NUTRITION.

HL Deb 05 May 1937 vol 105 cc132-75

VISCOUNT ASTOR rose to draw attention to the Report of the Advisory Committee on Nutrition to the Ministry of Health; and in view of the recommendations of this Committee to ask (a) whether the Ministry of Labour inquiry for the purpose of the cost of living index will include an inquiry into dietary surveys and, if so, how many families will be concerned in this inquiry, and what steps are being taken to ascertain the family incomes so as to correlate this inquiry with that proposed to be undertaken by the Registrar-General and an independent statistician; (b) whether steps have been taken by the Registrar-General to carry out this proposed inquiry into the constitution of families by age, sex, occupation and locality, and into the distribution of family incomes; (c) what local authorities in urban and rural areas respectively are conducting dietary surveys in England and Wales and in Scotland respectively, and about how many families will be covered in each country; and to move for Papers.

The noble Viscount said: My Lords, I am not going to spend any time in trying to explain the case of malnutrition. There have been so many reports, national and international, recently and the subject has been so much debated in Parliament and in the Press that I do not think it is necessary for me to set out to attempt to make a case. The causes of malnutrition are mainly two—ignorance arid poverty. Ignorance has a bearing upon it, but after one makes all allowances for the ignorance of the housewife and the cook it really is a very small contributory factor. The main cause of the evils of malnutrition is undoubtedly poverty. By malnutrition I do not mean hunger, I do not mean starvation; I mean a degree of ill-health or of subnormality due to malnourishment and in cases actual bad physical development due to malnutrition in early youth. So that the problem really is one of purchasing power.

Your Lordships are aware that an Advisory Committee on Nutrition was set up some time ago by the Minister of Health under the Chairmanship of my noble friend Lord Luke. The Committee have just issued a Report, and I would like straight away to draw attention to certain paragraphs in that Report headed "Variation in food consumption at different income levels" in order to substantiate what I have just said, that the problem of malnutrition is very largely a problem associated with lack of purchasing power. The Committee appointed a Statistical Sub-Committee that examined all the available data more particularly the data which had been collected by the Market Supply Committee. A Report from this Committee was published in the Journal of Proceedings of the Agricultural Economics Society in April, 1936, and the Advisory Committee state of this Statistical Sub-Committee that: After examining the data and the methods employed, the Sub-Committee did not discover any reason to suggest that the results arrived at by the Market Supply Committee are seriously misleading.… That is to say, they accepted them as being substantially correct.

Now, what are those findings of the Market Supply Committee? They are indeed very startling. Four and a half million people spend only 4s. a week on food. According to the Market Supply Committee, roughly half the people of this country are adequately and satisfactorily nourished. That means that the other half are inadequately and unsatisfactorily nourished. Lord Luke's Committee go on to say: … the conclusions as to the broad trend of consumption of the different articles of food over the income groups appear to us likely to be in accordance with the facts. That is to say that where you have got a small income you have a small expenditure on the essential foods, the health-giving foods. So that the Committee accepted straight away the broad conclusion that this problem is really a problem of purchasing power, or of lack of purchasing power.

It is a serious problem, because a large number of people who show the effects of malnutrition cannot be put right. It is a problem which arises very largely because of malnourishment in youth. There is periodically a discussion in the Press about excessive maternal mortality. A certain number of the cases of maternal mortality are due to malformed pelvis. That is due to the malnutrition of the woman when she was a child. I merely give that as an illustration of the connection between malnutrition and ill-health. The difficulty is that we have to get into our minds an entirely new standard. I have no doubt that at the beginning of last century medical officers who walked about our large industrial cities were perfectly satisfied with the housing conditions which they found there. To-day those same medical officers, walking down those same streets, looking at those same houses, would unanimously agree that those houses must be pulled down as slums. We have to bear that in mind when we see quoted, as we so often do, reports from medical officers of health to the effect that there is no problem of malnutrition. Those who make such reports are out-of-date; they are not acquainted with the new knowledge, with the new findings of science. After making all allowances for exaggeration and over-statement, one can say without fear of contradiction that there is a real problem of malnutrition affecting millions of people of this country.

Now, what is the size and nature of the problem? I sent to the noble Lord who is going to speak on behalf of the Government certain questions that I was going to put to him in order that he should be able to fortify himself and to give the House the benefit of the information I asked for. I also put them down on the Paper in order that your Lordships might know what some of the points were. The questions which I have drafted are entirely based on recommendations of the Advisory Committee and, in addition to that, there are two other points of which I have given my noble friend private notice. I would very much like to know how soon the result of these inquiries is likely to be published—the approximate date. In particular, I would like to refer to page 26 of the Advisory Committee's Report where reference is made to methods of clinical assessment. Do the Ministry contemplate undertaking an investigation of the clinical aspects in direct correlation with the dietary surveys which it is proposed to make?

Lord Luke's Committee emphasise the necessity of having more information upon detail. If we are going to deal with a problem such as this it is essential that we should have as much information as possible about all the details. Other countries, Scandinavia, the United States of America, when they make surveys—and they have been making surveys—make them on a large scale. In America I think they do it on the scale of 300,000 family budget inquiries. I am not suggesting that in a country with 44,000,000 people as compared with over 120,000,000 in America we should do it on that scale, but a great opportunity will be missed if the Government do not insist that these surveys should be adequate in their size and magnitude, and that a sufficient amount of information is collected. I am perfectly certain that the Government have no intention of waiting until they receive these surveys. After all, it does not matter whether the statements which I have quoted are exaggerated by 5 or 10 per cent or are under-statements by 5 or 10 per cent. The facts justify immediate action. As the Advisory Committee said, much of the health and of the physique of the nation is below what it should be because of malnutrition. So I hope that the Government will feel that they already have enough information to justify early action, however necessary it may be to get additional information on details.

The League of Nations Committee, over which I have the honour to preside, very soon after they started their work urged all Governments to set up ad hoc Nutrition Committees. They did that because the problem of nutrition is one which affects a large number of Departments. The commercial policy of a country, the health policy of a country, the state of industry of a country, the agricultural policy of a country—all of these have a bearing upon the price of food, and so upon nutrition. The population of a country cannot be properly nourished if that country has a wrong agricultural policy or a wrong trade and commercial policy. When this subject was first raised at Geneva one of the speakers referred to the marriage of agriculture and health. What is the main function of agriculture? Is it to give employment, is it to provide one of our assets in defence, or is it to feed the people? I suggest that the main function of agriculture in this country is not to give employment, is not to help in defence in time of war. Obviously it will give employment, obviously it will help in case of war. But the main function of agriculture, certainly in this country, should be to see that the right sorts of food are provided at the right costs for our people.

This has been a very difficult time for agriculture. There has been the world slump, the fall in prices; and, further, agricultural policy is very much disturbed and upset by a revolution which is going on. Your Lordships will remember how industry was upset by the industrial revolution of the last century. Now you have the chemist, the biologist, the engineer, all of them with their new inventions, their new processes, their new techniques, making life extraordinarily difficult for the agriculturist who wants to go on with the same methods and at the same pace as his fathers and his grandfathers did before him. Agriculturists have therefore been having an extraordinarily difficult time. All these things have upset them. The other day I was at Geneva and my Committee were discussing a draft of a final Report which had been prepared for them. I was very much amused when one of the members of the Committee who represents agricultural interests got up and said: "Mr. Chairman, I want to object very strongly to a phrase which you used. You referred to the profits of agriculture.' Mr. Chairman, I want you to realise that agriculturists never make profits!" That is one of the difficulties one has in dealing with agriculture, that agriculturists will never admit that times are good or that some of them are making profits. One is apt to listen far too much to the farmers who are losing money, when moulding policy or expressing opinions. I have always gone out of my way, when I have heard of a farmer who had altered his methods or who was making money, to try to get in touch with him and see him. It is extraordinary, when you do that, what great changes in food production you find here in this country.

We should aim at basing our agricultural policy upon the methods of the farmers who are making money rather than pay quite as much attention as we are apt to pay to the shouts and protests of the farmers who are not making money or who are losing money, or who do not want to change their methods in order to move with the times. Because of the slump in world prices and the revolution to which I have referred, consumers were threatened with cheap food; and farmers were threatened with the benefits of science and progress. That may be a slight exaggeration, but fundamentally it is true that too much of our agricultural policy has been directed to giving a standstill to agriculture—to making it easy for the farmers not to make use of science and progress. Then agriculture has had a further difficulty to contend with. During the last few years since the War there has been a great deal of talk about planning—the planning of industry. Noble Lords, particularly those belonging to the Socialist Party or the Communist Party were all for schemes of organisation. If you said you had a scheme of reorganisation they thought it must be wonderful, and too often noble Lords sitting on the other side, members of my Party, have also fallen for this planning of agriculture and for schemes, putting aside their practical experience which should have warned them of the difficulties. Obviously there has got to be some planning, only the amount of control which Parliament has attempted to impose upon farmers has been extraordinarily difficult for farmers. I do not believe it has been to the advantage of agriculture.

