deems they should so do.
  Clause 3 gives the short title of the Bill and its extent. Like the Public Health Acts whose provisions it supplements the Bill is to extend only to England and Wales.
  I would, with your permission, Mr. Speaker, ask the Minister to deal with the subsection which was added to the Bill in Committee. I would also ask him to give the House when he replies some idea of the regulations he will make affecting the standards of skill and attention which are so important for nursing homes.
  Finally, I would ask the House to be kind enough to pass this Bill, which I believe to be—as I am sure hon. Members would also believe had I been able to complete a part of my speech—possibly one of the most important pieces of legislation to come before the House for a long time.
  11.28 a.m.
  Mr. Kenneth Robinson: The House will have gathered from the unusually smooth passage which this Bill has had so far, as described by the hon. Member for Tottenham (Mr. A. Brown), that it has the support of my hon. and right hon. Friends. We welcome it as a distinct but certainly a limited advance in the care of the sick and the aged. In Com-
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  mittee, whose proceedings were quite brief, a number of questions were asked of the Joint Parliamentary Secretary. Most of them he answered, but one or two, quite understandably, he sidestepped and avoided answering. A certain amount of time has elapsed since then, and I wonder if he could today enlighten us on a couple of the points which were raised then.
  The definition of nursing home is something which seems to many of us not satisfactory today. Leaving aside the statutory definition, the phrase "nursing home" in everyday parlance covers an enormously wide range of institutions, from a home for aged and infirm people, to what is in fact a private hospital clinic. They are all known as nursing homes.
  This is not something that statutory definition can do much about. It seems to some of us that there are establishments which are in fact nursing homes for old people, containing mainly and sometimes wholly aged and infirm people, which escape all legislation covering nursing homes because they purport to be boarding establishments or boarding houses. I ask the Parliamentary Secretary whether his Department has given any thought to this, and whether he feels that it is necessary or that it will be desirable in the future, to amend the statutory definition of a nursing home to ensure that places like this, most, if not all, of which are run for profit, come within the regulations which he is proposing to issue.
  The other question which he did not say very much about was the capacity of local authorities to do the job which the regulations which he will make under the Bill will impose upon them. The effectiveness of this Measure, as of other Measures covering mental nursing homes, depends entirely on the quality and the number of personnel that local health authorities have at their disposal to inspect nursing homes in their areas, to inspect them with reasonable frequency and to ensure that proper standards are maintained. I think that most of us will agree that in many areas this job is not being effectively tackled today. I hope that we shall be able to have at any rate some encouraging remarks from the hon. Gentleman on that score.
  Lastly, there is the question of sanctions. It was said, I believe, in Com-

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  mittee that one of the difficulties about the existing legislation is that a local authority has only one sanction, that is to refuse or to withdraw registration of the home. Many local authorities are reluctant to do this because they know that they will be faced, as the local health authority or the local welfare authority, with finding accommodation for the people, probably old people, who are at present being looked after in the home. It seems to me that, even under this Bill, this will be the only sanction, although the regulations will lay down certain standards that will have to be maintained. In the last resort there is only one sanction, and that is refusal of registration, and the same difficulties will apply. Perhaps the Parliamentary Secretary will let us have his observations on that point.
  I regret to say that I do not know when the Minister intends to speak, but I have to leave the House at about 12 o'clock to catch a train to a longstanding engagement in the Midlands, and if it happens that he has not met my points by that time, I hope that he will acquit me of any discourtesy. I shall certainly read his replies with great care.
  We welcome this Bill and we wish it well through its passage in another place, which we hope will be as uneventful and uncontroversial as its passage has been through this House.
  11.33 a.m.
  Mr. Charles Doughty: In my humble opinion it is right that the House should consider this Bill a little more fully now because it had, as we have heard, an unopposed Second Reading when there was no opportunity for discussion, questions, criticism, if necessary, or praise, if that is the right word to use about the Bill. Let me say at once, before I deal with the actual details of the Bill, that if I should by any means be thought to have raised any points of doubt or criticism, it is not for the purpose of opposing the Bill, which has my support, but for drawing the attention of the House to one or two matters which should, in my view, be fully considered before we give the Bill its Third Reading.
  The hon. Member for St. Pancras, North (Mr. K. Robinson) referred to the
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  definition of a nursing home. It is just as well to know what the article is that we are discussing. A nursing home is defined in the Public Health Act, 1936, Section 199:
  " 'Nursing home' means any premises used or intended to be used for the reception of, and the providing of nursing for, persons suffering from any sickness, injury, or infirmity, and includes a maternity home, but does not include—
  (i) any hospital or other premises maintained or controlled by a Government department, county council (including the London County Council), local authority …"
  I shall not read the whole list of public authorities which ran hospitals in those days—
  "… any institution, house or home certified or approved by the Board of control under the Mental Deficiency Acts, 1913 to 1927."
  and, of course, the definition was carried on in the Public Health (London) Act, also of the same year.
  One has to remember that in the days when these two Acts were passed their consideration must have taken the House a considerable time, because there are hundreds of Sections in them, and the Committee stage on the two Bills cannot have been a very happy experience for those who had to consider them. In those days, before the days of the National Health Acts under which the hospitals are run by the Minister and so forth, we were dealing with public hospitals run by private boards, by charities, and, of course, the county council hospitals and institutions of that kind. It is important to remember that.
  Nursing homes, which, of course, include hospitals under this definition, are now run under the National Health Acts, but I wonder if the House realises the cost per week per patient in those hospitals. This is important when we are considering this Bill, because it bears relation to the cost of private patients, or patients whether private or public, in these nursing homes, and the charges that have to be made. It is important, when we consider that, that we should be careful not to put on these nursing homes additional costs that have to be passed on to the patients.
  The cost varies from hospital to hospital. Again, I am talking of hospitals, which means nursing homes under the National Health Service, and I am excluding altogether the medical costs, surgical costs, cost of operating theatres

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  and matters of that kind and considering only what might be called boarding and lodging costs. Does the House realise that I should not be exaggerating if I said that the average cost in the hospitals in and around the big cities is approximately £40 a week per patient? That is extremely high. If that is the cost of these institutions—and I do not criticise the running of them—what is the cost in smaller establishments run, it is said, for profit—under the description in this Bill—and how can they make a profit if they have to charge private patients in relation to the figures that I have mentioned? If we put additional regulations, additional burdens and additional restrictions on these nursing homes the people who suffer will be those who go into them for treatment and who receive their account at the end of their stay or at the end of each week.
  I appreciate that the Bill gives the Minister powers only to make regulations, but if the Bill becomes law, as I hope it will, I hope that the regulations will be of such a kind that additional costs and charges which have to be passed on to the patients, will not be put upon the nursing homes. We can, of course, make regulations and make these places in every circumstance most up to date and clean and with plenty of bed space, but it all adds to the cost, and the cost of the treatment must also be considered.
  I want to deal with some of the Clauses a little more fully. We are repealing part of the Public Health Act, 1936, and part of the Public Health (London) Act, 1936. I have dealt already with the conduct of nursing homes. Under Clause 1 of the Bill the Minister has power to
  "make provision as to the facilities and services to be provided in such homes".
  The words are short, but they are extremely extensive. "Facilities and services" means everything. The Bill will give the Minister power to regulate every single matter which occurs in a nursing home.
  I would remind the House that under both 1936 Acts the Minister already has very wide powers indeed. I will not weary the House with the powers in respect of appeals and registrations and other matters dealing with the conduct of nursing homes. If any hon. Member is interested, he will find the information
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  in Sections 187–195 of the Public Health Act, 1936, and there are approximately the same number of Sections in the London Act. Ever since that date—probably before then, for all I know—such nursing homes have had to be registered, and, under those Acts, they can be inspected and must have a very high standard before they are allowed to continue their registration and their business.
  Under Clause 1(1,b) the local authority—it is the local authority which is responsible for registration of nursing homes—would have the duty of enforcing any regulations the Minister saw fit to make under the provisions of the Bill. It could limit the number of persons who could be admitted to a nursing home at one time or the description of persons who might be received into the home. It could limit the registration to such numbers.
  We have not heard, partly because the Bill was not discussed on Second Reading, and apparently it went through the Committee stage extremely shortly, whether there has been proved to be any necessity for the very wide power which was given to the local authorities and to the Minister. Is there any evidence of overcrowding in nursing homes other than mental nursing homes—which I shall deal with in a minute because they are exempted from the Bill? Is there any evidence that any of these institutions are run in such a way that too many patients are accepted at any one time? There may be, but I do not know; I have not been able to find out because there was no Second Reading discussion. Also, we have not heard the Parliamentary Secretary on the subject, and it will be interesting to hear from him whether there is any necessity for this part. Maybe there is; but I am against—I am sure most hon. Members are—passing legislation for the sake of passing legislation and anticipating overcrowding when overcrowding does not exist. If there are nursing homes which are crowding patients in and putting beds close together and the patients cannot have proper attention, it is right that this provision should be passed. If there is such evidence, the Clause will have my support.
  Mr. K. Robinson: Surely the hon. and learned Member must know that it is not only a question of crowding too many

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  people into a given space. It is a question of having too many people in a home for the skilled staff available to look after.
  Mr. Doughty: I appreciate—
  Mr. Speaker: Order. We are a little outside the rules of order here. The fact that the Second Reading was unopposed does not affect the matter that the Bill has had a Second Reading. The House has already decided upon the principle of the Bill, and I had to stop even the promoter of the Bill from seeking to discuss now instances of evidence of the mischief which the Bill was designed to meet—because we are past that stage. I am fettered by the rules of the House in the matter.
  Mr. Doughty: Perhaps, Mr. Speaker, I may put what I want to say in a slightly different way and thus say the same thing again in a form which I hope will be in order.
  The Bill states that the regulations may
  "empower the local authority responsible for the registration of any such home under the said enactments to limit the number of persons, or persons of any description, who may be received into the home."
  That may be by reason of overcrowding or, as the hon. Member for St. Pancras, North has just said, by reason of the fact that the nursing home does not have sufficient staff. That is a matter which is mentioned in the Bill, and I should certainly like the Parliamentary Secretary to deal with it. Then there are the usual provisions providing for what takes place in the event of any contravention.
  It is upon the repealing of the earlier Sections that I should like to say a few words. Section 192 of the Public Health Act, 1936, which is to be repealed by Clause 2, says that the appropriate authority
  "may grant exemption from the operation of the provisions of this Part of this Act relating to nursing homes in respect of any hospital or institution not carried on for profit, and may attach conditions to any exemption granted by them."
  So the Section deals with the exemption of that type of nursing home.
  Why is it that we are withdrawing the exemption which was given to nursing homes not run for profit? It is
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  a little difficult to understand why that should be and why it is necessary to repeal that Section. Is it because some charitable body runs a nursing home without complying with the requirements applying to other nursing homes and is to be allowed to get away with it? That would be the effect of repealing the Section. It may well be that an Amendment might be tabled in another place after this question has been particularly considered. The same thing applies to Section 246 of the Public Health (London) Act, 1936, in which the same exemption was granted.
  Why we should not extend the Bill to Scotland or Northern Ireland I do not know. Looking round the House, I see no Scottish Members present. I am wrong; the hon. Member for Glasgow, Provan (Mr. W. Reid) is here. I do not see why the Scots should not have the same obligation put upon them. If there are—I do not know whether there are, and I do not for a moment think that there are—persons who run for a profit nursing homes which are badly conducted in order that they may make more money out of them, will they be able to cross the border into Scotland or go to Northern Ireland and carry on in the way in which they will not be able to carry on in England and Wales after the Bill becomes law? I think we are a little too sensitive about the feelings of the Scots in these circumstances, and I feel that in another place subsection (2) of Clause 3 might well be deleted. But distances are short nowadays, and some people might want to go to Scotland to be nursed. In case I am criticised for what I say, I had better add that so far as I know Scottish nurses are extremely capable and gentle and very efficient.
  Mr. William Reid: Hear, hear.
  Mr. Doughty: I am so sorry if I woke up the hon. Member. At any rate, I am glad to see that he agrees with me. Perhaps he will agree with me later on, if he catches your eye, Mr. Speaker, that the Bill should be extended to Scotland. Perhaps we could jointly agree that the benefits—
  Mr. Speaker: This is very difficult. One cannot propose on Third Reading Amendments that should be made to the text of the Bill in another place. That

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  cannot be fitted in with the rules of order.
  Mr. Doughty: I appreciate my difficulty and yours as well, Mr. Speaker. But I am drawing attention to particular Clauses so that the House may consider them. If I went too far and said that Amendments might be made in another place, I willingly withdraw. However, these are the matters to which I draw the attention of hon. Members so that when and if they catch your eye they may consider it worth while to give their views.
  I have expressed my own views only, such as they are, and having given them I shall listen with interest to what my hon. Friend the Joint Parliamentary Secretary has to say. Subject to that, and to an assurance that it will not make the cost of nursing homes to patients unduly high, the Bill will have my support.
  11.50 a.m.
  Mr. Eric Fletcher: I support this Bill, and I want to urge several reasons why it should be supported which have not yet been put before the House and which are of some importance. A great deal has been said about the patients in nursing homes and about staffs. We are all anxious, of course, for their welfare. But there is another class of person affected, and very often vitally affected, by what goes on in private nursing homes. These are the relatives of patients. It is on their behalf that I draw the attention of the House to certain circumstances which now exist, sometimes giving rise to scandals which I hope can be obviated in future if the appropriate regulations are made by the Minister as he will be empowered to make them under Clause 1.
  At present there is no redress, as I understand it, on the part of any relative of a patient in a nursing home who wants to visit that patient and who is refused admission by the matron or whoever is in charge. There is no redress, no appeal from her fiat. The Minister cannot intervene, nor can the medical officer for health for the local authority.
  It sometimes happens—I hope not too often—that very serious injustice is done and very great pain is caused by unfortunate decisions on the part of those in charge of a nursing home as to
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  whether or not certain close relatives of patients will be admitted.
  Mr. Doughty: Such decisions, distressing as they may be to close relatives sometimes, are genuinely made, if not in the interest of the nursing home or hospital, then certainly in the interest of the patients themselves, who will be better left alone and should not be worried.
  Mr. A. Brown Mr. A. Brown rose—
  Mr. Fletcher: Perhaps the hon. Memfor Tottenham (Mr. A. Brown) will let me reply to the hon. and learned Member for Surrey, East (Mr. Doughty) first. What the hon. and learned Member says should be the principle, and one would hope that the principle was generally accepted that decisions about the admission of relatives should be taken in the interest of the patients. But it does not follow that this principle is always observed. Occasions arise when there is a departure from that principle; nor is it always easy for the matron as distinct from the doctor, to determine what is in the real interest of the patient.
  I can best illustrate the point by giving an example which recently came to my notice and about which I have had correspondence with the Minister. I refer to the case of Mrs. Dorothy C. Brown—no relation, I hasten to add, of the promoter of the Bill. Mrs. Brown was an epileptic. She was seriously ill, and after being well looked after in a nursing home in Torquay she was eventually taken to the Dawlish Nursing Home. There she was visited on a number of occasions by her only relative, her brother, the Rev. E. F. Tozer, who was for forty years vicar of Emmanuel, Exeter, and his wife.
  White in the Dawlish Nursing Home, Mrs. Brown inherited from a cousin a large sum of money. Whether it was a coincidence or not I do not know, but from that moment onwards the matron refused to allow Mr. Tozer or his wife to visit this lady. Other persons were admitted. On what ground these decisions were made or applied I know not. But I do know that when a few weeks later Mrs. Brown died it was found that she had left a will in circumstances which, to say the least, gave cause for very grievous suspicion. A number of

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  complications have subsequently arisen into which I need not go at this moment.
  On the face of it, it seems very odd that during the last few weeks of this lady's life her only brother, a respected clergyman in Exeter, should have been debarred by the matron admission to see her, although other persons were allowed to visit her. This not unnaturally caused very great pain and distress to this elderly, respected clergyman and his wife.
  For a long time past I have been trying to ascertain what was the cause of it. It may well be that the matron had some good reason. Many people think that she had not good reason. Here we have a situation which certainly calls for some explanation. it so happens that there has been very considerable dispute about how Mrs. Brown's estate should go, because she apparently left some instructions which appear to be inconsistent with the precise testamentary provisions of her will. I do not need to go into that, however.
  I hope that this is a rare occurrence, but it is the kind of occurrence which occasionally produces, and is thought to produce, serious scandal in the administration of private nursing homes. In such a case, as I have said, the injured relatives, or relatives who think themselves affronted, are caused great suffering through being refused permission by a matron to visit a dying patient.
  I would like to know the grounds on which such decisions are made. As the law stands, relatives in that position have no redress. They cannot ask the Minister to intervene. I wrote to the Minister and had a very sympathetic reply from the then Joint Parliamentary Secretary, the hon. Lady the Member for Birmingham, Edgbaston (Dame Edith Pitt), who pointed out that the Minister was powerless to inquire into the case because private nursing homes are outside the National Health Service and he has no jurisdiction over them.
  I asked whether the right hon. Gentleman could suggest anything so that I could try to clear up a situation that seemed to me disturbing and something which ought to be inquired into. The hon. Lady pointed out that I might be able to bring the matter to the attention of the medical officer of health of the
  796
  registering authority. He had no power to investigate, no power to inquire into it, no power to see whether there was any justification for this refusal.
  Mr. Dudley SmithWould it not have been possible for the local authority or the medical officer to order a special inspection of the premises under the provisions of the present law?
  Mr. Fletcher: I dare say, but an inspection of the premises would not have revealed anything. I wanted not an inspection of the premises, but an inquiry into whether there was any possible justification for the matron of his hospital having refused the Rev. E. F. Tozer permission to go to the nursing home during the last few weeks of his sister's life, although he had been a regular visitor and closest friend of his sister for many years. He told me a few weeks before his own death, which was a few weeks ago, that not only was he not allowed to see her, but was not allowed to write to her.
  Mr. Speaker: I am not quite happy. There is no litigation about this, is there?
  Mr. Fletcher: No, Sir. There is no litigation. I do not think that there is any prospect of litigation. A set of circumstances came to my notice and produced the most unfortunate and undesirable consequences which could not have resulted if this lady had been in a hospital under the jurisdiction of the Minister of Health, or in a private nursing home over which a local authority had jurisdiction.
  Mr. Charles Curran: I am following the hon. Member with interest. Is he satisfied that this state of affairs could not recur when the Bill becomes law?
  Mr. Fletcher: That is precisely the question I am raising. I want to try to satisfy myself that it may be prevented in future, and I hope that the Minister will be able to satisfy the House to that effect.
  Mr. Tozer wrote to me to say that he felt it a ghastly business that in this modern age someone could be shut up in a private nursing home and her only relation excluded from visiting her. He said:
  "This could happen to anyone, as the present law stands …

