§ Mr. Speaker
Before I call the right hon. Lady the Member for Blackburn (Mrs. Castle). I should like to say something about the length of speeches, and I hope that it will percolate to those who are not yet here. There are about 20 hon. Members who wish to speak in this debate and I hope to get them all in. I hope that Front Bench speakers will be reasonably brief. However, the more that back benchers interrupt and the more often Ministers give way, the longer a speech by a Front Bencher becomes.
Yesterday there was one back-bench speech that lasted 30 minutes and two back benchers who promised to speak for seven minutes in fact each spoke for 16 minutes—that was one from either side. That makes it difficult to call all those Members who wish to speak in a debate.
Conciseness does not make a speech any worse. I have no sanctions, as the House knows, but I have a memory.
§ 11.5 a.m.
§ The Secretary of State for Social Services (Mrs. Barbara Castle)
I am very glad that the Opposition have chosen the theme of social policy for today's debate, because in our view social policy is at the heart of economic policy, and if we can get the Opposition today to agree with that, we can begin to see the glimmerings of a united attack on the stubborn economic problems facing this country.
As the Queen's Speech points out, the social contract is, among other things and crucially, about promoting social and economic justice. I know that the Opposition are fond of sneering at the social contract and that the right hon. Member for Lowestoft (Mr. Prior) has given it a new name. He calls it the Socialist contract. All I can say is that I am very proud to have the label "Socialist" attached to a policy designed to secure a more equal, and therefore more stable, society, because the two go together. That is why I am glad that we are to have a wider and more analytical debate today, because social policy should be about the quality of our society.
It is about the relief of poverty, but poverty is not just lack of money. It is about deprivation; it is about being left out; it is about being labelled second class. The interesting point about the social contract is that it is the least materialistic document that the trade union movement has ever produced, because it is about the just society, and that is about the quality of society.
Heaven knows that there is plenty to worry about in the quality of our society: the escapism of drug taking, the senseless violence of so much crime, the social aimlessness among young people. These are some of the manifestations of what we call the affluent society.
But it would, of course, be criminal nonsense to suggest that just because rising material standards have not given us the cohesive society, there is something wrong about raising standards in themselves. We think that the affluent society is a sick society because it is a divided society in which we fail to create a sense of social purpose, or to create a new social morality. Instead we have managed to build a system in which millions of people feel alienated from any such social purpose or social morality.
545 Therefore, the overriding purpose of social policy must be to build the cohesive society. We shall unite the nation only to the extent that we are willing to share things, to share common risks, to share common services, to share a common environment. We shall never unite it by creating two standards in our services, two standards of education, two standards of social services, two standards of health care.
That is why we are committed in our manifesto to phase out pay beds from the National Health Service, and we shall act on that this Session. We shall do so not out of envy or ideological spite but because it is wrong that those who have money should be able to jump the queue. It is wrong to have two standards of care for two classes of patients in our hospitals. As hon. Members are aware, a working party has already been set up and is working hard under my hon. Friend the Member for Plymouth, Devonport (Dr. Owen). It is looking at the future of consultants' contracts in the context of phasing out pay beds from our National Health Service hospitals. We had hoped that it would be able to report by November. As a result of the election, the timetable has slipped a little, but we are pressing on with it urgently and I have no doubt that my hon. Friend will have more to say about this important piece of work when he winds up the debate.
This brings me to the speech which the right hon. Member for Leeds, North-East (Sir K. Joseph) made recently in Birmingham. I have informed the right hon. Gentleman that I shall be referring to that speech today. I turn to it because the right hon. Gentleman intended it to be a carefully considered statement of his social policy. What that speech did was to heighten the divisions in our society. It did so by its general philosophy. It did so, above all, by importing into the argument an alarmist analysis on the basis of statistics the right hon. Gentleman had not understood and got wrong. I would not have referred to it again except that the right hon. Gentleman has been proved wrong but is still wriggling. I believe that is why it is so essential to get the facts straight and on the record.
It is no use arguing, as the right hon. Gentleman now does, that 546I said what generally needed sayingif what he said specifically in support of his general thesis was wrong. For what the right hon. Gentleman did was to talk about the "degeneration" of our society: delinquency, truancy, vandalism, hooliganism, illiteracy, and so on, matters which disturb and concern every one of us: and then inject into his pleas for the remoralisation of our society the emotive genetic argument thatthe balance of our population, our human stock is threatened".Why is it threatened? Because, he said—a high and rising proportion of children are being born to mothers least fitted to bring children into the world and bring them up. They are born to mothers who were first pregnant in adolescence in social classes 4 and 5. … Yet these mothers, the under-20s in many cases, single parents, from classes 4 and 5 are now producing a third of all births".That is a quotation from what the right hon. Gentleman said.
That statement is not true. If we take the Scottish figures, partly because the right hon. Gentleman quoted them and partly because they are the only ones which try to show the social class of all born babies, we find that the proportion of all births that are to single mothers in classes 4 and 5 is not a third but less than 4 per cent. This is not an exercise to which in any case I would attach much weight because, as the right hon. Gentleman now realises, social class is defined in terms of the father's occupation for legitimate births and mother's occupation for illegitimate births. But these are the statistics the right hon. Gentleman quoted and the fact is that they are wrong.
The right hon. Member then admitted that he had been "naїve" but asserted that he had been misrepresented and misunderstood. In an attempt to clear up the misunderstanding he issued a statement in which, quoting from an article in the Daily Mail, he asserted that35 per cent. of the next generation will be born to poor teenagersa high proportion of whom, he added, would be unmarried, deserted or divorced. This is totally false. Even if we assume that the whole of classes 4 and 5 in Scotland are poor, which is clearly absurd, the proportion of births to 547 poor teenagers—that is, teenagers in social classes 4 and 5—is not 35 per cent. but less than 5 per cent., and the proportion that are also illegitimate is only about 1 per cent. So the right hon. Gentleman has exaggerated the numbers of births to poor teenagers in Scotland by at least sevenfold.
Next, the right hon. Gentleman tried to explain himself in a letter to The Times, in which he made the by now notorious statement that a high proportion of births in classes 4 and 5occur—for lack of birth control—to unmarried or otherwise single-parent teenage households".The Scottish figures show that less than 4 per cent. of class 4 and 5 births are illegitimate births to teenage mothers. Making all possible allowances for differences in the definition of social class, it would be difficult to inflate 4 per cent. into "a high proportion".
In a speech last week in Liverpool I took the opportunity of correcting some of the right hon. Member's mutiple errors. His reaction to this, quoted in The Times on Monday, was to say:Whatever the argument about statistics, Mrs. Castle has missed the main point—which is that my reference was to the very large proportion of next year's likely births to poor teenagers, a high proportion of whom are likely to be unmarried, deserted or divorced".But it is precisely this that is entirely untrue. Not a very large proportion but a very small proportion of next year's likely births will be to poor teenagers, even if we accept the right hon. Member's very odd definition of poverty, and only a minority of this very small proportion will be unmarried, deserted or divorced mothers.
So what is the right hon. Gentleman trying to prove? What alarms him is not that these births are to poor families but that they are to single-parent teenage families. It just happens, he says, that it is the lower social class teenage girl who is not taking sufficient advantage of family planning services. If that is his argument, it is really astonishing that he as Secretary of State insisted on putting a prescription charge on the very contraceptives he is anxious for poorer families to use. I hope now he will have the courage to admit that he was wrong. But in fact it was he who imported the refer- 548 ence to "socio-economic classes 4 and 5" into the argument in a way that the article in Poverty he quoted did not sustain. His class slip was showing.
I ask the right hon. Gentleman now frankly and fairly to admit that the figures on which he based his argument were wrong. We must get the real facts on the record. Because what he has done, intentionally or not, is to heighten class prejudice and class bitterness—and the flood of letters he says he has received in support only prove that point. He has left a widespread impression that it is the lower social classes who constitute the "threat" to "our human stock". In his speech generally, not just in this part, he has weakened the national will to attack the evils of deprivation and poverty. Most unforgivable of all, he has deliberately propagated the lie that Socialism is synonymous with permissiveness. If this is to be the level of argument with which the Conservatives hope to restore their shattered fortunes, I hope they will at least have the decency to drop all their soggy sermons about "national unity".
For the Socialist thesis is this: the major need in this country if we are to have a healthy society is still to tackle the gross inequalities of wealth and opportunity which condemn so many people to pinching poverty and to deprivation in all its forms.
This can be done only by a planned collective attack on poverty. It can be done only by extending the system of universal social security benefits in which, of course, we direct help as much as possible on the basis of need, but we assess that as functional need—and it is functional need not means, which is the test: the needs of old age, widowhood, disability, or rearing a family. It is in this direction that we shall move steadily during the lifetime of this Parliament.
In this Queen's Speech we make a start. First, pensions for the old, the widows and others on social insurance benefits. We say in the Gracious Speech that weattach major importance to a general improvement in social security benefits".There will be another uprating. We are bound by law to increase benefits by next July, but we have always said that we would consider the timing of the next uprating in the light of the pensioners' 549 needs, and we shall be announcing the details in due course.
Our uprating of long-term benefits will be linked to the rise in earnings, not just prices. With all its talk about its commitment to six-monthly reviews during the election, the Tory Party has never committed itself to more than price protection in that proposed six-monthly review.
We have already laid before the House our Christmas bonus Bill. This year we shall extend it to 1 million more hard-hit people—invalidity pensioners, those on attendance allowance and widows' benefits, and those industrial injury or war pensioners who are so sick that they are incapable of work.
Finally, pensioners will get cheap beef this winter. But we shall ensure, in keeping with our dislike of means-tested benefits, that the cheap beef goes to all pensioners and not merely to supplementary pensioners. We have had a fight with the European Economic Commission over this, but we have won.
Next I deal with the question of family support. Here, too, it is essential to reduce the rôle of means testing. We all know that the family income supplement was an ill-conceived idea. It has not worked, not only because the take-up has been only 50 per cent. but because it polarises society by widening the poverty trap. To be poor is bad enough, but for a person to know that he or she cannot escape from poverty is even worse. Under the FIS scheme, every pound of extra earnings means a loss of benefit.
To reduce the rôle of FIS, the Government are committed to increase family allowances and introduce a new scheme of child allowances which will extend help to the first child. We refer in the Gracious Speech to the increase in family allowances, and hon. Members will not have to wait much longer for the details of the increase to be revealed. The child allowance scheme, involving, as it does, 14 million children, including about 7 million children who are not eligible for family allowance, will take more time.
Thirdly, there are the disabled. Here again we shall be extending income as of right to 250,000 disabled people whose only present recourse is to supplementary benefit. We shall be presenting proposals to Parliament which will intro- 550 duce a non-contributory invalidity benefit as of right to 220,000 disabled people of working age who have not been able to work and therefore contribute under the insurance scheme. This new benefit will begin to be paid in 1975.
We shall be introducing our invalid care allowance designed to help people who are not disabled but who have to stay at home to look after a disabled relative so that they, too, cannot work. We shall be proceeding towards our mobility allowance which we shall begin to phase in next year.
I come to our long-term pensions proposals—a crucial part of our developing plan for reducing the rôle of means testing. That is the major purpose of our pensions scheme. I believe that every hon. Member wants to find a way of taking pensions out of politics, and I think that together, by our discussions in the House, we may be able to forge lasting legislation which will achieve this aim.
There is a core of principle in our proposals on which the Government cannot compromise, such as the earnings-related basis of the benefits, the equal treatment of women, the reliance on final salary schemes in the contracting out proposals. But in the White Paper and in the consultative document we have set out a range of matters which we are specifically leaving open for consultation—for example, such important subjects as the type of provision for widows in contracted-out schemes and the terms and conditions on which those who leave such schemes may be brought back into the State scheme.
As well as those specific points, we are prepared to consider any other matters which may be put to us and which do not undermine the fundamental principles of the Bill.
We aim to introduce the Bill very early next year with a view to obtaining Royal Assent by the summer. I think that everyone in the country, and certainly people in the pensions business and those interested in this subject, want to achieve finality and to remove uncertainty. During the passage of the Bill the House will have ample opportunity to examine the proposals in the fullest detail. Right hon. and hon. Members will find that the Government are very willing to listen to any 551 constructive suggestions made in Committee.
By way of preparation, we are willing to consider any points which the parties represented on the benches opposite wish to put to us, whether of a particular or a general nature. If, as may well be the case, a particular concern of theirs relates to the terms of contracting out, of which the contribution adjustment represents an important part, then I may be able to help. I have asked the Government Actuary to prepare a factual memorandum giving the criteria and technical basis on which he will assess the actuarial elements before the Government make decisions on this point. I propose to send the memorandum to all the organisations concerned to which I have already sent the consultative document, and I shall also place a copy of it in the Library so that hon. Members may study it.
We have been immensely encouraged by the response we have had to our long-term pension plans, including a response from many working closely with the pensions business. We believe that through our plan we have a better chance of achieving a consensus on this vital matter than we have had at any time in the past five years. I hope that the House will play its part in helping us to forge an agreement on pensions policy which can stick and which will end the chopping and changing and the uncertainties. It is in that spirit that I commend this section of the Gracious Speech to the House.
§ 11.27 a.m.
§ Sir Geoffrey Howe (Surrey, East)
I begin by apologising to the House for the fact that I shall not be present at the end of the debate. I hope that the Minister of State will forgive me for that. It is an unusual but, I hope, a forgivable thing to have to say.
The Secretary of State began her speech by talking about her party's commitment to the idea of a cohesive society, which seems to me a longer way of restating my party's commitment to the concept of one nation. I should have thought that the record of my party in office over many decades showed that there was no zoom for doubt that that is our objec- 552 tive. The entire first half of the right hon. Lady's speech was devoted to the speech made recently by my right hon. Friend the Member for Leeds, North-East (Sir K. Joseph). I thought it a remarkable way for the right hon. Lady to spend her time in the debate on the Gracious Speech. My right hon. Friend can speak for himself, but I do not accept the right hon. Lady's definition of the purpose of my party.
The tragedy is that, although often well intentioned, Socialism is all too often divisive because it is founded upon envy—
§ Sir G. Howe
The hon. Lady must expect to hear some home truths—and it is all too often ineffective because it is not able to assess the proper order of priorities. That is one reason why our welcome of what is contained in the Gracious Speech is qualified in a number of ways.
We welcome the provision of the Christmas bonus and the prospect of a Children's Bill. Other proposals we receive with less than rapture—for example, those relating to family allowances, because we believe that the strategy is wrong and that it should be more plainly founded upon a development of the tax credit scheme. Some of the proposals we regret deeply—for example, the change made by the Secretary of State in relation to the second pensions scheme introduced by my right hon. Friend the Member for Leeds, North-East. However, we shall seek to save what should be saved for the good of the nation, responding to the spirit with which the right hon. Lady dealt with that matter.
We regard some omissions from the Gracious Speech as serious and we shall seek to rectify them. One is the absence of any stated concern about the increasingly serious problem of juvenile crime and about inadequate provision for the sake of the children who become involved in this kind of trouble.
We regard other proposals as wrongheaded, unjust and destructive. I refer, for example, to the Government's approach to private practice within the National Health Service and to the burden that ought to be borne by the self-employed in paying for the cost of improved benefits.
553 The right hon. Lady did not deal at length with the proposals relating to family allowances. We welcome the fact that the Government feel able to make some improvements in the general direction of relieving family poverty. However, I regret the right hon. Lady's attack, yet again, on the family income supplement scheme. The level of take-up is much higher by those in greatest need, as she knows.
The approach founded upon family allowances as the first priority raises many questions. We believe that the Government have wrongly rejected the tax credit scheme. Of course we want to end means-testing so far as possible, but that scheme, properly developed, would be the best way of achieving that end and, indeed, of reducing dependence on supplementary benefit.
We are curious to know when, if at all, the Government will vouchsafe something about their intentions regarding what I might call the Finer families—families the subject of the Finer Report—because for many of them the introduction of the tax credit scheme would indeed be the best way forward. I appreciate that the full extent of the Finer proposals would be very expensive, but I hope that we shall hear something about progress on at least those points where additional expense is not involved; for example, on discrimination between the single-parent family and the married two-parent family in local authority housing, and on the power of the courts to order protection for the single-parent family, which is not as extensive as for others.
We still find difficulty in reconciling a commitment towards increased family allowances with the continued commitment to indiscriminate food subsidies which are now beginning to run out of their effectiveness, even from the Government's point of view. The Government know that only about 25 per cent. of those food subsidies go to families with incomes below £30 a week. The fact that the Government, inevitably and realistically, are now allowing the price of sugar to be increased, shows that they have reached the end of the road on food subsidies. I cannot help wondering whether they were introduced for the sake of achieving a temporary and illusory success for electoral purposes at the expense of more sensible priorities.
554 I turn now to one of the many alternative areas where money could have been spent. I have mentioned our welcome for the proposed children's Bill, but I wish to draw attention to and express grave concern about the fact that nothing is said in the Gracious Speech about the problem of children and young persons in trouble. I do this in no vindictive sense. I should perhaps declare an interest. My wife is the chairman of a London juvenile court and has close experience and concern with this problem. I am concerned with those who come into conflict with the law and who, for that and perhaps other reasons, stand in need of care and treatment and sometimes—let us face it—discipline and security.
I make no apology for raising this matter in this debate with the Secretary of State present, because the responsibility for this subject is now shared between the right hon. Lady and the Home Secretary. This is one of the confusions that follows from the Children and Young Persons' Act 1969. I understand that the Home Secretary is responsible for the law and the right hon. Lady for the provision of accommodation. I believe most strongly that it is time that the right hon. Lady's Department took much more seriously the growing public concern at the volume of juvenile crime in cities, the absence of adequate accommodation and, more important—this is a consequence of the transfer of responsibilities—the absence of any system for appraising and improving that provision of accommodation.
It is difficult today, in contrast with the days of the approved school era, to secure figures about the availability of accommodation of the kind that is necessary. I emphasise that I am concerned with this subject as much for the sake of the children as of the community, if not more so, because more of these children who get into this kind of trouble are being encouraged by the default of our services into a pattern of deprivation, of indiscipline and, tragically, of crime.
We can go back almost to the beginning of the story, with the extent to which truancy, for whatever reason, is now increasingly regarded as tolerable and yet is always to be found as the background to 70 per cent. or 80 per 555 cent. of the children who ultimately get into trouble with the law.
When offences are proved to have been committed there is insufficient accommodation for those children. I do not blame this Government entirely for that situation—it is part of the problem of resources—but under the present system there is no duty, as there was with approved schools, nor is there any manifest central duty on the right hon. Lady's Department, to organise the availability of such accommodation. The delay in providing places for such children has risen from what used to be a maximum of two months to as much as six months and even longer. In that time further offences are often committed.
One report in the South London Press only a few weeks ago concerned a 10-year-old child who had been before the court for the fourth time for burglary, through no fault of his own but because of the non-availability of the appropriate and secure accommodation. One trembles to talk about secure accommodation for a 10-year-old child, but this is the reality which we are ignoring at our and their peril.
One consequence has been a rise in the number of borstal sentences. Magistrates, in despair, find themselves eventually compelled to commit children to borstal. That is no good for the children any more than it is for the community. There is, therefore, a decline in the standing, authority and confidence of those who deal with such cases, an uncertainty of rôle on the part of social workers, who are certainly doing their best, and a breakdown in respect for the effectiveness of the system and of the system itself. I hope that the right hon. Lady will regard this as a matter of real gravity and will pay attention to the representations made to her and to her right hon. Friend by those who have experience in this sphere. It is a matter to which we shall certainly want to return. It is an area where the Government have not manifested a proper sense of priority.
I turn now to the second pension scheme.
