§ 10.30 p.m.
§ Mr. John Stokes (Oldbury and Halesowen)
I beg to move, Amendment No. 7, in page 4, line 1, leave out Clause 4.
§ Mr. Deputy Speaker (Sir Robert Grant-Ferris)
With this amendment we are to take Amendment No. 127, in page 4, line 7, leave out from 'and' to end of clause and insert:'such arrangements shall provide that no charge shall be made for any such medical examination or treatment or for the supply of any such substances or appliances'.1350 and Amendment No. 128, in page 4, line 11, at end insert:'save that the Secretary of State shall ensure that no such prescription charges are made in any Area Health Authorities where a local health authority was at the time of passing of this Act already providing a family planning service free of charge for all advice and supplies'.I should say at this stage that Mr. Speaker has authorized me to say that he will be prepared to grant a division if required on Amendments No. 127 and 128.
§ Sir George Sinclair (Dorking)
On a point of order, Mr. Deputy Speaker. Am I to understand that we are to have a separate division on Amendment No. 128? Hon. Members have received a number of representations from the public on this particular issue and we should be very grateful if it were isolated from the other issues.
§ Mr. Deputy Speaker
I am sorry if I did not make myself clear. I thought that that was what I said. There should be a division if required on Amendments No. 127 and 128.
§ Mr. Stokes
I do not wish to weary the House by a repetition of the arguments about the clause that I used on Second Reading and in Committee, but as tonight will be the last occasion on which we shall have an opportunity to discuss what the clause involves, which is the provision of contraceptives by the State, it is important that we shall all be aware of exactly what the clause means.
I know that my right hon. Friend the Secretary of State and his supporting Ministers are men of the highest integrity and that the last thing that they desire is any lowering of moral standards. But that, I fear, will be the inevitable consequence if the clause is passed as it stands. I also respect the views—although I think that they are mistaken—of what I call the population or birth control lobby, who believe that population control in this country is of such vital importance that it must be achieved, whatever the cost and at whatever moral peril.
I believe, however, that the views that I am attempting to express, while they have not been voiced by the leaders of the church for reasons best known to themselves, are shared by millions of 1351 ordinary people who are Christians or who at least still respect the Christian ethic.
The effect of the clause is that anyone, married or single, can ask for contraceptives to be supplied by their doctor at the normal prescription charge. Had this arrangement really been family planning, as the clause is headed, planning for married people for true families, I should not have raised any personal objection. But because the clause includes single people it makes nonsense of the heading "family planning"—in this case a euphemism for contraceptives for all.
I ask the House to consider whether this is an activity which should be the concern of the State. Many people will say—indeed, many people have told me—that individuals who wish to commit fornication should pay for the contraceptives themselves. The moral argument is the most important. It is to that that I intend to address my remarks.
Surely if the State can no longer uphold a Christian ideal, an ideal adhered to for many centuries in England—I mean chastity before marriage and faithfulness within marriage—at least one would expect the State to be neutral. If the State is to provide a service as in this case, surely the State is also condoning the use of it, and taxpayers' money will certainly underpin it.
Who is to condemn what the State makes available at nominal charge to all and sundry? I believe that this is a most dangerous extension of State activity into the realms of private morals and it is bound to strike a deadly blow at parents, teachers, clergy, youth workers, and so on, who are trying to inculcate Christian moral standards.
On top of the enormous commercial pressures which we all recognise and of all the advertising on television, in magazines and newspapers, plays and films, we now have the State jumping on the bandwagon and implying that sexual intercourse with any partner is a free-for-all activity—normally, natural and, of course, State-aided. [Laughter.] At least the events of the past few weeks should have made the Government more cautious—[Laughter]—in providing for this vast new extension to the permissive society.
1352 If we are to demand higher moral standards from our leaders, what are the Government doing making contraceptives available so cheaply to anybody who asks for them? Can this be what the Government want or what the doctors want or even what some of the powerful birth control lobbies want, unless they are determined to try to destroy the Christian ethic in England which some people appear tonight to find amusing?
It is not often in the House that one can date the beginning of a disaster in history. If this legislation goes through unamended, we may unfortunately be able to say that that was the moment finally when England gave up being a Christian land.
Instead of the Government checking the permissive society with all the authority and all the influence which they have at their disposal, they have decided to go with the stream, to take the line of least resistance. I predict much misery to many families and, worse still, much damage to the institution of marriage as a result of the clause. Not least would it harm the women of this country. We should not be mealy mouthed about this. Abortion, venereal disease, divorce and other evils will, I fear, flourish to an even greater extent than now if the clause goes through unamended. Once the Government allow sexual intercourse for all, virtually paid for by the State, we shall see an end to our society, based as it has been for so long on the unit of the family.
I therefore call on hon. Members on both sides of the House to share my views and my fears and to support my amendment. At least we should ask the Government to think again and make these services available only for family planning and not for single people. I certainly propose to divide the House.
§ Mr. Pavitt
I do not wish to address myself to the debate which has been initiated by the hon. Member for Oldbury and Halesowen (Mr. Stokes) because no doubt the Secretary of State will deal with that adequately when he speaks. I wish to devote my speech to the amendment standing in my name, and I welcome that the Chair has permitted a vote on the third amendment. For my part, although that amendment does not go far enough, I shall be a supporter of the 1353 hon. Member for Norwich, South (Dr. Stuttaford) in the Division Lobby when we reach that stage.
But because we have debated this matter at great length on Second Reading and in Committee the order of the night must be brief speeches, and because this is such an important matter I do not see why I should not also be brief. Therefore, I hope that the hon. Member for Oldbury and Halesowen will forgive me if I do not take up the remarks he made. The arguments are well known and the sooner we reach a decision the better. Most of us will know how much this decision interlocks with so many other aspects of the health service. Every debate we have had on the Bill has been related to matters raised in other debates.
My amendment is designed to provide for free counselling, appliances, and education. In Committee by a very narrow margin the Secretary of State, almost by accident, managed to get a compromise through which will mean that the provision of medication, the provision of appliances, of intra-uterine devices, will now be subject to prescription charges. To counter this step in the wrong direction I hope that my amendment will be accepted. The imposition of prescription charges will create the very problems that the clause is seeking to deal with. Those problems include abortion, illegitimacy and unwanted children being born. There is adequate evidence of free supplies leading to more counselling, and the object of the exercise is to provide a comprehensive family planning service which will attract people who would not normally receive advice.
In London 19 out of 32 boroughs are already doing that. The whole sphere of social problems is affected by this. It is not just a question of family planning and whether or not unwanted children are borne. There is also the question of population control, which I know concerns many hon. Members on both sides of the House.
The right hon. Gentleman has had a barrage of demands from all quarters for a completely comprehensive free service—from the Association of Municipal Corporations, from professors of teaching hospitals, and from doctors, especially 1354 obstetricians and gynaecologists. The British Medical Journal of 7th April made it quite clear in a leader that on medical grounds the introduction of a prescription charge is a step in the wrong direction.
The debate is about preventive medicine, not treatment for illness. There is nothing ill in sex or having babies. They are natural functions. Every other immunisation service under the health service is free. We do not charge for jabs to prevent polio, for cervical smears, for chest X-rays. We try to prevent problems. Precisely the same should apply to family planning. It is a question not just of health but of trying to prevent problems in the community, which can be achieved by the comprehensive extention of family planning advice services.
The right hon. Gentleman made the change in Committee to save £3 million. In fact, he will not save even £1 million of that. A cost-benefit analysis would show that not only will the health service not save £3 million but that there will be a debit of £2 million or £3 million to be met by the taxpayer as a result of other social problems. By imposing a prescription charge the right hon. Gentleman is shelving problems for his Department but putting problems on to other social services, other Departments and the community at large.
I beg the right hon. Gentleman to accept the amendment. It is nonsense to impose prescription charges. It is nonsense in logic, organisationally, administratively, socially and clinically. It is sheer nonsense to ask doctors to do this kind of thing, distorting the whole family doctor service. The right hon. Gentleman will receive a demand for fresh contractual arrangements in the service.
If the right hon. Gentleman is not big enough to accept the position as it was in the other place, and although there is a free vote tonight, I urge all hon. Members on both sides to support the amendment, which seeks a humane and constructive approach to a serious social problem.
§ Dr. Stuttaford
I am grateful that we are to be allowed a separate Division on Amendment No. 128, an important amendment standing in my name and that of my hon. Friend the Member for 1355 Hampstead (Mr. Geoffrey Finsberg). It is important because we are trying not to do anything new but to preserve a service that has already been set up. In most places where it is working it has been going for two years, and in some cases as many as six.
If the House does not adopt our amendment we shall be scrapping that service in its existing form. We shall be changing it. That is something we never hoped to see any Conservative Government do. We never hoped to see ourselves go backwards.
It is particularly unfortunate when my right hon. Friend the Secretary of State has done so much for family planning. From a figure of £750,000 three years ago, the expenditure on family planning is to rise to £30 million. Yet we are to go back by £500,000. We are taking 60 paces forward and are to take one pace backwards. It is that one pace that will be remembered by everybody. It will be counter-productive in regard to all the advertising for contraception or for planned families.
It is axiomatic in medicine that we must set out not only to do good but to avoid doing harm. If tonight we curtail the services provided by the 33 local authorities that today provide them free, we shall be doing harm and going backwards. The services which have been provided have proved of benefit to the community. From such pilot schemes, information has been collected which shows that we are getting through to the people we have to get through to if we are to have an all-embracing family planning services.
It is often said that we will not get Social Class V along to the family planning clinics, but in the areas where a free service has been instituted, the number of people from Social Class V attending has doubled in the first quarter. It is also often said that if one starts a service in a new area one is bound to get people attending it who are dissatisfied with the service in the neighbouring area and will, in effect, be providing a service for those no longer prepared to pay. But this in practice has been shown not to be the case. The great majority going to local authority clinics for the first time are in fact having contraceptive advice for the first time. This is a matter not 1356 just of supplies but of counselling, of discussion with the doctor. It is an advice service as well.
Aberdeen is a city close to the heart of my right hon. Friend. He has poured scorn on its figures.
§ The Secretary of State for Social Services (Sir Keith Joseph)
I have paid particular respect to Aberdeen. I allowed myself some criticism of the author of the pamphlet about Aberdeen.
§ Dr. Stuttaford
There is a very subtle difference. The author got the figures from the Medical Officer of Health of Aberdeen, who is known to be in favour of the amendment, together with many other outside bodies. He is in favour because Aberdeen has found that, although it had an extensive service previously, when it started the free service in 1967 many people came forward who had not come forward before. Indeed, the number doubled. For example, many women who were at risk in childbirth came forward and pregnancies among such women dropped by one-third. That is very important. Medicine is a matter not only of prevention but of cure in this context. Here the two are combined. Aberdeen also found that Social Class V people came forward. No wonder the medical officer of health is enthusiastic for the amendment. He is enthusiastic because he has not just thought about this in Whitehall but has actually tried the system and has found that it works.