  797
  It cannot matter to me, now, as my sister is dead, but / wish to he instrumental in safeguarding others from a similar fate—at the hands of those who scheme for what the dying person has to leave."
  He said that he would be greatly obliged to me if, through Parliamentary channels, I could publicly rectify this scandal. This seems to be the opportunity to try to do something about it.
  Dr. Donald Johnson: Is the hon. Member quite satisfied that there is no remedy at law in a case like this which seems to be almost a case for habeas corpus or false imprisonment?
  Mr. Fletcher: I do not know. All I am saying is that it seems that the matron of a private hospital can decide in her own discretion whether to refuse the only or nearest relative permission to visit the patient.
  Dr. Johnson: The hon. Member has not answered my question. I am asking whether he knows how the law stands as regards habeas corpus in matters like this and whether it is not false imprisonment for which there is a perfectly good remedy at common law. I think he should inform us of that fact before he brings forward an instance like this.
  Mr. Fletcher: I will certainly answer the question. It does not seem that habeas corpus or false imprisonment has anything to do with it, because this patient was quite properly an inmate in the nursing home and was no doubt being well looked after there. One could not have obtained habeas corpus to remove her from the nursing home. I am complaining about the refusal of the authorities to enable third persons to visit her or write to her or otherwise communicate with her. No proceedings for habeas corpus or false imprisonment could be taken on behalf of the close relative of the patient of a nursing home. There is no injury to the patient, except perhaps, indirectly. It is an injury to her brother and his wife, her only relative, who were prevented from seeing her. It may well be that there was some medical justification, but I cannot believe that there was because I understand other persons were allowed to visit her.
  All I am saying is that as the law stands it is a most undesirable state of affairs that the discretion should be vested in the matron of a hospital, with-
  798
  out any possibility of her discretion being investigated by someone, by the Minister of Health, or the local authority, or someone else.
  It is because of this scandal which has come to my notice that I intervene in this Third Reading debate to ask the Minister to assure us that when he makes regulations under Clause 1 he will bear this in mind, in addition to all the others which have been brought to his notice. I was afraid that unless I made the point explicitly and ventilated it in public today as an example of what could occur, however infrequently, it might well be overlooked in the regulations which I hope will be subsequently made. It is for those reasons that I have intervened, and I hope that note will be taken of what I have said. Because of what I have said, I support the Third Reading of the Bill.
  12.7 p.m.
  Dr. Alan Glyn: I hope that the hon. Member for Islington, East (Mr. Fletcher) will not take it amiss if I do not follow him except to say that I would have thought that the words "conduct of nursing homes" in Clause 1(1) would cover the type of case which he has detailed.
  I have to be rather careful, Mr. Speaker, because already two hon. Members have been called to order for not discussing what is actually in the Bill in a Third Reading debate, and I hope that I shall be able to confine my remarks to the Third Reading.
  We are here discussing a Bill whose ramifications are very great. One of the country's greatest social problems is looking after the semi-infirm, particularly the elderly semi-infirm. Nobody in any walk of life can be unaware of the great difficulties encountered by relatives and medical people in securing adequate places for patients of this kind. The choice is between homes which are run by local authorities and those which are run by private individuals. The Bill deals with the privately run side of this social service. Although many of these homes are run purely for profit, there is an element of social service in many of them.
  The Bill quite rightly attempts to strike at those people who do not obey a

  799
  reasonable system of conduct in the manner in which they operate these homes. My hon. and learned Friend the Member for Surrey, East (Mr. Doughty) stressed an important point with which the Bill will deal. He said quite rightly that the present cost of looking after a patient in a public hospital is about £40 a week. It would not be right to go into that matter at this stage. What we have to consider is how much it costs in a private home, how many private homes there are and how many people this Bill will affect, because these are matters of considerable importance.
  The hon. Member for Islington, East also touched on an important point when he asked what would be the effect of the Minister making regulations and a local authority deciding to impose sanctions. As I see it, there are only two sanctions which my right hon. Friend can impose under the Bill. First, the radical one of striking the nursing home off the books—in other words, refusing to renew its licence—secondly, to use persuasion and tell the home in question that the beds are too close together, that it has not provided sufficient sanitation; and so on. These are the sanctions which we are proposing to allow the Minister to use under this Bill.
  The question is how these sanctions will be interpreted, and the hon. Member for Islington, East, was very fair when he put forward this point because he appreciated the difficulty with which we are faced. If a local authority imposes the ultimate sanction, it will be faced with the responsibility of finding accommodation for those who have lost it in the home which has been closed. The Minister will have to be very careful because he may be in an extremely difficult position. He will make the regulations, but it will be the responsibility of the local authority to interpret them.
  If a nursing home, or an old people's home—and I gather that this second category is covered by the Bill—is ordered to close, can it appeal to the Minister? I am not trying to defend bad nursing homes. I am trying to look at the problem from a practical point of view. I think that it is important to ensure that a nursing home has the right to appeal against a decision of a local authority, and I hope that my hon. Friend
  800
  will deal with this point, which, as my hon. and learned Friend the Member for Surrey, East said, is of considerable importance.
  We would of course like to see all those who need it to be looked after in the most delightful circumstances, but with this enormous backlog in the lack of facilities and beds for the two categories of people to whom I referred, we have to face the real practical problem of cost. The cost of staying in many of these homes compares favourably with that in a home provided by a local authority, though it is fair to say that the standards are not comparable, but there are many people who are able to pay a lower scale of fees to remain in a private home. The accommodation available under the National Health Service, or any other local authority service, is limited and promises to remain so for a long time, and there are many people with small incomes who, helped by pensions and National Assistance, are able to avail themselves of the facilities offered by this type of private nursing home or private old people's home.
  As I read the Bill, it appears to apply not only to those in nursing homes, but to those who are infirm, because the distinction between the two categories is very fine indeed. At what point does one say that an old person is an ill patient, and not merely an old patient? If the Bill became law, any regulations made by my right hon. Friend could cover both the ill and the elderly, and I hope that my hon. Friend will also deal with this problem.
  With great respect to my hon. Friend the Member for Tottenham (Mr. A. Brown), the important thing here is not so much the Bill itself, but the regulations which will be made under it, because this is an omnibus Measure which will give the Minister considerable powers to regulate the conduct of nursing homes and old people's homes, and it will be the responsibility of my right hon. Friend and his Department to ensure that the regulations are reasonable and flexible.
  I hold no brief for the bad nursing home, or for the badly run old people's home. I am not talking now about whether the beds are too close together, whether the motive is profit, whether there are no facilities whatsoever for the patients, or inmates, or whatever one calls

  801
  them, and so on, but I appeal to my hon. Friend to make sure that those who are struggling to keep down the costs of these homes, many of which are not entirely profit making—and here I am not referring specifically to the charitable organisations but to some homes which are run not only to try to make a small profit but to be of benefit to the community—are not prevented from doing so.
  I hope that the regulations will take account of these important facts: First, that we must preserve the number of privately run homes to take up the slack for which the national and local authorities are unable to cater. Secondly, that we must stamp out the really bad cases, because I believe that in the bad cases we should adopt the ultimate sanction and get rid of them.
  Many of these homes are run without qualified nurses. In some cases qualified nurses are not necessary because the people with whom they are dealing are not really sick. I hope, therefore, that this Bill will strike at the bad institutions. I hope that by this Measure we may be able to help those people who are genuinely trying to provide a good service. I hope that the regulations will not be so tough or unreasonable that the really good home, which perhaps has more beds than we would really like, is forced out of business. I hope that we shall not force the good homes to close by increasing their overhead costs to such an extent that they are unable to continue to provide the great social service which at present they provide throughout the country.
  12.20 p.m.
  Dr. Donald Johnson: I am also happy to support the Third Reading of a Bill which has enjoyed universal approbation among hon. Members—even to the extent of not being objected to by my hon. Friend the Member for Exeter (Mr. Dudley Williams) because it happens to be dealt with on a Friday. We can all feel happy about its provisions. I shall follow the remarks of my hon. Friend the Member for Clapham (Dr. Alan Glyn), and in order to keep within the rules of order I shall speak mainly to Clause 1(1)(a) concerning the Minister's powers in connection with the provision of facilities and services.
  We must now consider the question of the provision of these services from a
  802
  positive rather than a negative point of view. When I interrupted the speech of the hon. Member for Islington, East (Mr. Fletcher) I did not mean to express disapproval of what he was saying, but we have heard so much about the undesirable features of private nursing homes, and have read about them in the Press, because such matters make news. What does not make news is the quiet, honest service which is provided in many well-regulated nursing homes. We must consider the facts of the situation and realise that in this part of our social services there is a vast gap.
  Hardly one local authority is satisfied that it is making proper provision of residential accommodation for its elderly citizens—largely for financial reasons. The provision of private nursing home facilities can be of immense benefit to certain people who, from no sense of social snobbery or superiority but simply because they are busy people, find it convenient to be able to arrange their own stay in a nursing home or hospital rather than have to fit their arrangements into the more complex machinery of a local authority hospital.
  This supplementation of our social services by qualified nurses who happen to have a small amount of capital and start up these nursing homes—ordinary nursing homes or elderly persons' homes—is a welcome feature. These homes are started up as private ventures with a view to obtaining a quite legitimate form of livelihood.
  Trouble arises from the fact that in most cases the capital available is insufficient to provide the proper service which society demands in these days. From now on we must turn our thoughts in the direction of helping people who start nursing homes, as a supplementation of our social services, instead of blasting them all round, as seems to be the present policy both in this House and also at local government level.
  The Bill, by way of the regulations and the powers it provides, will help to give local authorities more confidence in the situation. Many local authorities, while admitting that they have a problem in finding residential accommodation for the elderly people on their hands, are still not willing to provide help—and often put up every possible resistance in their power—to those who seek to establish private nursing homes. Very

  803
  often this is because they feel that they lack the proper power to provide adequate supervision, in order to see that such homes reach required standards.
  Now that they are to be given these powers, I hope that local authorities will adopt a different and less ideological point of view towards this kind of supplementation to our social services. Nevertheless, I agree with my hon. Friend the Member for Clapham that if the regulations are applied too fiercely there is some danger that we shall regulate private nursing homes out of existence. The only effect of that will be to put a still greater load upon our already overloaded National Health Service, by making it even more difficult to cope with the immense load created by the situation of elderly people at the moment. I hope that the Government will bear that point in mind in applying the regulations.
  I have one small interest in the matter. I admit to a feeling of gratitude that I have been fortunate enough, during my stay in the House, to have needed medical attention of this kind only for two days. It was then entirely thanks to the existence of a private nursing home in south London—where I was able to arrange my own times—that in the last Parliament, when majorities were somewhat tighter than they are now, I was able to finish my week in the House and be fit enough to return to the House on the following Tuesday in response to a three-line Whip. This would have been quite difficult to arrange with ordinary hospital machinery, which does not allow a person to pick and choose his times.
  Furthermore, I was agreeably surprised at being provided with an excellent service at a cost almost 50 per cent. lower than I would have had to pay for a private bed in a hospital. It is possible for these homes to provide a good service at a much lower price than is charged for a private bed in a National Health Service hospital. As far as I know, this nursing home has now gone out of existence. It happened to be sited on valuable property, and nobody could blame the owners for selling it. I do not think that it has been replaced.
  These private nursing homes can provide facilities which are of great benefit to busy people who, when suffering from minor illnesses, find it important to be
  804
  able to receive treatment without the ordinary tenor of their lives being interrupted. Such people view with some apprehension the future of these nursing homes. That is why I ask my hon. Friend if he will look at the powers in the Bill in this way, as well as in the more negative ways as he has been urged to do. The only other thing I wish to do is to echo the request which has been made that if he can my hon. Friend should in the remarks he makes give us a clearer definition of a nursing home.
  12.30 p.m.
  Mr. Dudley Smith: I hesitate, in some ways, to follow two of my hon. Friends who are both medical men, but I should like to give a welcome to the Bill. I consider it a valuable step forward. I should also like to congratulate my hon. Friend the Member for Tottenham (Mr. A. Brown), who is not in his place at the moment, on his good fortune in the Ballot and on having had an unchequered path so far in the progress of the Bill. My hon. Friend has had the unique experience of having sat on both sides of the Chamber during the present Parliament, but I think it pretty obvious that on both sides of the House there is unanimous support for the Bill. We all welcome it, irrespective of our politics.
  Many local authorities carrying out their work extremely well in respect of the administration of the registration of nursing homes. They do their work conscientiously. I know something of the work of the Middlesex County Council, which is, the second largest local authority in the country. I know that the team of its Medical Officer of Health devotes a good deal of time to the inspection of nursing homes and to seeing that they are properly and effectively run as far as legislation permits. I think, therefore, that the Bill will do a good deal to strengthen their hands and that its introduction will prove to be very useful.
  I know, on the other hand, that there are some local authorities which are not quite as efficient as some of the large county councils in the administration of the registration of nursing homes, and I wonder whether in some ways the Bill, admirable as it is, will be strong enough to enable them to tackle the

  805
  job more vigorously than they have been doing up to the present. I agree with my hon. Friend the Member for Carlisle (Dr. D. Johnson) that the Bill may well give them confidence, but had there been more teeth in it perhaps we could have looked forward to a more wholesale reappraisal of the nursing home situation.
  There are something like 1,100 nursing homes in the country at the present time, many of which do an extremely good job. Some however, do not do such a good job. I have not come here today, to use the words of my hon. Friend, "to blast them all the way round." They fulfil a most useful purpose in society. On the other hand, of course, there are the black spots. We have heard about some of them today. I was perturbed to hear the observations of the hon. Member for Islington, East (Mr. Fletcher). The case which he cited may be a particularly bad one, and I hope very much that the hon. Gentleman is going to pursue the matter in the future. I hope, too, that my hon. Friend the Parliamentary Secretary has taken due note of it. It reveals a very disquieting state of affairs. I personally have heard of cases where relatives have had extreme difficulty in visiting a patient. Sometimes, of course, it was unsuitable medically for them to do so. One cannot imagine the same state of affairs in hospitals.
  The nursing home service provides a very valuable adjunct to the hospital service, particularly in maternity cases. This relieves the hospitals very largely. The service is extremely valuable, too, in cases where it is very difficult for a prospective mother to get into hospital, unless there are special medical circumstances, after the birth of her first child. Many expectant mothers, therefore, go into a nursing home to have their second and subsequent children. In these circumstances, it is right that there should be adequate inspection of nursing homes which provide maternity services.
  I was interested in the remarks of my hon. Friend the Parliamentary Secretary during the Committee stage. He said:
  "… there is one nursing home bed to every twelve hospital beds. It is clear therefore, that nursing homes are making a substantial contribution to the care of the sick. Of the total beds in these nursing homes, 1,558 were for
  806
  maternity and the remainder for acute, chronic or geriatric cases. About 85 per cent. of the patients were of pensionable age and the majority were over 80. This indicates how important it is that there should be effective control by the registration authorities over the conditions and conduct of these homes."—[OFFICIAL REPORT, Standing Committee C, 23rd January, 1963; c. 6.]
  I welcome very much those words of my hon. Friend. I think that they add particularly to the comments made by the hon. Member for Islington, East.
  Quite obviously, nursing homes cater, to a large extent, for the elderly, and we must always bear that fact in mind. How often we have heard that nursing homes have a general air of sadness about them because the older people who inhabit them are often those who have been left without relatives or who are unwanted. They have a little money and, therefore, do not go to the old people's homes run by the State or by the local authorities. They go instead into a private nursing home. They may be in failing health but still in control of their faculties. This is sometimes a very sad thing indeed. Often, they are in the position of having no one to keep an eye on them and so they go into a nursing home. If they have a little money they are able to pay for their keep, or sometimes relatives meet the cost. In the majority of cases these people are well and kindly treated, but, unfortunately, in other cases—I have had instances of this brought to my attention—these old people are shamelessly exploited. This is a scandal in this day and age, and I hope very much that the Bill will do something to correct that trend.
  I should like to ask my hon. Friend the Parliamentary Secretary whether he is aware of the practice which has developed in the last year or two, and whether or not it is covered by the Bill, whereby people start nursing homes and then find after a while that most of their patients are old people. They then change over to becoming private welfare homes catering exclusively for the elderly and the chronic sick. As a result, they are sometimes able to charge £30 or more a week, and make a fat profit. I do not say that many of these homes are badly conducted. They seem to be forming a new stream in this section of health administration. I wonder whether my hon. Friend realises that this is going on

  807
  and whether he feels that these private welfare homes are also covered by the Bill.
  I think that the limitation of numbers referred to in Clause 1(1,b) is particularly valuable, because it prevents gross overcrowding and provides that there should be proper sanitary facilities and adequate room for beds in nursing homes. I think that nothing but good will accrue from this provision.
  Unlike my hon. Friend the Member for Carlisle, I have been unfortunate enough to have two stays in hospital during the time that I have been a Member of the House. From my experiences, I would always prefer to go into a hospital rather than into a nursing home either as a National Health patient or as a private patient. It is absolutely essential that the nursing home system should be preserved in order to take some of the burden off the National Health Service.
  Looking at the penalties provided in subsection (2), I wonder if they are heavy enough. I wonder if for
  "a first offence … a fine not exceeding five pounds"
  is really going to deter anyone set on the course of running a nursing home in order to exploit the public. I suppose that, in the long run, the best deterrent to such a practice is the resultant publicity from court proceedings as in so many criminal cases. Perhaps, therefore, the fine even though I do not think it is enough, will have something of a deterrent effect.
  I believe that the Bill will provide useful facilities for the local authorities. It will give them that added strength which they need to make their system of registration effective and to carry out regular inspections. I think that it will do a good deal to preserve what is, despite the black spots, a very valuable service. Again I commend the Bill, as so many of my hon. Friends have done, and also thank my hon. Friend the Member for Tottenham for introducing it.
  12.40 p.m.
  Mr. Charles Curran: The purpose of the Bill is to prevent the exploitation of old age. It is for that reason that I and my colleagues have been happy to support my hon. Friend the promoter of the Bill and do all that
  808
  we can to turn it into law. The fact is that this country is now facing a problem for which, I fancy, we have not made adequate provision. It is the problem caused by the rising age level of our population and the presence in our society of a larger and larger number of people who are past working age.
  This problem is accentuated by the changing family pattern. The Victorian family was a three-generation structure. The Victorian family tended to take for granted that it was the business of that stratum of the family which was in active working life to look after that stratum which had become too old for work. This family pattern has now changed. We now have the two-storey family in this country.
  This is a change which has been accentuated and speeded up by the change in the housing pattern. We have followed ever since the war a policy of building houses which are big enough to hold two generations only. It is physically not possible for the average British family to make provision for the grand-parents, and some other provision has to be made for them. Victorian England tended to take it for granted that it was the business of married couples to look after the parents. Welfare-State England on the whole does not do that, partly because it very often does not want to, and partly because it cannot do so.
  Short of some radical change in our housing policy, short of some expansion of what is regarded as a normal house so that it will be possible for the ordinary family to make provision for, and to undertake care of, that generation which has got past working age, it is necessary for the State to step in, and it is also necessary for private nursing homes to step in.
  The purpose of the private nursing home is primarily to provide a shelter, a refuge, for people who are too old to work and who are financially able to take advantage of them or whose relations are able to to make some provision for them. When the Bill was in Standing Committee my hon. Friend the Joint Parliamentary Secretary to the Ministry of Health mentioned a figure which has already been quoted in the debate and which I propose to repeat. At the end of 1961 there were, in round figures, 18,000 beds in nursing homes. No fewer than 85 per cent. of the people occupying

  809
  those beds were people of pensionable age, people too old to work. The majority of the people in nursing homes were over 80 years of age. I suggest that these figures make what we are doing abundantly plain. We are seeking to provide protection for these people, most of whom are too old to work, and the great majority of whom are over the age of 80 and who, without the protection which the Bill will give when it becomes law, are liable to exploitation.
  I am not asserting—nobody in the House would assert—that nursing homes in general are open to attack. I do not believe that anyone would assert that. I have no doubt—nor, I fancy, has anyone who has spoken in the debate—that the great majority of nursing homes are well conducted. It is a fact, nevertheless, that it is possible, as previous speakers have shown, for the occasional nursing home to exploit the old people who go there in a fashion for which at present there is no redress. The Bill therefore closes a gap which needs to be closed in the interests of people who are too old to look after themselves.
  So far from supposing that the need for the provisions of the Bill will diminish, we must take it for granted that the need for them will increase. One of the most remarkable and enduring facts about England nowadays is the steady and continuous rise in the age level of the population. I think I am accurate in saying that at present roughly one-sixth of all the voters in this country are people who have passed working age. The proportion and the numbers keep on rising. This is a process which creates in our society a larger and larger number of people who are too old to look after themselves. The business of looking after them has been disrespectfully described by one member of the medical profession as a process of medicated survival. It is a process which necessarily continues and is extending all over the country.
  I do not believe that the Welfare State has applied its mind as it ought to do to the problem that is presented by this steadily increasing number of elderly people. I do not believe that our housing policy has been shaped with this fact in mind. I do not believe that our welfare services have been organised so as to cope with this steadily multiplying number. It
  810
  is quite clear from what we have heard in the debate that the job which is now being done by nursing homes which take elderly people is a job which needs to be done by them, because it will not be done by anybody else.
  I therefore welcome the Bill. I congratulate my hon. Friend the promoter. I recognise, as we all do, that he is closing a gap which needs to be closed if elderly people are to be protected. I hope that the Bill will become law as soon as possible.
  12.46 p.m.
  Lord Balniel: I, like my hon. Friend the Member for Uxbridge (Mr. Curran), am a sponsor of the Bill, one of the six Members on this side who have sponsored it. However, I am most anxious, for obvious reasons, to turn the debate as soon as possible to another Bill which I am promoting which is, alas, rapidly disappearing over the horizon of Parliamentary life. My remarks will therefore be brief indeed.
  As a sponsor of the Bill, I feel that the great mass of us fully support my hon. Friend the Member for Uxbridge's statement that the overwhelming majority of nursing homes are conducted with the very highest standards by people who have dedicated much of their life's work to helping old people. Equally, anyone who has read "The Last Refuge", by Mr. Peter Townsend, will realise that there is a great deal still which ought to be done to improve standards. I should also like to join in the congratulations to my hon. Friend the Member for Tottenham (Mr. A. Brown) on introducing the Bill and carrying it through the House.
  12.48 p.m.
  The Joint Parliamentary Secretary to the Ministry of Health (Mr. Bernard Braine): We have had a most interesting and constructive debate. I, too, should like to join with hon. Members on both sides who have congratulated my hon. Friend the Member for Tottenham (Mr. A. Brown) on putting through thus far this very useful Measure. I must confess that I had some sympathy with him during the course of his speech, in that it is a disadvantage of our procedure that if a Bill is not debated on its Second Reading there may be a lack of understanding as to what it seeks to do when it reaches Standing Committee or even