§ Mrs. Renée Short
Before the right hon. and learned Gentleman leaves the aspect of juvenile delinquency, may I ask 556 whether he is aware that he is turning over one of the stones left by the Conservative administration, when some of the most serious injustices took place? One of the results of the lack of provision of secure accommodation for certain young persons under the Act has been that young people of school age have been sent to adult prisons. Is he further aware that the cuts introduced by the former Chancellor of the Exchequer, Mr. Anthony Barber, last December exacerbated that situation and made it impossible for authorities to provide the necessary accommodation?
§ Sir G. Howe
The cuts introduced last December by the then Chancellor of the Exchequer were a necessary manifestation of the impact of oil prices on our living standards. They have not been restored by the present administration. That is the reality. It is all very well to talk about turning over stones left by a previous administration. That stone was laid by the Socialist administration of 1964–70. They introduced the Children and Young Persons Act—it was no doubt well intentioned and perhaps likely to be effective in due course, although I question some parts of it in the light of experience—without having made sufficient arrangements to provide the accommodation to make it work. That is where the responsibility lies. It is not possible for any Government to rectify a concept of legislation which was misconceived without adequate advance provision of resources. It is no use deceiving ourselves by saying that the problem will go away when the resources become available. Maybe it will, but until that day—there is no sign in the Gracious Speech of the resources being made available—we must take more effective action, I emphasise, as much for the sake of the children as for the community. I put that point forward seriously.
§ The Minister of State, Department of Health and Social Security (Dr. David Owen)
Will the right hon and learned Gentleman give way?
§ Sir G. Howe
There are two points. There are serious deficiencies in the legislation. I commend to the hon. Gentleman's attention representations made by the Magistrates' Association and a long report by the Society of Conservative Lawyers, under the chairmanship of my hon. and learned Friend the Member for South Fylde (Mr. Gardner), called "Apprentices in Crime", I believe, making specific proposals. But the other point is equally important. It was wrong to go ahead with changes of that kind in the law until alternative provision was made available. In some ways the basis of making that alternative provision is unsatisfactory. It is not working and it needs urgent re-examination by the Government.
I come to the second pension point. I myself am associated with an assurance company. I deplore, as we did in the last Parliament, the destructive decision of the right hon. Lady to scrap the scheme which was already in existence, ready for implementation and capable of improvement. The fact cannot be ignored that that decision has retarded for at least three years provision for millions of people who have to soldier on without prospect of a second pension at all. It has produced a hiatus for contributors to the Boyd-Carpenter scheme. We are anxious about the alternative approach of the Government. Savings will be seriously reduced. The burden of contributions falling upon our children and indeed on our grandchildren will rise and there will be a less secure foundation than a properly funded scheme. It will be even more difficult to cope with the future if occupational schemes are more seriously impeded by what is proposed.
One sees the motivation of inflation proofing, but inflation proofing will prove to be a mirage unless the Government demonstrate a more determined approach to the problem of inflation than is manifest in their policy. I recognise that in some areas an attempt has been made in the White Paper to combine the best in both schemes. I welcome the right hon. Lady's approach, although our dif- 558 ferences of principle remain. I believe it is the real duty of Parliament to future pensioners and those who have to devise and organise provision to try to establish some scheme on ground that may be identifiable as common ground at least on a durable basis. There is and has been much dismay expressed by people outside this House at our failure over the years to achieve that. That is why we regret the right hon. Lady's decision earlier this year. We, no less than the right hon. Lady, would not wish to give up our principles, and we shall have to argue this out and do what we can to influence the Government on those matters.
I make this important proposal in response to what the right hon. Lady said. I ask the Government to consider seriously the possibility that the legislation when it comes forward, once it has received its Second Reading, should then be considered, before it goes to Standing Committee, by a Select Committee of the House able to take evidence and respond to evidence submitted in the way in which the right hon. Lady has spoken. This was recommended by the Select Committee of this House which sat in 1971. It was said that certain Bills—I would have thought that this was ideally of that kind—could be considered by Select Committees where there was a clear need for the giving of evidence by those likely to be affected—that is essentially those who are likely to be involved in the insurance business.
I recognise that other things would follow from that procedure. It would follow that the Opposition would not seek to delay by protracting the hearing before the Select Committee. Indeed, we ought to have a date by which the Select Committee would report back to the House. Equally there would need to be discussions about a timetable thereafter. I put this forward not to be rejected as an unusual proposition—the right hon. Lady does not usually reject propositions on the ground of their eccentricities—but as something seriously to be considered. We welcome what the right hon. Lady has disclosed and her willingness to accept an important change where a case is made out for it. I therefore welcome this approach, as a contribution to hammering out a scheme for the future.
559 I turn to the more contentious aspect of the pensions proposals, namely the plans that the Government have in mind in relation to the increased cost of paying for existing benefits disclosed in the last Parliament, in the Bill which is being reintroduced in a slightly different form. In particular, we challenge the proposed trebling of the charges payable by married women who have opted not to pay the full contributions. That is a step in the wrong direction. We also challenge the proposed increase in the national insurance burden on the self-employed. As that has been developed by the Government, it amounts to a wholly unjustified extra tax on a single section of the community. The Government must face the reality that there is a mounting storm of anger outside Parliament about those proposals, and we shall be challenging them most vigorously.
It is right that the self-employed should bear their share of paying for increased pensions but they do not get benefits which are available to those in employment. Earnings-related benefits are available on a much less extensive basis. Whereas we made certain changes to take account of this in our 1973 Act—the maximum contribution payable by the self-employed under those proposals was £67—the present Government propose that the self-employed person earning up to £3,600 a year should pay an extra £160, not deductible from his taxable income, therefore requiring him from next April to earn another £238 in cash, simply to stand still in cash terms and not to achieve any increase at all in living standards. This strikes many people as a grotesque imposition on people ranging from greengrocers to journalists, sub-postmasters to architects all over the country.
I turn finally to some aspects of the National Health Service with which the right hon. Lady dealt. We note and approve the reference in the Gracious Speech to the commitment to maintain and improve the National Health Service "within available resources". It is almost the only reference in the Gracious Speech to the limitation of resources presently available in this country. It is regrettable that it is not reflected elsewhere in a coherent pattern of priorities. It must be 560 recognised that the National Health Service is in a critical condition and will in our continuing economic difficulties be facing mounting problems. This condition of the service is set out in the recent important statement by the President and Deans of Faculties of the Royal Colleges. It is implied in a memorandum, which I have not yet studied, published by other bodies today.
I suggest to the right hon. Lady that she will not get near solving this problem if she continues to believe that it is largely to be solved by attacking her predecessors and blaming us. Nor will she approach a solution if she thinks the situation can be solved by criticising the medical profession and suggesting that it is motivated by politics. That is a monstrous and unhelpful slur on the profession. The spirit in which the Royal Colleges have approached the problem gives the lie to that.
Under the last Conservative Government a rising share of the gross national product, and of a rising gross national product, was devoted to health; and this was taking place—a substantial expansion in real terms. The problem has always been accompanied by difficulties because there has always been a growing recognition of the needs, which have been neglected by all Governments, for example in the field of mental illness. There has been a progressive rise in the cost of sophisticated medical technology; and in the cost of progressively rising expectations. Now all that is set alongside a prospect of no increase in real national living standards for some time ahead. This will make it very difficult for us to sustain a further growth in real health provision which has been achieved over the years, although on a modest basis, since 1948. Add to that the impact of inflation and the need, to whatever extent is right, to compensate those who were in the National Health Service in respect of pay and conditions. Furthermore, we must recognise the real switch of resources mentioned by the right hon. Lady from buildings to pay and also appreciate the real risk of a decline in standards to which the Royal Colleges draw attention. In those circumstances I suggest that the Government's policies are, or threaten to be, positively harmful.
First, we know that neither in the Gracious Speech nor in the Secretary of State's speech was there any renewal of 561 the commitment to abolish National Health Service charges. If that represents a conversion, hurrah for that! At a time when resources are as scarce as they are at present, it would be total folly for the Government to go any further down that road. We have only to recollect the circumstances in which two Socialist Governments were eventually driven to make provision for such charges to meet the very scarcity problems they now face. If it represents a conversion by the right hon. Lady it would be remarkable, but if so it certainly deserves to be acclaimed.
The second matter we deplore is the attitude deployed by the right hon. Lady and the Government towards private practice—not because we cherish an institution of that kind as a symbol of two nations or any of that nonsense, but absolutely the contrary. We believe that the Labour Party's attitude on that proposal is wholly misconceived. The right hon. Lady says that she intends to phase out private practice from the NHS during the present Session. Neither the present Government nor any of those concerned should assume that the change will yet come. It is still part of the consultative process which is now being undertaken; it is still a matter which we shall debate and continue to debate in the House. We shall continue to challenge the Government and argue on the merits of the proposed change.
The fundamental flaw in the case against private practice is the argument that it diverts resources from the National Health Service. It does no such thing. The opposite is the case. Its existence within the service makes a contribution to the cost of that service—for example, for the payment of X-rays, laboratory investigations and so on.
§ Sir G. Howe
It is paid in charges to the hospital services by those receiving private treatment. The point made by the hon. Lady the Member for Wolverhampton, North-East (Mrs. Short) is wholly irrelevant. If that money were not raised by the private patient it would have to be raised by the taxpayer. Secondly, we must remember that a substantial proportion of consultants' earnings come from private practice.
562 Together these contributions amount to about £30 million a year. To exclude this provision from National Health Service hospitals would lead to a separation and, more plainly, would identify a two-tier service of the kind that the right hon. Lady seeks not to want. Furthermore, it would have the effect, in circumstances of shortage, of lengthening National Health Service waiting lists. It would waste time and resources on the part of consultants; it would lose us the advantage of integration with the National Health Service, it would risk growth in emigration of medical talents; and in non-urgent cases it would not exclude the queue-jumping of which the right hon. Lady complains. Whether in the private sector or otherwise, I do not doubt that politicians and others regard themselves as doing work of national importance and will always be able to find a reason for going to the top of queues in public or private services. That is why we believe it to be wrong in non-urgent conditions that those with sufficient thrift, foresight and concern should not be free to choose the time of operation and the consultant. Millions of people—not just rich people—do so already, at the expense of perhaps 20 cigarettes a day or at one-fifth the annual cost of running a small car.
All this is part of the freedom for patients and so deserves to be strengthened and extended. It is also part of the personal freedom for the medical profession. I understand that there are circumstances in which other employees in the health services may be dissatisfied with their present arrangements. That still does not add up to a case for allowing, still less encouraging, those people to bring about a change by industrial action. It amounts to a case for considering how they may be able to share in the way in which the service is organised and to consider any changes that should be made.
The right hon. Lady's approach to these questions during certain parts of the summer illustrates the way in which an over-dramatised and over-political attitude towards her responsibilities can be, and has been so far, positively harmful. I now commend to her the business of getting on with positive restoration of credible leadership within the health service by respecting the interests of every 563 group, not just of those who are industrially most powerful. We must consider the interests of smaller groups who for years have been complaining of the inertia of the Whitley system. I refer, for example, to the orthoptists and speech therapists. If the Secretary of State would approach her task in that way, less as a politician more as a Minister of Health, as presiding over a service to the community, then we shall have a chance of overcoming the real difficulties that will face our social services in the years of shortage and difficulty that lie ahead.
§ 11.58 a.m.
§ Mr. Sydney Irving (Dartford)
I begin by congratulating my right hon. Friend the Secretary of State for Social Services on exposing most effectively the fallacies in the case put by the right hon. Member for Leeds, North-East (Sir K. Joseph). Her speech completely destroyed the validity of the right hon. Gentlman's speech.
The House will also be grateful to her for the elaboration of the proposals which she has given to the House and, despite the remarks of the hon. Member for Surrey, East (Sir G. Howe), I believe that her proposals will help to bring about the fairer society that is our object.
I wish to welcome the proposals in the Gracious Speech which represent a comprehensive programme for the new Session covering practically every aspect of the Labour manifesto. For hon. Members they undoubtedly represent a very full year's work. I wish to reiterate the comment made by my right hon. Friend the Prime Minister in his speech on Tuesday that we were successful in the election just because we kept the promises which we made in February. We must be equally determined to carry through the promises made in the recent election.
Not all the cynicism about politics is justified, but it is a fair expectation that if we make promises to get elected we should do our best to keep them. Only by keeping faith with the electorate can we retain that confidence and, incidentally, help our democratic institutions to survive the strains now placed upon them.
I hope the House will forgive me if I go a little more widely in terms of social policy than the terms covered by 564 my right hon. Friend in opening the debate. I was pleased to see the phrase in the Gracious SpeechParticular attention will be given to the development of a fully comprehensive system of secondary education …''In some parts of the country, and certainly in my constituency, secondary education has got into such a tangle that resistance to reorganisation is stifling all progress. The Kent Education Committee, which for the last seven or eight years has retained its aim to abolish selection at 11, has, at least temporarily, had to go back on that objective. The failure to make progress in this respect has meant that a number of schools have been left in a chaotic state. One school in my constituency had buildings added as a complement to an existing school and these new buildings are being used to house a new secondary modern school. Since the two sets of buildings were intended to be complementary and are interwoven, it has been necessary to appoint one head to serve the two schools. I hope that in pursuance of the intention of making progress towards a comprehensive system, the Secretary of State will be able to take much more positive action to make progress in this respect than was possible between 1965 and 1970.
Of all the social problems facing the country—and, indeed, facing hon. Members in their constituencies—housing is by far the greatest and in some respects the most difficult. I still find that the biggest single group of cases coming to me are housing cases, and I have a constituency in the south-east, not in a northern industrial town. Not only are they the largest single group, but most of them represent real hardship—separation of husband and wife, separation of parents from children, and so on—because many of them arise from evictions, with the result that families have to live in conditions which are a threat to stable family life and an impediment to children in making the best of their opportunities at school.
I welcome the announcement by the Secretary of State for the Environment that he is investigating the possibility of an emergency programme. In my view, this brings to the problem a much-needed sense of urgency. I hope, however, that it will not be at the expense of the long-term building programme. Our housing 565 need can be met only by a number of years of sustained building at a rate higher than has ever been achieved in the past. I should not like to see any distraction or diversion of the building industry which prevented it reaching a high level of production at the earliest possible moment.
In his recent television lecture, Lord Goodman drew attention to the lack of any attempt to bring together the construction firms in the building industry. I believe that both the unions and the companies should be brought together within the same effort that the Government propose for other industries, so that targets, more efficient methods and better procedures may be agreed upon, thus assisting the industry to expand and ultimately to be able to sustain a steady level of production. There is need also for a determined effort to break the link between the mortgage rate and the investment rate and to ensure a steady supply of funds.
In my view, however, local authorities will remain the main building agencies in the country. Although Lord Goodman's comments on a changed relationship between the Government and local authorities contained, perhaps, more passion than firm proposals, I hope that the Government will look into the whole inhibiting arrangement of yardsticks. Where taxpayers' money is involved, obviously the Government must be concerned to get value for money, but in a time of inflation too rigid a control can lead only to delay.
The Government will have to make up their mind on the question of finance. There are three variables in housing revenue at present: subsidies, rents, and the general rate fund contribution. At a time of increasing difficulty for local authorities, with high rises in expenditure which must entail high rises in rates next year, anything which relies on an increased rate fund contribution can only add to the problems facing councils and is unlikely to secure the effective expansion of council house building.
Rents also are a sensitive area, and while the concept of the pooled historic rent is superior to the idea of a fair rent, I do not believe that it is practicable to load the cost of a new drive on either existing tenants or new tenants. This means that an increasing part of the cost 566 will have to be borne nationally, by increased subsidies or by other means.
Circular 18/74, issued in February this year by my right hon. Friend the Member for Blackburn (Mrs. Castle) and the Secretaries of State for the Environment and for Wales, seeks to make homelessness the responsibility of the present housing authorities. I believe this to be sound, but if the transition is not to lead to a worsening of the present difficult situation, because it is concerned more with reducing the high cost of social services bed and breakfast arrangements than with ensuring that districts and other councils can cope with the new responsibilities, districts will need to have money to enable them to provide the emergency and temporary accommodation for this purpose. This is necessary to prevent the homeless becoming a threat to those on the waiting lists at the moment, many of whom may have been waiting patiently a number of years for a house.
I am disturbed also at the separation that this involves between the previous social service responsibility in the counties from the housing responsibility which is essentially that of the districts. I believe that, once rid of the need for paying out large sums by way of bed and breakfast accommodation, some of the social service officers will perhaps be more critical of the housing authority's provision than they dared to be when their own authorities were providing accommodation for the homeless under their responsibility. The county councils have not been very successful in dealing with homelessness in the past.
There is also the problem of the redevelopment of existing council estates. I believe that it will be increasingly seen that many of them cannot be modernised and will have to be redeveloped.
The Government's proposal for the common ownership of land will assist in the Government's long-term plans. I am reminded by the Opposition's comments about the horrors of nationalisation that this proposal was first put forward in 1942 by an expert committee headed by Mr. Justice Uthwatt. It was an expert committee of five members. Mr. Justice Uthwatt was a radical, but no Marxist and certainly not a member of the Labour Party. The second member was Mr. Raymond Evershed, KC, who became a distinguished judge and Lord of Appeal. 567 The third member, unfortunately, died before he could ever attend a committee meeting, and the other two were no more radical than the others since they were the then President and Vice-President of the Royal Institution of Chartered Surveyors.
The Attlee Government rejected that proposal. I think this was a great pity, considering the pathetic history of our attempts to deal with this matter, ending with the abandonment of the Land Commission not long ago. If that proposal had been adopted, we might now have had the substantial income which would have accrued to the local authorities—possibly £750 million a year gross—which would have gone a long way to help local authorities to defend themselves against inflation and provide more civic facilities than they have been able to do up to now.
In supporting that proposal, therefore, I would add only that the housing programme needs the drive and the scale of effort which was given to war production. If we are to succeed, no less will do.
§ 12.8 p.m.
§ Mr. David Crouch (Canterbury)
I am glad that the right hon. Lady the Secretary of State is still in her place, because I wish to speak solely to the problems of the National Health Service. I welcome the statement of intention in the Gracious Speech that theGovernment will continue to maintain and improve the National Health Servicebut what concerns me most is the continuation of that sentence,and, following consultations, will introduce proposals on democracy in the Service".I must declare an interest here. As the right hon. Lady knows, I am a member of a regional health authority, the South-East Thames authority, and I am involved also in the medical profession, in the sense that I am a director of a pharmaceutical company. However, it is mainly from my standpoint as a member of a regional health authority that I shall address the House today.
Few, I believe, would argue with any proposition to introduce democracy into any institution. On the face of it, it seems proper. But we must look further to see what the effect would be on those working in the National Health Service and on the public and the patients. To introduce democracy in the National Health Service will seem to many to be 568 the right medicine, even if it is not just what the doctor ordered. We must see what the side effects will be, and whether the patient—the National Health Service—can stand it.
In her recent White Paper on democracy in the health service the Secretary of State has shown that she recognises some of the difficulties in the service under its new reorganised structure. She isaware of the uncertainties and stressesthat the staff are facing after reorganisation. I cannot emphasise too much what those stresses are. It is stress in the medical sense, and I have been most concerned in the examination I have carried out of the strains being endured by the administrators, the medical staff and those other workers who fit into the entirely new structure.
I do not seek today to dilate on the whole question of the structure of the health service. I hope that the Secretary of State, through the Leader of the House, will ensure that we have a full opportunity to debate the health service and its problems very soon. Nevertheless, she wants to proceed with the introduction of "a strong democratic element" in the health service as an aid to the devolution of management from Whitehall and the regions. She bases her argument on the idea thatthe democratic process is a complex interweave of management and representation".That is a most interesting phrase. It all sounds fine in theory, but what will it be like in practice? Will the Secretary of State be helping those who work in the health service?—because they desperately need her support and ours. They are devoted, dedicated people and they are not working against the community. Their whole lives are directed to the service of the community and the service of the sick. Will the Secretary of State be helping the sick with the introduction of democracy as she has proposed in her White Paper?