Let me just give two illustrations of the effect of some of these schemes upon two commodities. Take the Bacon Scheme, or bacon quota. I saw the other day a protest from a very important section of the pig producers. They complain because the Bacon Scheme, with the quota, had cost the consumer £5,000,000, and of those £5,000,000 taken from the consumer, £1,000,000 had gone to the Dominion farmers, £3,000,000 to foreign farmers, and the British farmer had only got the benefit of £1,000,000. That would be humorous if it were not so tragic—that the consumer should pay £5,000,000 and the British farmer should benefit only to the extent of £1,000,000 out of it. That is what I mean by saying that the farmers have to struggle against these ill-digested and ill-composed schemes which are imposed upon them.

Take another commodity, milk. The Advisory Committee's Report contains 35 paragraphs referring to milk, which indicates the importance to nutrition of milk as an article of consumption and diet. It is the foundation of good nutrition, as the Committee point out. Is this country a suitable and good country for milk production? Surely it is. We have got some of the best grass-land in the world, and an excellent climate so far as rainfall is concerned, and yet after four years of the Milk Marketing Scheme we find a very low consumption of milk, and retail prices higher in this country than almost any other country—the second highest in the world. The price is twice and three times the price of that in many countries in Europe, and the dairy farmers are all discontented. That is the situation after four years of the Milk Scheme—the farmers discontented, retail prices much higher here than on the Con- tinent, and a very low consumption of milk.

There surely must be something fundamentally wrong with a scheme that has such results. The first thing that is wrong with the Milk Scheme in my opinion is the structure of the governing body. If we were dealing with armaments, would anybody suggest we should go to the armament firms and say: "We will pass an Act of Parliament giving you statutory power to form a monopoly ring. You can elect your own governing body, and if any armament manufacturer dares to cut prices you can put him in prison, and we will have no Ministry of Munitions to supervise"? That is what is being done with the Milk Scheme. The Milk Board is elected by the farmers and is subject to re-election by the farmers. Any member of the Milk Board who wants to be re-elected is obviously going to try to keep the price up. He would not be reelected if he attempted to increase efficiency in the dairy industry by lowering prices. That is the first thing that is wrong with the Milk Scheme.

The second thing which is wrong is that the Milk Board has used its powers in order to try to develop new industries in this country. These existed to a limited extent before, but they are being expanded. I mean the new industries of butter making, cheese making, and processed milk. And how have they done it? They have built up these new industries by imposing a tax on milk drinkers. The drinkers of milk to-day are paying roughly a tax of 3d. a gallon on this account. This tax on milk drinkers last year totalled something like £6,000,000. The Treasury also are making a contribution of about £1,250,000 or £1,500,000 towards the development and expansion of these butter factories and other factories which compete very largely with our Diminion producers and exporters to this country. These activities of the "Milk Board" have been condemned both by the Milk Commission which has recently been sitting and also by the Milk Council; but the result of all this is that the price of milk in England to-day is much too high.

The Minister of Health the other day, as soon as the Report of the Advisory Committee was published, circularised all local authorities drawing their attention to the recommendations of the Report of this Committee and urging them to make more provision for supplying milk to mothers and children. Why should the Minister of Health ask the ratepayers to spend money in buying milk which has been artificially put up in price by another colleague in the Cabinet? The Minister of Health must get his colleagues in the Cabinet to give the country reasonably cheap milk—milk produced by an efficient dairy industry—and then he can ask the local authorities, with the expectation that they will accede to his request, to spend the ratepayers' money in providing milk for mothers and children and others who need it. The Minister of Health the other day, speaking in another place, referred to the fact that special provision had been made in the Rhondda for giving the inhabitants there—the unemployed in this distressed area—cheap milk, milk at 2d. a pint. Everybody ought to be able to get milk at 2d. a pint without subsidy. It is quite possible to do it. Our aim should be to reduce the price of milk by 8d. a gallon, which would bring it down to 2d. a pint instead of 3d., which is the present cost. Even after we have done that, we should still have to have subsidised milk for large sections of the community, but that should be the standard price of milk for the country as a whole.

I am going to show how it could be done. I am going to use only round figures. You can reduce the cost of milk by one-third. First of all you can save 3d. a gallon by stopping the subsidy—what I call the tax that is imposed on milk drinkers for the benefit of these butter factories, cheese factories, and the factories for dry and condensed milk. You can save 3d. a gallon in that way. Then you ought to be able to save 3d. or 4d. on distribution. The Food Council issued a Report recently. I am going to make two quotations from their Report, and the first one is as follows: … the retail margins or prices prescribed have not been fixed at sufficiently low levels and must impose on certain sections of the public charges for milk out of proportion to the services rendered in its distribution … And the second quotation is as follows: The tendency of producers is to seek the co-operation of the intermediaries (i.e. distributors) by securing to them minimum margins, which are frequently, exceeded and which are not based upon ascertained costs for the specific services to be rendered. So that the distribution of milk could be enormously cheapened.

An experiment has been made in Ulster on what I call the "cash-and-carry" basis. We ought to try that here. Instead of delivering milk, which is obviously expensive, I believe provision is made there that after a certain hour of the day, if consumers go to the milk shops and fetch milk for themselves, they can get it at 4d. a gallon less; at any rate there is a substantial reduction in price. I was talking the other day to a big dairyman, who told me that when he sold milk for cash and without credit in London he was able to sell it, I think, at one penny a quart less than afterwards when he sold for credit. The number of removals and bad debts add enormously to the cost of the distribution of milk. It is no exaggeration to say that we ought to be able to reduce the cost of milk distribution, to large sections of the community, by 3d. or 4d. a gallon. What about production? The Milk Commission stated on page 196: The needs of the liquid milk market and its reserve could have been supplied at an appreciably lower price which would still have been remunerative to the producers. If the present price to producers produces a large surplus beyond the requirements of the liquid milk market, it is quite obvious that a reduction of 1d. or 2d.—such a reduction as would equate supply with demand—would involve a saving in the cost of production. The Milk Commission, from whose Report I have made this quotation, was an impartial body which sat for nearly two years, and after going into the matter very fully it said that it was possible to reduce the cost paid to efficient producers substantially and yet give them adequate profits.

There is a great deal which the Government could do. We are always hearing what the Government are going to do in the matter of a long-term policy. The Government could do a great deal to reduce the price of milk with a wise long-term policy. Our dairy herds are riddled with disease—mastitis, abortion, tuberculosis. If the Government were to spend money on research and eradicate these diseases they would reduce the cost of milk production enormously. That would be an enormous help to the farmers of this country. If you take the herd life of cows here, it is lamentably short in comparison with the herd life of cows, say, in Denmark, and I think it is also shorter than the herd life of dairy cattle in Ireland. The Government, by giving premiums to satisfactory bulls, by helping farmers either with capital or credit to put their buildings in order, and in the matter of land drainage, could help enormously to reduce the cost of production. I expect most of your Lordships have heard of the new method of treating grass which is associated with the name of Professor Stapleton. A tremendous lot could be done to improve our pastures. I have done it myself. I have been fortunate enough to try it, and I know how much you can improve the productivity of your pasture, both in summer and also in winter, if you use the modern knowledge which is available.

I think I have shown that it would be quite easy without imposing any hardships upon the dairying industry to reduce the cost of milk by 8d. a gallon—that is to say, by one penny a pint. There are some who tell us occasionally that the price of milk does not affect its consumption. I do not say that an immediate drop of a penny would be followed by an immediate rise in consumption, but I am equally convinced that over a period of time a reduction in the price of milk would be followed by a very considerable increase in its consumption; in fact, the Advisory Committee admit that. They say that the variation in consumption between the highest and the lowest income groups is greatest in the case of milk, fruit and vegetables. People who have more money to spend, spend more on milk. It is a question of purchasing power.

A great deal can be done by education. I think one of the difficulties is that many of the children get a taste for tea before they ever go to school, and when they go to school I am sure one reason why more children do not avail themselves of the cheap milk provided there is the fact that they have had a cup of strong tea in the morning. They have become accustomed ever since they were babies not only to drink tea, but to drink strong tea, and their palate gets vitiated. I am certain that a great deal could be done in the way of education and in persuading parents not to cultivate tea drinking among very young children.

This question of purchasing power and cost of milk is not merely one which affects the lowest wage earners. The black-coated workers, the middle classes, and the hospitals also are suffering to-day because of the unreasonably high, the excessively high price of milk. The price is vital.

I never like to criticise without putting forward alternative suggestions. I have tried to indicate to your Lordships why I think the present structure is wrong, why a central authority elected only by farmers and responsible only to farmers cannot possibly have any sound national policy. You have only to turn to Ulster to see how it can be done. Ulster has a milk scheme which has been eminently satisfactory because the controlling influence on the Ulster Milk Board lies with the members nominated by the Government. They are the members of the Board who determine policy. The producers are represented too, but the controlling influence on the Ulster Milk Board is in the members nominated by the Government and representing the interests of the community as a whole. In Ulster they have another advantage. The milk is compulsorily graded according to its hygienic quality, and farmers are paid according to the grade they produce. It works automatically and, as a result, in Ulster the price of milk is very much lower than it is here.

