Lords Sitting of 14 May 1935

Preamble
The House met at a quarter past four of the clock, The LORD CHANCELLOR on the Woolsack.

MILITARY MANOEUVRES: MESSAGE FROM THE KING.
THE EARL OF CROMER: My Lords, I have to convey to your Lordships the following Message from the King:
"I have received your Address praying that I will make an Order in Council under the Military Manoeuvres Acts, 1897 and 1911, a draft of which was presented to your Lordships' House on the 12th day of February last. I will comply with your advice."

DISEASES OF ANIMALS BILL. [H.L.]
THE EARL OF LUCAN: My Lords, on behalf of my noble friend Lord De La Warr, I beg leave to introduce a Bill to make provision for the application of the enactments relating to diseases of animals as respects poultry; to amend those enactments; to provide for the regulation of the manufacture, sale and importation of certain therapeutic substances capable of being used for veterinary purposes; to extend Part I of the Ministry of Agriculture and Fisheries Act, 1919, to Scotland; and for purposes connected with the matters aforesaid; and to move that the Bill be read a first time.
Moved, That the Bill be now read 1a.—(The Earl of Lucan.)
On Question, Bill read 1a, and to be printed.

RENFREWSHIRE COUNTY COUNCIL (LOCHWINNOCH, ETC.) WATER ORDER CONFIRMATION BILL. [H.L.]
THE UNDER-SECRETARY OF STATE FOR WAR (LORD STRATHCONA AND MOUNT ROYAL): My Lords, I beg leave to introduce a Bill to confirm a Provisional Order under the Private Legislation Procedure (Scotland) Acts, 1899 and 1933, relating to Renfrewshire County Council (Lochwinnoch, etc.) Water.
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Bill presented; to be printed; and (pursuant to the Private Legislation Procedure (Scotland) Act, 1899, Section 7) deemed to have been read 1a and 2a and reported from the Committee.

STIRLINGSHIRE AND FALKIRK WATER ORDER CONFIRMATION BILL. [H.L.]
LORD STRATHCONA AND MOUNT ROYAL: My Lords, I beg leave to introduce a Bill to confirm a Provisional Order under the Private Legislation Procedure (Scotland) Acts, 1899 and 1933, relating to Stirlingshire and Falkirk Water.
Bill presented; to be printed; and (pursuant to the Private Legislation Procedure (Scotland) Act, 1899, Section 7) deemed to have been read 1a and 2a and reported from the Committee.

VOLUNTARY HOSPITALS (PAYING PATIENTS) BILL. [H.L.]
Order of the Day for the House to be put into Committee read.
Moved, That the House do now resolve itself into Committee.—(Lord Luke.)
On Question, Motion agreed to.
House in Committee accordingly:
[The EARL OF ONSLOW in the Chair.]
Clause 1:
Definitions.
1. In this Act unless the context otherwise requires—
VISCOUNT GAGE VISCOUNT GAGE moved to add to the clause:
"'Order' means an Order made by the Charity Commissioners for any of the purposes specified in subsection (1) of Section two of this Act."
The noble Viscount said: Perhaps I may be permitted on this Amendment to make a very few general observations on the Government's Amendments. Your Lordships will recollect that on the Second Reading the Government expressed general sympathy with the objects of the Bill, but at the same time they felt, in common with other members of your Lordships' House, that in granting new powers by way of a General Act careful provision ought to be made that the original intentions of existing trusts should be preserved. I think the particular concern of certain noble Lords