The Gracious Speech says that there will be "following consultations", and I tell the Secretary of State that we must have these consultations outside the House in the National Health Service and with any other body that can help in the decisions which will have to be made—as well, of course, as having consultations in the House. I challenge the 569 Secretary of State in her theory that management and democratic representation should be mixed to the extent that she is suggesting. I maintain that her proposals will gravely weaken the efficiency of the service. Good management is vital in the National Health Service if the appropriate strategies are to be determined and if positive decisions are to be made.
The National Health Service has not yet settled down by any means under its new management structure. It is in a state of great turbulence, and morale is very low. I am not exaggerating. Some of the officials that I work with would go much further in describing the state of morale. Frustration is acute. As my right hon. and learned Friend the Member for Surrey, East (Sir G. Howe) explained earlier, inflation has been a serious aggravation, but the real difficulty in the health service at the moment is settling down under the new management structure. It is not yet established or fully staffed. In some cases the under-staffing is as much as 70 per cent. It is inadequately housed. There is a new tier of management—the area health authority—which is inadequately housed and which has to cope with great pressures of management and management decision.
The Kent Area Health Authority, which I personally know, is the biggest in the country. It is working from a wartime hut with a staff of 30 when its true complement should be nearer 100. The administrators I meet are at their wits' ends in trying to make the system work, and many I know personally are working until midnight every night.
The problems in the teaching hospitals in London which I have been examining—Guys, in particular—stem from the change they have undergone from having boards of governors, convenient and powerful bodies that they could go to for decisions, sometimes very important decisions, about allocations of resources and, always, about the care of the patient and the best way of handling a medical decision and problem. These boards have now gone and, instead, there is a long line of bureaucratic command through which the doctors and the consultants, the nurses and the other techni- 570 cians in the service must now work. They are therefore in a state of anxiety, frustration and concern.
On top of this the Secretary of State has said she intends as a solution, to draft in hordes of conscripted councillors to help. How on earth does she think this will help the situation? It will satisfy those who have a blind belief in the mere dogma of democracy. It will do something for the health service. It will strike it a blow between the eyes and send it reeling. Those working in the National Health Service are utterly dismayed at the prospect. The right hon. Lady's proposal that the membership of area and regional health authorities must include one-third local councillors will make management unwieldly and, I believe, even unworkable.
The Kent Area Health Authority would have to be increased from 21 to 38, and the area health authority (teaching) in London, with which I am concerned, would go up from 28 persons to 41. There must be a limit in size and yet the proposal is supposed to provide good management. The introduction of so many extra persons will make the authorities unworkable and at best unwieldly. What help will these new councillors be able to bring? They will not necessarily bring wisdom—and I do not denigrate local councillors because they are local councillors. It has been said so often that whereas an MP is an amateur the local councillor is a part-time amateur.
Local councillors today are greatly overloaded in committee and council work in the new district and county councils. There is a further danger in the introduction of democracy that these councillors will introduce a small parochialism at a level of management where overall strategy and major decisions are needed. There is a danger of politics being introduced where politics is not wanted. It is inevitable that the councillors would have a split allegiance between the health authority they were serving and the local government interest. The health service cannot be equated with the education service by putting it under town hall control. Education and health are entirely different. The National Health Service is a vast, complex scientific organisation.
571 There is also the question of time. Work in the health service is timedemanding. It is essential that all members attend in order that decisions are taken and that the officials are given the support and direction they are seeking. At the moment it is not unusual for chairmen of authorities to work between two and three full workings days a week. I agree that these chairmen are paid part-time, but the member must put in not less than two or three full days a month in future, and that is the sort of time these councillors would have to find. It would not only be two or three days a month attending to the business of the authority, but a great deal of visiting as well. Can our already busy councillors find time for this? We should leave well alone for the time being in regard to the composition of the area and regional authorities. We have local councillor representation already.
I am against the idea of mixing management and representation any further, but I am not against the extension of democracy in the National Health Service where it can be most effective. We already have a health Ombudsman. We have created the Community health councils. These are the most excellent addition to the National Health Service because they are truly the people's voice. They are separate bodies and that is proving to be the secret of their success. As The Times put it on 1st June this year:The separation of rôles is important. It is by informed, lively, and detached criticism from the community health councils that the patients' interests can best be served in the new system.I believe that community health councils should be strengthened, not weakened. They are my idea of a contribution to the Secretary of State's intentions towards more democracy in the National Health Service. We should consider increasing their budgets from the paltry figure of approximately £10,000 a year at present intended for them to a more realistic figure—perhaps even five times higher. These councils need more staff, and more good staff. Such staff can be attracted only by good salaries and good conditions. In this way we can create a powerful voice of criticism representing both the public and the patient in the National Health Service. This voice can be heard not only 572 after the event but at the formative stage of decisions as well, as is already written into the legislation.
We must not tie down the new democrats in the National Health Service by under-provision; we should give them the priority they deserve. In my region they are already established and working. I am proud to say that my region was the first to establish all its community health councils. They are already assisting management considerably—as distinct from their recognised rôle as critics. I shall give one example of this. We wanted to close the Miller Hospital in Greenwich. A closure is always difficult and contentious. Local MPs and councillors protest, delays are inevitable, and often the public suffer from indecision which can arise. But with a community health council to represent the public—as a statutory body—the public could be truly consulted. In such a council there is a strong element of elected councillor representation. In the case to which I refer we were able to put the whole problem to the community health council for it to study thoroughly. The council did not object to the proposal and so the closure could take place. Such councils are positive bodies making a real contribution to the working of the National Health Service.
The Secretary of State must think again about her intentions. I hope she will not think that I am being unkindly critical of her intentions regarding democracy. I hope that she will recognise that I have tried to be constructive. But she must get out into the regions and the areas and the districts and talk to the people working in the National Health Service, including those involved in the new structure of management—and she must listen.
The National Health Service is in grave danger of collapse. It is not only money it needs; it also needs understanding. It is not only democracy it needs; it also needs leadership—leadership now from the Secretary of State, before it is too late.
§ 12.24 p.m.
§ Mr. W. T. Williams (Warrington)
I hope that the hon. Member for Canterbury (Mr. Crouch) will forgive me if I resist the temptation to take up his remarks in the field which he and my right 573 hon. Friend the Secretary of State have opened up, and in which they have wandered together, if not exactly hand in hand. The social field is a large one, which presents many problems for the social architect. Not the least of those problems—in a large area probably the basic problem—that we face is that of housing, and I wish to talk about this at the time at my disposal.
Housing affects many other social problems, not least—perhaps even especially—that of juvenile delinquency, to which the right hon. and learned Member for Surrey, East (Sir G. Howe) referred. One often feels, in listening to Conservative spokesmen dealing with problems of this kind, that they are concerned more with the consequences and effects than with the causes.
The overall problem of housing is that there simply is not enough housing of any kind, and what housing there is in Britain is increasingly difficult to obtain. Both private and public housing in Britain is scandalously inefficient. Private housing is too expensive, and public housing is wholly inadequate. The problems of both sectors are obvious enough, but will not, I think, suffer from being underlined now at the outset of a new Parliament.
Problems of private housing are: the price of land, the costs of building, as well as of building materials, and the continuing increases in mortgage interest rates. Problems of public housing arc possibly more complex. What is obvious is that the housing lists continually get longer and continually prove more intractable for local authorities to deal with. But every family that is inadequately housed is a standing rebuke to a civilised society. Nobody who shares the experience that is common to most Members of Parliament in listening to pitiful tales in constituency clinics about the consequences of bad and inadequate housing can fail to be moved. Every housing case is a demonstration of heartbreak.
Nobody can criticise the part that has been played by local authorities in the municipal ownership of houses. It is surprising that any political leader should think that a suggestion to sell part of a council housing stock will do anything 574 other than increase the problem of replacement in an area of society where the need is greatest, and in which the idea of replacing council houses with other houses, at higher cost is itself a mockery.
To say that one appreciates the part played by local authorities in providing rented houses is not, however, to fail to recognise that municipal housing in Britain is today running into the ground. Increased rents lay a tremendous burden upon people, like those in my constituency, where incomes are relatively low. The difficulties faced by local authorities in trying to find building sites or building workers are not to be underestimated. The problems councils face in trying to maintain their properties in good repair often lead them to despair. In my constituency, for instance, it is not uncommon for people to complain to me and to their councillors about having to wait 12 months, 18 months or even two years for necessary repairs to their council houses.
In their approach successive Governments, faced with tremendous problems in both private and public housing, have suffered from a kind of paralysis of imagination. Governments are content to run along well-tried and now well-worn paths in dealing with housing problems. In private housing, the division of the present Government to ensure the rapid public ownership of development land will obviously make a contribution towards solving the problem of the ever-increasing price of housing. Their assurance that they will deal with "the lump" will be welcomed by most local authorities, which find it perhaps the greatest obstacle to their direct labour departments' attempts. particularly to deal with repairs in their housing estates.
The Government have revealed no apparent interest in the ever-threatening changes in building society interest charges, however. Apparently, all that is being done is to deal with the problems in the branches of the tree, when what is needed is a much more radical approach—a root-and-branch approach. There is a need for a reduction in the number of building societies, whose overheads, duplicated and reduplicated a hundred times in every area, are an unnecessary addition to housing costs.
575 More important, there is an urgent need for a change of length and borrowing patterns for those who want to borrow money to buy their own house. Borrowing short and lending long, which is the general pattern of building societies, is a sure way to uncertainty for those who want to borrow from them to buy a house. Playing their part in the open market, as building societies have to do, is derisory in present circumstances. The need is for urgent Government intervention to treat private housing also as a public service, either by more intervention in building society affairs or by supporting alternative forms of private ownership.
The most urgent short-term need is for an inquiry into the whole system by which money is lent to borrowers to buy their houses. The Government should see whether the system cannot be taken out of the public money market.
Public housing is an area in which successive Governments have shown the greatest poverty of imagination. My hon. Friend the Member for Dartford (Mr. Irving) expressed his pleasure that my right hon. Friend the Secretary of State for the Environment had thought of a short-term scheme. But I am alarmed at my right hon. Friend's approach. It is a cause for alarm, not congratulations, that it should be suggested that in this day people should be asked to accept not just lowered standards but greatly lowered standards. The people of Britain will gain no benefit from the building of slums for the future.
One could have hoped that the Government would make greater use of the Housing Corporation, but the corporation appears to be increasingly irrelevant when it comes to dealing with the questions raised and the problem related to all forms of public housing.
I listened with interest and increasing concern to the recent speech of the Chairman of the Housing Corporation. I do not know him, though I have no doubt that he is exceedingly able. However, it is obvious that he has no ideas on the subject. His contribution was deplorable. He is too intelligent a man to want to play Pooh-Bah. It may be that the best thing that the Government can do is to invite him to resign, so that he may use his undoubted talents in activities of which he has more understanding. The 576 Government should consider the membership of the corporation and see whether the time has come increasingly to appoint men and women with long experience and an imaginative approach to the questions of public housing.
Here I have to bring to an end what is perhaps necessarily a sketchy essay on dealing with these matters. I wish to underline the need for attention to a matter which has not, I think, been brought in upon Government consciousness sufficiently forcibly—the importance of co-operative housing, which has made a tremendous contribution to housing in the United States, Scandinavia and many parts of Eastern Europe. Its success lies in this—that it enables those who wish to have the sense of ownership of their own property to have it with only limited costs laid upon them.
Co-operative housing, even in the areas in Britain in which it has tentatively begun to play a part, is making a real contribution to the relief of housing lists. It has the tremendous advantage of improving the sense of identification in ownership over a much larger part of the community. It is a more satisfactory way of ensuring that people have pride of ownership in their homes without at the same time providing what seems to be the unhappy solution of selling council houses. Co-operative housing can play a vital part in what is becoming one of the greatest problems facing local authorities in that it can help to solve the maintenance problems which face local authority housing departments increasingly.
The time has surely come for the Government to consider the whole concept of housing and to seek to bring about a new and radical approach towards helping those who have to buy. I hope that the Government will introduce a form of assistance that will be more sensible and more rational than the system, presently used by the building societies. In the public sector, I urge the Government to develop co-operative housing, which has many of the advantages and few of the disadvantages that local government housing now increasingly faces.
§ 12.42 p.m.
§ Mr. David Penhaligon (Truro)
I thank you, Mr. Deputy Speaker, for allowing me to catch your eye and make my maiden speech. I represent Truro. It was my birthplace, and is my home. 577 I have never really regarded myself as English, and that seems to be a substantial advantage, at least in this part of the House. I am the first Liberal Member of Parliament since 1929 to represent my constituency. I hope that if we should again lose the seat the next break will not be so long.
I must thank the previous Member for Truro for his efforts on behalf of my constituency. Without doubt he will be best remembered for spending a lot of time proving at least to his satisfaction that there were few Cornish people left in my area. It has long been my opinion that my constituency has been badly named. It is called the Truro constituency, but it should be known as Mid-Cornwall. It covers two centres of population, namely, Truro and St. Austell, the larger of which is St. Austell. With its enormous clay interests St. Austell is a major contributor to the British economy.
It has struck me during my interest in politics that my constituency suffers from a bad image or, rather, an incorrect image. It has the image of beautiful sandy beaches, shining sun and bikini-clad visitors, who appear to spend money rather as if we were about to stop printing the stuff. The reality of the area is somewhat different. It has the lowest average wage in Britain, bar one area in Scotland. In my constituency there are 49 primary schools which were constructed before 1903. There are three such schools with buckets reasonably placed to catch the rain on days when the weather is not in their favour. One primary school is half closed because of structural problems. In Truro, which is a city that takes great pride in itself, it is impossible for a young man to take any O level in any subject at any State school.
Agriculture is important to my constituency. Yesterday we went through the problems of agriculture in some considerable detail. The fourth part of my constituency's economy relies on tourism. Last year there were about 3 million visitors to our county. It is my opinion that we have very nearly reached the point where further increases in tourism will cause more problems than they will solve. The traffic conditions in the summer months strangle much of the industry that keeps the county going for the rest of the year. In the summer months there is 578 tremendous pressure on hospital services —not to mention such matters as sewerage problems. I understand that in Cornwall it is impossible at any hospital to have a non-essential operation in the months of July and August.
My constituency is believed to be rural, but I assure the House that parts of it are as urban as any other constituency. I am sure that many hon. Members have been subjected to the same pressure on housing matters as that which I have faced in my short time here. What amazes me is that we can best sum up the last 20 years of housing as having seen more failures than successes. It is time that something was done. I hope that the terms of the Gracious Speech mean that the Government will do something to improve the situation.
Another problem in my area is that of summer lets. It is time something was done to make it more difficult to transfer to the business of summer lets houses that are normally let for 12 months of the year to local residents.
Of course, I welcome some parts of the Gracious Speech. I hope that one day the Government will be converted to the idea of a national minimum wage. I believe that there is nothing that could do more to help areas such as mine than such a minimum. Besides being a mechanical engineer I did, at least until the election, hold the post of a sub-postmaster. That has given me an insight into many people's problems. I welcome the family allowance increases that are referred to in the Gracious Speech. Contrary to the belief of many Conservative hon. Members, a lot of the money that is spent on such allowances is not wasted. The fact that it will be extended to the first child could do more than anything except the introduction of a national minimum wage to attack poverty in low-wage areas.
It is time there was a radical reform of the whole social security system. It is far too complicated. It occurs to me that people sometimes need accountants to fill in their forms. The system needs to be incorporated into the tax system. I was delighted to hear the right hon. Lady say that in her opinion there are far too many means tests. It seems that there is little point in having a magnificent system of protection if the people do not feel able to use it.
§ 12.48 p.m.
§ Mrs. Renée Short (Wolverhampton, North-East)
It is my pleasant task to congratulate the hon. Member for Truro (Mr. Penhaligon) on having taken the plunge and undertaken the difficult task of making a maiden speech. I well remember making mine 10 years ago. I still feel almost the same every time I rise to speak. It is a great pleasure to congratulate the hon. Gentleman on his splendid name and on his splendid accent. Further, to my knowledge he is the only sub-postmaster to arrive at the Palace of Westminster in the past 10 years. The hon. Gentleman speaks with great energy and vigour about the problems of his constituency and his constituents. We shall look forward very much to hearing him take the plunge again when Mr. Speaker allows him to catch his eye. It is always difficult to do so after the first time. I congratulate the hon. Member, and look forward to hearing him on many occasions in future.
I welcome very much the renewed commitment in the Gracious Speech to develop nursery education. We have already discovered that the allocation of resources made by the right hon. Member for Finchley (Mrs. Thatcher) of £34 million to be spent over four years is nowhere near enough to provide for the programme that has been submitted by the local education authorities. When we bear in mind that the inflationary process has continued since that allocation was announced, it is clear that LEAs will be disappointed when they find that the number of places for which they have planned is to be reduced because the resources are inadequate. I hope that the Secretary of State for Education and Science will be able to bring some pressure to bear to ensure that adequate resources are made available.
The second matter I want to refer to is the undertaking to bring in a Bill to outlaw sex discrimination very shortly. I am delighted that the Bill is to appear this Session. Although I have some criticisms of the proposals in the White Paper, I feel that we should have a very interesting debate on the Bill, when I hope to be able to speak and make some proposals for a rather more radical approach to many problems.
I am concerned about the existence of single-sex schools, about the way in which 580 we pressurise very young children into accepting their conventional sexual rôles within society, about the suggestion that we should allow small firms with fewer than ten employees to escape the provisions of the Bill. It is in this area that the greatest discrimination against women occurs and where trade union organisation is non-existent, and therefore where women employed are without the protection of the organised trade union movement.
I return to the main theme of today's debate. On Tuesday, the Leader of the Opposition attacked the Gracious Speech for not being sufficiently doom-laden—that was not the word he used, but it represents the gist of what he said. The right hon. Gentleman said that the Gracious Speech did not underline the appalling difficulties facing us. He said that many of the measures it contained would be irrelevant and damaging. He should know about irrelevant and damaging legislation. We are facing a very difficult situation because of the damaging legislation that he introduced and the failure of much of it and of many of his friends to rally round, even though he pleaded with them to do so.
We are facing the consequences of the failure of industry to invest adequately—a failure that has persisted for many years. We are facing the consequences of the failure of the Conservative Government adequately to expand the export trade, particularly with Eastern Europe, where there are great facilities and possibilities for expansion. We are facing the appalling effects on British life, industry and agriculture of entry into the EEC on terms entirely inimical to the interests of the British people. The right hon. Gentleman also presided over one of the most disastrous declines in housing effort since the Second World War, and the present Government are having to tackle that as well.
In his turn, the right hon. Member for Leeds, North-East (Sir K. Joseph) was responsible for one of the greatest assaults on the National Health Service, disguised as an American-oriented reorganisation, that was and is bitterly opposed by all those who work in it, including doctors. We have seen many 581 of the difficulties latterly, in which members of the various unions in the National Health Service, including the National Union of Public Employees, the Confederation of Health Service Employees, the ASTMS, the British Medical Association and even the nurses have been moved to industrial action to show how frustrated they feel by the undemocratic changes which were pushed through this House by the Conservative Government.
All of us in the Labour Party regret that those changes took place, and I hope that my right hon. Friend the Secretary of State for Social Services will be able to carry out her proposals to introduce democracy into the National Health Service as rapidly as possible. She will have the entire support of a majority of Members of this House who care about the National Health Service and certainly the entire support of those working within the service.
I welcome very much what my right hon. Friend has said about her determination to see that the private sector of medicine is separated from NHS hospitals. If private medicine is as desirable as many of its protagonists claim, let us see if it can stand on its own feet. That means that it will have to provide the finance to set up its own hospitals and for paying all the staff that it employs and for all the equipment that it needs. It will find it very difficult to equate the expenditure of the National Health Service on new hospitals and on staff throughout the whole of the hospital service which it decides to set up.