As to distribution there is not time to go into that, but I would certainly support and advocate a bold policy. I see no reason why the nation should not have control over the wholesale distribution of milk. I believe a great deal could be done in that way, and I would not myself be afraid of doing something with the retail distribution too. As regards the volume of production, I think the aim of the central authority should be to supply that quantity of liquid milk that is required for the needs of consumers in winter. As your Lordships know, the volume of milk produced is less in winter than in summer. With a small reserve for contingencies in winter there would be a surplus in summer. I think the central authority should be empowered to own factories and use them for dealing with the surplus summer milk which factories do not buy. If that were done, then in winter the central authority could close these factories. This last winter, when there was a shortage of milk for liquid consumption, milk was actually going under contract to factories. Surely there must be something wrong there.

As I indicated just now, the Government could do a great deal to reduce the cost of milk if they had a long-range policy to help the cattle industry. But, I repeat, in addition to that even after we have reduced the cost of milk production by efficient dairying, we still shall have to subsidise milk for certain of the poorer sections of the community. A most interesting book has just recently been published by Mr. Seebohm Rowntree. I hope that everyone of your Lordships who is interested in social welfare, or in nutrition or housing, or the standard living of workers, will study that book carefully. Mr. Seebohm Rowntree points out that an industrial worker living in a city must have an income of 53s. a week if he is to provide himself and his wife and three children with adequate nutrition. In rural districts the amount required is 48s. and for every child over three 5s. is required if that child is to have adequate nutrition. I have every reason to believe that those figures represent accurately the situation over large parts of this country, and if they do then it means that tens of thousands of children to-day are being malnourished, and malnourishment in childhood means that there will be weakness of physique when they grow up.

Mr. Seebohm Rowntree suggests that some system of family allowances should, if possible, be devised so that where the number of children exceeded three a sum of 5s. per child should be given. I am not convinced that the best way of helping is by helping with cash. I am not sure it would not be better to help in kind. I would like to subsidise consumption. I believe that if we were to do that the public money which would be spent would be spent to the greater interests of the consuming public. I think that there would be less waste. Those sections of the community that need adequate food could be dealt with better, because they go through public institutions. I would develop enormously the feeding of school children. I went the other day to see a canteen in a very up-to-date central school in a very Conservative county. I found there that over 400 children every day take a hot mid-day meal. Their parents pay for it. These children were benefiting enormously by it.

When I was at Geneva the other day we heard what they do in Scandinavian Countries. There they have what is called the Oslo breakfast. The Oslo breakfast is a scheme whereby every child who arrives half an hour before school opens in the morning gets a free breakfast of a glass of milk and bread and butter or margarine, with fruit, and also a cereal if possible. I do not necessarily advocate free meals to all children, or say that all children should have to pay for them. I think we must contemplate subsidising food. That is what I mean by subsidising consumption. I would not limit this help to children of school age. I would also extend it to the pre-school child. A large number of children that go to school have physical defects which did not mar them when they were born. I think we ought to develop nursery schools and do what we can to feed the children in those nursery schools.

I was glad to notice that in his circular to local authorities the Minister of Health urged local authorities to help mothers at maternity centres. If we were to spend the sum of money which Mr. Seebohm Rowntree suggests—£5,000,000 or £6,000,000—in subsidising food supplied at maternity centres and nursery schools and elementary schools, we should have a different population at no distant date. We should have a strong and happy race and we should have a far more prosperous agriculture, an agriculture on a much sounder basis. The health foods are the perishable foods—vegetables, fruits, milk, agricultural products in regard to which we have the benefit of a natural protection. Those are the commodities which are what I call the health foods. If we were to subsidise the consumption of those protective foods so that mothers, pre-school children and school children had enough of them, we should in the next generation have a very much stronger and healthier race and a much more prosperous agriculture.

I apologise for having talked at such length, but I am perfectly certain that the subject is worthy of serious consideration. When our forefathers adopted modern sanitation at the end of last century I am certain they had no idea of the enormous benefit which would follow. If you compare the expectation of life to-day with that of a hundred years ago you will appreciate the results. Even if it is only compared with 1910 I believe we have added eight years to the average expectation of life. That is mainly due to modern sanitation and modern hygiene. I believe that, relatively speaking, if we adopt a wise nutrition policy we shall equally benefit the people of this country. I beg to move for Papers.

LORD SNELL

My Lords, I personally am very grateful to the noble Viscount, and I am sure your Lordships are also grateful to him, for having put this Question upon the Order Paper. It had been my own intention to raise the matter, but the noble Viscount luckily got on the Order Paper a day before myself. I feel, however, that the question that he has raised, though it is not comforting to our feelings, is nevertheless one of fundamental and even urgent importance. There is something incongruous at a time when we are undertaking great national rejoicings that we should have to confess to ourselves that upon such evidence as is available—evidence which I do not think can be successfully assailed—a large proportion of our population is actually underfed.

When we speak of malnutrition we do not intend to suggest acute starvation, or even that there is always a lack of bulk in food taken, but that there is a deficiency in kind and in quality of food that is necessary to give a balanced diet and vigorous health. By starvation I suppose we mean an inadequate total intake which gradually or quickly reduces the bodily weight and ends in death. By Ina/nutrition we mean, I think, the absence of sustaining and protective qualities in food the absence of which leads to physical defects, to a lowered standard of health and a lowered resistance to disease. The noble Viscount has proved, at least to my satisfaction, that such a condition does exist, and I believe it is more extensive than is generally thought. We should like more information as to whether it is widespread throughout the country or whether it is confined to certain areas. In any case there is sufficient malnutrition to create alarm in the minds of thoughtful persons as to the future of our race.

I am aware that the defenders of the capitalist system under which we half starve cannot bear that the grim antisocial god they worship can be associated with underfeeding of children in this country Therefore they feel it neces- sary, first of all, to deny that underfeeding exists; and secondly, they say that our social services are the best in the world They are always patting themselves on the back for the things that our social services have done for our benefit, and then when the two first propositions cannot be satisfactorily sus-stained they fall back upon the statement that this semi-starvation is due to kitchen illiteracy, and that it is the fault of the people themselves because they do not spend their money on the right things. If that charge is correct, if the people are ignorant, some responsibility for that ignorance falls upon the educational system of our country. We cannot help feeling that if children had been taught a little less about the Kings of Israel and a little more about the duties and the balance of life that ignorance would not have existed.

But in another sense the Government are partly responsible for this malnutrition, for they ought to have undertaken a definite campaign for the teaching of food values and not to have left half-educated people at the mercy of profit-making advertisers who induce poor people to spend their money in almost entirely unprofitable ways. The people are urged to drink more beer and all the rest of it, and they spend their hard pennies on this unprofitable hog-wash instead of spending it upon nutritious food. I do not know whether the poor are more guilty in this matter than anybody else. I wonder if the rich always spend their money profitably. I should very much like to overhaul the budgets of a few rich families and see what they would reveal. I rather fancy I might find such unprofitable expenditure as subscriptions to the Carlton Club and the Anti-Socialist Union and other organisations of that character. But I ask that we should not put too much tension on the accusation that the people do not know what to buy. The fundamental basic fact of malnutrition is poverty.

The working housewife may have no knowledge or very little knowledge of comparative food values, but she knows by rule of thumb what to buy if she has money at her disposal. Dr. M'Gonigle, a great food expert, said in The Times of March 26 of last year: Beware of the dicta of persons who for long denied the existence of any considerable amount of malnutrition and who now attribute its incidence to the housewife's ignorance of food values and of cooking. I think that malnutrition is due, not to ignorance, but to the poverty of the people. The income of poor families is not sufficient to enable them to buy food of the right kind. Mr. Rowntree, to whose book the noble Viscount has referred, in making this budget of what he calls a "Spartan" standard, does not allow for any fresh milk at all; yet he tells us that the urban worker who has a wife and three children requires 53s. and the agricultural labourer not less than 41s. to provide food upon even a low standard. When you reflect that the unemployed receive in urban districts 35s. and in rural districts 32s., you will see that in an unemployed household there must be some very considerable shortage.

As we have a round figure of more than 1,000,000 unemployed people in this country, this malnutrition is proved to exist over a wide area. This standard of Mr. Rowntree's assumes, moreover, that bread is baked at home, which comes to something cheaper than when it has to be bought in a shop. Remember that his analysis is for a compact city like the City of York, where rents are lower than they are in great centres of population such as London, Manchester and Glasgow. When we think of the results of malnutrition we realise that its influence on the nation must be profound. The cost to the individual shows itself in a lowered vitality, in susceptibility to disease, in constant or recurrent sickness. The cost to the nation is immeasurable, but we may be sure that it is immense. Some alarm is being expressed at the present time lest half-fed parents will not rear sons who are able to defend the capitalist system and its profits. This alarm seems to be justified by the returns of the defects in the recruiting offices, showing that a large proportion of the rejects come from the distressed areas.