  811
  when it is returned to the House. It is very important indeed to avoid any such misunderstanding about a Bill which, as is the case here, gives Ministers the power to make regulations. I know that my right hon. Friend the Minister of Health holds that view very strongly.
  Thanks to my hon. Friend the Member for Tottenham and to the hon. Member for St. Pancras, North (Mr. K. Robinson), who made such a useful contribution to the debate earlier today, the Bill had a swift and smooth passage in Committee. I am sure that the whole House is grateful for the very full explanation my hon. Friend the Member for Tottenham gave this morning in moving the Third Reading.
  My right hon. Friend welcomes this Bill. It is quite an important Bill in its way. It is, of course, designed primarily not to help the nursing home but to help the patient. If my hon. Friend had not had the good fortune in the Ballot and had not selected this Bill or been assisted in the way in which he has been assisted by hon. Members on both sides of the House in facilitating its passage, it would have been the Government's intention to take action in this field.
  My right hon. Friend welcomes the Bill because it enables him in respect of nursing homes to do what he already has power to do in respect of mental nursing homes and residential homes for the elderly and also for the disabled. That is to make regulations referring to their conduct, the standards of care they provide and the standards of staff whom they employ. I am very glad to know that there is broad agreement on both sides of the House that my right hon. Friend should have this power in respect of ordinary nursing homes.
  Dr. Alan Glyn: Will my hon. Friend clear up this point? Is the reason for subsection (5) of Clause 1 being in the Bill that the Minister has powers in other directions so to inspect?
  Mr. Braine: Yes. I shall later explain how the whole field is covered. In reply to the specific point raised by my hon. Friend the Member for Clapham (Dr. Alan Glyn), the effect of subsection (5) is twofold. It is, first, to exempt from the regulations which my right hon. Friend will make under the Bill, if it
  812
  becomes law, mental homes which are already covered by the equivalent provisions, partly in the Mental Health Act itself and partly under regulations already made under it—the Conduct of Mental Homes Regulations, 1962.
  The second effect of the subsection is to ensure that regulations to be made under the Bill will not apply to Christian Science nursing homes. These, as some hon. Members know, are already exempt from legislation by virtue of Section 193 of the Public Health Act and Section 247 of the Public Health (London) Act. It is clearly unreasonable to expect a registration authority or my right hon. Friend to take any responsibility for the conduct of homes run on Christian Science principles. Provision for the exemption of those homes by the Minister has existed since nursing homes were first registered. We feel—I am sure the House would agree—that it is wholly inappropriate for regulations made under this Bill to apply to those homes.
  I should say in passing that exemption is given on the advice of a special Christian Science committee, which requires applicants for exemption to undertake that only persons over 16 who wish to rely on Christian Science principles should be in those homes. I think tht there are adequate safeguards there for the individual.
  My hon. Friend the Member for Clapham asked how many nursing homes were likely to be caught by this Bill. I confirm the figures which have been given by other hon. Members. There are 1,100 nursing home in England and Wales, providing over 18,000 beds. There is one nursing home bed for every 12 hospital beds, apart from the provision for the mentally disordered. That is a very substantial contribution. It underlines what so many speeches this morning have made clear, that the private nursing homes are making a very substantial contribution to the care of the sick.
  However, as I believe my hon. Friend the Member for Uxbridge (Mr. Curran) said in his striking speech, of the total number of beds in those nursing homes between 1,500 and 1,600 are for maternity and the remainder for acute, chronic or geriatric cases. In them 85 per cent. of the patients are of pensionable age and the majority are over 80

  813
  years of age. It is quite clear that my hon. Friend was putting his finger on a major purpose of the Bill when he said that it is to prevent the exploitation of old age. We are concerned here with a particularly vulnerable group of people. On that account it is especially necessary that there should be effective control by the registration authorities in regard to the care and treatment of these patients.
  The Bill fills a gap. As the House knows, and as we have been reminded many times this morning, the Public Health Act, 1936, requires the registration with local authorities of nursing homes run for profit. It is an offence under existing law to run such a home without registration. My hon. and learned Friend the Member for Surrey, East (Mr. Doughty) asked if there was any justification for Clause 1(1,b). That goes to the whole root of the matter. I shall not stray outside the rules of order, Mr. Speaker, in view of your earlier Ruling. Suffice it to say that powers given to county councils and county borough councils and the provision for delegation to district councils for registration and inspection exempt nursing homes not run for profit, of which about 114 were exempted from these provisions.
  Incidentally, the Bill remedies that and brings them within its scope, allowing them a reasonable time before registration. All these nursing homes vary very much in size and type of case for which they provide. They range from quite small establishments, with a retired nurse caring for three or four elderly patients, to quite large institutions run on hospital lines. Whatever their size, and whatever the scope of their provision, they should be brought under effective control. In a moment I shall say why.
  My hon. and learned Friend asked why the Bill repeals Section 192 of the Public Health Act. There is no reason why non-profit-making nursing homes should be exempt from registration and inspection, especially as the best of them—and there are some very good ones—have elected voluntarily to become registered over the years. The less satisfactory compare unfavourably with a good many of the better nursing homes run for profit. The Bill will now end this anomalous situation.
  814
  The answer to my hon. and learned Friend is that as things stand my right hon. Friend has no jurisdiction over any nursing homes whatsoever. If a complaint is made to him, all he can do is to refer it to the registration authority. If the nursing home is well run, as the vast majority of them are, it matters not at all. If there are some not so well run, he still has no jurisdiction. For some time past the County Councils Association, the Association of Municipal Corporations, the Society of Medical Officers of Health and individual medical officers of health have been pressing my Department on the ground that local authorities have been finding increasing difficulty in securing the maintenance of reasonable standards in certain homes and that they need additional powers.
  The position was such that two county councils, Hertfordshire County Council and Devon County Council, were so concerned that they included provisions in local Bills. The House will find those provisions in the Hertfordshire County Council Act, 1960, and the Devon County Council Act, 1961. The Hertfordshire County Council Act includes provisions for taking power to register the proprietors of nursing homes, as to the numbers of patients, the suitability of nurses and medical staff, suitable care, suitable catering, and the keeping of records. These are regulations of a kind which my right hon. Friend will seek no doubt to introduce once this Bill becomes law.
  It may be asked why these difficulties have arisen. The answer came out very clearly in some of the speeches that we have heard this morning. There is a shortage of this type of accommodation. There is a great need for nursing home provision. True, in a glaring instance of inadequate provision, a registration authority can refuse to register or it can cancel a registration. That is a very drastic step to take. But the existing law does not provide any lesser sanction which would enable the proprietor to put his house in order before being put out of business. For this reason, local authorities have been reluctant in many cases to take enforcement action. The refusal of registration, or cancellation, penalises not merely the proprietor but, far worse, the patient who has been looking for a bed in the nursing home.
  Mr. L. M. Lever: The Minister was saying that local authorities have no power to give a proprietor an opportunity to put his house in order. May I say that in Manchester invariably in such a case before we make a final decision to refuse registration, we adjourn the application in order to give the person concerned an opportunity to put his house in order. We may give an adjournment of one, two or three months according to the exigencies of the situation. Therefore, although we can refuse to register, we have always been constructive in Manchester in trying to get the best out of these people before deciding whether to refuse registration. I thought that I should make that point clear.
  Mr. Braine: That was a most helpful intervention. I am sure that it is the practice of all enlightened local authorities to conduct their affairs in such a way—and who am I to say that Manchester is not in the front rank of such authorities? Nevertheless, the fact remains that the local authority associations and the medical officers of health, who after all are most closely concerned in seeing that proper standards are maintained, have been pressing the Ministry of Health for some time for the kind of regulations which this Bill will for the first time enable my right hon. Friend to make.
  Mr. L. M. Lever: I support the Bill and I am in favour of the regulations which this Bill will enable to be made, but without prejudice to what we have been doing so successfully in Manchester.
  Mr. Braine: I always admire the way in which the hon. Gentleman succeeds in striking a blow for his great city. I have no doubt that these things are very well organised in Manchester. But, as has been adduced in the course of the debate, there are glaring instances of local authorities which have felt unable, for one reason or another, to take appropriate action, and this is something which this Measure will remedy.
  In any event, the action by the registration authority is subject to an appeal to the magistrates' court. There has been, not unnaturally, a reluctance on the part of magistrates to deprive a proprietor of his livelihood. These factors
  816
  taken together indicate how necessary it is for my right hon. Friend to take the powers which this Bill will confer upon him. I am not saying—I do not think anyone has said in this debate—that there is widespread abuse, but clearly this is an unsatisfactory state of affairs and my hon. Friend's Bill will, as I say, provide a remedy. In short, it will close a loophole.
  My right hon. Friend already has adequate powers in respect of residential homes for the elderly and the handicapped under the National Assistance Act, and for the mentally disordered under the Mental Health Act. For example, my hon. Friend the Member for Brentford and Chiswick (Mr. D. Smith) raised a very important point about a marginal type of home which I think he described as a residential home, and I should like to say straight away that this would be caught by the regulations laid down under the National Assistance Act.
  It might be helpful at this stage if I were to attempt to answer some of the questions which have been put in the course of the debate. I am exceedingly sorry that the hon. Member for St. Pancras, North is not with us. I fully understand, as we all do, why he had to leave early in the debate. He has taken an interest in this matter for some time past. He contributed notably to our short but very interesting debate in Standing Committee and he has spoken this morning. I am, therefore, anxious to give him a reply to his questions. He asked for a definition of a nursing home. I think I can best answer that question by saying that nursing homes are covered at the moment under three Acts. A nursing home is defined in the Public Health Act, 1936, or in the corresponding Public Health (London) Act, as: "any premises used or intended to be used for the reception of, and the providing of nursing for, persons suffering from any sickness, injury, or infirmity, and includes a maternity home"—
  which is also defined in the Act—
  "but does not include … any hospital or other premises maintained or controlled by a Government department, county council … local authority … or any other authority or body constituted by special Act of Parliament or incorporated by Royal Charter."
  These are the nursing homes that we are seeking to cover by regulation under this Bill.

  817
  There are mental nursing homes already covered, subject to regulations, by the existing law. The Mental Health Act, 1959 provides for the registration of mental nursing homes under the Public Health Act. These are defined as:
  "any premises used or intended to be used for the reception of, and the provision of nursing or other medical treatment for, one or more mentally disordered patients (whether exclusively or in common with other persons)"
  subject to the exclusion of hospitals, and any other premises managed by a Government Department or provided by a local authority. The regulation-making power in this instance is contained in the Mental Health Act, 1959. Mental nursing homes, therefore, are already covered by adequate regulations which have been made by order by my right hon. Friend.
  Then we come to disabled or old persons' homes—the kind of establishment to which several of my hon. Friends, notably my hon. Friend the Member for Clapham, referred earlier. The National Assistance Act, 1948, as extended by the Mental Health Act, 1959, provides for the registration of disabled persons' or old persons' homes which are defined as:
  "any establishment the sole or main object of which is, or is held out to be, the provision of accommodation, whether for reward or not, for persons to whom Section twenty-nine of this Act applies …"—
  —that is a disabled person—
  "or for the aged, or for both."
  It also provides for the registration of residential homes for mentally disordered persons designated as:
  "an establishment the sole or main object of which is, or is held out to be, the provision of accommodation, whether for reward or not, for persons suffering from mental disorder.…"
  This category of home is covered by regulations made by my right hon. Friend; so the effect of the passage of this Bill will be to give my right hon. Friend the power to make regulations covering the whole range of these establishments. The answer to those who were doubtful about what would happen to a welfare home is it would be covered, if it would not provide nursing care, by the regulations made under the National Assistance Act.
  The hon. Member for St. Pancras, North asked whether I was satisfied that there is no serious gap. He expressed
  818
  the hope that, if there was, then at some future stage the definition of a nursing home might be amended to include all establishments where old people who are frail, confused or disabled in any way, are cared for. I have explained that there are three statutory codes for the registration of nursing and residential homes, each code defining the type of home to which it applies. I hope, therefore, that I have answered the hon. Gentleman's question.
  I understand the hon. Gentleman's fears. They are that there may be premises which ought to be registered and inspected, but which fall along the borderline between the three definitions and are not caught by any of them—rest homes; convalescent homes, not providing nursing service; nature cure homes, which do not provide conventional nursing service or treatment; guest houses; and boarding houses—where the guests are mostly infirm or bedridden but who may not be receiving nursing care.
  The hon. Gentleman's suggestion that any problem which there may be over these borderline premises might be met by having a single definition and a single system of registration for all the establishments which need to be registered, is similar to a suggestion made by the local authority associations in discussions with us over the last two years. The associations pointed out that there is increasingly an indeterminate borderline between old people's homes with a high proportion of very infirm or bedridden residents, and nursing homes with a high proportion of patients of the same kind. The associations suggested that new legislation on registration might well cover both nursing homes and residential homes.
  A similar point was made in the Report published in 1961 by Caroline Woodruffe and Peter Townsend—"Nursing homes in England and Wales. A study of public responsibility"—and in Mr. Townsend's recent book, "The Last Refuge". It is not clear that amalgamation of the systems of registration for nursing homes and residential homes would ensure that borderline homes not at present registered would become subject to that registration. The possibility of overlapping between residential homes, homes with a high proportion of bedridden residents and nursing homes with a high proportion of infirm rather

  819
  than sick patients is of limited practical consequence as long as registration is effected under the Public Health, National Assistance or Mental Health Acts.
  The home run for profit claiming to be a home for old people is almost certain to be registerable under the National Assistance Act or, if it employs nursing care, it would be caught under the Public Health Act and therefore under the regulations to be made under this Bill. I have gone into that in some detail because I recognise that there is a genuine anxiety in the minds of the hon. Member for St. Pancras and other hon. Members who have contributed to the debate.
  We have no evidence, however, that there is any serious gap between the present definitions which would allow homes which ought to be registered to escape registration. Moreover, it would be difficult, I am advised, to amend the present definitions with the object of widening them to catch more convalescent homes, or boarding houses which specialise in taking in elderly and infirm people, without there being a danger of making the definition far too wide. In short, my right hon. Friend is well aware of this point. But he does not feel that there is any present need to seek to extend the area covered by the effect of the various definitions under the present statutory codes. The object of the present Bill is to strengthen the hands of the local authorities in relation to nursing homes which are already subject to registration by enabling my right hon. Friend to confer on them by regulation powers similar to those which they already enjoy in relation to other types of homes. I hope that I have made that clear.
  I turn now to the second question asked by the hon. Member for St. Pancras, North, whether local authorities have adequate staffs for their functions of registration and inspection. The hon. Gentleman wanted to know whether existing staffs were adequate in number, qualifications and experience, and he asked for an assurance that, unless my right hon. Friend was satisfied that inspections are being properly carried out, he will see that the authorities obtain the necessary personnel to carry out inspections.
  820
  We have no reason to think that local authorities are unable properly to discharge the functions of inspection already laid on them by the Public Health Acts. Their wish to have their hands strengthened by powers such as are proposed to be conferred on them by regulations to be made under this Bill arises from the judgment of their officers who inspect at present that conditions in every case are not satisfactory. I think that this is a clear indication that the authorities have the staff which they are using to the best effect, short of the regulations which will give them more effective powers.
  I was asked by my hon. Friend the Member for Tottenham what form the regulations would take and how they will be used. A good deal of anxiety has been expressed about this, and rightly so, by a number of hon. Members. I will do my best to answer the question, I am sure, however, that the House will appreciate that it will not be possible at this stage for me to give any detailed list of matters which my right hon. Friend hopes to cover in the regulations he expects to make under the powers in Clause 1 of the Bill, for a very simple reason. It is the intention of my right hon. Friend, as the House will expect, to ascertain the views of the local authority associations and interested professional organisations, once the powers have been given to him. It is likely that the regulations will follow, in general, the lines of the National Assistance Conduct of Homes Regulations, 1962, and the Conduct of Mental Nursing Homes Regulations, 1962, and this enables me to give some sort of indication of what my right hon. Friend would probably like to see in the regulations.
  First, they will probably provide that each patient should have efficient nursing care, and for this purpose the nursing home will have to employ by day and night suitable qualified and competent staff in adequate numbers having regard to the size of the home and the number and condition of the patients received there. The regulations will probably be required to provide for each patient in the home by day and night reasonable accommodation and space having regard to the patient's age and sex and the nature and degree of the illness or disability from which he or she is suffering. They are also likely to cover the

  821
  provision of adequate and suitable furniture, bedding, curtains and, where necessary, screens and floor coverings in rooms occupied and used by patients. Appropriate and suitable medical and nursing equipment should be provided, having regard to the condition of the patients. There should be provision too for the use of patients of a sufficient number of wash-basins and baths, hot and cold water supplies, water closets, and the necessary sluicing facilities.
  The regulations would be expected to lay down certain standards of adequate light, heating and ventilation in all parts of the home occupied by the patients. There would be a requirement that all parts of the home occupied and used by the patients should be in good structural repair and should be clean and reasonably decorated. Inevitably there would be included provisions for adequate precautions against the risk of fire and accident, having regard in particular to the age and condition of the patients. This is very important when we consider the high proportion of very elderly patients one often finds in so many nursing homes.
  We should expect to see regulations to provide for efficient and suitable kitchen equipment, crockery and cutlery, together with adequate facilities for the preparation and storage of food. We should also expect provision for the supply of suitable and properly prepared food for the patients and for the regular laundering of linen and articles of clothing. It would also be expected that there would be some reference to the provision for any patient of medical and dental services under the appropriate statutes.
  One could think probably of a number of other provisions, and the hon. Member for Islington, East (Mr. Fletcher) raised a most interesting question about visiting. I think that I can say that my right hon. Friend will look at that point when he comes to make his regulations, although it may be that it can be met by means other than by inclusion in the regulations.
  Mr. Fletcher: The hon. Gentleman is giving us a long catalogue of all the regulations which he will expect to find. I certainly shall expect to find some regulations dealing with facilities for visitors to patients in nursing homes.
  Mr. Braine: Provision on that point does not exist in the regulations for the conduct of mental nursing homes where, after all, relatives also have an interest in the welfare and well-being of patients. Nor is provision for this made in respect of residential homes for the elderly and disabled. I am not saying that we will not look at the point. On the contrary, I undertake that we will. All I say is that there may be some other way of dealing with it. Normally, visiting is allowed in a nursing home in the same way as it is in a hospital but, as the hon. Member knows, there are difficulties. The governing factor must be the health of the patient and, as I think my hon. Surrey, East made clear, the decision rests not with the patient or his relatives but with the consultant, the doctor, the patient's medical advisers.
  Mr. Fletcher: I do not mind it resting with the patient's consultant or medical adviser but I would object to it resting with a matron or those who run the nursing home.
  Mr. Braine: I take the hon. Member's point. His argument this morning arose out of a particular case. Obviously I cannot comment on that case because I have not the facts at my finger tips. This is a matter which has occupied my right hon. Friend and my Department and I would not argue it on the basis of that case. I agree that there should be a definite rule about this. As the House knows, my right hon. Friend has taken the lead in trying to persuade the hospitals to provide more liberal visiting hours. This presents to even the best-run establishments some difficulty if large numbers of visitors come and stay for a long time.
  Dr. Alan Glyn: This new practice in the London hospitals has been very much appreciated by patients, although I agree that it means considerable work for the staff who, I gather, are willing to undertake it in the very genuine interest of the patients.
  Mr. Braine: I endorse what my hon. Friend has just said, and we all know that he is a medical man. I do not doubt that there is a therapeutic value to the patient in having visits from members of his family. This is a matter which must be seen in perspective. I think that all that the hon. Member for Islington, East would

