§ 3.30 p.m.
§ THE LORD BISHOP OF WINCHESTER rose to call attention to malnutrition and to ask His Majesty's Government if they propose to take further steps to provide milk either at a reduced price or free to (a) expectant and nursing mothers: (b) children below 66 the school age, and (c) children now at school; and to move for Papers. The right reverend Prelate said: My Lords, since I gave notice of this Question, the Government have introduced into another place the Milk Bill, which no doubt in due time will be discussed here. I do not think, however, that this discussion will necessarily in any way overlap the debate which will take place on the Milk Bill. As a rule, when a Milk Bill is discussed the controversy between the producers and the distributors is so great that the consumer is almost looked upon as an interloper if he ventures to express any opinion. Moreover, the question of nutrition is not concerned only with milk, or even only with food. Perfect nutrition requires not only adequate food but also adequate exercise, good air, mental contentment and so on. We are dealing, therefore, with a very wide subject indeed when we are discussing the question of nutrition, and the supply of milk is only part of the very much larger problem.
§ It may, however, be said that this Motion about nutrition is really unnecessary to-day, for the figures which we have recently heard in connection with the entrances for the Militia have been so satisfactory that they prove that there is really no serious malnutrition in the country. I am sure we all felt that these figures—92 per cent. admitted as fit—were most satisfactory, more satisfactory indeed than we dared expect. But I hope those figures have been very carefully scrutinised, for there is a somewhat startling contrast between those figures and the figures which from time to time we have had about applicants for entrance to the other armed forces. Not so long ago we were told that 60 per cent. of those who were applying for admission to the Army were rejected on physical grounds. We have been told that, I think it is 35 per cent. of those applying for admission to the Air Force have been rejected. Of course these are older figures, and there may have come a very great change during the last two or three years, partly, no doubt, as a result of the campaign for fitness, and it is possible that the standard of physical fitness for entrance in the Militia is a different standard from that which has been in the past adopted for the Army. I should be grateful if the President of the Board of Education, who is replying, would tell 67 us a little bit more about these figures. But whatever qualifications we may have to make in connection with them they are undoubtedly satisfactory. We certainly feel that the young men of the age of twenty in this nation are on the whole fit and strong, and I think that those of us who notice the large numbers who, either walking or cycling, come to the South of England during the week-end, will have been struck with their vigour and general healthiness.
§ And of course we are anxious that the boys and girls of to-day, either of school age or under school age, should grow up as healthy as apparently those who are now being admitted into the Militia. Very many improvements have been made in public health. I should be very sorry if anything I said appeared to overlook all that has been done in the health and welfare services during this century. The improvements in public health have been quite remarkable, but when all that has been said there still remain certain facts which I think are bound to cause us anxiety. There is a good deal of evidence that there is a considerable amount of malnutrition. I suppose in speaking of malnutrition one naturally starts from that most remarkable report made a few years ago by Sir John Orr. He most carefully and scientifically investigated the food and wages of the people of the country. He pointed out that for perfect health a large number of constituents must go to make up diet. It is not sufficient to have those constituents which bring warmth to the body, but you require others for body building and body protection. When he had taken all those into consideration he came to the conclusion that about one half of the people of the country had a diet which had in it all those constituents, but that twenty-two and a half millions of the people were lacking in some of the constituents necessary for perfect nutrition, and moreover—and this is what I wanted to lay stress upon—there are four and a half millions who lack any of the constituents which are necessary for an adequate diet. He also pointed out that something like 20 to 25 per cent. of the children of the country belong to that class.
§ Take a different line of investigation. One of the great authorities on wages and food is undoubtedly Mr. Seebohm 68 Rowntree. He made careful investigations into the food of the people. I will not trouble the House with the various statistics which led up to his conclusion, but his conclusion was this, that about one-third of the children of Great Britain during five of the most critical years of their lives are inadequately provided for. If you turn to the inquiries which have been made into wages and health in various great cities you will get the same kind of conclusion. A few years ago a survey was made about conditions on Merseyside, and it was found that about 16 per cent. of the population were living below the poverty line. Another survey was made in connection with Southampton, and it was found that about 21 per cent. of the population were living below the poverty line, although I have reason to believe that if such a survey were taken to-day considerable improvements would be shown. Then take quite a small provincial town, in which recently investigations were made into the nutrition of sixty-nine families, which had in them 288 children. Out of these sixty-nine families thirty-six of the families had a diet which cost less than 4s. per head. Now the significance of that would only be recognised when it is remembered that the British Medical Association said that 5s. 2d. is the lowest sum required for a sufficient diet. To turn away from the towns and to the country villages, again and again I have been told in country villages of children who are undernourished. A scientific inquiry has been made in Sussex by Mr. Frazer Brodington and in the last paper which he published he said that in the larger families there was lacking something like 50 per cent. of the constituents, such as milk and so on, which were required for an adequate diet.
§ These inquiries and these figures all show that there is a considerable amount of malnutrition among the children, especially, of the country. I do not for a moment mean to be understood as saying that there is anything like starvation. There is no evidence of starvation, but malnutrition does mean lower vitality, it means liability to serious illnesses, it means that a certain amount of the joy of life is lost, and there are some results which come quite directly from malnutrition. Under-nourishment means loss in weight and height—loss in body build- 69 ing. Sir John Orr in his inquiries found that the boys at Christ's Hospital were two inches taller than boys of the same age in the council schools. In Hampshire there is a school for defective children. The school is very well looked after, and the children there have what I believe is called the optimum diet. Well, children of that school, both in height and in weight, compare most favourably with the normal children in London. They are from one to two inches taller, and in weight anything from six to thirteen pounds more. No doubt there are other circumstances which affect this, but it is largely due to the better diet which they get.
§ Take, for instance, the effect of malnutrition on infant mortality. Infant mortality is a sure sign of the health and general welfare of the people. You will find that in the well-to-do classes the rate is thirty deaths of infants out of every 1,000; in the working classes it is seventy out of every 1,000, and among the unemployed 100 out of every 1,000. Here again the determining factor undoubtedly is that of nutrition. Another illustration is that which comes from maternal mortality. I think it is recognised that maternal mortality is very closely connected with nutrition. In 1934 in Wales the rate of maternal mortality was very serious. I think it reached rather over eleven per 1,000 in part of South Wales. Then free meals were given at clinics, and the next year that rate had fallen to a little over four out of every 1,000. The one difference apparently was that in the earlier year they had insufficient food and in the next year they had sufficient food. All these facts show that this question of malnutrition is a very serious one, notwithstanding all the improvements which have been made in recent years.
§ I think the causes of malnutrition are two—partly ignorance, but much more largely low wages. Partly ignorance because people do not know sufficiently about the food which is really health giving. In old days our forefathers ate anything which was put before them and, provided they had enough, they were quite content. But to-day men of science tell us that there must be a right balance in our food. Certain kinds of food may give us temporary warmth, but fail to build up the body. This knowledge needs to be made much more popular. So often 70 it is stated in scientific terms, in terms which are impossible for the layman to understand, and frequently quite unpronounceable. A good deal of education is required, but not all the education in the world will get over the main difficulty that a very large number of these families in which there is malnutrition are families in which the wage earner is bringing in week by week insufficient for the complete nutrition of his family.
