SECRETARY OF STATE for SOCIAL SERVICES

HC Deb 24 October 1968 vol 770 cc1609-61

4.15 p.m.

The Secretary of State for Social Services (Mr. Richard Crossman)

I beg to move, That an humble Address be presented to Her Majesty, praying that the Secretary of State for Social Services Order 1968 be made in the form of the draft laid before this House on 16th October. The proposed merger of the Ministry of Health and Ministry of Social Security was, I believe, welcomed by hon. Members on both sides of the House when it was announced by the Prime Minister last week. I trust, therefore, that the matter will not be controversial. I do not intend to spend a great deal of time at this stage going into the matter; but if hon. Members wish to raise points, then I will seek permission at the end of the debate to answer them.

The purpose of the Order is to bring into one Department, under a Secretary of State, the present Ministry of Health and the present Ministry of Social Security. The new Department will be known as the Department of Health and Social Security and will be placed in my charge as Secretary of State for Social Services. The House will notice that my title is wider than that of the proposed new Department. This is in recognition of the fact, as the Prime Minister mentioned in the House last week, that I have been asked to continue my coordination of the whole range of social services, in addition to my responsibility for the new Department. I am pleased that the title of the new Department retains the names of Health and Social Security. They are names which have come to mean much to large numbers of people in need of help.

Looking up the history of these matters, I notice that the title of the Ministry of Health goes back to 1919, when the Ministry was created by combining the functions of the Local Government Board and the National Insurance Commission. I suppose that one of the most famous Ministers of Health was undoubtedly Neville Chamberlain, who was Minister no fewer than five times. I sometimes think that if the cobbler had stuck to his last, his name might have had even greater fame.

In 1945, Nye Bevan became Minister and, at that time—I recall it vividly—there was a great discussion in Government circles about whether Nye Bevan should be Minister of Health and Local Government, or whether he should be Minister of one or the other. He determined to do both, although, on reflection, I think that it was a mistake, as was indicated a few years ago: in 1951, still under a Labour Government, the Ministry's functions were split and one lot went to the Ministry of Housing and Local Government, which was then called the Ministry of Local Government and Planning.

As for the Ministry of Social Security, that name is of much more recent origin, because it was set up only just over two years ago when my right hon. Friend the Member for Lanarkshire, North (Miss Herbison) brought together the Ministry of Pensions and National Insurance and the National Assistance Board. These two Ministries have either initiated or inherited a great many big changes. Particularly, I recall that in 1948 we had a new and comprehensive National Insurance scheme and, in the same year, the National Health Service was established and new welfare services for the elderly and handicapped were introduced under the National Assistance Act, with the abolition of the Poor Law.

Looking back, since 1948 the years have been devoted mainly to building on the foundations which were then laid down. There has been only one major change since then. On the social security side, there was a major change in 1966, especially associated with the name of my right hon. Friend the Member for Lanarkshire, North, who did a wonderful job in that Ministry. That was the setting-up of the Ministry of Social Security and the Supplementary Benefits Commission and the winding-up of the National Assistance Board.

When I recall that we had 40,000 new supplementary pensioners, I appreciate that that was a reflection of the new rates and conditions and was part of the success in beginning to remove the stigma and reluctance of some to claim. We all remember with gratitude what my right hon. Friend the Member for Lanarkshire, North did.

I spoke of 1948. Now, 20 years later, we are entering into a new epoch of change in relation to a whole series of proposals which are coming before us. We have the Green Paper which my predecessor, the then Minister of Health, proposed. He put it forward not as official Government policy, but as a suggestion for stimulating discussion. We have the Seebohm Report, which is already stimulating discussion in terms of a greater drawing together locally of the social welfare services. Both of these documents must be considered in the context of the recommendations in the local government sphere which we are awaiting from the Redcliffe Maud Commission. Also, in my Department we have the White Paper on the Government's new earnings-related insurance scheme, which is coming forward at the same time.

I believe that the House will agree, therefore, that this is the right moment to create a new and powerful Department of Health and Social Security which will be well-equipped to carry forward new thinking over a wide sphere and to look at the needs of our less fortunate citizens, whether in cash or in services, as a coordinated exercise.

I must say a word about the rôle which I see ahead. I had three predecessors as co-ordinator of the social services in the Labour Government. I believe that, if one asked any of them his view of this task, he would reply that one should not be a co-ordinator without a Department; otherwise, one finds oneself co-ordinating in the sense of asking people to do things with the result that nothing happens. Plainly, if one wants effective co-ordination, one wants a base from which to co-ordinate.

If I may say so, when I have observed the co-ordinating work which is usually done by the Chancellor of the Exchequer, though it might be done by a Minister without Portfolio, I think that he might well not be such an effective co-ordinator as he is in fact with the Treasury behind him. If he were asked about his part in all this operation, the answer would be that the co-ordination should be done from the base of a major Department in Whitehall.

I turn now to the Departmental questions, which, I expect, is what hon. Members will wish to hear about. The first matter which I take up was raised by my hon. Friend the Member for Birmingham, Perry Barr (Mr. Christopher Price)—he is not here at the moment, I think—when at Question Time he asked the Prime Minister about responsibility for the children's departments of the local authorities and the related section of the Home Office.

As the Prime Minister said in his statement, the question of exactly what will happen is highly arguable. First, we do not yet know what we shall do since we are waiting to consider the recommendations of the local authorities regarding the Seebohm Report. Second, we do not know whether the outcome will call for consequential changes in Whitehall. It is obviously sensible that one should not consider the question of the children's department of the Home Office and the related local authority departments until we see it in conjunction with the Green Paper and the Seebohm Report, and also, I am pretty sure, until we have at least had a look at the Maud Commission's Report on the reform of local government. It will be my job as co-ordinator to see that proposals are brought forward and to consider what consequences flow from them.

The activities of the two Departments are complementary, though in saying that I have no wish to beguile the House with the idea that they will be merged in the sense of mixing, on the one hand, services providing cash and, on the other, activities providing services. They are very different activities. One of the Ministries, as we all know, is largely a Department whose strength is in its regions, in the actual work which it does in the country, whereas the other is, so to speak, advisory, not having the same regional build-up. A large amount of the work will, therefore, remain separate in that sense within different parts of the one Department. However, it remains true that both provide short and longer-term help, and both are concerned with particularly vulnerable groups such as the elderly and the mentally ill.

The planning of services in kind and in cash benefits should be improved in comprehensiveness and efficiency if carried out within one Department, and in their practical operation there is much scope for co-operation at the local level between the local staff of the new Department, on the one hand, mainly in its social security side, and, on the other hand, the local authority officers dealing with health and welfare, the hospitals and the general practitioners.

The bringing of responsibility together will not automatically achieve a more effective service, but I am certain that it will help towards that end. However, I do not seek to exaggerate the extent of immediate or speedy results.

Having lived with these questions for some months, and thought about them deeply, I am sure that there is one area in which we can make considerable immediate improvements, namely, in the co-ordination of research and the development of central planning in the social services. If there is one area in which we need our information supply coordinated in the sense of getting our intelligence work done, it is in the area of the social services as a whole, and I believe that our Ministry will be able straightaway to start, with its rather larger staff, by merging the intelligence staffs of the two previous Ministries and working them together. I can see considerable improvements in that way and in the planning work resulting from the merging of the two Ministries.

Those are, I think, the main points which I wish to make. If I am asked detailed questions, I should do my best to answer them. I suspect that one or two hon. Members have questions of detail to put, and I shall be quite willing to answer them as best I can.

I am convinced that the case for the change which we are now making—to be fair, I think that it was urged first from the Opposition benches before it was urged from this side—has always been a strong one. In the last four or five months, I have learned a great deal, and I have a great respect for the work which the Ministers and civil servants have done in the past.

Here, if I may, I pay a special tribute to my right hon. Friend the last Minister of Health. He had a long time in that Department, indeed, one of the longest tenures of office. In the past six months, I visited well over half of all the regional hospital boards and talked to them, and I found an unbounded respect—this had nothing to do with party politics—for my right hon. Friend as a dedicated and devoted Minister. I am well aware that in taking over I shall have a very difficult job to live up to the reputation which he has left behind him in the Department.

As for my right hon. Friend the Paymaster-General, I say only that I shall miss her, because when we try to present to the House our proposals on pensions—the right hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) knows this very well—a powerful mind plus an understanding of women and their problems is an essential factor in the presentation. I shall miss my right hon. Friend a great deal, both for her mind and for her ability to understand the difficulties of the spinster, the married woman the widow, the wife and the rest—all the difficult issues which she was tackling but which mere men will have to tackle in the future in our merged Department.

I hope that I have said enough to show that we have accepted her advice—this shows how open-minded we are—given to us over a long time now by distinguished members of the Opposition. We hope that they will wish us success in the new merged Ministry.

Mr. Speaker

It may help the House if I remind right hon. and hon. Gentlemen that this is a narrow debate. We are debating a Statutory Instrument which dismisses two Ministries and establishes another Secretary of State to take over all their functions. What we are debating today is whether this draft Order be approved.

4.26 p.m.

Lord Balniel (Hertford)

The right hon. Gentleman was very generous in his tributes to various persons who have been concerned in these matters. I begin by extending to him our congratulations on his appointment as the first Secretary of State for Social Services, an office the creation of which flows automatically from the integration of the Ministries of Health and of Social Security. The right hon. Gentleman hoped that we would wish him well. We most certainly do wish him well in what will undoubtedly be a short tenure of office but one which undoubtedly comes at an extremely important moment in the development of this country's social services.

We have with us the former Minister of Social Security and the former Minister of Health. Although in past years I have disagreed with much of their policies, I know that there is no one who has not respected the two Ministers for their qualities of intellect and their dedication to the services which they have had to administer. They have had heavy responsibilities to fulfil—and they have earned the respect of the whole House. I join the right hon. Gentleman in expressing, to them, the same tributes as he himself has made.

The debate arises against a certain background of sadness and of expectation. It involves the ending of the separate existence of two of the great Departments of State. Both these Departments, the Ministry of Social Security and the Ministry of Health, have built up a fine reputation for the quality of their administration and both have, during their long history under various names, contributed substantially to the well being of the people. On this occation, when we are marking the end of a separate existence for the two Ministries, it is right that those who have worked in them should know how much all they have done is appreciated not only by Members of Parliament but by members of the community in general. For many of them as individuals, the work which they have done in the past will continue in exactly the same form for many years to come.