But some consultants have decided to fight—they made such a promise, but I do not know to whom—for the continuation of pay beds. They claim that private practice is neededto ensure the maintenance of standards of knowledge and skill, the encouragement of education and research, and the best use of those skills and resources.I challenge every word of that claim. It is only a minority of consultants who are digging their heels in on this matter, and it is necessary to point out to them that they have attained their status as consultants in their profession and their position in society by virtue of their employment in National Health Service hospitals. A consultant's status is not derived from any other source. The con- 582 sultants owe their training to the taxpayers; their experience and the skill they have acquired they owe to their service in NHS hospitals. If they are going to separate themselves, or be separated, as they claim they want to be, we need to look very carefully at the suggestion that we might expect them to pay back to society something of what they have already received from it before they became consultants and came to occupy the positions they now hold within the NHS.
§ Mr. Timothy Raison (Aylesbury)
Would the hon. Lady apply to everyone educated by the State and who does not then go on to work in the public sector the principle that consultants who accept private work should pay back to the NHS the cost of their education?
§ Mrs. Short
We are talking about the National Health Service, but there may be a parallel in the education system and private education. However, at the moment I am referring specifically to the NHS and consultants. We are frequently told that a number of people working in the NHS have been taking a militant stance and holding the country to ransom, and so on. But no one says that about consultants who threaten to withdraw completely from the NHS and to whom the right hon. and learned Member for Surrey, East (Sir G. Howe) referred, in his long catalogue of traditional Conservative dogma, as threatening to emigrate. Is not that the case of a minority of people threatening to hold the country to ransom?
When we are talking about some people leading a campaign for the retention of private practice, let us get another basic fact clear. Not long ago, I gave a very brief radio interview on this subject. I said at the time that it ill-behoved some of the people earning about £16,000 a year from their NHS work alone to campaign for the retention of privilege. I received a large number of letters. I believe that my right hon. Friend has also received letters from these gentlemen. I shall not comment on the rather hysterical nature of some of these letters, not complain when I am accused of being a liar—of producing incorrect statistics and lying in order to achieve my own political ends. Nor shall I make comment, as I am afraid I did when I interrupted the right hon. and learned Member for 583 Surrey, East today, about those who repeat the word "envy".
For some reason, those of us who criticise privilege in our society and who want equal opportunities for all our people are accused of being envious of something, though we are never told of what we are envious, or why. I am not envious of anything that anyone else has or does, and I am not envious of the large salaries that some consultants are earning. But let us get it straight. The top salary for a consultant in the National Health Service is almost £8,000 a year, and on top of that there is a merit award which some consultants receive and which is almost £8,000 a year. Thus, a consultant at the top of his salary scale and receiving the top merit award is earning practically £16,000 a year. I repeat: it ill behoves those men who are earning that sort of salary from the service to campaign for the retention of the opportunity to treat as many private patients as they are able to, sacrificing only two-elevenths of their salary for the privilege.
One of our major criticisms of the present situation where private pay beds exist within NHS hospitals is that there is an incentive for a minority of consultants not to be too energetic about the liquidation of their waiting lists. This is a means of pressuring patients if they are waiting to go into hospital for an operation. The surgeon says 'I am sorry but I cannot offer you a NHS bed for several months"—it may be six, 12, or even more months, for there are waiting lists longer than 12 months—"but I am able to offer you a private bed within a matter of days, and certainly within a week". This means of pressuring patients is open to abuse, and the existence of private practice within NHS hospitals is indictable on that account—that it allows an abuse if a minority of consultants wish to take advantage of that opportunity. It means that people can jump the queue. It means that people can get preferential treatment.
We are well aware of the reasons for people deciding to be private patients. The arguments were clearly rehearsed before a Select Committee and they are all documented and available for anyone to read. The main reason is that patients like to be private—at least, a large number do, though not all. If theirs is not an urgent case, a large number like 584 to be able to decide when to go into hospital. Those are the two major reasons. I do not think that people are too much worried about having better food or more choice of food.
I would say that those facilities should be available to all patients in the NHS hospitals if they feel that they need them. We need to study the design of our new hospitals and the way in which we reorganise the old ones to see that more private and amenity rooms are made available for those who prefer to be on their own rather than in a room with several other patients. The design of hospitals over the past 10 or 12 years has resulted in small wards, with perhaps four beds being provided. Such wards give far less privacy to patient and doctor than do the large wards that we use to abhor, because in a room with four patients it is possible to hear everything while in a large ward a lot of conversation goes on, and radios may be switched on, and nobody bothers what the patient says to the doctor behind the curtains, or what the doctor says to the patient. It is an interesting comment on the way in which we have developed our new hospitals.
The other major abuse is that of resources provided by the taxpayer—equipment and staff—being used for private practice, additional burdens being placed on the staff without any extra pay and often without time off. This results because the consultants require the help of junior medical staff in the operating theatre, and we are talking mostly about surgical procedures because it is in that connection that the bulk of private work is done.
It has been proposed that the £12 million a year spent on merit and distinction awards should be used to augment the salaries of consultants opting for full-time service within the NHS and for providing regional incentives to ensure that younger men applying for consultant posts will go to the less attractive areas. That would help a great deal to even out the supply of consultants throughout the country. There are several hundred vacancies now, and all patients requiring the attention of a consultant require it wherever they live. However, because of the existence of private practice in the South-East, the consultants concentrate in the areas near the London teaching hospitals, so that there is a strong pool of 585 consultants in this area leaving inadequate the consultant cover in many other areas, like the Midlands, the North-East, the North and Scotland.
That is why I support my right hon. Friend's determination that her proposals shall be implemented with the greatest possible speed. She will have the support of all the workers within the NHS and a large proportion of consultants are now opting for full-time service within the NHS, including younger men being promoted.
We need to have a much more careful and better informed method of controlling expenditure in NHS hospitals. The Expenditure Committee is much involved with looking at the ways in which estimated money is spent, but we are always doing so after the event. We investigated the cuts made last December by the then Conservative Chancellor of the Exchequer, and, clearly, the right hon. and learned Member for Surrey, East has not read that report. Those cuts caused chaos within the service and created concern and alarm in local authority social service departments and among social service directors, who particularly commented on the fact that their projected homes for providing secure accommodation for young persons under the Children and Young Persons Act had to be axed. Treasurers of area health authorities mentioned the cuts in minor capital works, for such works often provide patients with a great deal of convenience and comfort.
But the investigation is always made after the expenditure has occurred, and my right hon. Friend would be well advised to look at the way in which the vetting of expenditure in the service is undertaken and the way in which administration at all levels within the service vets its own proposals for expenditure. I am certain that many economies could be made without affecting staff or the comfort or medical well-being of patients. I hope that it will be possible for her somehow to improve accounting methods within the service at different levels.
Lastly, I am very disappointed that the Gracious Speech contains no proposals for the appointment of a Minister for Population, and nothing is said about the urgent need to expand this service within the National Health Service. Two Select Committees have made firm proposals to successive Governments that a 586 Minister should be appointed to be responsible for all population matters.
As a result of the reorganisation of the National Health Service we are seeing a breakdown on the family planning service. I speak from experience as a vice-president of the West Midlands Family Planning Association. We are now facing the closure of the excellent new premises that were opened eight or nine years ago in West Bromwich, where a very large number of clinics were held, where we pioneered vasectomy clinics, and where we are now facing the fact that area health authorities do not have the money to pay for patients to attend. Patients are being turned away from our premises daily; we cannot deal with them. The area health authority cannot pay for them. When we send the patients to the general practitioners, the general practitioners turn them away and say that they cannot deal with them either because they are not prepared to provide the service.
I therefore hope that my right hon. Friend will look urgently at what is happening in the family planning service throughout the country. It is not only the West Midlands that this difficulty is being experienced. We know full well that resources are needed to carry on this service. We know from the reports of the Select Committee that the amount of money required is minute compared with the enormous expenditure involved when unwanted births occur. I say to the right hon. Member for Leeds, North-East that unwanted births occur in every social group. If our aim is to ensure that every child born is wanted—I agree with the right hon. Gentleman in this respect—we need a very rapid expansion of education about family planning methods for both men and women, for married and unmarried people. This cannot be done within the context of the present overburdened Department with Ministers overburdened with a great deal of responsibility. Resources of manpower and money must be made available. I hope that it will be possible for there to be development on these lines very quickly this Session.
§ 1.12 p.m.
§ Mr. Richard Luce (Shoreham)
I echo the congratulations which the hon. Lady the Member for Wolverhampton. North-East (Mrs. Short) extended to the hon. Member for Truro (Mr. Penhaligon) on 587 his maiden speech. Not only has the hon. Member a splendid name and an unusual job; he made a short, sharp, brisk speech. If every hon. Member were to follow his example we would have more constructive debates and get more done in the House. For that reason alone, I congratulate him warmly.
Having said that, I had better try to pack my points into as brief a speech as possible. I shall address my remarks to two questions—first, mobility of the disabled and, secondly, on a slightly longer basis, the general question of the problems of retired people.
First, on the question of the mobility of the disabled. I welcome the appointment of the Under-Secretary of State as Minister for the Disabled. I wish him well. I believe that in the short time he has been in the post he has already begun to build on the achievements of the previous Conservative Secretary of State, my right hon. Friend the Member for Leeds, North-East (Sir K. Joseph), in all that he did for the disabled—the constant attendance allowance, the invalidity allowance, and so on. I believe that the Under-Secretary will do well to build up on those practical achievements.
In my constituency there are many disabled persons, partly because a high proportion of my constituents are retired people. On a national level, about 2½ million out of all the retired pensioners have some form of disablement. In the last few months we have been discussing at all levels the question of the mobility of the disabled. We have had the Sharp Report and the reaction of this Government to that report.
In the summer months I had many representations from disabled people. The Disabled Drivers' Association in my area organised a conference for me to discuss its members' problems. Five clear points emerged from this with regard to the Sharp Report. First, many disabled people wish to have the option of retaining the three-wheeler or having some form of special purpose-built vehicle. I therefore welcome the Government's indication that they propose to retain that option, although it will be essential to ensure that there are adequate safety standards and that servicing facilities are available in garages.
588 The second point to emerge was a strong criticism amongst disabled people that several thousand people who have cars now would be deprived of their cars under one of the recommendations in the Sharp Report. I am glad that the Government do not propose to implement that recommendation.
The third point that emerged clearly was the question of the criteria of eligibility for either a cash allowance or a car for the disabled. I am certain that the Sharp Report's definition of the criteria was far too narrow and limited and that, in particular, disabled passengers should have greater facilities and help available to them. For that reason, I, too, welcome the extension of help the Government have indicated that they will give to disabled passengers. In an ideal world the question of criteria for disabled people in obtaining a vehicle should include social isolation. If we were to implement that now, the cost would be prohibitive. I hope that when the economy begins to improve we will broaden the criteria in terms of eligibility.
The fourth point that emerged was the question of exemption from vehicle excise duty for particular categories of people with vehicles. I should be grateful if the hon. Gentleman would comment on this point. At present, only those who qualify for a car which needs conspicuous and permanent adaptation are entitled to exemption from vehicle excise duty. I should like to know from the hon. Gentleman whether the Government propose to abolish this exemption or to extend it to all those who are entitled to a mobility allowance.
The last point to emerge strongly from the conference was not only the need for choice in terms of whether a person should have the hard cash or the service of a vehicle available but the fact that we should be as generous as possible in terms of cash allowances. For this reason, too, I welcome the Government's proposals to introduce a weekly mobility allowance.
On the second of the two questions to which I said I would address my remarks—the general problem of retired people—a new phenomenon has developed since the war. There are nearly 9 million retired people—about one-sixth of the 589 population. Since 1900 the number of people of pensionable age has more than trebled. Today, perhaps because life expectancy has increased, people spend a far greater proportion of their lives in retirement. Indeed, many people spend up to one-third of their lives in retirement. Some enjoy their twilight years in happiness and activity; others spend them in misery.
One of the developments which has taken place over the last few years has been the flocking of retired people to our coastal areas. We have heard phrases, about people retiring to Sussex and other coastal regions, of "Costa Geriatrica", which is not only unfortunate but unfair. However, it is understandable. In some coastal areas, including my constituency, up to one-third of the population is aged 65 or over.
An interesting report entitled "Retiring to the Seaside" made recently by the charitable body Age Concern gave a number of reasons for people retiring to seaside areas—health, a better climate, more peace, less pollution, a better environment, more suitable housing, the chance for a fresh start, and better recreation and other facilities. But what is needed from the Government and from the Secretary of State is a fresh and concerted examination of the problems and variety of needs of retired people. Some require considerable assistance from the State; others are anxious to be active and to receive rewards for being active.
There are, therefore, two areas in which action is required. First, there are the problems of people who are really in need. In the coastal areas, and certainly in my area, there are enormous strains on the resources of the social services and the health services, under-staffing of the home help and meals-on-wheels services, and considerable strains on the hospital facilities. Therefore, the Government must give greater priority, through the local authority services and the area health services, to retired people who are specially in need in the coastal regions. There is a great voluntary spirit in this country. The Government must tap that spirit and the desire of many people to help their neighbours. These people must, however, be told how they 590 can help their neighbours, and the Government must give a lead.
The other area for action concerns the need for greater flexibility and choice in the rules and regulations relating to retired people. For example, people who wish to retire before the age of 65 should perhaps have the right to retire at 60 on a lower rate of pension—as people in Belgium do—and on a sliding scale basis. There is also a case for examining what happens at the other end of the scale and relaxing the rule about compulsory retirement and the payment of pension at 70.
The earnings rule has been considerably relaxed in the last four years. There is, nevertheless, an overwhelming case for abolishing the rule altogether. When we are canvassing and talk to retired people we may ask a retired person who is looking healthy what kind of activities he undertakes. He may say, "I do my garden all day and every day", or, "I like to get out and do a job." It is the activity which makes him healthy.
Every encouragement should be given to retired people who wish to work to earn a living without being penalised for doing so. They would then make an increased contribution to the production of this country. They would contribute through increased taxation payments, to the central Exchequer. They would be more cushioned from the effects of inflation. Apart from anything else, it would enable them to live healthy, active and more vigorous lives in retirement.
At a time of great national economic crisis it is irresponsible to advocate higher expenditure without suggesting how it should be paid for. I therefore hope that whenever any of us advocates extra help for any section of the community we shall say how it will be paid for. The Government and the Prime Minister often refer to "the need for social justice". We all have our own interpretations of "social justice".
To my mind, it is a strange pattern of priorities when the taxpayer doles out sums of money to the families of strikers for which the unions should bear the responsibility instead of making the money available to help, for example, the disabled and to further the interests and requirements of the Under-Secretary of 591 State who has responsibility for the disabled. It is a strange pattern of priorities to introduce indiscriminate food subsidies costing hundreds of millions of pounds, only a small proportion of which goes to those in need and to the retired. Surely it would be far better to use the money to ease the earnings rule or to give extra assistance to people who are desperately in need.
The Government would be well advised to drop their doctrinaire attack upon private medicine, which contributes so much to the standards of our health services, and to stop discouraging private occupational schemes. If they do that and adopt a hard, pragmatic scheme or series or measures to help people who are really in need, they will get the support of the Opposition and of the majority of our people.
§ 1.26 p.m.
§ Mr. John Watkinson (Gloucestershire, West)
I am grateful to you, Mr. Deputy Speaker, for calling me to speak at this early stage in my parliamentary career. I apologise to the House for being absent from the early stages of the debate. I was, unfortunately, called away on urgent constituency business.
My constituency is West Gloucestershire. It is sometimes thought that only hon. Members opposite enjoy the benefit of having great beauty spots in their constituencies, but West Gloucestershire is one of the fairest and most beautiful constituencies in the country. It contains the old Forest of Dean area. The people in the constituency are famous for their independence of spirit and judgment. Those are two characteristics which my predecessor, Mr. Charles Loughlin, possessed to an unusual degree. He was no one's man but his own. He spoke frequently in the House. Having recently shared a platform with him, I can assure you, Mr. Deputy Speaker, that he has lost none of his intensity or zeal for public speaking.
When I was elected, I was asked what was the principal social problem in my constituency, and I had to reply, "Housing". It may be that that subject falls outside the ambit of this debate, but I crave the indulgence of the House to refer to it because it is of pressing importance in my constituency. During the election, on only one occasion was I 592 offered votes for sale, and that was by a young couple who were touting their votes among the candidates because they were so desperately in need of housing. Constitutional propriety, and my inability at that stage to do anything about it, enabled me to turn down their offer, but it indicated the extent to which people are suffering from the grave housing shortage.
Since I have been a Member I have found, as no doubt other hon. Members have found, that the principal element in my postbag consists of letters connected with housing. I sometimes think that our people have become anaesthetised to the problems of housing. Is it so long since that celebrated programme "Cathy Come Home" was on television and had such an effect? Yet the circumstances which gave rise to that programme still exist in our society. The figures can be and have been rolled out, but they seem not to have the effect that they should.
It is necessary for us to accept and acknowledge that there is a grave national crisis in housing. It is a fact that, proportionately, we are spending less of our national expenditure on housing now than 20 years ago. It is also a fact that we have one of the worst house-building records in the whole of Europe. We have already heard in the debate of the falloff in house building during this year.
The real need in housing is indicated by council house waiting lists. In my constituency there are 3,000 people on the waiting list. The numbers may not be as great in other constituencies, but if we add that waiting list to lists in other parts of the country we find that the level of waiting is of fearsome proportions.
One of the sadder aspects of the waiting list in my constituency is that many people who are now on that list would in former times have been able to buy their own houses; but, because of the desperate spiral in house prices in the early part of the 1970s, young couples simply cannot obtain mortgages. It is a simple fact that in order to obtain a mortgage for a £9,000 three-bedroomed house it is necessary to earn over £50 a week. Only 14 per cent. of manual workers in this country earn anything like that amount.
I welcome the work done in the housing sphere by housing associations, I 593 welcome the attempts of local authorities to buy existing properties, and I also welcome the improvement grants which have been made to house owners. However, the fact is that this country needs an extension and an expansion of house building in both the private and the public sectors.
Because of the grave shortage of housing we on the Government side could not and cannot countenance the sale of council house property. I welcome the injection of £350 million which the Government have made available to local authorities to extend council house building. But whenever local authorities initiate schemes they come up against those twin task masters—the yardstick and that Parker Morris standards. It is right that the Parker Morris standards should be set high, but they are frequently set so high that local authorities are unable to meet the yardstick provision, which is set too low.
If we are to have an extension of house building there must be an improvement in the situation in the building industry. That industry is notoriously subject to cyclical fortunes. It is, in terms of its employment, subject to the misfortunes of the "lump". That is something which we on this side of the House are determined to do away with. The industry lacks effective training schemes. If any industry cries out for some form of planning agreement with the Government it is the construction industry.
I also urge upon the Government the necessity for some form of stabilisation of mortgage funds. I have referred to the fact that in the early part of this decade there was a mammoth increase in the cost of houses. That was largely connected with the fact that funds were available at a time when the housing stock was not expanding. It is necessary that the building societies should be subject to some form of stabilisation so that the quantity of funds coming on to the market for housing is consistent and in line with the amount of housing that is available. There should be a link between the two. When development land is taken into common ownership, that, too, should have a beneficial effect on the cost of housing.
As a member of the Multiple Sclerosis Society I welcome the directions that have 594 been given to local authorities by the Government to provide more housing suitably adapted for the disabled. Through contacts with the Multiple Sclerosis Society I have seen the suffering that ordinary people have had to endure because their houses were not suitably adapted to accommodate their disease. I welcome this move by the Government.
The housing problem can be solved. We do not need to await the appearance of some magician who will provide us with the answers. The answers are available to us. All that is lacking is the political will to bring about a marked increase in our house-building programme. I urge upon the Government the necessity of establishing as a first priority a commitment to increase dramatically the building programme. Only by doing that can we rid ourselves of one of the gravest social ills of our time.