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opposite was lest some of the advantages enjoyed by the poorer patients to-day should be in any way invaded by the new class of paying patients. I suppose no one imagines that that was the intention of the Bill in any way, and most of your Lordships, including the Government, would no doubt agree with the noble Lord, Lord Luke, when he said that the probable effect of these paying patients would be to add to the advantages enjoyed by the poorer class of patients, and not to prejudice them.
But, as my noble friend the Leader of the House observed on Second Reading, we felt that the safeguards in the Bill could be, and should be, strengthened in regard to certain particulars which he then specified, and that those safeguards need not necessarily cut into the principles of the Bill; and that is what is proposed by the Government's Amendments. If any of your Lordships feel that some of these Amendments are pedantic or unnecessarily restrictive, I may remind you that the Government have a peculiar responsibility in the matter of trusts. We have, of course, to consider the question of justice to particular classes, but there are more general considerations as well. If, for instance, however remote the contingency might be, it could be shown in some particular case that some benefaction had been devoted to purposes other than that for which it was intended, it might conceivably have an unfortunate effect on the great stream of charitable benefactions which is now being so happily maintained. There is a very real difficulty in finding forms of words which will give reasonable latitude to these great hospitals and at the same time meet the points to which I have been referring. The Government have been in close touch with the representatives of the hospitals in all matters concerning these Amendments, and I am glad to say that in every case there has been agreement except in one particular to which I shall refer later. The first Amendment is merely a drafting Amendment, to avoid repetition of words.
Amendment moved—
Page 1, line 14, at end, insert:
("'Order' means an Order made by the Charity Commissioners for any of the purposes specified in subsection (1) of Section two of this Act").—(Viscount Gage.)
LORD LUKE: It may save your Lordships' time if I mention that those who are responsible for the promotion of this Bill are willing to accept all the Amendments on pages 1, 2, 4 and 5 of the Marshalled List. The little lack of agreement which the noble Viscount mentioned has reference to the proposed new clause to be found on page 3, and I hope that when we reach that the noble Lord, Lord Macmillan, who is Chairman of the Voluntary Hospitals' Parliamentary Committee, will deal with that matter.
On Question, Amendment agreed to.
Clause 1, as amended, agreed to.
Clause 2:
Accommodation for and charges to paying patients.
2.—(1) Notwithstanding the trusts express or implied upon which the property and funds of a. voluntary hospital are held, and notwithstanding any prohibition or restriction imposed by or under any local Act, charter, scheme, trust, deed, will, or otherwise, not being a prohibition or restriction imposed by a Public General Act, the committee of management may provide and maintain on any 'and from time to time belonging to them such new buildings or such existing buildings of the hospital, or such parts of such new or existing buildings and such and so many beds therein and for such period as the Charity Commissioners may on the application of the committee of management from time to time by Order authorise, for the accommodation and treatment of patients who are able and willing to make payment therefor.
(2) The committee of management may charge such patients for accommodation, medical or surgical attendance and treatment in accordance with such scale of charges as may be specified in any such Order.
VISCOUNT GAGE: The first Amendment, in subsection (1), to leave out "trust," is a drafting Amendment.
Amendment moved—
Page 1, line 19, leave out ("trust").—(Viscount Gage.)
On Question, Amendment agreed to.
VISCOUNT FALMOUTH VISCOUNT FALMOUTH moved, in subsection (1), after "Public General Act, "to insert" or by any local Act not relating expressly to the voluntary hospital." The noble Viscount said; I understand from what the noble Lord, Lord Luke, said, that he accepts this Amendment. But I am not quite certain of the position as regards the Government, and whether they consider this is a suitable Amendment.
Amendment moved—
Page 1, line 20, after ("Act") insert the said new words.—(Viscount Falmouth.)
VISCOUNT GAGE: As this is not a Government Bill we have no desire to stand in the way of the noble Viscount, but we feel that the words he has chosen are rather wide for the purpose he has in mind, and although we have no objection to their being inserted at this stage, we wish to reserve the right to suggest alternative wording at a later stage.
On Question, Amendment agreed to.
VISCOUNT GAGE: My next Amendment, in subsection (1), to leave out "any" and insert "such," is practically a drafting Amendment.
Amendment moved—
Page 1, line 22, leave out ("any") and insert ("such").—(Viscount Gage.)
On Question, Amendment agreed to.
LORD MACMILLAN LORD MACMILLAN had on the Paper an Amendment to leave out "medical or surgical attendance and treatment" in subsection (2) and insert "treatment and maintenance (including such medical and surgical attendance and treatment as is given by the resident staff of the hospital)." The noble and learned Lord said: The Amendment which stands in my name is designed to meet a criticism which has been raised by the British Medical Association. Our intention in the clause as originally framed was that in any scheme which should receive the approval of the Charity Commissioners provision should be made for a tariff which would cover all the expenses incurred by the hospital in treating patients of this class—that is to say, expenses of management, maintenance, and so on, including nursing. It was not intended to deal with fees, which would be a matter of private arrangement between a paying patient and his or her own physician or surgeon. When attention was drawn to the clause it did appear there was some ambiguity. We are most anxious to clarify the matter, and we have done so in the language we propose to substitute.
If the Amendment on the Paper were made the subsection would run:
"The committee of management may charge such patients for accommodation, treatment and maintenance (including such medical and surgical attendance and treatment as is given by the resident staff of the
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hospital) in accordance with such scale of charges as may be specified in any such Order."
When we submitted these words to the British Medical Association they drew attention to the word "treatment" where it first occurs, and said that it was really redundant because we had dealt with medical and surgical attendance and treatment given by the resident staff, the paid staff, of the hospital already. I should be quite willing to meet them and to delete the word "treatment" so that the subsection would then read:
"The committee of management may charge such patients for accommodation and maintenance (including such medical and surgical attendance and treatment as is given by the resident staff of the hospital) in accordance with such scale of charges as may be specified in any such Order."
That would leave to the patient as at present—as is the general practice—the liberty of arranging with his own physician or his own surgeon who may attend him in hospital the particular fee which is to be charged. We do not desire that liberty of private arrangement to be infringed in any way, and should your Lordships be pleased to accept the new form of wording that would achieve the purpose and meet the wishes of the British Medical Association.
Amendment moved—
Page 2, line 7, leave out from ("accommodation") to ("in") in line 8 and insert ("and maintenance (including such medical and surgical attendance and treatment as is given by the resident staff of the hospital)").—(Lord Macmillan.)
On Question, Amendment agreed to.
VISCOUNT GAGE: The next Amendment is purely drafting.
Amendment moved—
Page 2, line 9, leave out ("any such") and insert ("an").—(Viscount Gage.)
On Question, Amendment agreed to.
VISCOUNT GAGE VISCOUNT GAGE moved to insert at the end of the clause:
"(3) An Order may include any consequential or incidental provisions appearing to the Charity Commissioners to be necessary or desirable.
(4) The Charity Commissioners may, from time to time on the application of the committee of management, vary an Order, and, if in the opinion of the Commissioners there has been any material change in the circumstances existing at the time when an Order was made, they may, after giving to the committee of management and to any other