We appreciate that our task in the House in passing an enabling Measure is a comparatively simple one. However, if the integration is to have any meaning at all and if we are to achieve the overall comprehensive thinking and overall executive action which is necessary, major administrative changes will in fact be necessary within the new Department, and this will be an additional challenge to those who work in this field.

I begin, as the right hon. Gentleman hoped, by assuring him that we shall in no way stand in the way of this integration, because it implements the policy which we have advocated for a considerable time. It was indeed part of the election manifesto which we presented to the country. The Conservative Party Manifesto stated that we were pledged to combine the Ministry of Health, the Ministry of Pensions and National Insurance and the National Assistance Board into a single Department with local officers who would have a positive duty to seek out those needing help, whether in cash or care". We therefore welcomed the partial implementation of this policy when the old National Assistance Board was incorporated in the Ministry of Social Security under the Ministry of Social Security Act, 1966.

My regret lies not in the present integration, which we welcome, but in the piecemeal, apparently haphazard and rather involuntary way in which we have reached this point, which for a long time we ourselves have regarded as inevitable. First, we had the 1966 Act and the changing of the name of the Ministry, which I welcomed. But our pressure to bring together the two Ministries at that time was resisted. Now we have this Order and again a new name is to be given to the Ministry. The painters of the local office boards throughout the country will be working overtime. So also will the printers of that great avalanche of leaflets which descends upon us from the two Ministries. More important, because of this piecemeal approach the poor public will become even more confused than was necessary.

My criticism is that even now we do not know when legislation will be introduced to set up a unified social security department at a local authority level. The trek from office to office which so many families in difficulties still have to undertake will continue until we know when the Government will introduce legislation. Until such a step is taken at the local level, the Government's action is basically a gesture, although it is a gesture in the right direction. It is little more than part of the Whitehall game of moving the demarcation line from one Ministry to another. Until the integration is echoed at the local authority level by the local authorities themselves, this measure, which is right in itself, will have very little impact on the public concerned. There will be a continuation of the bewildering variety of services, there will be a continuation of the overlapping of services, and of the gaps which at present exist.

I have paid a tribute to the civil servants who have manned the Ministries of Health and Social Security, however, I do not want to see these civil servants becoming one of the greatest growth industries in the country. The old economic law of the 1945 Government is once again developing in the present Administration. As we make our giant strides towards Socialism, every footprint seems to create more civil servants. The number has risen in the past four years by the staggering figure of 14,500. One has only to talk to any person working in the Health Service—general practitioner, consultant or member of a hospital management committee—or to anyone in the field of social work, and almost without exception he expresses the opinion that the administration is top heavy and, more important, that it is too remote from the local communities.

In private industry a merger almost invariably results in a reduction in the number of directors, and a reduction in the administrative staff. In its leading article on this subject, the Daily Telegraph commented, In private industry amalgamation normally produces redundancies. Not so apparently in Government". Indeed, the number of Ministers has increased from 90 to 107.

When we heard last week of the proposal to amalgamate these two Ministries, my right hon. Friend the Leader of the Opposition immediately asked the Prime Minister what would be the scale of the reduction in staff. The Prime Minister replied that savings in the Civil Service will be difficult to estimate at present. May I ask the right hon. Gentleman why? When two industries are integrated, one of the major financial considerations always taken into account is the degree to which they can make savings in overheads and administrative costs. Presumably in planning this integration the Government must have had business efficiency experts to examine the implications of the integration. One could at least rationally expect that the rate of recruiting of civil servants into the new Ministry would be reduced.

The number of headquarters staff at the Ministry of Health was 3,700. At the Ministry of Social Security the number of headquarters staff was 2,250. The Secretary of State for Social Services will have a combined headquarters staff of about 6,000. But the Ministry of Social Security also has about 2,000 staff in Blackpool, about 9,500 staff in Newcastle and about 44,000 staff in the various regional and local offices throughout the country. Far from indicating a reduction in the number of civil servants, the Secretary of State announced that an additional 1,500 civil servants would be recruited into the Newcastle centre alone. If the Minister is able so specifically to calculate the increases in staff for which he is planning, I fail to see why he cannot give even an indication of the decreases which will be achieved as a result of this integration. Perhaps he will give an indication in his reply to the debate.

Having urged this integration for so long, I emphasise that our intention is certainly not to establish one giant, monolithic structure. Our intention is the reverse. Integration is necessary because the problems which have to be solved are inter-related problems. There are the inter-related causes of poverty and distress, which lead to family breakdown or ill health. There are also the inter-related methods of service; of care and cash which ought to be used to solve the various problems. The problems which have to be tackled by the Ministry are part of a vicious circle—a vicious circle of shortage of cash, frequently shortage of jobs, physical or mental handicap, short-time working, inadequate health and welfare facilities in the area. A concentration of those problems often is to be found in those areas where there is a heavy influx of immigrants, with the consequential strain placed upon the education and housing services although these do not come within the right hon. Gentleman's remit.

Some degree of integration is necessary if we are to break down the vicious circle, and the step which is being taken today is a step in the right direction. Nobody will doubt the scale, the importance and the political bargaining power of this Ministry which will be very substantial indeed. The current cost of social security amounts to £3,100 million a year, and the combined health and social security Department's budget annually will reach a figure of about £4,700 million. This is more than twice the size of the budget of the Defence Department. It accounts for 30 per cent. of the totality of public expenditure in this country.

If this is not to be a vast bureaucratic organisation, three steps must be taken as part of this reorganisation. First, there must be a massive devolution of responsibility away from London to the localities and wherever possible—and I think that in a large degree it is possible in health and welfare—this devolution should contain a major element of devolution to locally elected local authorities.

I agree with The Times which commented on this rationalisation of the Ministries: Provided that it is accompanied by a greater willingness to devolve executive and detailed functions, preferably to locally elected authorities where this is appropriate, it could have a reviving effect upon the quality of public administration in Britain. I have no doubt that my hon. Friend the Member for Farnham (Mr. Maurice Macmillan) will be referring to this in connection with the Health Service, but in broad terms every argument for reviving local democracy and a sense of public participation in decision-making points in this direction of a massive de-devolution of decision-making and responsibility to local authorities.

The second step which should be taken as part of this reorganisation is that to which the right hon. Gentleman himself referred, namely, that within the new comprehensive Ministry an intelligence research unit, substantially stronger than that which exists at the moment, should be established. We are talking in terms of the development of social policy strategy and what is needed is not merely an administrative reform, but administrative arrangements for the future based upon clear, easily understood statistical information showing where the weaknesses exist today and showing projections for the next decade or 20 years. I am personally rather disappointed that the Government have not taken this opportunity of transferring responsibility for the Social Survey, which is the responsibility of the Central Office of Information, to the new Ministry for which the right hon. Gentleman is now responsible.

The third and last major development of policy which I should have liked to have seen taken in conjunction with this Statutory Instrument is perhaps the most crucial. It is that the Government should announce their acceptance of the principles of the Seebohm Report. They should announce their acceptance of the principle of establishing a new local authority social service department, taking its place alongside the education department and the reconstructed local authority health department.

I fully appreciate that consultations have to take place with medical officers of health, with the probation service, with child care officers and with the various social work professional organisations, and, of course, comments have to be invited and advice sought from the various local authority associations before final demarcation decisions can be reached. But it is important that acceptance of the principle of the Seebohm Report should be announced now, because only if it is done now can the professional organisations, the disciplines concerned, and the local authorities begin the necessary preparatory work, which will be a major undertaking for them.

I agree with the Seebohm Report—and here I parted company from the right hon. Gentleman, although I may have misunderstood him—that it is not necessary to await the reconstruction of local government before introducing legislation to implement the broad outlines of the Report.

Mr. Crossman

I may have said something ambiguous. What I hope I said was that we would await a sight of what the Maud Commission recommended, which is very different from awaiting its completion. We could hardly act without knowing what it would recommend.

Lord Balniel

I fully accept what the right hon. Gentleman has said. It is our expectation that the Lord Redcliffe-Maud Report will not be long delayed. I understand that it is now in draft.

This reorganisation strengthens the position of the Secretary of State for Social Services in political bargaining power in the Cabinet. This must now be accompanied, if it is to have any real meaning, by at least two major important themes of policy. Accompanying this integration of these two Ministries there must be a massive devolution of responsibility from the centre as far as possible to local authorities and there must also be set up an integrated social service department at local authority level. On that basis we warmly welcome this Statutory Instrument.

4.46 p.m.

Mr. James Griffiths (Llanelly)

I join with the noble Lord the Member for Hertford (Lord Balniel) in offering congratulations to my right hon. Friend on entering upon this new and very exciting post, and I wish him well. I also join with the noble Lord in paying tribute to the two Ministers, the last Minister of Social Security and last Minister of Health, who are now sitting on the Front Bench. I should also like to pay tribute to the right hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter) who had the privilege of serving in the old Ministry of National Insurance. I also pay tribute to the staff of that Ministry at every level. It was my great privilege from 1945 to 1950 to work in that Ministry and to create the central office. It is interesting to recall that one of the controversial questions at the time was whether a central office at Newcastle-on-Tyne could be successful. Much expert opinion said that it was essential to have everything in London. It is important to remember this when devolution is considered. The establishment of that office has been a wonderful success, and I hope that it will encourage the Government to send more and more administrative work out of London.

Like all these things, this Statutory Instrument is very complicated—perhaps it ought to have an introduction—but I gather that it is proposed that the Secretary of State for Scotland should retain his authority over these services in Scotland. If that is to be the case for Scotland, why not for Wales? We are now abolishing the old Ministry of Health. When that Ministry was set up in the years immediately after the First World War, it included a Welsh Board of Health. What is to happen to that? The Welsh Board of Health was set up in 1919. Is it to be continued as the Scottish Health Department is to continue? Surely this is an appropriate opportunity to transfer responsibility to the Secretary of State for Wales. The Secretary of State for Scotland and the Scottish Office will retain authority for the health services in Scotland the Secretary of State for Wales should be given control of these services in Wales.

I hope that my right hon. Friend has not closed his mind to taking another logical step. It is also my view that the responsibility which the Home Office now has for some parts of the social services should be vested in the new Ministry. Whilst we are doing this we should make a decent job of it.

After the passing of the National Insurance Act, 1946, we found it necessary to establish 1,960 local offices. We took over all types of buildings in those days of stringency immediately after the war when there were so many higher priorities, such as the reparation of bombed cities. I then made up my mind that some day we should establish one social security centre in every community, thus bringing all services under one roof. Some continental countries have already done this.