The Government have rightly to accept the criticism which the noble Viscount attaches to them for their attitude to this question. They might by foresight have done a great deal. It took two generations of agitation in this country to get even the principle of the feeding of necessitous children acknowledged. This cannot go on generation after generation without showing itself in a deterioration of our national stock. There are false ways of meeting this crisis, and His Majesty's Government at the present time, and people about the country, seem to be pursuing a false way in that they are putting the question of gymnastic exercises and of keeping fit before the question of feeding. It is a very good thing to see the grace of young life in gymnasia and elsewhere, but we ought to remember that inflated muscles do not compensate for weakened hearts, and that a jerry-built manhood of that character is not what our nation requires. Feed the people first, then encourage them to do the exercises that will develop the forces of their bodies.

I will not go lengthily this afternoon into the question of what has caused this condition. We do know, however, that with the cost of living rising both in materials and in food it is steadily becoming more difficult for people to live up to the standards that will keep them fit. Wages do not rise to these increased prices, and the Government, especially since 1931, appear to have done their very best to create scarcity of food by quotas, tariffs, restrictions and all the other devices that are due to the Protectionist mind. Thus we have had restriction in potatoes, bacon and the rest. The Import Duties have decreased the purchasing power of the people, and the incidence of these burdens has to be borne by the impoverished classes.

Then there is the question of housing. We are all enormously concerned that people should live in proper surroundings, that they should have fresh air and be free from overcrowding. But it sometimes happens that by moving people from a slum into a municipal area or one in which other houses are built you give them more air at the expense of less food. That has been proved statistically and I need not urge it this afternoon. The proposals that the noble Viscount has made should be borne in mind by His Majesty's Government and very seriously considered. I believe that the right way to begin is first of all by feeding the children and the mothers. There is no need to haggle about whether milk should be 3d. or 6d. a pint or what the profits should be. It is the business of the community to feed its children. What the children require is milk, and, if it cannot be paid for, the Government should provide that milk free for children and also for expectant and nursing mothers. If you do not spend the money on the child when it is in the nursery and in the school, you will have to spend it in other ways in an extended form when the child reaches adult life—if, happily, it does so.

There is nothing more that I need say except again to express my personal thanks to the noble Viscount for introducing this question and for the thoughtful and helpful speech that he made. This Report of the Advisory Committee is disquieting in the extreme. It is a criticism of our social life, and it is a challenge to us all, to whatever side of this House or whatever side of politics we may belong. It reinforces, as I believe, in the grimmest possible way the attacks upon the disorganisation of our social life which we on these Benches have so often made in your Lordships' House.

LORD ELTISLEY

My Lords, I will venture to trespass upon the time of the House only for a very few minutes, and for the reason that certain criticisms have been levelled at the work of the Milk Board. The rules of debate in this House are very wide, and the Motion on the Order Paper hardly indicated that so large a part of the debate would be taken up in criticising the work of the Milk Board. I only regret that a subject so large as the questions of milk marketing, and the manufacture and distribution of milk products, had not been made a separate subject of discussion, so that full justice could have been done to it.

I venture to suggest that the Milk Marketing Board, and the various Committees set up in connection with milk marketing in this country, have prevented a certain collapse of the milk industry in this country. It has saved from disaster, undoubtedly, 135,000 milk producers in our country, and it is, I believe, undoubtedly a fact that had not the Milk Marketing Board been set up, or similar machinery established, the milk industry would have gone the same way as the live-stock industry, which would not only have resulted in the ruin of a great many producers but also done away with, to a large extent, the fertility of our soil. One of the objects of agricultural policy at the present time is to take every possible step to see that the fertility of the soil is not only maintained but, if possible, increased, in view of an emergency which might arise.

With regard to the question of prices, it is suggested that the price of certain products is too high. I will illustrate the case of butter. At a shilling per pound it can be purchased more cheaply than the oil which is required for oiling motor cars and the wheels of machinery, and I think I am right in saying that in almost every case where the milk products of other countries are cheaper the producers of those countries have received some subsidy or other assistance from their respective Governments.

As to the suggestion that farmers have been given undue and unfair privileges by being allowed to set up these various boards, I would point out that farmers are in a very difficult position. Scattered as they are up and down the fields and valleys of our beautiful country, they find it exceedingly difficult to organise in an effective manner, and the legislation recently passed was really enabling legislation, which made it possible for farmers to come together on certain important points, and to organise their industry, in the same way as industrialists have long been able to organise their industry because they are more centrally situated and more closely united. Yet although the farmer has been given this power he is under the closest control by the Ministry of Agriculture and by the Committees of Investigation and the Consumers' Councils, and therefore I do not think your Lordships should begrudge the limited amount of power which is given to the farmer to organise his industry on up-to-date and much needed lines.

LORD NOEL-BUXTON

My Lords, I would like to support the appeal for action in regard to malnutrition, because I am connected with one of the philanthropic societies which are compelled to do their best to relieve malnutrition in various areas. I refer particularly to the well-known Save the Children Fund, which in various ways is in contact with this problem. The experience of such bodies, I think, more than confirms the plea that the noble Viscount, Lord Astor, has made. Although I have no claim to speak as an expert, I have been asked to give illustrations of the kind of intensity which this problem sometimes reaches; and the fact that philanthropic societies up and down the country are actively dealing with malnutrition is, after all, a very striking proof that there is a problem for authority to tackle.

In particular the society for which I speak, among many other activities, aids through school teachers in very many areas where the education authority is not on the side of activity in regard to feeding. These are particularly in the distressed areas, but elsewhere also. The society is also in touch with needy cases by a peculiar system which it maintains of inviting personal interest of charitable individuals who come in contact with the needy children. Under the title of "adoptions" these contacts are up and down England dealing with cases which illustrate the noble Viscount's point. A great many cases are reported also for which no adopter can be found. Thirdly, the society maintains various nursery schools, where they are frequently in touch, with the approval of the Board of Education, with some of the most distressing cases.

I would like to quote, if your Lordships will allow me, from a report of this society in regard to the question of milk in a distressed area. The report says that the Report of the Advisory Committee on Nutrition represents a counsel of perfection for numbers of families in the Special Areas and other penurious localities in which it carries on social welfare work. In one place in South Wales we have the experience of the head mistress of a school … that practically the only milk many of the children in her school get is that which is supplied through the Fund. She even goes so far as to say that, in specific cases, this regular grant of one pint of milk a day has saved the lives of children who had reached a very low state of under-nourishment because of persistent privation of essential foods, owing to the poverty of their parents. When, after a recent malnutrition survey of the school, the chief medical officer asked the assistant medical officer (who had made the survey) her general opinion, the latter stated that the standard of nutrition was much improved on the whole, adding 'for that we have to thank the mistress and the Save the Children Fund.' What, then, are the conditions in the undoubtedly more numerous places where it is not possible to establish voluntary aid of this kind? In another county, where the Save the Children Fund carries on work both for children under five (not school children) and for expectant mothers, the county medical officer of health says in a recent annual report: The supply of fresh milk from the Save the Children Fund was a great boon, and there is no doubt that the children to whom this was issued would have suffered considerably had it not been available. Then in regard to fruit and vegetables, the Committee draw attention to the place of fruit and vegetables in a balanced diet, and advocate an increased consumption of these commodities, but they are expensive luxuries to large numbers of our people. When the Fund carried out an inquiry into the effects of unemployment on children and young persons a few years since, it examined a number of family budgets among the unemployed of many industrial centres, and almost without exception, among families consisting of man, wife and several children, living on from 25s. to 35s. a week, the expenditure on vegetables was very small, rarely more than is a week, and on fruit generally nil. This is undoubtedly to be attributed not so much to ignorance of the value of fruit and vegetables on the part of these housewives, many of whom produced budgets showing remarkable discretion in the use of the small amount of money they had to handle, but to the greater hunger-repressing value (very different from nutritional value) of such commodities as bread and dried cereals. Among children whom the Fund helps we know of many families whose staple diet is bread, margarine and tea, the tea served not with fresh milk but with sweetened, machine-skimmed milk, the cheapest and least nutritious procurable.

A particular case shows that adequate nutrition may sometimes succeed in curing a severe case of impaired physique, even when hospital treatment has failed. Your Lordships will excuse my going into details of a particular case, but after all it brings home a situation which exists all over the country. 'This is the case of a North Country child aged two years and two months, who was admitted to one of the nursery schools established by the Fund with the co-operation of the Commissioner for the Special Areas. The medical report on her was that she had been discharged from a hospital where she had been treated for so-called "wasting disease," as the hospitals could do nothing more for her. When admitted to our nursery school she could not walk, her bones were malformed and, as so often happens in cases of severe under- nourishment in infancy, she seemed to be mentally deficient. She was given the usual course of nursery school routine; not only the "nutritional foodstuffs" on which the Report lays emphasis, but also fresh air and—what is a special advantage available at this nursery school—artificial sunlight treatment, which scientists agree may be an important element in overcoming deficiency diseases. She soon showed signs of recovery and now, at the age of four and a-half, she has healthy bones, and by all tests appears to be a healthy, normal child.

