MILITARY HOSPITAL, HANOVER (MEDICAL FACILITIES) (Hansard, 16 November 1967)

§ Mr. John Wells (Maidstone)
It is a simple and rather pathetic little matter that I wish to raise this evening. I ask the Minister for only two comparatively small assurances.
The story concerns a girl from Maidstone, whose name is known to the Minister. She is a soldier's daughter and was educated in the rather secluded atmosphere of a convent. She is now aged 19. A year or more ago she went with her parents to Germany, where her father was serving. She became acquainted with a corporal who was at that time married, and who, I understand, has only very recently been divorced. In due course she became pregnant by the corporal. Her family returned to England and she had a free passage home with them. She then returned to Germany at her own expense and of her own free will, and she has been living with or near her corporal friend near Hanover since then.
I am now asking that she should be given free medical attention in the British military hospitial at Hanover. Because she returned to England with her parents, she would not normally be entitled to this as of right, but I ask that the medical care which she may well need when the baby is born should be free for four separate reasons. The first is that the father of the baby and her own father are serving soldiers. The father of the baby, who, I hope, will marry her in due course, is serving in Germany and would, 776 therefore, himself be entitled to free medical care in the hospital.
Second, the hospital and all its services are there anyway. It will not cost a penny piece, other than for incidental drugs in a small way if the baby is born there. It will be only a book-keeping transaction, and therefore the cost to the taxpayer would be virtually nil—certainly a great deal less than the cost of this debate, for which I apologise to the Minister.
Third, the girl is very poor. She is the oldest of a large family. Her corporal friend has an ex-wife and children, and therefore her financial circumstances are strained. I hope that as she is a British subject living with a British soldier who is in Germany on public service this will weigh in her favour.
My fourth reason for asking for the medical treatment to be free is that the pregnancy had already gone too far medically for her to travel home before the full implications of the matter were understood by her. She is entitled to special consideration both in view of her age and the circumstances of the soldier who is probably to be her husband.
I am told that the girl's father has refused to pay anything towards the hospital care, and takes, for him, the perfectly reasonable attitude that the Army should look after his daughter. By contrast, her mother, whose sole anxiety is the welfare of the baby that is to be born, has, I understand—perhaps rashly—made some firm offer to pay something towards the cost.
As I understand the book-keeping cost of hospitalisation for a pregnancy at the hospital, it might amount to about £120. I understand that the mother has five 777 other children, not all of them in good health, and her only income is that as the wife of a fairly senior soldier and the allowances that go with his salary. She is not a rich woman. She has made this offer out of the goodness of her heart, wanting to see her prospective grandchild born in the most favourable circumstances. So I hope that the grandmother, if we can call her that, will be absolved from any rash past statement she may have made offering to pay.
I, like the grandmother, have the welfare of the baby nearest to my heart. This is why I seek to raise the matter with the Minister tonight. I understand that under both British and German law the baby will be born a stateless person. This is the second point on which I hope the Minister can give us guidance. But I understand further—this is where I hope we shall have a clear statement—that, provided that the British Consul applies in good time, at the instance of the mother the child can become a British subject reasonably quickly and reasonably inexpensively.
As I have already made the point that the family is not a wealthy one, I hope that officialdom—which I believe has already been extremely kind to them—will continue to look upon this unhappy baby in the kindest possible light and ensure that the arrangements for birth are easy, that the mother is given every medical care and that the child achieves preferably British nationality but, failing that, German nationality rather than be born a stateless person, or that it acquires British nationality as soon as possible. Perhaps there is some point about nationality—whether it is actually born in the hospital or not. Perhaps the Minister can give us guidance on that, too.
In conclusion, I would say how extremely grateful I and my constituent, the grandmother, are to the Minister and his Department for their very great kindness expressed so far. They have taken a great deal of trouble in contacting the father in the Far East and so on. My constituent is very grateful. But there are just these two final points—the nationality and the actual cost of hospitalisation. I hope that we can have these two matters put right so that the grandmother's mind can be at rest and the child will soon have married parents serving happily in the Army.