The other error committed by my right hon. Friend in discussion of future services is the problem of the provision of the male contraceptive, which is a useful, well-tried and effective method. My right hon. Friend's idea is that the male contraceptive should be prescribed by the general practitioner. Anyone involved in medicine knows that that will not work. It may seem a splendid idea when viewed from an office desk, but it will not work in the surgery. Men who need this method will not come into the surgery to queue up alongside people suffering from coughs, colds and varicose veins. Nor will general practitioners prescribe the male contraceptive. They say that this is not what they trained eight years to do. This is something more commercial, requiring very little skill. It is not like prescribing other forms of contraceptives. It is not a life or death decision such as prescribing the Pill can be.
1357 It is just an administrative method thought up in Whitehall that bears no relevance at all to what is going on in the surgery. On the other hand, it is right and proper that this should be provided easily. If the GPs are not to provide this, and they are not, who will? The answer is those clinics which, if we do not carry this amendment, are in danger of having their services curtailed.
These clinics can provide and are providing this service. We should be encouraging them to provide even more. We should do our best to see that this method is prescribed more widely, but not prescribed by the GP. It should he prescribed by those not necessarily medically qualified in the centres and clinics. If we look at the situation today and at what we want to do we must think carefully before we undo what has been done by those 33 boroughs. This is something which we may all regret because no one knows the impact of a charge on contraceptives in these clinics.
We do know the impact, those of us who have worked in the field, of any other form of prescription charge. I have practised medicine without prescription charges and with them. I have been even more fortunate; I have done it with, without and with again. There is no doubt in my mind that even a trivial charge acts as a deterrent. This is an area of medicine in which we should not be deterring anyone. We should be advertising it, doing our best to get people to have the right size family for their homes, themselves, their community and their country. If we put obstacles in their way, even apparently trivial obstacles to those well provided for, financially and intellectually, we may find we are doing everything which we have set out not to do. We shall discourage people from using the service, and I for one am not prepared to take any part at all in discouragement of this type.
§ Mr. Robert Hughes (Aberdeen, North)
The hon. Member for Oldbury and Halesowen (Mr. Stokes) made great play of the fact that in his view the decision of the National Health Service to become responsible for family planning services is some derogation from the moral standards of our society. I must tell him that his experience and knowledge of what happens in illegitimate pregnancies is non-existent and naive. The vast 1358 number of illegitimate pregnancies are the result of casual sexual encounters. The majority of unmarried couples who consult family planning services have a stable relationship and often marry at a later stage.
The decision of unmarried people to consult family planning services is a matter of responsibility. The service does not hand out some requisite and say "goodbye." It gives advice. I regard the use of contraceptives, whether supplied by the State or anyone else, as being the antithesis of what the hon. Member would call the permissive society. I believe that this is the view prevalent throughout the country.
There is no doubt that the decision take by the House on Amendments Nos. 127 and 128 will have a profound effect on the position in Scotland. Section 8 of the National Health Service (Scotland) Act 1972 is more widely drawn than is Clause 4 of this Bill, but even so I frankly doubt very much whether the Government will permit a different scheme in Scotland from that adopted in England and Wales.
I think it is necessary that the House should be aware, and I hope it will be, of the Scottish experience in family planning.
I have some relevant information to give, having been convener of the health and welfare committee in Aberdeen when it embarked on establishing a free family planning service, and from that I know the difficulties in selling this to the public—the feeling that sex is to be supplied on the rates, and that kind of extravagant claim which has been made. Such claims have been faced.
All Members, I think, have seen "The Benefits of Birth Control: Aberdeen's Experience, 1946–1970". Time does not permit me to quote extensively from it, but there are one or two items of information which I would mention and which I regard as important. The infant mortality rate in Aberdeen dropped from 19.2 per 1,000 live births in 1965 to 14.5 in 1970, and further reduced to 12.3, one of the lowest mortality rates in the world.
Another point is this. There were no maternal mortalities in 1969 or 1970. As we mentioned earlier, high-risk pregnancies have been greatly reduced, and 1359 the position is that in pregnancies to women aged 35 or more the risk has been reduced from 9.3 per cent. in 1961 to 4.8 per cent. in 1970. The report says:The rate of high risk births to mothers of large families was also reduced to 7.4 per cent. by 1969, about half the rate for Scotland as a whole.For example, the rate for Glasgow was 24 per 100 live births in 1969.
I am not suggesting that was all due solely to a comprehensive family planning service, because there has been great co-operation between the local authorities' health services and the regional hospital boards, which are now to pass out of existence, but it is also due to the pioneering work in obstetrics and gynaecology of Sir Dugald Baird and, now, Professor McGillvery, and also to improvements in housing and to the health education unit of Dr. MacQueen, the Medical Officer of Health of Aberdeen.
I feel entitled to claim that a service which started in the small way in a central clinic rather hidden from the public's view expanded to peripheral clinics and to the domiciliary services, and so to people who found it difficult to get to the central clinics because of transport difficulties. The costs to those people were extremely important. I shall not quote many statistics because of shortage of time, but in 1970 Aberdeen had approximately 37,400 women aged between 15 and 44, roughly the child bearing age, and by the middle of 1972 it was estimated that the local authority clinics had given contraceptive help to over 18,000 new clients, nearly half the number of women of child-bearing age in the city. These figures are in the report.
I hope the House will acquit me of immodesty when I say the town council has every reason to be proud of the policy decisions it took at a time when it was not the conventional wisdom to provide a free comprehensive system of family planning. Aberdeen's pioneering experience has not fallen on barren ground. In July 1972 52 out of 56 local authorities in Scotland provided some kind of family planning service. This shows how the whole family planning movement has gone forward. I have a letter for the Central Scottish branch of the Family Planning Association, and it 1360 points out that Glasgow and Renfrew-shire had had a free service for one and two years respectively. The number of new patients increased from 1,802 in 1968 to 5,027 in 1972. In the first quarter of 1973, 1,850 people attended, which is more than the number who attended in the whole of 1968. Using a not very elegant expression, the association says:Those of lower social classes who were previously deterred by fees now attend. Small as the 20p prescription charge is, it is still enough to prevent them attending for continuous supplies, which is essential for effective family planning.The association is reaching a number of people who find it difficult to meet their obligations and face their responsibilities.
The case is made out at the very least for the continuation of existing services. It is a great pity that those boroughs in England and Wales which operate comprehensive services are likely to have them eroded. It is a pity that, having grasped the nettle of providing the services and justifying them to the ratepayers, they should now see their work being eroded. They all expected—as we did in Scotland—that the services would be allowed to continue under the new area health boards.
I pay tribute to the Under-Secretary of State for Health and Education, Scottish Office, the hon. Member for Dumfries (Mr. Monro), for his courageous stand in Committee against his own back benchers. I believe that he was sincere in paying tribute to the Scottish local authorities who had done the pioneering work. He gave us good reasons for believing that the best of the services would be allowed to continue in Scotland. When we discussed Clause 8 of the Scottish Bill on Report he said—referring to the hon. Member for Roxburgh, Selkirk and Peebles (Mr. David Steel):As the hon. Gentleman said, the present responsibilities of the local authorities will be taken over by the health boards, and I have no doubt that areas such as Aberdeen which have very comprehensive family planning clinics at the moment will continue to do so under the health boards."—[OFFICIAL REPORT, 26th July 1972; Vol. 841, c. 1988.]If the Government override this view, if they compel uniformity throughout the United Kingdom, they will be in breach of faith and break the pledge solemnly 1361 given by the Scottish Office. That cannot be lightly contemplated either by the Government or the House. I hope that, whilst bearing in the mind the experience of England and Wales, the House will be well aware of the profound results the decision today will have on the authorities in Scotland and the excellent work that has been done.
§ Mrs. Jill Knight (Birmingham, Edgbaston)
There is virtually unanimous support in the House for responsible family planning, and overwhelming support for the work of the family planning clinics. The argument is about whether the service should be completely free to everyone who asks for it or whether a charge should be made.
I have been shocked by some statements made in the Chamber this evening, because those who have made them know perfectly well that there is absolutely no evidence to prove that more people take advantage of the family planning service if it is free.
§ Mrs. Knight
Birmingham has not proved it and neither has anyone else. There are still many areas of grave need within the health service. There are many areas in which money could be better spent than on totally free family planning.
I am strongly in favour of family planning and of every type of contraceptive being free to those who genuinely cannot afford to pay. But it is ridiculous to provide a totally free service and totally free contraceptives to people who can afford to pay for them. It would not be so stupid and wrong if there were not so many other areas of need. I cite only one, and that is the need for more kidney machines. There are people in this country who are dying because there are too few kidney machines. It seems to me quite extraordinary that we should be suggesting a provision which would deny money being spent on that vital matter where the need is so much greater compared with the matter we are now discussing.
I shall make a brief speech, but I am particularly anxious to call my right hon. Friend's attention to a point I made in 1362 Committee relating to the age of consent. As the Bill now stands, with family planning provision coming under the National Health Service, it would mean that although adults paid a prescription charge for contraceptives—unless they could not afford to do so—a child under 16 would be able to obtain these things absolutely free. The age of consent is still valid because it exists for the protection of young people. By passing one new law of this nature we shall make it easier to break another law, and this would lead to an extraordinary situation.
I put this point to my right hon. Friend in Committee, and his answer was:I should need a practising lawyer to answer that question"—and the question was whether the law would encourage on the one hand what it forbids on the other. The Secretary of State continued:The fact is that the Committee is now concerned with unwanted pregnancies. … That is the situation we face. My hon. Friend has asked me a legal conundrum I will look into it, and write to her with the best advice I can obtain."—[OFFICIAL REPORT, Standing Committee G, 17th April 1973; c. 302.]No doubt due to the heavy burden which my right hon. Friend bears, I have not yet received a reply, but I am sure he will give me a reply this evening.
I regard it as an extremely important point that the law of the land still says that the age of consent is a relevant factor in the protection of young people. Bearing that point well in mind, I would be grateful if my right hon. Friend could answer the question which I posed to him in Committee on that occasion.
§ Mr. David Steel (Roxburgh, Selkirk and Peebles)
It seems to me extraordinary that many hon. Members are prepared to set at naught the experience of local authorities in various parts of the country in family planning matters. With respect to the hon. Member for Norwich, South (Dr. Stuttaford), I feel that his amendment is second best. We should at least try to prevent the Government going backwards. Therefore, I support the hon. Member for Willesden, West (Mr. 1363 Pavitt) in hoping that we can get the Government to move forward.