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persons appearing to the Commissioners to be concerned an opportunity of making representations, of their own motion vary or revoke the Order."
The noble Viscount said: This Amendment is proposed because it is felt that some power of variation and revocation should be given to the Commissioners. It is not entirely drafting, but I think it is uncontroversial.
Amendment moved—
Page 2, line 9, at end insert the said new subsections.—(Viscount Gage.)
On Question, Amendment agreed to.
Clause 2, as amended, agreed to.
VISCOUNT GAGE VISCOUNT GAGE moved, after Clause 2, to insert the following new clause:
Provision for patients able to make some, but not full payment.
.—(1) Except where the Charity Commissioners are satisfied that it would be inappropriate in the circumstances so to do, they shall include in the scale of charges specified in an Order charges fixed with a view to meeting the needs of patients who, though able to make some payment, are unable to pay charges sufficient to meet the full expense to the hospital of their accommodation, medical or surgical attendance and treatment, and shall make it a condition of the Order that in the use of a number to be specified therein of the beds whose maintenance is authorised thereby priority shall be given to such patients.
(2) An Order may, in cases where the committee of management have not the power so to do apart from an Order, authorise them to defray out of any funds applicable to the general purposes of the hospital the difference between the full expense to the hospital of the accommodation, medical or surgical attendance and treatment of such patients as aforesaid on the one hand, and the sums with which those patients are charged under the authority of the Order on the other hand.
The noble Viscount said: Your Lordships will remember that on the Second Reading my noble and learned friend the Leader of the House intimated that some provision ought to be made for ensuring that paying patients' accommodation should be available for persons of limited means. The matter was fully debated, and your Lordships generally agreed that there are many patients who, although able to make some contribution towards the treatment received, are unable to pay the full cost. I am not entirely familiar with what actually goes on in hospitals to-day, but if these patients are admitted to the free wards of certain hospitals it is very doubtful whether that can be done legally and theoretically under certain
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trusts. It is obviously desirable that hospital accommodation should be available for such persons, and it is proposed by this clause to make it obligatory on the Charity Commissioners, unless they think it inappropriate in the case of any particular hospital, to reserve a certain proportion of the accommodation for such persons and to fix a scale of charges accordingly. The amount of accommodation so reserved will, of course, vary in each particular hospital, and it may be that in the case of some hospitals the committee of management will be able to satisfy the Commissioners that it will be inappropriate that such accommodation should be reserved.
Your Lordships will appreciate that, apart from the charges possible for such patients, the scale of charges fixed by the Commissioners will be graduated to meet the needs of the various classes of the community served by the hospitals. The second subsection is machinery, to enable the difference betwen the cost to the hospital of the maintenance of these persons and the amount of money which they can contribute to be charged against the general hospital fund. I must point out to your Lordships that later on safeguards are inserted to prevent the diversion of funds held upon trusts for the sick poor, or analogous trusts, for the purpose of providing paying patients' maintenance, but we consider it obviously reasonable to regard the payment of the balance of the expenses of persons who are near the poverty line over what they can afford to pay as, in fact, a payment on behalf of the poor. I beg to move.
Amendment moved—
"After Clause 2 insert the said new clause.—(Viscount Gage.)
THE EARL OF DUDLEY: I want to say one word on this. While I fully agree with the necessity for these new clauses, and I shall support them whole-heartedly, I would like to utter one word of warning to the Government, and it is this. I hope they realise that the cheaper beds, the four-guinea beds for instance, for which the noble Viscount is seeking under this clause to make ample provision, are largely "carried" by the more expensive beds, the ten-guinea beds, and if the Charity Commissioners are apt to restrict the number of expensive beds he will find that it will be impossible to maintain the beds which are below cost.