§ 1.38 p.m.
§ Mr. John Cordle (Bournemouth, East)
It has been my privilege only once before to follow a maiden speaker. I congratulate the hon. Member for Gloucestershire, West (Mr. Watkinson) on a most instructive and interesting speech. Obviously his sincerity regarding housing and his concern for the disabled will ring true, be of great importance in his division, and be well received. I warmly congratulate him on the way in which he presented this important subject today. We shall look forward to hearing from him on many occasions.
In view of the time, and as others wish to speak, I shall address myself only to the subject of law and order. The Gracious Speech, in the midst of the paragraph dealing with the vexed and tragic problem of Ulster, contains the general sentence:My Ministers will continue to act decisively against terrorism and lawlessness.That sentence is and ought to be regarded as being of general application to the whole of the United Kingdom. Bombs are planted not only in Belfast, but in London and Birmingham. But perhaps more worrying than the headline-catching acts of terrorism is the insidious growth of lawlessness in the country as a whole. The Secretary of State for Social Services spoke of the "sick society". I could not agree more. Economically we are nearly bankrupt, but certainly we are morally, 595 if not spiritually, bankrupt. Since the war there has been a collapse of the moral Christian principles which this country as a nation has enjoyed over the centuries. Only a few years ago it was the proud boast of the Englishman that he could walk unarmed, unconcerned and unmolested through the streets at night. That was in happy contrast with the experience of other nations. But no longer is that the boast so proudly made and no longer does it ring so true.
We have only to think that in recent months London's busmen and underground train drivers have felt compelled to threaten industrial action by way of protest because of the numbers of their colleagues attacked and injured. We have only to consider the disturbing increases in the level of violent crime generally throughout the country, and in particular in our major cities. We have only to remember the constant Press reports of indiscipline not only among certain elements in football crowds but also among certain teenagers reluctantly attending many of our schools.
All these are examples of a trend which disturbs many of our citizens who have come to feel less secure in their homes and on the streets. Many people today would question the underlying premise of that sentence of the Queen's Speech which I have quoted. They would question whether the Government are now acting decisively against lawlessness. Those people might well answer such a question in the negative and would then go on to state, firmly and unequivocally, that the Government ought to begin to act decisively against lawlessness from today onwards.
What should be done? Let me outline three things which should together constitute the decisive action which to date has been conspicuously lacking. First, there should be a more obvious and determined effort to support and assist our police forces in every way, to bring their numbers to full strength and to ensure that they are adequately equipped and fully backed in their efforts to stem the floodgates of lawlessness. Secondly, there should be a fundamental reappraisal of penological ideas or ideals for dealing with young offenders. The courts must have adequate powers to punish the wicked and malicious in order to deter 596 their like-minded brethren. In this context the whole scope of the Children and Young Persons Act 1967 ought to be reviewed and the reintroduction of corporal punishment seriously considered.
Thirdly, in the context of indiscriminate terror, the time has come to restore the death penalty. I believe, in absolute honestly, that I am voicing the considered opinions of tens of thousands of people in Britain today—decent, upright men and women in all walks of life who want to re-introduce capital punishment where specified crimes of murder take place, such as the murder of police or prison officers in the execution of their duty, together with private citizens who go to their aid. This should also cover assassination in furtherance of political objectives, shootings, bombing and explosions, as well as deaths resulting from hijacking of civil aircraft or passenger ships.
It is no good the Prime Minister or Home Secretary sending messages of commiseration or sympathy to relatives following another ghastly incident. What is wanted at once is a firm, iron hand at the head of our Home Office who will carry out the wishes of the people by either shooting or hanging the person or persons who take it upon themselves to deprive innocent men, women and children of their lives.
From earliest written records of humanity we have this dictum:Who so sheddeth man's blood by man shall his blood be shed.If the Government want to deal effectively with this scourge, they must take action at once or we shall see another Tower of London, another Aldershot, another Guildford or another motorway tragedy. For God's sake and for the sake of our people act now. To stamp our vandalism and terrorism adds another question to our reaction to the Gracious Speech. Can we talk in honest terms about the rule of law and the improvement of the quality of life when we are so soft as to allow vandals and terrorists to get off so lightly with a fine or, at worse, a few months' detention. The birch is wanted, and wanted quickly, if our towns, trains and football games are to be made safe and the quality of life improved.
I remember having the stick at school for woeful conduct and twelve of the best 597 hurt like hell, but I took very good care that it did not happen again. It hurt and I remembered. Effective deterrents for murder by death and terrorism by birch is the loud cry of the people of the nation at this moment, and a mounting storm of anger will be faced by the Government if they fail to take immediate action.
§ 1.48 p.m.
§ Mr. John Garrett (Norwich, South)
I should like to add my congratulations to my hon. Friend the Member for Gloucestershire, West (Mr. Watkinson) on a lucid and interesting speech on a fundamental question of public policy. I shall not take up the remarks of the hon. Member for Bournemouth, East (Mr. Cordle) on punishment and retribution since I consider his views singularly benighted.
I wish to welcome that part of the Gracious Speech which advances women's rights, and in the field of social policy I wish to press the Government to take steps to provide help and care in particular to one section of our community. I refer to battered wives, where hitherto it has been left to voluntary organisations to take action. Discrimination against women is rife in our society, and in matters of employment, training, promotion and the purchase of goods and services that discrimination is frequently overt and widely condoned. In other areas discrimination is more subtle. I am disturbed, for example, by the way in which girls often are conditioned from the beginning of their lives at primary school to accept that theirs is a rôle of supportive domesticity, limited horizons and narrow opportunities. This attitude is reinforced in secondary schools by inadequate facilities for training girls in technical and practical subjects. I understand that the Department of Education and Science is conducting an inquiry on this topic, and I hope that the House will have an opportunity to debate it.
It has often been said that Parliament cannot prescribe attitudes and personal behaviour but, as the Race Relations Board recently usefully pointed out, a law is an unequivocal declaration of public policy; a law gives protection and redress to those discriminated against; and a law reduces prejudice by discouraging the behaviour in which prejudice finds expression. Therefore, I am pleased to 598 see that the Gracious Speech anticipates legislation with the aim of making sex discrimination unlawful. The Government's recent White Paper on equality for women proposed that it should be unlawful to discriminate against women in employment and related matters, in education, housing and accomodation and in the provision of goods, facilities and services, and that an Equal Opportunities Commission should be set up to identify and eliminate discriminatory practices.
I am pleased to see that the Commission will be empowered to conduct investigations and to take action on its own initiative, to assist and represent individual complainants in appropriate cases, and to take action to educate and persuade public opinion. Even after that Commission has been in operation for years, I have no doubt that sex discrimination will continue in many areas of our national life. But at least the community as a whole will have stated its position and acquired valuable machinery for pursuing those who continue to discriminate. Women's rights must be advanced on several fronts simultaneously. I am pleased that the Government's proposed earnings-related pension scheme will end the discrimination in this respect and give women equal pension rights.
Most important in the field of social benefits, however, is the undertaking to increase family allowances. It is nothing short of a disgrace and a reproach, particularly to the last Cosnervative Government, that family allowances have not been increased since 1968 and that their purchasing power has been whittled away by inflation until they have halved in value since the last increase. I look for a massive and immediate increase in family allowances in the imminent Budget—justice could hardly be served by anything less than doubling them—not only as a means of assisting children in poor families but as a substantial advance in women's rights.
Mothers have a right to a payment from the community which they can call their own instead of having to rely exclusively on whatever their husbands see fit to allow them for housekeeping. I regard it as a very serious omission that the introduction of an allowance for the first child will have to wait for two years or longer until the family allowance scheme and child tax allowances can be recast.
599 I have never been able to understand why the introduction of an allowance for the first child should take so long. It was a serious weakness of the original family allowance scheme that the first child was excluded. The first child is always the most expensive child and there are many thousands of families with one child who are in the most desperate poverty. Successive Governments have been seized with paralysis when they should have acted on this most serious question.
The cause of battered wives is one which has been fought in previous Parliaments by my hon. Friends the Members for Stoke-on-Trent, South (Mr. Ashley) and Fife, Central (Mr. Hamilton). They have raised the matter in Adjournment debates in July 1973 and July of this year. There is no need for me to exemplify this problem by reciting the appalling case histories of violence, physical and psychological torture which have been widely reported since this dark aspect of our society began to receive publicity over the last few years. Suffice it to say that it has been estimated that some 25,000 women and at least double that number of children live in families in which wives suffer regular beating by their husbands.
In my own constituency of Norwich the Leeway voluntary organisation has set up a refuge for battered women and their children and in its first 22 weeks of existence, to August of this year, 29 women and 60 children have sought sanctuary there. In five cases there has been evidence that the children have been battered as well and in many others there are signs that the children are severely disturbed by what they have witnessed in the family and are well on the way to becoming social problems for the next generation.
In the Adjournment debate of 26th July this year the Under-Secretary of State for Health and Social Security assured my hon. Friend the Member for Fife, Central that the Government would support research into the question of violence within the family and that a Select Committee on the subject would be set up in the autumn. I hope that the establishment of that committee will be announced in the very near future and that it will report quickly.
It has been estimated that as little as £3 million would be enough to set up a 600 national system of sanctuaries for battered wives—places where these women and children could get away from violence and harassment for sufficient time to find a long-term solution to their problems or to find a breathing space in which to consider their future relationships with their husbands. What is needed is action, not the interminably slow churning of the bureaucratic machine. I doubt whether there is any single element of public expenditure of the size required which could do more to relieve human misery.
I believe that there are policies in the Gracious Speech which do much to promote the condition and status of women. I hope that a Socialist Government will have the conscience and good sense to do much more, particularly in the matter of married women's entitlement to a share of the income and property of the family and in the field of training and promotion. Society is ill-served by practices and institutions which deny equality to half the population.
§ 1.55 p.m.
§ Mr. Nick Budgen (Wolverhampton, South-West)
It is with great pleasure that I rise to compliment the hon. Member for Gloucestershire, West (Mr. Watkinson) on his maiden speech. He spoke with sincerity, with passion and, as I know well, as a result of deep thought and contemplation.
I feel that I have perhaps failed in the past in making the Tory beliefs known to him when I find that he considers that the proposals for the nationalisation of development land are non-controversial, for when he was a practising member of the Bar he and I shared a room for about two years and we discussed in the course of those two years many political subjects from our respective points of view. To find that after two years discussion with me he believes that the nationalisation of development land is likely to go through this House on the nod leaves me with a deep feeling of lack of confidence in my own advocacy. None the less, I am sure the House will in the future often have pleasure and instruction in hearing the hon. Gentleman's views upon many political subjects, and I know from my own experience what thought and passion go into his consideration of the political affairs of this nation.
601 It was also a pleasure to hear the maiden speech of the hon. Member for Truro (Mr. Penhaligon). It was particularly pleasant to me because he referred to a point which I am about to make about the importance of making sure that those who are entitled to benefit do in fact receive the benefit.
I would attack the Minister's speech, first of all, for her total failure to emphasise the most important point that the pensioner has to fear—inflation—above all else. It is no good talking about massive handouts of any sort, for even a Dr. Havenstein or a Mrs. Havenstein cannot print enough money to compensate pensioners for a 20 per cent. rate of inflation which is already accelerating. The one thing that the pensioner wants to be sure of is that the money she or he receives today will be worth approximately the same amount tomorrow or in three months' time.
Therefore, when I consider what we on this side of the House can suggest for the improvement and benefit of our fellow citizens I am bound to say that I find it difficult to support any suggestion for major increases today in social benefits. Such a major increase can only increase the already vast Budget deficit. We all know how, after the Chancellor's much vaunted attempt to reduce the Budget deficit in March, that Budget deficit has now started to expand once again. We know also—for it is an agreed fact of political life on both sides of this House—that there is a major need for a relief of taxation on private industry in the Budget on 12th November.
If it be that the rate of corporation tax is reduced, or if the time for payment of corporation tax is postponed, that will reduce the Government's tax upon industry and upon private citizens and will once more make it more difficult to reduce the Budget deficit. Therefore, I cannot recommend any immediate major increases in social benefits. If anybody makes recommendations of that sort, he or she is doing nothing more than making more certain the risk of a hyperinflation in 1976 or 1977.
There is, however, one matter upon which the Minister must concentrate, a matter to which the hon. Member for Truro has already rightly referred. The 602 principal defect of our social services is that those who most deserve benefit, those who most need benefit, do not receive it. It is upon this principle of the equality of opportunity to receive benefit that I most wish the Minister to concentrate.
Everyone knows the problem. There are at present 16 different means-tested benefits administered by the central Government, and there are 32 different means-tested benefits administered by local government. In her opening speech, the Minister spoke of the problem presented by the low take-up of family income supplement. The reason for the low take-up of FIS has nothing to do with the question whether FIS is or is not a good type of benefit or is or is not directed towards a particular sort of need. The problem with all the numerous means-tested benefits is that to work one's way round the present social services system a person needs not just a reasonable training in public administration or a degree in law but time, intelligence and the necessary energy.
It has been estimated that there are at present about 100 leaflets in circulation which explain the ways of the social services. It is impossible for a woman with five children—perhaps expecting a sixth—to leaf her way through 100 different leaflets and find out through the small print what her entitlement is.
The real scandal today is that, on the whole, those who most need help are not getting it. This applies not just to the 50 per cent. take-up of FIS. It applies also, for example, to the rent rebate scheme, for recent figures show that only 30 per cent. of those entitled to rent rebates in the private furnished accommodation sector were in fact claiming such rebates. A recent survey in Bethnal Green showed that only 50 per cent. of those entitled to supplementary benefit were in fact taking it up.
Is all this surprising? The plain fact is that there is a proliferation of various agencies trying to deal with the problem. In Manchester we have the welfare rights officer. In Wolverhampton—thanks, I am bound to say, to the efforts of the hon. Lady the Member for Wolverhampton, North-East (Mrs. Short) in her constituency—we have the Family Advice Centre at Low Hill. In other areas we have the community law centres. In 603 others there are the citizens advice bureaux. Elsewhere we have the consumers advice centres. Also, there are the welfare rights stalls run by Child Poverty Action Group branches. All these different services aim at the one central problem of low take-up, the central problem of people entitled to benefit but not claiming it.
I hope that, as an immediate response to that central problem, the Minister will start a review of all these services. It must be done carefully, for one thing which must not be done is to impinge upon the importance of voluntary aid in this area, for it is the voluntary organisations perhaps most of all which preserve the spirit of compassion and idealism within our society.
If we are to become one nation, we can do it most of all through one citizen helping another, not by ensuring that every service in the community is handed out by the unknowing unseen hand of the State. Therefore, when we review these services, let it be done in co-operation with the voluntary organisations. Let it be done, for instance, in co-operation with the National Council of Social Service. And let it be done in a way which respects the rights and independence of local government, for it would be quite wrong to have our social services in some way centrally directed or to take away the right of local councillors to assess the needs of their local areas.
There is, however, one way by which pressure can be brought upon local authorities. I suggest that, when the review has taken place, as I sincerely hope it will, the statistics should be published, so that the local electors will be able to see how their own local government organisation compares with others. In this way they will be able properly to criticise their local representatives.
I hope that the Minister will in that spirit determine her two central objectives: first, to control inflation, for without sound money the pensioner has no protection; and second, to concentrate on this cheap, effective and compassionate way of dealing with those who need and have the right to benefit but who do not claim it.
§ 2.6 p.m.
§ Mr. John Cartwright (Woolwich, East)
I, too, am very grateful for this 604 opportunity to address the House. Although this is a maiden speech, I shall not inflict on the House any potted history of my constituency, going back to Anglo-Saxon times, and nor shall I compete with my hon. Friend the Member for Gloucestershire, West (Mr. Watkinson) in extolling the beauties of my constituency. I am rather more concerned about its political loyalties.
Woolwich, East has over its 56 years of life shown a considerable faith in and loyalty to the Labour Party. There are just two blots on its escutcheon. The first occurred in March 1921 when Ramsay MacDonald succeeded in losing the seat in a by-election by 685 votes. That defeat was rapidly avenged at the General Election the following year, and Woolwich, East was then able to enjoy unbroken Labour representation until the summer of this year, when the sudden political metamorphosis of Christopher Mayhew resulted in my constituents experiencing the sudden and for them totally unwanted novelty of being represented by a member of the Liberal Party.
I realise that it is usual to refer to one's predecessor in the House. I know Christopher Mayhew well. I was his agent for four years, a period which covered two General Election campaigns. I have always said that I have the highest regard for the courage and determination with which Christopher Mayhew held unpopular views. I have rather less regard for his political judgment. I feel that the manner of his departure was a sad end to 23 years of representing one of the most loyal groups of constituents any Member of Parliament could wish to have.
I have promised not to undertake a panoramic tour of my constituency, but I ought to mention two organisations born in Woolwich, East of which Woolwich people are very proud. One is the Woolwich Labour Party, founded in 1903 as a result of the election to this House of Will Crooks in a by-election that year. It was the forerunner of Labour Party constituency organisation throughout the country, and it has always had a large membership. Today, it can claim the largest Labour Party membership in Great Britain.
The second organisation to which I must refer is the Royal Arsenal Co-operative Society Limited, born in a small front 605 room in Woolwich in 1868, with 20 members and a share capital of £4.11s.3d. Today, it is able to claim over 400,000 members, and its share capital stands at over £8 million. Its trade this year will be over £74 million. The Royal Arsenal Co-operative Society is an example of ordinary working people creating and building up an organ of competitive public ownership, and I have been proud to be associated with it over the years.
My constituency is in inner London, and it shares all the social problems of the inner London area, notably and inevitably, the problem of housing.
All of us in public life can get very little pleasure from the situation which currently exists in housing, particularly in our inner city areas. The problem in many cases has worsened considerably in the last two or three years with waiting lists becoming longer and longer and the problems of homelessness becoming ever greater. Therefore, like many of my hon. Friends, I welcome the pledge in the Gracious Speech to encourage the provision of more homes to rent and to reform the law on rents and housing subsidies. We must realise, however, that that pledge will not be easy to redeem.
There are considerable difficulties to overcome. At the forefront we must place the problem of housing costs. I am not sure that everyone in the House fully appreciates the extent to which inflation and rising interest rates have hit local authorities in their housing endeavours. In my constituency it costs the local authority more than £14,000 simply to build a three-bedroomed house or flat. When land costs are added the figure for a typical three-bedroomed house increases by £5.000. So an authority such as mine with 2,500 properties under construction is saddling itself with an increasing and crippling burden of debt. The injustice in the situation is that those areas with the biggest housing problems get deeper and deeper into this sort of financial difficulty.
It is well known that local government is now facing considerable financial difficulties. One of the reasons for that is undoubtedly the soaring cost of housing. I know from my contacts with leaders of local authorities in all the urban centres and great cities that they are likely to be faced within the next 12 months with 606 making the bitter choice between increasing rents or further adding to the burden on the ratepayers.
Therefore, if we are to achieve the promise to provide more homes to rent in the areas where they are most needed we shall need to give much more dramatic help to those hard-pressed inner city areas than we have been giving in recent years.
The second problem is one of land. In areas such as inner London, building land is running very short and in some areas the supply has dried up. Conflicts are developing between hard-pressed inner London boroughs and those of outer London which have the opportunities for building and often are not taking them. That sort of conflict will continue to develop unless in a city such as London we begin to treat the housing problem as one problem for one city, not a problem divided up between 32 independent boroughs.
Therefore while I welcome the pledge to take development land into community ownership I hope the legislation will include some reserve strategic powers to help the inner city areas where the land is so desperately needed to solve the housing problems.
The third difficulty is the problem of the building industry. I have experienced the frustration of being unable to get tenders for desperately needed housing because the building industry is too busy putting up luxury hotels and office blocks. I welcome the pledge in the Gracious Speech that our administration will tackle the problems of the lump, a system which has done so much to reduce training and recruitment in the industry, and also the pledge to create a stable work force.