It also seems to me extraordinary that many are prepared to set at naught the opinion of the Royal College of Obstetricians and Gynaecologists, which said:There should be no financial disincentive to the provision of advice and services by any doctor working within the National Health Service.It seems extraordinary that they are prepared to set at naught the opinion of the British Medical Association thata national and uniform family planning service should be set up, including the provision of free planning advice and equipment by general practitioners.It seems extraordinary that they would set at naught the opinion of our own Select Committee on Science and Technology or the view of the Population Panel. All these bodies have gone into this matter a good deal more fully and thoroughly than we have in short debates in this House.
The hon. Member for Oldbury and Halesowen (Mr. Stokes) spoke of the Christian ethic. I and others object strongly when those who hold one view within the Christian ethic appear to hijack unto themselves the Christian ethic to their own point of view. The most recent debate within the Christian denominations on this subject was two weeks ago in the General Assembly of the Church of Scotland, and nobody would accuse the Assembly of being over-adventurous or radical in matters of sex. Yet the Assembly, with the most up-to-date information, discussing precisely the proposal in this Bill, after heated debate and only by a majority, indicated its strong support for the policy of the Government. Therefore, to attempt to remove this proposal on Christian ethic grounds appears to have little support.
As to economies, to suggest that possible revenue from prescription charges estimated at about £3 million could somehow be used to buy kidney machines or something of the kind is extraordinary when one considers expenditure on health and welfare services at present caused by lack of a free family planning service.
A Government policy which produces such odd anomalies as free contraceptives 1364 for old-age pensioners is difficult to defend in logic. Whatever criticism one may have of the detail of the Political and Economic Planning report which said that for every £1 spent on family planning we could save £100 on health and welfare expenditure and I accept what the Minister said on a previous occasion—it is nonsense to talk of economies by making prescription charges for family planning.
Whatever our views on the Medical Termination of Pregnancy Act or abortion generally, we can agree that it is far better to prevent conception than to terminate pregnancies. Whatever our views on the argument on abortion generally, we must be concerned about the dramatic increase in demand for abortion. Yet research shows, as a matter of fact, that time and time again demand for abortion is caused by lack of knowledge and lack of use of birth control provisions.
In 1971 we had 53,000 National Health Service abortions costing £100 each, and the amount accumulated by prescription charges for birth control is trifling by comparison.
I agree with what the hon. Member for Aberdeen, North (Mr. Robert Hughes) said about the experience of that city. The medical officer of health there estimated that for his city the two items of expenditure of £17,000 on contraceptive services and of £18,000 on health visiting and health education represented a total annual saving in rates and taxes of £200,000.
The facts are in favour of the amendment in the name of the hon. Member for Willesden, West, but not only the facts. Reports in the House are in favour and public opinion as shown by National Opinion Poll, at 64 per cent., is in favour of free family planning. The House would be stupid to go against the facts and against public opinion, refusing to accept opinion in favour, and the general demand in the country for a free birth control service.
§ Mr. Ronald Bell (Buckinghamshire, South)
I support the amendment moved by my hon. Friend the Member for Oldbury and Halesowen (Mr. Stokes). Few things are more important than limitation of the increase of population, and one way to effect that is the inhibition of unwanted conceptions, sometimes grandly 1365 called birth control. That view is probably widely shared by both sides of the House. In supporting my hon. Friend, I can say that I probably advocated this view and pressed it before any other hon. Member at present in the House did so.
In supporting my hon. Friend, I am not withdrawing from my previous support for family planning, as it is conveniently called. Nor am I concerned with proposals for charging, or with whether the advice or the gadget should be supplied free. What is objectionable, in my view, is that the State should provide these appliances and this advice free to unmarried people.
I understand the attitude of those who say that it is possible to draw a clear distinction between making the appliances available and the moral precepts as to how one should behave in the matter of sexual conduct. I have always believed this to be a false distinction and one which cannot be made.
I remember when my friend Sir Alan Herbert, who I helped to return to this House many years ago, propounded the belief that the ease with which people could get out of marriage by divorce would not affect the state of mind with which they entered it. I always believed that to be a fallacy, and experience has amply demonstrated over the past 40 or 50 years that it is a fallacy. By making divorce very easy, we have gradually washed away the great institution of marriage. It is an illustration of hard cases making bad law if, by trying to relieve intolerable hardships, we destroy a very valuable human institution.
Those who advocate the free provision of birth control appliances to unmarried people are saying to themselves that it is possible to do this without encouraging promiscuity because, on the one side, there is the mechanical appliance and, on the other, there are the great moral questions which we can go on discussing.
I do not believe that there is any substantial number of young girls regularly taking the contraceptive pill who are living chastely. It would be nice if it were so, but I do not believe it. Nor does anyone else on either side of the House. The fact is that the two interact.
Then there are some who ask whether it matters, anyway. Is sexual promiscuity 1366 harmful to the community or a form of progress? It is too large a subject to go into at this hour when short speeches will be more appreciated than long ones. But I believe that there is ample evidence gathered by the methods of natural science to prove beyond dispute that sexual promiscuity damages the energy and the morale of a society.
If that be so, it must be wrong that the State, which is the official expression of the voice of us all, should set its imprimatur upon loose and casual sexual encounters. If that be so—and obviously those are the views underlying my own attitude—it would be right to make these appliances generally available free only if there were some countervailing consideration of greater magnitude.
I suppose the one which is put forward is that it will avoid some unwanted births. Inevitably it will, but I suggest that the number will be infinitesimal. It is not lack of money for contraceptives which causes illegitimate births. Nor is it ignorance of the existence of contraceptives. Does anyone seriously think that there will be a wider knowledge of the existence of contraceptives sheaths because they are available freely on the National Health Service? That is absolute nonsense.
Illegitimate births are caused by recklessness, by carelessness, by drunkenness and by incompetence, but never by lack of money to buy the appliances. Looking at the average industrial wage and accepting that it is an average and that there are some above and some below it, still the cost is so trivial that the argument is ridiculous. I find it astonishing when the effect of promiscuity upon the general moral tone of society is put forward as the only argument to counterbalance all the other considerations.
I am glad that my hon. Friend has moved the amendment, because it enables those of us who take that view—I believe if we get away from the fashionable froth, about nine-tenths of hon. Members take that view—to have an opportunity of expressing it in the Lobby tonight.
§ Mr. Selwyn Gummer (Lewisham, West)
Although sympathising with the attitude expressed by my hon. Friend the Member for Oldbury and Halesowen (Mr. Stokes), I think it is possible for those of us who are Christians to hold different views on contraception, as the 1367 hon. Member for Roxburgh, Selkirk and Peebles (Mr. David Steel) has suggested.
I believe it is difficult to take the line suggested by my hon. and learned Friend the Member for Buckinghamshire, South (Mr. Ronald Bell). If his argument is right, the State should not support homes for unmarried mothers. It is clear that if we make the situation more humane for those who have children out of wedlock, then it might be argued—indeed, our Victorian grandparents and great-grand-parents did argue—that this is an encouragement to promiscuity.
I believe that we should accept that we live in a society which presupposes the existence of contraception. Whether we like it or not, we have a generation which is growing up in that society and we must make our decisions in light of that situation. Therefore, there is no argument between most hon. Members on both sides, however strongly we may feel about pre- or extra-marital sex, about the need for a contraception service.
The real question is whether making that service free actually increases the number of people who will use it. I submit that that argument has not been carried by those who have put it forward.
The hon. Member for Roxburgh, Selkirk and Peebles repeated several times that it was important to see that the largest number of people possible use the contraceptive service. However, I do not believe that he adduced any evidence to show that a free contraceptive service will increase the number of people who use it.
§ Mr. Gummer
In view of the plethora of attempted interventions, I think it would be fair if I refused everybody.
§ Mr. Gummer
As I mentioned the hon. Member for Roxburgh, Selkirk and Peebles, perhaps it is fair to give way to him.
§ Mr. Steel
As evidence may I cite the medical officer of health for Lincoln, 1368 writing in the British Medical Journal earlier this year:the case for free family planning services is overwhelming. The local authority family planning service became completely free in September 1972, and the number of women attending in the first quarter was twice the average for the previous four quarters. This proves that although the cost of supplies may appear to be insignificant, it is indeed a disincentive to many women, and particularly many of the women whose needs are greatest.
§ Mr. Gummer
The hon. Gentleman does not mention that the medical officer of health for Lincoln could have pointed to the large increase in advertising of the service which accompanied that change. That is a totally unfair piece of evidence. That is an opinion by an individual medical officer of health.
§ Mr. Gummer
I must continue. It is only fair to try to make one's speech as short as possible at this time of night. The only so-called evidence put forward has been the opinion of a number of eminent and worthy people, but the opinion of a number of equally eminent and worthy people to the opposite effect was cited in Committee.
§ Dr. Stuttaford
There is some confusion between opinion and numbers. Will my hon. Friend consider the situation in Brent, where there was little, if any, advertising? In fact, a deliberate attempt was made to keep the service rather quiet. Yet, despite that, there was a 68 per cent. increase in new attendances in the first six months. Does he consider that that was entirely due to the almost non-existence of advertising or to the free service provided?
§ Mr. Gummer
My hon. Friend's figure for Brent would be more effective if it were not a percentage but numbers. I am sure that he would like to tell me later exactly what the numbers were.
It is reasonable to suggest that there is no evidence that a free contraceptive service, but for a small payment for a prescription, increases the number of people who attend those clinics.
Those of us who feel strongly, as does my hon. Friend the Member for Oldbury and Halesowen, against abortion, must 1369 be the first to be in favour of the widest contraceptive service. I would ask him to think again, when we come to decide on his Amendment, whether it is not much better to have a service of contraception throughout the country which will reduce the number of abortions rather than have the appalling incidence of abortion that we have at the moment.
I am very much, I might almost say enthusiastically, in favour of a widespread contraception service because I believe that abortion is much more unacceptable. Those of us who think that should think very carefully before we refuse to have the kind of contraception service that the Secretary of State's proposals would provide.
But the real issue is that, if it is true that doctors believe that there is no need for them to prescribe male contraceptives, we have to look carefully at the argument of my hon. Friend the Member for Norwich, South (Dr. Stuttaford) that doctors would feel that this was merely a dispensing service. I apologise for saying so, since my hon. Friend is a doctor, but it seems a very narrow view of medicine to say that a doctor is not prepared to accept that the opportunity to prescribe male contraceptives is a similar opportunity to that of providing—this entails much more difficult and complicated decisions—female contraceptives. As he and others have said, the provision of contraception is not as easy as that, but has very important effects upon the psychology of the person concerned. I hope that my hon. Friend's colleagues will take this opportunity to give the kind of proper medical service that many of us feel is not merely the prescription of pills but actually being concerned with the whole individual.