  823
  expect me to do at the moment is to say that I have taken careful note of what he has said and will ask my right hon. Friend to consider the matter. I must make it plain that my right hon. Friend will not make his regulations in a vacuum. He will be taking advice from a wide variety of bodies, but this is clearly a matter which he could consider and which may well be put to him from other sources.
  There would also probably be provision that if the registration authority considered that the regulations were not being applied, it could give notice to the managers of the nursing home to that effect, specifying what it considered should be done to satisfy the regulations. If after a period of notice the regulations were not complied with, the registration authority would be able to take proceedings against the managers for an offence under the regulations.
  This brings me to the point where I was asked by several hon. Members how these powers will be used. We certainly have no reason to believe that they will be abused. Powerful testimony to that effect was given by the distinguished former Lord Mayor of Manchester, the hon. Member for Manchester, Ardwick (Mr. L. M. Lever). The registration authorities have used their existing powers fairly. I know of no case where it could be charged that they have done otherwise. My hon. Friend the Member for Clapham asked about the right of appeal. The real safeguard against abuse lies in the courts. The Bill makes appropriate provision. A proprietor of a nursing home or a maternity home has a right of appeal to the courts against the cancellation of registration.
  If the regulations to be made under the Bill provide that contravention of the regulations shall be an offence, the issue of whether a local authority has acted unreasonably in insisting upon any particular standard of accommodation or staffing—to the extent to which standards are left to the discretion of local authorities under the regulations—would also need to be decided in the courts before whom proceedings were taken. In other words, the courts will have the power, as they should, to see whether what a nursing home proprietor is required to do is fair and reasonable in all the circumstances.
  My hon. Friend the Member for Brentford and Chiswick considered that
  824
  the penalty of £5 was too low. He was referring to the provision in Clause 1 (2). But this subsection also provides that conviction for an offence against the regulations may be a cause for cancellation of registration. This is a fairly powerful sanction. It means the closing of the proprietor's business and the ending of his livelihood. The beauty of the powers which the Bill provides is that local authorities will have more than this one sanction. They will be enabled to talk to the proprietors and to help them over a period to see what can be done to raise their standards.
  It is necessary to get this matter into perspective. My hon. Friend the Member for Carlisle (Dr. D. Johnson), who spoke with personal experience of a period spent in a nursing home, reminded us that the vast majority of nursing homes provide a good and efficient standard of care. They do not present a problem. It would not be necessary for the powers given under the Bill to be applied to them. They already provide adequate standards.
  In Standing Committee, the hon. Member for St. Pancras, North referred to recent surveys of old people in nursing homes showing that on the whole the best care that is given, especially to older people, is given in voluntary homes. I agree with him. We are not, however, dealing with a static situation. What were acceptable standards a few years ago are not always acceptable today and what is acceptable today may be quite unacceptable in ten years' time. The public are becoming more aware of the need for improved standards of care. Everywhere, we see better provision for the elderly being made by local authorities, including accommodation which combines privacy with comfort and a degree of oversight by a residential warden, who often may be a trained nurse.
  One cannot yet measure the effect of what is happening all over the country in the local authority welfare field. Because there is a degree of oversight, little illnesses among elderly people are prevented from becoming big illnesses. On the other hand, as my hon. Friend the Member for Uxbridge said, the numbers of elderly people are growing all the time and will grow substantially in the next decade. The numbers of the very old and frail will grow even

  825
  more sharply. Therefore, to some extent, improved residential care for the elderly, on the one hand, may be offset by increasing numbers, on the other hand.
  The development of domiciliary services means increasing availability of nursing help to people living either in their own homes or in residential or nursing homes provided by voluntary agencies and local authorities. Here, again, is another development which is now getting under way and will lead to a higher standard of health and welfare in the community than we have hitherto had. It is not yet possible to measure what effect this will have upon nursing home provision. We are not dealing with a static situation and it is right, therefore, that local authorities, as the registration authorities, should have power to insist upon decent standards of care and staffing in nursing homes. This is what the Bill will enable them to do.
  There was one last query which was raised by my hon. and learned Friend the Member for Surrey, East which I dare not pass over. He questioned the inclusion in Clause 3(2) of the reference to Scotland. He could, of course, have added Northern Ireland, but he showed no anxiety on that score. He could not understand why the provisions of the Bill should not be extended to Scotland. As an English Minister, I hesitate to say anything on that subject. Scotland has, of course, its separate code of Public Health Acts; it always has done and probably always will. It is not possible to forecast what action may be taken in relation to nursing homes in Scotland, which, in any event, are not covered by the English Acts to which the Bill refers. That is where we must leave the matter.
  In England and Wales, however, we should seek a steady improvement in the existing standards of care in nursing homes. The Bill fills a gap and it enables us to move forward in the right direction. For these reasons, I commend it to the House.
  Mr. A. Brown: With the permission of the House—
  Mrs. Hart: No.
  Mr. Deputy-Speaker: The hon. Member can speak only by leave of the
  826
  House. I understood that I heard an objection.
  Question put and agreed to.
  Bill accordingly read the Third time and passed.

  NURSING HOMES BILL
    CORN RENTS BILL
    Not amended (in the Standing Committee), considered; read the Third Time and passed.
EMPLOYMENT OF WOMEN BILL
Not amended (in the Standing Committee), considered.
EMPLOYMENT OF WOMEN BILL

  Clause 1.—(REGULATION OF EMPLOY MENT OF WOMEN AFTER CHILDBIRTH.)
  1.38 p.m.
  Mrs. Judith Hart: I beg to move, in page 1, line 6, after, "of", to insert "married".
  Mr. Deputy-Speaker: I think that it would be convenient to the House to discuss also the two Amendments in page 2, line 5: after "State", insert "married"; and after "includes", insert "married".
  Mrs. Hart: It is logical to discuss these Amendments together. The Amendment which I have moved has important implications for a small but significant group of people who might well be adversely affected by the provisions of the Bill: that is to say, those who are unmarried mothers and who might seek employment after the birth of their babies and who might find that difficulties arise as a result of the existing provisions of the Bill. The Bill at the moment would, through regulations, restrict the employment of all. I seek by means of the Amendment to make the Bill no longer relate to the restricting of employment of unmarried women.
  The concern about the position of the unmarried mother and her child is one that is growing year by year in the country as a whole. Indeed, there has been a considerable amount of discussion recently about the increasing rate of illegitimacy and of the consequences, serious as they are, both for the babies and the mothers who are put in this most unfortunate situation. There has been much discussion of the whole issue of sexual morality, particularly among teen-agers as a result of the increasing

  827
  problem which is presented by illegitimacy and by the position of mother and baby.
  There are two aspects to our concern about the problem. One is the concern we have for the baby. The other is the concern for the mother herself. I am sure that the noble Lord the Member for Hertford (Lord Balniel) will agree with me that we should be very anxious not to place the unmarried mother in greater difficulties than she has already to face in this very difficult position in which she finds herself, and therefore the question we need to ask is whether the Bill as it stands at the moment would put more difficulties in her way. I think it would.
  The reason for my belief is the way in which employers will be liable to penalties under subsection (3), the penalties liable to be paid on conviction of
  "Any person who knowingly requires or permits any woman in his employment to work in contravention of regulations …".
  So we are here immediately concerned with what position is going to be created by the employer knowingly employing a woman who has recently had a baby. What does it mean in relation to the employer who might seek to take into his employment a woman who has recently had a baby?
  It seems to me that we have to have a pretty realistic picture of who are going to be the girls seeking to return to work before the period specified for their complete recovery. Let us look at what I think normally happens to a girl who has an illegitimate baby. Two things, I think, may happen.
  The first is that she may be within the care of her family the whole time. She may be at home, she may go into hospital to have her child and may go back home afterwards, and her own mother may help to look after her and the child; the whole unfortunate episode will be, as it were, within the protection of the family. This very often happens, and it is a good thing that it very often happens. Where it does happen we need not have any serious concern that there will be a danger of the girl seeking to go back to work before she is fit to do so. There is no reason to believe that girls in this situation will be driven back
  828
  to work too soon or are likely to be exposed to the pressures of an employer to bring them back to work too soon. In this situation no problem arises of the kind about which the noble Lord is concerned.
  The second kind of situation is a very different one. This is where the girl is no longer in her own home. For various reasons she has left home, perhaps left the very town in which she was living, and gone somewhere else to have her baby. Many of the girls come to London to have their illegitimate babies, which is why we have such a high rate of illegitimacy in London, because of the number of girls who have left their own homes and sought the anonymity of London in which to have their babies. In this situation a girl is likely to be going to a home of some kind for the unmarried mother and her child. She will be under the care of the home, she and her baby, for a considerable period of time, whatever time is specified in the regulations—six weeks. At the end of it she will seek a place to live with her baby, or have the baby adopted. In either case, she is going to need to find a new job.
  She is not likely to return to her old job, for she has left home and she will live in a new place with her illegitimate child to make a new start. She is—I believe this to be usually the case—trying to establish herself, perhaps as a widow or a divorced woman, in a respectable position in society with her child. Or if she has had the child adopted she is trying to start a new life with the past left behind her.
  In this situation she applies for a job and goes to an employer. Here we are brought immediately face to face with what the employer is likely to ask her as a result of his concern that he shall not be exposed to any prosecution under this legislation as a result of the fact that he is knowingly employing a girl who has had a baby within a fairly recent period.
  I know that the noble Lord believes that the inclusion of the word "knowingly" is adequate protection against the kind of pressures which I would imagine to exist upon the girl to give the facts about her recent past. I know, for example, that in a letter which emanated from the Joint Parliamentary Secretary to one of the organisations which have

  829
  been very much concerned about the Bill—the Six Point Group—the Parliamentary Secretary said:
  "It would be for the prosecution to show that the employer knew the woman had recently had a child, not for him to prove that he did not and could not have known. There will thus be no need at all for an employer to question his employees about their private lives to protect himself from prosecution, or for women to fear that they will be subjected to impertinent or embarrassing questions when they seek employment."
  I am sure that will be the general tenor of the Joint Parliamentary Secretary's answer when he replies to the debate.
  Lord Balniel: The hon. Lady says that this is an added protection which I am putting into the Bill. What I should like to explain is that it is not an added protection. The word "knowingly" has been in the law since 1891. I make absolutely no alteration to the law on this subject. It has existed, so far as I know, without any difficulty since 1891.
  Mrs. Hart: The noble Lord will understand that I am referring to one of the discussions in Committee and to what happened about the Offices, Shops and Railway Premises Bill. Considerable emphasis was given to the fact that to include the word "knowingly" gives protection on this particular point. Certainly it stems from the past, but, as he will remember, this point was discussed on an Amendment moved to the other Bill and it is to that Bill I am referring.
  What I am anxious about is how this will affect the employer, since the onus will be on the prosecution to establish the employer knew the girl had had a baby within the specified period of time. He will be likely to subject his potential employee to the kind of questions which might prevent the unmarried mother from making a new start. This is the point which should concern us.
  It seems to me that this is not an adequate protection for her privacy. It is not an adequate protection of her anxiety that the facts about her recent past should not be known. It seems to me more than likely, when the girl comes to ask for a job and to be interviewed as a result of an advertisement for a vacancy, and she has a gap on her insurance card, that the employer, knowing that this Bill has just come into law, knowing that the interpretation of the
  830
  word "knowingly" in a court of law may be a delicate matter, will seek to protect himself by making quite sure that he establishes the facts about his new employee who has a gap on her insurance card. He is more likely to say to her, "You do not have to tell me, but you realise that if I do not know the facts about you, it may be that I shall be involved in some legal trouble. I realise that this may be slightly embarrassing for you, but probably you have just been ill, or have been away having a holiday, or for some reason you have not been working in the last six weeks or two months, and if you can tell me why I shall feel in a safer position."
  In nine cases out of ten, the girl would say to him, "I have been living in another part of the country. I have not been working; I have been staying with relatives." Or she might say, "I deliberately took two or three months away from work in order to do something else." But in the case where this is a girl who has had an illegitimate baby, who has had it adopted, and who is now seeking to start a new life, at this point it clearly becomes pretty impossible for her, unless she lies, to establish herself in this new job.
  This is a point that is of tremendous importance. It involves a very serious principle. I do not know of any other public health legislation or of any factory legislation which seeks to inquire so personally into the private life of an individual as this provision in the Bill would seek to do.
  Mr. Harold Lever: I am beginning to feel exceedingly apprehensive as a result of my hon. Friend's closely knit argument. I should like to ask her if any of these lamentable consequences have been observed in relation to the legislation already in force on this subject. Has it produced these dire results? Have any young ladies who have had illegitimate children experienced these anxieties, difficulties and cross-examination about their previous positions, and the like? Perhaps the hon. Lady would add to my anxieties by telling me that these horrible things have occurred or lighten them by telling me that they are only hypothetical?
  Mrs. Hart: I wish that I could give my hon. Friend a satisfactory answer. At later stages of the Bill, one of my

  831
  other objections is that there is no evidence of the need for this legislation at all. There is no evidence that the question arises in practical terms about a girl going back to work too soon after having had a baby. I think that my hon. Friend's question could have been more appropriately addressed to the hon. Member for Hertford. Perhaps he can provide evidence of the number of cases in which he has known of unmarried mothers going back to work too soon after having had their babies, or say whether he has any facts at all about who are the women who have had babies who go back to work, when they go back to work, and what is the factual background of the Bill.
  I can assure my hon. Friend that, as far as I am aware, there is no evidence at all, and I hope to refer a little later to one investigation carried out within the last year or two. The noble Lord may know of a book, dealing with the subject of mothers who are working, in which the point was made that there is a lamentable dearth of any information about the number of women who are working. I cannot offer any reassurance to my hon. Friend, and all I can say is that, in the absence of any evidence, my deductions as to what is likely to happen are fairly realistic.
  The Joint Parliamentary Secretary to the Ministry of Health (Mr. Bernard Braine): I have tried to follow the hon. Lady's argument. Can she say whether there have been any instances in respect of factory employment—where, after all, these provisions have existed for a good many years, more than half a century—of undue pressure being brought to bear in this respect upon women who have had illegitimate babies?
  Mrs. Hart: With respect to the Joint Parliamentary Secretary, I would have thought that the onus of giving evidence to show the need for including the provision in the Bill was a matter for him rather than for me. It would seem to me that there is every reason to suppose that it is right that one should treat differently, in relation to employment and regulations seeking to restrict employment, unmarried mothers from mothers who have a settled home background.
  Mr. Braine: I do not think that the hon. Lady has grasped the point. What
  832
  my noble Friend is seeking to do is not to introduce anything that is frightfully new. He is hoping to introduce something that is more flexible. We have had this prohibition of work for women after childbirth being employed in factories for well over half a century. If all these fears and anxieties about the pressure which a poor girl who has had an illegitimate baby seems to be subjected to, there should be some evidence, should there not, that girls in factory employment over the last half century have been subjected to this? I wonder whether the hon. Lady could give examples of this.
  Mrs. Hart: The hon. Gentleman has not answered my point. Can the Joint Parliamentary Secretary give me any instance of any prosecutions under the old legislation in the last ten or twenty years? To the best of my belief, that legislation is dead.
  I asked the Minister this question in the House a few weeks ago: how many prosecutions there had been? He was unable to tell me and said that it was a matter for local authorities to engage in prosecution. I have consulted one or two medical officers of health and I can assure the Joint Parliamentary Secretary that the initial reaction of the medical officers of health is to say, "If you will give me an hour or two I will try to trace the particular legislation I am supposed to prosecute under." To the best of my belief, the legislation is dead, and therefore the question he has asked me is unrealistic.
  Mr. Braine: The hon. Lady is drawing entirely the wrong conclusions from the facts. The legislation is not dead. The legislation has been very effective. She cannot give any instance and she will not attempt to give any instance down the years where women have been disadvantaged as a result of factory legislation. In modern conditions it may well be argued that the four weeks' rigid prohibition which applies to factory workers ought to be varied, as I understand it would be in my hon. Friend's Bill, in order to take account of differing circumstances, differing kinds of employment, differing conditions where the mother and her child are concerned. The point, of course, is that the absence of any large number of prosecutions over the years testifies to the adequacy and

  833
  strength of the legislation rather than otherwise. If this were not the case, if the legislation to which the hon. Lady refers were a dead letter, it seems very odd that the trade unions, the T.U.C. and the Gowers Committee and all the other learned bodies and Members of Parliament—
  Mr. Deputy-Speaker (Sir William Anstruther-Gray): I do not want to be unhelpful, but I think that the House should remember that we are on Report stage and we must not proceed as if we were in Committee.
  2.0 p.m.
  Mrs. Hart: While I am grateful, Mr. Deputy-Speaker, for your protection in the debate on this Amendment, I appreciate that the Parliamentary Secretary was trying to draw attention to some of the fundamental issues involved. I shall not seek to follow him. On the question he asked me about evidence of pressure on unmarried girls as a result of this provision, I would merely ask him to appreciate that in so far as the situation in 1963 in regard to the whole field of women's employment is wholly different from that in 1891 when the first provision came into being, not only can I argue that the legislation is dead—and the Minister cannot prove me wrong because there is no way of making it susceptible to proof—but I can also maintain—and the Minister cannot dispute this—that the number of occasions on which girls seek to return to work before they are completely fit to do so is infinitesimal. Therefore, not only is there no basis for rejecting the Amendment but there is no basis for the Bill at all. That is the point at issue.
  I would argue as forcibly as I can that even those hon. Members who want the Bill, who are sufficiently enmeshed in nineteenth century ideas to believe it is necessary, should look very carefully at the fundamental point of individual freedom which arises in relation to the inclusion in legislation which is bound to involve revealing facts about personal private lives of married women and unmarried women in one "umbrella" category. There are, clearly, important and relevant differences which must be taken into account in the situation arising in relation to each of them.
  834
  I give one instance of what might happen. This is to assume that there will be a few girls who because of the force of economic circumstances—perhaps they want to keep their babies and look after them, and are finding themselves a room where they can do so, with perhaps somebody to look after the baby, such as the landlady, or there may be a day nursery close at hand—want their jobs back as soon as possible, because that is the only means by which they can support themselves and their children. In this type of case, of which there will be a limited number, it might happen that a girl would be anxious to go back to work before she was quite fit to do so. Against this has to be set the fact that because of the provision that the employer will be exposed to prosecution if he knowingly employs the girl, he is bound to subject her to questioning. I cannot see how he can avoid it. If he avoids questioning her and, therefore, can say in court, "I knew nothing about it; I did not know I was employing a girl who had recently had a baby", the whole legislation becomes absurd and there is no basis for it at all. This would bring the law into disrepute.
  If the employer is conscientious in seeking to obey the law and not knowingly permit a woman to work for him in these circumstances, he must seek to reassure himself to some degree that he is not knowingly breaking the law. In that case he is bound to expose potential employees to some degree of questioning if there seems to be any doubt about the matter. He may say, "It is all right. I can be prosecuted only if the prosecution proves that I knew the girl had had a baby. So I will not ask her anything about it, even though I suspect that she may have had a baby. Then in court I can say, 'I knew nothing about it', and the prosecution will not be able to prove that I did". That would bring the law into disrepute. It would be a matter of an employer finding a way of avoiding a successful prosecution under the Bill.
  One or other of these things is bound to happen. The noble Lord cannot have it both ways. If he includes unmarried women in his legislation at the same time as he is including a provision about an employer knowingly allowing her to work for him in these circumstances, one or other of the situations is bound to