§ The Under-Secretary of State for Defence for the Army (Mr. James Boyden)
I am grateful to the hon. Member for Maidstone (Mr. John Wells) for bringing this case to my attention and for the courteous and constructive way in which he has put it. I am also glad of the opportunity of explaining the position of the British military hospitals overseas with regard to private patients.
The hon. Gentleman has asked why it is necessary to raise charges at all when non-entitled patients, even British nationals, are admitted to British military hospitals. The Army is not required by its rôle, and is simply not able, to provide free medical attention and treatment except for military personnel and civilian officials serving overseas for whom the hospitals and their capacity are designed. Nor would it be reasonable and just to ask the British taxpayer to provide for more than this.
To concede preferential treatment for any particular case, much as we may sympathise with the individuals involved and their circumstances, could only be regarded as setting a most undesirable precedent which could lead other private British nationals in West Germany or elsewhere abroad, either as residents or as visitors, to expect to be treated in the same way. The end result would be the virtual extension of the free National Health Service to all areas overseas where there is a military presence. The resultant cost would have to be borne on the defence Votes and there are already more than enough demands on the defence budget.
I explained to the hon. Gentleman in my letter of 31st October that the soldier's daughter—she is 19 years of age —could not be given free medical treatment at a British medical hospital in B.A.O.R. because she lost her entitlement to free treatment in B.A.O.R. when she returned home to the United Kingdom with her father at the end of his tour of duty in Germany at the end of January this year.
When she returned to West Germany, which I understand to have been in late June or early July this year, she did so entirely of her own free will and under her own private arrangements and thereby voluntarily placed herself outside the 779 scope of free medical treatment, either from the Army or from the National Health Service. She was thus now in precisely the same position as regards medical treatment as any other United Kingdom civilian national privately visiting Germany.
I should like to give an outline of what happened before the hon. Gentleman first spoke to my office on 27th October. We now know the mother wrote to her daughter on 1st August, telling her to contact the Army medical officer at Soltau, B.A.O.R. Apparently on 5th October the daughter did get in touch with an Army medical officer, but at Munsterlager, B.A.O.R., and he, in turn, got in touch with the British Military Hospital at Hanover. The latter, quite properly, said that the daughter was not entitled to free medical treatment at the military hospital, but should be treated by the German medical authorities or practitioners with whom we do not compete for private patients, and they advised her to see the local German midwife where she was living.
At this time, no detailed background was known to the military hospital authorities, nor were there any reasons to treat the daughter differently from any other non-entitled person. The hospital authorities in Hanover therefore acted quite properly.
Between the 10th and 14th October, the mother privately telephoned the military hospital at Hanover. She spoke to a British Red Cross representative at the hospital and urged that her daughter should not be refused treatment as had happened on 5th October. As a result, the British Red Cross visited the daughter and later reported back to the mother in the United Kingdom. I am not sure of what was said on that occasion.
The Army medical authorities acted quite correctly but, naturally, looking at the case with hindsight, the question of admitting the young woman to the B.M.H. might have been handled differently had all the circumstances been known at the time. The situation as regard hospital charges, however, would have remained the same in any case.
That is to outline what happened before the hon. Gentleman spoke to my office 780 on 27th October, which was the first occasion on which I and my Department learnt of the difficulties facing this young woman. I was, of course, anxious to do all that could be done to help, but there were a number of difficulties in our way. The hon. Gentleman said when he spoke to my office that, among other things, the parents of this young woman were most anxious that the expected baby should be born in the British Military Hospital, Hanover, or another British military hospital, and they were prepared to pay any costs involved.
Thus, at the very outset, I think that the parents expected charges to be made for their daughter's confinement if it were to take place in a military hospital. But, unfortunately, the hon. Gentleman, through no fault of his own, was not in a position to give us additional information which would have been most helpful; for example, we did not know the daughter's address in West Germany and it seems that the mother did not know. It was not until 9th November that we were able to get this information.
Obviously, we could take no action to get in touch with the daughter until we knew her address. The hon. Gentleman also mentioned that the baby was due within two weeks, that is, about 10th November, but we now know that the expected date of confinement is about 26th November. I mention these points only to illustrate the efforts to try to help the daughter and that these were somewhat hampered from the start through lack of information to begin with.
Despite these difficulties, I agreed that if the daughter arrived at the B.M.H., Hanover, she would be admitted and treated there as a non-entitled patient: this meant that the normal charges would have to be raised by the hospital in due course. These charges are £9 5s. a day for treatment plus about £26 for ante-and post-natal treatment, a total sum of about £120 for a 10-day stay in hospital. The charges apply to all non-entitled patients in any British military hospital overseas, not merely to B.A.O.R., and although they may seem high they are not so when compared with the costs charged in civil hospitals on the Continent.