I would like in connection with the mention of this work to pay a very warm tribute to the work of the National Union of Teachers, who co-operate with this Fund, and doubtless with others of a similar kind. They run a joint fund with the Save the Children Fund. Many of the teachers subscribe, and they act as almoners and are very devoted and sagacious. The inadequate policy which we are criticising to-day places a very heavy burden on the teachers, and I should like to ask your Lordships to consider whether it is a right thing that so much work—and some expense—in regard to nutrition should fall on the teachers and also on private benevolent organisations. Your Lordships will not fail to notice the significance of the fact that these cases are saved from disaster only by private charity. Private effort is driven by the urgency of the case, and I submit that it is not fair that people of small means who maintain charitable bodies should be under the necessity of undertaking what is really a public responsibility and a public interest in national physique.

Then ought we not to make this reflection—that these efforts which are evidently of the greatest value and of the greatest urgency, only cover a very small fraction of the area of the whole country, and elsewhere very grave injury must be occurring to countless children to whom it is in the public interest to supply the means of growing up healthy and strong? The position proves that the need is not merely local but national. Action is still a little hampered by the old theory that all ought to be left to parental responsibility. Forty years ago, when I was on the Whitechapel Board of Guardians, that was held to rule everything but the Government by degrees have superseded that theory, have taken over functions which were years ago regarded as precluded. I think nobody denies that it has been an immense public advantage that the Government have not been governed solely by the theory of parental responsibility, but have ensured a better start in life for countless children who otherwise would have suffered. I submit that all the evidence shows that that policy ought to be carried further. There is a deficiency in our system with which, as the noble Viscount says, the Government ought to deal.

VISCOUNT BLEDISLOE

My Lords, I hardly like to remain silent on this question, but I find it extraordinarily difficult to endorse in toto the views which have been so far expressed in relation to what appears to me to be an extremely complicated problem, and one involving considerations of the welfare of the agricultural community, national physical wellbeing, and indeed (bearing in mind what a large proportion of milk products come from overseas), the important problem of national security in the event of a serious emergency. I say I feel in a somewhat difficult position, because in the first place, as President of the National Council of Social Service, and as having from time to time to visit the Special Areas and distressed areas in the country, I cannot blind myself to the obvious fact that, although undoubtedly conditions have improved during the last eighteen months, malnutrition does undoubtedly exist in many of these areas, not so much or so obviously among the children, but amongst the mothers, who are quite plainly sacrificing a great deal in the best interests of their families. In that connection it cannot be denied that milk is undoubtedly far the most important food product so far as children are concerned and, as many would assert, so far as the population of all ages is concerned.

In the second place, I will not disguise the fact that I am myself a dairy farmer, and have no small sympathy with the anxieties and trials which the dairy farm industry is facing at the present time. But in the third place I have spent a considerable period of years in that particular country within the Empire from which the greater part of the dairy products that come into this country are derived—namely, New Zealand. In passing I would suggest that no butter, at any rate, is of greater nutritive, and I will almost say medicinal, value than that which comes from that sun-kissed country where it is known and admitted by the experts that vitamins are developed in dairy products which are of such a character as to enable those who consume these products not merely to assimilate those minerals or other food constituents which are so essential to human health, but also to resist contagious disease in its infinite variety.

I can only sympathise, not only with the noble Viscount who is going to reply to this debate, but also with the Government who have to solve, sooner or later, the problem which is exercising the minds of dairy farmers throughout the whole Empire and social reformers, and particularly those who are interested in the condition of the distressed areas and other areas where unemployment is rife. Speaking for myself, I feel we are passing through a transition stage in the matter of Government control and organisation in this connection. My attitude would be, either we want to have far less control—preferably, perhaps, with the abandonment of control altogether, and a free play for the forces of supply and demand—or we want a much more extensive and carefully planned control than has so far been developed on the part of the Government. I am so glad, if I may say so, to see reinforcement of the Liberal Benches, because I should have thought that the thesis which has been developed so ably by the noble Viscount ought very specially to appeal to that Party which, above all others in the past, has been the great champion of the free play of economic forces. I cannot help thinking that it is extremely dangerous, at any rate at long last, to interfere drastically with the laws of supply and demand as applied to the essential elements of our food supply, but in the meantime, as the noble Lord, Lord Eltisley, has pointed out, in view of the serious fate, amounting to potential bankruptcy, which was facing the dairy industry some two years ago, some measure of control was as an interim measure clearly justifiable but, as I hope, not necessarily permanent.

One point I should like strongly to emphasise is that milk is undoubtedly too dear, but, strangly enough—and I do not think the noble Viscount denies it—as was pointed out by Lord Eltisley, butter is relatively cheap, and so is cheese. What I consider an unfortunate factor in the present system of milk control is that the so-called surplus milk is being diverted into uneconomic butter and cheese factories which have been set up with the approval, if not under the direction, of the Ministry of Agriculture. These uneconomic butter and cheese factories are intended to deal with so-called surplus milk—surplus in spite of the fact that milk is too dear to be bought by some of the poorest classes in the community—and incidentally they are destroying to a large extent the farm-made cheeses of this country and to some extent the farm-made butter in this country which, in each case, is infinitely preferable to the factory product, at any rate as regards cheese, and, as far as this country is concerned, as regards butter also.

I dread the time which seems to be approaching when the famous farm-made cheeses of Cheshire, the Cheddar Valley, Somerset, Gloucestershire, Leicestershire, and other counties where famous cheese is made, will become a thing of the past, and all the more so because it is an almost inevitable concomitant of the successful conduct of swine husbandry. The two are so interlocked together that it is difficult to picture real success in pigkeeping without dairy farming, or dairy farming, at any rate on the part al the small farmer, without pigkeeping and the utilisation of the by-products of milk conversion. The noble Viscount who initiated this debate said we have some of the best pastures in the world. I want to say, with all respect, we have some of the worst, but they are pastures which might be made reasonably good by cultivation—and pastures require cultivation almost as much as arable lands—by good management, and by proper feeding.

But your Lordships may very properly ask, and I think we ought all to ask ourselves, what are the two main reasons, because there are two main reasons, why milk is so dear and why farmers find it impossible to produce it less expensively, with a margin of profit for themselves. Surely the answer is, first of all, the very high cost of imported feeding stuffs which, to my mind, is a very strong indication that we ought to raise within our own national borders far more of these concentrates which we require for the feeding of our stock than we do to- day; and in this connection let me say incidentally that I entirely endorse what the noble Viscount has adumbrated in the matter of improving grass production and grass drying We are beginning to learn that dried grass of good quality has more than twice the value of hay, and it a proper plant can be found on an economic basis to utilise to a large extent the wasted grass in this country—never more wasted than it was last year—it would provide a concentrated food for the maintenance of our farm stock without depending to such an extent as we do upon imported concentrated foodstuffs.

The other factor which renders milk expensive to the consumer is, of course, the margin of profit, or the reward permitted to a large host of middle men and distributors whose circumstances, as the noble Lord has pointed out, vary very considerably in different areas. I would venture to say in that connection that the chief objection to Government control surely is that, to avoid political disfavour, a premium is almost inevitably placed, not upon efficiency and quality, but upon mediocrity if not upon actual inefficiency, and this applies alike to the producer and to the converter and distributor. I am certain in my own mind that if a plan could be devised which would give a reasonable profit to the small milk retailer and the small distributor then the large retailer and the large distributor is going to get a margin of reward which is out of all proportion to the benefit that the producer and the consumer ought to derive.

As regards young children, I would venture to suggest that we, in this country, might learn a great deal more than we have yet learned about the care of infants and young children, and particularly the supply and treatment of milk, from New Zealand, where the Plunket or Truby King system has been in use for a great many years, and where the vital statistics show the enormous advantage to the infantile population as the result of this system, carried through not only for the benefit of nursing mothers but for the benefit of both mothers and children in what are known as the Karitane Homes which are to be found all over that Dominion.

I view with some anxiety a suggestion being made in many parts of this country, to-day, that the problem under discussion can only be effectively solved by shutting out the dairy products that are coming at the present time from New Zealand and other parts of the British Empire. I want most earnestly to ask the Government to be very careful before they yield too much to pressure of this kind exercised by the over-anxious farmer. Let us be fair both to the British farmer and to his fellow-farmer in the overseas Dominions. And in this connection I do most earnestly wish that you could get leading representatives of British dairy farmers and New Zealand and other overseas Dominion dairy farmers to meet representatives of our Ministry of Agriculture, of our Ministry of Health, and of our Board of Trade, because I believe that sitting round a table you might much more effectually find a solution of this difficult problem than you can by working in watertight compartments such as we are all working in at the present time.