  835
  arise. I cannot see any possible basis for this carelessness. I know haw well intentioned the noble Lord is and that he would not willingly do anything which would have an adverse effect an unmarried mothers, but there seems to be a certain degree of carelessness in seeking to deal in the same way with two situations which should be dealt with differently.
  Mrs. Patricia McLaughlin: There is one point that seems to have been forgotten, and that is that later on Report an Amendment will be moved which definitely states that if a medical certificate is provided it will not necessarily be required to state that the woman has had a child. This will be a matter for the doctor. If the doctor produces a certificate saying that the woman, having been off incapacitated, is now fit to work, this is perfectly satisfactory. This does not raise any question whatever. An unmarried mother can go with the medical certificate and there will be no further argument; the employer will be protected and there will be no discussion and no revelation of what the certificate stands for. That would be implicit. The general tone of the Bill is twentieth century, because the pressures on women are getting greater, and, whether we like it or not, we still have the old-fashioned way of having children, and so we must have some protection on that score.
  Mrs. Hart: I should be out of order if I anticipated debates on later Amendments. However, I hope to be able at a later stage fully to agree with the hon. Lady that there are tremendous economic pressures which seek to drive women back to work. The noble Lord ought to seek to deal with the economic pressure and not purely to introduce restrictive legislation which takes no account of the economic factors which are the only reality of the situation.
  As to the point about he medical certificate, this is anticipating a later Amendment, and I do not, therefore, seek to answer it in detail. I would merely say that if the situation which the noble Lord is envisaging as a result of his Amendment is that of a woman who has been away from work, either because she has been ill or because she has been having a baby, and is eligible for adequate insurance benefits or paid
  836
  leave while away from work, and returns to work with a medical certificate, there is no need for the Bill at all.
  The implications of the question with regard to the unmarried mother are very serious. It must be recognised that to the extent that it is made more difficult for an unmarried mother to start life again with her child there will be an increase in illegal abortion. That is indisputable. There are two ways of dealing with this immense and worrying problem of the increase in illegal abortion. One is to make abortion legal. The other is to make it more socially acceptable for the unmarried mother and her child to take their place in society. One or the other method must be adopted.
  I suggest that if the Bill treats the unmarried mother in the same way as the married woman with her settled home and family and does not take account of the special difficulties that face the girl with an illegitimate child, it will be one more thing which will tend to increase the chances that a girl will try to have an abortion rather than have her child.
  I hope that the noble Lord will regard this as a perfectly genuine Amendment which seeks to improve this Bill by eliminating one of the dangers that might result. I urge him to accept this improvement to the Clause.
  Mr. Charles Curran: The hon. Lady the Member for Lanark (Mrs. Hart) has made a most persuasive case for the Amendment. It is a case which must be answered. But, having listened to her with great interest, I believe that while the purpose of the Amendment is reasonable she has not gone far enough. I follow her argument about the differential handicap imposed upon unmarried women unless we give them the protection she urges. But she should have gone a good deal further. She should have faced the basic question posed by this Clause. How far is it the business of the Ministry or of anybody in this century to make regulations restricting the employment of women? That is the key question.
  As the hon. Lady suggests, the Amendment would go a small way towards removing one disadvantage from the great area of disadvantages created by the Bill. But it is idle to discuss

  837
  this question in isolation from the general issues raised by the Clause. As things stand, we have the practice, dating from the 1890s, of making regulations for the purpose of preventing women who have had children from going back to work in certain jobs. As my noble Friend has pointed out, this Bill derives from 1891.
  My noble Friend is entitled to argue that what he is doing is not to impose fresh liabilities on women but to accept the protection that some classes of women have been given and extend it to others. But to discuss the Bill on that basis, or to defend it on that basis, is unreal. It does not take account of contemporary conditions.
  In the British labour market today, two thirds of the people are women—eight million of them. It was very different in 1891. Roughly half of these women are married. Thus, when legislating about the employment of women, whether married or unmarried, I do not think that it gets us very far to base ourselves on the background of 1891. We must base ourselves on the contemporary scene and accept that more and more women go to work and that we have to look very narrowly at any Bill which seeks to restrict their access to the labour market, however well intentioned the attempt to impose these restrictions.
  We must decide what our first principles are to be. Are we to base ourselves on any assumptions, tacit or implicit, that women, because they are women, must have imposed on them by law restraints in the labour market which do not apply to men? This Bill would impose restraints, although with the best intentions. In a free society we have not the right to impose restraints upon women because of their sex, no matter what motives may animate us in seeking so to do.
  There is very little need—indeed I can see no need—in the labour market at present for the passing of laws restricting the access of women. It seems to me that the normal mechanisms of the labour market will give them any protection they need. There is no need for us to pass a law forbidding the employment of women as weight lifters any more than there is need for us to forbid the employment of men as nursemaids. The normal processes of selection in the
  838
  labour market will look after that. There is not the smallest necessity for this House to create artificial restraints where the normal processes will provide all the protection that is needed.
  We have to consider whether or not we believe in sex equality. This House would not dream of passing a law to say that when a man has been in hospital for an operation he should not be permitted to go back to work for a specified time. No one would say that after emerging from hospital he should be restricted from returning to work when he feels like it. The question that my noble Friend must answer is why he thinks it necessary in the 1960s to legislate for women as such.
  2.15 p.m.
  Lord Balniel: The discretion as to when a mother returns to work after her baby rests, under my Bill, solely in the hands of herself and her doctor. No restriction at all will be placed on the mother.
  Mr. Curran: I do not think that my noble Friend meets the point. The Clause asserts that
  "Any person who knowingly requires or permits any woman in his employment to work in contravention of regulations under this section shall be liable on summary conviction to a fine not exceeding sixty pounds."
  Why should there be regulations at all? Why make any regulations? It can be argued that there is need for them. But the burden of proof rests upon those who suggest that there is need. I am not satisfied that the burden of proof has been discharged so far.
  Mr. Deputy-Speaker: Order. I hope that the hon. Gentleman will bear in mind that we are discussing three Amendments—whether or not to insert the word "married". That is the detail upon which which we are engaged.
  Mr. Curran: I quite agree, Mr. Deputy-Speaker. Perhaps I missed my way. But I am certain that the question raised by the Amendment is one that goes further than the alteration proposed by the hon. Lady.
  Mrs. Hart: To the extent that there is a need for regulations at all, and only to that extent and within that context, one can discuss what one needs to do about married, as opposed to unmarried, women.
  Mr. Curran: I appreciate that. The hon. Lady is supporting my argument that we must consider whether we are discussing the position of married women or of unmarried mothers. We must ask ourselves what our assumptions are. There is a strong case for saying in the 1960s that we should leave these matters to be settled by the woman through her own decision as to when she is to go back to work. We do not impose such a restraint on men who have been in hospital. I do not see why we should impose it on women. I suggest that the whole approach of the Bill is wrong.
  Mr. Deputy-Speaker: Order. That is just what the hon. Gentleman should not do. He should not suggest anything about the whole approach of the Bill. These three Amendments deal with the same narrow point.
  Mr. Curran: I quite agree, Mr. Deputy-Speaker. But I point out that the Clause and the Amendments derive from the approach which the Bill makes, and I am looking at the Amendments against the assumptions on which they are based—assumptions which I want to challenge. No case has been made for imposing restraints, either upon married or unmarried mothers, of the kind that this Clause suggests. I hope that the House will not accept the Clause.
  Mr. H. Lever: The resentful feminism of my hon. Friend the Member for Lanark (Mrs. Hart) and the uncompromising Manchester liberalism of the hon. Member for Uxbridge (Mr. Curran) smell more of the nineteenth century than of the mid-twentieth century. One might say that this resentful feminism and Manchester liberalism make surprising bed fellows, especially in a context of illegitimate births. Perhaps it will give those who take my hon. Friend's view on this matter pause to think when, as must inevitably happen in the near future, a Labour Government comes into office and gives effect, or attempts to give effect to the international convention on this subject, and the economic requirements for which my hon. Friend has justly argued, although slightly out of order, are incorporated, from the Opposition Benches, opposing not this but the much more enlightened Bill which the Labour Government would bring in and which would give effect to the international con-
  840
  vention, will be heard the very arguments which my hon. Friend has just addressed to the House.
  Every argument which my hon. Friend has directed against the noble Lord's Bill would be equally effective in opposing that Bill, including the Clauses recommended by the International Labour Office which my hon. Friend the Member for Lanark has so warmly supported from time to time. My hon. Friend might be the Minister in charge of such a humane Measure under a Labour Government. We might hear her own words thrown back at her. She might be told that she was proposing further illegal abortions among unmarried mothers. The argument used by my hon. Friend was rather horrifying hyperbole. Are we really to suppose that there is liable to be an increase in illegal abortions because young ladies will be afraid of meeting an exacting cross-examination when they return to work at their places of employment?
  Mr. Curran: I do not want to intervene in the private debating match which the hon. Member for Manchester, Cheetham (Mr. H. Lever) wants to start with his hon. Friend the Member for Lanark (Mrs. Hart). When he accuses her of obstinate feminism and me of moth-eaten Manchesterism, or whatever his phrase was, I ask him to consider the friends and allies and colleagues who think with the hon. Lady and who have their criticisms of the Clause. To start with, we have the support of the National Council of Women.
  Mr. Deputy-Speaker: The hon. Member for Uxbridge (Mr. Curran) is quite out of order on more than one count.
  Mr. Lever: I am perfectly well aware that when one takes up a matter of this kind one is at best floating a frail raft of masculine rationality upon the turbulent sea of feminine prejudice, and I am therefore not in the least surprised to find that the National Council of Women supports the argument which my hon. Friend has put to the House; but if the hon. Member for Uxbridge will contain his soul in patience, I will elaborate upon my criticism of his contribution. I want, first, to warn my hon. Friend of mixing in dangerous company, because her arguments will defeat the very purpose which she so cordially supports.
  Mrs. Hart: I fail to see the logic of my hon. Friend's argument that if one provides paid leave and increased benefits for women having babies, whether married or unmarried, that will lead to an increase in difficulties for the unmarried mother that result from pure prohibition, as in the Bill.
  Mr. Lever: If an employer were prohibited from employing people too soon after they had had a baby because State assistance was provided to the unmarried mother, which is what my hon. Friend has urged, the unmarried mother would be liable to precisely the same cross-examination as would result from the Bill. What I am arguing is that the Bill does not provide any of the social welfare financial benefits which my hon. Friend desires, but that if they were added to the Bill that would not make the slightest difference to the narrow point which we are now discussing.
  Mr. Deputy-Speaker: I wander whether the hon. Member for Manchester, Cheetham (Mr. H. Lever) would explain how these benefits could possibly be added to the Bill while we are discussing three Amendments dealing with the one restricted point.
  Mr. Lever: May I respectfully submit that I am perfectly in order. The argument has ranged thus: my hon. Friend has said that the Clause as it stands cannot be accepted and that we must protect the unmarried mother, and that is what the Amendment is about; she said that if we did not protect the unmarried mother by accepting the Amendment we would get a frightful increase in the already appalling level of illegal abortions. What I am pointing out to my hon. Friend is that even if we had these wonderful financial provisions, the argument would still be maintainable by someone moving a similar Amendment to a slightly different Bill containing a similar Clause but complying with the provisions which my hon. Friend now wishes to incorporate. I also think that my hon. Friend is mistaken in supposing that the Bill must result in detailed cross-examination or become a dead letter and an insult to our law, as it were. There are many in-between situations.
  Pregnancy is not altogether unobservable in employees, and if one
  842
  wanted to sustain a charge against an employer of employing a woman within a month of her giving birth to a baby, one of the matters which might come into the consideration would be whether the lady had worked more for an employer during her period of pregnancy so that the employer knew that she took time off not because of toothache but in order to be delivered of a baby.
  Mrs. Hart: The essential point about the girl with the illegitimate baby is that she seeks to go to a new place of work and not to the old place; so that the question of her pregnancy does not arise.
  Mr. Lever: My hon. Friend has alleged that the Amendment is necessary to protect the woman against searching cross-examination; when it is suggested that there will not be any searching cross-examination of a female employee, she says that the law must be a dead letter. I am giving her an example in which it would not be a dead letter. It is the example of someone who had worked for an employer and who had gone back to the same place of employment after she had had her baby. If she came back within a month of having the baby, a prosecution would be sustainable on evidence that the lady had worked at the factory up to 31st January, say, had been away for a fortnight to have a baby and had then resumed employment. The case would rest on the fact that pregnancy is observable in its ninth month to most human eyes and in most individual cases. Consequently the law would not be a dead letter.
  For any young lady whose pregnancy was observable and whose failure to attain the married state had been noted in the factory, the place she came back to would be precisely the place of employment where, as it were, she had made peace with her reputation. If she had gone on working, as many unmarried mothers do, in a factory or in some other normal place of employment—and this happens in very exalted employment these days and it is probably just as well—the unmarried mother-to-be who continued to work in her employment—and it is difficult to get new employment when one is pregnant—would have to continue where she had been working and where her pregnancy would have been perfectly observable by the employer and the

  843
  employees. When she went off to have her baby, that fact would inevitably be known to the employer.
  Leaving aside the fact that most employers do not deliberately wish to break the law and hence would wish to observe such a law if it were brought into being, any employer who employed a female employee who went off to have a baby and who returned a fortnight later would be bound at law to risk of prosecution if the Bill were carried into law.
  Accordingly, I do not think that my hon. Friend has made her case, that there must either be a fabulous cross-examination of unmarried mothers or the law will fall into disrepute and disuse. I am confirmed in that view by my knowledge of factory conditions in the mid-twentieth century and by the fact that no such complaint has been raised in relation to existing legislation and by the fact that my hon. Friend and those who hold her view of the Bill are very anxious to have the Bill, with all its terrifying implications, provided that they can get some other irrelevant—irrelevant to this issue—if desirable benefits. In all the circumstances. I am bound to reject by hon. Friend's attempt to make my flesh creep and I consider that her case against the Clause and for the Amendment fails.
  2.30 p.m.
  The hon. Member for Uxbridge must not distort the reality of the situation. The arguments that he was addressing to the House were confidently and self-righteously addressed to the House of Commons in the last century every time an effort was made to improve working conditions for anybody. Every time an effort was made to save young children being driven to the pits at an early age, people with views similar to those held by the hon. Gentleman self-righteously defended the right to exploit these children by saying that they had the same right of access to the labour market as anybody else, and why should the House of Commons or anybody else intimidate their parents by threatening them with fines and imprisonment if they sent their children to work at a tender age?
  Mr. Curran: By using that illustration the hon. Gentleman is giving away his case. He is asserting that we have to
  844
  treat everyone as though they were children. I am asserting that we should consider this problem from the point of view of adults having access to the labour market.
  Mr. Lever: I am saying that the arguments which the hon. Gentleman used today were similar to those used in the last century to oppose every form of social advance. I am not an expert on the subject, but regulations have been made to keep women out of certain dangerous occupations. The hon. Gentleman may be unable to recognise any distinction between male and female in industrial employment, or in human capacity, or even in physiological weaknesses but the law has recognised it, and I suspect that most sensible people also have recognised that there is a difference between male and female in the capacity to endure certain industrial conditions.
  The hon. Gentleman will fairly say to the House that we should leave it to the market; that, after all, the market can deal with these things. But if the market is able effectively to deal with these things, we shall not do any harm by reinforcing the market by stating what is the national conscience in a Statute and making it illegal for those who are not curbed by the market to be curbed by law. The hon. Gentleman is defeating his own argument. If the market will prevent women going back to work too soon after childbirth in accordance with the objective standard which we might expect from the Minister, then no woman will lose any of the precious liberty which the hon. Gentleman is busy defending by reason of the Bill because she will not go back to work anyway. The market will see that she does not have access to work prematurely and the Bill will merely be declaratory of the consequences of the market.
  Mr. Curran: The hon. Gentleman is not discussing this Bill at all if he is using that line of reasoning, because the Clause imposes on employers of women certain penalties which it would not impose if women were not being employed. How can he say that the market mechanism will do that, if we are interfering with it in the Bill he is supporting.
  Mr. Lever: The hon. Gentleman must make up his mind. The market

  845
  mechanism in the mid-twentieth century is such that it would not bring pressure to bear on women to go back to work prematurely. If that be so, then any law we pass preventing women from going back to work prematurely would merely be declaratory of what would be the effect of the market. If the market does not prevent women from going back to work prematurely after childbirth, surely we stand in need of precisely the interference with the market which the Bill proposes to introduce?
  The Bill is harmless if it declares in law what would be the result of market forces. It is not interfering with anybody's freedom. On the other hand, if market forces allow women to go back prematurely then it is time the market forces were interfered with in the manner intended by the Bill, precisely in the way in which men and women of good will throughout the world intend to interfere with market forces, as evidenced by the International Labour Organisation on the subject, and precisely in the way in which the market is interfered with in almost every civilised country in the world.
  I beg my hon. Friend not to support an argument as reactionary as that adopted by the hon. Member for Uxbridge. My hon. Friend should see the error of her ways. Whatever the merits of the Bill as a whole, I beg her not to put forward arguments of the kind she has done, nor to support the arguments adduced by the hon. Gentleman, that the Bill proposes to impose restraints on women, that it proposes to impose unfair disadvantages on women, and so on. The Bill does not make women pregnant, and it does not bring about the physical disadvantage that results from delivering a child. This is due to providence and to the structure of the human female.
  Mr. Speaker: Order. I have only just returned to the Chair and I am somewhat puzzled to relate the hon. Gentleman's observations to these Amendments to which they must be confined.
  Mr. Lever: I do not dispute that in the course of endeavouring to reach a suitable peroration I have strayed slightly from the strict words of the Amendment.
  Mr. Speaker: I should much dislike to do anything to interrupt that.
  Mr. Lever: I shall bring my argument to a close. The two arguments are purely reactionary. There is the argument of the feminist mind and the argument of the excessively Manchester nineteenth century liberal mind. Whatever the House does with the Bill as a whole, I beg hon. Members not to accept either of the arguments advanced against the Clause.
  Miss Joan Vickers: I had not intended to take part in this discussion, because I have a later Amendment on the Notice Paper. It is a stronger Amendment than the one under discussion, but I intervene because of what was said by the hon. Member for Manchester, Cheetham (Mr. H. Lever) about feminism and what might happen if his party came to power.
  I thought that in these days feminism was as dead as the other things suggested by the hon. Gentleman. We are not doing this as feminists but purely on the basis that women should have an equal right to work as and when they think right, and that is why the Amendment was put forward by the hon. Member for Lanark (Mrs. Hart).
  If the hon. Gentleman and his party come to power I hope that it will have a forward look at the question of employing unmarried women, because there is the new international convention on maternity which proposes to give leave of absence in connection with childbirth, based upon a certificate of incapacity for her work given to her by her doctor, and we are working towards this. It is for this reason that I support not the Amendment but the general purpose of the hon. Lady, and it is the reason why I do not like the Bill as it stands.
  This is going back to the ancient legislation mentioned by my hon. Friend the Member for Uxbridge (Mr. Curran). We are looking forward to the new type of international convention which I think will be very much preferable to having these selective Bills—
  Mr. Speaker: Order. As far as I can see, all these benefits would be the same whether or not these Amendments were accepted. It is the issues arising on the Amendments that we can discuss now.
  Mrs. McLaughlin: I recognise that it is difficult to deploy all the arguments