The trouble about having scattered services is that people are chivvied from one place to another when they try to find out who is to deal with their problem. I believe that this is a wonderful opportunity to do this. I know from my own constituency that local authorities are now considering, and some are beginning to implement, plans for the reconstruction of town centres. I hope that the Government will enter into discussions with local authorities and say, "In the new centre, when you wipe away the remnants of the 19th century and have a new centre for the town, there should be one social security office covering all services". This should be done with local authority services, too. I hope that my right hon. Friend will take this opportunity of ensuring that there is one place to which people can go and get their problems attended to. It is no good building a wonderful structure right at the top if down below there are slummy offices.

The Health Service and the social security services are now to be in one Department. I set up local advisory committees under the 1946 Act. They bring together people from both sides of industry and from every section of the community. The managers and officers of the Ministry of Social Security local offices report to these committees and tender them advice and counsel. Complaints are brought to their attention. This ensures that local opinion can be brought to bear upon the administration.

Dealing with people who are in trouble is an administrative job performed in the most delicate or circumstances. These Committees have served well. There are about 250 local committees through which members of the community are able to bring to the notice of the administration people's problems, difficulties and complaints.

Not only should these Committees be continued. It is important that there should be brought within their purview the administration of the Ministry of Health and the health services. All of us felt that there was a strong case for creating the organisation of the Ministry of Health in the way it was done. However, at local levels it is the least responsible of all. There are executives in the counties. There are regional hospital boards. There is one for the whole of Wales.

We are shortly to tackle the problem of the reorganisation of local government in Britain. This will involve not only the amalgamation of present local authorities into larger and more powerful bodies with greater resources and responsibilities. We may also be discussing the possibility and desirability of establishing regional forms of local government in England, Scotland and Wales. I ask my right hon. Friend to give consideration to the problem raised by the noble Lord. I, too, think that there should be a devolution of authority to localities and that local authorities should be brought into some kind of partnership.

This new Ministry will handle for Parliament and for the whole country these very important human services. We must always remember that we are dealing with people. When I started my public life as a miners' agent my old chief gave me this advice, "People will come to you when they are in trouble. They will not find it as easy as you do to express themselves. Perhaps the biggest service that you can render is to listen to them and to share their troubles".

We owe the Ministry of Pensions and National Insurance, as it was, the Ministry of Social Security as it has been more recently, and the officers of the Assistance Board a deep debt of gratitude for the way in which they have performed their duties. The complaints have been few and far between. We can look back to a quarter of a century of good work. We can all take pride in the fact that a service has been rendered to the people. It is very important to render a service to people without undermining their dignity.

I believe that we may be at the beginning of a new social security structure, perhaps a change in the method of collecting contributions, perhaps in the method of fixing benefits. I hope that the next 25 years will be as fruitful as the last 25 years have been. I take the view that the Welfare State is not a luxury but an essential part of a civilised community. I am very proud that the Government of which I was a member from 1945–50 began this great transformation. I wish my right hon. Friend good luck for the future. I hope that he will give some attention to the problems which are being posed to him this afternoon.

4.58 p.m.

Mr. John Boyd-Carpenter (Kingston-upon-Thames)

Like my noble Friend the Member for Hertford (Lord Balniel) and the right hon. Member for Llanelly (Mr. James Griffiths), I begin by wishing the Secretary of State designate a short life but a gay one—in, of course, the official sense.

One of the least important and certainly least intended effects of the Order, if it becomes operative, as I hope that it will, will be a purely personal one. I shall be the person who will have held the Ministry of Pensions and National Insurance or the Ministry of Social Security, for they were basically the same, for a longer period than anybody else will ever be able to hold them. I had a longer term there than even my immediate predecessors, Lord Ingleby who, as hon. Members will remember, was Osbert Peake and who did a very fine job in the Department in difficult circumstances, and the right hon. Member for Llanelly, whom we are all delighted to see here today and who left behind him in the Department a memory which was very deeply revered and respected.

With that experience, I can very emphatically endorse what I was so glad my noble Friend said as to the very high quality of the staffs who have served successive Ministers in the Ministry of Pensions and National Insurance. It is not a combination that one always gets, but they have combined a very high intellectual quality with sensitive feelings of humanity, and they have deserved extremely well of their fellow countrymen.

I have always been an advocate of a unification of the Ministerial and Departmental structure in the social services. Somewhere mouldering in the files of Whitehall there is a paper over my initials advocating this and, as my noble Friend says, the party to which I happen to belong put forward this proposal at the election.

My only quarrel with the Order—and it is one with which a number of hon. Gentlemen are inclined to sympathise—is that it does not go far enough. I agree with the right hon. Member for Llanelly that it is a great pity that the Children's Department is not being taken from the Home Office. if ever there was a vital social service, it is that. I should have thought, particularly after the statement which we heard earlier today, that the Home Office had quite enough to do in its ordinary sphere of activity without acting as a social service department in this limited direction. I hope that the Secretary of State will use what will now be his very powerful position in Whitehall to do a little empire-building, at any rate in this direction. I say that with confidence, because some knowledge of him during my time at the Ministry of Pensions, when I had the pleasure of having him as my shadow, suggests to me that temperamentally he is not wholly opposed to empire-building. I wish him good hunting.

I have never understood why what used to be the Ministry of Labour, which has now gained without much change in function a more high-falutin title, should house a department concerned with unemployment benefit. It seems extraordinary to have, at the same time, an office in the Ministry of Labour dealing with unemployment benefit and a Ministry of Pensions and National Insurance office dealing with other benefits. I think that the unification could have gone further.

At the risk of annoying my Scottish friends I would say that it is absurd to retain the Scottish Health Department as a separate entity. The Ministry of Pensions and National Insurance and the Ministry of Social Services have always operated in Scotland. I have enough Scottish blood in me to know that the Scots are not backward in coming forward when they have complaints, but I do not recall any complaints about that. With respect to all who work in the Scottish Health Department, I cannot believe that it would not gain in efficiency from being brought into the general complex of the new Department. The Scots are particularly concerned to get good value for their health service, and I think that they should have the advantage of what I believe would be an improvement. I hope that there, too, there will be some expansion. It is of the essence of the Order before us that there should be an overall Ministerial command of the main body of our social services in the interests of all.

As the right hon. Gentleman was good enough to indicate that he would be prepared to answer specific questions at the end of the debate, I want now to ask a number of questions, some of which are based on my experience in the Department.

When two Departments amalgamate, in practice one provides the nucleus. Which will it be in this case? Will it be the M.P. and N.I. or Health? Where will the headquarters of the new Ministry be? Which is to be the centre on which the development is based? The Secretary of State is inheriting a brilliant stair at the Ministry of Pensions. I am not for a moment indulging in any invidious comparisons with the Ministry of Health, of which I have much less knowledge, but I hope that the right hon. Gentleman will take advantage of his good fortune in inheriting the staff at the Ministry of Pensions and National Insurance.

I suppose that he will have a number of Ministers of State and Parliamentary Secretaries. How will their functions be allocated? Will there be a Minister of State doing what the former Minister of Health did, and another doing a good deal of what the present Paymaster-General used to do? Alternatively, will the right hon. Gentleman follow the analogy of the Ministry of Defence and divide the responsibilities of his junior Ministers on a functional rather than a subject basis? Perhaps he will be able to tell us how many Ministers of State and Parliamentary Secretaries he will have.

In this connection, I would ask a specific question. There used to be a separate Ministry of Pensions for many years, dealing with war pensions. It is the oldest of all the Departments in the amalgamation over which he will preside. As the right hon. Member for Llannelly will recall, when that was merged in the time of Lord Ingleby into the Ministry of National Insurance, the ex-Service bodies were disturbed. They had been accustomed to having a Minister of their own. It was always the understanding that there should be, at any rate, a Parliamentary Secretary whose main duties were concerned with war pension problems to whom the ex-Service bodies would have frequent access. Under the new arrangements, is it intended to continue that? If so, will that Minister be a Minister of State or a Parliamentary Secretary?

There is a related problem. As the right hon. Gentleman knows, throughout the country there are war pension committees which, on a voluntary basis, do a remarkable job in looking after the interests of the war disabled in the broadest sense. Every Minister of Pensions and National Insurance went round the country at least once a year to meet the chairmen of those war pension committees, as I am sure the Paymaster-General would confirm if she were still in the Chamber. I suppose that it will be impossible for the Secretary of State to carry on that practice, with all the duties that he will have. Is it intended that it shall be carried on by a fairly senior Minister? The committees and the ex-Service bodies will attach great importance to it, and I should be glad to know what are the intentions of the right hon. Gentleman.

Then I take up what my noble Friend said. How far is unification intended at a local level? Already, within the new amalgamation, there are offices of the Ministry of Social Security in every town and, in a number of towns, offices connected with the Health Service, such as those of the executive committees. Is it intended to merge them? At the same time, now that the Supplementary Benefits Commission has taken the place of the National Assistance Board in the old Ministry of Social Security, is it intended that its offices should be merged? When my right hon. Friend talks about the numbers of staff, that is where the real numbers are. They are not at headquarters. If there is to be an increase in efficiency combined with a reduction in staff and costs to the public, it is in that direction that the real savings will be found.

May I also pick up what the right hon. Member for Llanelly said about the fact that the Ministry of Social Security has for many years been the only major Department to have its main headquarters out of London? It has been a great success. In the late Government, when I had the duty as a Treasury Minister of inducing some of my colleagues, with more or less enthusiasm, to move some of their Departments out of London, this was an extremely useful example to give. Though the right hon. Gentleman had some difficulty in persuading the staff to go, if any of his successors had tried to bring it back, they would have encountered greater difficulty. At one time, light-heartedly and to test the reaction, I told the chairman of the staff side that I intended to bring them back to London. He said, "They will go on strike if you do." It has been a great success, and I hope that, under the new system, the Secretary of State will use his considerable energies to secure that there are further moves out of London.

Here, again, there are economies to be achieved as the result of amalgamation. The Ministry of Social Security has at its Newcastle Headquarters what was, when it was installed, the largest computer in Europe. Right hon. and Hon. Members who have studied the use of computers know that the main problem is to find enough work to keep them fully occupied. When the amalgamation has taken place I hope that a good deal of the work of the old Ministry of Health can be transferred to Newcastle and use made of that very fine computer.