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That is to say, if they restrict the beds which are above cost, which help to carry the beds that are below cost, they will eventually drive all the hospitals into having a one-standard bed, the seven-guinea bed, which is, in fact, cost price. I hope that we shall have some assurance, either from the Government or from the promoters of the Bill, that there is no intention to restrict the, higher cost beds in the case of the hospitals which at present have power to make the higher charges, or to restrict unduly the higher paid beds for patients who can afford to pay for them even above cost price in the case of hospitals which be granted these Orders by the Charity Commissioners when the Bill becomes law; because if they do such action will obviously be imposing a hardship on the poorer patients since hospitals will not be able to maintain these lower paid beds.
On Question, Amendment agreed to.
VISCOUNT GAGE VISCOUNT GAGE moved, after Clause 2, to insert the following new clause:
Provisions for protection of existing trusts.
The Charity Commissioners shall not make an Order authorising any use or application of property or funds which, apart from the Order, would involve a breach of any trusts upon which 'lie property or funds are held or a contravention of any prohibition or restriction imposed as mentioned in Section two of this Act—

(a) on an application for authority to use land, unless they are satisfied that if the Order were not made the land would not come into use for the purposes for which the trusts were created or the prohibition or restriction was imposed until alter the expiration a substantial period from the date of the application;

(b) on an application for authority to use existing buildings or part of existing buildings, unless they are satisfied that the use of the buildings or part thereof for the purposes for which the trusts were created or the prohibition or restriction was imposed is impracticable, or is likely soon so to become, either because the committee of management have not at their disposal, and will be unable to obtain, sufficient funds to enable the buildings or that part thereof to be, or to continue to he, so used, or because of a shortage of demand for accommodation on the part of the persons for whose benefit the trusts were created or the prohibition or restriction was imposed;

(c) in any case, unless they are satisfied that the authorisation will not diminish or restrict the accommodation for such persons as aforesaid which is provided in the hospital at the date of the application for the Order and which the committee of management would be
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able to continue to provide if the Order were not made.

The noble Viscount said: The first part of this new clause is agreed as between the Government and the promoters. That is to say, safeguards are put in dealing with various matters, and this clause indicates the conditions under which the Commissioners may make an Order allowing the land of hospitals to be used for the purpose of building new wards or buildings for paying patients; but your Lordships will see that the land is only to be authorised for the provision of new buildings if the Commissioners are satisfied that the land would not be required for the purposes of the trust upon which it is held for a substantial period. The second part of the clause, paragraph (b), is the only one in regard to which we have not been able to come to an entire agreement. As I understand it, the promoters think that in certain cases it may be possible, by rearrangement of wards, minor structural alterations, and so forth, to provide extra accommodation within existing buildings for paying patients. I think they are quite ready to give safeguards to protect whatever number of beds for poor patients they may happen to have, and to see that none of those poor patients suffer in regard to space or treatment through this rearrangement, but they claim, as I understand, to have the right to use the new accommodation for paying beds, provided no reduction in the numbers of dais class is occasioned.
We cannot entirely agree that this could be done within the terms of the ordinary trust deeds. We contend that if, by rearrangement of certain buildings, it is possible to provide, say, fifty beds instead of forty, the poorer class of patient has the right, under most of the trusts, to those extra ten beds. In other words, instead of having, as the promoters suggest, say, forty poor patients' beds and ten paying patients' beds, we contend you ought to devote the whole fifty to the poor, of course, if funds permit. If they do not permit, then the Order could be made, because the purposes of the trust would have failed. It is true to say that none of these things could be done without the consent of the Commissioners, but surely the Commissioners must have regard to the wording of the Bill. If the Bill authorises them