  847
  affecting the Amendments and keep within the terms of your Ruling, but I shall do my best, and as briefly as possible.
  The arguments which have been put forward from both sides of the House have been put forward with the idea that everything affecting women's rights and women's right to be equal in every sense is paramount. This is one of the difficulties in discussing the Amendment, because whereas we want to recognise equality in every sense, there are some things in which both sexes cannot be equal, and there are certain times when we have to recognise that there are special circumstances which apply to one sex, and the Amendments endeavour to prevent the special circumstances pertaining to this Bill. The hon. Member for Lanark (Mrs. Hart) has put forward an able argument for virtually altering and preventing the passage of the Bill by tabling so many Amendments, the first of which we are discussing.
  Mrs. Hart: Surely the hon. Lady must recognise that it is the duty of every hon. Member to try to improve Bills if they seem to be in need of improvement? If a Bill needs improving, that is not the fault of hon. Members on this side of the House.
  Mrs. McLaughlin: That is just the point that I am coming to. I am certain that the hon. Lady is endeavouring to improve the Bill, but I am equally certain that this Amendment will not do so. Let us take, first, the case of the unmarried mother, about which the hon. Lady made such a powerful argument. There has been a great deal of concentration upon the problem of the unmarried mother and her child. Many organisations endeavour to look after both, and in all those organisations we find that the endeavour is to keep the mother and child together as much as possible until such time as the mother, thinking calmly and carefully, is able to decide whether she wants to keep her child or to have it adopted.
  There is no question of rushing through this process in a couple of weeks, or even six weeks. All the societies involved in helping women in this way are anxious that they must have time to be able to arrive at a true decision for themselves. Many pressures are put upon
  848
  a woman to go back to work as early as possible, and the period of six weeks is the period recommended by the medical profession as being the shortest period after childbirth before which a woman can be examined in order to determine whether she is properly fit to return to work. Not many medical practitioners would wish that time to be shortened.
  When we are discussing the problem of equality, and the rights of women, we must remember that there are different aspects of these rights. I am anxious that we should not forget that when we are dealing with married women the question is not so difficult. We must try to prevent unmarried women being discriminated against, but we must take into account the fact that the physiological condition of all women, married or unmarried will be the same, in the question of having a child.
  The future of the child is very important. If the Amendment were accepted I feel that it would help to force the separation of the mother and the child before the mother was in a fit mental state to make a final decision upon the child's future. In trying to avoid the creation of special protective legislation we must ensure that we are not sweeping away some protections which already exist.
  It is difficult for anyone to say what will happen if access to the labour market is changed. At the moment heavy pressures are put on women to return to work as quickly as possible after childbirth. Many employees are almost forced back because they are skilled or key people, and their employers do not want to have to take on someone else and train them, or to do without their former employees longer than is absolutely necessary. This situation applies to all sorts of work, whether it be manual, skilled, or purely intellectual. We cannot get away from the fact that these pressures do exist today.
  I know personally two or three women who have gone back to work sooner than they should have done. If they had waited for a few months they would have realised that it would have been wrong to go back earlier, because they would have known that they were not then completely fit, and able to say,

  849
  "I am now in a position to go back to work, because I feel utterly well." A woman may feel absolutely well and able to return to her past business life, but she may soon find that the work is a little harder than she expected, whereas if she had waited a few more weeks and relaxed completely, and taken up her previous occupation without any haste, and quite normally, she would have been much healthier.
  If the Amendment were carried it would act to the detriment of the unmarried mother more than anyone else. It would make certain that one type of mother was different from another. Society now tries to help the unmarried mother to fulfil her job as a mother as well as possible, and to do what she can for her child. If the Amendment were accepted it would mean that only those women with the word "Mrs." before their names would derive benefit from the Bill. It is quite easy for a woman to change her name by deed poll and become a "Mrs.", and to have her insurance cards altered, and so on. That would defeat the purpose of the Amendment.
  Mrs. Hart: That would be quite all right, because the woman would not then be placed in the position of an unmarried mother, with no protection and no status. If she were accepted as a "Mrs." everything would be all right.
  2.45 p.m.
  Mrs. McLaughlin: Then there is no reason for the Amendment. The majority of unmarried mothers who decide to keep their children take on the honorary title of "Mrs.", and there would appear to be no real reason for the Amendment.
  Mr. Braine: But would it be all right? Is not there a second party to be considered—the child? Would my hon. Friend like to develop that argument?
  Mrs. McLaughlin: I am grateful to my hon. Friend. I have not yet had sufficient time to develop my argument about the future of the child, but I shall move on to that as quickly as possible.
  The child has its place in the community, and it has its rights. I believe that there is no such thing as an illegitimate child; there are only
  850
  illegitimate parents. The concern of this House must be to see that no unnecessary difficulties are placed in the way of the child's happiness in life if it is born outside wedlock. The whole object today is to allow such a child to develop as naturally as possible. The child should have some say in what its future will be. It cannot do this for itself, so we, in Parliament, together with other authorities, have to act for it, and decide whether it should stay with its mother or be separated from her. I should be out of order in discussing the economic aspects of the matter, which are outside the terms of reference of the Bill. They are matters for the Ministry of Health. But I am convinced that our object should be to endeavour to allow the natural relationship of mother and child to exist in this modern society and that childbirth should not be regarded as something for a mother to take in her stride and then, after two or three weeks, when she is positive that she is better, to rush back to work. This may be all right for some married women in industry and professional life, but it may be a very different matter for the much smaller number of unmarried mothers in the same category.
  The whole problem comes back to the child. If the child is to have a fair start in life its mother should not be anxiety-ridden from the time the child is born; she should not be worrying all the time how quickly she should return to work. We must try to create a climate of opinion and practice which says that whether a child is born at home or not, the mother should have six weeks in which to devote her attention to bringing the child forward into a healthy and satisfactory life. For at least that period she should not be subjected to undue outside pressures.
  If she happens to be a woman whose physiological condition enables her to take childbirth fairly lightly, she and her medical adviser have the right to decide between them that she can return to work earlier. Furthermore, if the child should be stillborn, or so badly deformed that it has to be taken away from the mother and put into hospital, her medical adviser can help her to decide when to return to work. No one else should have the right to do so.

  851
  The hon. Lady talked about the nineteenth century. This is the twentieth century, and the faster and more rapidly children are forced into an unnatural relationship, in the modern, high pressure world in which we live, the more difficult it is for them to develop as stable citizens. It would be wrong to accept the Amendment, because the Bill does not seek to put women back into the nineteenth century; it merely seeks to provide that on one occasion when a woman cannot be equal to a man—during the period when she produces a child—there should be a little oasis of time in which she is free, by right, not to be forced to return to work by her employer. Women should have the opportunity to regain their health without outside pressures. Whether it be the nineteenth, the twentieth or the twenty-first century, as far as we can see this provision will become increasingly and not less necessary.
  Mr. Richard Marsh: The hon. Lady the Member for Belfast, West (Mrs. McLaughlin) made the point that we did not live in the nineteenth century. I should have thought from her speech, when she spoke of nineteenth century paternalism and of women having babies, that that was something which the House would applaud. The hon. Lady said that no woman should be forced against her will to go back to work when she wants time to look round. The whole objection that some have to this part of the Bill is precisely that it takes the ability to make the decision out of the woman's hands and says that we in Parliament shall decide whether a woman can be employed within a period of six weeks after the birth of her baby.
  This Amendment dealing with the unmarried mother is an important one. It is not an argument about equality, about women's rights. It is an argument about the specific inequalities between unmarried and married mothers, and those inequalities are primarily economic. One of the big factors in determining whether the unmarried mother keeps her child or not is her ability to produce the economic wherewithal to keep it. To say that for six weeks an unmarried mother cannot work is to increase the economic difficulties with which she is faced.
  852
  The other factor to which I object is this. I note that my hon. Friend the Member for Manchester, Cheetham (Mr. H. Lever) is rumbling away.
  Mr. H. Lever: The same argument would surely apply to any other regulation for the protection of ill people or women in factories, that it reduces their ability to earn, and if there happened to be unmarried mothers in the cases we are discussing it would reduce the possibility of their earning money for their children.
  Mr. Marsh: I should have thought that many people, including my hon. Friend, would now accept that there is at least a difference between a woman having a baby and a woman having an injury, certainly over a period of six weeks. What we are asking is that the unmarried mother shall not be forced into a position where she cannot earn a living for a period of six weeks in the event of this Bill becoming law.
  But there is another factor, a very real factor, and that is that it makes it an offence for an employer knowingly to employ a woman who does not—the noble Lord looks worried—
  Lord Balniel: I am staggered by the hon. Gentleman's argument. I have here a copy of a part of the Bill which the hon. Gentleman introduced and which has commanded universal support of the Conservative benches, the Opposition benches and the Liberal benches. The Bill was introduced only three years ago and it contains the following words:
  "The Secretary of State may provide by regulations for restricting the employment of women in offices after childbirth."
  There is no discrimination there at all between the married and the unmarried woman.
  Mr. Marsh: The noble Lord has made a perfectly fair point, and my only answer to it is that these matters were not made with the crystal clear clarity on that occasion with which my hon. Friend has made them this afternoon. I would also make the point that that passage was included subsequent to the drafting of that Bill, but that I did not draft it, that it was not in the original Bill, and that, subsequently, an Amendment was included with the support of hon. Members on both sides of the House.

  853
  However, whatever has happened—and I accept responsibility for it—the position of the unmarried mother is, I think, a very real one, and a very different one. It places upon the employer the task of establishing whether any member of his female staff has just had a baby or has not. Whatever one says, the position in relation to unmarried mothers ought to be, and I should have thought—[Interruption.] Of course they are different standards, different conditions. I wish that unmarried mothers were treated in the same way as married mothers, but they are not.
  It is not only embarrassing but it can be a serious handicap to an unmarried mother for it to be known that she is, in fact, an unmarried mother. It can equally be a handicap to the child in these circumstances. A Bill which makes it an offence for an employer knowingly to employ a woman who has had a baby within a period of six weeks and which forces the woman to make the fact known to her employer, especially in a small town, is not in the mother's interest.
  Mr. Braine: I am grateful to the hon. Gentleman for giving way, but for the sake of clarity could he pursue the matter a little further? He is aware, of course, that these restrictions have obtained in regard to factory employment for a very long time, that is to say, in respect of married and unmarried women. Is the hon. Gentleman arguing that the protection given to all women under factory legislation should be repealed?
  Mr. Marsh: There is a difference, I should have thought, between the employment of women in manual occupations and their employment in completely non-manual occupations.
  Mr. Braine: If there is no evidence that women who have had illegitimate babies have been placed under any undue pressure as a result of the factory legislation, what is the argument for saying that this will happen in other forms of employment, especially when the Bill provides additional safeguards in respect of the doctor's certificate?
  Mr. Marsh: If the hon. Gentleman really believes that it is no embarrassment and no inconvenience for an unmarried mother, for example, in a small town, to be forced by law to declare to her employer that she had a baby within the last six weeks—
  Lord Balniel: That is not the case.
  Mr. Braine: I must apologise for interrupting the hon. Gentleman once again, but there is no evidence that such a woman is so forced under present circumstances, and my point is that if this does not happen in factories, why should it happen, and how will it happen, in respect of other forms of employment?
  Mr. Marsh: Because it is impossible for an employer to operate an Act which says that a woman should not be employed for a period of six weeks unless he knows that she is pregnant or has had a baby.
  3.0 p.m.
  Mrs. Hart: May I intervene in my hon. Friend's argument to put this point to him? The Bill insists that prosecutions will be made against an employer who knowingly permits a woman to be employed? In a letter the Joint Parliamentary Secretary wrote to a member of a woman's organisation, he insisted that the onus of proof will be on the prosecution, which is clearly unrealistic, unless one is to accept the idea that the employer will conscientiously have sought to observe the law by not knowingly having employed the woman. There is the additional point, which the noble Lord and the Joint Parliamentary Secretary seem determined to ignore, that since it is a reasonable assumption that married mothers and unmarried mothers should be treated differently, because they have different problems, the onus of proof is on the Joint Parliamentary Secretary to show that in this instance they should be treated in the same way.
  Mr. Marsh: I am grateful to my hon. Friend. The difference between those who are in favour of the Amendment and those who are not is, as I understand it, that hon. Ladies and hon. Gentlemen who are against the Amendment do not draw a distinction between the unmarried mother and the married mother.
  Mr. H. Lever: In terms of the protection they get.
  Mr. Marsh: The protection which they get and the effect of the Bill upon them is in many cases conditional upon their different status. There is a difference

  855
  here. There is an economic difference and there is a social difference. I very much wish that there were not. There is no point in us continuing to argue this point, because we clearly disagree on this. I feel strongly that the unmarried mother cannot be treated in the same way in relation to the Bill as the married mother can be treated, because the unmarried mother in the society in which we live is treated very differently from the married mother.
  Mr. A. P. Costain: What is the hon. Gentleman's attitude to a divorced woman and a widow?
  Mr. Marsh: It is clear that there is no point of contact between us. I am not criticising. The married woman has in almost every case her husband's income. An unmarried mother has no other source of income. She is suddenly faced with considerable economic pressure which frequently leaves her with only one method of meeting her commitments—by doing the very thing which the hon. Lady the Member for Belfast, West (Mrs. McLaughlin) would not want her to do, passing the baby over to someone else. She has not the wherewithal to keep the baby. There are plenty of married women with babies who have perfectly happy family lives and perfectly happy children who go out to work. The economic pressures on the unmarried mother to go out to work are very real. Anything which alleviated those pressures, if she wishes and if she is able, is in her interests and is very much in the baby's interests.
  Mrs. McLaughlin: The point I should like to ask the hon. Gentleman to reiterate is this. Is he satisfied that the present legislation, which restricts the employment of women—it does not state whether married or unmarried—in factories has worked against the unmarried woman? Would he not agree with me that in fact this has built up in factories a climate of opinion and a climate of practice whereby it is automatic that one expects a woman to be away for the period permitted under the Regulations and that in fact that happens? This is what will happen with this Bill. In a very short time, if the Bill becomes law, it will be accepted that six weeks is the time. There will
  856
  not be any argument. Those who wish to do so and who are fit to do so will go back earlier. At the moment there is no means of forcing a woman to return earlier to a factory than the permitted time.
  Mr. Marsh: It is very difficult to force a person back to work in these circumstances. This Section of the Factories Act is completely dead. I know of no evidence that this Section of the Factories Act is at any time operative.
  Mr. H. Lever: All the time.
  Mr. Marsh: I would be interested to know how many prosecutions have been brought under this Section of the Act in the last ten years. I should be surprised to find that there were any. The point is clear. There is a difference between us on this Amendment. It is a fundamental difference. Both sides feel strongly about it. It is a view which can easily be resolved. If we try to persuade ourselves that the unmarried mother and the married mother are equal and do not have different problems, we are living in a world which bears little relation to reality.
  Lord Balniel: With this Amendment we come to the first of about forty Amendments which have been tabled, as even a child could see, with the sole purpose of talking the Bill out. It is not unreasonable—
  Mrs. Hart: On a point of order. Is it in order for an hon. Member to assert that another hon. Member is attempting to talk out the Bill when a number of Amendments have been put down which could be regarded as being desparately needed to be made to the Bill?
  Mr. Speaker: Although there is disagreement between the hon. Lady and the noble Lord as to the purpose of the Amendment, the noble Lord is entitled to say what he thinks about it.
  Lord Balniel: I make no protest about this, but I think it reasonable to comment that this Bill had an unopposed Second Reading, has the categorical support of the Opposition as well as the support of Her Majesty's Government and emerged unamended from Committee. The hon. Lady who has now put down a considerable number of Amendments did not put down a single one to be considered in Committee. She herself supported Clause 1

  857
  and did not vote against it. That Clause is the heart and soul of the Bill but now, when we have less than half a day for the Bill on the Floor of the House, I find a very considerable number of Amendments on the Notice Paper. I am in the difficulty that we have to discuss on one single Amendment—
  Miss Vickers: I should remind my noble Friend that there were several Amendments put down in my name and supported by the hon. Member for Lanark (Mrs. Hart) in Committee. It is not really fair only to say that the Bill went through Committee unamended. We took a vote and we would have voted on other Clauses but for a misunderstanding.
  Lord Balniel: I think it perfectly fair to say that Clause 1, which is the heart and soul of the Bill, went through without any Division. I realise that the hon. Lady the Member for Plymouth, Devonport (Miss Vickers) has taken a deep interest in the Bill, but she will have noted that in subsequent Amendments in my name on the Notice Paper I have tried to meet some of the points she made. I am rather tempted to agree with a former Prime Minister who once declared:
  "Never do good; it always causes trouble."
  There is a certain temptation to a Member of Parliament to remain a kind of vegetable and to allow the law which he sees to be in need of improvement to disintegrate and collapse.
  Mr. Speaker: I think that at this point we had better get back to the Amendment, after "of" insert "married".
  Lord Balniel: This Amendment touches profoundly on two basic principles which lie behind the Bill. It infringes both those principles which are foundations of the Bill. The first of those principles is that the decision when a mother, be she married or unmarried, should return to work after childbirth is a decision she and her doctor should take. It probably comes as quite a surprise to hon. Members who have not themselves been involved in the details of this Bill to know that under the existing law it is in fact illegal for a mother working in a factory, even on her doctor's recommendation, to return
  858
  to work within the period of prohibition which has been laid down in the old Factories Acts.
  This infringement on the individual liberty of the mother, in consultation with her doctor, is something which is wrong in principle. It is also to my mind certainly wrong from the medical point of view because in modern medical practice there would certainly be cases when, for instance, after a mother has had a stillbirth the doctor would actually recommend the mother to return to work within the specified period of prohibition. It seems right from the medical point of view and from the point of view of principle that the mother, whether she is married or unmarried, should have the discretion placed in her own hands.
  I cannot help feeling that half the welter of misunderstanding which has arisen around the Bill has been as a result of misunderstanding that this is one of the basic purposes of the Bill. Perhaps, as it is directly relevant to the Amendment, I may quote from a letter circulated to all hon. Members. It is from the National Council of Women of Great Britain, a body for whom I have the very highest respect. This letter says:
  "It would give the Minister of Health unlimited power to make regulations …".
  This point we can deal with in later Amendments—
  "restricting any woman's return to paid employment after childbirth without having any regard to her circumstances or the opinion of her medical adviser."
  As I said, one of the main purposes of the Bill is to enable a woman, on the advice of her medical adviser, to return to work if that is considered advisable. It seems to me that the hon. Lady bases her Amendment on the assumption that this Bill imposes a restriction or disadvantage on the unmarried mother. In fact, the Bill imposes no restriction whatever on the mother herself. There are restrictions imposed on the employer, but thos restrictions immediately fall to the ground when the mother, in consultation with her doctor, is considered fit to return to work.
  Mrs. Hart: May I ask the noble Lord two questions? First, is he surprised if there is a misunderstanding about the Bill and there is a lack of Amendments in Committee when there is an attempt to get legislation through on the nod without a Second Reading debate? Secondly,

  859
  would he not agree, on the basis of his own argument, that it would be reasonable to assume that a woman's right to return to work is a matter between herself and her doctor, and that the reasonable and sensible thing to have done would have been to repeal the previous legislation, which would have left the situation open, instead of producing this further restrictive Bill?
  Lord Balniel: To answer the second point first, this Bill repeals all the legislation of the subject and provides a structure on which a modern form of legislation, flexible and designed to accord with medical opinion, could be built for the second half of the twentieth century.
  As to the hon. Lady's first question, I have no intention of getting the Bill through on the nod. I was present for the Second Reading of the Bill and I was perfectly willing to debate the subject. Neither the hon. Lady nor anybody else was prepared to raise a point of opposition to the Bill.
  Perhaps I could now return to the second principle which this Amendment infringes. This Amendment departs fundamentally from all modern law on this subject, and it does so in this respect. The Offices Act, 1960, which was introduced by the hon. Member for Greenwich (Mr. Marsh), and which enables the making of regulations which can take account of the opinion of the mother, whether she be married or unmarried, and of her doctor's opinion, is automatically, for purely technical reasons, being repealed by the Offices, Shops and Railway Premises Bill. So all modern legislation on this subject is being repealed. But the old legislation, dating back in essence to 1891, in which no account can be taken of the views of the mother, whether she be married or unmarried, nor of the views of the doctor, will continue in existence.
  Indeed, although the hon. Lady says that this is legislation dating back to the nineteenth century—in fact, by opposing this Bill and by doing so by means of such Amendments as these—the hon. Lady is not only figuratively speaking but literally continuing in existence legislation dating back to 1891 and wiping out all modern legislation on the subject.
  I must confess that when I heard the hon. Lady speak on this subject on a
  860
  number of occasions she reminded me of the Royal duke back in the nineteenth century, who once declared that "any change at any time for any purpose is highly to be deprecated". This is not a view that I take. I think the law is in need of reform, and this is an attempt to reform the law.
  Mrs. Hart: I do not know how the noble Lord can accuse me of resisting change when he reads the Amendments on the Notice Paper.
  Lord Balniel: I realise that the hon. Lady is trying to improve the Bill. To some extent, she feels that I am putting the cart before the horse. I feel that she is allowing the horse to die on its feet. I entirely agree with the general purport of what the hon. Lady is trying to achieve. But I think that this Amendment is mistaken.
  3.15 p.m.
  It introduces into legislation, for the first time to my knowledge, discrimination between the married and the unmarried mother. What is more, it proposes to retain for the married mother the protection which a mother has at law, but to remove that protection from an unmarried mother. It seems to me that this procedure would turn the Bill on its head. It is probably the unmarried mothers who are most more in need of help.
  The hon. Lady is trying—and here I agree with her—to solve a problem which surely arises not in relation to a married or an unmarried mother, but in relation to the mother without financial support. There must be unmarried mothers who are extremely wealthy. Many married mothers because they may have been abandoned by their husbands, or divorced, or for some other reason, are extremely short of finance. The hon. Lady criticises the Bill, through this Amendment by arguing that it does not provide for the financial need of a mother. She would like there to be seven weeks' paid leave, or an improvement in the maternity allowances. I also would like to see these things. But this Bill is solely concerned with health legislation. It takes this subject out of the sphere of factory legislation, which deals with machines, and out of office legislation, which deals with such things as fire escapes and sanitary accommodation, and makes it a public health matter.