I hope, too, that it may be possible to have a closing up at Blackpool. I hesitate to mention that salubrious resort in the light of recent circumstances. However, there are two substantial Departments there. I hope that they can be brought together and some economy achieved in that way.

Those are only a number of the questions relating to what is, in its way, an historic Order. Though there may be right hon. and hon. Members who have their doubts about it, I think that it is a step in the right direction, but I should like to see this step carried even further. I hope that the right hon. Gentleman will bend his undoubted energies to the task of seeing that an administrative change, which most of us welcome, justifies our hopes.

5.11 p.m.

Mr. Eric Moonman (Billericay)

By Friday next the "mating" referred to in the Order takes place. Clearly implicit in the change is the desire to give an even better service in health and welfare and also to combine and co-ordinate two Departments. Yet it has been said that changes in structure do not necessarily change attitudes, nor make staffs agree or share a common objective. This is an area which the Secretary of State ought to consider. The evidence that we have from industry of mergers taking place and the evidence of public enterprise having been taken over from private enterprise suggests that although there are substantial financial, economic and political reasons for doing it, often the attitudes of the people concerned working within the organisation are not affected. This is a serious matter if we want to coordinate as well as change attitudes.

If the change implied in and required by the Order is to be met, something more than a merging of two Ministries is required. I suggest that it can be looked at under three heads.

First, a careful assessment at all levels of the way that work practice is performed is vital. I am not simply talking about methods. A common affliction of the civil servant when trying to be efficient is to look at methods. I suggest that throughout the entire organisation it is systems which require careful thought and assessment.

Some of the characteristics are worth mentioning in the merger of the two Departments if it is to bring about an improved and co-ordinated service. I mention two or three of the elements.

First, information collection. Is the previous technique still suitable in a "really big Department"? The kind of questions which ought to be looked at as soon as the merger gets under way are the collection of information not only between the two Departments, but also the information process between the staff and the administrators. Generally, informa- tion collection must form a vital part in the efficiency of the service.

Secondly, analysis and appraisal. How often were the previous work practices appraised? Who did the appraisals? With a vast amount of material now available on the subject, I suggest that there has been, and there should be, a regular injection of ideas and techniques to meet the new structure.

Thirdly, decision making. The way that decisions have been taken in both Ministries now needs to come under sharper focus. The Secretary of State will not be able to engage in extensive detail of the lower levels of decision making. But he will, I suggest, need to be satisfied that the decision-making process is right not only at the top of the organisation, but also in the middle ranges of the new Ministry.

Finally, control. This requires a close watch on the variations in standards of service of social welfare in different parts of the country. For instance, the ways—the peculiar ways—of local councils and the encouragement or not, as the case may be, of voluntary groups. When one considers the state of the community's mental health it is specially interesting to observe the way in which Sections 25 and 29 of the Mental Health Act are interpreted. For example, the Parliamentary Information Unit has discovered that, in the Liverpool hospital region, the compulsory admission rate is over 110 per 100,000 of the population compared with, say, Oxford where it is about 50 per 100,000 of the population.

The second broad area my right hon. Friend ought to consider is concerned with Article 2 of the Order dealing with the transfer of functions and dissolution of the Ministries. It is neat and looks very tidy. But where does this leave Seebohm? This has been brought out on several occasions by different speakers. I would urge my right hon. Friend, either tonight or at the earliest opportunity, to tell us the terrible truth about this report dealing with the personal social services. I should like to think that we could take it. If it is not one of the functions covered by Article 2 there will be some very odd noises in various parts of the social services that a big, brand new, with-it Ministry of Social Affairs does not include responsibilities relating to the family or personal social services.

It may be that the Prime Minister did not assist in the confusion when he said: I think the House generally will recognise that there are a number of aspects of social, health and welfare matters where the division of responsibility between Departments can complicate the furtherance of desirable policies. It is for this reason that, as the House knows, I have decided to amalgamate the Ministries of Health and Social Security and have asked my right hon. Friend the Lord President of the Council to supervise the planning and timetable for the amalgamation."— [OFFICIAL REPORT, 11th April, 1968; Vol. 762, c. 1582.] I appreciate that evidence and comments are still coming in from interested bodies on this report, as my right hon. Friend told me in answer to my Written Question on Monday.

Finally, where does the Ministry's functions operate at local level? I will keep my comments brief, because this has been covered most critically. I would remind my right hon. Friend that the Seebohm Committee spent a great deal of time and energy looking at the work of children's departments, the services for the old and the disabled provided by welfare departments under the National Assistance Act 1948, and the services at local level concerning education, welfare and child guidance, home helps, mental health social work, and so on. This is a critical part of the social framework for which my right hon. Friend is responsible. I hope that there will be some indication about how this will be tackled.

Thirdly, the problems of staffing. I hope that the policy of the new Ministry will be to encourage and stimulate a dialogue between the Ministry being taken over and Members of Parliament in a way which has not always been possible in the past. For instance, with the children's service, the Home Office has gone a long way towards making available information on staffing. Figures are available to show that there are many small authorities in Britain which have substantially lower proportions of qualified staff. It would be a reasonable assumption that at times of shortage of professionally qualified case work and field staff in all the social services, it is in the public interest that the distribution of the qualified staff should be related either to need or at least should be fairly evenly distributed.

I have offered these comments briefly, and perhaps with some criticism, but I trust in a positive way. I know that my right hon. Friend, as the Secretary of State for the Social Services designate, has a considerable responsibility in tackling a service, which is the most personal of all administered by the Government, and, therefore, will be subject to keen and close scrutiny. There is no doubt in my mind that my right hon. Friend is the most fitted in this House to stimulate the energy and enthusiasm to merge the two departments. I wish him well.

5.18 p.m.

Sir John Vaughan-Morgan (Reigate)

We all wish the right hon. Gentleman very well in his new office and in his new and immense task. I almost hesitate to cast a note of doubt, dissent and discord into the cosy colloquy which has been going on so far. But I think that this is probably the wrong initial step in this important task. It was described to me, by one far more expert in these matters, as the marriage of chalk and cheese. I cannot but feel from the right hon. Gentleman's introduction that even he has not any very great hopes that this immediate merger, or even marriage, will be very fruitful.

I do not want so much to stress that side of it as to concentrate on the constructive side of the right hon. Gentleman's task, which is the co-ordination of the various services. Here—and perhaps this is the reason for my dissent—I should point out that the Ministry of Health, the Department which I know best, has obvious affinities with, and overlaps, other Departments, particularly the Ministry of Housing and Local Government, the Department from which it originally sprang, and to which I should have wished to see it returning today.

The right hon. Gentleman referred to the divorce which took place in 1951. When I spent a brief spell at the Ministry of Health there was a legend circulating that when the division took place it so happened that Dr. Dalton got to the office first, which was why he was in Whitehall, while the Ministry of Health was cast into the outer darkness of Savile Row. If, therefore, the marriage had been restored. the right hon. Gentleman would have been able to go straight back to Whitehall where it all started, and I feel that this might even be a sentimental reason for him so doing.

Furthermore, I cannot help drawing attention to the fact that there would be absolute advantages in that merger. At a time when the Green Paper has been launched and is out for discussion with all those concerned with the National Health Service, and at a time when the Redcliffe-Maud paper on local government is coming forward, I feel that this would have been the right merger and would have led in the near future to some positive benefit. As I said earlier, I thought that this proposal for the merger of these two Ministries was a foolish one when it was put forward in my party's manifesto, and I knew for certain it was when it was adopted by the Labour Government.

I should like to make one point on the new set-up, and that is that, judging from the Prime Minister's replies to Questions recently, it appears that the two Ministers of State are going to divide their responsibilities between the two Departments. One has a vision of the two Ministers of State permanently oscillating between the Elephant and Castle and the Adelphi. I hope that this will not be so. I hope that to begin with there will be one Minister of State for the health side, and one Minister of State for the social services.

This is extremely important. Anyone who has been at the Ministry of Health knows that the Minister has vast administrative responsibilities. He is, indirectly, perhaps one of the largest employers in the country. He has to negotiate with many different grades and degrees of people, many of whom—and one section in particular—are particularly difficult to negotiate with, and I refer, of course, to the doctors. I know that there is every reason for some of their difficulties in negotiations, but it is a tact. I think that there will be a much better chance of success for the right hon. Gentleman in his task if, at any rate to begin with, there is one Minister of State to whom everyone concerned knows they can appeal.

One other point which has been referred to is the curious anomalies with which the right hon. Gentleman starts. First there is his curious Scottish schizophrenia, by which he sheds his health hat as he crosses the border to Scotland, but not when he crosses the border to Wales. No doubt the right hon. Gentleman will deal with that.

The acid test of the right hon. Gentleman's prospects of success is whether he can take over the children's department of the Home Office. I shall give a loud cheer if he can winkle that away from the Home Office. He will, I believe, succeed where others have tried and failed. I have never understood why children's welfare was in that ragbag of a Department, all mixed up with police, prisons, fire brigades, aliens, and all sorts of curious duties connected with the Channel Islands. Last, but not least, I understand that the Home Office has the duty of maintaining the Standing Roll of the Baronetage. I cannot help feeling that none of these duties has anything in common with the care of children. It may be the right hon. Gentleman's Waterloo, but we all wish him every success in taking that over as soon as possible. The only argument that I have ever heard was that it was suggested that it humanised the Home Office, but that has not been so in my experience during the last year or two.

Some reference was also made to the fact that certain duties remained with the Minister of Labour. I add to that the responsibility which the Minister of Labour still has for industrial health. This is something which ought straight away to be brought under the umbrella of the new Minister.

Those are a few comments on this change, but I should not want to sit down without being allowed to pay my own very warm tribute to the last Minister of Health. The National Health Service has, fortunately, as regards most matters, now got beyond mere party politics. Therefore—and I think this will be agreed to by both sides of the House—I can now, as one who in a small way has something to do with the National Health Service, pay a very warm tribute to the right hon. Gentleman.

The Times, in a rather quaint phrase, said that it was no occasion for shedding crocodile tears on his transference to other responsibilities. I am no crocodile, but I should like to shed a very slight tear at the right hon. Gentleman leaving the sphere of the National Health Service. He has won the warmest regard of everyone, even some of the most difficult people with whom he has to deal, and I think it would be right for it to go on record that we all wish him well in his new task, and thank him very much for all he has done in the past.

5.27 p.m.