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to accept a definite limitation on the number of poor patients' beds in a given building, I presume they must abide by the decision of Parliament. If any other form of words can be devised to get over these difficulties, we will very carefully consider them, but we cannot at present accept words which vary the purpose of the trust in the way which we suggest will otherwise be done.
There is, I must say, one contingency which I think the promoters have in mind which does not, it seems to me, encroach upon the principle dealt with. A case may arise where a hospital has buildings, the trusts attaching to which do not allow the taking of paying patients, and also has other buildings. If such hospital desires to make an exchange there does not seem any reason, provided proper safeguards are given, why such an exchange should not be permitted. It is perhaps not an eventuality which would often happen, but if, under the Government Amendment, the Commissioners have not sufficient powers to meet it, we should be quite willing to consider words to give effect to an exchange. I beg to move.
Amendment moved—
After Clause 2 insert the said new clause.—(Viscount Gage.)
LORD MACMILLAN: I share the satisfaction which the noble Viscount has expressed at the large measure of agreement which has been achieved in the carrying through of this very beneficent measure, and I regret that there should remain even one point upon which we are not entirely agreed. But I venture to think the Committee, when I explain the point as we see it, will find itself in sympathy with the view I propose to express. The purpose of the new clause is really to meet the directions to the Charity Commissioners in the framing of new Orders under the Bill and to ensure that these Orders shall not infringe upon any existing purpose or involve diversion of the funds or property of the hospital from their original purpose. There are three paragraphs, (a), (b) and (c). Those relate, I take it, to the three forms of property which a voluntary hospital owns—first, land, secondly, buildings; and thirdly, funds. The purpose is to see, with regard to each type of property, that adequate safeguards shall be provided. As regards
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the use of land for providing accommodation to house paying patients, such land is not to be used for that purpose unless there is no prospect of its being used within a reasonable period for its original purpose. Therefore it would mean putting to a good purpose land which for the moment is really sterilised.
It is in regard to the use of existing buildings that we think the clause is not satisfactory. A very common case, which we have in mind, is that of a hospital where the funds are at present entirely devoted to the existing type of beneficiary, that is, the ordinary poor patient. I cannot say non-paying patient because experience shows that in many hospitals a large number of poor patients actually pay something now. The new category of patients will be patients against whom a charge is made as distinct from patients who merely pay something voluntarily. In many hospitals it would be possible by internal rearrangement at a relatively small expenditure to accommodate a limited number of patients against whom a charge might be made. But under the safeguard that is proposed here it would not be possible to do that unless the hospital management could show one of two things—either that the hospital was short of funds to engage in its ordinary work, which, of course, would not apply to most hospitals; or that there was a shortage in the demand for accommodation. Both these things, or either of them, might be very difficult indeed to prove in many instances. There would be an instruction to the Charity Commissioners not to allow the adaptation of existing buildings unless those rather unusual conditions obtained.
The noble Viscount said that if there were to be any extension or adaptation of any existing building it ought primarily to be for the original beneficiaries, but I should like to point out to him that the expenditure incurred in adaptation would be expenditure incurred for the very purpose of providing for the new type of paying patient. The extension or adaptation of accommodation would not come into existence at all if not to provide for paying patients. In many instances it would be possible by rearrangement, without prejudice to existing accommodation, to obtain a certain amount of room which could be adapted to accommodate these paying patients.

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I should have hoped that a sufficient safeguard with regard to existing buildings would be that the Charity Commissioners should not sanction any Order for adaptation or alteration of existing buildings so as to accommodate paying patients unless the Charity Commissioners were satisfied that equivalent accommodation was maintained for existing poorer beneficiaries; or, if the word "equivalent" is thought to limit and possibly to restrict too much the accommodation provided, it might be said that adequate provision should be made for that class.
I would remind the noble Viscount who has just spoken that a clause in the Bill which we have passed seems to me to protect against any possible abuse those who use the hospitals. The Charity Commissioners are empowered to recall or vary any Order and they may do that of their own mere motion. Consequently, if any hospital, having obtained an Order for the adaptation of a building for this new purpose, so acted as in any way to prejudice existing beneficiaries, the Charity Commissioners might,, if they pleased, recall the Order or vary the Order at any time; so that they have the most adequate hold, I think, upon the administration of the hospital. I should have thought, therefore, that the Government might have seen their way to regard as adequate a safeguard which provides that the Charity Commissioners should not grant any powers to adapt a building unless adequate or equivalent accommodation was maintained for the original class of patient. If it had been proposed here to empower hospitals themselves to do these things I could have imagined there was more reason for anxiety, but hospitals are not being empowered to do anything by the Bill. It is the Charity Commissioners who are empowered to sanction schemes, and all the details of a scheme will be put before the Charity Commissioners, than whom no people are more qualified to gauge the whole circumstances. If they have a general direction to safeguard existing beneficiaries by seeing that accommodation is gained for the new without detriment to the old, that, I think, should be a sufficient safeguard.
In paragraph (c) you have again an admirable safeguard. That paragraph
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says that the Charity Commissioners shall not make an Order
"in any case, unless they are satisfied that the authorisation will not diminish or restrict the accommodation for such persons as aforesaid winch is provided in the hospital at the date of the application for the Order and which the committee of management would be able to continue to provide if the Order were not made."
There is there a general overruling consideration that the new provision is not to diminish or restrict accommodation for existing beneficiaries. Therefore I appeal to my noble friend in charge of the Bill to consider whether it would not be possible to alter the wording of paragraph (b)—which is the only one on which we do not see eye to eye—so as to give a greater measure of freedom for the adaptation of buildings without the necessity of incurring the expense of providing new buildings. A great deal can often be done internally at comparatively small cost, saving a little space here and a little there, in order to provide for paying patients. In that way accommodation can be found for the new class of patient without real detriment to the original class of patient. I appeal to my noble friend to consider between now and Report stage whether he can see his way to modify this very stringent provision because the conditions imposed are conditions which so seldom happen that the clause would really become of no effect.
LORD SANDERSON: As I raised certain objections to this Bill on Second Reading, objections to which the noble Viscount referred in his opening remarks, I should like to say that we on these Benches are in favour of all the Amendments that have been proposed. We think that they remove the objections which I raised and that they are adequate to preserve the rights of poorer patients under existing trusts. I particularly welcome the new clause which is now under discussion. It is the one which I think goes furthest in the direction of safeguarding the poorer patients about whom I am anxious. I am afraid that I have not been quite convinced by the argument of the noble Lord, Lord Macmillan, because I think that, if hospital authorities can enlarge old buildings—or rather, make more room in those buildings for snore beds—these extra beds, as the noble Viscount said, should be used for the poorer patients. I feel