When we considered the question of the medical costs which would arise if 781 the young woman were admitted to the B.M.H. at Hanover, we took into account, of course, the fact that she was only 19 years of age, and therefore a minor. Consequently, our first move was to approach her father, at present temporarily on duty in the Far East, to find out whether he would meet these costs if raised. He did not, however, agree to be responsible for them.
The mother, on the other hand, said she would help her daughter financially, but she did not say to what extent. She has since told us that her daughter has not so far asked for financial assistance and in fact had returned money previously sent to her. These are of course domestic details which do not concern us directly, and I think we would feel bound not to interfere. This is in conflict with the information given to me by the hon. Gentleman that the parents were willing to pay the military hospital charges for their daughter.
If, as we now know, the baby is expected at the end of November, it is evident that the young woman must have been fully aware of her pregnancy at the time she returned to West Germany, of her own free will, in June or July this year. Why she took this step concerns herself and her family alone, but as the alleged father of the expected child was also in Germany, we do not have far to look for a reasonable motive. The fact remains, however, and I think this is important, that she apparently did not make any attempt to return to the United Kingdom at an earlier stage of her pregnancy, where she could have obtained excellent treatment, free of charge, either in a military hospital or under National Health Service arrangements.
In my view, it would not have been too late to do this even when the hon. Gentleman first contacted my office on 27th October. I could only conclude therefore that this young woman wished to have her baby born in a foreign country, regardless of the expense and difficulties which this might entail. This assumption is borne out, I think, by the fact that she did not take the normal action of a British national who is in distress or difficulty abroad by getting in touch with the nearest British Consulate in Hanover. The Consulate, when approached by the 782 military authorities, had no knowledge of the young woman's presence in Germany.
All this shows, I believe, that the young lady wishes to make her own arrangements in what must be a difficult situation for her. I do know however that there is concern about the nationality of the baby when it is born.
Assuming no marriage is contemplated between the mother and the putative father, under German law the child has no national status. Under Section 1 of the British Nationality (No. 2) Act, 1964, the mother can apply for registration of her child as a citizen of the United Kingdom and Colonies provided that the mother herself is a United Kingdom citizen at the time of the birth, as I assume she is, and the child is and always has been stateless. The application, supported by evidence from the German authorities that the child is and always has been stateless, can be made through the nearest British Consulate on payment of a fee of 30s.
If the parents do marry before the No. 2 Act procedure is completed, then the marriage may legitimate the child in retrospect under English law. An application should be made in these circumstances to the Secretary of State for Home Affairs through the nearest consulate for the child's nationality to be confirmed under Section 23 of the British Nationality Act, 1948. The procedure is reasonably straightforward on either count to ensure that the child is British.
When the military authorities in Germany finally found out where the young lady was living, the local military padre, and a representative of the military welfare services went to see her and they explained the position to her again, saying that she could be admitted to the B.M.H. at Hanover as a non-entitled patient. She was, however, adamant that she did not wish to enter the hospital and preferred to have the baby where she was living. However, I have arranged that, should any medical emergency arise, she should be conveyed direct to the B.M.H., if she then so wishes.
Despite the understandable interest and concern of the mother, the hon. Gentleman will realise that we have no power to insist on the young woman entering the B.M.H. against her wishes and that there is really very little more we can 783 do. But, as I have already made clear, if she does go to the hospital she will be admitted. She will be told the probable cost of her treatment, but I can assure the hon. Gentleman that there will be no question of her not receiving any treatment she may need if she says she is unable to pay the costs.
We have been considerably hampered by lack of information, but as soon as all the facts were available to us we did what we could and, as I have already said, I am sure that my Department and the B.H.M. authorities have dealt quite properly with the case.
I hope that the hon. Gentleman will be satisfied that we have done all we can, and that the young lady will be able to settle what are quite difficult emotional and matrimonial problems in the very near future.

§ Mr. Speaker
Order. The hon. Member has exhausted his right to speak, but 784 he can ask a question before the Minister sits down.

§ Mr. Wells
Before the Minister sits down, may I ask whether, in the event of the putative father being posted elsewhere before the marriage takes place—and if the hon. Gentleman does not have the answer now perhaps he will write to me and let me know so that I can forward the information to the grandmother —the nationality situation will be made more difficult in any way because of the absence of the couple from Germany, and therefore the lack of evidence through the British Consul in Germany? Will it be possible to act direct through the Home Office.

§ Mr. Boyden
I do not know the answer to the second point. On the first one, I will ensure that the corporal is not posted until these matters are satisfactorily settled.