Mr. Laurence Pavitt (Willesden, West)

in a quiet way, in a quiet House, at the end of the Session, we are witnessing the start of a revolution. Perhaps revolutions in this country always happen that way, and perhaps it is just as well, but the House should be aware of the significance of this Order as part of a period of radical change which is as significant to the ordinary people of this country as was Beveridge in 1942, and the 1946 and 1948 Acts in the matters which the Secretary of State will now take over.

We are witnessing radical changes throughout both Ministries and my main doubt relates to timing, whether this is the right time at which these two Ministries should be welded together, and whether sufficient discussion has gone on prior to the welding operation. I accept that there is never any right or opportune time, and that if one waits for an opportune time one may wait for all time, but I regret that this action has been taken before very full and comprehensive discussions of the complicated measures which will be involved in the merging of two major Ministries. However, that is water under the bridge and I think that there is therefore no point in doing other than accept the fact and be open minded in welcoming the step that has been taken and seeing what we can do to ensure that it yields the maximum benefit in both spheres for which the Secretary of State will be responsible.

The right hon. Member for Reigate (Sir J. Vaughan-Morgan), the right hon. Member for Kingston-upon-Thames (Mr. Boyd-Carpenter), and all those who have spoken have paid tribute to the previous Minister of Health, my right hon. Friend the Member for St. Pancras, North (Mr. K. Robinson). I should like to add my voice to those tributes. No one has more right than I in this House because I suppose that during the last four years no-one on these benches has done more than I have to support him, and no one has attacked him more vigorously than I have when I thought he was wrong.

One reason why he was one of our greatest Ministers of Health was that he was devoted to the Health Service. He was aware of the intellectual problems involved and of the stresses and strains involved in dealing with them, and his compassion and knowledge gave him the imagination and insight which were so necessary when dealing with a problem such as that which arose when general practitioners were on the rampage.

One of the reasons why he was so successful was that for the first time for many years we had a Minister of Health who did not regard his job as being the bottom rung of the ladder, so that he wanted to go upstairs somewhere else. He wanted to be Minister of Health. He was devoted to the job, and was committed to it. I pay tribute to his work and I am certain that my right hon. Friend the Secretary of State will find valuable in building even better in the future that which he has inherited from my right hon. Friend in the past.

The right hon. Member for Reigate and the right hon. Member for Kingston-upon-Thames referred to the responsibilities of the Ministers of State—a question that I raised with the Prime Minister on Tuesday. I hope that if special designation is given, so that one Minister will be responsible for health and the other for pensions it will not mean a transference of the pull-devil, pull-baker strain on resources to within the new Ministry the struggle which probably took place previously at Cabinet level. One of the advantages of the merger is that we have a Cabinet Minister with an overall and planned approach to the problems previously divided between two Ministers. But this operation will be abortive if there is merely the sort of struggle below him that we previously had within the Cabinet. I do not think that that will happen. Even if one Minister is designated for special responsibility in one Department and the other for special responsibility in the other, this conflict need not necessarily occur.

The changes required are tremendous at both central and local level. The main area in which we find common ground is in the work of the welfare inspectors—at the moment under the Ministry of Social Security—the people who are assessing the needs of elderly people. I pay tribute to their work in the last few years, which has often extended itself into social welfare activities, but at present these workers are not trained for that purpose. They are trained to assess cash needs and to say whether or not a case is deserving. There is no reason why their work should not be extended into family case-work but, if so, the Ministry will have to have a crash training programme to qualify them not only to assess the cash and material needs of people who are worthy of help but to be able to follow through with all the resources of the welfare activities in the locality, to give the additional support that these people may need.

Mention has been made of the immense changes on foot at the moment within the Ministry of Health. The Green Paper foreshadows the integration of what were three separate Departments into a single administration covering all three wings. Inevitably, at the local level, there will be an impact on the whole question of social welfare. In opening the debate for the Opposition the hon. Member for Hertford (Lord Balniel) drew attention to the need for a unified social services structure at local level. This will be better put into operation as a result of this Statutory Instrument than would have been possible with two separate Ministries.

We cannot discuss the consequences of this Statutory Instrument, but it will provide many new opportunities, and I am certain that my right hon. Friend will take full advantage of it. When I first came to the House I spent some time trying to persuade the previous Administration to put the Minister of Health into the Cabinet. The nearest to success I got was when the right hon. Member for Wolverhampton, South-West (Mr. Powell) found himself in the Tory Cabinet. I cannot claim credit for that; indeed, it was not my intention at that time.

Now we have a Minister with responsibility for health and social security in the Cabinet, and this is a move in the right direction. This will enable a forceful case to be made for a balance to be achieved in respect of demands on the nation's resources. This sector, which already spends £4,700 million a year, will have a powerful voice and will be able to put its case in a proper way. It will command respect for the arguments that it musters.

If I have a little concern for my right hon. Friend it is not in respect of his capacity. Everybody knows that he applies himself to any job that he does with a tremendous amount of energy and intellectual capacity. The finest speech I have heard on pensions was that made by my right hon. Friend in 1957 at the Labour Party conference. I am certain that on that side he will bring an expertise second to none to the unified Ministry, besides a command of knowledge and information and sources of information also second to none. Nevertheless, since pensions was his first child I urge him to make sure that his second child—health—receives the same amount of intellectual understanding and the same right to call upon resources.

The question of Scotland has been raised. Theoretically, I have always felt it was wrong for Scotland to be hived off from the rest of the country in health matters. In practice this has worked well, and I am happy to know that there will be no alteration to the present system. I can put forward theoretical arguments showing that unifying health administration in one British ministry would be better, but in practice, in many respects—especially in respect of the integration of teaching hospitals and regional hospital boards—Scotland has been in advance of England.

I add my voice to that of the right hon. Member for Reigate in respect of the pieces missed out. I hope that they are missed out only temporarily. When the Health Service was established we put up three walls to protect the citizen against the impact of ill-health and disability—first, general practice; second, hospital services, and, third, local health authorities. The fourth wall was left open to all elements and concerns what happens to people at work. The Annual Report of the Ministry of Health published today reveals an increase in the stresses and mental strains, and the illness which follows, many of which take place while people are at work, indicating that a complete occupational health service is long overdue in order to establish a fourth wall.

The Department of Employment and Productivity has already started to reorganise its own health side. Two thousand general practitioners, who now turn up on Friday afternoons to see whether 15-year-olds are healthy when being recruited, will disappear from this part-time employment. A more positive rôle will be carried out by a new health inspectorate. I have made representations to my right hon. Friend that whilst these changes are in the offing they should be incorporated in his Ministry, and his present answer is "Not yet". I hope that that answer is not final. When we have a comprehensive health service bound up with a comprehensive social security service it is inevitable that we shall have to take heed of the welfare and health of people while at work, and that this must be co-ordinated with what is going on in respect of domicilary and institutional care, especially in health matters.

Therefore, unless we are to have a waste of medical manpower and resources, and a duplication of effort, they must ultimately come within the purview of the new Ministry and thus be the responsibility of my right hon. Friend the Secretary of State. Only in that way can we move from the purely legalistic approach of making sure that factory inspections are carried out and that the law is complied with to the more positive one of preventing people from becoming ill because of the conditions in which they work and the mental strains and stresses from which they suffer, often unnecessarily. I agree that this Statutory Instrument will not allow us to do everything at once.

There is duplication in the dental service, with the school dental service, the general practitioner service and the hospital service. The latter two are likely to be tied up under the proposals of the Green Paper, but the third is under the control of the Secretary of State for Education and Science. Similarly, there is the possibility of dental care being a unified service with aspects of the health service. Now that there is a comprehensive general dental practitioner service, could there not be co-ordination so that important and scarce dental manpower could be saved? That could be done if this were part of forward planning.

I welcomed my right hon. Friend's comment that planning and research will be one of his priorities. Obviously his first responsibility must be for those matters within his own Department but I hope that the research will not ignore peripheral matters, in which a little research at this stage might lead to a more effective and comprehensive service in a few years' time. I accept, and will not repeat, the point made by many hon. Members about child care, another aspect which should be incorporated into this new gigantic Ministry.

I conclude with an appeal based on some remarks by the noble Lord who opened for the Opposition concerning the relationship to the new Ministry of voluntary effort and the participation of the local community in what is being done centrally and locally through the initiatives of the new Ministry. I hope that we shall see many initiatives from the new Ministry. One of our failures in the last twenty years has been our inability to identify either the patient or the recipient of the benefits which we—the ordinary people—provide for each other with the service which is being given. People still say that it is the Government who give. It is still regarded as a free Health Service, in spite of the fact that most of us present in the House today have paid at least £800 into it since its inception. The service has become impersonal and not part of ourselves—"they" and not "us".

If the new planning, the new research and the new drive which I know will come from the Minister are to be effective, people must be made to feel that the service belongs to them and that they are participating in it. Local voluntary bodies and organisations must feel that they are not peripheral to the service but that the service belongs to them, that they have paid for it and that it is their right—not a service which a paternal Government provide out of their charity or the goodness of their heart. There must be local participation and activity, not a feeling that decisions are handed down from Sinai like the Ten Commandments. There must be an effective approach to bring in constructive criticism and argument. Unless this is the case, we may well find ourselves in a more sterile situation than is healthy.

I join other hon. Members in wishing my right hon. Friend good luck in the task which he faces. I understand the size and the great complexities of the problems in the field of health with which I have been concerned. But I am certain that no hon. Member is more capable of coping with these great pressures than is my right hon. Friend, and I wish him well.

5.44 p.m.

Mr. Marcus Worsley (Chelsea)

Until this afternoon we have been given remarkably little information about the proposed merger. There is a marked difference between this proposal and that in respect of external affairs, about which there have been reports and discussions over a long period. Although he introduced the debate lucidly, the new Secretary of State has not explained the thinking and the philosophy behind this change. I sometimes wonder whether it has been fully thought through.

May I interpose one word in a completely lost cause which has not been espoused so far today? We are suffering from a hopeless proliferation of Secretaries of State. It is not a smart thing at all now in Government to head a Department unless one is a Secretary of State. With all respect to the right hon. Gentleman who is to become one very shortly, the title has become hopelessly devalued, in the same way as have ambassadors in the diplomtic field. This is not a party point, because I recognise clearly that the Government of my party started this Gadarene rush when they turned the simply worded Ministry of Education into the Department of Education and Science with a Secretary of State at the head of it. I do not believe that government is more efficient because there are grandiloquent titles among Ministers.