§ A very striking illustration of this was found in the Report which we debated about a year ago in your Lordships' House, the Report of the Unemployment Assistance Board, when the Chairman pointed out that some 30,000 of the unemployed were receiving, when unemployed, almost as much as they received when in full work. The Board's payments were simply insufficient to meet the essential needs, and yet they were only just below what these men, and tens of thousands of others, were receiving when they were in full work. I know it is impossible to suggest that at this moment there should be a general raising of the standard of wages, but I do feel that there is a very strong case to consider the policy of family allowances. I hope the noble Earl who will reply may possibly be able to say something about this. The problem has been discussed here before, and I know that there are serious difficulties in the way. We have to convert the Party opposite, I think, to family allowances, and the trade unions certainly have to be converted to it. There are different schemes. I do not venture to express an opinion on any one of these schemes, or to advocate any one special scheme for family allowances. But what I do urge is that the Government should appoint a Committee to inquire into the whole matter as thoroughly as possible, conferring, of course, with those who are at present opposed to this policy.
A much more direct way of dealing with the problem of malnutrition is seeing that those who are unable to provide sufficient milk for their families have this milk, either given free or at a lower price, through subsidies. There are other noble Lords present who can speak with much greater authority than I can about the value of milk. I would only quote a sentence from the Report of the Mixed Committee of the League of Nations on Nutrition. In this it is said:
Of special importance is the adequate consumption of milk by infants, children, adolescents and expectant and nursing mothers. Its value is unique, it is indispensable. More than any other food it contains the elements essential for life and growth. It has no satisfactory substitute, and it is in itself the nearest approach we possess to a complete food.
This leads me to the questions that I want to ask of the noble Earl. First I want to ask what further steps the Government propose to take to provide milk, either at a reduced price or free, to expectant and nursing mothers and children below school age. In the Milk Act of last year provision was made for this. A certain sum of money was set aside for this very purpose, but I understand that not one farthing of that money has been spent on this matter.
§ I believe there were negotiations between the producers and the distributors—I am speaking of the negotiations of last year—but those negotiations were unsuccessful. I understand from a statement in another place that negotiations have been renewed, but it does really seem deplorable that when the Government have set aside a considerable sum of money for this purpose it has not been found possible to use it. If these negotiations fail, I hope His Majesty's Government will make it perfectly plain on whom blame rests for the failure. There fore my question is: What do the Government propose to do to provide milk, either at a reduced price or free, to expectant and nursing mothers and children below school age—this means, I think, something like 3,000,000 mothers and children—and also what further steps do they propose to take to provide milk for the children now at school?
§ The noble Earl who is replying has shown his sympathy in this matter, and a great deal has already been done, but half the children in the schools are not receiving this milk. The children, I think, have received one-third of a pint a day, which is a good deal less than is recommended by the authorities; also they are only receiving it when they are at school, and the school days take, I think, about two-thirds of the year. On their holidays they are not receiving any milk. I do not know whether the Government can take further steps in this matter. I would remind the House that a very large amount of milk goes week by week 72 to the factories, and goes to the factories at a much lower price than it costs to supply the children with the milk. I should have thought that some way might have been found through this difficulty. I quite understand how difficult it must be for any Minister of to-day, however sympathetic, to reply satisfactorily to demands which involve a larger expenditure. We are, however, happily not in the position of another country where the choice has to be between guns and butter. We are asking for guns, butter, and milk, and we believe that the health of the people of the country is as necessary for national defence as the armaments which may have to be used. I beg to move for Papers.
§ 3.52 p.m.
§ LORD SNELL
My Lords, I shall not detain you for more than one or two minutes, but we should not like this matter to be discussed in your Lordships' House without a word of commendation of the point of view which has been put before your Lordships by the right reverend Prelate, whom I very sincerely thank for bringing this matter before the attention of the House. In the course of his speech the right reverend Prelate expressed a fear lest we should be deluded by the figures of the examinations for the Militia. I am incompetent to speak about that, because I do not know if the standard of examination is just the same. It may be that a lower standard is required for Militia service than for the Regular Army, but, assuming that the standard is the same, we have every right to be thankful for this indication of improved health on the part of our younger population. I cannot help saying in that regard that at long last our faith in the wisdom of Social Services has borne fruit of a very valuable kind. But we must not forget that, in all probability, health and strength are determined in the early years of life, and that if you have starved children you may have a weakened adolescent and adult population growing up. Certainly there is nothing worse than hunger in the school. It is to a very large extent a waste of public money to supply buildings, teachers, and curriculum, and then to have children who are not sufficiently nourished to take full advantage of the provision that is made for them. Most teachers, I think, would say that the experiment of giving 73 milk to children has, so far as it has gone, been justified in the increased capacity of the child to absorb the education given.
We see something of what the absence of proper feeding has meant if we look at the factory populations of the last generation. They are, on the whole, of a lower stature than people in other parts of the country. That shows there was something wrong in their early nutrition. I do not wish to speak at length on this matter, but I do commend what the right reverend Prelate has brought to your Lordships' attention, and I hope the Government will be able to offer a satisfactory reply to the questions he has asked. To feed hungry children is not only right in itself, but it is, as we hold, a good national investment. It has its reaction on the prosperity of agriculture. It creates a demand for home-produced products, and is helpful in many ways. Surely, if we can afford anything at all, we can afford to feed necessitous children. That seems to me to be the first of all claims upon whatever we can spend; for remember that a child is not only the child of John Smith, it is also the child of John Bull, who is interested in having it grow up to health and efficiency. If the right reverend Prelate will forgive me, I will not go this afternoon into the difficult question of family allowances. The trade union difficulties are serious ones, and I agree with him that some inquiry should be made to allay same of the fears that they have. I have pleasure in supporting what the right reverend Prelate has said, and again, in conclusion, express the hope that His Majesty's Government will be able to give some satisfactory reply.
§ 3.57 p.m.
§ LORD HANKEY
My Lords, I would like to associate myself with the thanks to the right reverend Prelate for raising this question. I feel sure that the House will welcome very warmly his last words and endorse them—namely, that there is nothing more important to Imperial defence than national health. I frankly confess it was that which attracted my interest to this question some years ago. As Secretary to the Committee of Imperial Defence, I was profoundly shocked and humiliated by the fact that year after year more than 50 per cent.—sometimes up to nearly 60 per cent.—of the men offering for enlistment in the Army were rejected for physical and medical reasons. 74 Under another alias, as Clerk to the Privy Council, I addressed myself to the late Sir Walter Morley Fletcher, then Secretary to the Medical Research Council. He assured me that medical research had proved that the defects which caused these rejections were curable by proper means of nutrition, but he warned me also that it took at least fifteen years to translate research into action in such matters. Since then I have been doing my best to forward the good work, not always with complete success.