But we must recognise that to create a stable work force we must create a stable demand for the building industry. It is sad that whereas this time last year local authorities were unable to get tenders because of the pressures on the building industry, the threat of redundancy now exists for many workers in the industry. That is no way to get a stable work force.
I have referred to the difficulties facing local government, and perhaps I should declare my interest as a former leader and still a member of a London borough council which until recently included among its members my hon. Friend the Member for Norwich, South (Mr. 607 Garrett). The problems local government now faces are not just the obvious financial problems of inflation in labour-intensive services such as the social services. It is not just a problem of building costs or rising interest charges. It is to some extent a rapidly increased public expectation which has been nourished by Ministers in successive Governments. At times one could hardly open a newspaper without reading of Ministers urging on local government the need to do more and more for the elderly, the mentally ill, the mentally and physically handicapped, the homeless, children in care, for consumers and so on. The list is almost endless.
What is sometimes not recognised is that one cannot turn the tap on and off in local government spending quite as easily as that. The decisions local authorities took last year will have their impact on the rates next year as the old people's home is actually built and comes into use, or as the children's home or the other social services provision become available. The expenditure begins from that point. One of the reasons local authorities will be faced in the next few months with extremely difficult decisions about either reducing the level of their services or incurring unprecedented rate increases is the feeling that efforts are now being made to turn that tap off and hold down spending.
It is difficult for local government to think in terms of long-term planning when the rolling 10-year programmes of social service provision which we were asked to put up are cut to shreds when it comes to loan sanction. My local authority put up a detailed programme for social service provision linked to our housing schemes so that alongside the housing, we provided facilities for the elderly, the young and the handicapped. It is sad to find that programme cut to ribbons when it comes to loan sanction.
I recognise that government is about priorities. I recognise, too, that my right hon. Friends will have some unenviable decisions to take in the difficult days ahead. All I ask is that they ensure that when the sacrifices are shared out, the burdens do not fall on the homeless, the badly housed, the handicapped, the elderly and all those who depend so 608 heavily on the services provided by local authorities.
§ 2.17 p.m.
§ Mr. John Stanley (Tonbridge and Malling)
It gives me great pleasure to congratulate the hon. Member for Woolwich, East (Mr. Cartwright) most warmly on an articulate and deeply-felt maiden speech. The House will have appreciated the magnanimity with which he paid tribute to his predecessor, and I know that he will not take it amiss if I say that his presence in the House will be a constant warning to right hon. and hon. Members should they choose not to take the advice of their agents.
The House will have noted and appreciated the detailed knowledge that the hon. Member has about his part of inner London and the way in which he spoke about the related problems of housing construction and land. He has clearly a substantial contribution to make to our debates and we look forward to hearing from him on many occasions in the future.
I wish to refer to two aspects of our debate. The first concerns the Government's plans for occupational pensions, and the second the disabled. I hope that when the Secretary of State introduces her new legislation on occupational pensions she will for the first time consider providing fresh statutory protection in the area of disclosure for those who are members of occupational pension schemes—an area which so far has been left untouched by legislation.
It is one of the anomalies which currently exists that whereas successive Acts of Parliament have provided quite considerable protection for employees by way of greater knowledge and understanding of the terms of their employment, we have done very little to see that employees are properly informed about the likely terms on which they will retire.
Employees now have a statutory right to a contract which defines in some detail their earnings, the way in which their overtime is calculated, their hours of work, length of breaks for meals and refreshment, their holiday entitlement, entitlement to sickness benefit, and terms of redundancy. However, we still have no statutory obligation on occupational pension funds to ensure that the members of those funds—the likely beneficiaries 609 from them—have real information as to the likely scale of benefits they will get when they retire.
It is highly desirable for occupational pension funds to be made statutorily obliged to issue some form of annual statement to the members of those funds. It is reasonable to expect an annual statement to include, among other things, an indication of the categories of investment into which employees' contributions have been invested.
It would not be necessary to show every individual investment, but it would be reasonable to know, for instance, the balance between fixed interest and equity stock. It would also be reasonable for occupational pension fund managers to indicate how their funds had performed in the past year. Managers of the funds could show the prospective actuarial surplus or, as has been the case in many funds recently, the prospective actuarial loss, at a given time. It would also possibly be necessary to show who is responsible for the management of the funds and what are the terms of management.
In other words, it would be reasonable to expect employees to be given some detailed information about the likely worth of what are in effect deterred earnings which they will receive when they retire, just as it is reasonable that they be shown in detail their current earnings and entitlement to sickness and holiday benefits etc.
When I questioned the Secretary of State on 1st July, she said that she had asked the Occupational Pension Board for its comments on the whole principle of statutory disclosure to employees of the performance of occupational pension funds. I hope that when the Secretary of State introduces her proposed legislation in the new year we shall for the first time be taking a move towards statutory disclosure for the benefit of employees.
I turn to matters regarding the disabled. It is agreed on both sides of the House that there is probably no other single area of public expenditure in which the expenditure of relatively small sums can produce an instantaneous and almost total transformation in the quality of life of individual families. This applies not so much to the allowances available to the disabled as to the provision of specialist 610 equipment which would benefit disabled families.
At present two pieces of equipment for the disabled are in strikingly short supply. I hope that the Secretary of State will be able to get additional funds to make this equipment more readily available. The first piece of equipment is the wheelchair with an elevating seat. At present there is no means whereby a disabled person can obtain such a wheelchair through the National Health Service. I understand from correspondence that the Department of Health and Social Security has initiated a research and development project to provide this type of wheelchair. But, knowing the way these things go, it is likely to be many years before this type of wheelchair materialises, whereas there is already an urgent need for it among certain categories of disabled people, particularly the disabled housewife who is not able to have her home designed exclusively for her own needs. She has other adults in her home, such as her husband and perhaps a teenage family. It is vital, if she wishes to have any chance of performing the normal duties of a housewife, that there should be a possibility of her obtaining a wheelchair with an elevating seat.
I understand that the reason that no such chair is yet available is that a model which meets with the Department's safety requirements has not yet been produced. Press reports last weekend stated that the firm of Otis is making a number of wheelchairs with elevating seats available to thalidomide children. I cannot believe that there is not somewhere in the world a company that can produce—or already has available—a wheelchair with an elevating seat of a type that would satisfy the Department's safety requirements. If such chair exists I urge the Secretary of State to consider making a purchase.
In my constituency there is a lady who unless she gets such a chair may have to go into a geriatric hospital. Unless she has this type of chair she will be unable to cope in her home. Surely the cost to public funds of a person going into a geriatric hospital will be far greater than the cost of providing a wheelchair with an elevating seat.
Another piece of equipment which is urgently needed and which would transform the way of life of certain categories of disabled people is the disabled person's 611 vehicle in which a passenger can be carried. The present rules whereby a person can have through the National Health Service a disabled person's car, as opposed to a three-wheel vehicle, are very narrowly drawn, and it is difficult for many categories of disabled people to obtain passenger-carrying vehicles. I note from figures given by the Secretary of State that only just over 10,000 of these cars for disabled people have been made available.
I refer to another constituency example. A constituent of mine has a serious respiratory disease and is confined to a wheelchair. He qualifies for a three-wheel vehicle but not for a car. The three-wheel vehicle is useless to him because, due to his disability, he has to have a passenger to enable him to get out his wheelchair when he arrives at his destination and to take him where he wishes to go. Unfortunately, this man's wife is unable to drive. He cannot afford a car of his own and so he is totally housebound until such time as a car is made available to him through the National Health Service.
I was sorry that in her statement on 13th September the Secretary of State did not make any reference to altering or widening the rules for making cars available to disabled people. But I welcome the part of her statement in which she said that she would engage in consultations with car manufacturers to see whether cars for the disabled might be made available for cheap purchase or for rental. I urge the Secretary of State to press on with this idea as rapidly as she can. It would be particularly useful if cars could be made available at rentals related to the incomes of the users. The lives of thousands of disabled people would be completely transformed if the Government provided cars as opposed to three-wheel vehicles.
If the Secretary of State can get additional funds for the type of specialist equipment for the disabled that I have mentioned, her action will be warmly welcomed and applauded on both sides of the House.
§ 2.27 p.m.
§ Mrs. Maureen Colquhoun (Northampton, North)
It is with great pleasure that I congratulate my hon. Friend the Mem- 612 ber for Woolwich, East (Mr. Cartwright) on his outstanding maiden speech, which reflected the valuable contribution which I am sure he will make in the House. He has had wide experience as leader of his local council and in the Co-operative and Labour movements. I listened to him with great pleasure.
I was glad to see proposals for a new earnings-related pension scheme included in the Gracious Speech. The Government's White Paper on pensions is one of the most important documents towards achieving security in old age that has been published this decade. On this side of the House we greatly welcome the work of my right hon. Friend the Secretary of State and her Department towards the important aim of securing a pension for everybody.
My hon. Friend the Member for Norwich, South (Mr. Garrett) talked about women's rights. It was a great pleasure to hear a male Member speak with such compassion and understanding on the problems of women. I hope that the proposed new pensions legislation will include measures to protect men's rights because there is an anti-male aspect about pensions related to the fact that women are entitled to a pension at 60 while men are not entitled until they are 65. Statistics show that many men die between the ages of 55 and 65. We want liberation not only for women but for men. I hope that my right hon. Friend will look into the matter carefully and give men, too, the choice of a pension at 60. That would be a proper step towards male liberation.
My right hon. Friend inherited a situation within the National Health Service that can be described only as chaotic. With typical energy, she tackled it and began to remove the great sense of injustice felt by National Health Service workers and nurses, a feeling that had pervaded the service until the day she took over her great Department of State. She is also beginning the long haul back, in a severe economic crisis, to a totally free National Health Service at source, democratically run, with the only criterion for hospital treatment or a hospital bed being that of need.
In these dangerous times, with the chronic economic situation largely inherited from the previous Government, the National Health Service can be in no better hands than those of my right hon.
613 Friend. It was with great surprise that I heard the right hon. and learned Member for Surrey, East (Sir G. Howe) accusing my right hon. Friend of being political. It would be hard to find a nonpolitical person in the House.
I wish to draw the attention of the House and the Government to the situation of the boot and shoe industry in the nation generally and in Northampton in particular. I ask the Government to balance their commitment to the underdeveloped nations with workers' jobs in this country and in particular in the shoe industry in Northampton, where many of our workers are on a four-day week, with no overtime. In the present inflationary situation, the cost of living being what it is, that is a cause of human misery. The workers in the boot and shoe industry must have a realistic working week.
There is a need for broad-based Government inquiry into the importation of cheap shoes and into the shoe industry generally. After considerable research, I find it by no means clear that the flooding of cheap shoes into this country under aid agreements is entirely to blame for the recession in the shoe industry. It is time the Government investigated the effects of the shoe industry distributive monopoly, including the effect on workers in our industry. A responsibility rests on the manufacturing companies, the British companies which are handling the cheap shoe imports and shedding crocodile tears about them, sticking British labels in foreign shoes. We should know what profits they are making and whether those profits are made at the expense of the long-term health of the British shoe-manufacturing industry and of workers' jobs.
A monopoly of half the shoe shops in Britain is held by the same men, by a company called Sears Holdings, chaired by Sir Charles Clore. The Government must look into every aspect of the problems of distribution, particularly the High Street shoe monopolies.
For environmental reasons, I will not ask hon. Members to take off their shoes and see whether they are British-made. But I can tell hon. Members that if they buy a pair of shoes from Dolcis, Lilley and Skinner, Saxone, Freeman Hardy and Willis, Curtess or Tru-Form they are buying them from the same men. This monopoly has a significant effect on the British 614 shoe industry. Now is the time for the Government to balance their commitment to under-developed nations with workers' jobs in this country, before those jobs disappear before our astonished gaze. They must inquire into the industry and save it before it deteriorates further. I ask the Government to hold that inquiry into every aspect of the shoe industry now—before it is too late.
§ 2.36 p.m.
§ Mr. Julian Ridsdale (Harwich)
I join in the congratulations to the hon. Member for Woolwich, East (Mr. Cartwright) on his excellent maiden speech. The Labour Party is fortunate in having a worthy successor to Christopher Mayhew, who was a friend of mine; it is fortunate in having someone with the hon. Gentleman's knowledge and experience. I am sure we shall listen to him many times in the House with great interest.
One of the fundamental principles in which we on this side of the House believe is the freedom to choose. I welcome many of the concessions the Secretary of State for Social Services has very humanly made to the elderly and the retired, but she arrogantly, though charmingly, announced in her speech that she would abolish the private patients schemes. I am beginning to understand the meaning of the phrase, "I am the master now", or perhaps in the right hon. Lady's case, "I am the mistress now". She announced, in the middle of negotiations with the medical profession, that she is to abolish the concessions for private patients and to alter completely the private patients' provision scheme. I heard on the radio this morning that £900 million would be needed for the Health Service. Therefore, I wonder whether her decision is wise at this time.
§ Mrs. Castle
The hon. Gentleman rather confusingly characterised me as both charming and arrogant. Therefore, may I ask him a simple question about his definition of arrogance? Does the hon. Gentleman think it arrogant to fight an election on a clear manifesto and then, having won the election, to announce that one will carry out one's election promises?
§ Mr. Ridsdale
When there are three or four years ahead of one, and negotiations are going on with the medical profession, the courteous thing would be at least to 615 listen to the views of the medical profession before making that decision. It is for that reason that I call the right hon. Lady's action arrogant.—[Interruption.] The hon. Member for Feltham and Heston (Mr. Kerr) always makes interruptions from a sedentary position. It may be that he wishes to adopt that position because he comes from Down Under. The freedom to choose is a fundamental matter which is felt keenly by many of my right hon. and hon. Friends.
Another important aspect of the National Health Service is that there must be a fairer share of the allocation of existing resources bearing in mind, as the hon. Member for Woolwich, East said, that there is a scarcity of resources. We must see that the available resources are used properly.
It is for that reason that I underline that in constituencies such as mine, in which there is a high proportion of retired and elderly people, it is, alas, the case that resources are not allocated fairly to the retired. Sadly, the hospital services in my constituency fall behind some of the services in what the hon. Member for Woolwich, East describes as the deprived areas—namely, city centres. Perhaps this is an argument for getting more funds out of the Government. Let the Government realise that the people in areas similar to that which I represent will speak up strongly to ensure that they get the kind of resources that they should receive.
The hon. Member for Woolwich, East referred to the city centres and described them as decaying areas. The Secretary of State for the Environment used that argument when he took money that had been allocated by the previous Conservative Government from the rural areas to give to the city centres. The argument that I am putting forward applies to concessionary fares for old people. In London there are concessionary fares and yet in the country, because resources and rateable values are less and because additional charges cannot be put on the ratepayer, such fares are not available for the elderly. For the Secretary of State for the Environment to take money from the rural areas to give to the city centres is unfair and has caused great concern in my constituency.
616 I hope that the right hon. Lady will listen to the point that I am making. She asks for politics to be taken out of pensions. How can we do so if there is unfair treatment for the elderly in the rural areas? I ask the Government to consider the matter carefully because concessionary fares in the election campaign aroused strong feeling. I bear in mind our scarce resources but something must be done. It is not a matter that can be undertaken by local councils because of the increasing calls on the ratepayers, particularly the retired in rural areas.
In my constituency we face a 50 per cent. increase in the rate burden. That is why I ask the Government to ensure that there is a fairer allocation of resources. They must ensure that there is a fairer allocation for concessionary fares for the elderly. They must bear in mind the rate problem that faces the elderly and hospital services.
Finally, I underline my disappointment that the right hon. Lady should make an announcement about private patients when negotiations are taking place with the medical profession.
§ 2.45 p.m.
§ Mr. Tom Litterick (Birmingham, Selly Oak)
One experience that I seem to share with most new Members is that I have been greeted with an avalanche of mail. It comes tumbling through the letter box day after day. For a while, it was bewildering. One noticeable feature is that the bulk of the mail concerns housing. It seems as though the election of a new Member raises some small hope in the minds of many people that somehow the new man might just be able to do something for them. What we read in the letters are the chronicles of despair of people who have been waiting and waiting. They are not waiting for somebody to transform their lives by magic; they are simply waiting to be given a decent house.
As a result of the things that I have been told in the letters that I have received during the past two weeks and because of my experience of several years as a councillor, I welcome the emphasis placed in the Gracious Speech on the commitment to raise the housing supply. I welcome the commitment to provide a sufficient supply by the various different means described.
617 I am not too much concerned with the means by which houses are built. I know that what matters is the provision of houses, whether they are to be bought or rented, or whether old houses are to be made habitable. Experience tells of the devastating effects on families of bad housing. I am sure that all hon. Members will agree that the family is the basic unit of our community and that the vitality and health of the family is the basis of the health and vitality of the community.
It must be accepted that wretched housing conditions smash families. Such conditions cause physical and mental damage. That applies particularly to the mothers of families living in bad conditions. Bad conditions lead to low educational performance by the children and cause a vicious cycle of destruction. The children of families who are badly housed fare badly as a consequence. In turn they end up at the bottom of somebody's wages scale. Later they arrive at the bottom of somebody's housing list. That means an endless wait. Again they start the familiar pattern of life that their parents had to endure. That means demoralisation. Very often someone in public life who has never waited on a housing list and who has never had to worry about how much a house costs will say that such people need to be remoralised. It is hollow and cruel hypocrisy to say such things to people in that situation.
In my political activities I have visited homes which seem like shell-holes in a battlefield. The people living in these places were keeping their heads down and hoping that society would not lob yet another deadly missile in their direction. Their attitude was, "For heaven's sake go away. Do not notice us." Their experience of the system has been disaster after disaster, indifference and hopelessness.
It is not difficult to understand why such people sometimes say to parliamentary candidates, "Why should we vote for you or for any of you?" They are not interested in the Common Market or somebody's notion of freedom or liberty. They are not much interested in things called capitalism and Socialism. That is because they are at the dirty and sharp end of the system. They know what our cruel system can do to people 618 who are not in a position to defend themselves. For them it is not next week, next month or next year, but now. They are concerned with the cost of today's groceries, this week's rent and whether the next rainstorm will mean yet another wet night in a bedroom. What is the council going to do about their street? What will the landlord do to them next? And so on.
These are not perhaps thought of as great issues, but nevertheless they are plain, awful, devastating things which we have to translate into politics, into the policies of what I would call "satisfaction"—the satisfaction of people who are in need. The central element in any family's standard of life is the kind of house it lives in. As a nation, our housing performance is truly deplorable. We spend far less as a proportion of our national expenditure on housing than we do on defence. The strange and sad fact is that if anyone suggests that we cut defence expenditure there is great noise in the land, but one can cut housing expenditure at a stroke—indeed, stroke after stroke—without any such protest. That is the record of house building in the 1970s.
There was a time when we managed to build more than 400,000 houses in one year. Last year, we built fewer than 300.000. Yet perhaps even that was an achievement because, clearly, someone made deliberate decisions to cut down on the construction industry and the building of houses. That set of decisions was a crime against the British people.
I represent the constituency of Selly Oak in the city of Birmingham. Birmingham has a housing waiting list of 31,000 families. The city administration thinks that it might be able to complete 2,000 houses this year. The phrase is not original, but I suggest that this is truly the arithmetic of despair. Such arithmetic shows that the waiting list will get longer and despair more profound. The right hon. Member for Leeds, North-East (Sir K. Joseph) will be perhaps even more frantically convinced that more people need to be remoralised.
The proposals in the Gracious Speech for dealing with the housing situation are those dictated by common sense, land, money and the building industry itself. I do not think that anyone would argue against the proposition that a sufficiency 619 of land needs to be available on which housing can be placed. But I offer, with all humility, the suggestion that Her Majesty's Government should move quickly to ensure that a sufficient supply of land is made available and should not make concessions to those people who already possess property rights in land simply because, in the Government's view, it might be politically dangerous not to do so or might cause some other difficulty. The needs of people who do not have housing should be paramount over the needs of those who possess land. The Government should be prepared to be ruthless in this respect.
