HC Deb 13 October 1976 vol 917 cc559-89

Amendment made: No. 113, in page 34, line 9, column 3, before 'Section 43(2)' insert— 'In section 34(1)(i), the word "and".'.—[Mr. Ennals.]

Order for Third Reading read. [Queen's Consent, on behalf of the Crown, signified.]

Mr. Speaker

Before I call the right hon. Gentleman to move the Third Reading, may I make a brief appeal to hon. Members? We have one-and-a-quarter hours of debate on Third Reading and a number of hon. Members wish to speak. Therefore, I appeal to all Back Bench Members—and I am sure that my words will also be heard by those on the Front Benches—to recognise that other hon. Members wish to make contributions.

9.45 p.m.

Mr. Ennals

I beg to move, That the Bill be now read the Third time.

It is almost six months since the House gave a Second Reading to the Bill, and almost a year since my right hon. Friend the Member for Blackburn (Mrs. Castle) worked out with representatives of the medical and dental professions, through the intermediary of Lord Goodman, the principles by which we would give effect to our manifesto commitment to phase out private practice from the hospital service. Those were the words in our February manifesto. We stand by them. What we were prepared to discuss was the mechanism for achieving our essential aim: that is what the Goodman compromise proposals were all about. They were a compromise; a middle course. And since those proposals were drawn up I have stuck firmly to the middle of the road—though I am increasingly con- scious of the fact that the middle of the road is a place where one is liable to get hit by traffic coming both ways.

The Government have been criticised on the one hand by those who wish to see an immediate separation of private practice and, in some cases, its complete abolition and, on the other, by those who would prefer to defend a position of privilege. We have met these criticisms from the firm and unshakeable position that, as a Government, we stand by the undertaking given last December: that if the Goodman proposals proved acceptable to the profession as a basis for legislation, we would incorporate them in statute, recognising that the profession would reserve its right to try to influence Parliament's decision on the principle of phasing out. It has sought to do that, assisted by the Opposition. That is what we said we would do. That is what we have done.

I have constantly upheld the principles and spirit of the Goodman proposals but, as I said on Second Reading, I would not adopt an unbending attitude to amendments genuinely designed to improve the Bill. On that, too, the Government have kept their word.

I need hardly remind the House of the very long and careful scrutiny which the Bill received in Standing Committee D during the summer. In all, the Committee met 29 times and, as a result of its labours and the further examination the House has given yesterday and today, I think we can confidently claim that the Bill has been appreciably improved.

I suspect from his statements and hints that the right hon. Member for Wanstead and Woodford (Mr. Jenkin) has been paving his way to saying that the Bill has not had adequate attention because of the timetable motion. Had there not been a timetable motion we would not have had the opportunity we had in Committee of careful examination—we even had the final sitting left over. On Report, but for so many Second Reading speeches from Conservative Members, we should have been able to deal with far more amendments than we have dealt with today.

Before asking the House to give the Bill a Third Reading I should like briefly to remind hon. Members what the Bill seeks to do and—just as important—what it does not seek to do. It is not and never has been this Government's policy to abolish private medical practice. What we promised the electorate—in two General Elections—was that we would separate private practice from the National Health Service. We were convinced, and we remain convinced, that the co-existence of private practice and NHS practice in our hospitals would not be a peaceful co-existence. On the contrary, it had become a constant source of grievance, recrimination and sometimes serious industrial unrest, with action and counteraction by the medical profession and other health service employees. All this meant damage to the health service and risk to the lives and health of the patients it exists to serve. No responsible Government could allow such a situation to continue.

Some hon. Members opposite may think the problem could be solved by ignoring it—that is the talk they often pursue. That is their favourite policy prescription. Like their defence of privilege, it is the essence of Conservatism. But we were determined to deal with this festering sore once and for all, so that we could protect the interests of patients, put an end to industrial unrest and restore the morale of the service.

Mr. Julian Ridsdale (Harwich)

I have spent time in hospital recently, and what the right hon. Gentleman is saying is far from the truth. The medical profession looks after people fairly and reasonably. He is making a complete exaggeration of what is happening in hospitals.

Mr. Ennals

I am glad that the hon. Gentleman has just joined the debate. I am glad that he has recovered from his illness. I am sure that he had excellent treatment from the doctors. Several hon. Members spent some time in hospital during the Summer Recess and they all received excellent treatment, as I have done myself. I have said nothing against the treatment given in our hospitals, but I thank the hon. Gentleman for his strange intervention.

None of this could be achieved unless we phased out pay beds and ended the scandal of queue jumping. But from the very start my right hon. Friend and predecessor the Member for Blackburn made it clear that it was in the interests of patients and the service that the separation should take place in a reasonable and orderly manner. In the Government's view, the Goodman proposals will do precisely that.

First, they provide for the early elimination of the many pay beds which have been seriously under-used—1,000 beds will be phased out in the first six months. Secondly, they provide for the progressive withdrawal of the remaining beds on the recommendation of an independent board working within the principles approved by Parliament—principles which leave reasonable time for those who wish to do so to make alternative arrangements for private practice, but outside the NHS. Thirdly, the Goodman proposals—proposals which, as I said, have been embodied in this Bill—were acceptable as a basis for legislation to the majority of those who participated in the consultants' ballot, although the majority also opposed phasing out on principle.

These points, taken together, mean that we can achieve, in an orderly way, our aim of removing a major source of dissension and dispute from the health service. That is the answer to the right hon. Member for Wanstead and Woodford and his hon. Friends when they say that the Bill is irrelevant to the needs of the NHS. On the contrary, it is essential to those needs.

I said earlier that the Government had been taken to task from both sides of the House. I know that some of my hon. Friends feel that the Bill does not go far enough, in particular that it should set a time limit on the separation of pay beds—they stated their view quite clearly in the Division Lobby yesterday. They fear that, without a final date, pay beds may continue indefinitely in our hospitals, especially if the private sector is slow to make alternative arrangements But the Bill is quite clear.

Clause 2 makes the purpose of the Bill and the task of the board crystal clear—the progressive withdrawal and separation of private practice from NHS hospitals. The board has a duty to supervise this phasing out and to make regular reports which will be available to the House. Clause 4 provides the board with guidelines which leave no doubt that if the private sector fails to take reasonable steps to provide alternative facilities, that failure in itself is ground for phasing out the particular private facilities concerned.

So my hon. Friends may rest assured that our intentions will not be frustrated. We are determined to uphold the principles on which the National Health Service was founded—the principle that health care is not a commodity like any other to be sold in the market place to the highest bidder, but that it is a human right to be enjoyed equally by all without regard to their financial power, the principle that health care should be free at the point of use and available equally to all on the basis of medical priority alone; the principle that there should not be one standard of care for the rich and another for the poor, but that there should be one standard. That is what we mean by a national health service.

We will no longer endure the injustice of queue jumping. It is a scandal that has gone on long enough, and that is why Clause 6 lays a duty on the board to make recommendations to the Secretary of State within six months on achieving a common waiting list for NHS and private patients. The pay beds will go, but for the temporary period while some remain those who use them must be admitted on the same basis of medical priority as all other patients. Varicose veins and hernias hurt the poor just as much as the rich. That simple truth underpins this Bill.

The professions have reserved the right to oppose the principles of the Bill and the Government have recognised that right. But, equally, the professions will recognise that they must accept the decision of Parliament that private medical practice will from now on be separated from NHS hospitals. That is our policy. It has been endorsed twice by the electorate and I commend it to the House both because it is right in principle and because it offers the opportunity for doctors and all other staff in our hospitals to work together in a spirit of co-operation, providing the highest possible standard of health care for our people in what we can at last truly call a National Health Service.