  861
  My hon. Friend asked whether we should not remove the law protecting the mother. That really is old-fashioned, laissez faire liberalism of the nineteenth century. It is quite true that the situation is better than it used to be. But there are still unscrupulous employers. Certainly they still exist. I think it would be wrong to give them a completely free hand.
  Mr. Marsh: The noble Lord argues that this is a Bill restricting the powers of employers, but that women employees will still be free to take a decision, Will he tell me—this is a serious question—where in the Bill the distinction is drawn which enables women to go back to work?
  Mr. Deputy-Speaker (Sir William Anstruther-Gray): Order. I hope that the noble Lord will remember that we are still discussing this one group of Amendments.
  Mr. Marsh: Then may I, Mr. Deputy-Speaker, ask the noble Lord whether he will tell me where in the Bill is a provision that an unmarried mother may go back to work?
  Lord Balniel: I am in difficulty. If the hon. Gentleman had read the Bill carefully he would have seen that in lines 8 and 9 there is the necessary power. This is no more than enabling legislation, and it was implicit throughout the Bill. But as misunderstanding was caused, I have made it absolutely explicit by way of an Amendment which we shall reach later.
  The hon. Gentleman asked what evidence was there of the need for this kind of legislation and how many prosecutions had taken place under the existing law. The number of prosecutions is no criterion whatsoever of the worth of social legislation. If there are no prosecutions, it could mean that the law is working effectively. If there are many prosecutions, it might show that the law was working ineffectively. That is not a criterion on which to judge the law on this subject.
  I hope that I have dealt with the point raised in this rather short and curtailed debate on a very limited Amendment. I hope that this discrimination which is being introduced in the Amendment
  862
  against the unmarried mother is something which does not commend itself to the House as a whole.
  Mr. R. T. Paget: I have found the arguments advanced in favour of the Amendment a little odd and I agree with my hon. Friend the Member for Manchester, Cheetham (Mr. H. Lever) that they are a little reactionary. I remember a time a good many years ago when those who extolled the Russian system used to point to the equality exercised there as demonstrated by the fact that women heaved coal and cleaned the roads. I was not entirely certain that if I had been a woman this would have been the precise terms in which I should have found equality attractive.
  Here the underlying argument seems to me to be that work is something which people do because they choose. I think that it was H. G. Wells who on one occasion observed that the difference between man and the ant, and man's superiority to the ant, lay in the fact that the ant liked work. We have, of course, peculiar people who are ants, but I rather doubt whether they would include a woman who has just had a baby. Working at that time is not a privilege, it is an economic necessity and a cruel one. That this particularly cruel economic necessity should be preserved for the unmarried mother does not seems to me to be of its essence progressive.
  Mr. Marsh: I am following my hon. and Learned Friend's argument with interest. Does he suggest that the economic pressures on the unmarried mother are made easier by her not working after having a baby?
  Mr. Paget: I was expressing more agreement with my hon. Friend's late Bill than with his present attitude. The answer is "Yes, I do." If the law does not allow her to go back to work the community recognises its necessity and has to support her. If, on the other hand, she is allowed to go back to work she does not get that support, or at least is not entitled to it. It seems to me that that is the essence of this matter, but since, for the maintenance of equality, my hon. Friend the Member for Lanark (Mrs. Hart) and the hon. Lady the Member for Plymouth, Devonport (Miss Vickers) wish to claim equality for their sex in such cruel terms and appear determined to talk the Bill out in order to

  863
  impose this on their sisters, there does not seem to me very much point in going on, because they will certainly succeed.
  Mrs. Hart: I do not know whether my hon. and learned Friend the Member for Northampton (Mr. Paget) was here to take note of the fact that I never mentioned equality in my speech. I was concerned with the difference that must be recognised in the social treatment of unmarried mothers, and the need to emphasise their special desire to start a new life unencumbered by demands from the employer under the provisions of the Bill.
  I am most anxious to move on in the Bill to what I regard as an essential part of it. At this point, before knowing what action to take on the Amendment, I should like to ask the noble Lord the Member for Hertford (Lord Balniel) whether he will indicate his attitude towards my basic Amendment later to provide for the economic protection of women after they have had a baby. If the noble Lord is prepared to accept that Amendment—
  Mr. Deputy-Speaker: Order. I am afraid that we are getting quite out of order. We must deal with the three Amendments which are before the House.
  Mr. Braine: I rise to make only two points. The hon. Lady the Member for Lanark (Mrs. Hart) has chosen to make today the points which she could have made in Committee upstairs. I make no complaint about that. I find this proposal quite astonishing. It is, I understand, without precedent and I should regard it as a most retrograde step if the House were to accept the Amendment and make a distinction of this kind. I wonder whether the hon. Lady has been in touch with any of the women's organisations about this.
  I cannot think that the House could agree that a distinction of this kind should be written into a Statute. It ignores the fact, as has been the case with all its opponents, that the Bill is concerned not with the status of women as such—women as opposed to men, or married as opposed to unmarried women—but with safeguarding the health of the mother and her child.
  864
  My hon. Friend the Member for Uxbridge (Mr. Curran), for whom I have a deep affection, shocked me, as I think he shocked most hon. Members, by saying that he saw no distinction in this context between men and women. In connection with the Bill, I have had to see a great many people concerning the Government's attitude towards it. My hon. Friend the Member for Uxbridge advanced the same sort of argument as was put to me by a lady who said that she thought there should be no distinction between illness for a male worker, which necessitated his going off from work for a period, and childbirth. To use her actual words, she saw no distinction in this context between hernia and childbirth. It was most refreshing to hear my hon. Friend the Member for Belfast, West (Mrs. McLaughlin) this afternoon sweep away that sort of nonsense.
  Mr. Curran: I was not asserting that there was no difference between men and women. The point to which I should like my hon. Friend to address himself is this. Why should he make regulations which make decisions for women unless we are asserting that women are not capable of making these decisions for themselves? Why should not we allow women, as we allow men, to choose for themselves when they go back to work?
  Mr. Braine: Under the Bill, which is sponsored by my noble Friend the Member for Hertford (Lord Balniel), women will be permitted to go back to work as a result of a choice which they exercise in consultation with their medical adviser, for the very reason which I am advancing, that we are concerned here not merely with the woman, but with the child as well. The Bill relates—
  Mr. Marsh: There is nothing in the Bill which states that a woman can go back to work after consultation with her doctor. If there were, it would change the Bill, but there is nothing in it to say this.
  Mr. Braine: The hon. Member has not done his homework. So many Amendments have been put down that, perhaps, he may be excused for not doing it.
  Mr. Curran: May I remind my hon. Friend of the opening words of the Clause:
  "The Minister may by statutory instrument make regulations for restricting the employment of women for reward …"

  865
  The Minister is, therefore, being given by the Bill the power to make decisions on behalf of women. I urge him to read the Clause, which he is defending.
  Mr. Marsh: Hear, hear.
  Mr. Braine: My hon. Friend should have looked a little bit further. The sponsor of the Bill is sitting in front of him and may direct his attention to the detail, but I should be straying too far from the bounds of order if at this stage I tried to start educating hon. Members not only about what the Bill contains, but about the effect of Amendments which we have not yet discussed.
  Mr. Marsh Mr. Marsh rose—
  Mr. Braine: I cannot give way. I have a number of things to say.
  Mr. Marsh: Gross misrepresentation.
  Mr. Braine: The hon. Member can not only hand it out. He must take it.
  Mr. Marsh Mr. Marsh rose—
  Mrs. Hart: On a point of order. Is it in order, Mr. Deputy-Speaker, for the Joint Parliamentary Secretary to use in relation to the Amendment an argument which presupposes the consequences of a later Amendment?
  3.30 p.m.
  Mr. Deputy-Speaker: What is in order is to discuss the three Amendments which are being taken together. Let me read them out to the House. The first Amendment immediately under discussion is in page 1, line 6, after "of" to insert "married". The two others being taken with it are, in page 2, line 5, after "State", insert "married"; and in page 2, line 5, after "includes", insert "married". All we are discussing is whether or not the word "married" should be inserted.
  Mr. Braine: In subsection (1) of the Clause appear the words:
  "subject to such exceptions if any as may be prescribed in the regulations".
  If this be read in conjunction with an Amendment which is down on the Notice Paper in the name—
  Mrs. Hart: On a point of order. I was ruled out of order in making an argument on the assumption that later, basic Amendments which I have down
  866
  would be accepted. Surely the Minister is not entitled to argue on Amendments to a later part of the Bill?
  Mr. Deputy-Speaker: Clearly it is not in order to discuss a later Amendment than that which we have already reached. I think the House must be fully seized of this.
  Mr. Braine: That is, of course, the difficulty. A moment ago the hon. Gentleman challenged me to say where provision was in the Bill to ensure that a woman could go back quite soon after the birth of her child if this were hex wish and if this were in accord with her doctor's opinion. I was challenged to say where the provision is. I am now ruled out of order in seeking to show the hon. Gentleman what he would have seen for himself if he had read the Notice Paper and had studied the Bill.
  Now to obey your injunction, Mr. Deputy-Speaker, I return to the Amendment and to the Bill which relates to the employment of women not because they are women but because they bear children. Now this involves a risk to health and it means, as I understand it, some restriction of women's freedom of action. As the Report of the Maternity Services Committee, the Cranbrook Report, makes plain:
  "The post-natal period may be one of strain to the mother due to extra work, breast feeding, residual anaemia, and the difficulties involved in the readjustment of family life. It is therefore important that the midwife, health visitor or doctor as may be appropriate should be available to help the mother with any problem which may arise."
  Thus, we are here concerned not merely with the woman's right to return to work, which has been the main burden of the argument of the hon. Lady, but with the child's rights, too. The mother's health is necessary to her child's well-being in the early weeks after the child's birth, and therefore not only the mother but the child has a need for protection against possible exploitation, and I think—I say this on medical advice—that both mother and child are often at risk in this period. This applies not merely to the married woman and her child: it applies with equal force to the unmarried woman and her child.
  Mr. H. Lever: Why do the hon. Gentleman and the noble Lord the Member for Hertford (Lord Balniel)

  867
  burke the argument that this Bill restricts the freedom of women? It does restrict the freedom of women, and quite rightly restricts the freedom of women, to go back to work too soon not only in the interests of the mother but also in the interests of the child.
  Mr. Braine: I do not burke the issue at all. The hon. Gentleman at an earlier stage of the debate tore the Amendment to shreds, and the matter could have gone to a Division then and there. I do not burke the issue, but I would go rather further and say that if one takes the interests of the mother and child, far from the Bill restricting freedom, it widens freedom in the broader sense, and I see that I carry the hon. Gentleman with me.
  I turn to the second point I wanted to make. It seems to me that the sole reason—I think that in this regard the hon. Lady is perfectly genuine and I listened with great care to what she said—for the Amendment is to protect the unmarried mother against the embarrassment of questioning. We can well imagine the additional difficulties which such a woman might encounter.
  The Bill provides, like the present legislation for factories, that an offence is committed only where an employer, in full knowledge of the facts, employs a woman within the period of restriction specified in the regulations. This will have to be proved against him. It will not be for him to prove that he did not know, and could not have known, that the woman had a child a short time before—there will be no need for him to make inquiries of his employees.
  Here I come to the point, which the hon. Member for Greenwich (Mr. Marsh) so persistently ignored, that this is not a new provision. In respect of women employed in factories there has been a rigid prohibition for a four-week period after childbirth for more than half a century. If there had been evidence that women workers had been discriminated against unfairly and that undue pressure had been brought to bear upon them, this would have been made known, one would have thought, through the trade union movement which is better organised in factories than it is anywhere else.
  On the contrary, we find that the Gowers Committee in 1949 recom-
  868
  mended that the protection which women in factories have enjoyed for more than half a century should be extended to women in other forms of employment. Was that ever contested in the House? On the contrary, a provision to this effect was written into the Bill brought to the House by the hon. Member for Greenwich. He seems now to want to wash away all responsibility for the measure which he fathered.
  Mr. Marsh: May I ask the hon. Gentleman two questions? Firstly, can he produce any evidence of any attempt to implement this Section of the Factories Act, or any evidence that it ever has been implemented during the last 20 years? Secondly, if the Government now feel so strongly about this, will he tell us why they made no attempt to incorporate this legislation, which they now say is so important in the Factories Act, into the Shops, Offices and Railway Premises Bill?
  Mr. Braine: I should have thought that anybody would have read into the remarks that I have just addressed to the House the fact that this is primarily public health legislation. It is not industrial legislation. The purpose here is a health purpose, and it is on that ground alone that the provision was not written into the Shops, Offices and Railway Premises Bill now before the House.
  As to the argument that unless I can produce a whole list of successful prosecutions—
  Mr. Marsh: No.
  Mr. Braine: —the existing law in regard to factories, which has operated now for more than half a century, must be a dead letter, I would suggest that that is ridiculous. How many prosecutions would I have to produce in order to show how efficacious the law has been? One, two, 20, 200?
  Mrs. Hart: Just one.
  Mr. Braine: I find this argument coming from the hon. Members opposite quite extraordinary. Those who know anything about the history of the trade union movement ought to know of its proud claim that it has been responsible—a claim which my party on these benches can share with it—for successive measures to widen the real freedom of the worker by

  869
  protecting him against bad conditions and bad employment. I find it quite extraordinary to ignore the fact that in 1891 legislation was introduced to protect women and that for 60 years it has effectively been protecting them and educating employers and creating the right conditions—
  Mrs. Hart: The hon. Gentleman must recognise that what has created the different situation in 1963 is the work of trade unionists. They have created such better conditions for staff that there is no longer the need to provide for this sort of thing. He is talking about the need to prove that this legislation needs to be introduced. Is he not aware that the National Union of General and Municipal Workers, which covers more women workers than any other union in the country, has a resolution tabled for the Women's Trade Union Conference this month protesting against the implications of the Bill and saying that this should be purely a personal matter between a woman and her doctor and not legislation such as is proposed?
  Mr. Braine: I am delighted that the hon. Lady has come completely clean and now admits that the system for factories has worked very happily and that there is no evidence of undue pressure having been brought to bear on unmarried mothers. Why she wishes to oppose the extension of the protection, though in much more flexible form, to other forms of employment defeats me when one bears in mind that over the last decade all parties have pressed for precisely the kind of provisions which my noble Friend's Bill contains.
  The Bill provides, like the present legislation for factories that an offence is committed only when an employer who is in full knowledge of the facts employs a woman within the period of restriction specified in the regulations, and that must be proved against him. The hon. Lady has completely ignored the point that the protection, albeit much more inflexible, has long existed in regard to women employed in factories.
  There is no magic in "knowingly". It is a term which has long been used in this and other legislation. The purpose of the word is to protect an employer who employs a woman innocently and in ignorance of the fact that she has had a recent child. There is no need for an employer to assume that the law is being contravened and to ask questions unless he has some good reason to suspect that she has had a child. In fact the position for an offence to be committed is that the employer must know that the woman has had a child. It is not, as the Irishman might say, that he must not know that she had not had a child.
  It seems to me, therefore, that there is no ground whatsoever for writing into the law this entirely novel distinction between one woman and another, between the married woman and the unmarried. I repeat that the whole object of the Bill is to protect the mother and the child in what is probably the most important part of the child's life.
  Question put, That "married" be there inserted in the Bill:—
  The House divided: Ayes 7, Noes 28.

  Division No. 92.]

  AYES

  [3.43 p.m.

  Brockway, A. Fenner

  Hart, Mrs. Judith

  Carmichael, Neil

  Milne, Edward

  TELLERS FOR THE AYES:

  Edwards, Robert (Bilston)

  Stonehouse, John

  Mr. Skeffington and Mr. Marsh.

  Hate, Leslie (Oldham, W.)

  NOES

  Allason, James

  Lewis, Kenneth (Rutland)

  Rees-Davies, W. R.

  Braine, Bernard

  Lipton, Marcus

  Reynolds, G. W.

  Brown, Alan (Tottenham)

  Lubbock, Eric

  Russell, Ronald

  Costain, A. P,

  MacArthur, Ian

  Speir, Rupert

  Curran, Charles

  McLaughlin, Mrs. Patricia

  Thorpe, Jeremy

  Drayson, G. B.

  Maddan, Martin

  Vickers, Miss Joan

  Elliot, Capt. Walter (Carshalton)

  Moore, Sir Thomas (Ayr)

  Harvey, John (Walthamstow, E.)

  Paget, R. T,

  TELLERS FOR THE NOES:

  Holman, Percy

  Pearson, Frank (Clitheroe)

  Lord Balniel and Mr. Channon.