You do not want, surely, to render New Zealand bankrupt? You have to remember that the dairy industry is to-day the largest industry in that Dominion, and that no less than 93 per cent. of the whole of the primary products exported from New Zealand come to this country, and, as I have good reason to know, can find no other alternative outlet at the present time, or at any rate until secondary industries are set up and a larger consuming population is to be found within her own borders. After all, New Zealand owes this country a very considerable amount of money, and if she is going to be true to her obligations and to meet the service of her United Kingdom loans you must permit her to carry on her export trade to a reasonable extent in her dairy products so as to meet the service of those loans.

I know that the noble Viscount—and in this I frankly differ from him, although I do not think he has elaborated the subject to-day—assumes the continuity of interchange between the products of British factories and overseas farms. I believe that that assumption will have to be abandoned for all time in the early future. We are talking to-day about the necessity of reviving emigration. At the same time we are putting more and more restrictions upon imported foodstuffs. I want to suggest that we cannot have it both ways. I am perfectly certain that, in the best interests of the security of this country and of the overseas Empire, it is desirable to encourage a system under which there will be a greater interchange between primary and factory products within our own borders and also within the borders of our overseas Dominions.

I am going, finally, to say this. Butter to-day is not to any large extent a manufactured commodity in this country. Excellent butter, and, as I have suggested, "sun-kissed" butter, is coming from other countries, and is, I believe, contributing materially to the health of the nation. Why not leave butter to New Zealand? It forms no vital or essential part of our dairy farming in this country. Where butter making is carried on in this country it is generally uneconomic, the butter being made in a small churn such as our grandmothers used some sixty or eighty years ago, with an output of, say, anything from ten to twenty pounds—often, incidentally of an extremely unhygienic character—in competition with churns turning out under most sanitary conditions from three-quarters of a ton to a ton and a half. I must apologise to your Lordships for taking part in this debate, especially as I find myself, as I pointed out, in an extremely difficult position, and with no real solution to suggest, but I do venture to submit these considerations to your Lordships as worthy of notice in discussing and in endeavouring to settle an extremely complicated problem.

THE LORD BISHOP OF NORWICH

My Lords, the speech of the noble Viscount who has just sat down tempts me to make a few remarks on this subject which has interested me, I need hardly say, for a great many years. The noble Viscount, Lord Bledisloe, gave two reasons for the difficulties that now beset the dairy industry. I believe there is another one, and I believe it is due to a certain confusion of thought. I think that we are apt to confuse the nutritive value of milk with the other side of the milk question. Both sides of the question are very important, but I cannot feel certain that the restrictions that we now put upon the quality of milk are really as necessary as the doctors tell us that they are; and the dairy farmers are in consequence straining to reach a standard that, after all, the doctor may one day tell us is unnecessary.

We all know of the questions raised in regard to boiling milk, in regard to the pasteurisation of milk, and in regard to plain milk; but I have never yet seen anything really convincing to show the relative nutritive value of plain milk, pasteurised milk and boiled milk. Some people tell us that boiled milk is just as nutritive as ordinary milk, yet you find that children do not like it: and it is no use saying they ought to drink boiled milk and that it is good for them, if they are unwilling to drink it. Then we are told that we should not go so far as boiling but should satisfy ourselves with pasteurisation. But no one has told us in a really authoritative way what is meant by pasteurisation. We may learn the temperature to which milk should be raised but not for how long it should stand at that temperature. It is found also that in many cases those who do drink raw milk, and do it without contracting disease, seem in fact to flourish more on the plain raw milk than upon milk that has been treated in any way.

At the present time dairy farmers have to conform to extremely exacting regulations, and yet I confess that I cannot persuade myself that all our system of bottling and so on is really satisfactory in delivering pure milk to the child. There are so many opportunities of lapses. It may be that some of the dirtiness of milk that we all deplore takes place after the milk has reached the house and not in the course of its handling on the dairy farm. I believe that we should discover that great impetus was given to dairy farming if the standards demanded were readily intelligible and easily carried out: if we became intelligent pupils and not the slaves of laboratory experiments male on the side of medicine: and if we were able to take a broader and more common-sense view of the whole situation. The noble Viscount who has just sat down explained to us the great waste that goes on, because after the milk has left the cow—being then presumably, in most cases, good milk—the arrangements for supply are not adequate and satisfactory.

But do we want these perfect milks to be assured before we are in a position to allow milk to do its work for nutrition? The very names by which milk is known are changing. It was a most confusing thing for the public to discover some time ago that Grade A milk was so far down the list that it was comparatively inferior milk. Now we have other names attached, but even those names are not self-explanatory. A clearer list of names that exactly suit the situation—and suit the situation from a nourishment point of view rather than a prophylatic point of view—would be of very great value, and would be a further incentive beyond the points which the noble Viscount, Lord Bledisloe, mentioned, to our dairy farmers, because they would then understand better what we really want and how they can best produce it for us.

LORD DENMAN

My Lords, I will only detain you for a very few minutes. I think there has been a consensus of opinion in this debate on one particular point, and that is that the price of milk to-day is too high in this country. As the noble Viscount, Lord Astor, said, it is higher here than in any other country in Europe. It costs twice the amount that it costs in Belgium and Holland, nearly twice as much as in France, and is much higher than in Germany. I submit that that price is felt not only by the working classes, but by the middle classes, by those who live on fixed incomes, by institutions such as hospitals, and others. I think the high price is especially felt in country districts. One would have thought that people living in the country, at all events, would be able to get cheap milk, but that is not the case at all. More and more the milk supply in this country comes from large herds. Milk is sent to London, and other great towns and cities, and the agricultural worker with his lower wage is quite unable to pay the high price for milk for his family. That is a most unfortunate state of things. The noble Viscount, Lord Astor, showed—and I think he proved his case—how the price of milk could be lowered. The price of milk is high because the milk drinker is taxed in order to subsidise milk products. It might be possible to reduce the price in this respect and to save money in distribution. Even if the price of milk were reduced, it would still have to be subsidised for certain sections of the population, for maternity centres, for nursery schools and for elementary schools, but if the price were reduced the burden of the taxpayer would not be nearly so excessive.

Mention has been made of the circular recently issued by the Ministry of Health. The Ministry circularised maternity and child welfare authorities asking them to review arrangements for the supply of milk to mothers and to young children. The Minister suggested that "scales should be so framed as not to render it difficult for mothers to take advantage of the authorities' arrangements." A society I represent here this afternoon complains that this instruction is too indefinite, that in some areas mothers and children under school age cannot obtain free milk unless family income falls within a very low limit. In some cases the income, after deduction of rent, for a family of five must be as low as 25s. or even 22s. 6d. before free milk is granted. I suggest that the Minister might be able to issue more definite instructions on that point, or that he might ask his Advisory Committee to draw up for the guidance of local authorities a scale based on the present knowledge of food requirements. It seems to me that the Minister's circular, valuable as it may be in some respects, goes only a small way towards securing increased consumption of milk by mothers and young children.

There is only one other matter to which I would refer, and it is one on which I agree with the noble Viscount, Lord Bledisloe. I also have heard it rumoured that pressure is to be brought, or is being brought, on the Government to impose tariffs on imported butter, cheese and other milk products. I hope, if that is the case, that the Government will not give way to that pressure, because it is quite certain to put up the price of the article against the consumer. I hope it may be possible for the noble Viscount who replies on behalf of the Government to reassure the noble Viscount, Lord Bledisloe, and myself on that point.

VISCOUNT GAGE

My Lords, this matter has been recently debated in another place, but none of us complain of its being raised again in your Lordships' House. Debate on this matter is very valuable. A mass of gratuitious advice is offered to the public as to what people should eat and drink, and when that has been going on in the form of advertising for a number of years, one can hardly blame people for a certain apathy on this subject. We should certainly feel grateful to my noble friend Viscount Astor for bringing forward this matter, because he is peculiarly well qualified to take a leading part in a campaign of this sort, associated as he has been with many committees of national and international distinction, over some of which he has presided. Nor can we complain that my noble friend has, by the terms of his Motion or by his speech, unduly narrowed the scope of this discussion. He spoke at some length on agricultural policy. Agricultural policy, tariff policy, unemployment policy, physical fitness and all kinds of other major issues can quite properly be related to this matter of nutrition. If I confine myself to certain aspects of this problem, it is not because I do not realise the relevance of these major issues, but because I could hardly expect that any conclusions which I offered to your Lordships on these large issues would be accepted with any degree of finality.

It seems to me that the investigations into nutritional problems fall into three quite simple categories. There are investigations into what we ought to eat, into what we do eat, and into methods of improvement. I take the question of what we ought to eat first, because it seems to me to be the category in which there is more information than in the other categories. There is indeed a vast mass of literature on this subject. Fortunately some fairly simple deductions can be made from that information. The Report shows that one of the most important of these deductions is that certain foods, especially milk, dairy products, green vegetables and fruit, are essential to health. They have what is called a protective value because they stop certain definite deficiency diseases and also build up the resistance of the body to other forms of disease. It seems difficult to exaggerate the importance attached by these experts, with a unanimity rare among experts, to the value of these protective foods, especially in infancy, and I have only to say that we entirely accept the conclusions of the Report on that subject.