I realise that before long all Ministers will be Secretaries of State, to the complete confusion of our Continental friends who regard a Secretary of State as a very inferior animal indeed. Much more important is the confusion in the public mind caused by these continual changes. It is only a matter of months since the pots of red paint had to be employed to change all the notice boards of the Ministry of Pensions and National Insurance and of the National Assistance Board. Then all the boards of the Ministry of Labour had to be changed when it became the new and ludicrously grandiloquent Department of Employment and Productivity. Now there is to be a new painting of boards right across the country—so that there is at least one area of the economy in which there will be no unemployment.

Hon. Members must appreciate the confusion which all these changes cause in the public mind. These are not things which happen only in Whitehall or among Ministers sitting around a Cabinet table. They involve changes right across the country—changes of name for many people who find these technicalities very difficult to follow. I hope that at least we shall not have another change in this respect and that this time we have it right.

I am not enamoured of the right hon. Gentleman's title. I find it excessively sibilant. There are two many s's. I should have preferred a much more general title, for instance, Secretary of State for Social Affairs. I say that not only because it avoids the excessive sibilance to which I have referred but also because it would signify a more general responsibility across the field. After all, what we are discussing this afternoon is not a new structure but a merger.

Like other hon. Members, I fear that it will be a monolithic structure and that the monolith will be very hard to administer. Certainly when I, and I hope many of my hon. Friends, were advocating a single Ministry, I did not mean just a merger. What I want to see is a strategic Ministry over-seeing the whole social field and accompanied, as my noble Friend the Member for Hertford (Lord Balniel) said, by a massive devolution from the centre, together—a point not yet sufficiently stressed this afternoon—with the maximum encouragement of private provision. I want to see a Ministry freed from detail and therefore free to think and plan and. above all, free to think and plan ahead in a rapidly changing society.

In his statement of 16th October the Prime Minister spoke of the duties of the Secretary of State in co-ordinating the whole range of social services. I hope that in summing up the debate the right hon. Gentleman will be more specific about what that means. Everybody knows that co-ordinating responsibilities in Government are eyewash. The Secretary of State said as much today. Indeed, I thought that he was a little unkind to his right hon. Friend the Paymaster-General who was sitting on his left.

Mr. Crossman

Really?

Mr. Worsley

The right hon. Gentleman obviously did not appreciate what I said. I repeat that he said, in effect, that co-ordinating responsibilities in Government were ineffective. Had he noticed that seated next to him but one on the Front Bench was another Minister concerned with co-ordination, who was looking somewhat unhappy at the right hon. Gentleman's remarks, I believe that he would have chosen his words more carefully.

Why has this division been drawn on the lines of these two Ministries? Why are other social services apparently necessary subjects only for co-ordination whereas those covered by Health and Social Security must be directly administered? Is there anything behind this decision, and what is the logic of it? We have heard something about the children's service, and I echo what hon. Members have said about that. But what are the other social services which the right hon. Gentleman considers are in need of co-ordinating and why do they have to be co-ordinated rather than managed? My feelings are slightly like those of E. M. Forster about democracy. I say "two cheers" for it and I support it, but I regard it as only a clumsy first step in the right direction.

5.51 p.m.

Mr. Tim Fortescue (Liverpool, Garston)

I, too, welcome the appointment of the right hon. Gentleman and pay tribute to the work which previous Ministers have done. I hope that I will not be accused of indelicacy when I say that if we have not learned to love them, we have learned to live with them. Included in my tribute is a "Thank you"—no hon. Member has so far paid this tribute—to the Parliamentary Secretaries of the two Departments; and I am delighted to see the stalwart figure of the Parliamentary Secretary to the Ministry of Health in his place. We lived with him for many hours when debating a number of Measures in the past year or so and have all come out unscathed.

Without referring to any one Minister, I suggest that it is not a good thing for Ministers to be in one job for too long. Ministers, however admirable and whatever their party, begin to regard their surroundings as fixed and immutable if they are in the same post for too long, and they cease to see the wood, however undesirable the trees. Ministers are like mini skirts. They are of absorbing interest at first, but their attraction decreases as one realises that what they display was perhaps more pleasing when it was partly concealed.

The second Article of the Order transfers all the functions of the two Ministry's to the Secretary of State. What other functions and powers, besides those residual ones, will he have? For example, will he wish to eliminate some of the present anomalies of one Department seeming to be working in opposition to another? This would seem a fundamental part of his duties and I trust that he will eliminate such friction.

I will give a vivid example of how this friction is working. We have in past months heard much of the so-called scroungers, cheats and lay-abouts who draw social security benefits fraudulently. I had the privilege and pleasure, as a result of the co-operation of the still Minister of Social Security, to whom I am most grateful, to spend some days during the last Recess working in the local office of the Ministry of Social Security in my constituency.

What I saw there convinced me of the excellence and high standard of the work that is done in these offices. I was enormously impressed by the skill, patience and fund of compassion possessed by the comparatively young men and women who serve behind the counters and who are faced every day with many and difficult cases, sometimes being submitted to insult and abuse by the customers. They take it all with a smile and always they have compassion.

There are, of course, some scroungers and lay-abouts, but only a few. With millions of £s of public money being handed over these counters, only when we are all angels will there not be somebody trying to get a payment to which he is not entitled. As I observed what was happening in my local Ministry office, I noticed that the employees there knew these people a mile off. They saw them coming before I did and they knew most of them and referred to them as "regulars". Once convinced that a person applying was dishonest, the Ministry's officers saw to it that they did not get anything out of the Ministry. However, this was done with tact, patience and compassion and we need not fear that money is being too easily handed out by Ministry officers.

There is, however, an exception; a category of fraudulent claimants with whom the Ministry's officers cannot cope. They know that they cannot cope and there is nothing that they can do about it. I refer to the claimant who arrives with a note signed by his doctor saying that he is unfit for work and is therefore entitled to draw sickness benefit.

I am not casting aspersions on the medical profession—on the ordinary hard-pressed and overworked G.P.—but when a patient says to his doctor, "have a backacke and I do not think I am fit for work", it is the normal practice of the G.P. to say, "You had better take a week off".

If the new Secretary of State will, when he has time, take a look at the incidence of backache in the summer months, at holiday time, he might be surprised to find that this not too serious complaint has a remarkable change of statistic when holiday time is upon us. There is nothing that the doctor can do. He cannot diagnose or treat a backache on a Monday morning. There is nothing that the Ministry's officers can do. They have the doctor's word that the man is not fit for work. Probably they never see the man again, as he draws his one week's benefit and goes off on holiday.

I do not make this accusation lightly. I have spoken with many doctors on the subject and they have admitted to me that they will give a note on this basis for a complaint which they cannot check in the short time at their disposal. After all, they must also worry about their practices. There is in Liverpool a case of a doctor's windows having been broken because he refused to give notes on slender evidence.

The other day I asked a Question on this score and got a rather dusty Answer. I suggested that for certain mild complaints of this nature a note from a G.P. should not be enough to qualify a man for sickness benefit and that the case should be referred to a doctor of the Ministry, or confirmed by a doctor at the man's place of work. I was told that that would not be possible because the only man who could diagnose the complaint was the doctor treating the man. But I am not talking about treatment. I am speaking about a man who, out of the blue, goes to his doctor and says, "I have a backache." He is the man with a fraudulent claim for sickness benefit and there is nothing that the Ministry can do about it. If the new Secretary of State is to have proper co-ordinating functions between Health and Social Security he could put a stop to this practice.

Among the many other matters which I would like the right hon. Gentleman to consider is the question of the activities of the special investigation officers of the Ministry of Social Security. Mr. Speaker has told me that if I raise this matter now I will be ruled out of order, although he has promised me an early opportunity of raising it on the Adjournment.

I have a particularly scandalous example of the activities of these men in my constituency. I will ask the Secretary of State to look at these duties and at the behaviour of these officers. Their very title—special investigation officers of the Ministry of Social Security—has an Orwellian flavour about it and I hope that something will be done to ensure that they do not continue to exceed their duties and power in visiting private citizens in their own homes.

Among other matters which must be looked at in the context of today's conditions are the proposed regulations relating to unemployment benefit for occupational pensioners which have roused such violent protests and opposition from practically everyone in the country, including the T.U.C. I hope that we shall hear no more about this proposal. Again, a Bill has now been enacted which enables the Minister of Health to extend the range of those to whom invalid transport can be issued, and we hope to see very early action in that respect.

The right hon. Gentleman the Member for Llanelly (Mr. James Griffiths) spoke of the labour exchanges. Why should not these Departmental offices be merged with the local offices of the Ministry of Social Security? I understand that in many cases the Ministry of Social Security, as the paymaster on behalf of the Department of Employment and Productivity, provides the money, so there seems to be no reason why the two offices should not be merged.

The very important point of compassion comes in here. Many people hate to be seen going into the office of the Ministry of Social Security because their neighbours, if they see them, think they must be in trouble of some kind. But if, as the right hon. Gentleman suggested, we had a central place where all local government and social services offices were combined, to go in there could not be thought of as a stigma. Many people could be going there for quite different reasons which in the general public's mind would not be stigmatic at all.

There is also the question of amenities at the offices of the Ministry of Social Security. Perhaps the right hon. Gentleman would turn his mind for a moment to the contrast between the conditions in hospitals, where so much has been spent, let us say, since the war, in providing amenities for visitors—warmth and comfort and cups of tea—and the conditions in which visitors to Ministry of Social Security offices have to wait. In many cases, these offices are slumlike. In my constituency, they are still in wooden huts. But all these people are citizens of this country, and should be allowed to wait in warmth and comfort, and in a place which does not remind them of a slum.

I welcome the merger, I pay my very warm and sincere tribute to what has been done in the past, and I look forward to a very bright future for the combined Department.

6.3 p.m.

Mr. Kenneth Baker (Acton)

like all hon. Members who have spoken so far, I welcome the merger, but with qualifications. I see it as the first step along a very long road. I regret that this debate has had too much of a funereal atmosphere about it. We have all been standing at the gravesides of the Ministries of Health and Social Security, paying fulsome tribute, and only a few hon. Members have looked at the exciting future which lies ahead as a result of this merger, and the additional responsibilities which the new Ministry should have.

I am still not convinced that moving the children's department of the Home Office to the new Department would be right. I agree—

Mr. Deputy Speaker (Sir Eric Fletcher)

Order. I must remind the hon. Gentleman that in this debate we are dealing with the merger of two Departments. We are not entitled, in this debate, to advocate at great length the merger of other Departments. One can touch on it, but one cannot make it the subject of one's speech.