9.56 p.m.

Mr. Patrick Jenkin

I had not intended to refer to the guillotine under which we have debated a large part of the Committee stage and the whole of the Report stage, but the Secretary of State's remarks leave me with no option. He said that in the Committee stage we finished with a sitting left over at the end. If that is how he uses it, that is the last time I shall make a bargain with him. We agreed at his request that we should finish the last sitting at lunch time. The debates on the new clauses were extremely short in order to enable the Government to complete the Committee stage by lunch time.

We have now finished the Report stage with over 50 amendments totally undiscussed, including some of the Government amendments—which certainly in one case made a substantial change in the Bill—and most of the amendments which were debated in Committee and defeated only by the Chairman's casting vote. We have not had a word about any of those.

As to the Secretary of State's comment about Second Reading speeches, we spent five hours yesterday, one for one, from either side of the debate, on the amendment moved by his hon. Friend the Member for Brent, South (Mr. Pavitt). The guillotine has undoubtedly severely curtailed debate on the Bill. No doubt note of this will be taken in another place.

But a Third Reading is a welcome occasion because it provides the opportunity to express thanks to one's hon. Friends who have played a very notable part in the proceedings on the Bill. I thank my hon. Friend the Member for Reading, South (Dr. Vaughan), who brings not only a deep humanity but a very considerable knowledge to the subject. I am sure that my other hon. Friends will forgive me if I mention my hon. Friend the Member for Ealing, Acton (Sir G. Young), who acted also as Whip on the Committee and made a most valuable contribution to the debates.

I thank, too, the hon. Member for Preston, South (Mr. Thorne) and his hon. Friend the Member for Barking (Miss Richardson), because they served throughout our proceedings as the headlight beaming ahead down the wrong road, showing us where we would go if we followed their recipes.

Mr. Thorne

That is praise indeed.

Mr. Jenkin

The hon. Gentleman may take it as he wishes. I also pay tribute to the hon. Member for Brent, South, who provided us with one of the new concepts coming from the Labour Benches. He has never been slow to remind us how many years of study he has made of health matters. He coined the remarkable classification of patients not as National Health Service and private patients but as deserving and undeserving patients. From the Labour Benches we now have, in addition to the undeserving poor, the undeserving sick.

It is right that I should set out in the Third Reading my party's view on the Bill. We believe that on balance it has been to the advantage of the National Health Service and of the ordinary National Health Service patient that consultants have been able to treat their private patients in the same hospitals as they treat their NHS patients. We believe, therefore, that the system should continue.

We believe, too, that at a time when the acute services in the NHS are under very great strain due to the virtual standstill on resources, it is an act of consummate folly deliberately to throw away the revenue which pay beds bring in.

More fundamentally, we believe that the concept which my hon. Friend the hon. Member for Bromsgrove and Red-ditch (Mr. Miller) described as "medical apartheid"—the concept embodied in the Bill—inevitably will lead to just those double standards which the Secretary of State said that it was his intention to avoid. We shall have a vigorous, efficient, well-equipped private sector financed by the market through the growth of provident funds contrasting with a struggling, inadequate and overburdened public sector financed by taxation. As the gap widens, as inevitably it will, so will the best talent not only of doctors but of nurses, radiographers, therapists and others be attracted into the private sector. Success will create its own momentum, and the process will intensify. Within a few years, this system of medical apart- heid will have returned this country to the pre-1948 situation when the voluntary hospitals provided first-class care and attracted first-class talent while the municipal hospitals were almost always the poor relations.

This dilemma is there, and the gut Socialist reaction to it has been to ban independent medicine altogether. The House will remember that yesterday, in speech after speech by Government supporters sitting below the Gangway, they advocated precisely that authoritarian Marxist solution. It is also the policy which has been adopted repeatedly by Labour Party Conferences. The Government's answer was a different one. Although not going as far as an outright ban, their initial reaction was to put an absolute ceiling on the size of the private sector at its March 1974 level. Something else which is sometimes forgotten is that they also proposed to ban advertising of independent medical, surgical or maternity facilities to the general public.

Even the right hon. Member for Blackburn (Mrs. Castle) was forced to concede that that was not compatible with the kind of free society in which she at any rate believes. It would make the provision of additional medical care outside the National Health Service a criminal offence like trafficking in narcotics or selling pornography to juveniles.

Instead, we have in the Bill the watered-down Socialism of Part III—a new quantity licensing system which Ministers justify wholly on account of the need to protect the health service. But what can one think of a philosophy of medicine which is viable only if citizens of this country who already pay their full taxes for the National Health Service have to go on bended knee to the authorities for permission to make separate health provision above a certain size?

Of course, there must be quality control. No one disputes that. But quantity control is just one more nail in the coffin of the plural society about which the right hon. Member for Birmingham, Stechford (Mr. Jenkins) spoke earlier this year.

Yet without restraint, the dilemma remains—a steadily widening gap between standards of care in private medicine and standards in the National Health Service. It is no accident that today a growing number of the new subscribers to the provident funds are people who have had an unhappy experience as National Health Service patients and are determined to avoid a repetition.

What is the way ahead? Surely it must be to abandon the concept of medical apartheid. This Bill goes diametrically in the wrong direction. As The Times said after the publication of the right hon. Lady's consultative document in August 1975, The wiser course has always been to interweave them if anything more closely so that they could share, with a proper division of cost, the use of scarce resources both of facilities and manpower. In that way private medicine could benefit from some of the specialised facilities of the NHS, and the money flowing into private medicine might be used to irrigate the British medical system more generally. We agree with that philosophy.

A future Conservative Government will therefore reverse the policy of phasing out pay beds. We want to keep the best consultants in the National Health Service and not drive them out. We want to increase the flow of money to the National Health Service hospitals, not to reduce it. We want to ensure that the best care for all National Health Service patients is available in National Health Service hospitals.

We have heard much about queue-jumping, by which in practice one means having two queues, one for private patients and one for National Health Service patients. The Tribune Group's remedy is simple—have only one queue. In the view of its members all private medicine must be outlawed. Although it is wholly abhorrent to those who believe in a plural society and a free society, that remedy has a certain cold logic.

The Government's remedy is wholly without logic. What they say is that two queues are all right provided they are at different hospitals. That amounts to the old doctrine of "Out of sight, out of mind". Provided the other queue is somewhere down the road, it does not matter how many people jump it. What is offensive, according to the Government, is not that one patient should be treated ahead of another—that will certainly happen under the Bill—but that people should see that that patient is being treated ahead of another. That is nothing more nor less than the politics of envy. That is what the Bill is all about.

We on the Conservative Benches are not interested in envy. The real evil is the size of the waiting lists. No other country suffers waiting lists like ours. No other country faces the prospect of waiting lists growing longer and longer month by month. For us, therefore, the real question about two queues is how to shorten the waiting lists for everybody. One way not to do it is to shorten the number of hours that consultants spend in National Health Service hospitals, which is one certain effect of the Bill.

The remedies lie not in pandering to the politics of envy but in improving the efficiency of hospitals, cutting down the length of hospital stays and increasing bed usage, all of which must depend, in some measure at least, on creating the right pressures and incentives within the NHS to ensure the most effective use of resources. For that reason we are examining in some depth how other EEC countries and developed Commonwealth countries deal with these problems. We are examining alternative methods of health financing, perhaps involving greater dependence on insurance.