I should now like to turn to the question of what we actually consume. On this question there is, again, a great deal of information, though perhaps of a more limited kind. My noble friend has asked me for some specific information on certain points concerning what we are going to do, and I hope in a minute to be able to give him that information. First, however, I should like to refer to the knowledge that we have already. As the noble Viscount told us, the Report refers to the Board of Trade statistics and the Ministry of Agriculture statistics of the amount of food imported into and grown in this country. These deal with totals only, and somewhat crude totals at that, because they make no allowance for wastage. Nevertheless, deductions can be made from them, some more reassuring than others. It is satisfactory to know, for instance, that the average consumption per head of most foodstuffs has increased since just before the War, and that with one exception there has been a general improvement in the quality of the national diet. It is also satisfactory to know from the Report that the supply of energy-giving foods available for the nation is more than was considered adequate by the Committee of the League of Nations.

I think my noble friend rather omitted references to any question of improvement. I quite realise that improvement may be slow and ought to be quicker, but I think that, if we are going to approach this subject in a scientific spirit, it is necessary to give weight to these figures of improvement. Of course we accept the conclusions of the Committee that, although there is no evidence of widespread malnutrition in the sense of starvation, there are a certain number of people who are suffering from under-nourishment, particularly in regard to first-class proteins and fats. We know, too, that the Committee emphasise that the consumption of certain protective foods, particularly of fresh milk, is much below the recommended standard. Besides these official figures, there are before us researches of certain private investigators who have attempted to divide up these totals and to show how the food is distributed according to the various occupations, wages, incomes, and so forth. There was, for instance, the celebrated inquiry of Sir John Orr, and we may recognise that his report, taken, as it was intended by the author to be taken, with all the qualifications that he made, is a document of considerable value. Nevertheless, some of the deductions made from that document for the purposes of political propaganda—such, for instance, as that it showed that half the country was suffering from starvation—we do not regard as scientific deductions.

Other reports are also available, some of which have been quoted this afternoon. But we do fully accept the recommendation of the Committee that much more information is desirable, and we are prepared to collect it. Incidentally, I did once or twice seem to notice a tendency for certain noble Lords to make assertions based on statistics with great conviction, and almost immediately afterwards to point out the necessity for further information. I should like to point out that, although we are prepared to do our best to collect this information, such inquiries are not always quite so easy as is sometimes imagined. Dietary surveys are not like geological or ordnance surveys; they are really inquiries into the habits of the great British public, and we have to take into account the idiosyncrasies of the public. For instance, it is obviously important to relate the family budget to the family income. Although we find that people are very willing to co-operate with us in explaining what their outgoings and their budget consist of, they seem to be very unwilling to disclose what their incomes are, or at least to disclose them accurately. We have, therefore, to estimate these incomes and relate them to the budget in rather a roundabout way.

What we have in mind is really a three-fold inquiry. There is, first, the Ministry of Labour inquiry in connection with the cost-of-living index figure. For this it is hoped to procure the weekly budgets of 10,000 families taken over four separate weeks in various parts of England, Wales and Scotland. These families will all come from the classes covered by the national insurance scheme. Naturally, the inquiry will comprise information besides that relating to food, but the special information relating to food will be summarised separately. Then there is a further consideration in that family budgets are made up as a rule in rather a rough-and-ready way. For certain purposes calculations of that sort may be quite sufficient, but when we are trying to find out about the number of calories, vitamins, carbohydrates and so forth that are consumed, we cannot afford to be rough-and-ready. Accordingly, we propose to check these results by another inquiry, called a "quantitative dietary survey," which will be of a much more detailed character. It is in fact already in progress and will eventually embrace 500 families, of which 200 will come from Scotland. This may appear to be a small number, but I would like to emphasise what a dietary survey of this kind involves. It means that a qualified investigator, somebody with a degree, has got to spend much time in the homes of these families, weighing up all the food which comes into the house, and what is left over, estimating its composition down to the constituents even of the cakes and puddings and so forth, and noting any wastage. It may be a small matter, but I wonder with what degree of enthusiasm your Lordships, or rather your Lordships' wives, would view the prospects of a quantitative survey of this kind in your homes. I think we should be grateful to these families for co-operating with our inspectors to the extent that they have.

My noble friend asked for particulars about this inquiry. In the first place, I cannot give him the dates by which the whole inquiry will be completed, but I would refer him to the results of the surveys which have already taken place at Newcastle-on-Tyne, affecting 69 families, published some months ago. Then there is another inquiry affecting 205 families in the West Riding, the results of which will be probably published by the end of this year. These are not included in the 500 families which I have mentioned. An inquiry has already been begun in the Isle of Ely, Surrey, Glossop, Aberdeen and certain industrial towns near Glasgow. It will be extended to Somerset, Glamorgan, Carmarthen, Cardigan, Aberdeen County, Banff, Kincardine, Dumfries and the Border counties. The next step after this will be to take out from the last census figures a definite proportion, say of one in five hundred, or one in a thousand, of all the family census schedules, and this we expect will show roughly, after certain allowances have been made for altered conditions, the distribution of the population according to occupation. These statistics will then be compared with information in the possession of the Ministry of Labour with regard to wage rates current in such occupations. The art of the statistician is highly technical, and it is impossible to give more than the very broadest outline of how they will proceed, but it is hoped that they will on this basis be able to correlate to some degree all these inquiries, and to present a working analysis of how the incomes of various classes of the community are divided with special reference to food.

I will now return to the third and most controversial question of how we can improve. I quite admit that three-quarters of the problem turns, and must turn, on the capacity of the people to buy the right foods, and that, therefore, food must he cheap. It is surely equally important that the people should have the wages to pay for the food, and again it is obvious that unstable conditions, gluts followed by shortages and violent fluctuations in price, are definitely bad for steady progress. I know there is a class of criticism which proceeds on the assumption that when things go right it is always due to natural causes, and that when they go wrong it is invariably the fault of the Government. We shall have to bear this sort of criticism with what equanimity we may, fortified, perhaps, with the knowledge that during our period of office the number of those in employment has increased by about 2,000,000, and that in one year over 2,350,000 have benefited from an increase of wages amounting to nearly £190,000 a week, and that the price of essential foodstuffs, in spite of some rather wild statements to the contrary, has during the last five years remained fairly steady.

I would like to quote a few figures on that particular point which I think are important. Lord Astor quoted certain foodstuffs—what he called, I think, health foods. He has very strong views on the subject of the price of milk, but at any rate the price has not varied very much since 1931. In 1931 the price per quart was 6d., and in 1937 it is 6½d. Cheese, per lb., in 1931 was 10¾d., and in 1937 it is 9¾d. Beef (ribs) in 1931 was Is. 3¾d., and in 1937 is Is.1½d. The respective prices of cheaper quality were 8½d. and 7d. Eggs in 1931 were 1¾d. each, and in 1937 1¼d. I agree that all things do not show a decrease—bread has risen from 7d. to 9¼d.—but I maintain that the general result of an examination of these prices, of what my noble friends calls health foods, shows that there has not been the great increase of prices sometimes hinted at, and that in fact prices have been fairly steady.

My intention is for the moment to concentrate on the more direct contribution made by the Government to this nutrition problem, and here again I would start on what has already been done, in no spirit of complacency, but because we believe—and I think any of your Lordships who have had administrative experience will probably agree—that progress is best maintained and improved on the basis of an extension of existing services wherever possible. Also I rather think that if somebody had listened to this debate without knowing the conditions of the country he would assume that there exist no food services at all in this country. Following the almost unanimous advice of our experts and of the noble Viscount, we have been, as he knows better than I know, particularly active in connection with a supply of milk on special terms to special classes of the community, principally school children, expectant mothers and infants, and unemployed in the distressed areas. There are also schemes for the provision of free and cheap food to similar classes.

Taking first the school children, the scheme for providing them with cheap milk was started in 1934, and has now been made available to 92 per cent. of all the school children in the country, and 2,500,000 school children are making use of the scheme. Free food may also be supplied to any child showing signs of requiring it, though certain safeguards obviously have to be observed in this connection. Over 400,000 children received free milk last year, and 23,000,000 free meals were consumed by 143,000 children. About £700,000 was paid to the local authorities by the Government in specific grants towards these schemes. As to the mothers and infants, at all maternity and child welfare centres and at all antenatal clinics free food and milk may be supplied under medical advice to necessitous cases, special attention being paid to malnutrition, rickets and so forth. There has been a large extension of these centres in the last few years, and the attendances have greatly increased. Two hundred and ninety seven thousand mothers now attend the clinics. Last year the equivalent of about 7,000,000 gallons of milk was distributed free or at less than cost price according to the means of the applicants. In regard to the Special Areas, schemes for cheap milk have been adopted in Rhondda, Jarrow and Walker-on-Tyne. These schemes resemble the maternity and child welfare schemes in other areas, but have this difference, that the cost of them is borne in part by the Commissioner for Special Areas instead of by the local authorities.