Mr. Baker

I accept your Ruling, Mr. Deputy Speaker, but three other hon. Members have mentioned this possible merger of the children's department of the Home Office with the new Ministry and have put forward their reasons at great length. I was about to refer to it, and say that I agreed with the new Minister.

We are rather lonely, I think, because we are the only two people here this afternoon who do not believe that this should be done. And I have had, therefore, to examine my reasons very carefully. It seems to me that the children's department of the Home Office covers such a range of responsibility and raises such very deep issues, which you touched on yourself. Mr. Deputy Speaker, in your Ruling, such as the whole relationship of borstals to the community, that difficulties would arise if this department were combined in the new Ministry. However, this is a subject for further debate.

There seems to be an amazing inadequacy in this merger. It is extraordinary that the new Department which will look after social welfare of the people will not be responsible for welfare housing at all. How otherwise can the right hon. Gentleman fulfil his responsibilities and obligations towards many classes of socially deprived people whose real need is housing? The social groups I have in mind, and they are very substantial groups, consist of families with four or five children and which are usually low wage earning. The local authorities do not want them as tenants nor build them appropriate houses, but they are the responsibility of the Ministry of Social Security. Another group consists of the fatherless families, the unmarried mothers, the deserted wives, the widows with children and lastly the very old single people living alone.

These people usually have acute housing problems: how will those problems be met if the new Ministry is not given responsibility for subsidised welfare housing? I hope that when the Seebohm Report is implemented at local level, the new local administrations that will emerge will have responsibility in the social department for subsidised welfare housing. If I may adapt the phrase coined by the Minister of Technology, I believe that welfare housing is too important a matter to be left to the Ministry of Housing—

Mr. Deputy Speaker

Order. We cannot, in this debate, deal with the desirability or otherwise of transferring functions of welfare housing. We are dealing with the desirability of merging the Ministry of Health and the Ministry of Social Security.

Mr. Baker

I accept your Ruling, Mr. Deputy Speaker. I wanted to know how the Minister proposed to fulfil his responsibilities to these socially deprived groups who, socially, need housing, and for whom his Ministry is responsible.

The main functions of the present Ministry of Social Security is the distribution of cash. The right hon. Gentleman discussed at length the difference between the cash side—the Ministry of Social Security—and the care side—the Ministry of Health. As I believe that in the 'seventies with more advanced computers we will move to a form of negative Income Tax—which I do not believe is a cranky idea—it may be necessary to look again at the cash side of the Ministry of Social Security and see whether that would not be better combined with the Treasury and the tax system. Eventually, we have to face the fact that in this merger we are tending to put together chalk and cheese. One has to envisage a type of organisation for our social security system which is one Ministry that deals with cash—taxes and payments and, on the other side, the Ministry dealing with care, whether that care be hospital care, G.P. care, community care or housing care. Only a Ministry which has its functions split in that way can adequately deal with the enormous social problems which we have so far been unable to solve satisfactorily.

6.9 p.m.

Mr. Maurice Macmillan (Farnham)

I do not wish to delay the House unduly, so 1 hope that the right hon. Gentleman will not think my welcome to this Order and my congratulations to him are perfunctory. He has, at least, succeeded in being almost the first co-ordinator to succeed in having power as well as responsibility for what he co-ordinates.

In a speech made on 11th October at Brighton, my right hon. Friend the Member for Leeds, North-East (Sir K. Joseph) referred to what we have in the social field as being more of a welfare archipelago than a Welfare State. We had, he suggested, a large number of welfare islands separated by seas of emptiness and confusion. I welcome this effort in what, in this metaphor, one might call land reclamation which the Secretary of State is putting forward today. That was the purpose of our putting this proposal in our 1966 election manifesto.

The object of combining the Ministry of Health, the Ministry of Pensions and National Insurance and the National Assistance Board was, as the right hon. Gentleman has generously admitted, to achieve an organisation with the positive duty of seeking out those who needed help, whether that help was needed in cash or care, and a research organisation to pinpoint the changing needs in the rapidly changing society in which we live.

The 1966 Act went part of the way, and my hon. Friend the Member for Melton (Miss Pike) took the opportunity to hope that the Measure which we are now debating would soon come forward. Although we still have some reservations on matters of detail, we on this side of the House are almost unequivocally glad that the Government have acted in this way.

I was reassured by some of the right hon. Gentleman's opening remarks when he made it clear that he regarded this not as an end which had been realised at long last, but rather as part of a development which had now been going on for a long time and which needed to be carried further and perhaps accelerated in the changing conditions of the future. The degree to which that is likely to happen depends not only on the structure of the organisation set up to deal with these problems, but also upon the attitude which that changing structure develops among all those who are in this work and the attitude to the problem not only of the new Ministry, but of the local authorities of whatever sort emerged from the various debates now taking place. It requires the change of emphasis and philosophy to which my hon. Friend the Member for Chelsea (Mr. Worsley) referred.

It was expressed by my right hon. Friend the Member for Leeds, North-East, in that same speech, as a hope that we could now move from what he referred to as a symptom orientated social service towards a person or family orientated service. That is certainly much to be desired. It is happening in other respects and it is a recognition that it is families and individuals in all circumstances who matter to the Welfare State rather than merely some aspect of one difficulty into which they have fallen.

It carries the implication—and I should like to know the right hon. Gentleman's view—that we are changing our concept towards subsidising, with help or cash, people rather than things. It is an idea which is implicit in a number of proposals which have been put forward by various private organisations, including the Disablement Income Group, and it is a concept which means a great deal more success in dealing with those who are suffering in one way or another at possibly less cost to the State and the taxpayer, as, for example, the proposal for a disablement income as a method of preventing people from requiring institutional care.

As has been said, much depends on an effective integration of the structure at every level, but, even with such integration, all those working in it must be consciously moving towards the identification of family needs and finding how people are being affected by changing circumstances and identifying needs as they arise.

My second point has already been mentioned by my noble Friend the Member for Hertford. That is the use of a potential intelligence unit and inspectorate. As time is short, I will say merely that I hope that this will not be entirely central, but that any concept of an intelligence unit, research unit, or inspectorate, will include not only getting a high standard achieved throughout the entire service, but identifying special local needs and changing local circumstances. As the hon. Member for Willesden, West (Mr. Pavitt) said, things are not the same in different parts of the country, and needs and difficulties change greatly in different parts of the world.

I am inclined to agree with the right hon. Gentleman that it is difficult at this stage to go much further with the structure while we are still awaiting reports and ideas on the organisation of local government, and so on. He hinted that his role of co-ordinator was a prelude, in some cases, to making a takeover bid for some of the things which he was co-ordinating, and I hope that for one he will be able to tell us that his takeover bid for the children's department of the Home Office is coming soon. However, I agree that until we get over the restructuring of local government and the reorganisation of the Health Service, it will be difficult for him to be more explicit.

I hope that he will be able to say two things. The first is that his concept of integration and control from the centre will be used to give greater freedom in the field and greater freedom in the regions and areas. Taking a commercial organisation as an example, the degree to which Marks & Spencer have allowed their stores local control depends partly upon the efficiency of the amount of centralisation, and perhaps that could be emulated by the right hon. Gentleman.

It is difficult to exaggerate the importance of the local element and I hope that when we consider the whole question of area health boards the right hon. Gentleman will remember that he may repay on the welfare social security side the responsibilities which some local authorities fear that they are losing on the health side. I for one would prefer to see a more co-ordinated effort in health and social security based on the unit of elected local government, whatever that may turn out to be. Perhaps the right hon. Gentleman will be able to give us a few of his thoughts on this.

I want, finally, to refer to decentralisation within Whitehall. My hon. Friend the Member for Chelsea hoped that the new Ministry would be able to devote its attention, freed from a certain amount of detail, to planning and considering the future and trends. The right hon. Gentleman is a great one for Specialist Committees of the House of Commons and I wonder whether he has considered the possibility of some of the functions or the day-to-day organisation of the Health Service being delegated to an organisation coming under the framework of his Ministry, but not within it, and being answerable to a Specialist Committee on health for its day-to-day control.

I am sure that whatever else he is trying to do, if the new organisation in local government or area health boards and the other proposals contained in the Green Paper are to be fitted coherently into this proposal, the right hon. Gentleman must ensure a reasonable degree of democratic control at local and central level and, above all, the use of the methods of communication which will be available to him to make people realise that he is concerned with them and not merely with a tidy administrative structure.

6.20 p.m.

Mr. Crossman

With the leave of the House, I would like to say a few words in reply. I would like to start with the hon. Member for Chelsea (Mr. Worsley), and his very pertinent query as to why anyone wanted to become a Secretary of State. Let me tell him why. It is not that I did not like being Lord President of the Council. It is always nice being a President and, if I had been on the Board of Education in the old days, I might have been President of the Board of Education long ago. It was simply not a question of accepting a substitute for this, it was all to do with the merger.

I learned a great deal about the intricacies of Whitehall, discovering the difficulties of not offending Departmental susceptibilities. It is easy enough if one Department swallows another. One has only to have a negative Resolution, and one can do almost anything one likes, under a Minister. If one is to create a new Ministry, under which no susceptibilities are injured, and if it is a Depart- ment of Health and Social security, genuinely new and created so that each part is equal, then this requires a Secretary of State to achieve it.

I hope that the hon. Gentleman will appreciate that it was not, therefore, my just wanting a new title. It was a belief that the Department would prefer it that way, even if we have a very good debate as he result of an affirmative Order at night.

The hon. Gentleman was also quite right in saying that one must be modest about this. It is exactly what he said, a first step, and I think that it is in the right direction. I would go further and say that it will be justified very largely not by what it does for itself, but by what it leads to. I should not be at all content to stay put at this point. It would not be a monumental advance to put these two Ministries together and then stay put.

I must admit to the right hon. Gentleman for Kingston-upon-Thames (Mr. Boyd-Carpenter)—he is watching me at work—that I have been given enormous ambitions. When I look at the list of the things I am asked to take over, and the list of my colleagues that I would passionately offend in the course of so doing, it is astonishing. I would remove from the Minister of Housing and Local Government all that he likes best, from the Home Secretary what he likes best and, most dangerous of all, from the First Secretary all that she likes best. At the end of this time I shall be a popular, successful new Secretary of State.