§ Dr. Stuttaford
Would my hon. Friend agree that I said that the clinics can well provide these male contraceptives and that doctors may recommend their patients to go to the clinics to get them? He surely would not expect GPs month after month to count out Durex to hand to patients. That would be unrealistic. It is reasonable that there should be a consultation and a recommendation, but the actual dispensing is not a reasonable request.
Mr. Gummer But
if my hon. Friend believes that it is beyond the wit of the medical profession to organise in this 1370 respect the kind of regular and repeated prescriptions which arise over a number of chronic illnesses, he underestimates his colleagues. It is possible for them to do this.
The whole contraceptive service, like other kinds of preventive medicine, should be within the National Health Service. It is unacceptable to suggest that another £3 million does not matter, when many of us, on behalf of our constituents, have been fighting for much smaller sums for the improvement of health service provision. Perhaps hon. Members are not happy with the example of the kidney machine, but I should be much happier if that £3 million were spent on extra-domiciliary services, with more money on advertising, in a greater endeavour to reach those people who at the moment are not reached by contraceptive services than the mere provision of this free service for which no evidence has been adduced save the individual opinions of some people.
If this is so, those hon. Members who rightly have a strong view about the sanctity of marriage and the whole nature of the use of sex should think carefully about the extra abortions to which the policy they advocate leads. On the other hand, those who really believe—and there are many on this side of the House—that the small prescription charges levied in the case of life and death drugs would be so much of a deterrent in the case of contraception that they cannot be levied in that case should think again and wonder whether that £3 million would not much better be spent on advertising and better domiciliary services or elsewhere in the National Health Service, in order to ensure that we are not guilty of throwing away that money merely because of the unsupported evidence of the opinions of one or two.
§ Mr. Leo Abse (Pontypool)
It had not been my intention to intervene in this debate, whose subject matter was amply ventilated at an earlier stage, but, listening to it, I am prompted to intervene—even if only for a few minutes—because, although I have heard a great deal about birth control, contraceptive services, the sexual habits of the nation, promiscuity, the expertise of abortion, and some profound comments about the etiology of illegitimacy from at least one hon. Member, I have heard extraordinarily 1371 little about what the debate should be about; namely, children.
We sometimes tend to forget that we are talking not about promiscuity but about the consequences that may arise from deep springs and from many other causes than accidents, but which may arise undoubtedly from fecklessness and carelessness of another order.
During the last few months, in speeches of great interest and sensitivity, we have all heard a great deal from the Secretary of State about the cycle of deprivation. No one has emphasised it more, and it would be churlish of anyone on the Labour benches not to pay tribute to the Secretary of State, because he is aware that if we are to deal with the problems that cause hon. Members on both sides of the House so much concern, and if we are to break the concatenation of events whereby the problems of the parents are thrown upon the children, we must tackle the technique of breaking that terrible cycle.
When we already know from our experience of the operation of the Family Planning Act—with which I was early associated—that the most positive benefit that came from that measure was that we were able to reach out, through domiciliary visits, to those who would not otherwise use contraceptives; when we are all thinking, "Can we help in any way to reach out to what we may regard as the poverty-stricken or feckless", I find it quite extraordinary that we are being asked for evidence of the kind that is now being demanded in order to establish that we must do far more if we are to reach those people than we have done up to the present.
What we did in the Family Planning Act was to take contraception away from the barber and from the machines from which it could be bought, in garages and elsewhere, and to begin to drive people into the family planning centres. Anything that we do that turns them back to the barber or the slot machine is fundamentally reactionary, and who can doubt that that is one of the main consequences of what is being suggested in the amendment? Who can doubt that harassed hard-pressed doctors will not be the people who will give supportive advice and guidance to people who go to see 1372 them? Who can doubt that these are not the sorts of people who we are trying to reach—people who will queue in an overcrowded surgery to get a prescription? The effect of this move is bound to be that we will turn people from the clinics, where they were getting free contraceptive appliances and were available to be given advice, back to the barber's shop and the machines?
It is true—I accept the argument that has been presented—that we may be spending too much, and money which could be directed elsewhere, by giving a totally free service. But can anyone doubt that unless we are prepared for this overkill operation we shall not reach that particular section of the community which breeds the large families, in every one of our cities and our constituencies? We well know that certain families will continue having more children than they can manage and support in the centres where it is likely that we get problem children and delinquent children, the problems about which the Secretary of State says that he is most concerned.
The Secretary of State is faced with a challenge tonight to see how he can harmonise all the views that he has put forward about his pre-occupation with the cycle of deprivation when he well knows that as a result of the operation of this scheme he will miss out that section of the community which has to be reached.
I find it sad that the Secretary of State is failing here in doing this. He has done a great deal. This is an extraordinary thing to do. It is not for me to teach the Secretary of State his own politics, but he must know that the result of the debate will be that everyone will regard the Government as reactionary on this issue, as they are in so many respects, even while he can claim rightly that he has done a great deal more in terms of finance than any previous Government. But it will surely go out from this House, as it must, that the right hon. Gentleman is the Secretary of State who has smashed to a large degree the work of the most progressive authorities throughout the country. It will go out that he is hamstringing entirely all the innovating work done in Scotland. It will go out that the right hon. Gentleman is sabotaging the main efforts put forward by those who have been desperately concerned, often 1373 against public opinion, for family planning. The right hon. Gentleman really should reconsider this matter.
If the right hon. Gentleman argues that the evidence does not show this need, robust common sense will tell all of us that if things are free people are more likely to have them and use them. There are very few exceptions to that principle. If we are asked to adumbrate evidence to prove something that is so obvious, the perception of this House is being underestimated.
Even at this late hour I hope that the Secretary of State will have a change of mind. If the right hon. Gentleman will not yield to us, I hope that hon. Members will use their votes in order—I say this to Conservative hon. Members—to save them politically from the opprobrium that is bound to fall on them, to save them from making fools of themselves, as they are, by giving millions of pounds on the one hand but, on the other hand, sabotaging the efforts of all those who have been most concerned about this matter.
Hon. Members must have a sufficient degree of political sophistication to be able to see the dilemma in which the Secretary of State has placed himself. Perhaps together we can save him and the nation from this little folly.
§ Mr. Geoffrey Finsberg (Hampstead)
I am not sure that the speech to which we have just listened particularly helps the case that I want to argue. It tended to bring an unwanted aspect into the debate; namely, political expediency. I am sorry that the speech finished in the way it did.
I make no apology for intervening in the debate, for quite a few reasons. First, what we are asked to debate in these various amendments is a matter of fundamental importance. I want to speak in some detail of a particular authority of which I have knowledge. I need, at least on this occasion, perhaps as on others, to be completely consistent. I want to speak about the London borough of Camden, because I was the leader of the Conservative Party on that council when we implemented, on 11th March 1968, the only free family planning service at that stage that was permitted under existing legislation.
1374 11.45 p.m.
From 11th March 1968 no charge was made to Camden residents for advice or medical examination but a charge, subject to abatement, was made for the supply of requisites prescribed to persons seeking advice on social grounds. Those were the first steps on the issues I want to talk about tonight.
I subsequently became the Leader of Camden Council but gave up that post. I am still a member of the council and of its health committee.
Since 1st January 1972 no charge has been made to Camden residents for family planning supplies or appliances prescribed at the council's family health clinics or at clinics run by voluntary bodies as agents of the council or to Camden residents referred by general practitioners.
I will give figures to my hon. Friend the Member for Lewisham, West (Mr. Selwyn Gummer) and others to show that the introduction of a fully free service—not in percentages, but in numbers—has been justified.
I start by giving some figures in financial terms for the three years in question. In 1970–71 Camden spent £24,000 on family planning, in 1971–72 £37,000 and in 1972–73, the first full year of a fully free service, £67,000. The provisional estimate for the current financial year is £74,800.
The cost of advice and supplies to one woman is about £7 to £8 per annum. The cost of maintaining a child in a day nursery is £400 per annum. The cost of maintaining a child in a residential children's home is £1,800 per annum. Even on a cost benefit basis I submit that a fully free service is completely justified and justifiable.
I will now give some figures in numbers, not percentages. I will again take the three years 1970, 1971 and 1972. In 1970 a total of 11,000 people received advice or prescriptions in Camden. This is from all agencies—general practitioners, various advice services and voluntary bodies. In 1971 the figure was 13,400 for direct council supply and 3,000 by organisations like the Family Planning Association and Marie Stopes. In 1972, the first full free year, Camden's own figures had risen to 16,200 and the number of residents served by voluntary bodies had 1375 risen to 5,000 bringing in the Brook Advisory Centre.
That correlation between expenditure and numbers of residents served is evidence that the House should not lightly disregard.
The hon. Member for Roxburgh, Selkirk and Peebles (Mr. David Steel) quoted the National Opinion Poll figures. I heard murmurs to the effect, "It depends on what the question was." I agree that with any public opinion poll it depends on exactly what the question is and how it is put. Perhaps the breakdown of the figures is important because, irrespective of what the question was, the answer came through clearly.
The hon. Gentleman said that 64 per cent. of those questioned thought that the Government should provide a free birth control service for all men and women. The survey went on to say that in the under-45 age group, which, if my demographic mathematics are correct, is now beginning to be somewhat larger than that of the elderly citizens, the view was held by 79 per cent. of the electorate. I shall be completely impartial. They then analysed the answers from the adherents to the three major political parties. The results showed that 62 per cent. of Conservatives supported it, 70 per cent. of Labour and 62 per cent. of Liberal voters. Those people favoured a free contraception service.
One of the reasons I am particularly interested in the subject is that one of the purposes of the Bill is, through the reorganisation, to tidy things up. London has been "tidied up". It had its reorganisation in 1964 and it is working pretty well. Camden can claim to be a forerunner in the provision of family planning services. One of the three units of the Camden-operated scheme originates from 1939 under powers taken under the Public Health (London) Act 1936. When Camden came into being in 1965 reactionary Tory Hampstead and Holborn happily accepted the view taken by St. Pancras and everyone went along with the idea. Decisions taken by Camden on two occasions have been bi-partisan with no opposing vote recorded. My hon. Friend the Minister for Housing and Construction has certain views about Camden, and so have but on this issue Camden was completely united.