In the provision of the necessary money, the idea of a stabilisation fund commends itself to me—the idea that housing finance, or at least the interest rates on money available for housing, should be insulated from the commercial market. There are dangers here of which I trust the Government will be well aware.
But I believe that the most important element in the solution to the housing problem is the state of the British building industry. It is one of our most inefficient industries. This I believe, is not due SO much to incompetence among the people in managerial positions in the industry as to the industry's unfortunate structure. It is characterised by small operating units which, because of their very smallness and the cyclical nature of the industry, suffer desperately from financial instability. Thus, as and when the weather changes, they die like mayflies and the industry suffers accordingly.
One of the long-term effects has been the deplorable failure of training in the industry, so that it has been bled over the last few years, or perhaps even longer, of its skilled and trained people. No industry can be made to recover from such a situation overnight, so I welcome the proposals to revitalise the training system within the industry and, more important, the more general proposals about intervention through the National Enterprise Board in industries which, in the Government's view, need the assistance of the commmunity. I assure the Government that the building industry is in dire need of help from the Government and that the community is in dire need of an energetic and efficient building industry.
620 Much has been made by right hon. and hon. Members on both sides of the House about the great economic crisis. There is, of course, an economic crisis which affects the so-called Western or free world almost universally. But far too little is made of the great crises which occur every day in the lives of ordinary people. I have referred to one dimension of crisis in the lives of working people—housing. There is for ordinary people a crisis every day—there is absolutely no end to crises. Yet one does not hear Cabinet Ministers or would-be Cabinet Ministers falling off hovercraft or jumping up and down on the spot talking about the crisis of "Mr. Nobody" who lives in a dingy street in a miserable excuse for a house with virtually no chance of a decent place in which he can live. Yet his is the real crisis, because he is the nation.
I put it in this way because another aspect of the crisis propaganda—and it is propaganda—is that there are people in the world whose confidence is important to us. It is not difficult to understand. It is the confidence of a bank president here, a company chairman there—and "here" and "there", I remind the House, may be New York or Hamburg or even Yokohama. The poor man who lives in Selly Oak is not mentioned in this context. Yet it is his confidence that truly matters. He should feel satisfied that he lives in a country which cares about his confidence and rather less about the confidence of those far-away people in remote institutions in New York, Hamburg or Yokohama but whose confidence is apparently so desperately important to so many people in public life.
There is a grave misplacing of priorities here in the minds of so many public people. The confidence of such persons is of no importance at all. When the argument about confidence is advanced, what is being said in effect is that the priorities of the man in New York or Hamburg are more important than the priorities of the man in Selly Oak. I beg to differ. I hope that during my parliamentary life I shall go on consistently opposing that view.
The priorities of the man in Selly Oak are and should always be paramount. Let the Government concentrate on that. 621 Let them concentrate on the confidence of the average family in Selly Oak and less on the confidence of these other groups elsewhere. If they do so, Her Majesty's Government will enjoy not only a successful tenure of office in this Parliament but success at the next election, and the next and the next.
§ 2.59 p.m.
§ Mr. Timothy Raison (Aylesbury)
I rise slightly earlier than I had expected, which we may well describe as a tribute to Mr. Speaker who, at the beginning of the debate, exhorted hon. Members to reasonable brevity.
We have covered a great deal of ground in today's debate, which has been notable for three maiden speeches. The first came from the hon. Member for Truro (Mr. Penhaligon). As both succeeding speakers said, he has a very romantic name. It struck me that his name might well be that of one of the Knights of the Round Table. However, I suspect that, unlike most of the Knights of the Round Table, he came to his present position from being a sub-postmaster, and I think that many of that rather absurd body would have benefited by the sort of experience that he has had. I think that the House was impressed by the way in which he showed good earthy common sense and an ability to judge what was going on in the lives of his constituents.
We then heard from the hon. Member for Gloucestershire, West (Mr. Watkinson), who spoke with normal pride of his constituency and who pointed out that he followed Charles Loughlin, who was certainly not a Member to hide his light under a bushel He made his mark, and I have no doubt that the new hon. Member will do the same. He spoke principally on the subject that has formed a kind of sub-plot of today's debate, and I shall return to that later. The House will agree that he spoke in a clear and straightforward style that was attractive and effective.
We also had a maiden speech from the hon. Member for Woolwich, East (Mr. Cartwright). He has succeeded Chris Mayhew, who did not hide his light under a bushel and who was very much one of the striking characters of the House, even though he was not always as assiduous in attending it as some others. He was nevertheless a notable personality 622 and he left his mark on politics. I think that his successor showed from his clear grasp, confident style and knowledge-ability that he, too, will leave his mark on politics. He stressed that government was about priorities and that it was no good looking at social problems in this present climate without recognising that. That shows that he is not merely a man of passion and concern for his constituents but has common sense.
The debate has ranged very much wider than my remit, which is to speak about the health and social services side of social policy. There was a very clear sub-plot in that several hon. Members have spoken about housing. The hon. Member for Birmingham, Selly Oak (Mr. Litterick), in what was to me a maiden speech, although not, I gather, a maiden speech proper, spoke very eloquently about housing, as did the hon. Member for Dartford (Mr. Irving) and the hon. and learned Member for Warrington (Mr. Williams). Without commenting further, I should like to say that it is absolutely proper that hon. Members should have spoken in this debate about housing, for we all know from constituency experience that housing problems crop up most often in our surgeries and interview rooms and constitute a large proportion of constituents' worries.
Other speakers referred to subjects outside health and social services. My hon. Friend the Member for Bournemouth, East (Mr. Cordle) spoke about law and order, and the hon. Lady the Member for Northampton, North (Mrs. Colquhoun) spoke about shoes. My hon. Friend the Member for Harwich (Mr. Ridsdale) spoke about the present deep problems of rates. All those were valuable contributions.
However, I want now to talk particularly about the problems of health and social security. A number of contributions were made on this subject that were worth careful consideration. My hon. Friend the Member for Canterbury (Mr. Crouch) demonstrated his great knowledge of this matter, and I shall return to what he said. The hon. Lady the Member for Wolverhampton, North-East (Mrs. Short) spoke very forcefully and, as usual. I found her speech a mixture of prejudice and insight. I shall not discuss her prejudices, which were familiar debating grounds, but what she had to 623 say about privacy was of genuine interest to the House as a whole.
My hon. Friends the Members for Wolverhampton, South-West (Mr. Budgen) and for Tonbridge and Mailing (Mr. Stanley) also had worthwhile contributions to make. My hon. Friend the Member for Tonbridge and Mailing referred to the need to indicate the likely level of benefits in occupational pension schemes and to provide more information about the way in which the money in such schemes was invested. Those were valid points that were worth making. I thought that the hon. Lady the Member for Northampton, North had some very worthwhile points to make on behalf of the male sex.
One question which I wish to put to the Minister of State, and which was raised by the hon. Lady the Member for Wolverhampton, North-East is about family planning. I will not follow the Secretary of State in her long discussion of a certain recent and rather controversial speech, but I think that it is reasonable to ask the Minister of State whether he can give the House a little more information as to what exactly is happening on the provision of family planning services by general practitioners. This is a matter which has been in dispute for some time, but we need now to know how the position stands.
I turn to the Gracious Speech more specifically and will concentrate on some of the different topics on which we want to press the Government. One of the ingredients in the speech which we welcome is the decision to legislate in the wake of the Houghton Report on Adoption. As has been made clear, we on this side support the principles that underlie that report and were very sympathetic to a trial run for a Bill of this kind, that was foreshadowed in the Private Member's Bill which the Minister of State himself put forward.
We accept the broad principles of what we take to be the likely approach. We are very much aware of the implications of the Maria Colwell case and other such cases.
Although we accept this broad approach, we shall give the Bill, as I think is entirely proper, very close scrutiny. History shows that there is 624 sometimes a danger that when one legislates in the wake of traumatic happenings of the kind we have recently seen, one may be too swayed by these happenings and not give quite enough attention to the overall picture. I expect that we shall ask many questions in Committee and in particular try to ensure that, in the very understandable concern which exists about the rights of the child, the fact that parents also can have rights will not be wholly forgotten.
Another important element in the Gracious Speech is the question how to bring about greater democracy in the National Health Service. Can the Minister of State give us any indication how the consultations which have been taking place in the wake of the consultative document have been going and what kind of time scale he has in mind? There are a number of points about this on which we want to be satisfied. One of them was raised by my hon. Friend the Member for Canterbury.
The first point must be the question of the increased size of area health authorities under the Government's scheme. I accept that the Government have indicated that they are not unaware of the problem. They said in the consultative document that there comes a point, which seems to be somewhat above 30, when area health authorities are getting too large. Even so, I should like the Minister of State to give us some reassurance on the general notion that it seems right to allow these bodies to go up in size from the present normal level of 15 to 19 to something that is at least 25 and possibly 30 or more.
I, like my hon. Friend the Member for Canterbury, query whether we shall get effective management from bodies of that size. It is often grumbled that the Cabinet is too large at 20 or 23, or whatever it is. but there are perhaps reasons why that body has to be of that size. If it is difficult to manage the country with a body of that size, it must be all the more difficult to manage what is, after all, a very much smaller concern—that of the health of a particular area. It is questionable whether such bodies should be allowed to expand. I know that they have not been in existence long and that it is hard to pass judgment on their effectiveness or otherwise, but this is a criticism of the Government's proposals 625 which should be taken seriously and about which I hope the Minister of State will do something.
I also question whether having more local authority members on the committees means more democracy, or more accountability, which I take to be an important part of democracy. They will not have been elected for this purpose. Moreover, they will not report back to the bodies from which they come—or will they? As I read the proposals, they would not take part in debates in their local authorities on the management of the area health authority. I therefore doubt whether we can say with truth that they will be accountable. We are told that once these elected representatives have been put on the area health authorities it is no longer their job to represent local authority interests. They will be told, again understandably, to act as though they are part of the management team.
It is therefore questionable whether the proposal genuinely extends local democracy. We must recognise the serious point made by my hon. Friend the Member for Canterbury that the local authority people who will serve on these bodies will almost certainly already be heavily burdened. We know what happens when local authorities nominate people to represent them on hospital management committees and other bodies. The clerk to the authority says, "There is a vacancy on this body. Does anyone feel like taking it on?" Somebody then asks, "What time of day does it meet—morning, afternoon or evening?", and the appointment depends on who is available.
I do not wish to exaggerate the point, but I hope that it will be recognised that there is something in it. People who serve on local authorities have an enormous amount of work to do, and the ablest of them have the most to do. The risk of the Government's poposal is that the people local authorities provide for the area bodies are likely to be the least able. In other words, we may see the stage army marching backwards and forwards and sideways without being of benefit to the people who matter—the providers and consumers of the service.
I wish to put to the Minister of State another point which has not been widely discussed but which I believe is serious. The Secretary of State refers in paragraph 626 23 of the consultative document to certain decisions which have already been taken and she makes it clear that they are not matters for consultation or discussion. Nevertheless, I hope that she will forgive me if I seek to discuss them now. Paragraph 23(e), referring to hospital closures, states:At present all closures are subject to specific authorisation by the Secretary of State. In future where the community health council accepts the proposed closure this authorisation will not be required".I can understand the reasoning behind that. I understand the desire to get on with things and the necessity that a long time should not elapse before implementing decisions. But the effect of what is said in paragraph 23 may be that hon Members will have no chance effectively to raise with the Government the question of hospital closures.
Under the present procedure by which the Secretary of State authorises a closure we in Parliament have a chance to take up the matter. But under the Government's proposal all that is required is for the area authority to put forward a recommendation, and, if it can persuade the CHC that the recommendation is sensible, it will be implemented and, by implication, Parliament will not be allowed its say.
I hope that the Minister of State will deal with that point, because one comment which must be made about democracy in the National Health Service is that it is absolutely vital that Parliament should have the right to scrutinise and question every aspect of NHS activity. The only democratic accountability in the National Health Service is to Parliament through the Secretary of State. No one can argue whether that is the right system, but it is the system that we have, and anything that takes away from the power of Members of Parliament to question any aspect of the service is very damaging. I hope that we may have reassurance on the point or that the Government will be prepared, since they state that they are adamant about it, at least to look at the matter again.
I turn to another important subject— the disabled. We have had good speeches on this subject today by my hon. Friends the Members for Shoreham (Mr. Luce) and for Tonbridge and Malling. They have kept up what seems to have been a consistently high standard of discussion 627 in this House on the problems of the disabled.
We broadly accept the Government's proposals on disablement income as realistic and sensible. This may be partly due to the fact that they are similar to the proposals that we put forward shortly before the election, even to nominating the figure of £6 a week as the appropriate size of the non-contributory pension. We believe that what the Government have put forward is sensible. I was glad to note that the Government's estimates of the cost were somewhat lower than those with which we came out.
We welcome the £6 a week invalidity care allowance and the extension of £2 a week so-called pocket money for people of working age in psychiatric hospitals. We believe that the Government have taken the right steps.
The only thing that we regret is that the Government have not come up with any proposals for disabled housewives. However, we note that they recognise that this matter ought to be tackled.
On the mobility side, I believe that the Government have come up with sensible proposals as a whole. In principle, I think that the idea of the £4-a-week mobility allowance is very attractive. It is ingenious, and I congratulate the Government and no doubt, in particular, the Minister with responsibility for the disabled, on bringing it forward. However, I should like to ask some questions about it.
First. I should like some assurance or more detail on whether the proposed £4 a week will be sufficient to buy and run a car. Will it provide an effective alternative to the present vehicle? I realise that the Government say that it is possible to give advice to help people in making the best use of this money, but, as this is an important proposal, it would be helpful, either now or at some fairly early stage, to have more information on it.
Secondly, I should like some reassurance whether these proposals will enable us to replace the tricycles with cars quickly enough. Some groups, who find the tricycles more satisfactory, want to retain them. It is right that those people should have the chance to do so. Nevertheless, I think we are all agreed that in principle Lady Sharp is right and that there is a good argument for switching 628 from the tricycle to the car. Inevitably, I think that we have been worried by some of the additional recent evidence on the safety of three-wheel vehicles. Therefore, it seems important that the switch from the three-wheel vehicle to the car should be effected as quickly as possible. I should like an assurance that this matter will not be held up and that it will be possible to make an early substantial start on the process of transition.
I should like to refer to another point about disability which is perhaps closer to the specific responsibility of the Minister of State. The recent discussion about the thalidomide case, amongst other things, has made us aware that we go about the business of looking after such groups in a rather piecemeal way. I think that it is necessary to try to achieve a more uniform and coherent policy. In this respect, I particularly mention the campaign—to my mind, the persuasive campaign—being mounted at the moment for compensation for vaccine-damaged children. This seems to be part of the same picture and I hope that Government policy will move fairly rapidly in producing a coherent answer.
I wish to turn to the difficult and deep problem of financing the National Health Service. We are entitled to ask the Minister of State to give a fuller glimpse of what the Government intend to do about this admittedly very difficult problem. The Queen's Speech says:Within available resources, My Government will continue to maintain and improve the National Health Service…That is an unexceptionable statement but it needs to be filled out.
With regard to resources, we must hear more about where finance is coming from. The Government talk reasonably enough about "available resources", but all the indications are that there is tremendous pressure to increase those available resources. Indeed, almost everything that happens constitutes a demand for more resources. The Government must say where they believe the additional resources will come from. Are they to come entirely from taxation or from other forms of revenue charges or whatever it may be? Have the Government changed their view on charges? My right hon. Friend the Member for Surrey, East (Sir G. Howe) has already made the point that there is nothing in the Queen's 629 Speech about the abolition of prescription charges. I know that this has always been a tenet of Socialist faith, but I believe that at present it is pie in the sky.
Will the Minister say how he thinks the additional demands on the health service are to be financed? Furthermore, will he comment on whether there will be additional economies in the service? I know that this notion will arouse horror among people who regard economies as unthinkable, but a recent leading article in the British Medical Journal deals specifically with possible economies and has some sharp words to say to the medical profession and those who work in hospitals. We are entitled to some comment from the Minister on these aspects.
Will the Minister give a little more information as to what is behind the phrase in the Queen's Speech about maintaining and improving the health service? The great problem in financial terms is that people who work in the health service understandably demand that they should be better paid than they have been in the past. We supported the right hon. Lady's actions over the Halsbury Report. We accept that more money will have to be spent on paying people who work in the service. But we must ask the Government to give their view on what this means in terms of capital and running costs.
What are the prospects in the next year or two of meeting the enormous needs that exist? My hon. Friend the Member for Harwich talked about the great needs in North-East Essex, and I could talk at length of needs in Buckinghamshire, due to expansion of population, and of the intolerable problems at Stoke Mandeville and Milton Keynes. I am sure that many other hon. Members could make the same sort of plea. There is a desperate need for more facilities. The Government must say whether these facilities will be provided—or that they cannot be provided. It is intolerable for the medical profession, for the administrators and everybody else to be left in such an uncertain position about what they can expect in future.
The problem of finance is grave. A report has been submitted on this topic today to the Prime Minister, and only a few days ago we had a report from the Royal Colleges. We must face the fact 630 that one of the most serious jobs facing the present Government is how they will respond to these reports. We cannot expect the Government to answer everything, but we can ask for some lifting of the veil.
Everything I have said about health applies even more to community services and social work. Hon. Members on both sides of the House know that the position in the community services and the social work services is even more desperate than that in the health service. There has been a justifiable policy of trying to switch people from institutions to the community; we have tried to take them out of the long-stay hospitals and to put them in hostels of one form or other. However, when those people have gone back to the community, we have not been able to provide the care they desperately need. In some ways this policy has led to a worse position than that which existed before the policy was embarked upon.
I am not making a party political point, but I am making an extremely important point and I think that the country is entitled to ask from the Government what hope they can see for the provision of effective community services, domiciliary services, and so on, in the next few years. There could be no higher priority for any money which may become available than trying to deal with these matters. I hope that we shall tighten up the way in which we look at the social services on the ground. The case which has been advanced for a social services inspectorate or a combined social services and health inspectorate has a lot of force behind it and I hope the Government will consider it carefully.
We recognise the extreme difficulties facing the social services today. My hon. Friend the Member for Wolverhampton, South-West (Mr. Budgen) stressed the economic background to it very effectively. I would say to the Minister of State and to the Secretary of State, as did my right hon. and learned Friend the Member for Surrey, East, that we shall help as constructively as we can whenever the Government respond to these challenges with measures which we deem to be sensible. We supported them on nurses' pay. We supported them in general over the disabled. We support 631 the increased retirement pensions. Equally, we shall not make a job for ourselves of asking for more for everybody.
It would be hypocritical if we as a party devoted our time to harassing the Government because they have not provided this, that or the other desirable improvement. We have to recognise the economic background. But I feel bound to say that when the Government make mistakes we shall criticise them, and we believe that the Government have already, in their previous incarnation before the election or in their promises, made a number of serious mistakes. The action by the Secretary of State over the whole business of a second pension was a very serious mistake indeed. It would have been far better to implement our scheme—to improve on it, by all means —and to build on it than to scrap it.
I was glad to hear the tone with which my right hon. and learned Friend approached this subject today. It is desirable that the House should have a chance to think about these matters seriously, and I hope that the right hon. Lady will take seriously my right hon. and learned Friend's proposal for a pre-legislation committee. We believe that the Government have made a great mistake—indeed, a vindictive mistake—over the contributions of the self-employed. One category who will be hit very hard are the doctors themselves. We believe that there is a grave long-term folly in the rejection of the tax credit scheme, which I am sure in the long run has a tremendous amount to offer to the social welfare of this country.