Clearly, major changes must await the Royal Commission, but it is already clear that if the health service is to survive and to go on making its vital contribution to the nation's health, we must recognise that changes are needed. The assumption on which Lord Beveridge and Aneurin Bevan based their proposals—that as the nation's health improved demand would be reduced—has not been borne out. Instead we have what is called the infinity of demand having to be met by finite resources.

Of one thing we can be sure, that the Bill is wholly irrelevant to these major questions that confront the health service. It is nothing less than tragedy that so much of the energy of Ministers, officials, Parliament, trade unions and others should have been expended on such a fruitless effort, a product of nothing more than blind prejudice. I invite my right hon. and hon. Friends to divide against the Bill when the guillotine falls.

10.9 p.m.

Mrs. Castle

It is obviously a matter of very great pleasure to me that a Bill which saw the light of day under my administration should now be reaching the end of its journey through the House. I want very sincerely to congratulate my right hon. Friend the Secretary of State on standing firm behind the principles which inspired the Bill.

I am sure that he will be the first to join me in congratulating also, in his absence, my right hon. Friend the Member for Plymouth, Devonport (Dr. Owen), who did such a brilliant job in Committee—as I know my right hon. Friend the Secretary of State agrees—in carrying all the detailed work. I am well aware of what I owe to him as my right-hand man when I was Secretary of State. It is only right to place on record the great debt that the National Health Service owes to him.

We have reached the end of one of the most protracted discussions on any Bill of similar length that I have known in my 31 years in Parliament. We have had a guillotine so generous that it has exceeded life itself. It has given us a massive amount of time and full opportunity to explore every nook and cranny of the Bill. Indeed, those of us who served on the Standing Committee know that during the Report stage we have been retracing ground which was exhaustively covered in detail in Committee. In fact, we have retraced that ground to the point of utter tedium to Members on both sides who served on the Committee. I fully accept the right of other hon. Members who did not serve to join in the discussions, but I would point out that tedious repetition has been caused by the procedures of the House.

Mr. Speaker

Order. May I inform the right hon. Lady, because I made the selection of amendments, that 56 amendments were carried in Committee by the casting vote of the Chairman? In these circumstances, it is customary to call such amendments on Report.

Mrs. Castle

Out of my eternal and deep respect for you, Mr. Speaker, I was going to make that point and say that because of the procedures of the House this repetition was an inescapable necessity because decisions in Committee were made by the casting vote of the Chairman.

Under our curious procedures we were level-pegging in Standing Committee. The hon. Member for Ealing, Acton (Sir G. Young) admitted earlier this evening, rather regretfully I thought, that, now that the Bill has been brought back into the gladiatorial contest on the Floor of the House, the majorities have been larger than they were in Committee. It has been extremely interesting to note the votes tonight. We have had three Divisions and we could have had a great many more if the Opposition had dared to continue to put the issues to the test. In the three Divisions we had, the majorities on the Floor of the House were all higher than the majority on Second Reading, which shows that as a result of the exhaustive examination of the Bill the House has become more convinced of its merit, and not less convinced. All the efforts of the right hon. Member for Wanstead and Woodford (Mr. Jenkin), who led for the Opposition with such passion, have resulted merely in convincing more hon. Members that he is wrong.

Support for the Bill has increased, not diminished, as it has gone through the parliamentary process. Earlier this evening there was a very significant vote on the major principle embodied in Clause 2—the principle of phasing out. That principle of separation was endorsed by the House by 29 votes. I hope very much that this fact will be noted in another place. The right hon. Gentleman, with his customary incendiary tendencies, tried to insult another place with pathetic pleas that we had not properly considered this measure and that it had not been properly dealt with by this House. A majority of 29 can hardly be called a minority attitude of this House.

We all know that on Report, as a result of the lengthy discussions at earlier stages, we have not, to my intense regret, had a rediscussion of Part III, which deals with licensing. I have no doubt that the right hon. Member for Wanstead and Woodford is already calculating in his brain how he can persuade their Lordships, when it comes to their turn, that there has not been proper discussion of the principle of licensing of the private sector, that it was not in the Labour Party's manifesto and that their Lordships ought to throw it out.

Therefore, through the right hon. Gentleman, I should like to remind their Lordships that we had adequate discussion in Committee of the licensing sections of the Bill. Indeed, so adequate was the discussion that the Opposition ran out of arguments before we ran out of time. We had a situation in Committee when, under the guillotine, another half day of discussion would have been available. Some of my hon. Friends, including me, pleaded to be allowed to go to the full span of time. Unfortunately, there was not enough argument left in the Opposition's lockers to keep the Committee going for the full length of the guillotine. Therefore, I say advisedly to the right hon. Member for Wanstead and Woodford that he should not try any incendiary nonsense about any part of the Bill not having been adequately discussed or backed by adequate majorities.

I repeat, we are talking about a bargain. This House has endorsed the bargain. Nothing has been included in the Bill that was not included in the bargain that was struck. When the Opposition try to throw out the licensing provisions, let them remember that part of the bargain. The authenticity of those provisions comes from the Goodman proposals. That is what validates them. When we—I, as my right hon. Friend's predecessor, and my right hon. Friend the then Minister of State—discussed how to reconcile the Government's commitment to phase pay beds out of National Health Service hospitals with our desire to do it peaceably by democratic means, we struck a bargain. I made great compromises. Of course, I would have preferred my consultative document. All my hon. Friends know that. But I made sacrifices for the sake of a peaceful acceptance by the medical profession that this was a matter for Parliament to decide. It is odd that we should have to make major policy compromises to persuade the medical profession to leave the decision to Parliament, but that is what we had to do. I did it for the sake of the NHS because I knew that it was being torn in two.

The Opposition have talked about the interests of patients. It was I who, in that situation, put the interests of patients and peace in the NHS first. I warn the Opposition that, if they carry on this battle as though that bargain had not been struck, they will be jeopardising peace and setting law and order at naught. I say that advisedly to those who may be contemplating such action in another place.

I should like to remind the House of the terms of the bargain that was struck. I quote from paragraph 3 of the Goodman proposals: Despite its continuing opposition"— fair enough; nobody objects to that— the medical and dental professions acknowledge that the phasing out of pay beds in NHS hospitals may, through legislation, become the will of Parliament. In that event the phasing out should he subject to the safeguards outlined below". Every one of those safeguards—nothing else—is embodied in the Bill. I ask both Houses to think seriously on that. The will of Parliament has been clearly expressed.

The safeguards stand or fall as a whole. One is that the Government need to be satisfied that the development of the private sector will not jeopardise the interests of NHS patients. If someone attempts to split the safeguards and pick and choose, the whole issue of war or peace will be opened again. The message going out from here tonight is that this democratically-elected House of our Parliament has said that it believes the time has come to phase pay beds out of NHS hospitals and that, in doing so, it wishes not to abolish private practice but to make it stand on its own feet.

The right hon. Member for Wanstead and Woodford made great play of the fear that the Bill would result in the development of two standards in medicine and the creation of a medical apartheid. But there has been a financial apartheid written into the heart of our NHS. There have always been two standards.

We all know of people close to us who have been worried not about a major crisis or emergency operation but about an important operation which could have enduring effects if it were not carried out rapidly and who have been told that they would have to wait two or three years under the NHS but that they could have the operation done next week if they were willing to pay.

The right hon. Member for Wanstead and Woodford said that our philosophy on private practice was "out of sight, out of mind". Private practice has been bolstered by the massive resources of the NHS, and the proper epigram should be "out of subsidy, out of existence".