As to the future, I can undertake that we shall press forward with all these schemes to the best of our ability. We have recently issued a circular inviting all the local authorities to review their arrangements under the Maternity and Child Welfare Acts and to improve and increase the diet, and especially the milk diet, of expectant mothers and children. We have laid emphasis on the necessity for securing the purity of the milk. We note that nearly all local authorities have made arrangements under these Acts, and indeed I may remark in passing, in spite of what was said by the noble Lord, Lord Snell, that our maternity and child welfare centres have been praised by foreign commentators as some of the best in the world. Although the noble Lord is a very exalted member of a local authority and I am a very humble one, it does sometimes seem to me that there are large numbers of very deserving people, not confined to representatives, but including also officials, who do a great deal of very good work in connection with these services; they do not get a great number of pats on the back, and I think if they are given pats on the back by foreign commentators they might perhaps be given the credit here.

In spite of what the noble Lord, Lord Denman, said, we are asking that certain limitations observed by some of the authorities should be removed from these maternity centres. I was not aware of some of the doubts which he expressed, and I am sure my right honourable friend will consider his objections very carefully. We feel that there might be an improvement in the number of mothers attending the ante-natal clinics, although there are, we estimate, about 5o per cent. of them attending now. I might refer to the publicity campaign which the Ministry of Health and the Board of Education, in co-operation with the Central Council for Health Education, are initiating in the autumn to make better known the existence of these ser- vices. I would also call attention to the fact that we have put another £5,000,000 into the general pool available under the block grant scheme, and by the re-weighting of the formula we feel that the necessitous local authorities will be placed in a better position to bear their part of the financial burden.

I know that it is usual, whenever a debate of this character is raised, for a conventional hope to be expressed that at the end of it the Government's spokesman should get up and announce some new and remarkable extension of Government policy, but perhaps my noble friend will forgive me if, so soon after the debate in another place, and before the publication of the Government conclusions on the Milk Re-organisation Report, upon which much depends, I do not respond to this larger invitation. But that does not imply that we propose to stand still, nor does it rule out the possibility of such announcements being made in the future. But I hope I have said enough to convince the noble Viscount that we are alive both to the necessity of further information and further action, and that, although scientific research is valueless if unduly hurried, we propose to press on with what information we have.

I should like, in conclusion, to say one word of what I might call subdued optimism. In the seventies of last century there was a death-rate of 21.4 per thousand. In 1936 the death-rate was 12.1 per thousand. In the nineties the death-rate of children under one year was over 150 per thousand. By 1936 this figure had been reduced to 59 per thousand. The death-rate from tuberculosis is less than half what it was twenty-five years ago, and from rickets less than half what it was five years ago. Of the 1,700,000 children inspected by school medical officers during 1936, the nutrition of 14.6 was said to be excellent, 74 per cent. were normal, 10.5 per cent. slightly subnormal, and 7 per cent. bad. These figures, I think, do show that we are making real progress and, what is more important, are a general encouragement to further effort. My right honourable friend the Minister has shown by his speeches all over the country the profound interest he takes in this problem of nutrition, and indeed, setting aside all questions of human sympathy, a vast amount of administrative effort which is now being spent on the cure and care of disease would obviously be immensely reduced if illness could be prevented, as the experts claim it can be, by better nutrition. We have to assist us bodies of unimpeachable reputation, such as the Medical Research Council and the Advisory Committee on Nutrition, presided over by Lord Luke; the qualifications of our experts are recognised all over the world, and we have the services of many distinguishd men; and, as they have already been praised by foreign countries, perhaps I might without impropriety include among them some of my own colleagues. All these factors seem to indicate that if prosperity can be maintained progress in nutrition will also be maintained with increasing impetus.

VISCOUNT ASTOR

My Lords, I think we have had a very interesting debate and I would like, with your Lordships' permission, to deal briefly with one or two points which have been made. My noble friend Lord Eltisley complained that I had raised certain matters of agricultural policy. I should have thought it required no very great imagination on his part to realise that any discussion on the consumption of food which turns on price must inevitably affect the question of the production of food. On the mixed Committee of the League of Nations over which I preside, the largest proportion of it, members represent agricultural interests. This is a Committee dealing with nutrition. The noble Viscount who has spoken for the Government assumed that naturally I should deal with the question of agriculture, and more particularly with milk which, as the Advisory Committee point out, is fundamental to the whole question of nutrition. The noble Lord replied to various charges which, in fact, I had not made. I was not condemning the personnel of the Milk Marketing Board, I was condemning the structure. It is perfectly ridiculous to give any industry the right to form a ring and charge minimum prices and expect the greatest measure of efficiency in that industry. I did not suggest that there should be no central authority—in fact I indicated very clearly how I thought there could be a central authority which could prevent the bottom falling out of the milk industry, but which would consider the problem in the national interests, instead of merely sectional interests, on the lines that have been adopted with such success in Ulster.

The noble Lord thought I complained about the high price of milk products. I did not. I complained about the high price of milk. It is very interesting that the Report of the Markets Supply Committee, which met with the support and approval of the Advisory Committee, indicates that the consumption of milk went down by 5 to 10 per cent. whereas the consumption of butter increased by 56 per cent. and the consumption of cheese by 43 per cent. These two commodities—butter and cheese—are foods of high biological value. Their consumption increased so remarkably because prices were cheap, and I would deprecate any attempt to make the price of butter or cheese expensive by attempting to develop and expand home industries in these products by tariffs. If that is done the consumption of butter and cheese will go down, and that will not be in the interests of nutrition nor will it be in the interests of those who do it, because the greatest mistake that is made by some who speak on behalf of farming interests is to forget that 80 per cent. of the people of this country are townsmen. They are perfectly prepared to do what is right by the other 20 per cent. who are connected with agriculture, but agriculture must see that the industry is efficient, and must see that we produce here in this country those commodities for which our climate, our soil, and our traditions are particularly suited.

I do not know that I shall follow the right reverend Prelate in the discussion he initiated on the relative merits of pasteurisation, or whether more damage is done by giving people raw milk, leading to undulant fever or tuberculosis, or giving them unlimited quantities of raw milk without previous protection; but it may interest him to know that there is an experiment being conducted at the present time. I happen to be Chairman of the supervising Committee which is dealing with 8,000 children at an expenditure of £12,000 in order to see what the effect is on large numbers of children of giving them raw milk, pasteurised milk, and no milk. The results of this investigation will not be published for some time, but, when they are published, if they can settle this very vexed question I am sure every one, whether connected with agriculture or the medical profession, will be glad.

May I just deal very briefly with some of the remarks which the noble Viscount made speaking on behalf of the Government? I fully realise there has been an enormous improvement in physique and in consumption and all that. I did not emphasise that because I did not want to speak too long. But the noble Viscount is perfectly right. There has been a very great improvement; but even after all that I come back to the findings of the Rowntree book. Even after that there are millions of people who have not got the purchasing power to buy adequate nutrition. You cannot get away from that fact. That is why it is necessary for us to have efficiency in food production and, after that, subsidised food for certain sections of the community. I will say a word about the price of milk. The noble Viscount seemed to indicate that the price of milk was not unduly high, or that it had not risen unduly. Let me quote from the index numbers of prices of agricultural products. Taking 1914 as 100, I find that in the year 1931–1932, for milk, the index figure was 139, whereas it is now 170. For butter it was 106, now it is 86—a drop in butter prices, and an increase in the consumption of butter. For cheese, in 1931, the index was 124, it is now 92. May I refer the noble Viscount to a passage in the Report of the Food Council on page 14? It is as follows: The retail price of milk as recorded by the Ministry of Labour stands higher in relation to pre-War than that of any other food except fish. The index was higher last year than in any year since 1922, having risen since 1933 by nearly 10 per cent.

VISCOUNT GAGE

May I say I was only quoting from 1931 to April, 1937? I have no figures by me going further back than 1931.

VISCOUNT ASTOR

I should have made no comment if the noble Viscount had not implied that the price of milk was not unduly high. I had to point out that the price of milk was not only unduly high, but had risen over a period of years. I thank the noble Viscount for his information about the surveys, but I would urge the Government to see whether they cannot increase the scope of them. A year ago, when we had a debate on nutrition, Lord Luke, who is Chairman of the Advisory Committee, when referring to Sir John Orr's report, said that because it dealt with only 1,200 families it provided insufficient data to justify far-reaching conclusions. I suggest that having an inquiry into 500 family budgets, of which 200 are in Scotland, will not enable us to get that detailed information which is required if we are to deal with this problem adequately. If we take what is done in the way of surveys in other countries—in America and in Scandinavia, for example—we find it done on a very much bigger scale. This is a unique opportunity. It would be a tragedy if this unique opportunity, when there is already an inquiry going on—the Ministry of Labour inquiry into the cost of living—were not used by the Government to couple with it an investigation on a sufficiently large scale to give us full information. Having said that, I wish to congratulate the noble Viscount and the Government on what they have done. At the same time I would urge them not to sit back satisfied with what they have done, but to realise that there is still a great deal that requires to be done. I beg leave to withdraw my Motion.

Motion for Papers, by leave, withdrawn.