I find myself in close accord with what has been said already about the satisfactory result of the enlistment of young men for service in the Militia. It does afford a real ground for satisfaction, and I should be the last person to underrate it. But because that is satisfactory we must not desist from our efforts to get matters still better, and there is still great room for improvement. The Lancet points out that there is no specified minimum of height, weight or chest measurement for the Militia, and that some of the men with minor defects of feet and vision who are placed in Grade 2 (a) of the Militia would be rejected for the Regular Army; and even for the Regular Army the standard was lowered in 1936, and since 1937—again my authority is the Lancet—recruits have not been rejected on dental grounds.
There has been a tendency in some quarters to underrate this question of the importance of good teeth as an element in national health and physique That, I submit, is a very short view. The League of Nations Report on Malnutrition, which the right reverend Prelate has already quoted, explains in some detail how "dental caries lays the foundation for much ill-health." That is by no means all. Defective teeth go with defective bone formation in the body as a whole. According to the League of Nations Report, as the result of an inquiry in London schools in 1931, it was revealed that among children of five years of age there were from 67 to 88 per cent. of cases of abnormalities in the bones, and from 88 to 93 per cent. had badly formed or decayed teeth. Those are very formidable figures, and the report continues:There is evidence that the defective bone formation and much of the dental decay among these children would have been avoided by the inclusion in their diet of large quantities of protective foods, such as dairy 75 products, and therefore less reliance upon bread and other cereals.I learn also on a high medical authority, that our bones are much too prone to fracture, and that this can be cured by proper nutrition.
I do not want to exaggerate or to paint too black a picture, because I know how much the national health has improved, but I fear that this bad state of teeth and bones is not the only evidence that our national health is not all that it might be. The number of unfit people that one meets in all classes and of all ages is very disturbing. The very low resistance, especially in winter, to the minor ailments, influenza, colds and coughs, the prevalence of digestive troubles, stiff limbs and joints, and indifferent nervous systems to say nothing of major diseases like tuberculosis and cancer with their terrible incidence; the number of major operations; the increase in the number and size of hospitals, sanatoria and asylums—all these, to the layman, seem to be very unpleasant features. Moreover, if national health were on a really sound footing we should not get this spate of advertisements that defiles our highways and fills the advertisement columns of our Press. Not long ago I found in two of our most popular weeklies that half the advertisement columns contained descriptions of patent remedies. I conclude, therefore, that while public health has vastly improved by comparison with some years ago, and has improved steadily, there is still very much room for further improvement.
Then another factor is the increasing cost of medical services. Here I quote the last report of the Medical Research Council:Only by improving the general health and eliminating disease can it be hoped to reduce this present tendency of ever-increasing medical services, and the annual expenditure of between £200,000,000 and £300,000,000 which such services necessitate.Never in the history of the nation was economy more important than to-day, provided it is true economy, which means increased efficiency, and never was the need for improved national health and physique more vital than at a time like the present, when we are confronted with a long-drawn emergency. So I ask the question: How can economy and efficiency in national health be achieved? 76 How are we to endow ourselves with the physical qualities of a great Imperial race? The answer is to be found in full detail in the very illuminating and enlightened Report of the League of Nations Mixed Committee on Nutrition, 1937, the Committee which was presided over by the noble Viscount, Lord Astor, with the most extraordinary success.
Now the Report of that Committee is, of course, much too long to summarise in a speech of a few minutes, but the Medical Research Council has succeeded in its Report for 1937–38 in condensing some of the main results into a very few words, and they seem to me to be of very great importance. Here they are:A much greater consumption of milk and other dairy products, of eggs, of vegetables, including potatoes, of fruit, and of fat fish, at the expense of bread, biscuits, sugar and sweets, especially in early life, is an urgent national requirement; it will not only improve the physique of the people but will reduce the amount of dental decay and greatly raise the standard of health. An increase in breast-feeding will still further reduce the high mortality rate of infants from gastro-intestinal troubles and bronco-pneumonia. Whatever advances in medical knowledge may come, until these simple precepts are adopted there will still remain a great deal of preventable disease in this country.That, in a nutshell, is the new science of nutrition.
I would like if I may to emphasize a few of those sentences. They are "simple precepts"; they are "an urgent national requirement"; they will "improve the physique of the people"; and they will "greatly raise the standard of health" but without them there will still remain a great deal of preventable disease in this country. These words do not come from amateurs. These are the words of the greatest experts in the country and perhaps in the world. It is the basis of a new charter for the people, a charter of life and hope. Well, it all sounds too easy. There must be some catch—but the real catch is in ourselves. To get people to change their habits of feeding is harder than it was to persuade Naaman to try bathing seven times in the Jordan to cure his leprosy:If the prophet had bid thee to do some great thing, would'st thou not have done it?And so it is with ourselves. Few of us, if left alone, will take the advice of these great world experts, even though it is proved up to the hilt by large-scale experiments. Most of us would rather continue in our deep-rooted but faulty 77 methods until old age overtakes us prematurely, until we contract some chronic complaint, or worse, and have to submit to a succession of costly cures—mostly only temporary in effect—or to some crippling major operation.
This can be avoided, so we are told, by proper nutritional methods. It is a fact anyone can prove for himself with common sense, perseverance and just a little guidance. But the tragedy is that the people who want to try these methods do not know how to begin. In our schools next to nothing is taught about this question of nutrition, and what is taught is mostly out of date We do not even know the jargon. How many people know, even approximately, what foods are proteins or carbo-hydrates and what part they play in the health of the body, or fats, or minerals or the different vitamins? Yet for practical purposes most of that could be taught in the elementary schools. It is quite true that there are a few admirable magazines. They are for the most part run by pioneers who for forty or fifty years have been blazing a track far in front of even the distinguished advanced guard of medical research or the slower moving body of the public health services. But their work is carried out in a comparatively restricted sphere. Surely now that the facts are established officially by the highest national and international authorities, the time has come for a great national work of propaganda and education.
Nothing less than a sustained campaign will overcome the apathy, which is not confined to the general public. Here is what the Medical Research Council say on that subject:There is great reed for some authoritative body to transmit the necessary information which will stimulate public co-operation. With a more rapid understanding of the facts on the part of the public, delay in application of new knowledge to human needs ought not to be so long as it has been in the past.This task of public enlightenment ought not to be a very difficult matter. It is not like Air-Raid Precautions, where a new machinery of Government had to be set up. This tremendous Governmental machinery on health questions is ready to hand. There is the Medical Research Council, doing research work all the time; there is the Ministry of Health and the corresponding Scottish Department, maternity and infant welfare organisa- 78 tions, a national system of education, school care committees, the national fitness organisation, and the national health insurance organisation, including the panel doctors, hospitals and infirmaries and the medical schools. Why, from the cradle to the grave the bulk of our people are accessible all the time to medical advice and instruction. There is no doubt that the influence of the Government could be powerfully exerted through this system if a real effort were made.