I do not believe that the separation of pay beds from the NHS will lead to the building up of a great separate private health service. The people of this country could not afford the economic cost of meeting their whole medical care without the sustenance of the public financed NHS. Perhaps a few Arab potentates or, dare I say it, Lady Beaverbrook might be able to afford it. Those people might fill the London Clinic and other such places, but 99 per cent. of our people have depended on the National Health Service, free at the point of use, and will continue to do so. When they get into an inconvenient or uncomfortable situation, perhaps with tonsillitis or a hernia, they have to take their turn in a medical queue.

We believe that is the only way to unify society, and in the present acute economic emergency society must be unified or it will fall.

10.24 p.m.

Mr. Thompson

I congratulate the Secretary of State on guiding the Bill through the House, but I cannot say the same for Labour Members from Scotland. They have not been much in evidence in our debates. The hon. Member for Edinburgh, West (Lord James Douglas-Hamilton) and I have constituted the Scottish representation on the Bill most of the time.

The Bill does not take away from the wealthy or the less wealthy the freedom to pay for private medical practice if they wish to spend their money in this way. The Bill accords well with SNP policy. Our stated health policy is to phase out pay beds within the Scottish health service. But we envisage a separate private sector that is serviced by part-time consultants. I do not think that Scotland could support full-time consultants in private practice, a private sector having minimum standards of staffing and facilities prescribed for it to ensure the proper care of private patients. I very much hope that after independence our Scottish health service will be so good that the desire for private treatment will decrease over the years and perhaps in the end fade away entirely.

The SNP was accused yesterday of having the expectation that manna will fall from Heaven and that the millennium will be ushered in by the attainment of Scottish independence. That is not so. I do not share the Utopian expectations of the Marxists. If we are bidden by William Blake to strive to build the new Jerusalem here below, I rather incline to the opinion of St. John the Divine that the new Jerusalem will in part at least come down from Heaven. I believe, however, that we must strive, and the Bill seems to be part of the striving, to bring fair treatment to the common folk of our respective countries.

I have several times said during our debates on the Bill that it has a special relevance to England. That is because Scotland has relatively few pay beds. Galloway, which is my own constituency, has none. If, in helping in the phasing out of pay beds in Scotland, we have helped forward the cause of the common folk of England in their struggle against privilege, and if there is a politics of envy, there is also a politics of privilege that is represented by the Tory Party. If we see that we have helped on the cause of the common folk of England, that gives an added pleasure to the work we have accomplished on the Bill. My hon. Friends and I will support it on Third Reading.

10.27 p.m.

Mr. Thorne

I approached the Bill some time ago in the expectation that a real attack on privilege was to be made. However, on reading the Bill before it went into Committee it was apparent that that was not to be the case in the terms that some of us had envisaged. Therefore, in the early stages in Committee we approached various problems with mixed feelings. We were concerned—my hon. Friend the Member for Barking (Miss Richardson) and myself in particular—about the apparent support for private medicine that appeared to be contained within the Bill. We were anxious to proceed with the phasing out of pay beds as expeditiously and efficiently as possible. That was a manifesto commitment. Unhappily, the Bill had no target date—nor did the manifesto. We have already debated that during the past 48 hours.

We all know that the Bill now refers to 1,000 beds that have been largely under-used recently. It seems that when the Bill becomes an Act we shall have to be concerned with two major areas. We shall have to apply considerable vigilance if we are to achieve even the modicum of advance that my right hon. Friend the Member for Blackburn (Mrs. Castle) has always argued will be possible should we accept the Bill. The two specific areas relate to the activities of the board in phasing out the further beds following the 1,000. It seems that the House will continually have to address itself to the progress that is being made by the board in that task.

As has been said before, the price of freedom is eternal vigilance. I point out to my right hon. and hon. Friends that we shall need to apply that vigilance to the board's progress.

I am also concerned—I do not think I am on my own—about the Bill's contents relating to private medicine. I believe that we could well see a mushrooming of private medicine. Here I part company with my right hon. Friend the Member for Blackburn. I think that it is possible for certain organisations, individuals and collectivities within Britain to amass enough capital to give a considerable fillip to private medicine in Britain. I believe that it can stand on its own feet. What I deplore is that the resources that will then be used by that amassed capital are resources that should go to the NHS for the use of the majority of the people.

It is in those two areas that I feel a certain degree of scepticism. Hope springs eternal. I have promised to be brief. I am a little sad in saying that probably hope is all that some of us have left in regard to the Bill. It is only hope that will persuade me to vote for the Third Reading—and then urge upon my hon. Friends, as I have said, the maximum vigilance about the progress of the Health Services Board in carrying out its tasks.

10.31 p.m.

Lord James Douglas-Hamilton

I should like to express gratefulness to the Secretary of State for one amendment that was accepted in Committee—that account be taken of representations made by interested parties in Scotland to the Scottish Committee. I am at least thankful for small mercies.

I should like to tell the hon. Member for Galloway (Mr. Thompson) that half of the area health boards in Scotland have pay beds. They are much in use. In 1974–75 more than £500,000 of income came as a result of them.

One problem that has been raised by the Bill is the prospect of loss of money for research purposes. A few days ago the Secretary of State wrote to my right hon. Friend the Member for Wanstead and Woodford (Mr. Jenkin) saying that at least £50,000 would be lost. He did not give any evidence in his letter. It may well be that the figure will be very much higher, because, as hon. Members appreciate, consultants give some of their fees towards research in teaching hospitals, and it seems that many private patients give a lot of money as well.

One of the most poignant matters mentioned in the debate was when the hon. Member for Aberdeen, North (Mr. Hughes) said that a family had taken out a mortgage to get an operation. He said that if he were in a similar situation he might put aside his principles and do the same thing.

The essence of our case can be summed up in one sentence. Rather than restrict opportunity, we want more opportunity for more people.

10.33 p.m.

Mr. Pavitt

Most hon. Members who served on the Standing Committee will heave a sigh of relief at the passing of the Third Reading stage. Of all the Committees on which I have served, the Committee on this Bill was unique. I have previously been in situations in which there has been a majority of one on the Government side. This was the first time I served on a Committee which was exactly even. The result of that was that on one occasion when, under the rules of procedure, the Chairman had to give a casting vote, it meant that the normal procedures for further sittings was defeated and we had to keep going on. One of the results of that was that we had more Second Reading speeches on amendments than have been made in Committee on any other Bill with which I have been concerned.

However, we continued with the Bill. I pay tribute to the Opposition's acting unpaid Whip, the hon. Member for Ealing, Acton (Sir G. Young), and to our paid Whip, my hon. Friend the Member for Stalybridge and Hyde (Mr. Pendry). I also add the customary tribute to the hon. Member for St. Albans (Mr. Goodhew), the Chairman of the Committee, because he had to sit at his place, with good humour, and listen to more nonsense than I have ever heard in relation to any other Bill.

I want to put this matter in to perspective. We have been talking about a majority and a minority. The majority are the cases in the NHS, which in 1975 totalled 5,296,136. The minority sector which has been the subject of all the argument and conversation, in Committee, in the corridors, in the House and in the country, is the sector of privilege in which 97,641 cases were dealt with last year. I appreciate the fact that minorities always have rights, but the majority have more rights than the minority. That is what the Bill is about, and that is what the Third Reading has been about.

The Opposition have argued strongly on the question of something being done about waiting lists and the ending of waiting lists. Clause 6 contains provisions for that. I hope that the medical profession will reverse its original decision. We pleaded with its members to do what we proposed, but they refused. I hope that the Opposition will add their voice and persuade the medical profession to implement this proposal.