1376 It should be taken into account that in terms of rateable value on the old valuation lists Camden is the fourth wealthiest local authority in Britain. It is a major authority and it cannot be lightly dismissed. I appreciate and anticipate one argument that my right hon. Friend will put up against our amendment. He will say that what I have explained about Camden may be true but that it will cease to exist as Camden when the new areas for local authorities come in, and that it will be merged with Islington. He will say that we cannot expect only people in Camden to be able to get free service while the people in Islington are left out of the scheme. My right hon. Friend the Secretary of State has held office as Minister of Housing and Local Government. May I remind him that one of the first things we learn in local government is that when amalgamation or reorganisation comes along there is for the staff what is known as a "no detriment" or "no worsening" provision? I am not prepared as one of the Members of Parliament for Camden to see 20,000 of the electors of that borough being forced to pay for a service which has been free for two years—and it will be three years by the time the Bill becomes law.
I urge my right hon. Friend to be realistic about this and to accept that he will have what can only be called a unique opportunity to prove or disprove his ideas on the matter. If he allows these 30 or so authorities who were farsighted enough to provide a free service to continue he has the ideal basis of a controlled experiment which will show whether there is a proper uptake in Class V as mentioned, whether there is a proper co-relationship between expenditure and the number of people making use of the service. He will have the opportunity. If he can tell the House after five years "Here are the figures for the areas where we have permitted a free service to continue, and there are the figures for areas that have had no service other than the prescription charge service, and they show that a prescription charge is no deterrent", I shall be man enough to say "I was wrong". He has the chance of proving that to us without any difficulty.
I ask the House to realise that those of us advocating the course of action proposed are not calling for any extension of 1377 the service. We are saying "Retain the service which is free, which has been provided by 30-odd local authorities".
If my right hon. Friend is not able to concede the democratic right of those authorities that freely accepted that service, after their members on both sides had fought elections, I shall have to go into the Division Lobby against him, at least on that amendment.
§ Sir G. Sinclair
I support Amendment No. 128. The House has heard with growing conviction the case in support of it made by my hon. Friends the Members for Norwich, South (Dr. Stuttaford) and Hampstead (Mr. Geoffrey Finsberg).
Many of us on this side who signed Early Day Motion No. 177 welcome the great advance made by my right hon. Friend the Secretary of State in the provision of family planning services, a great advance on anything this country has hitherto contemplated.
Many of us believe that the Bill goes far towards meeting the real need and the public demand. But some of us believe that it is wrong to take away from about 10 million people living in 33 local health authority areas the free services that they have enjoyed for some years—for two years in some areas and for as long as seven years in others—by provision from the rates as well as by grants from the central Government.
It is all very well for my logical and youthful hon. Friend the Member for Lewisham, West (Mr. Selwyn Gummer) to scout the evidence. It has been available to him. To say that nothing is proved is to fly in the face of what my hon. Friend the Member for Hampstead has just said and of the evidence provided by the Birth Control Campaign to my right hon. Friend in the past 10 days.
§ Mr. Selwyn Gummer
The facts and figures put forward by my hon. Friend the Member for Hampstead (Mr. Geoffrey Finsberg) show precisely the opposite. There was a bigger percentage rise in the number of women at the clinics between 1970 and 1971 than between 1971 and 1972. All that happened between 1971 and 1972——
§ Mr. Selwyn Gummer
I apologise, Mr. Deputy Speaker.
The figures mean exactly the opposite to what is suggested, because the percentage rise between 1971 and 1972 was higher than that between 1971 and 1972, when the service was made free.
§ Sir G. Sinclair
However my hon. Friend may try to present these figures, the common sense of the local authorities and the demand that they are meeting show where public judgment lies in this sensitive matter.
If it is argued that there is insufficient evidence, it seems to me crazy to wipe out the very basis of those areas in which real evidence about the value of a free service can be gathered. This point was eloquently made by my hon. Friend the Member for Hampstead. I believe that the whole House was carried by this point. Our plea to my right hon. Friend is "Do not wipe out the control areas if a civilised and forward looking judgment is to be made on the merits of this case".
§ 12 midnight.
§ Mr. Mudd
It is all very well to talk in terms of demographic surveys and social classes, but we are talking about human reaction, and human reaction is immediate reaction inspiring illegitimacy and the other problems. If people are in the discotheque on Saturday night and in bed on Sunday morning, they are not saying to each other "Let's wait for 48 hours until we have been to the clinic."
For years the Royal Navy and the Merchant Navy have enjoyed a free contraceptive service. I hope that my right hon. Friend will be able to reassure me that venereal disease and paternity orders against sailors have declined in number as a result of the availability to them of a family planning service.
§ Sir K. Joseph
The House is asked to deal with a group of three amendments which have been moved in very sincere speeches and supported or commented upon by equally sincere speeches. Amendment No. 7 wants us to have less family planning, as far as it comes from the State. Amendments No. 127 and 128 want more family planning to be paid for by the State. My position is clear. I ask the House to reject all three, sincere and, indeed, passionate as support for them has been. I want to put forward what I believe are very strong arguments against them.
I say in passing, because I recognise that it is of the essence of what the House wishes to discuss, that if Amendment No. 7 were passed there would be no family planning service. The Bill abolishes the power of the local authorities to provide a service and Amendment No. 7 would remove any power in the National Health Service to provide family planning advice or supplies except for those who need them for medical reasons.
I say to hon. Members—and I am guilty of this myself—that when dealing with this subject most of us tend to over-dramatise and over-simplify. It is a very difficult question. But what we are doing tonight will not lead to extreme results either way. Loose and casual people are not made loose and casual by the availability of contraceptive supplies, whether free or for 20p. By hypothesis, they do not take the trouble to equip themselves. Nor will a free service eliminate illegitimacy, unwanted pregnancies or abortions.
The reason why most of us on both sides of the House want to make a sensible increase in the availability of family planning advice and supplies is that we believe it will help reduce illegitimate and unwanted pregnancies. My hon. Friend the Member for Oldbury and Halesowen (Mr. Stokes), supported by my hon. and learned Friend the Member for Buckinghamshire, South (Mr. Ronald Bell), laid great emphasis on the first word in the phrase "family planning". He asked that any contraceptive device and all supplies provided by the taxpayer should be limited to married couples.
I can assure the House that the vast majority of users of the family planning service will be married or at least living 1380 in stable unions. I must point out to my hon. Friend that a very large proportion of those who have illegitimate children, of those who have abortions, of those who have unwanted pregnancies, are single people. That is, I believe, why the Church leaders, recognising these facts and maintaining steadfastly their view on the prime importance of chastity before marriage and fidelity in marriage, have still recommended that the State should extend family planning advice and supplies. That is why my hon. Friend the Member for Lewisham, West (Mr. Selwyn Gummer) was quite correct in what he said.
I must turn from the larger argument to a small but important argument put forward by my hon. Friend the Member for Birmingham, Edgbaston (Mrs. Knight). She asked me in Committee a totally unanswerable conundrum about the inter-relationship of the Sexual Offences Act 1956, and Clause 4 of the Bill. The point was that a doctor giving advice, as he is allowed to do under Clause 4, to a girl under the age of 16 might be thought to be conniving at an offence under the Sexual Offences Act. I told my hon. Friend and the Committee that I could not answer that question myself and that I would seek the advice of the Law Officers. I have that advice and it is that there is no conflict between Clause 4 and Sections 6 and 28 of the Sexual Offences Act.
I will if the House wishes, read it out. I can only read it out because it is legal advice. If the House will allow me, I will send it to my hon. Friend and if she wishes she can table a Parliamentary Question about it, or have it published in some other way.
I turn to Amendment No. 127, tabled by the hon. Member for Willesden, West (Mr. Pavitt), which goes in the other direction. He accepts that the Government have gone 90 per cent. of the way, in money terms, to a totally free service. He dismissed, and the House tended to dismiss, I thought unfairly, the comments of my hon. Friend the Member for Edgbaston, that £3 million is a lot of money and there are many other priorities. A number of my hon. Friends from time to time worry about the level of public expenditure.
I am not this evening leaning heavily on the argument of other priorities for the 1381 £3 million. The reason why the Government so firmly believe that it is right to make a prescription charge for contraceptive supplies, except for the relevant exempt categories, is that we believe it is right to normalise the family planning service, to make it a normal ingredient of medical consultation and, to that extent, equipment.
The prescription charge is normal and taken for granted. There are exemptions. The exemptions relevant for our purposes are those for a mother for a year after childbirth, and for people who are receiving supplementary benefit or family income supplement. They get automatic exemption, while those who are just above supplementary benefit level may make application for it. There is no evidence that has been given to the House or country that a 20p charge will deter people who would take the trouble to seek prescriptions if the supply were free.
I shall draw the threads together before I finish, if I can, but I turn now to Amendment No. 128 proposed by my hon. Friend the Member for Norwich, South (Dr. Stuttaford) and strongly supported by my hon. Friend the Member for Hampstead (Mr. Geoffrey Finsberg) and my hon. Friend the Member for Dorking (Sir G. Sinclair). This amendment would preserve the free service in the new health geographical areas, in such areas as contain at the moment a local authority area in which a free service is being provided. I could make a number of administrative arguments against this, but, again, I will not lean on them. I wish to take the argument head on.
I maintain that there is absolutely no reason in family planning policy to maintain what I might call for convenience the present free zones. It is true that in the present free zones there is increased use of the service, but as my hon. Friend the Member for Lewisham, West rightly points out, what would one expect if there is greatly increased advertising, what would one expect if doctors, nurses, administrators take infinite trouble to adapt opening hours of clinics for access by the public and to make it as easy as possible to get advice and supplies?
Above all—I ask the House to heed the argument—it is very natural that people should go to use free supplies when the alternative is supplies at com 1382 mercial prices. This is the alternative at the moment. In the areas where a local authority offers a free service the alternatives are stark: they are, first, a free service if one goes to the clinics—and many of the people who use clinics do not come from that local authority area—and, second, there is the commercial charge, varying at the moment, let us say, between £4 and £6 a year. Well, of course, the contrast is so sharp one would expect an increased take up when the service is free. There is absolutely no evidence that any substantial part of the increased take up is accounted for by people who have not hitherto at all been using contraceptives.
The position after April next year will be another contrast altogether. There will not be a contrast between free and £4 or £6 a year. The contrast will be a loss of a free service and a charge of 20p for a prescription. Therefore, I say to my hon. Friends that, despite the argument from Camden, the case has not been proven.
When the hon. Member for Roxburgh, Selkirk and Peebles (Mr. David Steel) says the Government are flying in the face of the evidence I say it is he who is ignoring the fact that there is no evidence that a free service has reached effectively into those groups in the population who never have used contraceptives at all.
My hon. Friend the Member for Norwich, South was particularly worried because there might not be availability for male demand of sheaths if we were to abolish the free clinics. I must tell my hon. Friend that in the free clinics which particularly seek to make available sheaths to men there has been extremely little demand by men on their own account. That may sound very odd, but I mean that there are cases where women, who with their husbands prefer sheaths on preferred contraceptive advice, have gone to the clinics and asked for sheaths. That will continue, where this has been so, in the future. But there has been very little take up by men.