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that rather strongly, especially when I remember the long waiting lists which there are in nearly all hospitals at the present time, and which I suppose are likely to exist for a long time to come. I therefore hope that the Amendment will go through as it stands.
LORD GREVILLE: The noble Lord who has just sat down suggested that in a hospital that may have extra space, those additional beds should be devoted to the non-paying patients. But what about a hospital whose endowment funds do not allow it to increase those beds, whereas if it were allowed to have paying beds it would be able to use the extra space to have those paying beds and thereby increase the hospital services? That is a point to which I should like to draw the attention of the noble Viscount.
THE SECRETARY OF STATE FOR WAR (VISCOUNT HAILSHAM): Possibly, as I addressed your Lordships on the Second Reading, I may be allowed to say just a few words on this point. I would point out that, as I am sure my noble friends on the Cross Benches realise, the Bill is a purely private venture. It is brought forward by them; the Minister in charge of the particular Department which is primarily concerned with watching over the interests of this class of public activity is not a member of this House, and the Attorney-General, who is by law and custom the protector of all charities, although always summoned to attend your Lordships' House, never avails himself of the privilege, because if he did so he would instantly lose his right to sit in another place. Accordingly there is no one here who can speak with much authority; we can only represent to your Lordships the opinion which has been formed by those who are primarily responsible after considering the arguments on each side. I am quite sure that the noble Lords on the Cross Benches will concur with me when I say that the Government have tried very hard to reach an agreement with them and have given to the Bill which they are introducing a very careful and, I hope they will agree, a sympathetic consideration. I know that, personally, I have done my best to ensure that that shall happen.
As regards this particular Amendment, which is really the only matter in controversy now as between the Government and the promoters, my noble friend Lord
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Macmillan naturally stated the position with admirable clarity and lucidity. He would not have attained to his present position in your Lordships' House if he did not always do that. I think, however, that it is just as well to explain, if I may, the difficulty which the Government feel about this. There is, of course, no difference between us that where there is any unused land for which there are no funds and no likelihood of funds to build free wards, under the provisions of this Bill it will be possible to erect paying wards. There is no difference between us there. When there are existing buildings containing beds which are used for the patients who cannot afford to pay, there is to be no question of any of those beds being diverted to the purpose of the paying patients—the patients against whom a charge is made—unless, again, the Commissioners are satisfied that there is no prospect of its being possible to use them for their existing object. As to that there is no difference between us, and there is no question at all in the minds of the Government in considering this clause as to protecting the public against an irregularity. My noble friend Lord Macmillan said that ample provision was made by other clauses in that regard.
Here, however, it is not a question of any irregularity at all. Also, my noble friend was quite right when he said that under the provisions of the Bill the Charity Commissioners are the people who will have authority to lay down rules and to see that they are properly carried out. I agree entirely that that is so. Naturally the Charity Commissioners, when they are considering whether or not they will give the sanction which the Bill empowers them to give to do what would otherwise be a breach of trust, must look at the measure to see what Parliament says are the circumstances under which the breach of trust may be authorised by them. It was therefore essential, as it seems to us, that in the Bill itself we should lay down quite clearly the circumstances in which the Charity Commissioners are to have authority to permit a breach of trust. The point at issue between us, and I think the only point at issue, is this. We agree that where there are existing buildings with existing beds, they cannot be diverted to other uses unless the conditions of the Bill are satisfied. My noble friends want