The Government are open to some criticism for the confusion which they have shown on the subject of National Health Service finance, on their erratic approach to the question of charges and so on. Perhaps worst of all, the Secretary of State has by her actions allowed bitterness to grow up in the health service between one section and another. She has either shown weakness or allowed management in the health service to show weakness in the face of union pressures in certain respects which have been very damaging and which in the long run may prove to be still more serious.
I intend, with my colleagues, to press these criticisms very hard, but we shall do 632 so in a constructive way because fundamentally we know that the problems are enormous and that it will require the skill and talent of the whole of this House if we are to get anywhere near to resolving them.
§ 3.29 p.m.
§ The Minister of State, Department of Health and Social Security (Dr. David Owen)
We have had an extremely interesting debate, and I take pleasure in beginning my speech by congratulating the four hon. Members who made maiden speeches. First, I refer to my three hon. Friends. My hon. Friend the Member for Gloucestershire, West (Mr. Watkinson) has a special welcome from me. Labour Members from the West Country, unfortunately, are too few, and he is a welcome addition to the House. We all remember his predecessor, Charlie Loughlin, with great affection.
Unfortunately, I missed the speech of my hon. Friend the Member for Woolwich, East (Mr. Cartwright), but my right hon. Friend tells me that it was most impressive. My hon. Friend the Member for Birmingham, Selly Oak (Mr. Litterick) made a speech of great eloquence, which I am pleased to say I heard.
I think it significant that all three maiden speakers from this side chose housing as their main subject of concern. In this debate, which is predominantly about social policy, there can, I think, be no disagreement among us that housing is of fundamental importance to any serious attack on poverty in this country.
Although I shall speak in a few minutes about social security benefits and about the health service, I am under no illusion that we can expect to eradicate poverty in Britain when, as my hon. Friend the Member for Selly Oak said, the housing waiting list in Birmingham totals 31,000 families, when in my constituency there is a substantial housing list, and when so many other hon. Members can say much the same. One cannot put medicine into people and then send them back—perhaps four, five or six to a room—to the gross over-crowding which now exists. It is no good even increasing benefits when people go back to grossly inadequate housing conditions.
When we debate the priorities of the health service, we must never forget the 633 problems which people have and the difficult economic choices which face the country today. I am sure that the general practitioner in Salford, if he were asked what his priorities were, would put housing high on the list. I imagine that the casualty officer seeing the child late at night and deciding whether to admit that child into hospital rightly takes a great deal of notice of the housing conditions to which the child would go back—every bit as much as of the health and purely clinical indications. Speaking for the Department of Health and Social Security, therefore, I assure my hon. Friends that we attach every bit as much importance as they do to housing, which is rightly one of the main priorities of the present Government.
Next, I welcome the hon. Member for Truro (Mr. Penhaligon). It is appropriate, perhaps, that a Devonian should welcome a maiden speech by a Cornishman. It is nice to hear the authentic Cornish dialect again in the House. The hon. Gentleman made a moving speech, and I sensed that he is on the left of his party. We have been a little worried about some of the ramifications of Liberal Party policy in recent years, and it is nice to think that on some issues anyhow we shall have an ally.
I turn to two social security matters to which the right hon. and learned Member for Surrey, East (Sir G. Howe) referred. First, I take the question of the contributions which will be required from next April to pay for the £10 and £16 pensions linked to earnings. The Social Security Amendment Bill which provides for these contributions is, as the House knows, due to have its Second Reading next Wednesday. We can then take up in more detail the points which the right hon. and learned Gentleman raised. Perhaps I may simply say now that we are not introducing any new principle into the treatment of the self-employed. The principles of our Bill are exactly the same as those in the 1973 Social Security Act of the Conservative Government. The only difference is that, because they are to receive higher benefits, the self-employed, like the employed, are being asked to pay a higher contribution. We shall listen with interest to hear how the right hon. and learned Gentleman proposes that the benefits for 634 the self-employed at their new level should be financed.
The right hon. and learned Gentleman responded to my right hon. Friend's wish to establish a pensions structure which would no longer be subject to constant chopping and changing—a theme reiterated by the hon. Member for Aylesbury (Mr. Raison). All of us see the need for a structure which will provide a firm basis for development over many years to come.
The right hon. and learned Gentleman said very fairly that, while the Government's scheme includes elements from previous schemes put forward by each of the main parties when in office, there are still points on our scheme which exercise him. He indicated that he feels a need for further evidence from outside organisations to be brought to bear—and I believe that he has organisations in the occupational pensions field particularly in mind. He suggested a particular mechanism for doing this, namely the appointment of a Select Committee immediately after Second Reading. My right hon. Friend has asked me to say that she is very willing to consider with her right hon. Friends any suggestions put to her on the most effective way of proceeding, but, frankly, she is not satisfied that in this instance we should gain advantage from departing from the normal processes of Parliamentary consideration of a Bill.
The Opposition have, I understand, indicated a particular concern about the place of occupational schemes in the new arrangements. My right hon. Friend said something on this earlier in the debate. She explained that the Government Actuary will—at her request—be making available a memorandum setting out the criteria and technical basis on which he will be assessing the actuarial elements relevant to the contracting out terms, before the Government take their decision. We do not believe that the most satisfactory way of proceeding on points such as this would be by way of a Select Committee. But what my right hon. Friend suggests is this—that when the right hon. and learned Gentleman has considered further with his hon. Friends, he should let us know on which particular points they see the need for further preliminary exploration. We shall 635 then, in our turn, consider how best we could help.
We are most anxious that all the relevant facts and considerations should be before the House when these difficult and important matters come to be discussed. I hope that the right hon. and learned Gentleman will find this a helpful response consistent with the spirit in which he put forward his proposal, and in which my right hon. Friend couched her original speech.
The right hon. and learned Gentleman spent the major portion of his speech discussing the Children and Young Persons Act. The publicly expressed anxiety about the workings of the Act, particularly by magistrates and by the police, is fully shared by the Government, by the Department of Health and Social Security and by all the social service departments which now have much of the responsibility for the community homes.
If ever an Act had to be introduced in difficult circumstances, this is it. It became law in 1969 and was followed by the Seebohm reorganisation of the social services departments. It then had to cope with the local government reorganisation and it was, in my view, given inadequate financial resources throughout that period. In recent times, and particularly this year, it has had to cope with the very staggering rise in the numbers of juvenile delinquents coming before the courts.
My right hon. Friend the Home Secretary has already explained that the Government are prepared to look at the Act, but I ask the House not to forget the philosophy which lies behind the Act or the responsibility of successive Governments to put resources into this area. We hear a great deal about law and order, but there can be few more important areas in which we should try to live up to our social responsibilities than juvenile delinquency. If we make mistakes in that area we make mistakes which may dog us for a lifetime and which are frequently repeated in a cycle through future generations.
We attach great importance to the Act and to the criticisms of its working. The right hon. and learned Gentleman spoke about the gravity of the situation and said that we ignored it at our peril. He was, however, unwise to make it a politi- 636 cal point when he accused us of not manifesting a proper sense of priorities. Few issues have taken more of my time since I came into the Department in March than the working of the Children and Young Persons Act. I have had two meetings with the regional planning committees which are responsible in this area, and we have discussed the problem of resources.
It was the Conservative Party which in December cut back into the social services and the health services. It was the Conservative Party which, if it had wished to amend the Act, could have done so at any time when it was in Government. Too often we will the end without providing the means and then make scapegoats of the people who have to implement the measure.
My right hon. Friend the Chancellor of the Exchequer has already announced financial help to the construction industry by increasing the capital expenditure budget by £25 million for the health and social services. This allows us to increase loan sanctions to local authorities over the next few months for social services.
We have a difficult choice: do we spread the money over the whole of the social services budget or do we concentrate on these loan sanctions? We believe that we have manifested a proper sense of priorities. We have decided to give highest priority to providing additional resources for community homes with special emphasis on secure accommodation. This will in effect restore the £1.5 million cuts from the community home programme made in December 1973. That is our response to the right hon. Gentleman on that point. I hope that when the opportunity arises he will withdrawn his accusation about a lack of a proper sense of priorities.
I warn the House that if a switch is made in priorities the price has to be paid somewhere else. I hope that the special pleading which has tended to dominate this particular area will stop.
For our part, we shall put before the House and the country the facts, the demands and the money available. We do not necessarily say that we shall make all the right choices. But we say that it is no use failing to recognise that if resources are directed towards one place they are often being taken away from somewhere else.
637 Many issues have been raised in today's debate and I wish to deal with a few of those relating to the National Health Service. The hon. Member for Canterbury (Mr. Crouch) referred to the consultative paper relating to democracy in the National Health Service. It was not a White Paper. It was deliberately put forward for consultation. I listened to the hon. Gentleman with great attention because he understands these problems, but to describe the proposal to have a third of the membership of area and regional health authorities composed of local authority councillors and to talk about hordes of constipated councillors —I mean conscripted councillors; I have a doctor's handwriting—was a little savage.
A balance has to be struck. We are all well aware of the problems of the National Health Service. No one should be more aware of these problems than the Opposition who gave us this great reorganised National Health Service with all its bureaucratic difficulties. We recognise that the changes we propose must be introduced cautiously, bearing in mind at all times that nothing we do must damage the care of patients. That will be our dominating theme and that is why we say we shall consult.
The hon. Member for Canterbury spoke about the work of the community health councils and referred to a case in Greenwich in which one of these councils had been involved in consultations regarding a hospital closure. We have been asked what has been the response to the idea of a democracy in the NHS. One pays one's money and takes one's choice. There is an extraordinary variety of views on this matter. Thus we must be prepared to consult for a little longer and take some time before proceeding with our proposals—
§ Mr. Raison
On the point we are now considering, the document which has been mentioned states specifically that it is not a matter for consultation but that the decision has been made.
§ Dr. Owen
The hon. Member for Canterbury pointed out one case of the successful implementation of consultation involving a community health council. If representations are made to us, only a foolish Government would say that they had totally closed their minds on the 638 matter. Consultation is now operating and we are able to judge the situation in the light of experience. I should be interested to hear other people's views, but it is no use mouthing devolution without accepting all the consequences of it. It is a constant dilemma, particularly in the House, that people talk about democracy and devolving power but when a decision is made by another body they want a further appeal court.
We have a problem concerning the number of detailed decisions being referred up under the present reorganised structure of the National Health Service, and this is causing my right hon. Friends and myself considerable concern. Detailed decision making is referred up from area to region, or from region to the Department, whereas all the people involved in the National Health Service want to see greater devolution.
We believe that devolution becomes more acceptable if it is accompanied by democracy. We cannot talk of these two things separately. They are inextricably linked. We are not finally committed on these matters and we shall bring forward proposals. Some of these, such as those involving regulations, will need to be discussed in the House and no doubt there will be time for debate.
A number of Members asked questions about disablement, including amongst others the hon. Memer for Aylesbury. I shall draw the matters raised to the attention of my hon. Friend the Under-Secretary, who has special responsibility for the disabled, and he will write to hon. Members on points of detail.
Questions have also been raised regarding the problem of vaccine-damaged children. The Government and I have a great deal of sympathy with those concerned. It is a genuine problem. The country believes it right to have mass vaccination, which has been one of the staggering success stories of preventive medicine. But in a small number of cases there are undesirable side-effects. Society must carefully decide the consequences. The Pearson Commission is sitting to consider the whole question of civil compensation, and the Government and my Department are giving evidence to it. We shall have to await its decision before making a final decision. Our sympathy for the small number of children involved is real.
639 My hon. Friend the Member for Wolverhampton, North-East (Mrs. Short) made a most interesting speech about many elements of the National Health Service, but she spoke in considerable detail about private practice, because she is now Chairman of the Expenditure Committee and was Chairman of the subcommittee that dealt with the whole question of private practice. I was a member of the Expenditure Committee when it considered my hon. Friend's report. My hon. Friend thought that the separation of private medicine was right; she believed that when it stood on its own feet it would find that it has been carefully buttressed by the National Health Service. My hon. Friend said that the status of consultants owed a great deal to the training and experience gained within the NHS. She welcomed amenity beds, and thought that privacy should be available within the NHS. She argued for distinction awards being confined to whole-time consultants.
I shall bear in mind all those points. I do not want to go into too great detail on the progress of a working party of which I am chairman and which is still sitting, but I think that I can give the Government's view on private practice. The first thing to emphasise is that discussions with the medical profession are not purely about private practice. On taking office in March, we found a request, which had been sat on by the previous Government, to establish a joint working party to examine in depth hospital consultants' contracts. We accepted that immediately, because we believed that there were genuine grievances that needed to be corrected.
We recognise that in order for the NHS to function effectively over the next few years, particularly in the national climate of economic difficulty, it is necessary to restore a feeling of confidence and united purpose throughout the service, which means all groups. Private practice is only one part of the remit of the joint working party, but it is an important part. It raises strong feelings. I ask hon. Members, particularly Conservative Members, to recognise that there are those feelings within the NHS. That is the main reason why the matter has now come to the forefront—because the division of opinion on it is very strong within the NHS.
640 The present controversy over private practice within the NHS stems from the controversial rôle of private medicine within society. It is not a new controversy. The Teaching Hospitals Association said in evidence to the Expenditure Committee:Private practice, when conducted in hospitals, has always been a matter for controversy ever since the voluntary hospitals first began to provide beds for paying patients and so if it continues, it will certainly and unavoidably remain.The Government believe that by taking a whole series of interrelated, sensible steps—not doctrinaire or dogmatic—the controversy within the NHS can be greatly eased. That is the spirit in which we are conducting our discussions in the joint working party. We are trying to reduce the controversy surrounding private practice within the NHS hospitals and to improve the overall effectiveness of the NHS, to which we on the this side of the House feel deeply committed. I hope that the medical profession will recognise the spirit in which we are doing this.
When they were in Government and faced similar controversial political issues, Conservative Members did not carry out the same amount of prior consultation and did not spend the same time in trying to reach agreements. But I must tell the medical profession that in the last analysis the decisions will have to be made by the Government, a Government elected with a clear view on the issue in two elections.
The essential issue with which I should deal is the financing of the NHS. This raises major problems, and I thought that the hon. Member for Aylesbury accepted that as the position. He said that he had supported our policy of trying to right the considerable inequalities of pay in relation to other comparable professions right across the range within the National Health Service.
When my right hon. Friend and I first drew attention to the fact that we intended to put people before buildings, we warned the House that there were certain consequences which would have to follow that decision. We warned that if that were to be our top priority, it would be harder to restore the capital building programme.
641 As the hon. Member for Aylesbury said, we also had the problem of dealing with inflation. I do not think that it is widely enough recognised how much we are doing to protect the National Health Service from inflation. When we came into office in March we recognised that the existing revenue allocations for 1974–75 would prove inadequate in view of the way in which prices had moved so far and in view of the more up-to-date calculations of the level of spending on what were previously the local authority health services.
To meet the situation we decided to provide for a further £40 million in England for revenue expenditure in the present financial year. We cannot foresee the future movements of prices, but it was the Government's general policy to restrain inflationary pressure. I think that we have had some limited success. Subject to the requirements of general economic policy, it has been our intention to provide additional allocations at the appropriate time.
In the light of experience of price increases, regional health authorities were each given an early indication through their treasurers of the broad effect of the additional £40 million on their revenue allocations. Details of the revised allocations were notified to the regions on 12th September under two heads. First, they were notified of their share of the £12 million towards the cost of formal local authority health services, together with a further £1 million towards the cost of family planning services. Much has been said about providing additional money for family planning, and a further £1 million has been provided.
The authorities were also notified of regional allocations to meet the cost of increases in the price of goods and services up to about the end of May 1974. More recently, on 21st October, letters were sent to the regional treasurers informing them that a further £14.4 million was being provided to meet increases in prices up to and including August 1974, to be distributed in the same proportions as the original shares of the £28 million. Thus the share of the £14.4 million available to the regions will be known pretty closely. Formal letters notifying the precise change in allocations, including the effect of a further £2.7 million for 642 price increases in September, will be sent out shortly.
That is a considerable financial commitment, in addition to the increase announced by the Chancellor of the Exchequer to help the construction industry, which will help the capital programme and maintenance. I believe that these are significant steps coupled with matters such as the Halsbury award to nurses. They represent substantial amounts of money for the continuing Halsbury review of the professions supplementary to medicine—namely, some parts of the scientific side, the technicians, the pharmacists, the regional works officers. They also provide for some of the administrative increases as a result of reorganisation.
These matters have led to a substantial increase in the pay bill. When Mr. Robert Maxwell for McKinsey's considered international comparisons with the National Health Service he drew attention to a number of matters which allow us to provide a good National Health Service in comparison with other countries while spending a lower proportion of our gross national product. One reason is that it is a national service and considerable economies in resource allocation are possible as a consequence. Another reason is that we do not pay the people who work in the NHS anywhere near enough in comparison with other services. That situation will change.
We have now before us an interesting document published in today's British Medical Journal which was sent to us by the Royal Colleges and another document supplied by the British Medical Association and the British Dental Association. It comes as a result of their conversations with the Prime Minister. Many of their figures—for example, the £900 million—are based on international comparisons. Before this becomes a rallying cry we shall seriously consider these issues with them. We welcome the opportunity to undertake detailed discussions.
It is very important that we should be careful not to draw too simplistic conclusions from international comparison. A great many things save us in the National Health Service. For example, we negotiate the prices paid for drugs and have generally lower prices than in other countries. I hope that we shall be able 643 to do more to reduce our drugs bill in the next months and years. We negotiate the mark-up that the chemist gets for dispensing. We have a planned hospital system. There are many factors, but perhaps the most important—this relates to the community services—is the frontier, which needs careful examination, between the NHS and the personal social services.
Increasingly, we see these two sectors overlapping and have been transferring responsibility for care from the NHS to the personal social services. This is particularly true of the care of the aged, the mentally ill and the mentally handicapped. Unless we look at the budgets for both these services together, we are likely to draw wrong conclusions about the strict health budget.
Many countries, for example, as part of their health services, include responsibilities of what we would describe as social services. I need hardly remind the House how rapid has been the expansion of expenditure in real terms in social services over the past few years. In real terms, the growth was 11 per cent. in 1971–72, was 17 per cent. from 1971–72 to 1972–73, and is estimated at 15 per cent. from 1972–73 to 1973–74. This must be taken into account when we look at the demands for health service expenditure, and we must increasingly develop a habit and an administrative structure which sees these two aspects as closely related entities.
There is no need to change social service departments, or the status of social workers who have been transferred to social service departments, but the need for extensive cross-fertilisation and collaboration is manifest.
We have said that we envisage proposals whereby the Hospital Advisory Service will work with our Social Work Services, which will be particularly important in relation to the large chronic hospitals where such cross-fertilisation is so crucial. We also face the problems of local authority financing in that we are putting extra burdens on local authorities, both revenue and capital, for example, in the provision of hostels for the mentally handicapped and mentally ill.
When people look at our proposals for democracy in the National Health Service, they will be led to the obvious conclusion that the links between the local 644 authorities and the NHS need to be strengthened in terms of membership as well as of the joint co-ordinating committees which exist.
No one can look forward over the next two or three years at the economic life of the country without realising that we face very difficult choices. We are rightly debating social policy. The House has today been examining our social security system and our housing system, and some hon. Members have mentioned education and its important ramifications.
Any pressure group which exists today must bear in mind that, in the few years ahead, if it pre-empts resources it will be taking them from some other section. There is a strong case for redistributing more fairly our resources. I think that the inequilities of provision for the NHS are a strong criticism of how we have run it even since 1948. There are marked inequalities in provisions not only between regions but between areas and districts. There are some indications that these inequalities are greater than those which exist between local authority social service departments.
We have had an interesting debate and I promise to reply in writing to those questions which have been raised by hon. Members but which I have been unable to cover in my speech.
Debate adjourned.—[Mr. Pavitt.]
§ Debate to be resumed upon Monday next.