I must make reference to Aberdeen because the hon. Member for Aberdeen, North (Mr. Robert Hughes), with great sincerity, spoke on the subject. It is hard, as he recognises, to disentangle the effect on abortion of contraception. I have great respect for Aberdeen's efforts for the public good, but I must point out 1383 that, taking the legitimate birth rate alone, over 10 years from 1962, despite Aberdeen's free service, the birth rate fell by 14 per cent., compared with much larger falls in the three cities of Dundee, Edinburgh and Glasgow, three cities which were not offering a free service.
These figures can be interpreted as meaning that Aberdeen has made considerable achievements with its family planning services, but they do nothing to support the thesis that the greater generosity with which family planning supplies have been given in Aberdeen has resulted in a fall of births whereas in cities which have not given free supplies there has not been a fall in births.
I come now to the most formidable argument of all—if I may make such an invidious remark. The hon. Member for Ponytpool (Mr. Abse) made a powerful speech in which he fought me with my own weapons. He rightly pointed out that the Government are dedicated to an attempt, however difficult, to reduce the cycle of deprivation and the creation of problem families. We all know that that is a difficult problem, and we are suitably diffident in approaching it.
The hon. Gentleman asks how, in the face of this self-imposed task, we can remove the possibility of totally free supplies to those, admittedly often casual, households. I say to the hon. Gentleman, whose views on this subject I very much respect, that the people whom he is discussing and in whom I am particularly interested will not be helped by the opening of clinics. They will not be helped by the sort of service we all have in mind. They need domiciliary advice. Skilled doctors and nurses with the gift of persuasion are needed to persuade married couples that for their own benefit they need to use contraceptive techniques.
When the hon. Gentleman says that it is necessary to use the technique of overkill—to be wasteful with that last £3 million—to reach the most casual in society, he deludes himself. Even totally free services will not reach the most casual. We need to reach out to them through the local authorities with domiciliary advice, and that is what the Government have consistently said during the three years 1384 we have been in office and what will be the centre of our plans from April 1974.
I conclude by reminding the House of the Government's strategy, which is to normalise family planning advice and supplies within the National Health Service. Hon. Members are apt to generalise about public opinion. It is true that many members of the public believe that it would be right to have a totally free service. On the other hand, many people believe that that would be to go too far and that it is fair enough to treat contraceptive supplies as we treat life-saving medicines and charge 20p for them.
There is no argument that those who are casual will be deterred by the 20p charge. The casual will not be reached either by a free service or by a 20p service. Therefore, I say to the House and particularly to my hon. Friends, let the Government put the family planning service within the National Health Service and normalise it. That is why I ask my hon. Friends to reject—however sincerely they were moved—Amendments Nos. 7, 127 and 128.
§ Dr. Summerskill
The Opposition are to have a free vote, and I regret that hon. Members on the Government benches are not to be allowed the same facility. I trust that the 70 hon. Members who signed the motion asking for a totally free family planning service will be consistent and go into the Lobby to support Amendment No. 127.
The Secretary of State has been at his most passionate tonight defending a case which until the Lords amended the Bill he did not extol so passionately. But we are now in the position of having before us a Bill from which the Lords Amendment was removed in Committee in another place by a majority of 12 votes to 11. The Government now wish to retain the Bill as it was before it went to the Lords.
We have heard speeches from both sides of the House advocating the case for a totally free service. When the right hon. Gentleman the Secretary of State for Social Services claims that he is trying to normalise the family planning service he is indulging in a great deal of wishful thinking. He is, for example, labouring under the belief that a charge has been imposed which has been reduced to such 1385 a level that nobody could possibly be defeated by it. This is purely a matter of opinion. There is a great body of opinion that the charge is a deterrent, and that opinion includes the British Medical Association and the 33 local authorities which are now running a free family planning service.
The Secretary of State believes that the exemptions will be helpful, but the exemptions include a majority of people under the age of 15 or over the age of 65. The charges are based on the charges for drugs used in the treatment of sickness. Preventive medicine is free in this country; curative medicine has a charge attached to it. Therefore it is totally illogical to base the charge on curative medicine and not on preventive medicine. At the same time, despite protests from all the 33 local authorities—including the West Riding, in which the Secretary of State's own constituency is situated—a measure is being brought in which will reverse a free system and is reactionary and regressive. This dilemma has been created in the last few weeks because of the Lords Amendment which reversed the Government's policy.
When one examines the policy put forward by the Government, with its anomalies, injustices and discrepancies in so many ways, it is clear that the only
§ fair, just and humanitarian system of family planning is to have a totally free service easily available to everybody. This would be sound on economic, social and medical grounds. It has the support of the British Medical Association and of every progressive local authority.
§ If Amendment No. 127, which stands in the name of my hon. Friend the Member for Willesden West (Mr. Pavitt), is not agreed to, I suggest that the second best is Amendment No. 128, which stands in the name of the hon. Member for Norwich, South (Dr. Stuttaford) since at least it would prevent a regressive state of affairs and would be better than nothing. But the only fair and just way is to support the amendment for a totally free service.
§ Amendment negatived.
Amendment proposed: No. 127, in page 4, line 7, leave out from 'and' to end of Clause and insert
'such arrangements shall provide that no charge shall be made for any such medical examination or treatment or for the supply of any such substances or appliances'.—[Mr.Pavitt.]
§ Question put, That the Amendment be made:—
§ The House divided: Ayes 127, Noes 243.1387
|Division No. 151.]||AYES||[12.25 a.m.|
|Abse, Leo||Dell, Rt. Hn. Edmund||Jeger, Mrs. Lena|
|Allaun, Frank (Salford, E.)||Douglas-Mann, Bruce||Jenkins, Hugh (Putney)|
|Armstrong, Ernest||Driberg, Tom||Jenkins, Rt. Hn. Roy (Stechford)|
|Atkinson, Norman||Edwards, Robert (Bilston)||John, Brynmor|
|Barnes, Michael||Edwards, William (Merioneth)||Johnston, Russell (Inverness)|
|Bidwell, Sydney||Ellis, Tom||Jones, T. Alec (Rhondda, W.)|
|Blenkinsop, Arthur||English, Michael||Kinnock, Neil|
|Booth, Albert||Fernyhough, Rt. Hn. E.||Lambie, David|
|Boothroyd, Miss B. (West Brom.)||Fisher, Mrs. Doris (B' ham, Lady wood )||Lamborn, Harry|
|Brown, Hugh D. (G'gow, Proven)||Fletcher, Ted (Darlington)||Lamond, James|
|Buchan, Norman||Foot, Michael||Leonard, Dick|
|Butler, Mrs. Joyce (Wood Green)||Ford, Ben||Lewis, Arthur (W. Ham, N.)|
|Carmichael, Neil||Forrester, John||Lyon, Alexander W. (York)|