What I am urging, then, is that the whole of this vast machinery should be used for a great and sustained campaign of propaganda and education on the subject of nutrition. The very text books are to hand in the Reports of the League of Nations Mixed Commission and the Medical Research Council. Those responsible for national health have a unique opportunity to carry a stage further the great work that they have already accomplished for the health of the people in the mass by the provision of pure water supplies and sanitation and by the advance of curative and prophylactive medical science. But in this new stage it is up to them to bring home to the individuals who make up the mass of the nation a knowledge by which they can improve their own health and secure an immense increase in happiness and efficiency, both for themselves and the nation as a whole—to say nothing of an immense economy.
We are told on this tremendously high authority, that these simple precepts will improve the physique of the people and raise the standard of health, and that without them there will remain a great deal of preventable disease. If that be true—and having tried out the system for five years myself I give my testimony that it is true—what excuse is there for delay? We may not yet be able to provide what the right reverend Prelate the Bishop of Winchester aims at—an optimum diet for perfect health—but surely we ought not to deny for a day the knowledge as to how expenditure can best be laid out to obtain perfect health. In conclusion, then, I ask the noble Earl who is to reply from the Government Benches to tell your Lordships whether the Government accept the Report of the League of Nations inquiry of 1937 into nutrition and the advice of the Medical Research Council on the subject. I also ask what is being done 79 and what is intended with a view to spreading throughout the nation and the Empire the epoch-making discoveries contained in these Reports, for I believe that this is the most important task in the work of national regeneration that lies before us.
§ 4.18 p.m.
§ VISCOUNT ASTOR
My Lords, all who realise the magnitude of what is commonly called the problem of malnutrition and who are interested in removing it must be grateful to the noble Lord who has just spoken and to the right reverend Prelate for bringing forward this question and dealing so effectively and attractively with it. They have dealt so lucidly with the question that I propose to speak very briefly and not attempt to go into detail. My association with this problem is due to the fact that for two years I was Chairman of the League of Nations Committee on Malnutrition. Two things came out quite clearly before that Committee. One was that in every country there is a big social problem due to malnutrition, and the other was that if all countries tackled the problem of malnutrition and had adequate nutrition policies, it would mean a reorientation and modification of trade policy which would be so great that there must be a great increase in the exchange of goods between one country and another. Therefore an indirect result of tackling this social problem must be a greater atmosphere of peace, which necessarily follows from an improvement in trade.
The Committee over which I presided was very fortunate in being helped in three ways. First of all we had the unanimous recommendation of an international committee of experts defining the nature of the problem, indicating its scope and outlining quite clearly the remedies which would deal with the problem. Secondly, we were fortunate in having a report of an entirely different Committee, a Committee set up by the International Labour Office, which reported while we were sitting. Thirdly, there was the overwhelming and conclusive evidence that in all countries, rich as well as poor, there is this great social problem due to malnutrition, the causes of which everyone agreed to be twofold: ignorance and poverty. Incidentally, that Committee showed the value of an impartial body such as the League in elucidating 80 economic and social questions. No other body has similar facilities for dealing with a world problem such as this. But I realised fully, while I was Chairman of that Committee, the limitations of the League so long as all countries insisted on maintaining complete sovereignty. Even on a problem like malnutrition there was a great difficulty in getting anything like agreed recommendations.
I am not going to deal with the international problem, and I am not going to repeat what noble Lords have said before me. I want to deal very briefly with one or two immediate problems nearer home. Whatever the noble Earl who is going to reply may be obliged to say in his official capacity as mouthpiece of the Government, with all the limitations necessarily attached to that capacity, we realise the great work which he has done in educating the public and stimulating nations to tackle this problem. And when we deal with the question of malnutrition among children and the need for giving them adequate supplies of milk, let us also not forget the pre-school child. Two points stand out as obvious to anyone who studies this problem: that the child is the kernel of the problem, and that milk is the most important food. If we tackle this question in childhood, and if we see that children have enough milk, then many of the ill-effects of malnutrition can be avoided.
The great need at the moment here in this country is for cheaper and safer milk. The other day it was my privilege to address a three-day conference organised by the British Medical Association. All of us who follow this question realise that up to date members of the great medical profession have not been able to act with complete vigour in the campaign to increase the consumption of milk, because they realise what I realised many years ago when I was Chairman of the Committee dealing with publicity on milk: the difficulty of urging mothers to give their children more milk when you cannot at the same time guarantee that the milk that will be available is reasonably safe. Every year there are 6,000 fresh cases of bovine tuberculosis and over 2,000 deaths. It is because of that fact that it is really necessary for the Government to do what they can to see that the milk supply is safer. I am not to-day going to discuss the Milk Bill which will come before your Lordships very shortly. It is, however, 81 indeed regrettable that three of the main proposals in a Bill which the Government brought forward in December last year, and which would have assisted substantially in making the milk cheaper and safer, have been dropped and are not in the present Bill. As the League Committee stated, milk is not only the most nutritious food but it may at times be a dangerous foodstuff. I do not want to exaggerate that danger, but everybody who has studied the question knows that milk is a medium for the transmission of tuberculosis, diphtheria, typhoid and scarlet fever unless it is properly treated.
I think it was in 1934 that the Milk Marketing Board, very wisely and very generously, provided a considerable sum of money, over £10,000 if my recollection serves me aright, in order to experiment on three separate points: whether children who were given an additional ration of milk showed an improvement in their physique over children who were not given that ration but had a biscuit; whether children who were given a double ration of milk showed better results in physique and health than children who were given a single ration; and what, if any, difference there was between giving children raw milk and giving them pasteurised milk. I was Chairman of the Advisory Committee to the Milk Board that supervised this experiment. The final report of this inquiry will probably be published this autumn; up to date two interim reports have been published. I should like to say that great care was exercised in order to try to arrive at satisfactory conclusions. Care was taken in selecting a committee of medical and other experts to supervise the experiment; the teaching profession's help was obtained, and four medical officers were selected to supervise the whole thing. By the help of the authorities and of the parents something like 8,000 children were under supervision.
So far in the interim reports three things have been brought out. In growth and weight the children who received a ration of milk improved more than those who got no milk; the children who got a double ration of milk improved more than the children who got a single ration of milk; and, so far from there being any difference between giving children raw milk and pasteurised milk, there was substantially no difference. It is very important to have found that last fact, 82 owing to the prejudice in some minds against the pasteurisation of milk. My inclination is to oppose pasteurisation of milk, because I am a milk producer and want to sell raw milk, but I have to recognise the fact that there is this problem. I confess that I think the farmers are shortsighted if and when they oppose measures to facilitate the pasteurisation of milk which does not come from tubercle-free cows. A farmer only gets something like sixpence for milk which goes to factories, whereas if it is sold as raw milk he gets double that price. It is therefore to the farmers' interest to get the backing of the medical profession for a "Drink more milk" campaign, but they will only get that backing wholeheartedly if the milk supply is rendered safer. I therefore think they are shortsighted if they oppose measures for the pasteurisation of milk which does not come from a tubercle-free herd.