It is nice to have the ideas given me, but we must take it as a first step and be serious, and say that this has been done now because we want a powerful new Ministry so that when different things come up, the Seebohm Report and the Green Paper, and the rest, we are in a very powerful position -from which to see that the changes get through, without complete inter-departmental deadlock, which is a risk.

I shall ask the House to wait a little to see what happens, resting content with the assurance that it is true that I would not be content with this step. What we have in this Ministry is the first, not the last, step. It will be a very shortsighted thing to think that we have made a great change for the better, although we have made some quite useful changes.

The right hon. Gentleman asked me a specific question. He asked where my headquarters were to be. I shall probably relieve the anxieties of my hon. Friend the Member for Willesden, West (Mr. Pavitt), who knows so much about the Health Service, when I say that my headquarters will be at Alexander Fleming House, Elephant and Castle, and not in John Adam Street. It is not just that it is more comfortable—it is not comfort I seek, but convenience. This is essential. It is a better and bigger building, but it is also extremely important for the reasons which my hon. Friend gave, with great tact.

My hon. Friend said that I know a lot about social security and a little about health. I know more now than I did four months ago, because I have been studying. He is quite right about social security. I feel myself at home. I know the gambits of pensioneering, I have learned it for a long time, and I feel deeply at home in John Adam Street, whereas I am a new boy at the Elephant and Castle. He is quite right that this is one of the major things which made me take the decision.

I said that I would go to the place I knew least and have my headquarters there. The people there have to be convinced that I am their Minister, not merely taking it on as an appendage to that about which I know something. Very naturally, the centre of balance will in that sense be at the Elephant and Castle, and the central planning headquarters will be at my headquarters. The Departments which are merged will be merged into that building.

On the other hand, I have been very anxious, because there are very important things going on in the Ministry of Social Security, to keep in touch there, and I have asked my hon. Friend the Member for Newcastle-under-Lyme (Mr. Swingler) to be there for the time being. I am not intending to move the Parliamentary Secretaries at present because I am not sure, first, how many Parliamentary Secretaries I need and, secondly, where they should be. I am leaving them for the time being, but am asking my hon. Friend to take up quarters in John Adam Street, because I really must concentrate, in the short run, apart from the details of preparing the pension plan, in really getting to know and understand the problems of the Health Service, which, as everyone has emphasised, is a very considerable thing to do.

I have had luck in knowing six months before I took over that I was to do so. I have been able to do a little in that time of meeting and contacting. Now the serious work has to start.

The other thing that I must explain is to do with functional divisions. We cannot start with this at the beginning. We have only to look at the Ministry of Defence in its stages of development to see that it did not start with functional divisions between its Ministers of State. It started by taking them as they were and gradually forming functional divisions. We are a long way from that at present, and having asked my hon. Friend to concentrate for the time being in John Adam Street, I shall ask the other new Minister, my hon. Friend the Member for Dover (Mr. Ennals), to be with me in Alexander Fleming House.

As is known, I shall have two Permanent Secretaries there. The Permanent Secretary of the big merged Department, and the No. 2 Permanent Secretary, who is a specialist on health. I have asked him and my hon. Friend the Member for Dover, again in the first instance, for the first three or four months, to do the detailed running of the Health Service while we organise the central headquarters and central intelligence units, the handling of the Seebohm Report and the Green Paper. I shall ask my hon. Friend to delve and to learn. He will have a Permanent Secretary of great experience, Mr. A. S. Marre, who has come back from what was the Ministry of Labour. He will be there to give us the confidence of his staff.

I shall have the Permanent Secretary of the former Ministry of Social Security with me, learning how to run the huge thing at the top, while having a specialist on the Health Service with whom my hon. Friend the Member for Dover will work. I cannot say more than this; it is temporary for the first three, four or five months.

I was asked about war pensions. I entirely agree that this is a tradition, which, directly I saw it, I realised was one which we cannot and do not want to change. War pensions are very special, and the Ministry is proud of their being very special. Each case is regarded as a special case, with the possibility of Ministerial interest. We will certainly keep this tradition as long as war pensions last, which, in a sense, is not forever, because there are a dwindling number of cases.

Mr. Boyd-Carpenter

Does the right hon. Gentleman mean that one of his Parliamentary Secretaries will concentrate primarily on war pensions work?

Mr. Crossman

Yes, there will be someone primarily responsible for war pensions, and he will do the regular touring visits which are so important.

The right hon. Gentleman also asked me about computers and whether we could not use our computer at Newcastle to help the Ministry of Health. I hesitate to tell him how computers breed computers in this world, but a new Ministry of Health computer has been constructed at Fleetwood, and I have to reveal to the right hon. Gentleman that we now have other computers at Newcastle because of the new pension plan. He must not blame me, because I told him, and he knows it very well, why that great computer is there. It is because he invented the most intricate graduated pension plan, a plan so complicated that one could not possibly work it without a huge, brand-new computer. I said at the time that, however bad his plan was, it would at least enable us to have machinery to develop a splendid new plan. I am deeply grateful to him. A computer is there, but I fear that it is a little brother compared with those which are growing up now, because it is true that we shall take over more and more clerical work with computers.

I admit that, in introducing computers, in the short run one increases the number of civil servants. Once computers are there, however, transfers take place. No one can predict with certainty how large a subtraction of staff will occur in that particular case.

May I now turn to the question of staff cuts. In headquarters, we will obviously look for rationalisation. We can have hopes there of staff savings as the result of the merger. I would not be frank with the House if I gave great hopes of staff reductions in the regions on the social security side, for two reasons. The first is that we have greatly increased and improved our social services recently, and we knew that if we greatly improved the standard of the social services, increasing the amount of money paid out, we would have to see that there was no abuse of what we had done.

We have to ensure that investigation is adequate and we have to consider the number of people who make visits. People should not just work behind the counter and have no time to visit the old people. I can give no assurance that the number of people engaged in this kind of work in the new Ministry will be reduced. If the House insists that we be absolutely sure that we cover all pos sibilities of abuse, more, and not fewer, staff will be required. Therefore, in this respect, I do not see any chance of a great reduction being made. However, I see a chance of some reductions being made in headquarters staff.

I turn to the speech of my right hon. Friend the Member for Llanelly (Mr. James Griffiths), for whose congratulations I am very grateful. What a charming speech he made to remind us of the tradition which he created! I entirely agree with him. One of the most invigorating things is to go to Newcastle and see what a difference to a development area a great Government Department has made.

I have learnt that people there are grateful for Government Departments because this is the kind of work that they like. The wages and salaries seem to be good. The stability of the work is excellent. The people work better. Those who are crowded together in London fall over themselves and there is competition with other forms of business for a quality of staff which one cannot readily get in the overcrowded South. First-rate staff is obtainable in a development area. If I can do anything in the time that I am at the Ministry to ensure that we get administrative devolution of this kind, with the recruitment of staff in areas which are grateful rather than having offices in areas in which there is a turnover of 70 or 80 per cent. in staff because there is over-full employment, I shall try to do it.

My right hon. Friend the Member for Llanelly asked about Welsh devolution in health matters. I say to him, "Despair not, friend. It is something which I shall think of very soon when the take-over is done". This matter is not excluded from my mind. Things will remain the same in Scotland, and I would not dare to upset that as a first contribution by me to Anglo-Scottish relations.

We have been asked whether we can bring together the social security offices. We can. As I travel round, I see that we have done this to some extent. Since the merger of the Supplementary Benefits Commission, in 1966, out of 983 offices we have merged 141—[HON. MEMBERS: "Local offices?"] Yes, local offices. In 141 cases, we have merged the area offices of the Supplementary Benefits Commission with the National Insurance local offices. Therefore, we have gone a little way. Those are mostly places in which we have better offices.

Turning to the question of the bad offices, I agree with the hon. Member for Liverpool, Garston (Mr. Fortescue). We had to take over hundreds of offices all over the place, and we have inherited some in poor condition. I did not think that he was fair when he said that I gave higher priority to making hospitals nice with flowers than to offices. If I had to choose, I would give it to the hospitals first and the offices second.

Mr. Fortescue

I was not referring to the amenities of patients in hospital. I meant; the amenities of people visiting the patients in hospital

Mr. Crossman

Patients it hospital are allowed to have flowers. I do not say that this is as important a matter as all that. We have to improve our offices. I congratulate the people at the old Ministry of Labour for what they achieved. Sometimes at a local Ministry of Labour office there is a sense of the Government competing with employers as an employment exchange or bureau. That is excellent. I shall compete with the First Secretary of State in insisting in getting as much money spent on our offices as she does on her offices. That is a good form of competition which I hope will be accepted by the House.

I turn to the very interesting speech of the hon. Member for Hertford (Lord Balniel), which was echoed by the hon. Member for Farnham (Mr. Maurice Macmillan). I want to put to the House my doubts about what was meant concerning devolution. The Health service is already a highly decentralised service. Some people think that it is too decentralised and that there is too great a variety in the standard of treatment between one regional hospital board and another. There is devolution in terms of the executive councils.

There is devolution in each of the three parts of the Health Service to local bodies and the Ministry acting largely in an advisory capacity. I am not sure how much farther we can go in this process. I shall keep my mind open. But I shall be surprised if anybody believes that further devolution of this kind will save staff. This I cannot understand. Centralisation has standardisation advantages. I am a little baffled about what is meant by devolution in this connection.

I give one reflection to the House on local democracy. Here we have a mixture of people who are partly from local authorities and partly from the Health Service. When I have them all together, I always ask the same question. I say, "Would you tell me what you think? Which service is better run—the service with elected local councillors or the service without?". I cannot say that there is a unanimous view that the service with elected local councillors is better. I have learnt enough to know that it is not true to say that the simple solution is to get It all done locally. Even those who come from local authorities have their doubts about that as the solution. I think I know what is meant when people say that we must have local democracy and grass roots democracy, but handing over matters to local authorities like that without question is open to discussion. I am prepared to learn. I do not yet know the answer, and I shall not know it for some months.

I am glad to have support for the Central Intelligence Unit. One of the great possibilities of this new merged Ministry is a unit which can look synoptically at the whole of our social services, which include housing and education. We need a central intelligence unit for that purpose. That is one of the great advantages of the Ministry.

I think that I have managed to answer all the points which have been raised by hon. Members who have been extremely kind to me as a newcomer to this job.

Question put and agreed to.

Resolved, That an humble Address be presented to Her Majesty, praying that the Secretary of State for Social Services Order, 1968, be made in the form of the draft laid before this House on 16th October.

To be presented by Privy Councillors or members of Her Majesty's Household.