|Carter-Jones, Lewis (Eccles)||Fraser, John (Norwood)||McCartney, Hugh|
|Castle, Rt. Hn. Barbara||Galpern, Sir Myer||McGuire, Michael|
|Clark, David (Colne Valley)||Garrett, W. E.||Machin, George|
|Cocks, Michael (Bristol, S.)||Gibert, Dr. John||Mackie, John|
|Coleman, Donald||Grant, John D. (Islington, E.)||Mackintosh, John P.|
|Concannon, J. D.||Griffiths, Eddie (Brightside)||McMillan, Tom (Glasgow, C.)|
|Crawshaw, Richard||Hamilton, William (Fife, W.)||McNamara, J. Kevin|
|Cronin, John||Hannan, William (G'gow, Msryhill)||Mallalieu, J. P. W. (Huddersfield, E.)|
|Crosland, Rt. Hn. Anthony||Hardy, Peter||Marquand, David|
|Cunningham Dr. J. A. (Whitehaven)||Hart, Rt. Hn. Judith||Maxwell-Hyslop, R. J.|
|Dalyell, Tam||Horam, John||Mayhew, Christopher|
|Davies, G. Elfed (Rhondda, E.)||Houghton, Rt. Hn. Douglas||Mendelson, John|
|Davies, Ifor (Gower)||Howell, Denis (Small Heath)||Mikardo, Ian|
|Davis, Clinton (Hackney, C.)||Hughes, Robert (Aberdeen, N.)||Miller, Dr. M. S.|
|Davis, Terry (Bromsgrove)||Hughes, Roy (Newport)||Mitchell, R. C. (S'hampton, Itchen)|
|Deakins, Eric||Iremonger, T. L.||Molloy, William|
|de Freltas, Rt. Hn. Sir Geoffrey||Janner, Graville||Orme, Stanley|
|Owen, Dr. David (Plymouth, Sutton)||Silkin, Rt. Hn. John (Deptford)||Tinn, James|
|Palmer, Arthur||Silkin, Hn. S. C. (Dulwich)||Tope, Graham|
|Parker, John (Dagenham)||Silverman, Julius||Urwin, T. W.|
|Radice, Giles||Smith, Cyril (Rochdale)||Walden, Brian (B'm'ham, All Saints)|
|Reed, D. (Sedgefield)||Smith, John (Lanarkshire, N.)||Watkins, David|
|Reed, Laurance (Bolton, E.)||Spearing, Nigel||Whitehead, Phillip|
|Roderick, Caerwyn E.(Brc'n&R'dnor)||Stallard, A. W.||Williams, W. T. (Warrington)|
|Rodgers, William (Stockton-on-Tees)||Stewart, Rt. Hn. Michael (Fulham)||Woof, Robert|
|Roper, John||Stoddart, David (Swindon)|
|Rowlands, Ted||Strauss, Rt. Hn. G. R.||TELLERS FOR THE AYES:|
|Sandelson, Neville||Stuttaford, Dr. Tom||Mr. Laurie Pavitt and Mr. David Steel.|
|Shore, Rt. Hn. Peter (Stepney)||Summerskill, Hn. Dr. Shirley|
|Short, Mrs. Renée (W'hampton.N.E.)||Thomas, Rt. Hn.George (Cardiff, W.)|
|Adley, Robert||Fidler, Michael||Lloyd, Ian (P'tsm'th, Langstone)|
|Alison, Michael (Barkston Ash)||Fisher, Nigel (Surbiton)||Loveridge, John|
|Allason, James (Hemel Hempstead)||Fletcher-Cooke, Charles||MacArthur, Ian|
|Archer, Jeffrey (Louth)||Fookes, Miss Janet||McCrindle, R. A.|
|Astor, John||Fortescue, Tim||McLaren, Martin|
|Atkins, Humphrey||Foster, Sir John||Maclean, Sir Fitzroy|
|Awdry, Daniel||Fowler, Norman||McMaster, Stanley|
|Baker, Kenneth (St. Marylebone)||Fox, Marcus||McNair-Wilson, Michael|
|Baker, W. H. K. (Banff)||Fraser,Rt.Hn.Hugh(St'fford & Stone)||McNair-Wilson, Patrick (New Forest)|
|Balniel, Rt. Hn. Lord||Galbraith, Hn. T. G. D.||Maddan, Martin|
|Batsford, Brian||Gardner, Edward||Madel, David|
|Bell, Ronald||Gibson-Watt, David||Mahon, Simon (Bootle)|
|Bennett, Sir Frederic (Torquay)||Gilmour, Ian (Norfolk, C.)||Marten, Neil|
|Bennett, Dr. Reginald (Gosport)||Glyn, Dr. Alan||Mather, Carol|
|Benyon, W.||Godber, Rt. Hn. J. B.||Mawby, Ray|
|Berry, Hn. Anthony||Gorst, John||Meyer, Sir Anthony|
|Bitten, John||Gower, Raymond||Mills, Peter (Torrington)|
|Biggs-Davison, John||Grant, Anthony (Harrow, C.)||Miscampbell, Norman|
|Boardman, Tom (Leicester, S.W.)||Gray, Hamish||Mitchell, David (Basingstoke)|
|Boscawen, Hn. Robert||Green, Alan||Moate, Roger|
|Braine, Sir Bernard||Grieve, Percy||Money, Ernle|
|Bray, Ronald||Griffiths, Eldon (Bury St. Edmunds)||Monks, Mrs. Connie|
|Brown, Sir Edward (Bath)||Grylls, Michael||Monro, Hector|
|Bruce-Gardyne, J.||Gummer, J. Selwyn||More, Jasper|
|Bryan, Sir Paul||Gurden, Harold||Morgan-Giles, Rear-Adm.|
|Buchanan-Smith, Alick(Angus, N&M)||Hall, Miss Joan (Keighley)||Mudd, David|
|Buck, Antony||Hall, John (Wycombe)||Neave, Airey|
|Bullus, Sir Eric||Hall-Davis, A. G. F.||Noble, Rt. Hn. Michael|
|Burden, F. A.||Hamilton, James (Bothwell)||Normanton, Tom|
|Butler, Adam (Bosworth)||Hamilton, Michael (Salisbury)||Nott, John|
|Campbell, Rt.Hn.G. (Moray & Nairn)||Harrison, Col. Sir Harwood (Eye)||O'Halloran, Michael|
|Carlisle, Mark||Haselhurst, Alan||Onslow, Cranley|
|Carr, Rt. Hn. Robert||Hastings, Stephen||Oppenheim, Mrs. Sally|
|Channon, Paul||Havers, Sir Michael||Page, Rt. Hn. Graham (Crosby)|
|Chapman, Sydney||Heseltine, Michael||Parkinson, Cecil(Harrow, W.)|
|Chataway, Rt. Hn. Christopher||Higgins, Terence L.||Percival, Ian|
|Chichester-Clark, R.||Hiley, Joseph||Pike, Miss Mervyn|
|Clarke, Kenneth (Rushcliffe)||Hill, John E. B. (Norfolk, S.)||Pink, R. Bonner|
|Clegg, Walter||Hill, S. James A. (Southampton, Test)||Pounder, Rafton|
|Cockeram, Eric||Holland, Philip||Powell, Rt. Hn. J. Enoch|
|Cohen, Stanley||Holt, Miss Mary||Price, David (Eastleigh)|
|Cooper, A. E.||Hordern, Peter||Prior, Rt. Hn. J. M. L.|
|Cordle, John||Hornsby-Smith.Rt.Hn.Dame Patricia||Proudfoot, Wilfred|
|Corfield, Rt. Hn. Sir Frederick||Howe, Rt. Hn. Sir Geoffrey||Raison, Timothy|
|Cormack, Patrick||Howell, David (Guildford)||Rawlinson, Rt. Hn. Sir Peter|
|Costain, A. P.||Howell, Raiph (Norfolk, N.)||Redmond, Robert|
|Critchley, Julian||Hutchison, Michael Clark||Rees, Peter (Dover)|
|Crouch, David||Irvine, Bryant Godman (Rye)||Rhys Williams, Sir Brandon|
|Crowder, F. P.||James, David||Ridley, Hn. Nicholas|
|Dalkeith, Earl of||Jenkin, Patrick (Woodford)||Rippon, Rt. Hn. Geoffrey|
|d'Avigdor-Goldsmid, Sir Henry||Johnson Smith, G. (E. Grinstead)||Roberts, Wyn (Conway)|
|d'Avigdor-Goldsmid.Maj. -Gen. Jack||Jones, Arthur (Northants, S.)||Rossi, Hugh (Hornsey)|
|Dean, Paul||Jopling, Michael||Rost, Peter|
|Dixon, Piers||Joseph, Rt. Hn. Sir Keith||Russell, Sir Ronald|
|Dodds-Parker, Sir Douglas||Kaberry, Sir Donald||St. John-Stevas, Norman|
|Drayson, G. B.||Kellett-Bowman, Mrs. Elaine||Scott, Nicholas|
|du Cann, Rt. Hn. Edward||Kimball, Marcus||Scott-Hopkins, James|
|Dykes, Hugh||King, Evelyn (Dorset, S.)||Shaw, Michael (Sc'b'gh & Whitby)|
|Eden, Rt. Hn. Sir John||Kirk, Peter||Shelton, William (Clapham)|
|Edwards, Nicholas (Pembroke)||Kitson, Timothy||Shersby, Michael|
|Elliot, Capt. Walter (Carshalton)||Knight, Mrs. Jill||Simeons, Charles|
|Elliott, R. W. (N'c'tle-upon-Tyne.N.)||Knox, David||Skeet, T. H. H.|
|Emery, Peter||Lamont, Norman||Smith, Dudley (W'wick & L'mington)|
|Eyre, Reginald||Lane, David||Soref, Harold|
|Farr, John||Langford-Holt, Sir John||Speed, Keith|
|Fenner, Mrs. penal||Le Merchant, Spencer||Spence, John|
|Sproat, Iain||Tilney, John||Weatherill, Bernard|
|Stainton, Keith||Trafford, Dr. Anthony||Wells, John (Maidstone)|
|Stanbrook, Ivor||Trew, Peter||Wiggin, Jerry|
|Stewart-Smith, Geoffrey (Belper)||Tugendhat, Christopher||Wilkinson, John|
|Stodart, Anthony (Edinburgh, W.)||Turton, Rt. Hn. Sir Robin||Winterton, Nicholas|
|Stokes, John||Van Straubenzee, W. R.||Wolrige-Gordon, Patrick|
|Sutcliffe, John||Vaughan, Dr. Gerard||Wood, Rt. Hn. Richard|
|Tapsell, Peter||Vickers, Dame Joan||Woodnutt, Mark|
|Taylor, Sir Charles (Eastbourne)||Waddington, David||Worsley, Marcus|
|Taylor, Frank (Moss Side)||Walder, David (Clitheroe)||Wylie, Rt. Hn. N. R.|
|Taylor, Robert (Croydon, N.W.)||Walker, Rt. Hn. Peter (Worcester)||Younger, Hn. George|
|Tebbit, Norman||Walker-Smith, Rt. Hn. Sir Derek|
|Temple, John M.||Wall, Patrick||TELLERS FOR THE NOES:|
|Thomas, John Stradling (Monmouth)||Walters, Dennis||Mr. Paul B. Hawkins and Mr. Oscar Murton.|
|Thomas, Rt. Hn. Peter (Hendon, S.)||Ward. Dame Irene|
|Thompson, Sir Richard (Croydon, S.)||Warren, Kenneth|
§ Question accordingly negatived.
Amendment proposed: No. 128, in page 4, line 11, at end insert:
'save that the Secretary of State shall ensure that no such prescription charges are made by any Area Health Authorities where a local health authority was at the time of passing
§ of this Act already providing a family plan ping service free of charge for all advice and supplies '.—[Dr. Stuttaford.]