There will be a lot of talk over the next six months while 1,000 pay beds are being phased out, but the point made by my hon. Friend the Member for Preston, South (Mr. Thorne) is well taken. In six months' time we shall want to see progress, and six months after that we shall want to see more progress. I have been speaking for only two minutes tonight, but I assure the House that I shall speak a lot more unless we get the kind of results that we expect from the passage of the Bill.

I congratulate my right hon. Friend the Secretary of State and add to his tribute to our right hon. Friend the Member for Plymouth, Devonport (Dr. Owen). I admired the way in which he steered so much of the Bill through the Committee because my right hon. Friend the Secretary of State had to be at Cabinet meetings. The House owes a debt of gratitude to my right hon. Friend the Member for Devonport.

10.36 p.m.

Sir George Young

The House listened with interest to the threat that the right hon. Member for Blackburn (Mrs. Castle) made publicly to her husband in another place. While he may respond to it, I very much hope that others of their Lordships will not, because there is a fund of medical knowledge in the other place which should be focused on the Bill.

I should like to put right something that was implied about support for the Bill. On Second Reading there was a majority of 20 in favour of it. Since then there have been by-elections, and tonight there have been majorities of between 25 and 29 in favour of the measure. I do not think it can be said that there has been a great tide of support for the Bill since the earlier occasion.

I refer to the principles of the Bill which the Secretary of State set out on Second Reading. He said: The separation of pay beds from the Service is the only solution that will end tension and conflict within the service."—[Official Report, 27th April 1976; Vol. 910, c. 204.] If I believed the right hon. Gentleman to be right I should not be so uneasy about the passage of the Bill, but he is wrong. I say that for two reasons. First, in the speeches of some of his hon. Friends yesterday we heard disgraceful language about the medical profession, and I propose to give some examples.

The hon. Member for Aberdeen, North (Mr. Hughes) said that the medical profession has always played politics with the lives of its patients when it comes to the question of resource management in the NHS. The hon. Member for Sheffield, Hillsborough (Mr. Flannery) said: they wish to capitalise on the sickness of their fellow human beings. Finally, there was the disgraceful speech of the hon. Member for Ormskirk (Mr. Kilroy-Silk), who referred to some consultants as holding the sick to ransom, being more concerned with lining their own pockets, than they are with the health and welfare of, their patients."—[Official Report, 12th October 1976; Vol. 917, cc. 325–39.] The hon. Gentleman referred finally to the "excrescence" of private practice in the National Health Service.

If the Secretary of State believes that that provides a foundation for the resolution of tension and conflict—

Mr. Robert Kilroy-Silk (Ormskirk)

Will the hon. Gentleman give way?

Sir G. Young

No. These are the professional medical practitioners upon whom the Secretary of State has to rely if he is to build the service up to the standards that he wishes to see, and it is clear that there will be no resolution of tension and conflict while the medical profession continues to be attacked in the way that it has been by Labour Members below the Gangway.

Mr. Kilroy-Silk


Sir G. Young

No. I wish to conclude my speech quickly.

The second reason why this is not the end of the story is to be found in the peroration of the Secretary of State, when he said that he hoped the Bill would lead to the end of dual standards. It will do no such thing, because private practice will continue and there will be pressure on the right hon. Gentleman from his hon. Friends to curtail private practice. This is not the end of the story, but the beginning of another story, and there will be more tension and conflict because of the Bill than there would have been without it. The right hon. Gentleman is polarising dual standards to a far greater extent than would otherwise be the case. That is why I am sad that the Bill is going through. It is not the end of the story but is the beginning of another story.

10.40 p.m.

Mrs. Renée Short (Wolverhampton, North-East)

I was not one of those fortunate enough to serve on the Standing Committee. [An HON. MEMBER: "Shame."] Yes, it was a shame. I should have been glad to be there with the hon. Gentleman. Nevertheless, the House has been able to hear the Opposition today and yesterday. I sat through most of yesterday's debate but was not able to be called. One gets somewhat concerned at the repetition of certain tedious and jejune arguments by Conservative Members such as references to the politics of envy and a Marxist philosophy.

The hon. Member for Ealing, Acton (Sir G. Young) attacked my hon. Friend the Member for Ormskirk (Mr. Kilroy-Silk) for his remarks about the attitude of certain consultants. No one on this side is saying that all consultants are rogues and rascals. What we are saying, and what we have documented evidence for, in spite of what the hon. Member for Birmingham, Edgbaston (Mrs. Knight) said yesterday, is that certain doctors are taking a good deal of advantage of the situation to make considerable amounts of money at patients' expense. By eliminating a number of private beds, we are restricting that opportunity to make money at the patients' expense.

The fact that private practice is available and that waiting lists can be, have been and are being built up means that there is an incentive to allow waiting lists to expand in order to pressurise patients into going private and paying considerable fees. We have evidence of elderly patients with cataract, for example, being 18 months on the waiting lists, and of doctors saying "I am building up my waiting lists so that they will eventually go private."

The hon. Member for Reading, South (Dr. Vaughan) had all that evidence, just as I had and all the other members of the Select Committee had, yet he chooses to say that all this evidence should be discounted and that it is not true. But the evidence came from members of his own profession. One supposes that, as a doctor, he assumes that all members of his profession are honourable men and that the evidence they submit should therefore be taken into account.

We welcome this reduction in the number of pay beds. Opposition Members have made great play in recent days about public expenditure. One is surprised that they are not concerned that the NHS has been deprived of some money in return for the services it provides for consultants working with their private patients. We have evidence of the junior hospital doctors' time which is wasted. We have evidence of the time and resources of pathology laboratories in hospitals being devoted to testing the samples of private patients. We have evidence about the use of out-patient departments. This is all without charge to the private patients but a burden on the NHS. [HON. MEMBERS: "Of course they pay."] No—hon. Members have not read the evidence. There is provision in the regulations for separate billing for all these services, but there is also a good deal of evidence that hospital administrators do not pursue the matter and that private patients do not pay for these additional services.

I endorse what my hon. Friend the Member for Preston, South (Mr. Thorne) said, that we need to take a careful look at the way in which the board operates and private beds are phased out. Unless we are very careful, we shall see a two-tier service developing again and the clock put back to the position before the National Health Service was established if private practice is allowed to expand. We need to be vigilant.

Several Hon. Members


Mr. Speaker

Order. May I remind the House that the Opposition Front Bench spokesman hopes to begin his reply at 10 minutes to 11 o'clock.

10.45 p.m.

Mrs. Knight

I shall confine myself to two points raised by the hon. Member for Wolverhampton, North-East (Mrs. Short). The first point I wish to make is that the passage of the Bill will make no difference at all to the waiting lists and may even make them worse because money is being diverted elsewhere. I detest the fact that in Birmingham, and I am sure in many other areas, people have to wait a quite unconscionable time before undergoing even simple operations. It will now take six months, or even nine months, for someone to receive care from a skin consultant in my area. During that time a person will be away from work. A child who needs a heart operation may have to wait so long that his life is endangered. None of these things will be altered by the passage of the Bill, and it is nonsense to suggest the contrary.

Private patients have paid into the National Health Service as much as any other patients. The way some Labour Members talk, one would think that private patients do not pay tax. Private patients have paid all, and more, than the ordinary NHS patient has paid. To talk about the facilities being available to those people as if there was something wrong with that is quite unjust and totally wrong.

This is a sad day for the British medical profession and a sad day for the National Health Service. What we are doing tonight has nothing whatever to do with the welfare of patients. This is what we should be concerning ourselves with, not this politically-motivated load of rubbish that the Government have given us.