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the Bill to allow the Charity Commissioners to say that, where existing buildings have been erected and money has been provided for the express purpose of giving free medical or surgical help to the poor, then those buildings provided with that money may be adapted to hold more beds than they do at present, and the surplus beds in those existing buildings may then be used for all the patients, notwithstanding the fact that there is money available to the hospital to use them as free beds and that poor people unable to pay anything would like to avail themselves of those free beds.
Now those responsible for advising the Government and for considering this matter on behalf of the Government take the view that, where buildings have been provided for the very poor, the people who can pay nothing, and where there are very poor people who need the help of that hospital and there is no room for them at present., and if it be possible by rearrangement of those existing buildings to provide extra accommodation, then that accommodation should be earmarked and devoted to the purpose for which the buildings were erected—namely, the purpose of providing free help for the poor. My noble friends, on the other hand, say: "Oh, no; if the rearrangement is afforded by monies which axe obtained from outside sources, then the extra. accommodation so provided may be used for patients against whom a charge is made." Well, it is a matter of principle, on which it is quite obvious that different views may be held. We have considered the matter carefully, and. we do not feel that it would be right to allow existing buildings which were provided for the poor and which the poor need, and which the hospital would be in a position, if the internal alterations were made, to use for the very poor, to be used for any other purpose. It is on that ground that we think that the Amendment ought to be carried in the form in which it stands on the Paper.
As I say, I can understand a different view. It is really, I suppose, a question of principle when you look at it. It is certainly not a question of any fear of any irregularity, or any distrust of the hospital authorities or the Charity Commissioners; it is only a matter of asking Parliament, in sanctioning the possibility of breaches of trust in certain circumstances, to define the limits within which
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they think that these breaches of trust ought to be permitted. I am sorry that we have not been able to reach agreement on the point with those responsible for the Bill, who are, as we know, the spokesmen for those who carry on the very arduous and responsibe work of maintaining and managing the hospitals, and who do it with great sympathy and efficiency. I can assure them that it is from no lack of sympathy with their objects, but unfortunately, because we differ from them in the way we look at this particular question, that we are unable to yield to their solicitations and feel bound to press upon them that, if the Bill is to have a chance of further consideration, the Amendment should go forward in the form in which my noble friend Lord Gage has moved it. If, on the other hand, they deem it to be true, which I think is a little bit of exaggeration, that the Bill is of no value unless this form of breach of trust is authorised and permitted, it does not make much difference—
LORD MACMILLAN: May I interpose to say that I should not have said that the Bill would have been of no value, but I should have said that this provision would have been of little value.
VISCOUNT HAILSHAM: I thought the noble Lord was rather over-stating, and I hope that he, and those who act with him, will realise that possibly half a loaf may be better than no bread, and that it might be worth while getting this Bill in the form which we propose. However, it is entirely for them. It is a matter for people who, I know, are considering it in no spirit of controversy, but only in what they conceive to be their duty. Having explained the difficulty which the Government feel, I can only leave it to them to decide whether or not they desire to press their objection to the Amendment.
LORD LUKE: I do not want to take up your Lordships' time, but I would like to take this opportunity of thanking the noble Viscount, the Leader of the House, and the Government, for all the trouble they have taken in connection with this Bill. I still have hope that between now and the Report stage we may find some form of words which will improve the position.
VISCOUNT HAILSHAM: The noble Lord will perhaps allow the Amendment to go through in its present form, and