  Houghton, Douglas

  Price, David (Eastleigh)

  Lever, Harold (Cheetham)

  Pym, Francis

  Mrs. Hart: I beg to move, in page 1, line 7 after "childbirth", insert:
  "in industries and occupations satisfying the conditions prescribed in subsection (2) of this section".
  Mr. Deputy-Speaker: With this Amendment can be taken those in page 1, line 12, to leave out from "prescribed" to end of line 13. In line 13, at the end to insert:
  (2) The Minister may make regulations only in relation to those industries or occupations in which agreements have been negotiated, between employers and the trade unions or professional associations representing employees, providing for a period of at least seven weeks' paid leave, and an optional further period of unpaid leave, before or after childbirth, and prohibiting the employer from dismissing any woman expecting a child during the period with which the agreements are concerned.
  and in line 19, after "section" to insert:
  "or who fails to fulfil obligations placed upon him by agreements of the kind specified in subsection (2) of this section."
  Mrs. Hart: I am most anxious in the very limited time available to emphasise that in moving these Amendments I have sought to create a real measure of protection for women who have had babies and who are in employment, that is to say, to ensure that the regulations should apply only to industries in which there are agreements providing for the kind of economic conditions which have been recommended time and again by international conferences on this kind of thing and recommended by the European Social Charter, and that industries and employers and trade unions should be encouraged to reach agreements of this kind within their own industries. There is the further possibility that the Minister of Health himself, in industries where agreements do not already exist and in which there are no signs of agreements being reached within the next year or so, will positively prescribe the right conditions, instead of being so anxious purely to prohibit, so as to encourage women to stay at home with their babies so long as possible.
  I should like briefly to summarise the situation in many other parts of the world. It comes as rather a shock to discover how much Utopia other countries have achieved in this regard and how little our own employers have done for their employees so far. In Sweden there
  872
  are agreements within industry between employers and trade unions, for example, in the Swedish metal trade, which give women approximately two-thirds of their regular wage or salary during the period up to six months which she may have off work when having a baby.
  In the European Social Charter, the international agreement to which Britain was a contributing nation although she has not rectified this section of the Charter, it is provided that there shall be 12 weeks' paid leave before and after childbirth. In addition there shall be a guarantee against a woman being dismissed during that period. In other words, a woman knows that she may give up her job during her pregnancy when her health demands it. She may spend a considerable time at home with her child and enjoy complete economic security. There is no economic pressure on her to go back to work, and she has the guarantee of getting her job back when she decides to return.
  After all, this happens in our Civil Service. The Government, in conjunction with the Staff Side, have created conditions providing for established women civil servants to have two months leave on full pay for a confinement and a further period of special leave without pay, and presumably, since she is an established civil servant, she has a guarantee against dismissal from her job. This is what I want to see, and if the noble Lord is concerned about providing women with the possibility of staying at home with their children for as long as possible after childbirth, he ought to agree to what I am suggesting. Prohibitions are of no value in the situation he is trying to meet, unless they are underwritten by economic security which is so desperately needed by so many women.
  In the publication to which I referred earlier, one sees conclusively that only women with a pressing economic necessity ever want to return to work after having children. The normal pattern, which the noble Lord must appreciate since we are living in 1963—and the argument advanced by the hon. Member for Belfast, West (Mrs. McLaughlin) is utterly wrong—is that a woman will work after her marriage and during her pregnancy up to the point where it seems desirable to both her and her doctor

  873
  that she should give up her job, but that after she has had her baby she does not want to return to work until that baby is at school, unless there are pressing economic factors which demand that she return to work earlier.
  If the noble Lord is seeking to protect women who have babies, he ought not to look to the easy method of making an open-ended umbrella law giving unrestricted powers to restrict and prohibit the employment of women. He should instead consider the economic factors which are the reality of the situation in 1963 and seek to encourage in industry the creation of an agreement providing for paid leave and at the same time try to ensure that the Government bring in measures to increase the insurance benefits. Up to the point when agreements do not exist sickness benefit could also be considered. This is the Swedish position and ensures that the economic pressure on a woman who has had a baby is removed. In that situation there is real freedom for a woman, in conjunction with her doctor, to decide when she can go back to work, and I think that this is the realistic way in which to approach the subject.
  Because this was a bad Bill needing a great many Amendments, it has been talked out this afternoon. Those who share my views think that we ought to seek the permission of the House to introduce the kind of legislation which we think ought to be brought in to deal with this subject, and I hope that the Government, who have accepted that economic factors are important in this situation, will give us facilities to bring in a Bill which we might produce, just as they have provided facilities for the noble Lord to bring in his Bill.
  Mr. Braine: I am glad to have the hon. Lady's admission at last that she has sought to talk the Bill out. What she said is of considerable interest. There may be some merit in her ideas, but they are not appropriate for a Bill which is a health Bill.
  The effect of the Amendment is to limit the Minister's power to make regulations to industries and occupations in which agreements have been negotiated between employers and representatives of employees to provide for at least seven weeks' paid leave. The hon. Lady knows that this would nullify the effect of
  874
  the Bill for a long period of time and the Amendments therefore are unacceptable—
  It being Four o'clock the debate stood adjourned.
  Debate to be resumed upon Friday, 26th April.

DOG RACING (APPOINTED DAYS) BILL
Considered in Committee; reported, without Amendment; read the Third time and passed.

TRAVEL AGENCIES (REGISTRATION) BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 26th April.

PUBLIC ORDER ACT 1936 (AMENDMENT) BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 3rd May.

RACIAL DISCRIMINATION AND INCITEMENT BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 19th April.

SERVICE DISABILITY PENSIONS BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 26th April.

INDUSTRIAL DISEASES (BYSSINOSIS) BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 26th April.

NATIONAL INSURANCE ACT 1957 (AMENDMENT) BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 26th April.

CRIMINAL INJURIES (COMPENSATION) BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 26th April.

WORLD SECURITY AGENCY BILL
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 26th April.

STOCK TRANSFER BILL [Lords]
Order for Second Reading read.
Hon. Members: Object.
Second Reading deferred till Friday, 26th April.

PUBLIC LAVATORIES (TURNSTILES) BILL
Read a Second time.
Bill committed to a Standing Committee pursuant to Standing Order No. 38 (Committal of Bills).

TAXI SERVICE, LONDON
Motion made, and Question proposed, That this House do now adjourn.—[Mr. Pym.]
4.4 p.m.
Mr. Rupert Speir: Once again I rise to draw attention to the problem of the London taxi service. Once again I shall be told by representatives of the taxi owners and drivers that all is well, and that the present number of cabs and drivers provides London with a satisfactory public service. Again, no doubt, the representative of the Home Office will say that while the Home Office lays down rules and regulations regarding taxicabs and their drivers, it is not the duty of the Home Secretary to provide cabs or to see that an adequate number of cabs is provided.
I am not sure whether in this matter the Home Secretary has responsibility without power, or power without responsibility. As the late Lord Baldwin made very clear, neither is a very nice thing to have. As my hon. Friend's predecessor in office put it when I first raised the subject of London's taxi service on 9th November, 1960—and I
quote from the OFFICIAL REPORT of that date:
"I think that he"—
Myself—
"realises that there is no way in which the Home Secretary can actively promote an increase in the number of taxicabs, and I am sure that he would agree that this should be decided by the taw of supply and demand."—[OFFICIAL REPORT, 9th December, 1960; Vol. 629, c. 1185.]
That sounds all very nice and sensible, but there is, I think, a flaw in that argument. The trouble is that the demand is most certainly there but not the supply. The demand is really terrific, and even in the off-peak periods the supply of taxicabs is not adequate to meet it.
Why is this so? I certainly do not put the blame on the existing taxicab drivers or their owners, with their limited number of vehicles. Although this is a motoring age, the fact is that there are hundreds, if not thousands, fewer licensed taxicabs in London today than there were 30 years ago. But with its limited numbers the taxi trade does its best, and it really provides a remarkable service. However, for a great metropolitan city,

877
a great capital city, the service today is really just not good enough. Certainly the service is not good enough to encourage private car owners not to use their cars in central London. Yet, surely, that should today be one of the prime aims of the Government. As long as people have to move about and so long as there is a shortage of taxicabs, and so long as it is impossible to be sure of being able to hail a taxicab at short notice, the public obviously will continue to use their private cars.
Once again I suggest that the main reason for the shortage of taxicabs in London today is that the law on the subject is completely out of date and the rules and regulations governing the size of the cabs and the type of vehicles to be used and concerning the driver's knowledge—although I admit that some of these rules and regulations have recently be amended—are far too severe.
I suggest that the requirements are out of date and outmoded. Why, for instance, does the London taxicab, unlike taxicabs in other provincial cities, have to have a chassis? Why does it have to be constructed in this particular manner when so many modern cars do not have chassis? Why, too, must the London taxicab be so constructed that every passenger sitting in the back seat must be able to sit there wearing a top hat? Surely that is a ridiculous requirement in this day and age, and yet, I believe, that is the effect of the rules and regulations, that the height of the taxicab must be sufficient to enable a top hat to be worn.
I suggest that one of the main reasons why there is a shortage of taxicabs in London and why London is not getting the service which it deserves is largely, but not entirely, the fault of the Home Office. London is not getting a decent taxi service because Bumbledom is at the wheel, because of the fuddy-duddy requirements of the Home Office and the Metropolitan Police. The Home Office may not be acting as the fifth wheel to the coach in this matter, but it is certainly acting as the fifth wheel to the London cab.
I am sure that when my hon. Friend replies he will agree, as, indeed, the various official committees and working parties have agreed, that it is high time that we had a revision of the hackney
878
carriage law which dates back to, I think, the year 1869. It is high time that some of the more silly rules and regulations disappeared. It is, for instance, absurd, although it may have been all right in the days of the horse-drawn vehicle, that taxis need not today take passengers more than six miles. The result is that there are unseemly arguments with distinguished foreigners such as occurred when President Kennedy's brother arrived at London Airport. Such arguments occur also at many other places and on many other occasions.
I quite understand that the Home Office may say that these rules and regulations are designed for the sole purpose of safeguarding the public. I believe that in this matter the Home Office is out of touch with reality. For better or for worse, Colonel Blimp is dead and I just do not believe that the majority of the London public want or need to be safeguarded to the extent that the Home Office appears to think necessary. By all means in this free country let those who want to do so continue to ride about in a taxi capable of taking six passengers and constructed like an armoured car, and they can wear their top hats if they like. They can also continue to have a driver with a really encyclopaedic knowledge of the streets of London. In that case they will have to pay for it. I think that the London taxi trade is perfectly entitled to ask for an increase in fares.
On the other hand, I know that there are literally millions, because the figures speak for themselves, who are prepared to make do with a smaller, cheaper vehicle and to employ them. So let us have the freedom to choose the simpler vehicles, whether they be minicabs or whether they be of a kind of motorised rickshaw in which my hon. Friend the Member for Twickenham (Mr. Gresham Cooke) and I drove to the House this morning. Other capital cities use this form of transport and I cannot see why it should be denied by law to the public in London.
I should like to end my remarks on this subject of London's taxi service as I began them on the last occasion that I raised the subject, by paying tribute to London's taximen. I repeat and make it abundantly clear that I am not criticising the London taximen. They are

879
some of the best drivers in the world. Their knowledge of London is quite fantastic. They operate under difficult conditions. My only complaint is that there are not enough of them. It is my hope and belief that the alteration of the hackney carriage law and some of the Home Office rules and regulations would make the taximen's life easier and would make life for most of London easier too. I therefore hope that my hon. Friend the Under-Secretary will be able to give us some indication of an improvement in the rules and regulations in an attempt to see whether we can bring the taxi trade in London up to the requirements of a large modern city.
4.13 p.m.
Sir Hugh Lucas-Tooth: I wish to intervene for only a minute or two. First, I should like to congratulate my hon. Friend the Member for Hexham (Mr. Speir) on his constant interest in this subject. We do not always agree about what should be done, but I think that we can both agree that this is a matter of urgency which ought to be attended to. My hon. Friend said that the law was out of date. In that I could not agree with him more strongly, but recently, when I introduced a Bill the title of which would have permitted any amendment whatsoever to the law in this connection, he did his best to oppose it, although the Bill in fact received on the Motion for leave to bring it in the approval of a majority of about two-thirds of those who voted.
My hon. Friend referred to the limitations of the number of cabs. I agree with him that every Member of Parliament, and indeed everyone who uses taxis in London, is undoubtedly aware that there are times when there are not as many taxis on the streets as we would like to see. I am not sure that it is altogether right to put this down to the number of cabs which are licensed and to suggest, as my hon. Friend rather did, that this is the responsibility of the Home Office.
So far as I am aware, the Home Office would be glad to see more cabs licensed. The trouble is that there are not enough licensed because the trade itself is in an unsatisfactory condition. I do not think that what I might call "tinkering about" with the regulations dealing with the
880
cabs, important though they may be, would solve the problem. The cost of a taxi rank is attributable to many factors, the pay of the men, the cost of the fuel, the initial cost of the cab and, more particularly, the speed of depreciation. I think my hon. Friend will find, making any calculation he cares to make, that, whatever the regulations provided in the way of relaxation as to the kind of cab which should be used, that would not itself make a great difference. What we need is a much more fundamental change in the law.
I appreciate that if I tried to touch on that in an Adjournment debate I should be out of order. I merely make the point that the law needs reform. I have suggested certain particulars and I do not want to be dogmatic. I think there are other matters which need attention besides those in the Bill which I introduced. The matter requires complete overhaul. I support my hon. Friend in urging on the Home Office that this is a matter of urgency which cannot be allowed to drift on with nothing happening about it. I hope that my hon. Friend the Under-Secretary will be able to make a forthcoming answer within the limits of what is in order in such a debate as this.
4.16 p.m.
Mr. R. Gresham Cooke: I wish to support my hon. Friend the Member for Hexham (Mr. Speir), who has been so pertinacious in bringing this matter forward year by year. The time has arrived when we should have more flexibility in the type of vehicles running on the roads. It is ridiculous to have 2 tons of metal to carry 1½ cwt. of human flesh.
When I was in Tokyo a short time ago I noticed that there were three types of taxi. There was the four-seater, the two-seater, and the rickshaw type pulled by a scooter. I do not think that we should go down to the rickshaw in a great capital city such as this, but we could have a four-seater cab and two-seater minicab. We know enough now to be able to make vehicles strong enough to carry two people about, and often only two persons wish to use a cab. Regulations could be made to meet the requirements for both these types of taxi. In London in future we could have the two-seater and the four-seater cab.
4.18 p.m.
Mr. Marcus Lipton: It is agreed that we have a problem. It seems that one way of beginning to tackle it would be for the Home Office to enter into consultations with the representatives of the taxicab trade, the trade unions, the cab owners and all who have a working interest in the matter. I am sure that if some such consultation were initiated and suitable action taken by agreement, an improvement could be effected in the situation.
Mr. Speir: Does the hon. Member want another Dr. Beeching?
4.19 p.m.
The Joint Under-Secretary of State for the Home Department (Mr. C. M. Woodhouse): My hon. Friend the Member for Hexham (Mr. Speir) and others who have spoken in the debate have raised a number of interesting points to which I shall try to reply individually so far as time allows.
I should like first to say something about what I consider to be the underlying principle by which my hon. Friend's argument was motivated, because I think it important to get this clear. As I understood him, he was seeking to regard the Home Office as responsible, not only for the conditions under which taxis should operate, but, at any rate by implication, for a more active role in taking positive steps to ensure that there should be an adequate supply of taxis in the Metropolis.
I think it right to emphasise, in order not to mislead the House, that this is not at present the responsibility of my right hon. Friend. I think there are only two ways in which my hon. Friend's desire could be met. One would be that of expressly extending the Home Office's responsibilities by legislation, and the other would be by measures within the existing powers of the Home Office—in other words, a relaxation of the criteria which my right hon. Friend imposes.
To take the first point, it seems to me that in order to have a much wider control over the conduct of the taxi trade, which my hon. Friend apparently wishes, it would be necessary for the Government in effect to take over the trade or to arrange for its transfer to some public body; because, so far as we can see, there is no halfway house between leaving
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the service to be provided by private enterprise with the kind of negative controls which we at present exercise, and the direct operation of the trade by a Government agency. I think it only right to make it clear that my right hon. Friend would have no intention at all of embarking on that course.
My hon. Friend argues that it is not necessary to extend the legislation but only to bring it up to date. In answer to this point, it would be only courteous of me to clarify the necessarily rather abbreviated reply which I gave to his Question on 7th February when he suggested that the insufficiency of the London taxi service was due to the rules and regulations. By this I have no doubt he meant the statutory provisions to which he referred today and which were, as he pointed out, enacted in the last century.
It is true that the principal statute, the Act of 1869, goes back to the time of the hansom cab, but it was a very widely-drawn Act and its provisions are not in themselves inapplicable to modern conditions, and they do not in themselves in any way impair the efficiency of the taxi service or impede its expansion. What the Act did was to empower the Home Secretary, who has delegated the powers to the Deputy Commissioner of Police, to license taxicabs and taxicab drivers in the Metropolitan area. This Act was supplemented by the Act of 1907 empowering the Home Secretary to fix the fares, and, in addition, by a number of other Acts of various dates, into which I need not go, to regulate various details of the conduct of the trade.
While I concede that there may be something to be said for consolidating these provisions for convenience if and when Parliamentary opportunity offers, it does not seem to me that in substance they are unsuited to the requirements of today's taxi service, with one very important qualification to which my hon. Friend referred. This is the rule known as the six-mile limit, which I need not define in detail. We recognise the validity of the number of complaints by the public about the effects of this limit. We also recognise, as we are bound to do, the difficulties which a change in this rule inevitably

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presents from the point of view of the cab drivers, for whom it would mean a loss of money which they can earn.
The Government understand these difficulties, but we are hopeful that a way may be found which would enable the law on this point to be brought more into line with the requirements of modern life in the Metropolis, if not with the agreement of the drivers at any rate with their acquiescence. I hope that I need say nothing more on this point. In part it touches on the point made by the hon. Member for Brixton (Mr. Lipton) about consultations with the proprietors in the trade, which is very much in our minds.
Mr. Lipton: Are they going on at the moment?
Mr. Woodhouse: I would rather not say any more about them.
This point does not bear on the numbers or the efficiency of the taxi service. The main points at which authority impinges on the control of the service are in licensing the vehicles and the drivers. We do this because, although the taxi service is a commercial enterprise, it is also a public service, and it is essential that certain standards should be imposed on it, as they are under the 1869 Act. Regarding the conditions governing the construction of vehicles, as no doubt my hon. Friend knows, an independent Committee examined this matter last year. Its recommendations were accepted by the Deputy Commissioner and brought into force on 1st January this year. I can assure my hon. Friend that they contain no reference to gentlemen wearing top hats; though they do prescribe dimensions in the interior of the cab which may, or may not, enable a gentleman to wear a top hat inside the vehicle. But they are not designed solely for that purpose.
Similarly regarding the requirement about a knowledge of London by taxi drivers. I think it important that people who hire cabs in London and have confidence in them, should have some assurance that they will be conveyed to their destination by the most direct route. Some hon. Members besides myself may have had experience of a Middle Eastern capital during the war where it was universally known that the only two
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addresses known by taxi drivers were Shepheards Hotel and the headquarters of the British Secret Service. I am sure that we do not want a service of that kind, and there is no doubt that the London taxi service in this respect sets a standard which is envied in other capitals. I think that is a standard which we should try to maintain.
My hon. Friend the Member for Twickenham (Mr. Gresham Cooke) referred to the possibility of introducing two-seater cabs, or mini-cabs or even rickshaws. I wish to make clear that there is nothing in the present conditions of fitness to prevent the use of a smaller vehicle. I would rather not elaborate this point which was brought out by my right hon. Friend, the then Minister of State, in two Adjournment debates in which he went into the matter in some detail. The independent Committee to which I have referred examined the possibility of a two-seater cab or a light taxicab and reported that it was not impressed by the evidence that such a vehicle could be operated economically in the conditions prevailing in London. As there is a copy of the Committee's report in the Library, I will not weary the House with the details. But I repeat that there is nothing in the conditions of fitness to prevent the use of such a vehicle.
Rickshaws and small private hire vehicles would be quite another matter because neither would conform, nor could be made to conform in present conditions, with the requirements of fitness for operating conditions in London. The Government stand by the revised conditions of fitness which came into effect on 1st January and do not regard the present as appropriate to attempt any review or revision of them. I think this also deals with the point regarding mini-cabs—a term which is now rather inaccurate, but which I take to refer to vehicles operating not as taxis but as private hire cars.
I have dealt, somewhat briefly, with the numerous points raised in this debate in so far as they concern the Home Office. I should like to say to my hon. Friend that a number of points raised in this and previous debates on the same subject, are, strictly speaking, not concerned with matters directed by the Home Office. I have in mind, for instance, points which my hon. Friend

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has raised about the need for more taxis at peak hours or the question of increased fares to make the operating of taxis more economic, and a number of other such points.
It is difficult to get more taxis on the road at peak hours and at the same time run an economic service, because it would mean that at other than peak hours there would be large numbers of taxis standing idle. Increasing fares is a matter for the Home Secretary but only on the initiative of the trade. If it seeks an increase on the present fares, which were fixed in 1958, there is no reason why such a fresh approach should not be made.
I do not think that there is any need for despondency about the taxi trade in London today. It is perfectly true that there are fewer taxis on the road than there were before the war, but it is equally true that there has been a steadily growing number of taxis on the road since the war.
Mr. Lipton: And more private cars.
Mr. Woodhouse: That is also true, though not exactly relevant to the point.
At the end of last year the number of taxis on the road was 6,800, compared with 5,400 ten years ago, and there has been a steady growth during that period. The number of drivers
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over the same period has grown from 9,000 to 10,400. It certainly does not seem to be the case that the test of knowledge of London applied by the Deputy-Commissioner is unduly restrictive, because most of the applicants for licences succeed in passing it. All signs at present point to the likelihood of a continuing gradual rise, although I should not like to make any firm prediction. The authorities—the Home Office and the police—set no limit on the number of vehicles, except that the drivers and the vehicles must satisfy the conditions which I have mentioned.
The construction requirements have recently been reviewed, and they certainly will not be reviewed again in the immediate future. I do not think that my right hon. Friend can be expected to accept the suggested encouragement of an increase in the number of drivers at the expense of a substantial reduction in their knowledge of London. It is one of the essential features of the taxi service that taxis should be robust and efficient and that the drivers should be competent. I am sure that it would be a mistake deliberately to worsen the excellent service which taxis and drivers give in this respect.
Question put and agreed to.
Adjourned accordingly at twenty-six minutes to Five o'clock.