10.47 p.m.

Mr. Crouch (Canterbury)

I do not feel terribly strongly about the question of private beds. The House must know this. I do feel strongly, however, about the preservation and improvement of the National Health Service. This tiny piddling Bill, which has lasted so long, will harm the service and the public it serves. In this brief intervention I cannot change the way the House will vote. It is difficult enough to cope with the Secretary of State. It is like trying to wrestle with a shadow. It is even more difficult to cope with a second shadow behind the right hon. Gentleman who makes an even longer speech.

This measure will not improve the service in the care it gives to the sick. This is what upsets me most of all. The Bill seeks to bring about the removal of 1,000 beds now—and perhaps 2,000 or 3,000 later by regulation—from the private sector so as to produce a Socialist purge of the National Health Service. It I could believe that this would produce a better service for the sick and suffering, I would support the Bill. The Bill will do positive harm to the service. It will create a new private sector health service which will rob the National Health Service, which we should all be seeking to serve and improve, whether we were originally supporters of Aneurin Bevan or supporters of the Joseph proposals. This measure will do harm, and that is why I am against it.

10.49 p.m.

Dr. Vaughan

Nothing could have demonstrated more clearly the disruptive, unfeeling views which have so damaged the National Health Service in recent months and the arrogant disregard for undertakings entered into than the words we heard from the right hon. Member for Blackburn (Mrs. Castle) tonight. However strident her cries, the plain fact is that over 50 amendments which resulted in a tied vote in Committee have not been debated tonight because of the guillotine. That is a disgraceful reflection on the way in which an issue such as this is handled these days.

Nothing that has been said in this debate could possibly change our view that the Bill is totally irrelevant to the real needs of the National Health Service. With low morale, a desperate lack of resources and staff leaving in ever-increasing numbers, the Bill will increase, not decrease, those problems in the NHS.

The words of Nye Bevan have rightly rung round the Chamber several times in this debate. The right hon. Member for Blackburn said that Nye Bevan would have welcomed the Bill. He would not. He would not have welcomed it because he recognised what the right hon. Lady does not—namely, the danger if health care is split into two separate services, a State service at one level and a private service at another. Is this what Labour Members want?

Mrs. Renée Short


Dr. Vaughan

It is certainly not what the majority of people in the National Health Service want but it is certainly the situation that will be brought about by the Bill. Nye Bevan would have seen such a Bill as a measure that would cause great damage in the service, and that is how we regard the Bill.

What has come out of this debate more clearly than anything else is the appalling gap between the views of Labour Members and the views of the majority of people working in the Service. Labour Members do not like to accept that truth, but they are not members of a party which concerns itself with the care of patients and for high standards. They are members of a party which displays envy and a desire for destruction and prejudice in the health field, and they know it.

The Secretary of State was asked on Second Reading and again yesterday to say who will benefit from the Bill, but he did not answer. Indeed, he could not answer—or certainly did not want to. It is certainly not the patients who will benefit from the Bill. The overwhelming opinion in National Health Service circles is that patient care will suffer very seriously indeed. That was the opinion of the Presidents of the Royal Colleges, and they are careful not to take a party political view. Their charge is to look after the standards of the service. They see great dangers for the care of patients.

The majority of union members, as we know from the opinion polls, also do not believe that the Bill will bring any great benefits. Indeed, trade union members believe that the Bill will increase rather than decrease unemployment in the National Health Service. A factor has arisen which has not reared its head before—namely, a shortage of nurses in certain parts of the country and a surplus of nurses elsewhere.

The truth is that only the militants will welcome the Bill. It is interesting to note when one listens to the most militant militants that they are people who have only recently come to this country from overseas or people who admit that they have never worked in a hospital. Those are the people who lead the revolt.

Mrs. Renée Short

Name them.

Dr. Vaughan

Certainly the Bill will not help the Chancellor of the Exchequer. An extra sum of £12 million or £15 million will have to be found to pay for the administration of the Bill—money to be found at a time when £40 million of private money will be lost to the National Health Service and at a time when the basic standards of the service are falling rapidly. It will certainly not help the Exchequer in any way at all. The damage done by this purely political Bill will be deep and widespread.

The Bill will certainly not help professional people working in the service. Labour Members have repeatedly tried to say that my right hon. and hon. Friends and I represent only the views of the doctors. That is blatantly untrue. We represent the views of the dentists, the nurses, the physiotherapists, the radiographers, the porters and the ward maids. If Labour Members are honest with themselves, they will accept that the majority of people in the service see the Bill as a major intrusion into their professional freedom.

Mr. Ennals

Does not the hon. Gentleman accept that it is the considered view of the National Health Service unions and of the Royal College of Nursing—[HON. MEMBERS: "Rubbish".] It is not rubbish. A deputation came to see me to record the views of the Royal College in support of the measures the Government were taking to phase out pay beds. It is the considered view of the vast majority of those working in the National Health Service that this measure is essential and that it will bring peace to the service.

Dr. Vaughan

I do not accept that. What the Secretary of State has said is totally untrue, and he is misrepresenting the views of the nurses. Labour Members' speeches will have increased fears over freedom. The Bill will not sow peace. It will sow the seeds of resentment which will continue for years to come.

Labour Members will come to regret the Bill. It is a squalid, vindictive

Division No. 320.] AYES [11.00 p.m.
Abse, Leo Cohen, Stanley Fletcher, L. R. (Ilkeston)
Allaun, Frank Coleman, Donald Fletcher, Ted (Darlington)
Anderson, Donald Concannon, J. D. Foot, Rt Hon Michael
Archer, Peter Conlan, Bernard Ford, Ben
Armstrong, Ernest Cook, Robin F. (Edin C) Forrester, John
Ashley, Jack Corbett, Robin Fowler, Gerald (The Wrekin)
Ashton, Joe Craigen, J. M. (Maryhill) Fraser, John (Lambeth, N'w'd)
Atkins, Ronald (Preston N) Crawford, Douglas Freeson, Reginald
Atkinson, Norman Crawshaw, Richard Garrett, W. E. (Wallsend)
Bagier, Gordon A. T Cronin, John George, Bruce
Barnett, Guy (Greenwich) Crosland, Rt Hon Anthony Gilbert, Dr John
Barnett, Ht Hon Joel (Peywood) Crowder, F. P. Golding, John
Bates, Alf Cryer, Bob Gould, Bryan
Bean, R. E. Cunningham, G. (Islington S) Gourlay, Harry
Benn, Rt Hon Anthony Wedgwood Cunningham, Dr J. (Whiteh) Graham, Ted
Bernett, Andrew (Stockport N) Davidson, Arthur Grant, George (Morpeth)
Bidwell, Sydney Davies, Bryan (Enfield N) Grant, John (Islington C)
Bishop E. S. Davies, Denzil (Lianelli) Grocott, Bruce
Blenkinsop, Arthur Davies, Ifor (Gower) Hamilton, James (Bothwell)
Boardman, H. Davis, Clinton (Hackney C) Hardy, Peter
Booth, Rt Hon Albert Deakins, Eric Harper, Joseph
Bottomley, Rt Hon Arthur Dell, Rt Hon Edmund Harrison, Walter (Wakefield)
Bradley, Tom Dempsey, James Hart, Rt Hon Judith
Bray, Dr Jeremy Doig, Peter Hattersley, Rt Hon Roy
Brown, Hugh D. (Provan) Dormand, J. D. Halton, Frank
Brown, Robert C. (Newcastle W) Douglas-Mann, Bruce Healey, Rt Hon Denis
Brown, Ronald (Hackney S) Duffy, A. E. P. Heffer, Eric S.
Buchan, Norman Dunnett, Jack Henderson, Douglas
Buchanan, Richard Eadle, Alex Hooley, Frank
Butler, Mrs Joyce (Wood Green) Edge, Geoff Horam, John
Callaghan, Rt Hon J. (Cardiff SE) Edwards, Robert (Wolv SE) Howell, Rt Hon Denis (B'ham, Sm H)
Callaghan, Jim (Middleton & P) Ellis, John (Brigg & Scun) Hoyle, Doug (Nelson)
Campbell, Ian Ennals, David Huckfield, Les
Cant, R. B. Evans, Fred (Caerphilly) Hughes, Rt Hon C. (Anglesey)
Carmichael, Neil Evans, Gwynfor (Carmarthen) Hughes, Robert (Aberdeen N)
Carter, Ray Evans, Ioan (Aberdare) Hughes, Roy (Newport)
Carter-Jones, Lewis Ewing, Harry (Stirling) Hunter, Adam
Cartwright, John Faulds, Andrew Irvine, Rt Hon Sir A. (Edge Hill)
Castle, Rt Hon Barbara Fernyhough, Rt Hon E. Irving, Rt Hon S. (Dartford)
Clemitson, Ivor Fitch, Alan (Wigan) Jackson, Miss Margaret (Lincoln)
Cocks, Rt Hon Michael (Bristol S) Flannery, Martin Janner, Greville