As regards the public, there is a great amount of ignorance and prejudice, partly due to the fact that people confuse commercial pasteurisation, unsupervised, with the artificial treatment of milk by heat subject to conditions laid down by the Ministry of Health and efficiently carried out. The evidence for the value of pasteurisation is simply overwhelming, and I hope that if and when there is this educational campaign for which the noble Lord who spoke before me pleaded, the findings of those authoritative bodies will be put before the public—the findings on the value of pasteurisation of milk. The Milk Reorganisation Commission, known as the Cutforth Commission, supported it, as also did the Advisory Committee on Nutrition to the Ministry of Health, the Luke Committee, the Committee on Cattle Diseases of the Economic Advisory Council, presided over by Sir Gowland Hopkins, and the Ministry of Health and Department of Health for Scotland. In 1934 the Board of Education, when circularising local authorities, said thatthe Board desire to urge that in all areas where a supply of efficiently pasteurised milk is available, such milk should in all cases be provided.Then one final testimony. The Ministry of Agriculture are anxious to encourage the number of tubercle-free herds of dairy cows in this country, and it is to the interest of farmers to have tubercle-free herds, because they will get an increased price for their milk. In the 83 conditions laid down by the Ministry of Agriculture, conditions which have to be carried out in order to obtain the necessary certificate for the increased price, is a condition that no calf in a herd which it is hoped would be a tubercle-free herd is to be given any milk except milk from a cow guaranteed to be free from tuberculosis, unless that milk has been pasteurised. If the Ministry of Agriculture consider it necessary that a calf should have pasteurised milk if the milk cannot be guaranteed tubercle-free, surely we are entitled to ask equally that provision be made to secure safe milk for the children of this country. I am indeed grateful to the right reverend Prelate for having brought this subject before the House.
§ 4.33 p.m.
§ VISCOUNT DAWSON OF PENN
My Lords, I will not take up the time of your Lordships by stressing the existence of malnutrition, for surely it is a fact plain before us all, and brought home to us this afternoon by the eloquent speech and convincing facts put before us by the right reverend Prelate. I will take one of his statements: that 22 to 25 per cent. of the children of this country are not receiving the diet appropriate to their age and necessary for their proper growth. I think if we take the country across it will be impossible to gainsay that statement, and if we take it alone it is surely an eloquent fact. One asks oneself, is there any evidence of improvement? Undoubtedly, yes. You have only to watch the children who run about the streets and come out of the elementary schools, and you can see obvious improvements in their health and in their teeth. We have a long way to travel yet, but the improvement has advanced sufficiently for it to be obvious even to the superficial eye.
Then the Militia. We have to remember that the Militia represents all classes of young people from the whole population, and we should therefore expect to find a better average health among them than amongst those who apply for entrance to the ordinary Army in ordinary times, partly because the applicants, those who are being brought into the Army through the Militia, are sufficiently young to have profited from the improved knowledge of feeding during these recent 84 years. On the other hand, those who go into the Army in the ordinary way contain amongst themselves a larger proportion of those who are down on their luck and not of those who have been under parental care. I will take it therefore as an established fact, supported by accumulated and growing knowledge, that if we want strong and healthy childhood we must see to it that there is available for the children not only food adequate in quantity but food proper in quality, according to what is well known and has been brought home to us by modern research. Above everything else there must be a sure supply of foods which are both fundamental and protective, and a supply of fresh food such as milk, vegetables, eggs and the like. Such forms of food are of greater importance to us to grow in this county than corn and cereals. I am not urging that corn and cereals are not important as foods, but they are second in importance to a proper provision of freshly grown protective foods, like milk, vegetables and eggs. That is a plea for adequate attention to pasture. After all I take it that it is not difficult to store corn. There is no need for it to be fresh, but dairy produce and green vegetables must be freshly produced.
Here may I say a word in support of the policy of the pasteurisation of milk? Is it unfair to say that Government after Government have been like unto Pharaoh in their obstinacy in this matter? How many more warnings are to be given before the Government of this country are converted to the necessity for the pasteurisation of milk? What about Bournemouth? Was not that evidence enough? What about the outbreaks through the years of diphtheria and scarlet fever, proved over and over again to be due to milk? And what about the new trouble coming amongst us, due rather to overfeeding than to under-feeding, undulant fever? I do not want to stress any more that part of the question.
The right reverend Prelate, when talking of nutrition, said he took it in the large sense of the word as including not only food but fresh air and exercise. I would, however, venture to bring this before your Lordships, that whether we look upon proper nutrition as affecting the individual child, or as part of the safeguarding 85 of the interests of the nation, we have to realise that the conditions which make for the greatness of a nation to-day are totally different from those conditions which surrounded our forefathers. We have a different task from that which they had to do. We have to create quality. We have to build up fitness, and if we do not do it we are destined to decline as a nation. That is due to this. In past days you had your big birth-rate, your big death-rate, and therefore a big turnover. The weaklings were killed off. In a rough and tumble way nature brought the stronger to the top, and the stronger survived. But for more than a generation the death-rate has been declining—160 per 1,000 in the latter part of the last century and 53 per 1,000 last year. Put, following the decline of the death-rate, there has been a decline in the birth-rate, with the result that we are no longer reproducing ourselves, and that 100 women during the producing time of their lives only produce 76 girl babies. And the less we reproduce ourselves the more and more are we dependent on the quality of those who are produced.
That brings me to the next point. In the days gone by when there was an adequate supply of children there was no need for the State to bother about it. The children just came. But in these days, when it is within the power of the individual citizen to control his output of children, the children become a voluntary contribution, and therefore it is in the interest of the State, I submit, to share with the individual parents the interest in and responsibility for their progeny. It is true that within regent years the responsibility of the State has been recognised in various forms of social legislation. This very question of milk in schools and milk for nursing mothers and maternity services provides an illustration. Altogether there is quite a collection of legislative enactments which has the object of helping the rearing and nurture of children.
But if we are to achieve fitness, if we are to build up good quality children we must have a persistent policy from the time the child is born to the age of sixteen. What so often happens now is that a young child may be taken care of; it may be given food in school—though as the right reverend Prelate says, it does 86 not get the same food during its holidays, so that I imagine it is almost tempted sometimes to wonder whether it would not prefer to be back at school, where it would get better food. Then the children pass out of school and there is no control of them from the school-leaving age onwards. We want, I suggest, a large and comprehensive policy, which recognises that the State has an interest in the nurture of children from the time of their birth to at least eighteen years of age. It is in the interest of the State, it is in the interest of the future of this nation.
The Fisher Act provided for the continuation of education after young people have gone to employment. That is an essential part in such a comprehensive scheme, for thereby there is a control of the health of adolescents, which at present we do not possess. For at present it is quite a usual observation to see a child, which is in good health when it leaves school, deteriorating during the teens. It may be asked, Where is the money to come from for a policy of this kind? I would urge that the building up of the future nation should take precedence of everything else. Whether you regard it from the point of view of the health and happiness of individual children, or as a fundamental necessity for a strong nation in the future, it becomes the best investment, and all measures that would make for fitness should be a prior claim on the Treasury, especially in these days, when the population is declining, for unless we build up for quality we are bound to deteriorate.