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I can assure him that it will not prejudice him in any discussions which may take place between himself and members of the Government who are responsible.
On Question, Amendment agreed to.
Clause 3:
Power to Charity Commissioners to make rules.
3.—(1) The Charity Commissioners may make rules in relation to applications for Orders in pursuance of this Act and proceedings in connection therewith, and to the publication of notices and advertisements and the manner in which and the time within which representations or objections with reference to any application or other proceedings are to be made, and to the holding of inquiries in such cases as they may think advisable and to the cost of such inquiries and to any other matters arising under or in pursuance of this Act.
(2) Any rules made in pursuance of this section shall be laid before Parliament as soon as may be after they are made and shall have the same effect as if enacted in this Act.
VISCOUNT GAGE: My first Amendment is drafting.
Amendment moved—
Page 2, lines 11 and 12, leave out ("in pursuance of this Act.")—(Viscount Gage.)
On Question, Amendment agreed to.
THE LORD CHAIRMAN: In order to save a later Amendment standing in the name of Lord Luke, perhaps the noble Viscount will permit me, when he moves his next Amendment, to put it in this form: That the words "and to the" stand part of the clause.
VISCOUNT GAGE: I am ready to agree to that. This Amendment is also drafting, and instead of moving to omit the words" and to the cost of such inquiries," I will move to leave out "and to the."
Amendment moved—
Page 2, lines 17 and 18, leave out ("and to the.")—(Viscount Gage.)
On Question, Amendment agreed to.
THE LORD CHAIRMAN: Perhaps Lord Luke, instead of moving his next Amendment, to substitute "costs" for "cost," will move to leave out "cost of such inquiries."
LORD LUKE: I will move the Amendment in that form. "Cost" is a misprint.
Amendment moved—
Page 2, line 18, leave out ("cost of such inquiries").—(Lord Luke.)
On Question, Amendment agreed to.
LORD LUKE LORD LUKE moved, in subsection (2), to leave out "and shall have the same effect as if enacted in this Act." The noble Lord said: These words are now unnecessary.
Amendment moved—
Page 2, line 22, leave out from ("made") to the end of line 23.—(Lord Luke.)
On Question, Amendment agreed to.
VISCOUNT GAGE VISCOUNT GAGE moved, after subsection (2), to insert:
"(3) The Charity Commissioners may require such sum as they may determine to represent costs or expenses incurred by them in the exercise of the powers conferred upon them by this Act (including a sum in respect of the services of an officer engaged in !an inquiry) to be provided out of any funds, being funds under the control of the committee of management of the hospital in relation to which the expenses are incurred, whether representing capital or income, which in the opinion of the Charity Commissioners may properly be made applicable for that purpose."
The noble Viscount said: I think this is a perfectly clear subsection. The Charity Commissioners do not, under the existing practice, make any charge to charities for their services. Under the powers conferred upon them by this Bill, the Commissioners will have additional duties cast upon them, which may involve extra expenditure. For example, it is not unlikely that it will be necessary to hold local inquiries, and it is felt that such expense ought to be borne by the hospital concerned. This Amendment has been inserted to give the Commissioners power to recover their costs and expenses from the applicants under the Order.
Amendment moved—
Page 2, line 23, at end, insert the said new subsection.—(Viscount Gage.)
On Question, Amendment agreed to.
Clause 3, as amended, agreed to.
Clause 4 [Savings]:
VISCOUNT GAGE: The next three Amendments are purely drafting Amendments.
Amendments moved—
Page 2, line 24, leave out subsection (1).
Page 2, line 37, leave out ("provisions of") and insert ("powers conferred on the Charity Commissioners by")
Page 2, line 38, leave out from ("any") to the end of the clause and insert ("other powers exercisable by them"),—(Viscount Gage.)
On Question, Amendments agreed to.
VISCOUNT GAGE VISCOUNT GAGE moved to insert at the end of the clause:
"(4) Except to the extent of an application of funds authorised under subsection (2) of Section three of this Act, an Order authorising the provision or maintenance of any buildings or beds shall not be construed as conferring on the committee of management any power, which apart from the Order would not be exercisable by them, to apply funds in the provision or maintenance thereof."
The noble Viscount said: Clause 2 of this Bill enacts that, a committee of management may be authorised to provide and maintain beds for paying patients. Standing alone this authorisation would impliedly carry with it an authorisation to meet the expenses of the provision and maintenance of the beds. For the protection of existing trusts it is necessary to make it quite plain that funds held on trust for the sick poor are not to be applied in meeting those expenses except in so far as this Bill will expressly authorise such application; that is to say, as provided in the first new clause dealing with the balance of the expenses of patients who are near the poverty line. The insertion
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of this subsection will make that quite plain.
Amendment moved—
Page 2, line 40, at end insert the said new subsection (4).—(Viscount Gage.)
On Question; Amendment agreed to.
Clause 4, as amended, agreed to.
Clause 5:
Short title and extent.
5.—(1) This Act may be cited as the Voluntary Hospitals (Paying Patients) Act, 1935.
(2) This Act shall not apply to Northern Ireland.
LORD LUKE LORD LUKE moved, in subsection (2), before "Northern Ireland," to insert "Scotland or to." The noble Lord said: In Scotland they have not got the Charity Commissioners, and therefore this Bill could not very well function there.
Amendment moved—
Page 2, line 43, after ("to") insert ("Scotland or to").—(Lord Luke.)
On Question, Amendment agreed to.
Clause 5, as amended, agreed to.

COUNTERFEIT CURRENCY (CONVENTION) BILL. [H.L.]
Read 3a (according to Order), and passed, and sent to the Commons.
House adjourned at ten minutes past five o'clock.