irrelevance, pushed through by people who do not understand what they are doing. We will reverse that policy. We will encourage private skills into health care. We will develop schemes for reintroducing private resources into the National Health Service so that we may free State money to be better spent in other areas, such as on the young, the old and the chronically sick. Ours is a policy of compassion.

People in the National Health Service who are afraid for their freedom and for the freedom of their patients are quite right to be concerned and to see the Bill as an attack on their future. They are right to believe that Labour Members care more for ideology than for patients. We believe in freedom in all areas. We believe in freedom in the National Health Service. The Bill will reduce freedom, and we shall unhesitatingly vote against it.

Question put, That the Bill be now read the Third time:—

The House divided: Ayes 288, Noes 264.

Jay, Rt Hon Douglas Moonman, Eric Spearing, Nigel
Jeger, Mrs Lena Morris, Alfred (Wythenshawe) Spriggs, Leslie
Jenkins, Hugh (Putney) Morris, Charles R. (Openshaw) Stallard, A. W.
Jenkins, Rt Hon Roy (Stechford) Morris, Rt Hon J. (Aberavon) Stoddart, David
John, Brynmor Moyle, Roland Stott, Roger
Johnson, James (Hull West) Mulley, Rt Hon Frederick Strang, Gavin
Johnson, Walter (Derby S) Murray, Rt Hon Ronald King Strauss, Rt. Hon G. R.
Jones, Alec (Rhondda) Newens, Stanley Summerskill, Hon Dr Shirley
Jones, Barry (East Flint) Noble, Mike Swain, Thomas
Jones, Dan (Burnley) Oakes, Gordon Taylor, Mrs Ann (Bolton W)
Judd, Frank Ogden, Eric Thomas, Dafydd (Merioneth)
Kaufman, Gerald O'Halloran, Michael Thomas, Jeffrey (Abertillery)
Kelley, Richard Orbach, Maurice Thomas, Mike (Newcastle E)
Kerr, Russell Orme, Rt Hon Stanley Thomas, Ron (Bristol NW)
Kilroy-Silk, Robert Ovenden, John Thompson, George
Kinnock, Neil Owen, Rt Hon Dr David Thorne, Stan (Preston South)
Lambie, David Padley, Walter Tierney, Sydney
Lamborn, Harry Palmer, Arthur Tinn, James
Lamond, James Park, George Tomlinson, John
Latham, Arthur (Paddington) Parker, John Tomney, Frank
Leadbitter, Ted Pavitt, Laurie Torney, Tom
Lee, John Pendry, Tom Urwin, T. W.
Lestor, Miss Joan (Eton & Slough) Perry, Ernest Varley, Rt Hon Eric G.
Lever, Rt Hon Harold Phipps, Dr Colin Wainwright, Edwin (Dearne V)
Lewis, Ron (Carlisle) Prentice, Rt Hon Reg Walden, Brian (B'ham, L'dyw'd)
Lipton, Marcus Price, C. (Lewisham W) Walker, Harold (Doncaster)
Litterick, Tom Price, William (Rugby) Walker, Terry (Kingswood)
Lomas, Kenneth Rees, Rt Hon Merlyn (Leeds S) Ward, Michael
Loyden, Eddie Reid, George Watkins, David
Luard, Evan Richardson, Miss Jo Watkinson, John
Lyons, Edward (Bradford W) Roberts, Albert (Normanton) Weetch, Ken
Mabon, Dr J. Dickson Roberts, Gwilym (Cannock) Weltzman, David
McCartney, Hugh Robinson, Geoffrey Wellbeloved, James
McDonald, Dr Oonagh Roderick, Caerwyn Welsh, Andrew
McElhone, Frank Rodgers, George (Chorley) White, James (Pollok)
MacFarquhar, Roderick Rodgers, Rt Hon William (Stockton) Whitehead, Phillip
McGuire, Michael (Ince) Rooker, J. W. Whitlock, William
MacKenzie, Gregor Roper, John Wigley, Dafydd
Mackintosh, John P. Rose, Paul B. Willey, Rt Hon Frederick
Maclennan, Robert Ross, Rt Hon W. (Kilmarnock) Williams, Alan (Swansea W)
McMillan, Tom (Glasgow C) Rowlands, Ted Williams, Alan Lee (Hornch'ch)
McNamara, Kevin Ryman, John Williams, Rt Hon Shirley (Hertford)
Madden, Max Sandelson, Neville Williams, Sir Thomas (Warrington)
Magee, Bryan Sedgemore, Brian Wilson(Alexander (Hamilton)
Mahon, Simon Selby, Harry Wilson, Gordon (Dundee E)
Mallalieu, J. P. W. Shaw, Arnold (Ilford South) Wilson, Rt Hon Sir Harold (Huyton)
Marks, Kenneth Sheldon, Robert (Ashton-u-Lyne) Wilson, William (Coventry SE)
Marquand, David Shore, Rt Hon Peter Wise, Mrs Audrey
Marshall, Dr Edmund (Goole) Short, Mrs Renée (Wolv NE) Woodall, Alec
Marshall, Jim (Leicester S) Silkin, Rt Hon John (Deptford) Woof, Robert
Mason, Rt Hon Roy Silkin, Rt Hon S. C. (Dulwich) Wrigglesworth, Ian
Maynard, Miss Joan Silverman, Julius Young, David (Bolton F)
Meacher, Michael Skinner, Dennis
Mendelson, John Small, William TELLERS FOR THE AYES:
Millan, Rt Hon Bruce Smith, John (N Lanarkshire) Mr. Frank R. White and
Miller, Dr M. S. (E Kilbride) Snape, Peter Mr. Thomas Cox.
Miller, Mrs Millie (Ilford N)
Adley, Robert Brotherton, Michael Crouch, David
Aitken, Jonathan Brown, Sir Edward (Bath) Davies, Rt Hon J. (Knutsford)
Alison, Michael Bryan, Sir Paul Dean, Paul (N Somerset)
Amery, Rt Hon Julian Buchanan-Smith, Alick Dodsworth, Geoffrey
Arnold, Tom Buck, Antony Douglas-Hamilton, Lord James
Atkins, Rt Hon H. (Spelthorne) Budgen, Nick Drayson, Burnaby
Awdry, Daniel Bulmer, Esmond du Cann, Rt Hon Edward
Baker Kenneth Burden, F. A. Dunlop, John
Beith, A. J. Carlisle, Mark Durant, Tony