§ 4.46 p.m.
THE EARL OF CORK AND ORRERY
My Lords, I wish to give my support, for what it is worth, to those who are trying to better the present position of the children of this country. In spite of all that has been done, I think it is not too much to say that the present state of things is a disgrace to our nation. As has been pointed out, there is a network all over this country of Government authorities, local authorities and voluntary institutions, all trying to deal with the same subject of looking after the mothers and the welfare of children. There is a tremendous amount of overlapping, even in the Government measures. Take this question of milk, this mysterious Milk Marketing Board. Since it began its 87 operations it has cost the voluntary hospitals a quarter of a million of money, and I understand that under the new measure that is being introduced, although the children in the schools get milk, if they go to hospital they do not, though I should have thought that was just the time that they required it. If it is possible in war-time to go about with a coupon for meat in your pocket surely a child in a hospital should have a milk coupon.
I am one of those who would very much like some information about this suddenly improved standard of health among the recruits for the Forces. I should very much like to know if it is the same standard as was applied in the past, for you have only got to carry your mind back two years and remember when the attention of the whole nation was focused on thirty-three boys to see whether we could make soldiers of them, and a Minister of the Crown went down and ordered them another helping of butter. I cannot really believe that this wonderful improvement has been made in two years. I must confess that I always thought that was a great waste of time, because any one of the three Services which have dealt with recruits could have told the Government how the health of young men in their teens could be improved by regular meals, regular exercise and regular facilities for sleep. And a great number of institutions could have done the same—the Borstal homes for example. All those institutions keep statistics. I myself from my experience of a training ship for boys could have told the Government a great deal that they wanted to know, and have saved their time.
As to the question of milk, I have not the knowledge of the experts who have spoken, but I have been watching experiments by giving young boys milk, one in a Government training ship, and the other in a training ship of which I am on the Committee. I have spoken to the medical officers, who within three months were saying that the boys were coming along splendidly, their resistance to the minor ailments was very much improved, and altogether their health was on the up-grade. In the summer of 1937 my noble friend the First Lord of the Admiralty introduced into your Lordships' House a Bill dealing with physical 88 and recreational training. I put myself down to oppose that Bill, not because I did not approve of the principles—I thought they were excellent—but because the measure did not go half far enough. It was like so many things we do. It simply touched the fringe of a great problem. The physical training of boys was, of course, given great assistance, but the proposals never reached down to those who cannot get away to get their training, and who, probably from under-nourishment, after a long day's work do not feel inclined to take any physical exercise. During two years which I have just spent at Portsmouth I have been interested in the welfare of the wives of young sailors who were under twenty-five when they married, which meant that they got no marriage allowance. While going into these various cases, I was brought into contact with civil cases. In a town like Portsmouth, with a most superior population, largely composed of pensioners from the Services and the large body of intelligent men who work in the dockyard, where there is a most go-ahead municipal council and where the Naval Benevolent Trust is working hard, the conditions under which some of these people were living really appalled me when I came to know them.
I could quote many examples. I will mention one case, that of a girl of eighteen who got 17s. a week from her husband and eked it out by going out and doing a few hours work. When she became pregnant, she had to give up her work. She had to pay 7s. or 8s. a week for her room, and on the rest that girl was trying to prepare herself, in the first place, for the birth of the child and then to keep herself and the child. You might say that she could have gone here or gone there, but that girl could not. She did not dare leave her room. She had no clothes in which to go out, and did not want her neighbours to see how low she had fallen. With all respect to my noble friend, she did not know what all these things he has talked about were. She was existing on dry bread, stale bread, margarine, and weak tea. That was the wife of a young sailor, one of the very people from whom we want to breed, a young man who, if I may use the expression, had the guts in him not to lounge about but had joined one of the Fighting Services. While he 89 was in the service of his King and country abroad, that vas the state his wife and child got into.
That has been got over. Three weeks ago they started marriage allowances to young men under twenty. Then I thought everything was all right. But just about that time the Shoreditch Report came out. Can anyone who is proud of his country read that Report without feeling a sense of shame. When we read that 50 per cent. of the people have not enough of the proper foods and that 30 per cent. of the school population show malnutrition, and combine that with the description of the insanitary houses in which they have to live, the dirty conditions, bug-infested rooms, and all the rest of it—how can we breed an Imperial race if this is going on? I am one of those who believe that every child born in these Islands is born a citizen of a rich country and has a birthright. That birthright is to be provided with everything that is necessary to develop it. How much must we have lost in brain, muscle, initiative, and even in genius because the small bodies which might have contained all these desirable qualities have not been given a fair chance to develop? We have now taken a short view of national defence, but if we take a long view I consider the best form of national defence for our Empire is to breed healthy and happy men, and that we are not doing at the present time.
§ 4.55 p.m.
§ THE PRESIDENT OF THE BOARD OF EDUCATION (EARL DE LA WARR)
My Lords, we are all under a deep sense of gratitude to the right reverend Prelate for the debate he has raised to-day. The contributions which have been made to that debate show that your Lordships appreciate the immense importance of the subject. We have had contributions discussing the subject from the social side, the economic side, and last, but not least, the side of Imperial defence. During the last few years such bodies as the British Medical Association and our own Medical Research Council have been giving consideration to the problem. We have had an important Committee sitting, studying the problem from the point of view of our Colonial Empire—a most important side of the problem—and also we have had a Committee set up under the League of Nations which has been so ably presided 90 over by the noble Viscount, Lord Astor.
The importance of this debate has been enhanced by the fact that the problem has really been presented, with extreme force, it is true, but also with extreme moderation, and it has been set, if I may say so, in very much its right perspective. In my capacity as head of the Board of Education I have opportunities of surveying the problem from the point of view of our educational services, and we are in a position to obtain a great deal of information, for instance, from our school medical inspections. But the value of these reports is inevitably vitiated to some extent by the fact that there are, as yet, no very objective or exact methods of measuring nutrition and malnutrition. To some extent the figures that we have for malnutrition sometimes tend to look as though the problem is on the increase. I do not think that is so, and what has been said in the debate this afternoon would justify me in saying that it is not so. Any such difference in the figures arises from a better reason—namely, the fact that day by day our standards are tending to improve. Whereas in the old days the child had to be virtually starving before it would be certified as suffering from malnutrition, to-day we demand a higher standard.
Though the figures of the school medical inspections may not be so helpful as at first sight they appear to be, there are certain things we can measure—for instance, the heights and weights of children. Though there are no national figures available on this point, we have a considerable number of figures from certain towns and localities. Thus I have certain local authority figures which show that, as compared with twenty years ago—1919, a post-War figure—children of twelve and thirteen have increased in weight by from 6 to 8 lbs. and in height by from 2 to 3 inches. We would all agree that that is gratifying. I saw it quoted the other day that, based on a sample of 2,000 boys fourteen years of age, the average increase in weight as compared with sixty-three years ago was 18 lbs. That, again, is to some extent encouraging. I agree with noble Lords who said that we should beware of reading too much into the figures with regard to acceptance for the Militia. Undoubtedly all these questions are matters of standards, 91 and the standards vary as between this particular standard for acceptance and that required for acceptance into the Regular Army. But if the figures I have ventured to give your Lordships are to some extent encouraging, I would not like to say that they are in any way sufficiently good to enable us to feel we have really begun to solve the problem or any justification for complacency. Rather I would interpret them in this way: they show that while there is still a very great deal to do we can feel that to some extent, in so far as we have tackled the problem, we have been tackling it on fairly sound lines, and that it is possible, if we go further, to get even better results.