§ Question put, That the amendment be made:—
§ The House divided: Ayes 138, Noes 240.1391
|Division No. 152.]||AYES||[12.35 a.m.|
|Abse, Leo||Garrett, W. E.||Orme, Stanley|
|Allaun, Frank (Salford E.)||Gilbert, Dr. John||Oswald, Thomas|
|Armstrong, Ernest||Grant, John D. (Islington, E.)||Owen, Dr. David (Plymouth, Sutton)|
|Atkinson, Norman||Griffiths, Eddie (Brightside)||Palmer, Arthur|
|Barnes, Michael||Hamling, William||Parker, John (Dagenham)|
|Bidwell, Sydney||Hannan, William (G'gow, Maryhill)||Pavitt, Laurie|
|Blenkinsop, Arthur||Hardy, Peter||Quennell, Miss J. M.|
|Booth, Albert||Hart, Rt. Hn. Judith||Radice, Giles|
|Boothroyd, Miss B. (West Brom.)||Hicks, Robert||Reed, D. (Sedgefield)|
|Bowden, Andrew||Horam, John||Reed, Laurance (Bolton, E.)|
|Brown, Hugh D. (G'gow, Provan)||Hornby, Richard||Renton, Rt. Hn. Sir David|
|Buchan, Norman||Houghton, Rt. Hn. Douglas||Roderick,Caerwyn E.(Br'c'n&R'dnor)|
|Butler, Mrs. Joyce (Wood Green)||Howell, Denis (Small Heath)||Rodgers, William (Stockton-on-Tees)|
|Carmichael, Neil||Hughes, Robert (Aberdeen, N.)||Roper, John|
|Carter-Jones, Lewis (Eccles)||Hughes, Roy (Newport)||Rowlands, Ted|
|Castle, Rt. Hn. Barbara||Hunt, John||Sandelson, Neville|
|Clark, David (Colne Valley)||Iremonger, T. L.||Shore, Rt. Hn. Peter (Stepney)|
|Cocks, Michael (Bristol, S.)||Janner, Greville||Short, Mrs. Renée (W'hampton, N.E.)|
|Coleman, Donald||Jeger, Mrs. Lena||Silkin, Rt. Hn. John (Deptford)|
|Concannon, J. D.||Jenkins, Hugh (Putney)|
|Crawshaw, Richard||Jenkins, Rt. Hn. Roy (Stechford)||Silkin, Hn. S. C. (Dulwich)|
|Cronin, John||Jessel, Toby||Silverman, Jullus|
|Crosland, Rt. Hn. Anthony||John, Brynmor||Sinclair, Sir George|
|Crossman, Rt. Hn. Richard||Johnston, Russell (Inverness)||Smith, Cyril (Rochdale)|
|Cunningham, Dr. J. A. (Whitehaven)||Jones, T. Alec (Rhondda, W.)||Smith, John (Lanarkshire, N )|
|Dalyell, Tam||Kinnock, Neil||Spearing, Nigel|
|Davies, G. Elfed (Rhondda, E.)||Lambie, David||Stainton, Keith|
|Davies, Ifor (Gower)||Lamborn, Harry||Stallard, A. W.|
|Davis, Clinton (Hackney, C.)||Lamond, James||Steel, David|
|Davis, Terry (Bromsgrove)||Leonard, Dick||Stewart, Rt. Hn. Michael (Fulham)|
|Deakins, Eric||Lewis, Arthur (W. Ham, N.)||Stoddart, David (Swindon)|
|de Freitas, Rt. Hn. Sir Geoffrey||Lomas, Kenneth||Strauss, Rt. Hn. G. R.|
|Dell, Rt. Hn. Edmund||Lyon, Alexander W. (York)||Stuttaford, Dr. Tom|
|Digby, Simon Wingfield||McGuire, Michael||Summerskill, Hn. Dr. Shirley|
|Douglas-Mann, Bruce||Machin, George||Thomas,Rt.Hn.Georgo (Cardiff,W.)|
|Driberg, Tom||Mackie, John||Tinn, James|
|Edwards, Robert (Bilston)||Mackintosh, John P.||Tope, Graham|
|Edwards, William (Merioneth)||McMillan, Tom (Glasgow, C.)||Urwin, T. W.|
|Ellis, Tom||McNamara, J. Kevin||Vickers, Dame Joan|
|English, Michael||Mallalieu, J. P. W. (Huddersfield, E.)||Walden, Brian (B'm'ham, All Saints)|
|Fernyhough, Rt. Hn. E.||Marquand, David||Watkins, David|
|Finsberg, Geoffrey (Hampstead)||Mayhew, Christopher||Whitehead, Phillip|
|Fisher, Mrs. Doris (B' ham, Ladywood)||Mendelson, John||Williams, W. T. (Warrington)|
|Fletcher, Ted (Darlington)||Mikardo, Ian||Woof, Robert|
|Foot, Michael||Miller, Dr. M. S.||TELLERS FOR THE AYES:|
|Forrester, John||Mitchell, R. C. (S'hampton, Itchen)||Mr. R. Maxwell-Hyslop and Mr. N. Winterton|
|Fraser, John (Norwood)||Molloy, William|
|Galpern, Sir Myer|
|Adley, Robert||Amery, Rt. Hn. Julian||Atkins, Humphrey|
|Allson, Michael (Barkston Ash)||Archer, Jeffrey (Louth)||Awdry, Daniel|
|Allason, James (Hemel Hempstead)||Astor, John||Baker, Kenneth (St. Marylebone)|
|Baker, W. H. K. (Banff)||Griffiths, Eldon (Bury St. Edmunds)||Page, John (Harrow, W.)|
|Balniel, Rt. Hn. Lord||Grylls, Michael||Parkinson, Cecil|
|Batsford, Brian||Gummer, J. Selwyn||Percival, Ian|
|Bell, Ronald||Gurden, Harold||Pike, Mist Mervyn|
|Bennett, Sir Frederic (Torquay)||Hall, Miss Joan (Keighley)||Pink, R. Bonner|
|Bennett, Dr. Reginald (Gosport)||Hall, John (Wycombe)||Pounder, Rafton|
|Benyon, W.||Hall-Davis, A. G. F.||Powell, Rt. Hn. J. Enoch|
|Berry, Hn. Anthony||Hamilton, James (Bothwell)||Price, David (Eastleigh)|
|Biffen, John||Hamilton, Michael (Salisbury)||Prior, Rt. Hn. J. M. L.|
|Biggs-Davison, John||Harrison, Col. Sir Harwood (Eye)||Proudfoot, Wilfred|
|Boardman, Tom (Leicester, S.W.)||Haselhurst, Alan||Raison, Timothy|
|Boseawen, Hn. Robert||Hastings, Stephen||Rawlinson, Rt. Hn. Sir Peter|
|Braine, Sir Bernard||Havers, Sir Michael||Redmond, Robert|
|Bray, Ronald||Hawkins, Paul||Rees, Peter (Dover)|
|Brown, Sir Edward (Bath)||Heseltine, Michael||Rhys Williams, Sir Brandon|
|Bruce-Gardyne, J.||Higgins, Terence L.||Ridley, Hn. Nicholas|
|Bryan, Sir Paul||Hiley, Joseph||Rippon, Rt. Hn. Geoffrey|
|Buchanan-Smith, Alick(Angus,N&M)||Hill, John E. B. (Norfolk, S.)||Roberts, Wyn (Conway)|
|Buck, Antony||Hill, James (Southampton, Test)||Rossi, Hugh (Hornsey)|
|Bullus, Sir Eric||Holland, Philip||Rost, Peter|
|Burden, F. A.||Holt, Miss Mary||Russell, Sir Ronald|
|Butler, Adam (Bosworth)||Hordern, Peter||St. John-Stevas, Norman|
|Campbell, Rt.Hn.G.(Moray & Nairn)||Hornsby-Smith.Rt.Hn.Dame Patricla||Scott, Nicholas|
|Carlisle, Mark||Howe, Rt. Hn. Sir Geoffrey||Scott-Hopkins, James|
|Carr, Rt. Hn. Robert||Howell, David (Guildford)||Shaw, Michael (Sc'b'gh & Whitby)|
|Channon, Paul||Howell, Ralph (Norfolk, N.)||Shelton, William (Clapham)|
|Chapman, Sidney||Hutchison, Michael Clark||Shersby, Michael|
|Chataway, Rt. Hn. Christopher||Irvine, Bryant Godman (Rye)||Simeons, Charles|
|Chichester-Clark, R.||James, David||Skeet, T. H. H.|
|Churchill, W. S.||Jenkin, Patrick (Woodford)||Smith, Dudley (W'wick & L'mington)|
|Clark, William (Surrey, E.)||Johnson Smith, G. (E. Grinstead)||Soref, Haroid|
|Clegg, Walter||Jones, Arthur (Northants, S.)||Speed, Keith|
|Cockeram, Eric||Jopling, Michael||Spence, John|
|Cohen, Stanley||Joseph, Rt. Hn. Sir Keith||Sproat, Iain|
|Cooper, A. E.||Kaberry, Sir Donald||Stan brook, Ivor|
|Cordle, John||Kellett-Bowman, Mrs. Elaine|
|Corfield, Rt. Hn. Sir Frederick||Kimball Marcus||Stewart-Smith, Geoffrey (Belper)|
|Cormack, Patrick||King, Evelyn (Dorset, S.)||Stodart, Anthony (Edinburgh, W.)|
|Costain, A. P.||Kirk, Peter||Stokes, John|
|Crouch, David||Kitson, Timothy||Sutcliffe, John|
|Crowder, F. P.||Knight, Mrs. Jill||Tapsell, Peter|
|Dalkeith, Earl of||Knox, David||Taylor, Sir Charles (Eastbourne)|
|d'Avigdor-Goldsmid, Sir Henry||Lamont, Norman||Taylor, Frank (Moss Side)|
|d'Avigdor-Goldsmld,Maj.-Gen.Jack||Lane, David||Taylor, Robert (Croydon, N.W.)|
|Dean, Paul||Langford-Holt, Sir John||Tebbit, Norman|
|Dixon, Piers||Le Marchant, Spencer||Temple, John M.|
|Dodds-Parker, Sir Douglas||Lloyd, Ian (P'tsm'th, Langstone)||Thomas, John Stradling (Monmouth)|
|Drayson, G. B.||Loveridge, John||Thomas, Rt. Hn. Peter (Hendon, S.)|
|du Cann, Rt. Hn. Edward||MacArthur, Ian||Thompson, Sir Richard (Croydon, S.)|
|Dykes, Hugh||McLaren, Martin||Tilney, John|
|Eden, Rt. Hn. Sir John||Maclean, Sir Fitzroy||Trafford, Dr. Anthony|
|Edwards, Nicholas (Pembroke)||McMaster, Stanley||Trew, Peter|
|Elliot, Capt. Walter (Carshalton)||McNalr-Wilson, Michael||Tugendhat, Christopher|
|Elliott, R. W. (N'c'tle-upon-Tyne,N.)||McNair-Wilson, Patrick (New Forest)||Turton, Rt. Hn. Sir Robin|
|Emery, Peter||Maddan, Martin||van Straubenzee, W. R.|
|Eyre, Reginald||Mahon, Simon (Bootle)||Vaughan, Dr. Gerard|
|Farr, John||Marten, Neil||Waddington, David|
|Fenner, Mrs. Peggy||Mather, Carol||Walder, David (Clitheroe)|
|Fidler, Michael||Maude, Angus||Walker, Rt. Hn. Peter (Worcester)|
|Fisher, Nigel (Surbiton)||Mawby, Ray||Walker-Smith, Rt. Hn. Sir Derek|
|Fletcher-Cooke, Charles||Meyer, Sir Anthony||Wall, Patrick|
|Fookes, Miss Janet||Mills, Peter (Torrington)||Walters, Dennis|
|Fortescue, Tim||Miscampbell, Norman||Ward, Dame Irene|
|Foster, Sir John||Mitchell, David (Basingstoke)||Warren, Kenneth|
|Fowler, Norman||Moate, Roger||Weatherill, Bernard|
|Fox, Marcus||Money, Ernie||Wells, John (Maidstone)|
|Fraser,Rt.Hn.Hugh(St'fford & Stone)||Monks, Mrs. Connie||Wiggin, Jerry|
|Galbraith, Hn. T. G. D.||Monro, Hector||Wilkinson, John|
|Gardner, Edward||More, Jasper||Wolrige-Gordon, Patrick|
|Gibson-Watt, David||Morgan-Giles, Rear-Adm.||Wood,Rt. Hn. Richard|
|Gilmour, Ian (Norfolk, C.)||Mudd, David||Worsley, Marcus|
|Glyn, Dr. Alan||Neave, Airey||Wylie, Rt. Hn. N. R.|
|Godber, Rt. Hn. J. B.||Nobie, Rt. Hn. Michael||Younger, Hn. George|
|Gorst, John||Normanton, Tom|
|Gower, Raymond||Nott, John||TELLERS FOR THE NOES|
|Grant, Anthony (Harrow, C.)||O'Halloran, Michael|
|Gray, Hamish||Onslow, Cranley||Mr. Kenneth Clarke and Mr. Oscar Murton.|
|Green, Alan||Oppenheim, Mrs. Sally|
|Grieve, Percy||Page, Rt. Hn. Graham (Crosby)|
§ Question accordingly negatived.