Bell, Ronald Chalker, Mrs Lynda Eden, Rt Hon Sir John
Bennett, Sir Frederic (Torbay) Channon, Paul Edwards, Nicholas (Pembroke)
Benyon, W. Churchill, W. S. Elliott, Sir William
Berry, Hon Anthony Clark, Alan (Flymouth, Sutton) Emery, Peter
Biffen, John Clark, William (Croydon S) Eyre, Reginald
Biggs-Davison, John Clarke, Kenneth (Rushcliffe) Fairbairn, Nicholas
Blaker, Peter Clegg, Walter Fairgrieve, Russell
Body, Richard Cockcroft, John Fell, Anthony
Boscawen, Hon Robert Cooke, Robert (Bristol W) Fisher, Sir Nigel
Bottomley, Peter Cope, John Fletcher-Cooke, Charles
Bowden, A. (Brighton, Kemptown) Cordle, John H. Fookes, Miss Janet
Boyson, Dr Rhodes (Brent) Cormack, Patrick Forman, Nigel
Bradford, Rev Robert Corrle, John Fowler, Norman (Sutton C'f'd)
Braine, Sir Bernard Costain, A. P. Fox, Marcus
Brittan, Loon Craig, Rt Hon W. (Belfast E) Fraser, Rt Hon H. (Stafford & St)
Brocklabank-Fowler, C. Critchley, Julian Fry, Peter
Galbraith, Hon. T. G. D. Lawrence, Ivan Ridsdale, Julian
Gardiner, George (Reigate) Lester, Jim (Beeston) Rifkind, Malcolm
Gardner, Edward (S Fylde) Lewis, Kenneth (Rutland) Rippon, Rt Hon Geoffrey
Gilmour, Rt Hon Ian (Chesham) Lloyd, Ian Roberts, Wyn (Conway)
Gilmour, Sir John (East Fife) Loveridge, John Rodgers, Sir John (Sevenoaks)
Glyn, Dr Alan Luce, Richard Ross, Stephen (Isle of Wight)
Godber, Rt Hon Joseph McAdden, Sir Stephen Rossi, Hugh (Hornsey)
Goodhart, Philip McCrindle, Robert Rost, Peter (SE Derbyshire)
Goodhew, Victor McCusker, H. Royle, Sir Anthony
Goodlad, Alastair Macfarlane, Neil Sainsbury, Tim
Gorst, John Macmillan, Rt Hon M. (Farnham) St. John-Stevas, Norman
Gow, Ian (Eastbourne) McNair-Wilson, M. (Newbury) Scott, Nicholas
Gower, Sir Raymond (Barry) McNair-Wilson, P. (New Forest) Shaw, Giles (Pudsey)
Grant, Anthony (Harrow C) Madel, David Shepherd, Colin
Gray, Hamish Marshall, Michael (Arundel) Shersby, Michael
Grieve, Percy Marten, Neil Silvester, Fred
Griffiths, Eldon Mather, Carol Sims, Roger
Grimond, Rt Hon J. Maude, Angus Sinclair, Sir George
Grist, Ian Maudling, Rt Hon Reginald Skeet, T. H. H.
Grylls, Michael Mawby, Ray Smith, Cyril (Rochdale)
Hall, Sir John Maxwell-Hyslop, Robin Smith, Dudley (Warwick)
Hall-Davis, A. G. F. Mayhew, Patrick Speed, Keith
Hamilton, Michael (Salisbury) Meyer, Sir Anthony Spence, John
Hampson, Dr Keith Miller, Hal (Bromsgrove) Spicer, Michael (S Worcester)
Hannam, John Mills, Peter Sproat, Iain
Harvie Anderson, Rt Hon Miss Miscampbell, Norman Stainton, Keith
Hastings, Stephen Mitchell, David (Basingstoke) Stanbrook, Ivor
Havers, Sir Michael Moate, Roger Stanley, John
Hawkins, Paul Molyneaux, James Steel, David (Roxburgh)
Hayhoe, Barney Monro, Hector Steen, Anthony (Wavertree)
Heath, Rt Hon Edward Montgomery, Fergus Stewart, Ian (Hitchin)
Heseltine, Michael Moore, John (Croydon C) Stokes, John
Hicks, Robert More, Jasper (Ludlow) Stradling Thomas, J.
Higgins, Terence L. Morgan, Geraint Tapsell, Peter
Holland, Philip Morgan-Giles, Rear-Admiral Taylor, R. (Croydon NW)
Hooson, Emlyn Morris, Michael (Northampton S) Taylor, Teddy (Cathcart)
Hordern, Peter Morrison, Charles (Devizes) Tebbit, Norman
Morrison, Hon Peter (Chester)
Howe, Rt Hon Sir Geoffrey Mudd, David Temple-Morris, Peter
Howell, David (Guildford) Neave, Alrey Thatcher, Rt Hon Margaret
Howells, Geraint (Cardigan) Nelson, Anthony Thomas, Rt Hon P. (Hendon S)
Hunt, David (Wirral) Neubert, Michael Townsend, Cyril D.
Hunt, John (Bromley) Newton, Tony Trotter, Neville
Hurd, Douglas Nott, John Tugendhat, Christopher
Hutchison, Michael Clark Onslow, Cranley van Straubenzee, W. R.
Irving, Charles (Cheltenham) Oppenheim, Mrs Sally Vaughan, Dr Gerald
James, David Page, John (Harrow West) Viggers, Peter
Jenkin, Rt Hon P. (Wanst'd & W'df'd) Page, Rt Hon R. Graham (Crosby) Wakeham, John
Jessel, Toby Paisley, Rev Ian Walder, David (Clitheroe)
Johnson Smith, G. (E Grinslead) Pattie, Geoffrey Walker, Rt Hon P. (Worcester)
Jones, Arthur (Daventry) Penhaligon, David Wall, Patrick
Jopling, Michael Percival, Ian Walters, Dennis
Joseph, Rt Hon Sir Keith Peyton, Rt Hon John Warren, Kenneth
Kaberry, Sir Donald Pink, R. Bonner Weatherill, Bernard
Kershaw, Anthony Powell, Rt Hon J. Enoch Wells, John
Kilfedder, James Price, David (Eastleigh) Whitelaw, Rt Hon William
King, Evelyn (South Dorset) Prior, Rt Hon James Wiggin, Jerry
King, Tom (Bridgwater) Pym, Rt Hon Francis Winterton, Nicholas
Kitson, Sir Timothy Raison, Timothy Wood, Rt Hon Richard
Knight, Mrs Jill Rathbone, Tim Young. Sir G. (Ealing, Acton)
Knox, David Rawlinson, Rt Hon Sir Peter Younger, Hon George
Lamont, Norman Rees, Peter (Dover & Deal)
Lane, David Rees-Davies, W. R. TELLERS FOR THE NOES:
Langford-Holt, Sir John Renton, Rt Hon Sir D. (Hunts) Mr. Spencer Le Marchant and
Latham, Michael (Melton) Renton, Tim (Mid-Sussex) Mr. Cecil Parkinson.

Question accordingly agreed to.

Bill read the Third time and passed.