The right reverend Prelate referred firstly to the question of mothers and children under five, and he put them together as being part of one problem because they are helped by the same machinery of local welfare authorities, which have the power to-day to supply milk free or at a reduced price to mothers and young children. A Circular was issued by the Ministry of Health in 1937 which drew the attention of all local authorities to the importance of overhauling their arrangements for the supply of milk and the desirability of increasing that supply. One can say, I think, that the response to that Circular has been to some extent satisfactory, though not on nearly so large a scale as one would have liked to see. There has been an increased consumption of liquid milk for this purpose from 2,500,000 gallons to 3,300,000, an increase of something like 32 per cent., and even a larger corresponding increase in the dried milk used for that purpose. In Scotland also there has been a considerable development.
But in spite of those figures I think it is perfectly clear—and the Government freely admit it—that these figures are quite inadequate to the problem, and that the only way to secure an adequate increase in the figures is by a substantial reduction in price. In 1936–37 four experimental schemes for the supply of milk to mothers and children under five were started in the Special Areas. These schemes involved the co-operation of the distributors, the local authorities, the Milk Marketing Board and the Commissioners for the Special Areas. Up to date just over 20,000 persons have benefited 92 under the scheme, consuming something over a million gallons of milk. Based on these experiments it has been the Government's policy since 1937, working with the industry, to secure a reduction in the price of milk to local authorities for the purpose of this supply of milk to mothers and children under five. We estimate that if we are able to put this reduction in price into operation it will mean an increase in the consumption of milk for this purpose of from something over 3,000,000 gallons a year to something over 20,000,000 gallons a year.
As the right reverend Prelate has already said, the present Milk Bill before another place makes financial provision for this purpose. At the present moment, as your Lordships have been told, the matter is still the subject of negotiation between the various bodies concerned. The right reverend Prelate is perfectly right, this is quite deplorable when His Majesty's Government are prepared to make available money for this purpose if a scheme is in fact put through; but I think at the same time your Lordships will agree with us in saying that a scheme of this character is really so dependent for its successful working on the co-operation of the distributors and the Milk Marketing Board and other bodies, that it is desirable to make every attempt possible to get some agreement. I can assure noble Lords that the Government are really serious in their intention to put a scheme of this kind into operation. In the meanwhile it has already been applied to Scotland, and we hope for very considerable results from that.
Perhaps I may now pass for a moment to what is happening at a later stage in the schools, particularly the elementary schools. The Government policy is not only based on the experiments of the past to which reference has been made, but also on the experience during the last few years of our milk-in-schools scheme, which gives children in the schools milk at half price. As your Lordships are already aware, a very large demand has been created by this reduction in price, something over 20,000,000 gallons a year being consumed for the purpose. I think we should all desire to express our appreciation to the teachers of the schools for the manner in which they co-operate in this purpose. It frequently has meant a very great deal of extra work for them, and 93 the success of the scheme is very largely due to the enthusiasm with which they have thrown themselves into it, solely for the purpose of aiding their children. This reduced price applies not only to the scheme under which the children pay for their milk but also to the milk that is supplied to local authorities to give free to under-nourished children.
Perhaps I might give your Lordships some figures on the operation of our scheme. I will first give some total figures to show what the scheme is achieving, and then go on to show how we are endeavouring to face up to the task of filling up the gaps which still remain. The latest figures show that in England and Wales there are 2,500,000 children paying for their milk in schools, while a further 500,000 are receiving it free. The percentage of children in elementary schools, therefore, who are receiving milk in one way or another is now 55.6; it is slightly lower in Scotland, 51 per cent. The scheme started with such a very large and rapid increase that I think it is only natural that the increase now is rather slower than it was, but it is quite definite and continuous. Thus, during the six months ended March 31 last, the percentage of children receiving milk in the schools has increased by something over 2 per cent., from 53 per cent. to 55 per cent. Though the school population has fallen by just over 30,000 the number of children taking milk has increased by 70,000.
How are we tackling the problem of trying to fill up the gaps, because as the noble Viscount, Lord Dawson, said, while it is very good to be supplying milk to 55 per cent., what about the other 45 per cent.? The first portion of the scheme is being extended to schools and departments which are not yet covered. During the last six months the percentage of departments covered rose from 86 per cent. to 87 per cent. There are several special difficulties in connection with rural schools. It seems a tragedy and a folly that in the rural areas, where the milk is produced, it should be so difficult to get supplies always for the schools. To some extent, however, we are finding ourselves able to tackle the problem. There are rattier exaggerated statements made sometimes about the standards which the Board of Education demand for the supply in certain cases. 94 Our rule is quite definitely to leave the final discretion to the local medical officer of health, and I think that is inevitable; but we have made it quite clear that we will allow considerable freedom to supply a bulk supply—that is, a supply not in bottles—in areas and in cases where it would obviously make the scheme impossible if we insisted on a bottled supply. We are working at this problem in the closest connection with the Milk Marketing Board.
Then there is the problem of persuading larger numbers of children in the individual schools to take milk when and where it is available. A great deal of propaganda is being done on this problem. We find quite extraordinary variations. In one area, a poor area, we find 80 per cent. of the children who are not given free milk are buying it, while in a neighbouring area, no poorer, the figure is 39 per cent. We find in certain prosperous areas a very low figure sometimes, while in needy and poor areas there is a high figure of consumption. It is quite clear that it is not purely a question of poverty. My own personal view is that we shall never really be able to tackle the problem of the number of children who will not take milk until we are able to deal with the problem which was particularly emphasized, I think, by the right reverend Prelate—namely, the supply of milk to children under five. I believe a great number of children break the milk-drinking habit, and that it is much harder to get that habit restarted—I do not know whether the noble Viscount, Lord Dawson, will agree with that—than to keep up a continuous liking for milk as a beverage. In the meantime we are continuing to do everything we can by propaganda with the children and with the teachers to get a wider application of the scheme.
The question of the provision of milk during holidays was brought up, again, I think, by the right reverend Prelate. I would like to assure your Lordships that we are doing everything in our power to press local authorities on this point. It is frequently a very difficult matter of organisation, particularly in the rural areas, but last summer holiday arrangements were made in some 90 areas, and we are very hopeful that this summer that figure will show a very considerable increase. The noble Earl, Lord Cork, 95 brought up the question of children in hospitals. That is a question I would like to go into, but I can tell the noble Earl that we have been able to make arrangements lately for the parent of a sick child either to call at the school for his bottle of milk or in some cases to arrange for it to be taken to the child's home. I must confess, however, that the point about hospitals is a new one and I will certainly make inquiries into it. The right reverend Prelate referred to the fact that one-third of a pint a day is undoubtedly a small amount. We never, however, pretended that that should be the only source of supply. We are making an effort to persuade children to take the supply of one-third of a pint twice a day. In almost all cases children given free milk receive two-thirds of a pint, and about 10 per cent. of the other children are taking a supply twice a day. We should be very pleased to see that extended.
I am afraid I am taking rather a long time over this reply, but it seems to me so important a subject that I hope your Lordships will excuse me. Now I will turn, if I may, for a moment to the question of the provision of free milk. I have been dealing with milk supplied at a reduced price. The policy of the Board of Education with regard to the provision of free milk for under-nourished children was restated in a Circular issued four years ago. We laid it down that free milk or meals should be provided wherever necessary "for any child who showed any symptoms, whether educational or physical, however slight." I think your Lordships will agree that that was a real lead to teachers and local authorities. I am glad to say that to a considerable extent that lead has been followed. At the moment we are giving our attention in trying to secure greater uniformity. Undoubtedly while a number of authorities are operating the scheme with generosity, there are many who are not yet doing so. What we are doing is to have a survey of the position in every area. Instead of just issuing general Circulars to all authorities, which I do not think is always a very effective way of dealing with the matter, we are sending letters to individual education authorities calling attention to the particular defects in their particular areas. 96 These defects include the provision of milk for an insufficient number of children, the provision of an insufficient quantity of milk per child, an unduly severe income scale, and the absence of local nutrition surveys of all the children.
We have sent letters of this character to 130 local education authorities, and we have been able to produce, I think, very appreciable and worth-while results. Nine years ago, that is in 1930, only about 36,000 elementary school children in England and Wales were receiving free milk. Now the figure is nearly 500,000, more than a ten-fold increase, and it is still increasing rapidly. During the last six months there has been an increase of some 47,000, or about 10 per cent., in that short period. Seven years ago only 12,000,000 free milk meals were provided, and last year the figure rose to 97,000,000—an eight-fold increase in seven years. I hope your Lordships will feel from hearing those figures that a good deal is being done already under the Government's policy in the schools.
§ LORD MOTTISTONE
Before the noble Earl leaves the point, could he perhaps tell us—we have raised the matter here before—what is the total number of school children and what is the proportion of those who receive milk? He told us the number was half a million; how many school children are there altogether?
§ EARL DE LA WARR
Speaking offhand, I should say that the number was in the neighbourhood of 5,000,000, and therefore approximately 10 per cent. are receiving free milk and between 45 and 50 per cent, cheap milk. Free milk is, of course, only for those who are showing some special need for it. The noble Lord has referred specially to milk, but I hope the House will forgive me if I carry the matter a little further and deal also with the related subject of solid meals. In rural areas it is becoming more and more the practice of schools to provide canteens for children who come from a distance, and local authorities are making at the same time very considerably increased use of their powers to provide free solid meals as well as paid-for meals. Last year over 22,000,000 free meals, other than milk, were provided, which is more than double the number provided ten years ago. In addition, as I say, these canteens are springing up, particularly in the rural areas, and we are 97 doing everything in our power to encourage all the local authorities, especially those in the rural areas, to provide canteens. I have been round to some of these schools and partaken of the meals, and I was particularly gratified by their quality. The average price on the whole is about 3d., sometimes with reduction for large families and also reduction for a constant attendance throughout the week. Although in most cases the quality is good, in some cases it is capable of improvement, and last year the Board appointed a dietician who could go round the authorities and help them on the best way of serving meals, on diet, and so on. That is a very important aspect of the problem. The surveys that we have been making cover the whole field of what is being done to deal with the problem of nutrition both by milk and by solid meals, but there is more in the problem than merely the provision of meals, either paid-for or free.
The noble Lord, Lord Hankey, touched on an aspect of the problem which, if I may say so, I think is a very important one. Improvements are being made, and made very rapidly, in the instruction that is given in the schools on domestic subjects—instruction dealing both with the technique of cookery and also with the whole question of food values; and, more important, that instruction is being related to the life and work of the school. In the past quite a considerable amount of this instruction was given, but frequently out of school, by the girls being taken to outside centres, and that meant that it was frequently done on a very unsatisfactory and superficial basis. Now not a single senior school or secondary school would be built without full provision being made for the teaching of domestic science. To-day the girls leave the school with a very real grasp of the fundamentals of good cooking and a simple and intelligent view of food values.
This applies very much more to the new schools—that is, the reorganised schools—than it dots to some of the older ones. We are reorganised throughout the country to the extent of something like 70 per cent. at the present moment, but obviously in some of the old schools which are not reorganised that instruction is rather more difficult. In all schools, however, where provision is made for domestic science—and that is in the vast 98 majority of schools—every girl in her last years gets at least one half-day a week instruction in the subject, and in her last term or so that time is probably increased. In addition, more classes are being provided for those who leave school and for young adults, helping to build up a community of people who know what sound feeding means and see that they get it for themselves and their children. I might say here that I think the school meal is not only of value from the point of view of the food that it gives the child, but also in the formation in the child of the habit of demanding the right type of food.
In addition to what the Board of Education are doing, the Ministry of Health has welfare centres at which it carries out instruction on these subjects. It is making use of the machinery of the women's institutes; it is making use of such great exhibitions as we had at Glasgow the other day, where an extraordinarily interesting exhibition was put up on the subject of domestic science. From what I have ventured to say I hope the noble Lord, Lord Hankey, will feel that I have really answered this question of whether or not His Majesty's Government accept the points made in the Report of the League of Nations Committee. I should say most certainly we do accept what they say. We are pressing forward on the lines that I have tried to lay down.
This is a great problem, in searching for a solution of which we have to deal with the question of poverty. I agreed with the right reverend Prelate when he made the statement that he thought that poverty was the basis of this problem. It is, however, also a problem in which ignorance plays a very large part. I hope I have managed to satisfy your Lordships that while perhaps we are only beginning to tackle the problem, we are in fact tackling it on wise lines. I think it is probably the feeling of most of your Lordships that if we are going to tackle it satisfactorily, more machinery than we yet have will be needed in the future. It is also, however, very clear to my mind, in operating the machine as we have it at the moment, that we could make a great deal more use of the existing machine than is being made. If local authorities can only be encouraged to do yet more in the schools than they are doing, a very large contribution could be made. I can assure your Lordships 99 that on the specific point raised by the right reverend Prelate, of milk for mothers and children under five, we will press forward with negotiations. I believe that it is the most important next step that can be taken. Finally, I hope the right reverend Prelate who has raised this Motion will feel that he has, by doing so, done valuable service to what I think all of us feel to be a really good cause.
THE LORD BISHOP OF WINCHESTER
My Lords, I should like to thank the noble Earl for the full answer that he has given. He has been most sympathetic, and very encouraging, and I beg leave to withdraw my Motion.
§ Motion for Papers, by leave, withdrawn.